bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of tourniquet release timing on blood loss and functional outcomes in total knee arthroplasty: Insights from a low‐ and middle‐income country
Authors: Ghazni Khan Muhammad Ahmed , Sulaiman Mohammad Ahsan , Zahid Marij , Kumar Suresh , Ahmad Tashfeen 
Published: July 2024

AbstractPurposeTo identify the effect of releasing a tourniquet before versus after wound closure in total knee arthroplasty (TKA) on blood loss, functional outcome and postoperative complications.MethodologyA prospective cohort study was conducted including 53 patients from May 2023 to September 2023. All patients underwent unilateral TKA and were divided into two groups based on surgeon preference of deflating tourniquet, Group A consisted of patients in whom the tourniquet was deflated before wound closure for haemostasis and Group B consisted of patients in which tourniquet was deflated after wound closure and compressive dressing. Blood loss was evaluated via intraoperative blood loss (the number of soaked sponges/gauzes, blood in a suction bottle, total output in a suction bottle—irrigation used) and on‐field blood loss and calculated blood loss (Using Gross and Meunier's formula). The Functional outcome was evaluated using Knee injury and osteoarthritis score‐42 questions. Early postoperative complications and differences in the requirement of blood transfusions were also assessed.ResultsThere was a significant difference in intraoperative blood loss between the two groups. The median intraoperative blood loss was 135 mL (interquartile range [IQR]: 90–149) in Group A and 56.2 mL (IQR: 45–68) in Group B (p value: 0.001). However, no difference was found between the groups in calculated blood loss using Gross and Meunier's formula. The median calculated blood loss was 439 mL (IQR: 450–813) in Group A and 508 mL (IQR: 226–671) in group B (p value: 0.981). There was no significant difference between the groups in blood transfusion requirements or functional outcomes.ConclusionBased on our results, we conclude that the intraoperative blood loss in TKA is significantly different between the groups but only represents a fraction of true blood loss (23%). The timing of releasing the tourniquet does not affect functional outcomes, blood transfusion and postoperative morbidity; hence, any time can be opted as per surgeon preference.Level of EvidenceLevel II, prospective comparative study.
Addressing meniscal deficiency part 2: An umbrella review of systematic reviews and meta‐analyses on meniscal scaffold‐based approaches
Authors: Wu Kevin A. , Therien Aaron D. , Kiwinda Lulla V. , Castillo Christian J. , Hendren Stephanie , Long Jason S. , Amendola Annunziato , Lau Brian C. 
Published: July 2024

AbstractPurposeMeniscal injuries are common in knee surgery and often require preservation techniques to prevent secondary osteoarthritis. Despite advancements in repair techniques, some patients undergo partial meniscectomy, which can lead to postmeniscectomy syndrome. To address these challenges, meniscal substitution techniques like scaffolds have been developed. However, a comprehensive synthesis of the existing evidence through an umbrella review is lacking.MethodsA comprehensive search was conducted in the MEDLINE, Embase and Scopus databases to identify relevant systematic reviews and meta‐analyses. Studies were screened based on predefined inclusion and exclusion criteria. The quality of included studies was assessed using the AMSTAR‐2 tool.ResultsA total of 17 studies met the inclusion criteria and were included in the review. Most studies focused on the use of collagen‐based scaffolds, with fewer studies evaluating synthetic scaffolds. The majority of studies (52.9%) were rated as having ‘Critically Low’ overall confidence, with only one study (5.9%) rated as ‘High’ confidence and most studies exhibiting methodological limitations, such as small sample sizes and lack of long‐term follow‐up. Despite these limitations, the majority of studies reported positive short‐term outcomes, including pain relief and functional improvement, following scaffold implantation. However, some studies noted a relatively high failure rate. Radiographically, outcomes also varied, with some studies reporting morphological deterioration of the implant seen on MRI, while others noted possible chondroprotective effects.ConclusionsMeniscal scaffold‐based approaches show promise in the management of meniscal deficiency; however, the current evidence is limited by methodological shortcomings. One notable gap in the literature is the lack of clear guidelines for patient selection and surgical technique. Future research should focus on conducting well‐designed randomized controlled trials with long‐term follow‐up to further elucidate the benefits and indications of these techniques in clinical practice. Additionally, efforts should be made to develop consensus guidelines to standardize the use of meniscal scaffolds and improve patient outcomes. Despite limited availability, synthesizing the literature on meniscal scaffold‐based approaches is crucial for understanding research, guiding clinical decisions and informing future directions.Level of EvidenceLevel IV.
Real‐world outcomes of intensive induction approaches in core binding factor acute myeloid leukemia
Authors: Rojek Alexandra E. , McCormick Benjamin J. , Cwykiel Joanna , Odetola Oluwatobi , Abaza Yasmin , Nai Nhi , Foucar Charles E. , Achar Rohan K. , Shallis Rory M. , Bradshaw Danielle , Standridge Meaghan , Kota Vamsi , Murthy Guru Subramanian Guru , Badar Talha , Patel Anand A. 
Published: July 2024

