bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative hypotension following acute hip fracture surgery is a predictor of 30-day mortality
Authors: Donald Neil , Eniola Grace , Deierl Krisztian 
Published: February 2024

AimsHip fractures are some of the most common fractures encountered in orthopaedic practice. We aimed to identify whether perioperative hypotension is a predictor of 30-day mortality, and to stratify patient groups that would benefit from closer monitoring and early intervention. While there is literature on intraoperative blood pressure, there are limited studies examining pre- and postoperative blood pressure.MethodsWe conducted a prospective observational cohort study over a one-year period from December 2021 to December 2022. Patient demographic details, biochemical results, and haemodynamic observations were taken from electronic medical records. Statistical analysis was conducted with the Cox proportional hazards model, and the effects of independent variables estimated with the Wald statistic. Kaplan-Meier survival curves were estimated with the log-rank test.ResultsA total of 528 patients were identified as suitable for inclusion. On multivariate analysis, postoperative hypotension of a systolic blood pressure (SBP) < 90 mmHg two to 24 hours after surgery showed an increased hazard ratio (HR) for 30-day mortality (HR 4.6 (95% confidence interval (CI) 2.3 to 8.9); p < 0.001) and was an independent risk factor accounting for sex (HR 2.7 (95% CI 1.4 to 5.2); p = 0.003), age (HR 1.1 (95% CI 1.0 to 1.1); p = 0.016), American Society of Anesthesiologists grade (HR 2.7 (95% CI 1.5 to 4.6); p < 0.001), time to theatre > 24 hours (HR 2.1 (95% CI 1.1 to 4.2); p = 0.025), and preoperative anaemia (HR 2.3 (95% CI 1.0 to 5.2); p = 0.043). A preoperative SBP of < 120 mmHg was close to achieving significance (HR 1.9 (95% CI 0.99 to 3.6); p = 0.052).ConclusionOur study is the first to demonstrate that postoperative hypotension within the first 24 hours is an independent risk factor for 30-day mortality after hip fracture surgery. Clinicians should recognize patients who have a SBP of < 90 mmHg in the early postoperative period, and be aware of the increased mortality risk in this specific cohort who may benefit from a closer level of monitoring and early intervention.Cite this article: Bone Joint J 2024;106-B(2):189–194.
The characteristics and predictors of mortality in periprosthetic fractures around the knee
Authors: Nasser Ahmed A. H. H. , Sidhu Manpreet , Prakash Rohan , Mahmood Ansar 
Published: February 2024

AimsPeriprosthetic fractures (PPFs) around the knee are challenging injuries. This study aims to describe the characteristics of knee PPFs and the impact of patient demographics, fracture types, and management modalities on in-hospital mortality.MethodsUsing a multicentre study design, independent of registry data, we included adult patients sustaining a PPF around a knee arthroplasty between 1 January 2010 and 31 December 2019. Univariate, then multivariable, logistic regression analyses were performed to study the impact of patient, fracture, and treatment on mortality.ResultsOut of a total of 1,667 patients in the PPF study database, 420 patients were included. The in-hospital mortality rate was 6.4%. Multivariable analyses suggested that American Society of Anesthesiologists (ASA) grade, history of peripheral vascular disease (PVD), history of rheumatic disease, fracture around a loose implant, and cerebrovascular accident (CVA) during hospital stay were each independently associated with mortality. Each point increase in ASA grade independently correlated with a four-fold greater mortality risk (odds ratio (OR) 4.1 (95% confidence interval (CI) 1.19 to 14.06); p = 0.026). Patients with PVD have a nine-fold increase in mortality risk (OR 9.1 (95% CI 1.25 to 66.47); p = 0.030) and patients with rheumatic disease have a 6.8-fold increase in mortality risk (OR 6.8 (95% CI 1.32 to 34.68); p = 0.022). Patients with a fracture around a loose implant (Unified Classification System (UCS) B2) have a 20-fold increase in mortality, compared to UCS A1 (OR 20.9 (95% CI 1.61 to 271.38); p = 0.020). Mode of management was not a significant predictor of mortality. Patients managed with revision arthroplasty had a significantly longer length of stay (median 16 days; p = 0.029) and higher rates of return to theatre, compared to patients treated nonoperatively or with fixation.ConclusionThe mortality rate in PPFs around the knee is similar to that for native distal femur and neck of femur fragility fractures. Patients with certain modifiable risk factors should be optimized. A national PPF database and standardized management guidelines are currently required to understand these complex injuries and to improve patient outcomes.Cite this article: Bone Joint J 2024;106-B(2):158–165.
Comparison of survival prediction models for bone metastases of the extremities following surgery
Authors: Park Jay H. , Won Juneseok , Kim Han-Soo , Kim Yongsung , Kim Shin , Han Ilkyu 
Published: February 2024

