bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left atrial vortex flow and its relationship with left atrial functions in patients with congenital heart disease
Authors: Ito Keita , Oka Hideharu , Shibagaki Yuki , Sasaki Yuki , Imanishi Rina , Shimada Sorachi , Akiho Yuki , Fukao Kazunori , Nakagawa Sadahiro , Iwata Kunihiro , Nakau Kouichi , Takahashi Satoru 
Published: May 2024

Abstract
Background
Four-dimensional flow magnetic resonance imaging (MRI) enables blood flow visualization. The absence of left atrial vortex flow (LAVF) has been implicated in the development of thrombus formation and arrhythmias. However, the clinical relevance of this phenomenon in patients with congenital heart disease (CHD) remains unclear. This study aimed to unravel the relationship of LAVF with left atrial functions in patients with CHD.

Results
Twenty-five participants who underwent cardiac MRI examinations were included (8 postoperative patients with CHD aged 17–41 years and 17 volunteers aged 21–31 years). All participants were in sinus rhythm. Four-dimensional flow MRI (velocity encoding 100 cm/s) assessed the presence of LAVF, and its relationship with left atrial function determined by transthoracic echocardiography was explored. LAVF was detected in 16 patients. Upon classification of the participants based on the presence or absence of LAVF, 94% of participants in the LAVF group were volunteers, while 78% of those in the without LAVF group were postoperative patients. Participants without LAVF had a significantly lower left atrial ejection fraction (61% vs. 70%, p = 0.019), reservoir (32% vs. 47%, p = 0.006), and conduit (22% vs. 36%, p = 0.002) function than those with LAVF.

Conclusions
LAVF occurred during the late phase of ventricular systole, and left atrial reservoir function may have contributed to its occurrence. Many postoperative patients with CHD experienced a loss of LAVF. LAVF may indicate early left atrial dysfunction resulting from left atrial remodeling.
Non-mass enhancement on breast MRI: Clues to a more confident diagnosis
Authors: Mohamed Sara , Elhamd Eman Abo , Attia Noha M. 
Published: May 2024

Abstract
Background
Non-mass enhancement (NME) seen on dynamic contrast enhanced breast MRI (DCE-MRI) may be caused by benign, high risk or malignant lesions. Making a clear distinction between these lesions is challenging due to the significant overlap in their imaging appearance. Our study aims to assess the various patterns of distribution, internal enhancement patterns (IEPs) and kinetics of NME using the BI-RADS lexicon fifth edition with histopathologic correlation to aid in making a more confident recommendation regarding clinical management.

Results
Sixty-six female patients with NME on DCE-MRI were included. Thirty-four lesions (51.5%) were histopathologically proven to be benign and 32 (48.5%) were malignant. Segmental distribution was the most common pattern and was found in 22 cases (33.3%), 14 of them were malignant with p-value < 0.05. Linear distribution was reported in 14 cases, (21.2%), five of which were malignant, with p-value > 0.05. Thirteen cases (19.7%) had focal distribution, only two of them were malignant with p-value < 0.05. Twelve cases (18.2%) were of regional distribution, seven of which were malignant. Multiregional and diffuse distribution were the least common and were found in 3% and 4.5% of cases respectively. As for the enhancement pattern, 30 cases (45.5%) had heterogeneous enhancement. Nineteen of which were malignant with a p-value < 0.05. Clumped enhancement was found in 24 cases (36.4%); 12 cases were found to be malignant. Nine cases (13.6%) were of homogeneous enhancement, all of them were benign and three cases (4.5%) were of clustered ring enhancement with p-value > 0.05. Restricted diffusion value was detected in 75% of malignant cases with p-value < 0.05. In terms of kinetic curve, the most frequent curve was found to be type II plateau curve (26 cases, 39.4%), 15 cases were of benign pathology and the other 11 cases were proven to be malignant. Followed by type III washout curve which was detected in 25 cases (37.9%), 20 cases were malignant and five cases were benign. And type I persistent curve was found in 15 cases (22.7%); 14 cases were histopathologically proven to be benign, and only one case was of malignant pathology, with a total p-value < 0.05.

