bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aggregating Distributed Energy Resources: Efficiency and Market Power
Authors: Gao Zuguang , Alshehri Khaled , Birge John R. 
Published: March 2024

Problem definition: The rapid expansion of distributed energy resources (DERs) is one of the most significant changes to electricity systems around the world. Examples of DERs include solar panels, electric storage, thermal storage, and combined heat and power plants. Because of the small supply capacities of these DERs, it is impractical for them to participate directly in the wholesale electricity market. We study in this paper the question of how to integrate these DER supplies into the electricity market, with the objective of achieving full market efficiency. Methodology/results: We study four aggregation models, where there is an aggregator who, with the knowledge of DERs’ utility functions and generations, procures electricity from DERs, and sells them in the wholesale market. In the first aggregation model, a profit-maximizing aggregator announces a differential two-part pricing policy to the DER owners. We show that this model preserves full market efficiency, that is, the social welfare achieved by this model is the same as that when DERs participate directly in the wholesale market. In the second aggregation model, the profit-seeking aggregator is forced to impose a uniform two-part pricing policy to prosumers from the same location, and we numerically show that there can be large efficiency loss. In the third (fourth) aggregation model, a uniform (semiuniform) two-part pricing policy is applied to DER owners, whereas the aggregator becomes fully regulated but is guaranteed nonnegative (positive) profit. It is shown that these models again achieve full market efficiency. Furthermore, we show that DER aggregation also leads to a reduction in the market power of conventional generators. Managerial implications: DER aggregation via profit-seeking and/or regulated aggregators has been investigated by California Independent System Operator and New York Independent System Operator, among others, and the recent Federal Energy Regulatory Commission Order No. 2222 paved the way for aggregators to bid in the wholesale market. Our four aggregation models may shed light on how DERs should be included in the wholesale electricity market. Funding: This work was supported by the King Fahd University of Petroleum and Minerals [Grant INML2106] and the National Science Foundation [Grant 1832230]. Supplemental Material: The online appendices are available at https://doi.org/10.1287/msom.2021.0539 .
Factors associated with decreased length of stay following robotic arm-assisted and conventional total hip arthroplasty
Authors: Fontalis Andreas , Wignadasan Warran , Mancino Fabio , The Crystallynn S. , Magan Ahmed , Plastow Ricci , Haddad Fares S. 
Published: March 2024

AimsPostoperative length of stay (LOS) and discharge dispositions following arthroplasty can be used as surrogate measurements for improvements in patients’ pathways and costs. With the increasing use of robotic technology in arthroplasty, it is important to assess its impact on LOS. The aim of this study was to identify factors associated with decreased LOS following robotic arm-assisted total hip arthroplasty (RO THA) compared with the conventional technique (CO THA).MethodsThis large-scale, single-institution study included 1,607 patients of any age who underwent 1,732 primary THAs for any indication between May 2019 and January 2023. The data which were collected included the demographics of the patients, LOS, type of anaesthetic, the need for treatment in a post-anaesthesia care unit (PACU), readmission within 30 days, and discharge disposition. Univariate and multivariate logistic regression models were used to identify factors and the characteristics of patients which were associated with delayed discharge.ResultsThe multivariate model identified that age, female sex, admission into a PACU, American Society of Anesthesiologists grade > II, and CO THA were associated with a significantly higher risk of a LOS of > two days. The median LOS was 54 hours (interquartile range (IQR) 34 to 78) in the RO THA group compared with 60 hours (IQR 51 to 100) in the CO THA group (p < 0.001). The discharge dispositions were comparable between the two groups. A higher proportion of patients undergoing CO THA required PACU admission postoperatively, although without reaching statistical significance (7.2% vs 5.2%, p = 0.238).ConclusionWe found that among other baseline characteristics and comorbidities, RO THA was associated with a significantly shorter LOS, with no difference in discharge destination. With the increasing demand for THA, these findings suggest that robotic assistance in THA could reduce costs. However, randomized controlled trials are required to investigate the cost-effectiveness of this technology.Cite this article: Bone Joint J 2024;106-B(3 Supple A):24–30.
Threshold for anterior acetabular component overhang correlated with symptomatic iliopsoas impingement after total hip arthroplasty
Authors: Baujard Alexandre , Martinot Pierre , Demondion Xavier , Dartus Julien , Faure Philippe A. , Girard Julien , Migaud Henri 
Published: March 2024