AbstractCore‐binding factor acute myeloid leukemia (CBF‐AML) is characterized by the presence of inv(16)/t(16;16) or t(8;21) and is classified as a favorable risk by the 2022 European LeukemiaNet (ELN) guidelines. The CD33‐targeting antibody‐drug conjugate, gemtuzumab ozogamicin (GO), is commonly added to intensive chemotherapy (IC) in CBF‐AML. We sought to compare outcomes in patients treated with IC with or without GO in CBF‐AML. We included 200 patients with CBF‐AML treated with IC across seven academic centers. Induction treatment regimens were categorized as IC alone, IC with GO, or IC with KIT inhibitor (dasatinib or midostaurin). Median follow‐up for the whole cohort was 2.5 years. Three‐year overall survival (OS) was 70% and 3‐year event‐free survival (EFS) was 51%. Patients treated with IC with GO experienced a 3‐year EFS of 50% compared to those treated with IC alone who experienced a 3‐year EFS of 47%, with no statistically significant difference (p = 0.62). Similarly, those treated with IC with GO did not experience an improved OS compared to those treated with IC alone (p = 0.67). Patients treated with IC with KIT inhibitor experienced a significantly improved 3‐year EFS of 85% compared to those with IC with or without GO (p = 0.04). We find in our study that there is no survival benefit in patients treated with IC with the addition of GO; improved EFS was seen in patients with CBF‐AML treated with IC plus KIT inhibitors, consistent with outcomes noted in prospective studies utilizing this approach.
An approach for the diastereoselective synthesis of (R)‐(+)‐methyl pipecolate and (+)‐dextro‐erythrophacetoperane from (S)‐(−)‐methylbenzylamine
Authors: Aguilar‐Aguilar Alan , Carrasco‐Carballo Alan , Gnecco Dino , Rodríguez‐Matsui Hisami , Aparicio‐Solano David , Terán Joel L. 
Published: July 2024

AbstractA diastereoselective synthesis for the preparation of (R)‐methyl pipecolate and dextro‐erythrophacetoperane, analogs of methylphenidate, drugs used to treat attention deficit hyperactivity disorder, is reported. The key steps involve a high diastereoselective ring‐closing reaction via enolate formation and a diastereoselective ketone reduction reaction. The total synthesis of these valuable drugs could be obtained in only 5 and 8 steps, respectively, starting from (S)‐(−)‐methyl benzylamine.
Record‐breaking heatwave in North China during the midsummer of 2023
Authors: Wang Qian , Liao Zhen , Zhai Panmao , Peng Yu 
Published: July 2024

AbstractIn midsummer 2023, a record‐breaking extreme heatwave hit North China, causing significant impacts on people's daily lives and production. This study comprehensively analysed the unique features of this extreme event based on five indices describing the intensity, frequency and impact range. The results show that four of these indices broke the historical record in 2023, and the spatial extent (Tmax >40°C) is the second highest in history. The number of hot days with Tmax >40°C (Tmax >35°C) even reached 23 times (4.2 times) the normal. The combined results of these five indices undoubtedly indicate that this heatwave event is featured by high intensity, long duration, numerous extremely hot days and wide impact range. Furthermore, physical mechanism study revealed that the abnormally warm high‐pressure system persisted in dominating North China, resulting in descending airflow and temperature increases. The enhanced and unprecedented westward extending Western North Pacific Subtropical High, the enhanced and eastward extending Iran Subtropical High and the abnormal high‐pressure over southwestern China form an east–west connected anomalous high‐pressure zone, blocking the water vapour transport from lower latitude oceans to North China. Noticeably, North China has experienced a reduction in precipitation since about 2 months preceding this extreme heatwave, leading to severe soil moisture deficiency and reduced evaporation. Consequently, it increased surface sensible heat flux that led to a rise in temperature. This local land‐atmosphere positive feedback mechanism plays a crucial role in the intensification and maintenance of this extreme heatwave event.
Cutibacterium acnes invades submicron osteocyte lacuno‐canalicular networks following implant‐associated osteomyelitis
Authors: Botros Mina , de Mesy Bentley Karen L. , Schloemann Derek T. , Saito Motoo , Constantine Robert , Ricciardi Benjamin F. , Muthukrishnan Gowrishankar 
Published: July 2024