Conclusions
Our study found that the most common distribution pattern was segmental distribution, being statistically significant with p-value < 0.05, being more common among malignant lesions. As for the enhancement pattern, heterogeneous enhancement was the most common pattern, mainly detected in malignant lesions, with p-value < 0.05. The most common type of kinetic curve was type II curve.
Endoscopic transcanal underlay myringoplasty using a platelet-rich fibrin (PRF) membrane
Authors: Hammouda Mostafa , Heiba Mohamed Hassan , Ibrahim Hazem Othman , Sourial Mina Safwat 
Published: May 2024

Abstract
Background
Tympanic membrane perforations are among the most common indications for otological surgery. Surgeons from all around the world have made accidental and intentional contributions to find the perfect graft material and the best approach to perform tympanoplasty. Platelet-rich fibrin (PRF) use in myringoplasty has been popular in the last decade among many surgeons. We aimed to evaluate the efficacy of using PRF only as a graft material in myringoplasty.

Methods
We conducted a prospective study including 20 patients with dry central tympanic membrane perforations. The patients underwent endoscopic transcanal myringoplasty using a platelet-rich fibrin membrane by underlay technique. Follow-up was done 3 months postoperatively regarding graft uptake and hearing outcome by audiological assessment using pure tone audiometry.

Results
Sixty percent of patients were surgically successful with complete healing of the tympanic membrane, 10% were partially successful with partial healing of the tympanic membrane, and 30% failed with complete loss of graft. The mean air-bone gap closure was 3.5 dB. No major complications were reported.

Conclusion
Endoscopic myringoplasty using platelet-rich fibrin alone can be performed in cases with tympanic membrane perforations as an alternative to using other autologous grafts. It is a new reliable method for myringoplasty, as well as being an easy, time-saving procedure that avoids the need for any skin incision.
Cotton aphid (
Aphis gossypii
Glover:
Aphididae
) influence associated to water hyacinth nutrient (
Pontederia crassipes
Mart.: Pontederiaceae) in lath house conditions in Great Rift Valley of Ethiopia
Authors: Kassu Tatek , Getu Emana , Muleta Diriba 
Published: May 2024

Abstract

The cotton aphid,
Aphis gossypii
Glover is a polyphagous herbivore known worldwide. The aphid infestation could be considered as a challenge to crops, but an opportunity for alien invasive weed management. Hence, this study was initiated to investigate the potential of cotton aphid on the management of water hyacinth. Aphid-infested water hyacinth plants were used as a stock for rearing the aphid in a lath house at Ethiopian Sugar Corporation, Research and Development Center, Wonji. After rearing, randomly collected 30 aphids were placed onto water hyacinth plants cultivated under three nutrient levels. Aphid population, water hyacinth biomass and percent nitrogen and phosphorus were analyzed. The water hyacinth treated with a high nutrient level had the highest (295.0) mean aphids on apical leaves followed by the middle (178.3) and basal (104.7) leaves. The water hyacinth subjected to medium and no aphid treatment had the highest dry (44.3 g) biomass. However, when treated with a low nutrient level and aphids resulted in the lowest dry (31.9 g) biomass. Nitrogen and phosphorus concentrations were found high in the water hyacinth that received a high nutrient and no aphid treatment. The presence of the aphids reduced the biomass and nutrient concentration of the invasive weed. The findings of the current study revealed that the cotton aphid affected the water hyacinth in the lath house conditions in Ethiopia.
Navigating a complex case of Mycobacterium xenopi in a patient with blue rubber bleb nevus syndrome
Authors: Gondal Muhammad Umer Riaz , Rovenstine Luke , Ansari Fawwad , Kiyani Zainab , Jyothi Ramachandran Nair Devi Parvathy , Khan Toqeer , Donato Anthony 
Published: May 2024

