bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of postpartum long-acting reversible contraceptives in the extended postpartum period in Shashago district, Central Ethiopia: a cross-sectional study conducted in the community
Authors: Eristu Tesfaye , Mekis Abera , Abdo Ritbano Ahmed 
Published: May 2024

Abstract
Background
Women who fail to initiate contraceptive use within the first year after childbirth face an increased likelihood of experiencing unintended pregnancies in close succession. In regions with limited resources, the use of postpartum contraceptives, particularly long-acting reversible contraceptives, remains notably low. Consequently, this study sought to assess the prevalence and determinants of postpartum long acting reversible contraceptives in the extended postpartum period in the Shashago district, Central Ethiopia.

Methods
This study employed a community-based cross-sectional design, conducted between March 1, 2021, and April 15, 2021, involving a total of 617 women of reproductive age. The selection of study participants was performed using a multistage stratified sampling technique. Data collection was carried out through the use of a structured interviewer-administered questionnaire. Subsequently, the collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for further analysis. Bivariate and multivariable logistic regression analyses were conducted, and statistical significance was determined using a P value of 0.05, along with adjusted odds ratios (AORs) and their corresponding 95% confidence interval (CI).

Results
A total of 224(36.3%) women used long-acting contraceptives after giving birth. Among these women, 31.1% used Implanon, while 5.2% used an intrauterine device (IUD). Factors significantly associated with the use of long-acting contraceptives after childbirth included age 25–29 years (AOR: 1.8, 95% CI: 1.1-3.0), age ≥ 35 years (AOR = 8.7, 95% CI: 3.6–21.5), primary education (AOR = 3.3, 95% CI: 1.6–6.7), secondary education and above (AOR = 3.5, 95% CI: 1.5–8.3), and history of abortion (AOR = 2.7, 95% CI: 1.3–5.4). Additionally, having good knowledge of long-acting contraceptives after childbirth (AOR: 2.4, 95% CI: 1.5–3.9) was significantly associated with their use.

Conclusion
This study revealed that a small number of women opt for long-acting contraceptives after childbirth, with Implanon being more popular than IUDs. Factors such as age, education level, abortion history, pregnancy counseling, and knowledge about long-acting contraceptives were linked to their usage. Integrating contraceptive counseling into routine antenatal and postnatal care is essential for ensuring access to postpartum contraception. Tailored interventions based on age and education level could also help promote long-acting contraceptive use. More research and targeted interventions are needed to overcome these barriers and improve access to these methods for postpartum women.
Metformin mitigates dementia risk among individuals with type 2 diabetes
Authors: Aderinto Nicholas , Olatunji Gbolahan , Kokori Emmanuel , Fawehinmi Praise , Moradeyo Abdulrahmon , Igwe Stephen , Ojabo Rebecca , Alabi Badrudeen Olalekan , Okafor Emmanuel Chuka , Ologbe Damilola , Olafimihan Ayobami , Olawade David B. 
Published: May 2024

AbstractThis mini-narrative review explores the relationship between diabetes and dementia, focusing on the potential mitigating role of metformin in reducing cognitive decline among individuals with type 2 diabetes. The interplay of factors such as glycemic control, diabetic complications, and lifestyle influences characterises diabetes-related dementia. This review emphasises the significance of comprehensive diabetes management in addressing the heightened risk of dementia in this population. Methodologically, the review synthesises evidence from 23 studies retrieved through searches on PubMed, Embase, Google Scholar, and Scopus. Current evidence suggests a predominantly positive association between metformin use and a reduced risk of dementia in individuals with diabetes. However, the review shows the complex nature of these outcomes, revealing variations in results in some studies. These discrepancies show the importance of exploring dose–response relationships, long-term effects, and demographic diversity to unravel the complexities of metformin's impact on cognitive health. Limitations in the existing body of research, including methodological disparities and confounding variables, necessitate refined approaches in future studies. Large-scale prospective longitudinal studies and randomised controlled trials focusing specifically on cognitive effects are recommended. Propensity score matching and exploration of molecular mechanisms can enhance the validity of findings in clinical practice. From a clinical perspective, metformin can serve as a potential adjunctive therapy for individuals with diabetes at risk of cognitive decline.
Resources recovery-rubidium recovery from desalination brine through hydrometallurgy techniques
Authors: Lee Cheng-Han , Chen Wei-Sheng , Liu Fan-Wei 
Published: May 2024