AbstractCutibacterium acnes, part of normal skin flora, is increasingly recognized as an opportunistic pathogen capable of causing chronic prosthetic joint infections (PJI) associated with total hip and knee arthroplasty. However, there is a paucity of literature examining the pathogenesis of C. acnes during PJI. To study this, we developed an implant‐associated osteomyelitis murine model in which 8–10‐week‐old C57BL6 mice were subjected to transtibial implantation of titanium or stainless‐steel L‐shaped pins contaminated with C. acnes. Postsurgery, mice were killed on Days 14 and 28 for terminal assessments of (1) bacterial load in bone, implant, and internal organs (heart, spleen, kidney, and liver), (2) bone osteolysis (micro‐CT), (3) abscess formation (histology), and (4) systematic electron microscopy (EM). In vitro scanning EM (SEM) confirmed that C. acnes can form biofilms on stainless‐steel and titanium implants. In mice, C. acnes could persist for 28 days in the tibia. Also, we observed C. acnes dissemination to internal organs. C. acnes chronic osteomyelitis revealed markedly reduced bone osteolysis and abscess formation compared to Staphylococcus aureus infections. Importantly, transmission EM (TEM) investigation revealed the presence of C. acnes within canaliculi, demonstrating that C. acnes can invade the osteocyte lacuno‐canalicular networks (OLCN) within bone. Our preliminary pilot study, for the first time, revealed that the OLCN in bone can be a reservoir for C. acnes and potentially provides a novel mechanism of why C. acnes chronic implant‐associated bone infections are difficult to treat.
Relationships of race and area deprivation indices to outcomes in pediatric patients with inflammatory bowel disease
Authors: Hasan Faria , Kim Vivian , Silver Ellen J. , Tomer Gitit 
Published: July 2024

AbstractObjectivesSocial determinants of health (SDOH) are nonmedical factors that influence health outcomes. Children with chronic illnesses living with socioeconomic risk factors have higher rates of unfavorable health outcomes. Our study aimed to assess the association between area deprivation indices (ADI), as a proxy for SDOH, and outcomes in pediatric patients with inflammatory bowel disease (IBD).MethodsA retrospective chart review was conducted on 134 pediatric patients with IBD, ages 0–21 years. Explanatory variables were the patient's ADI and demographics. Outcomes were assessed from time of diagnosis over a 1‐year follow‐up period. The primary outcome was the ratio of missed to completed appointments; secondary outcomes were the numbers of IBD‐related emergency department (ED) visits and IBD‐related hospitalizations.ResultsRace/ethnicity was significantly associated with ADI (p < 0.001). In a multivariable regression model, no variables were associated with ratio of missed to completed appointments. Notably, ADI was not significantly associated with the ratio of missed to completed appointments. In a Poisson regression, Black (non‐Hispanic) and Hispanic race/ethnicity, Medicaid insurance, female gender, and lower age were significantly associated with more IBD‐related ED visits; ADI was not. In a similar model, Black (non‐Hispanic) race, Medicaid insurance status, and lower age were significantly associated with more IBD‐related hospitalizations; ADI was not.ConclusionsIn our cohort, ADI was not significantly associated with the ratio of missed to completed appointments, IBD‐related ED visits, and IBD‐related hospitalizations; however, race/ethnicity, age at diagnosis, insurance, and gender were associated with these outcomes.
Twisted Stacking Metasurface for Complete Amplitude and Phase Control of Circularly Polarized Terahertz Waves
Authors: Hao Xiaoyuan , Xu Quan , Niu Li , Yao Zhibo , Liu Mai , Wu Tong , Yuan Xinyao , Chen Yupeng , Zhang Xueqian , Cheng Xiaomeng , Li Yanfeng , Li Quan , Zhang Weili , Han Jiaguang 
Published: July 2024