Introduction: Blue rubber bleb nevus syndrome is a rare disorder of venous malformations, with around 200 cases reported. We present a case of Mycobacterium xenopi infection in a patient with blue rubber bleb nevus syndrome. Case Description: A 40-year-old female with blue rubber bleb nevus syndrome, asthma, and bronchiectasis came to the pulmonology clinic with shortness of breath and a cough. She was recently admitted for a bronchiectasis exacerbation but continued to have a worsening productive cough and fevers. The most recent CT scan of the chest showed interval stable right upper lobe fibrocavitary disease, demonstrating gradual progression over two years. She had occasional positive cultures for Mycobacterium Avium Complex and M. xenopi one year previously, assumed to be a colonizer and not treated. Most recent hospital cultures were negative for bacteria and an acid-fast bacilli smear. She was sent to the emergency department for bronchiectasis exacerbation and returned to the clinic six weeks later with two sputum cultures growing M. xenopi. It was decided to treat M. xenopi as this was likely the cause of her cavitary lung lesion and frequent infections. Azithromycin, rifampin, and sulfamethoxazole/trimethoprim were initiated. Intravenous amikacin was added later on. She finally had a right partial lung resection done after one year at an outside hospital. She was on and off antibiotics for M. xenopi for approximately three years with negative repeat cultures for non-tuberculous mycobacteria. Conclusion: Due to the high mortality of M. xenopi infections (which can be as high as 69%), treatment of at least twelve months is recommended. To our knowledge, this is the first reported case of M. xenopi in a patient with blue rubber bleb nevus syndrome.
Financial knowledge, financial attitude, and personality as antecedent of financial management behavior
Authors: Rahmi Mustika , Al-Shaghdari Fahd , Sulistiyani Tina , Amwa Fanji 
Published: May 2024

Purpose: This study looks into the relationship between financial management behavior and financial knowledge, attitude, and personality.
Design/Methodology/Approach- The study population included Yogyakarta's Micro, Small, and Medium-Sized Ceramic Crafts Enterprises. Data for this study was collected through purposeful sampling, with 45 respondents forming up the study sample. Analysis processes were performed on this research data using an analysis program called SPSS.
Findings-The findings show that personality, financial attitude, and financial knowledge positively influence the financial management behavior of Yogyakarta's Micro, Small, and Medium-Sized Ceramic Crafts Enterprises.
Research limitations/implications- To promote the growth of financial management behavior, the ceramic craft industry must maximize its financial knowledge, attitude, and personality.
Originality/value-The study of financial management behavior in Micro, Small, and Medium Enterprises, especially ceramic crafts, is still quite limited. In addition, no previous research has discussed financial management behavior by adding personality variables as one of the influencing factors.
Employee performance: The role of competence, organizational culture, and motivation
Authors: Ridwan Selvy Amelia , Yusuf Muhammad , Marhumi Sitti 
Published: May 2024

Purpose-A company's internal and external elements might affect employee performance. This study focuses on how motivation, organizational culture, and competence influence employee performance.
Design/Methodology/Approach- The study population consisted of all employees at PT. Telkon Indonesia Regional VII. Data for this study was collected through questionnaires and 54 respondents were collected. The data analysis of this study was processed using the SPSS 25 statistical tool.
Findings-The findings showed that PT. Telkom Indonesia Regional VII employees' performance is positively impacted by competency and organizational culture. However, motivation shows the opposite effect on PT. Telkom Indonesia Regional VII employees' performance. These findings suggest that encouraging a positive company culture and increasing staff competency can both enhance employee performance. However, motivation had an insignificant effect on increasing employee performance in this study.
Research limitations/implications-For every company, it should be necessary to improve or optimize competence, work culture, and motivation in order to encourage morale which ultimately affects employee performance. This finding shows that improving employee performance can be done in various ways including internal and external aspects of the company.
Originality/value-Study of employee performance in service business, especially PT. Telkom Indonesia Regional VII is still quite limited. Previous research similar to this study in measuring employee performance using different indicators and different objects.
QUANTIFYING RADIATION EXPOSURE IN THE RADIOLOGICAL INVESTIGATION OF NON-ARTHRITIC HIP PAIN
Authors: Mayne Alistair , Saad Ahmed , Botchu Rajesh , Politis Angelos , Wall Peter , McBryde Callum 
Published: May 2024