AbstractBecause of the water scarcity in many regions, different methods have been implemented to address this problem. The desalination technique is known as a practical solution among them. However, brine from the desalination process, which contains high concentrations of salts, minerals, and chemicals, will cause environmental harm to the sea, soil, and groundwater if it is not properly treated. Therefore, recovering critical resources from brine is essential for reducing brine disposal. This study aims to apply two hydrometallurgy systems, namely ion exchange and ionic liquid extraction, to circulate rubidium resources from brine. Dowex G26 resin was employed in the ion exchange system, and the adsorption isotherm model and saturated adsorption capacity were explored initially. The optimal parameters such as pH value, L/S ratio (liquid/solid), adsorption period, and adsorption temperature will then be investigated. In the ionic liquid extraction process, the t-BAMBP/C2mimNTf2system (4-tert-Butyl-2-(α-methylbenzyl) phenol/1-ethyl-3-methylimidazolium bis(trifluoromethyls​ulfonyl)​imide) was used, and the parameters including pH value, concentrations of t-BAMBP, (O + I)/A ratio (organic + ionic liquid/aqueous), extraction time, and extraction temperature will be optimized as well. The results reveal that adsorption capacity and extraction efficiencies were 14.3 mg g− 1and 86%, respectively. Furthermore, suitable reagents, including HCl and HNO3, were applied to desorb and strip rubidium from the Dowex G26 and t-BAMBP/C2mimNTf2systems. To sum up, environmental hazards of desalination brine and rubidium resources can be reduced and recovered through the two different extraction systems.
Zasilanie, wydajność i cechy hydrochemiczne wód źródeł Czarnej Wody
Authors: Fac-Beneda Joanna , Lidzbarski Mirosław 
Published: May 2024

Czarna Woda zwana również Czarną Wdą płynie w głębokiej dolinie – rynnie Jeziora Dobrego. W jej zlewni występują dwa duże obszary źródliskowe. Jedno ze źródlisk znajduje się w pobliżu dawnej kaszubskiej osady Trzy Młyny. Warunki geomorfologiczne, hydrogeologiczne i hydrograficzne tego terenu sprawiają, że od prawie 200 lat wody tego źródliska są wykorzystywane do hodowli ryb. Jednocześnie jest to teren chroniony prawem, znajduje się bowiem w zasięgu Obszaru Chronionego Krajobrazu Puszczy Darżlubskiej, obszaru Natura 2000 Trzy Młyny PLH220029 oraz rezerwatu leśnego Źródliska Czarnej Wody. Źródliska Czarnej Wody zasilane są wodami infiltracyjnymi poprzez rozbudowany system cyrkulacji wód podziemnych, połączony z czwartorzędowym poziomem wodonośnym. Głównym czynnikiem kształtującym reżim źródeł Czarnej Wody jest infiltracja. Teren rezerwatu jest bardzo zróżnicowany, a na uwagę zasługuje tu silna erozja wsteczna, będąca efektem intensywnego wypływu wód ze źródlisk. Badania wydajności wypływów przeprowadzano patrolowo w roku 2009 (PIG-PIB) i 2015 (Katedra Hydrologii). Próbki do analiz chemicznych (NO2, NO3, NH4, SO4 i Cl) pobrano tylko w 2009 r. Na podstawie przeprowadzonych obliczeń można stwierdzić, że wydajność źródlisk Czarnej Wody (wszystkich wypływów) wynosi około 152 dm3∙s−1, a po uwzględnieniu dodatkowego zasilania na obszarze alimentacji może przekraczać 167 dm3∙s−1. Szacuje się, że prawie wszystkie te wody odprowadzane są przez źródła znajdujące się w rezerwacie. Według pomiarów patrolowych ilość wody źródlanej wynosi około 116 dm3∙s−1. Jak wykazano, wody źródlisk Czarnej Wody pochodzące z międzymorenowego poziomu wodonośnego są odporne na antropopresję. Ich skład chemiczny jest najczęściej zbliżony do naturalnego tła (tab. 4). Jedynie w przypadku dwóch źródeł stwierdzono nieznaczny wzrost zawartości związków azotu oraz chlorków i siarczanów.
TOTAL KNEE ARTHROPLASTY REVISION RATES IN MOBILE- VERSUS FIXED-BEARING IMPLANTS: A NEW ZEALAND JOINT REGISTRY STUDY
Authors: Scherf Erynne , Willis Jinny , Frampton Chris , Hooper Gary 
Published: May 2024