AbstractTerahertz (THz) metasurfaces have emerged as a powerful tool for manipulating THz wavefronts, typically achieved by adjusting various geometric parameters. In this study, an approach is introduced by incorporating interlayer coupling into twisted stacking metasurface design to completely control the amplitude and phase of circularly polarized THz waves. By leveraging the interlayer coupling effect and the Pancharatnam–Berry phase, the study achieves efficient control over transmission phase and amplitude by simply adjusting the relative twist angle between paired C‐shaped split‐ring resonators. To validate the concept, a holographic metasurface is fabricated and characterized, providing experimental evidence of its THz wavefront manipulation capabilities. This design strategy presents a versatile and tunable solution for THz wave control, promising applications in a wide range of functional devices.
Simulation on Critical Frequency of Polymer in Electrostrictive Properties
Authors: Wang Yulong , Liu Tong , Wang Meng , Li Lili , Gao Junguo , Guo Ning , Zang Defeng , Liu Ji 
Published: July 2024

AbstractThe critical frequency and the relaxation time are analyzed through deformation and displacement during electrostriction which is induced by the electrical field at different frequencies. First, when the frequency is 50 Hz and the field strength is 2.5 kV mm−1, the electrostrictive displacement of polyethylene is 6.72 × 10−4 mm. After the data fitting, it is found that the displacement increases linearly with the square of field strength and that the proportional coefficient of 50 Hz is 1.08 × 10−4. Second, due to the influence of relaxation polarization and power loss, with the increase of frequency, the displacement and the proportional coefficient first increases then decreases, and when the frequency is 10 kHz, the displacement of 2.20 × 10−6 mm and the proportional coefficient of 3.51 × 10−7 have minimum values, which are 99.67% and 99.68% lower than that of 50 Hz, respectively. There is the critical frequency. Finally, based on the characteristic of anomalous dispersion, the relaxation time of polyethylene is 9.19 × 10−6s, which is in the time range of thermionic relaxation polarization and consistent with the actual situation. This analysis confirms the quantitative relationship between electrostrictive characteristics, field strength, and polarization. In addition, the relationship between frequency and strain is discussed, and the critical frequency in polymer and the relaxation time are confirmed.
From Wilson's Disease to Neurodevelopmental Disorder with Involuntary Movements, Different Genetic Interpretations in a Female Patient
Authors: Jin Shan , Sun Zhengzhe , Fang Xiang , Yang Wenming , Fang Shuzhen , Zhang Jing 
Published: July 2024

AbstractBackgroundA 19‐year‐old female patient presented at 2 years of age with dysarthria, incoherent speech, and unsteady ambulation. She is prone to leaning backward when walking and has involuntary movements of the whole body. Besides, she has poor numeracy skills. She has been diagnosed with Wilson's disease (WD) in China and Japan.ObjectiveThe objective of this study was to further clarify the diagnosis of this patient.MethodsThe patient and her parents were detected with whole‐exome sequencing.ResultsBased on the genetic test results, genetic analyses, and clinical manifestations, a diagnosis of WD in this patient was ruled out. The patient was eventually diagnosed with neurodevelopmental disorder with involuntary movements.ConclusionsThis study reinterprets the genetic test results of a young female patient and leads to reflections on the genetic diagnostic criteria for WD: the Leipzig score is suitable for the diagnosis of most WD patients, and the genetic testing section of the score is of great diagnostic value. However, in some special cases, the proband and their first‐degree relatives should further complete cosegregation analysis to determine the origin of the lesion gene and to verify the reliability of the genetic test. In addition, this study suggests that further improving the scoring rules of the gene testing part of the Leipzig scoring system may be more helpful in achieving an accurate diagnosis of WD. © 2024 International Parkinson and Movement Disorder Society.
Clinical and genetic variability among Bulgarian patients with autosomal recessive spastic ataxia of Charlevoix–Saguenay
Authors: Chamova Teodora , Ivanova Neviana , Cherninkova Sylvia , Koleva Maya , Zlatareva Dora , Bojinova Veneta , Mihova Kalina , Georgiev Martin , Ferdinandov Dilyan , Bichev Stoyan , Kaneva Radka , Mitev Vanio , Jordanova Albena , Tournev Ivailo 
Published: July 2024