AimsMechanical impingement of the iliopsoas (IP) tendon accounts for 2% to 6% of persistent postoperative pain after total hip arthroplasty (THA). The most common initiator is anterior acetabular component protrusion, where the anterior margin is not covered by anterior acetabular wall. A CT scan can be used to identify and measure this overhang; however, no threshold exists for determining symptomatic anterior IP impingement due to overhang. A case-control study was conducted in which CT scan measurements were used to define a threshold that differentiates patients with IP impingement from asymptomatic patients after THA.MethodsWe analyzed the CT scans of 622 patients (758 THAs) between May 2011 and May 2020. From this population, we identified 136 patients with symptoms suggestive of IP impingement. Among them, six were subsequently excluded: three because the diagnosis was refuted intraoperatively, and three because they had another obvious cause of impingement, leaving 130 hips (130 patients) in the study (impingement) group. They were matched to a control group of 138 asymptomatic hips (138 patients) after THA. The anterior acetabular component overhang was measured on an axial CT slice based on anatomical landmarks (orthogonal to the pelvic axis).ResultsThe impingement group had a median overhang of 8 mm (interquartile range (IQR) 5 to 11) versus 0 mm (IQR 0 to 4) for the control group (p < 0.001). Using receiver operating characteristic curves, an overhang threshold of 4 mm was best correlated with a diagnosis of impingement (sensitivity 79%, specificity 85%; positive predictive value 75%, negative predictive value 85%).ConclusionPain after THA related to IP impingement can be reasonably linked to acetabular overhang if it exceeds 4 mm on a CT scan. Below this threshold, it seems logical to look for another cause of IP irritation or another reason for the pain after THA before concluding that impingement is present.Cite this article: Bone Joint J 2024;106-B(3 Supple A):97–103.
Should high-risk patients seek out care from high-volume surgeons?
Authors: Thomas Jeremiah , Ashkenazi Itay , Lawrence Kyle W. , Davidovitch Roy I. , Rozell Joshua C. , Schwarzkopf Ran 
Published: March 2024

AimsPatients with a high comorbidity burden (HCB) can achieve similar improvements in quality of life compared with low-risk patients, but greater morbidity may deter surgeons from operating on these patients. Whether surgeon volume influences total hip arthroplasty (THA) outcomes in HCB patients has not been investigated. This study aimed to compare complication rates and implant survivorship in HCB patients operated on by high-volume (HV) and non-HV THA surgeons.MethodsPatients with Charlson Comorbidity Index ≥ 5 and American Society of Anesthesiologists grade of III or IV, undergoing primary elective THA between January 2013 and December 2021, were retrospectively reviewed. Patients were separated into groups based on whether they were operated on by a HV surgeon (defined as the top 25% of surgeons at our institution by number of primary THAs per year) or a non-HV surgeon. Groups were propensity-matched 1:1 to control for demographic variables. A total of 1,134 patients were included in the matched analysis. Between groups, 90-day readmissions and revisions were compared, and Kaplan-Meier analysis was used to evaluate implant survivorship within the follow-up period.ResultsYears of experience were comparable between non-HV and HV surgeons (p = 0.733). The HV group had significantly shorter surgical times (p < 0.001) and shorter length of stay (p = 0.009) than the non-HV group. The HV group also had significantly fewer 90-day readmissions (p = 0.030), all-cause revisions (p = 0.023), and septic revisions (p = 0.020) compared with the non-HV group at latest follow-up. The HV group had significantly greater freedom from all-cause (p = 0.023) and septic revision (p = 0.020) than the non-HV group.ConclusionThe HCB THA patients have fewer 90-day readmissions, all-cause revisions, and septic revisions, as well as shorter length of stay when treated by HV surgeons. THA candidates with a HCB may benefit from referral to HV surgeons to reduce procedural risk and improve postoperative outcomes.Cite this article: Bone Joint J 2024;106-B(3 Supple A):10–16.
Influence of the type of stem and its fixation on revision and immediate postoperative mortality in elective total hip arthroplasty
Authors: Morlock Michael , Perka Carsten , Melsheimer Oliver , Kirschbaum Stephanie M. 
Published: March 2024