IntroductionThe mobile-bearing (MB) total knee arthroplasty (TKA) design was introduced with the aim of reducing polyethylene wear and component loosening seen in the fixed-bearing (FB) design. A recent joint registry study has revealed increased risk for all-cause revision, but not revision for infection, in MB-TKA. We used the New Zealand Joint Registry (NZJR) to compare all-cause revision rates, and revision rates for aseptic loosening of MB-TKA compared with fixed bearing (FB) TKA.MethodsAll patients who underwent a primary TKA registered in the NZJR between the 1st January 1999 to 31st December 2021 were identified. Analysis compared MB to FB designs, with sub analysis of implants from a single company. We identified 135,707 primary TKAs, with 104,074 (76.7%) FB-TKAs and 31,633 (23.3%) MB-TKAs recorded. We examined all-cause revision rates, reasons for revision and performed survival analyses.ResultsFor all-comers, MB-TKA had an all-cause revision rate of 0.43/100-component-years (OCY) compared with 0.42/OCY for FB-TKA (p=0.09). The all-cause revision rate was higher for those age < 65 years (MB TKA 0.60/OCY vs. FB-TKA 0.59/OCY) compared to those > 65 years at time of primary TKA (MB-TKA 0.29/OCY vs. FB-TKA 0.32/OCY), however there was no statistically significant difference between implant design in either age group (p=0.16 and p=0.64; respectively). Similarly, there was no difference in revision rates for aseptic loosening between implant designs. Kaplan-Meier survival analysis demonstrates no statistically significant difference in revision-free survival of implants, with both MB-TKA and FB-TKA demonstrating ∼93% revision free survival at 23 years.ConclusionsBoth FB- and MB-TKA demonstrated excellent survivorship, with no significant difference in all-cause revision rates or revision for aseptic loosening between implant designs.
ACCURACY OF REGISTRY-REPORTED REASONS FOR UNICOMPARTMENTAL KNEE ARTHROPLASTY REVISION
Authors: Chen William , Tay Mei Lin , Bolam Scott , Rosser Kenrick , Monk A. Paul , Young Simon W. 
Published: May 2024

IntroductionA key outcome measured by national joint registries are revision events. This informs best practice and identifies poor-performing surgical devices. Although registry data often record reasons for revision arthroplasty, interpretation is limited by lack of standardised definitions of revision reasons and objective assessment of radiologic and laboratory parameters. Our study aim was to compare reasons for unicompartmental knee arthroplasty (UKA) revision reported to the New Zealand Joint Registry (NZJR) with reasons identified by independent clinical review.MethodsA total of 2,272 patients undergoing primary medial and lateral UKA at four large tertiary hospitals between 2000 and 2017 were included. A total of 158 patients underwent subsequent revision with mean follow-up of 8 years. A systematic review of clinical findings, radiographs and operative data was performed to identify revision cases and to determine the reasons for revision using a standardised protocol. These were compared to reasons reported to the NZJR using Chi-squared and Fisher exact tests.ResultsOsteoarthritis progression was the most common reason for revision on systematic clinical review (30%), however this was underreported to the registry (4%, p<0.001). A larger proportion of revisions reported to the registry were for ‘unexplained pain’ (30% of cases vs. 4% on clinical review, p<0.001). A reason for revision was not reported to the registry for 24 (15%) of cases.Discussion and ConclusionWe found significant inaccuracies in registry-reported reasons for revision following UKA. These included over-reporting of ‘unexplained pain’, under-reporting of osteoarthritis progression, and failure to identify a reason for revision. Efforts to improve registry capture of revision reasons for UKA should focus on increasing accuracy in these three areas. This could be addressed through standardised recording methods and tailored revision reason options for UKA for surgeons to select when recording the reasons.
OUTCOMES OF TRABECULAR METAL IN REVISION ACETABULAR RECONSTRUCTION IN AUCKLAND
Authors: Sim Katarina , Schluter Dean , Sharp Rob 
Published: May 2024