AbstractBackgroundAutosomal recessive spastic ataxia ofCharlevoix–Saguenay (ARSACS) is a rare neurodegenerative disorder characterizedby early‐onset cerebellar ataxia, peripheral sensorimotor neuropathy, and lowerlimb spasticity. We present clinical andgenetic data of the first Bulgarian patients diagnosed with ARSACS by wholeexome sequencing (WES).MethodsVariant filtering was performed usinglocally established pipeline and the selected variants were analysed by Sangersequencing. All patients underwent clinical examination and testingincluding the standard rating scales for spastic paraplegia and ataxia.ResultsFive different SACS gene variants, three of which novel, have been identified inpatients from three different ethnic groups. In addition to the classicalclinical triad, brain MRI revealed cerebellar atrophy, linear pontineT2‐hypointensities, and hyperintense rim lateral tothalamus combined with retinal nerve fiber layer thickening on opticcoherence tomography (OCT).ConclusionWe expand the mutation, geographic, and phenotypic spectrum of ARSACS, adding Bulgaria to the world map of the disease, and drawing attention to the fact that it is still misdiagnosed. We demonstrated that brain MRI and OCT are necessary clinical tests for ARSACS diagnosis, even if one of the cardinal clinical features is lacking
Omnichannel services in the presence of customers' valuation uncertainty
Authors: Liu Huan , Cao Ping , Wang Yaolei 
Published: July 2024

AbstractWith the advancement of online‐ordering technology, an increasing number of service providers are transforming to sell services through online channels alongside traditional offline stores. Our paper studies this emerging business model (also known as omnichannel services) in which customers can choose between online and offline ordering. We develop a queueing‐game‐theoretic model to evaluate the performance of omnichannel systems in terms of throughput and social welfare when customers strategically choose their ordering channels in the presence of service valuation uncertainty. We also contrast omnichannel services with single‐channel services, that is, online‐only and offline‐only services. Our analysis yields the following main insights. First, although customers run the risk of making suboptimal decisions and suffering from unexpected losses when they are uncertain about their service valuations, we find that all customers would be better off in expectation with an increasing level of service valuation uncertainty. Second, while social welfare improves as ordering online becomes more convenient in some cases, it (even online customer welfare) can also be worse off in others, especially when the system operates under heavy congestion, because customers' self‐interested channel choice behavior would impose significant negative congestion externalities among customers. Third, despite the fact that omnichannel services provide customers with an additional, more convenient ordering channel option in comparison with conventional offline‐only services, we find that, somewhat surprisingly, adopting omnichannel services does not necessarily guarantee improvement in social welfare. Finally, we discuss two alternative modeling assumptions to demonstrate the robustness of our main insights.
Professional development sessions increased teacher knowledge and confidence to include agriculture in core curricular courses
Authors: Bowling A. M. , Klooster W. , Lindsey A. J. 
Published: July 2024

AbstractAgricultural systems are complex and can be used as examples to teach science, technology, engineering, and math (STEM) concepts. However, inclusion of agriculture in core STEM courses is often limited. Three professional development sessions for K‐12 teachers were offered in 2021–2022 (hybrid or remote sessions) and repeated in 2022–2023 (in‐person sessions) to highlight ways that agricultural plant production systems could be incorporated into core courses like biology, environmental science, chemistry, and math. Teacher participants asked how knowledge level and confidence were influencing their inclusion of agriculture into STEM courses before and after the sessions, and gains in knowledge on content‐based questions were also evaluated. Response rates in Year 1 ranged from 8.0% to 38.5%, and usable response rates in Year 2 ranged from 47% to 68%. The availability of lessons or activities and teacher content knowledge both increased teacher likelihood to incorporate in three sessions. However, the additional time needed to incorporate new lessons was identified as affecting the likelihood to incorporate materials after the Year 1 ecology session. Teacher confidence to incorporate agricultural lessons or activities into their courses increased in four of the sessions, though teachers became more aware that limited resources are available to help increase adoption. Awareness of how agriculture can be used to meet learning standards also improved teacher confidence in four sessions. Average score on knowledge‐based questions increased in all six sessions, but was only significant for two sessions. These sessions were successful at increasing teacher knowledge and confidence to incorporate agriculture into STEM courses.