AimsDespite higher rates of revision after total hip arthroplasty (THA) being reported for uncemented stems in patients aged > 75 years, they are frequently used in this age group. Increased mortality after cemented fixation is often used as a justification, but recent data do not confirm this association. The aim of this study was to investigate the influence of the design of the stem and the type of fixation on the rate of revision and immediate postoperative mortality, focusing on the age and sex of the patients.MethodsA total of 333,144 patients with primary osteoarthritis (OA) of the hip who underwent elective THA between November 2012 and September 2022, using uncemented acetabular components without reconstruction shells, from the German arthroplasty registry were included in the study. The revision rates three years postoperatively for four types of stem (uncemented, uncemented with collar, uncemented short, and cemented) were compared within four age groups: < 60 years (Young), between 61 and 70 years (Mid-I), between 71 and 80 years (Mid-II), and aged > 80 years (Old). A noninferiority analysis was performed on the most frequently used designs of stem.ResultsThe design of the stem was found to have no significant influence on the rate of revision for either sex in the Young group. Uncemented collared stems had a significantly lower rate of revision compared with the other types of stem for females in the Mid-I group. There was a significantly higher rate of revision for uncemented stems in females in the Mid-II group compared with all other types of stem, while in males the rate for uncemented stems was only significantly higher than the rate for cemented stems. Cemented stems had a significantly lower revision rate compared with uncemented and short stems for both sexes in the Old cohort, as did females with collared stems. The rate of immediate postoperative mortality was similar for all types of stem in the Old age group, as were the American Society of Anesthesiologists grades.ConclusionIn patients aged > 80 years, uncemented and short stems had significantly higher revision rates compared with cemented and collared stems, especially in females. The design of the stem and type of fixation have to be analyzed in more detail than only considering cemented and uncemented fixation, in order to further improve the success of THA.Cite this article: Bone Joint J 2024;106-B(3 Supple A):130–136.
Magnetically driven antegrade intramedullary lengthening nails for tibial lengthening
Authors: Vogt Bjoern , Lueckingsmeier Milena , Gosheger Georg , Laufer Andrea , Toporowski Gregor , Antfang Carina , Roedl Robert , Frommer Adrien 
Published: March 2024