IntroductionAcetabular component loosening with associated bone loss is a challenge in revision hip arthroplasty. Trabecular Metal (TM) by Zimmer Biomet has been shown to have greater implant survivorship for all-cause acetabular revision in small cohort retrospective studies. Our study aims to review outcomes of acetabular TM implants locally.MethodThis is a retrospective observational study using data from Auckland City and North Shore Hospitals from 1st of January 2010 to 31st of December 2020. Primary outcome is implant survivorship (re-revision acetabular surgery for any cause) demonstrated using Kaplan-Meier analysis. Secondary outcome is indication for index revision and re-revision surgery. Multivariate analysis used to identify statistically significant factors for re-revision surgery.Results225 cases used acetabular TM implants (shells and/or augments) over 10 years. Indications include aseptic loosening (63%), instability (15%) and infection (13%). Of these, 12% (n=28) had further re-revision for infection (54%) and instability (21%). Median time to re-revision was 156 days (range 11 – 2022). No cases of re-revision were due to failure of bony ingrowth or acetabular component loosening. Ethnicity, smoking status, and age were not risk factors for re-revision procedures. Additionally, previous prosthetic joint infection, ethnicity, sex and age were not significant risk factors for re-revision due to infection. Implant survivorship was 80% at 1 year, 71% at 5 years and 64% at 10 years.DiscussionMain indications for re-revision were infection and instability. Demographic factors and co-morbidities did not correlate with increased re-revision risk. Survivorship is poorer compared to cumulative survivorship reported by the New Zealand Joint Registry (NZJR). Explanations are multifactorial and possibly contributed by underestimation of true revision rates by registry data.ConclusionsWe need to identify alternate causes for poorer survivorship and review the role of TM implants in acetabular revision within our specified population.
INFLUENCE OF OBESITY ON FUNCTIONAL OUTCOMES AND REVISION RATES FOLLOWING REVISION TOTAL KNEE ARTHROPLASTY
Authors: Penumarthy Rushi , Jennings Angus 
Published: May 2024

BackgroundObesity has been linked with increased rates of knee osteoarthritis. Limited information is available on the survival and functional outcome results of rTKR in the obese patients. This registry-based study aimed to identify whether BMI is an independent risk factor for poorer functional outcomes and /or implant survival in rTKA.MethodsNew Zealand Joint Registry (NZJR) data of patients who underwent rTKA from 1st January 2010 to January 2023 was performed. Demographics, American Society of Anesthesiologists (ASA), BMI, Operative time, indications for revision and components revised of the patients undergoing rTKA was collected. Oxford knee score (OKS) at 6 months and rates of second revision (re- revision) were stratified based on standardised BMI categories.ResultsOf the 2687 revisions, functional outcome scores were available for 1261 patients. Oxford knee scores following rTKA are significantly inferior in higher BMI patients (36.5 vs 31.5 p<0.001). This held true when adjusted for age (35.7 vs 30.9 p<0.001).Tibial component loosening was a more common indication for revision in patients with BMI >40 (31.1% vs 21% for BMI <25), whereas periprosthetic femoral fracture was significantly more commonly seen in patients with BMI <25.Re-revision rates displayed no significant differences between any pairs of BMI groups (2.18/100 component years) and adjusting for age and sex did not alter this (p= 0.462). Indications for re-revision were also not different between BMI categories.Over 50% of the rTKA patients were obese. Significantly more obese patients were ASA grade 3,4 and more were <75 years. Operative time was longer in the obese patients (p<0.001).ConclusionsAlthough overall re-revision rates are similar between all BMI categories, the functional outcomes favour those with lower BMI. Patients with higher BMI are younger, more comorbid and carry potentially higher perioperative risks. The registry data provides valuable information when providing counsel to patients undergoing rTKA and lends further support to optimising patients prior to pTKA.
RANDOMIZED PROSPECTIVE TRIAL COMPARING THE SALTO TALARIS FIXED-BEARING AND SALTO MOBILE-BEARING TOTAL ANKLE ARTHROPLASTY
Authors: Sevic Aleksandar , Patel Chetan , Tomlinson Matthew 
Published: May 2024

IntroductionComparative studies examining Fixed-Bearing (FB) and Mobile-Bearing (MB) Total Ankle Replacement (TAR) designs have demonstrated similar results and successful long-term outcomes for both. To date there has been no study directly comparing FB and MB designs of the same prosthesis. We present the first prospective randomised trial comparing patient satisfaction, functional outcomes and radiographic results of the Salto Talaris Fixed-Bearing and the Salto Mobile-Bearing Total Ankle Replacement in the treatment of end-stage ankle arthritis.MethodsA total of 108 adult patients with end-stage ankle arthritis were enrolled in the study between November 2014 and October 2021 with similar demographic comparison. Prospective patient-reported outcomes and standardised weightbearing ankle radiographs were performed preoperatively, at 6 weeks, 6 months and 12 months post-operatively, followed by yearly intervals. All surgeries were performed by a single non-design orthopaedic foot and ankle specialist with experience in over 200 Salto and Salto Talaris TAR prior to the study. Radiographs were examined independently by two clinicians. Complete patient data and radiographs were available for 103 patients with an average follow up of 2 years.ResultsBoth groups demonstrated statistically significant improvement from preoperative evaluation to most recent follow up with no statistically significant difference between the two groups in all outcome measures. Radiographic incidence of subchondral cyst formation was 8.9% and 38.2% for FB and MB, respectively. Talar subsidence occurred in 2.2% and 5.5% of FB and MB, respectively.DiscussionOur study demonstrates a higher than previously reported rate of cyst formation in the MB TAR and comparatively higher talar subsidence in the MB TAR vs FB however this did not correlate with clinical outcome measures which were favourable for both groups.ConclusionFixed-Bearing and Mobile-Bearing Total Ankle Replacement demonstrate comparable favourable
LACTOFERRIN AS AN ADJUVANT ANTIMICROBIAL IN BATTLEFIELD-RELEVANT OPEN FRACTURES
Authors: Joseph Reece , Callon Karen , Lin Jian-ming , Matthews Brya , Irwin Stuart , Williams Dustin , Ashton Nicholas , Crawford Haemish , Wen Jingyuan , Swift Simon , Cornish Jillian 
Published: May 2024