Radiological investigations are essential in the work-up of patients presenting with non-arthritic hip pain, to allow close review of the complex anatomy around the hip and proximal femur. The aim of this study is to quantify the radiation exposure associated with common radiological investigations performed in assessing young adult patients presenting with non-arthritic hip pain.A retrospective review of our UK tertiary hip preservation centre institutional imaging database was performed. Data was obtained for antero-posterior, cross-table lateral and frog-lateral radiographs, along with data for the low dose CT hip protocol and the Mako CT Hip protocol. The radiation dose of each imaging technique was measured in terms of dose-area product (DAP) with units of mGycm2, and the effective doses (ED, mSv) calculated.The mean effective radiation dose for hip radiographs was in the range 0.03 to 0.83mSv (mean DLP 126.7–156.2 mGycm2). The mean effective dose associated with the low-dose CT hip protocol was 3.04mSv (416.8 mGycm2) and for the Stryker Mako CT Hip protocol was 8.4mSv (1061 mGycm2). The radiation dose associated with use of CT imaging was significantly greater than plain radiographs (p<0.005)Investigation of non-arthritic hip pain can lead to significant ionising radiation exposure for patients. In our institution, the routine protocol is to obtain an anteroposterior radiograph and then a specific hip sequence 3 Tesla MRI including anteversion views. This provides the necessary information in the majority of cases, with CT scanning reserved for more complex cases where we feel there is a specific indication. We would encourage the hip preservation community to carefully consider and review the use of ionising radiation investigations.
HOW MUCH DO HIP ARTHROPLASTIES COST? THE BURDEN AND BUDGET IMPACT OF IMPLANTS AND HIP ARTHROPLASTY ON THE NATIONAL HEALTH SYSTEM FOR ENGLAND AND WALES
Authors: Whitehouse Michael 
Published: May 2024

Total hip replacement (THR) is one of the most common and cost-effective elective surgical procedures. In the National Health Service (NHS) of England and Wales a myriad of implants for THR are offered at a variety of locally negotiated prices. This study aims to estimate the total burden of elective THR to the NHS, expenditure on implants, and different scenarios of cost changes if implant selection changed for different patient groups.Using National Joint Registry (NJR) data and NHS reference costs, we estimated the number and expenditure of NHS funded primary and revision THR in the 10-year period 2008–2017 and forecasted the number and expenditure on THR over the next decade. Using NJR average NHS Trust prices for the different implant combinations we estimated the average cost of implants used in THRs and estimated the budget impact on NHS providers from switching to alternative implants.The NHS spent over £4.76 billion performing 702,381 THRs between 2008–2017. The average cost of implants was £1,260 per surgery, almost a fifth of the cost of primary THR. Providing cemented implant combinations in primary elective THRs may potentially save up to £281 million over the next 10 years, whilst keeping 10-year revision risks low.The NHS is likely to spend over £5.6 billion providing primary elective THR over the next decade. There are efficiency savings to realise in the NHS by switching to more cost-effective implant combinations available for patients undergoing primary elective THR surgery, but these will need to be balanced against the risks inherent to a change in selection of implants and surgical practice. The HIPPY programme will be conducting practice surveys, discrete choice experiments and a large randomised controlled trial of cemented, uncemented and hybrid fixation in THR for patients under 70 to answer uncertainties.
ENDOPROSTHETIC REPLACEMENT FOR NON-ONCOLOGICAL CONDITIONS (EPRO) STUDY: A UK MULTICENTRE STUDY INTO CLINICAL OUTCOMES OF PROXIMAL FEMORAL REPLACEMENT
Authors: Wijesekera Maheshi , East Jamie , Chan Corey D , Hadfield James , As-Sultany Mohammed , Kassam Al-Amin , Petheram Tim , Jones Henry Wynn , Palan Jeya , Jain Sameer 
Published: May 2024

This large UK multicentre study evaluates clinical outcomes and identifies factors associated with local complication following PFR for non-oncological conditions.132 patients across four UK centres underwent PFR from 01/08/2004-28/03/2023 with median follow-up of 1.9 (Q10.5-Q34.2) years. 75 (56.8%) patients were female and the mean age was 74.0 (SD 11.7) years. 103 (78%) patients had Charleston Comorbidity Index â‰¥3. ASA class was III or IV in 66.6%. Indications were infected revision (39, 29.5%), periprosthetic fracture (36, 27.3%), acute trauma (30, 22.7%), aseptic revision (17, 12.9%), failed trauma (nine, 6.8%) and complex primary arthroplasty (one, 0.8%). The primary outcome was the local complication rate. Secondary outcomes were systemic complications, reoperation and mortality rates. Comparisons were made with t-tests and Chi2 tests to investigate patient and surgical factors associated with local complication. Statistical significance was p<0.05.There were 37(28.0%) local complications. These were 18 (13.6%) dislocations, eight (6.1%) prosthetic joint infections, four (3.0%) haematomas, three (2.3%) superficial infections, one (0.8%) wound dehiscence, one (0.8%) sciatic nerve palsy and one (0.8%) femoral perforation. Dislocation mostly occurred in conventional articulations (12, 9.1%) followed by dual-mobility cups (three, 2.3%), constrained cups (two, 1.5%) and hemiarthroplasty (one, 0.8%). Median time to local complication was 30 (Q14-Q3 133) days. Seven (5.3%) patients developed a systemic complication. Thirty-three (25.0%) patients underwent reoperation. Thirty-day and one-year mortality rates were 3.8% and 12.1%, respectively. Longer surgical waiting times (7.9 \[SD 16.9) versus 2.6 \[SD 4.4\] days, p<0.001) and longer operating times (212.5 \[SD 71.8\] versus 189.4 \[SD 59.3\] mins, p=0.0450) were associated with local complication.Due to its high complication rate, PFR should be a salvage option when performed for non-oncological indications. Conventional articulations should be avoided. PFR should be delivered in a timely manner and ideally as dual-consultant cases to reduce operating time.
ACHIEVING DISTAL FIXATION AND EARLY MOBILIZATION IN PATIENTS WITH SEVERE FEMORAL BONE LOSS USING AN INTERNAL PROXIMAL FEMORAL REPLACEMENT PROSTHESIS
Authors: Menakaya Chinyelu , Durand-Hill Matthieu , Carrington Richard , Hart Alister , Donaldson James , Miles Jonathan , Briggs Timothy , Skinner John 
Published: May 2024