AimsAs an alternative to external fixators, intramedullary lengthening nails (ILNs) can be employed for distraction osteogenesis. While previous studies have demonstrated that typical complications of external devices, such as soft-tissue tethering, and pin site infection can be avoided with ILNs, there is a lack of studies that exclusively investigated tibial distraction osteogenesis with motorized ILNs inserted via an antegrade approach.MethodsA total of 58 patients (median age 17 years (interquartile range (IQR) 15 to 21)) treated by unilateral tibial distraction osteogenesis for a median leg length discrepancy of 41 mm (IQR 34 to 53), and nine patients with disproportionate short stature treated by bilateral simultaneous tibial distraction osteogenesis, with magnetically controlled motorized ILNs inserted via an antegrade approach, were retrospectively analyzed. The median follow-up was 37 months (IQR 30 to 51). Outcome measurements were accuracy, precision, reliability, bone healing, complications, and patient-reported outcome assessed by the Limb Deformity-Scoliosis Research Society Score (LD-SRS-30).ResultsA median tibial distraction of 44 mm (IQR 31 to 49) was achieved with a mean distraction index of 0.5 mm/day (standard deviation 0.13) and median consolidation index of 41.2 days/cm (IQR 34 to 51). Accuracy, precision, and reliability were 91%, 92%, and 97%, respectively. New temporary range of motion limitations occurred in 51% of segments (34/67). Distraction-related equinus deformity treated by Achilles tendon lengthening was the most common major complication recorded in 16% of segments (11/67). In 95% of patients (55/58) the distraction goal was achieved with 42% unplanned additional interventions per segment (28/67). The median postoperative LD-SRS-30 score was 4.0 (IQR 3.6 to 4.3).ConclusionTibial distraction osteogenesis using motorized ILNs inserted via an antegrade approach appears to be a reliable and precise procedure. Temporary joint stiffness of the knee or ankle should be expected in up to every second patient. A high rate and wide range of complications of variable severity should be anticipated.Cite this article: Bone Joint J 2024;106-B(3):293–302.
Orthopaedic management of children with spinal dysraphism
Authors: Pinto Deepika , Hussain Sabba , Leo Donato G. , Bridgens Anna , Eastwood Deborah , Gelfer Yael 
Published: March 2024

AimsChildren with spinal dysraphism can develop various musculoskeletal deformities, necessitating a range of orthopaedic interventions, causing significant morbidity, and making considerable demands on resources. This systematic review aimed to identify what outcome measures have been reported in the literature for children with spinal dysraphism who undergo orthopaedic interventions involving the lower limbs.MethodsA PROSPERO-registered systematic literature review was performed following PRISMA guidelines. All relevant studies published until January 2023 were identified. Individual outcomes and outcome measurement tools were extracted verbatim. The measurement tools were assessed for reliability and validity, and all outcomes were grouped according to the Outcome Measures Recommended for use in Randomized Clinical Trials (OMERACT) filters.ResultsFrom 91 eligible studies, 27 individual outcomes were identified, including those related to clinical assessment (n = 12), mobility (n = 4), adverse events (n = 6), investigations (n = 4), and miscellaneous (n = 1). Ten outcome measurement tools were identified, of which Hoffer’s Functional Ambulation Scale was the most commonly used. Several studies used unvalidated measurement tools originally developed for other conditions, and 26 studies developed new measurement tools. On the OMERACT filter, most outcomes reported pathophysiology and/or the impact on life. There were only six patient- or parent-reported outcomes, and none assessed the quality of life.ConclusionThe outcomes that were reported were heterogenous, lack validation and failed to incorporate patient or family perceptions. Until outcomes can be reported unequivocally, research in this area will remain limited. Our findings should guide the development of a core outcome set, which will allow consistency in the reporting of outcomes for this condition.Cite this article: Bone Joint J 2024;106-B(3):277–285.
Design of a dynamic target simulator optical system with a large FOV and long exit pupil distance
Authors: Cao Tuo , Wang Ling Yun 
Published: March 2024

According to new generation missile test and detection requirements, it is necessary to introduce hardware-in-the-loop (HIL) simulation technology to realize the performance test of the seeker. This paper introduces the concept of secondary imaging and uses the method of focal distance allocation so that the optical system field of view (FOV) can still be greater than 6°, under the condition that the exit pupil distance is larger than 800 mm and a high-quality lighting system is designed. The design results show that when the exit pupil distance of the system is 1000 mm and the FOV is 6.4°, the modulation transfer function (MTF) of the system is 60lp/mm>0.4, and the distortion is less than 0.1%. The uniformity of the illumination system is greater than 90%, meeting the requirements of the design index.
Management of antipsychotics in primary care: Insights from healthcare professionals and policy makers in the United Kingdom
Authors: Woodall Alan A. , Abuzour Aseel S. , Wilson Samantha A. , Mair Frances S. , Buchan Iain , Sheard Sally B. , Atkinson Paul , Joyce Dan W. , Symon Pyers , Walker Lauren E. 
Published: March 2024

Introduction
Antipsychotic medication is increasingly prescribed to patients with serious mental illness. Patients with serious mental illness often have cardiovascular and metabolic comorbidities, and antipsychotics independently increase the risk of cardiometabolic disease. Despite this, many patients prescribed antipsychotics are discharged to primary care without planned psychiatric review. We explore perceptions of healthcare professionals and managers/directors of policy regarding reasons for increasing prevalence and management of antipsychotics in primary care.