IntroductionMajor trauma during military conflicts involve heavily contaminated open fractures. Staphylococcus aureus (S. aureus) commonly causes infection within a protective biofilm. Lactoferrin (Lf), a natural milk glycoprotein, chelates iron and releases bacteria from biofilms, complimenting antibiotics. This research developed a periprosthetic biofilm infection model in rodents to test an Lf based lavage/sustained local release formulation embedded in Stimulin beads.MethodSurgery was performed on adult rats and received systemic Flucloxacillin (Flu). The craniomedial tibia was exposed, drilled, then inoculated with S. aureus biofilm. A metal pin was placed within the medullary cavity and treatments conducted. Lf in lavage solutions: The defect was subject to 2× 50 mL lavage with 4 treatment groups (saline only, Lf only, Bactisure with Lf, Bactisure with saline). Lf embedded in Stimulin beads: 4 bead types were introduced (Stimulin only, Lf only, Flu only, Lf with Flu). At day 7, rats are processed for bioluminescent and X-ray imaging, and tibial explants/pins collected for bacterial enumeration (CFU).ResultsRats without treatments established a mean infection of 2×106 CFU/tibia. 4 treatment groups with a day 0, one-off lavage demonstrated >95% reduction in bacterial load 7 days post-op, with a reduction in CFU from 1×106/tibia down to 1×104/tibia. There was no statistically significant difference between each group (p = 0.55 with one way ANOVA). The stimulin bead experiments are ongoing and complete results will be obtained in the end of July.ConclusionsThis research demonstrated a clinically relevant animal model of implanted metalware that establishes infection. No additional benefit was observed with a one-off, adjuvant Lf lavage during the initial decontamination of the surgical wound, compared with saline alone, and in combination with the antiseptic Bactisure. This animal model provides the foundation for future antibiofilm therapies.
PREPARATION TIMES FOR ELECTIVE ORTHOPAEDIC SURGERY
Authors: Earp Jack , Hadlow Simon , Walker Cameron 
Published: May 2024

IntroductionThis study aimed to assess the relationship between preparation times and operative procedures for elective orthopaedic surgery. A clearer understanding of these relationships may facilitate list organisation and thereby contribute to improved operating theatre efficiency.MethodsTwo years of elective orthopaedic theatre data was retrospectively analysed. The hospital medical information unit provided de- identified data for 2015 and 2016 elective orthopaedic cases, from which were selected seven categories of procedures with sufficient numbers to allow further analysis - primary hip and knee replacement, spinal surgery, shoulder surgery (excluding shoulder replacement), knee surgery, foot and ankle surgery (excluding ankle replacement), Dupuytrens surgery and general orthopaedic surgery. The data analysed included patient age, ASA grade, operation, operation time, and preparation time (calculated as the time from the start of the anaesthetic proceedings to the patient's admission to Recovery, with the operating time [skin incision to skin closure] subtracted). Statistical analysis of the data was undertaken.ResultsA total of 1596 procedures performed over the two year period were analysed. Preparation times for the different procedures were assessed, along with the relationship to the procedure complexity. Neither age nor ASA correlated strongly with preparation times. Spine procedures had greater preparation times than hip and knee arthroplasty. Greater uniformity in preparation times for hip and knee arthroplasty was seen across the anaesthetic group than operative times across the surgeon group.DiscussionPreparation times are just one aspect that may be evaluated with regard to theatre utilisation. This study did not address the theatre turn-over time between cases, which includes transfer of the patient from the admitting/pre-operative area into the theatre.ConclusionPreparation times for elective procedures follow a pattern which may be used to inform list planning, with the potential for greater theatre efficiencies with regard to list utilisation and staff allocation.