The management of femoral bone loss is challenging during revision hip arthroplasty. In patients with Paprosky grade IIIB and IV defects, obtaining fixation and rotational stability using traditional surgical constructs is difficult. The use of a custom-made internal proximal femoral replacement prostheses has been proposed as a solution in patients, with severe femoral bone stock loss. However, there is a paucity in the literature on their use and long-term outcomes. We report on the clinical and radiological results of our cohort.We retrospectively reviewed all patients who underwent internal proximal femoral replacement for revision hip arthroplasty between April 1996 and April 2019. All patients had at least 2 years of follow-up time.160 patients underwent limb salvage at our institution using internal proximal femoral replacement. The mean follow-up was 79.7 months (S.D 41.3). Indications for revision included periprosthetic fractures, aseptic loosening, and deep infection. The mean Oxford hip score increased from 13.8 (0–22) to 31.5 (18–43) (paired t-test, p < 0.001). Kaplan-Meier prosthesis survival analysis with revision as the endpoint was 87% at 5 years. None required revision of the femoral stem. There were four dislocations (5%) and there was failure to eradicate the deep infection in four.This technique allows instant distal fixation, allowing for early mobilisation. Long-term clinical and radiological outcomes are encouraging and the complication rates are acceptable for this patient group.
A GEOMETRIC MODEL OF IMPINGEMENT DURING DISLOCATION-PRONE ACTIVITIES IN DUAL-MOBILITY AND STANDARD ACETABULAR CUPS
Authors: Williams Simon , Smeeton Mackenzie , Isaac Graham , Anderson James , Wilcox Ruth , Board Tim , Williams Sophie 
Published: May 2024

Dual Mobility (DM) Total Hip Replacements (THRs), are becoming widely used but function in-vivo is not fully understood.The aim of this study was to compare the incidence of impingement of a modular dual mobility with that of a standard cup.A geometrical model of one subject's bony anatomy \[1\] was developed, a THR was implanted with the cup at a range of inclination and anteversion positions (Corail® stem, Pinnacle® cup (DePuy Synthes)). Two DM variants and one STD acetabular cup were modelled. Joint motions were taken from kinematic data of activities of daily living associated with dislocation \[2\] and walking. The occurrence of impingement was assessed for each component combination, orientation and activity. Implant-implant impingement can occur between the femoral neck and the metal or PE liner (DM or STD constructs respectively) or neck-PE mobile liner (DM only).The results comprise a colour coded matrix which sums the number of impingement events for each cup position and activity and for each implant variant.Neck-PE mobile liner impingement, occurred for both DM sizes, for all activities, and most cup placement positions indicating that the PE mobile liner is likely to move at the start of all activities including walking.For all constructs no placement positions avoided neck-metal (DM) or neck-PE liner (STD) impingementevents in all activities. The least number of events occurred at higher inclination and anteversion component positions. In addition to implant-implant impingement, some instances of bone-bone and implant-bone impingement were also observed.Consistent with DM philosophy, neck-PE mobile liner impingement and liner motion occurred for all activities including walking. Neck-liner impingement frequency was comparable between both DM sizes (metal liner) and a standard cup (PE liner).