Methods
Qualitative study using semi-structured interviews with 11 general practitioners (GPs), 8 psychiatrists, and 11 managers/directors of policy in the United Kingdom. Data was analysed using thematic analysis.

Results
Respondents reported competency gaps that impaired ability to manage patients prescribed antipsychotic medications, arising from inadequate postgraduate training and professional development. GPs lacked confidence to manage antipsychotic medications alone; psychiatrists lacked skills to address cardiometabolic risks and did not perceive this as their role. Communication barriers, lack of integrated care records, limited psychology provision, lowered expectation towards patients with serious mental illness by professionals, and pressure to discharge from hospital resulted in patients in primary care becoming ‘trapped’ on antipsychotics, inhibiting opportunities to deprescribe. Organisational and contractual barriers between services exacerbate this risk, with socioeconomic deprivation and lack of access to non-pharmacological interventions driving overprescribing. Professionals voiced fears of censure if a catastrophic event occurred after stopping an antipsychotic. Facilitators to overcome these barriers were suggested.

Conclusions
People prescribed antipsychotics experience a fragmented health system and suboptimal care. Several interventions could be taken to improve care for this population, but inadequate availability of non-pharmacological interventions and socioeconomic factors increasing mental distress need policy change to improve outcomes. The role of professionals’ fear of medicolegal or regulatory censure inhibiting antipsychotic deprescribing was a new finding in this study.
Financial indicators utilization among community pharmacists: A comprehensive study for pharmacy management
Authors: Abu Assab Mohammad , Hasan Hisham E. , Alhamad Hamza , Albahar Fares , Alzayadneh Abdallah , Abu Assab Hanadi , Abu Dayyeh Wael , Zakaraya Zainab 
Published: March 2024

Background
The financial management of community pharmacies is a critical aspect of healthcare delivery, as pharmacists often operate as healthcare providers and business managers. Understanding pharmacists’ awareness, perceptions, and practices related to financial indicators is essential for effective pharmacy management. There is a paucity of research addressing this issue regionally and locally.

Objectives
This study aimed to investigate the perceptions and utilization of financial indicators among community pharmacists in Jordan and identify demographic and contextual factors influencing their financial practices.

Methods
A cross-sectional study was conducted, surveying 353 community pharmacists from various regions of Jordan. The developed and validated survey assessed demographic characteristics, utilizations of financial indicators, and perceptions of their significance. Pharmacists were queried about their financial practices, including the use of various financial indicators. Descriptive and analytical statistics were used to portray the study’s findings.

Results
The study included a diverse group of community pharmacists in terms of demographic characteristics. Most pharmacists exhibited awareness of financial indicators, with a higher awareness of profitability and liquidity indicators. Pharmacists generally had positive perceptions of the importance of these indicators in daily practice. High agreement was observed in financial practices, including following up on payables and receivables, monitoring changes in monthly revenue, and preparing income statements. There was significant variation in the utilization and perception of financial indicators based on factors such as pharmacy ownership, province, foundation age, and practical experience.

Conclusion
The findings indicate a positive correlation between utilization and perception, emphasizing the importance of raising awareness of financial indicators among pharmacists. The study also highlights the significance of tailored financial training programs for pharmacists at different stages of their careers and the importance of regional context in financial practices. Understanding these variations can lead to more effective financial management and improved healthcare services in community pharmacies.