AimsThis study aimed to compare the performance of survival prediction models for bone metastases of the extremities (BM-E) with pathological fractures in an Asian cohort, and investigate patient characteristics associated with survival.MethodsThis retrospective cohort study included 469 patients, who underwent surgery for BM-E between January 2009 and March 2022 at a tertiary hospital in South Korea. Postoperative survival was calculated using the PATHFx3.0, SPRING13, OPTIModel, SORG, and IOR models. Model performance was assessed with area under the curve (AUC), calibration curve, Brier score, and decision curve analysis. Cox regression analyses were performed to evaluate the factors contributing to survival.ResultsThe SORG model demonstrated the highest discriminatory accuracy with AUC (0.80 (95% confidence interval (CI) 0.76 to 0.85)) at 12 months. In calibration analysis, the PATHfx3.0 and OPTIModel models underestimated survival, while the SPRING13 and IOR models overestimated survival. The SORG model exhibited excellent calibration with intercepts of 0.10 (95% CI -0.13 to 0.33) at 12 months. The SORG model also had lower Brier scores than the null score at three and 12 months, indicating good overall performance. Decision curve analysis showed that all five survival prediction models provided greater net benefit than the default strategy of operating on either all or no patients. Rapid growth cancer and low serum albumin levels were associated with three-, six-, and 12-month survival.ConclusionState-of-art survival prediction models for BM-E (PATHFx3.0, SPRING13, OPTIModel, SORG, and IOR models) are useful clinical tools for orthopaedic surgeons in the decision-making process for the treatment in Asian patients, with SORG models offering the best predictive performance. Rapid growth cancer and serum albumin level are independent, statistically significant factors contributing to survival following surgery of BM-E. Further refinement of survival prediction models will bring about informed and patient-specific treatment of BM-E.Cite this article: Bone Joint J 2024;106-B(2):203–211.
Migration and clinical outcomes of a novel cementless hydroxyapatite-coated titanium acetabular shell: two-year follow-up of a randomized controlled trial using radiostereometric analysis
Authors: van der Lelij Thies J. N. , Marang-van de Mheen Perla J. , Kaptein Bart L. , Koster Lennard A. , Ljung Peter , Nelissen Rob G. H. H. , Toksvig-Larsen Sören 
Published: February 2024

AimsThe objective of this study was to compare the two-year migration and clinical outcomes of a new cementless hydroxyapatite (HA)-coated titanium acetabular shell with its previous version, which shared the same geometrical design but a different manufacturing process for applying the titanium surface.MethodsOverall, 87 patients undergoing total hip arthroplasty (THA) were randomized to either a Trident II HA or Trident HA shell, each cementless with clusterholes and HA-coating. All components were used in combination with a cemented Exeter V40 femoral stem. Implant migration was measured using radiostereometric analysis (RSA), with radiographs taken within two days of surgery (baseline), and at three, 12, and 24 months postoperatively. Proximal acetabular component migration was the primary outcome measure. Clinical scores and patient-reported outcome measures (PROMs) were collected at each follow-up.ResultsMean proximal migrations at three, 12, and 24 months were 0.08 mm (95% confidence interval (CI) 0.03 to 0.14), 0.11 mm (95% CI 0.06 to 0.16), and 0.14 mm (95% CI 0.09 to 0.20), respectively, in the Trident II HA group, versus 0.11 mm (95% CI 0.06 to 0.16), 0.12 mm (95% CI 0.07 to 0.17), and 0.14 mm (95% CI 0.09 to 0.19) in the Trident HA group (p = 0.875). No significant differences in translations or rotations between the two designs were found in any other direction. Clinical scores and PROMs were comparable between groups, except for an initially greater postoperative improvement in Hip disability and Osteoarthritis Outcome Symptoms score in the Trident HA group (p = 0.033).ConclusionThe Trident II clusterhole HA shell has comparable migration with its predecessor, the Trident hemispherical HA cluster shell, suggesting a similar risk of long-term aseptic loosening.Cite this article: Bone Joint J 2024;106-B(2):136–143.
Leg length discrepancy should be assessed based on the whole length of the lower limb in patients with osteoarthritis secondary to developmental dysplasia of the hip
Authors: Sato Ryuichi , Hamada Hidetoshi , Uemura Keisuke , Takashima Kazuma , Ando Wataru , Takao Masaki , Saito Mitsuru , Sugano Nobuhiko 
Published: February 2024

AimsThis study aimed to investigate the incidence of ≥ 5 mm asymmetry in lower and whole leg lengths (LLs) in patients with unilateral osteoarthritis (OA) secondary to developmental dysplasia of the hip (DDH-OA) and primary hip osteoarthritis (PHOA), and the relationship between lower and whole LL asymmetries and femoral length asymmetry.MethodsIn total, 116 patients who underwent unilateral total hip arthroplasty were included in this study. Of these, 93 had DDH-OA and 23 had PHOA. Patients with DDH-OA were categorized into three groups: Crowe grade I, II/III, and IV. Anatomical femoral length, femoral length greater trochanter (GT), femoral length lesser trochanter (LT), tibial length, foot height, lower LL, and whole LL were evaluated using preoperative CT data of the whole leg in the supine position. Asymmetry was evaluated in the Crowe I, II/III, IV, and PHOA groups.ResultsThe incidences of whole and lower LL asymmetries were 40%, 62.5%, 66.7%, and 26.1%, and 21.7%, 20.8%, 55.6%, and 8.7% in the Crowe I, II/III, and IV, and PHOA groups, respectively. The incidence of tibial length asymmetry was significantly higher in the Crowe IV group (44.4%) than that in the PHOA group (4.4%). In all, 50% of patients with DDH-OA with femoral length GT and LT asymmetries had lower LL asymmetry, and 75% had whole LL asymmetry. The incidences of lower and whole LL asymmetries were 20% and 42.9%, respectively, even in the absence of femoral length GT and LT asymmetries.ConclusionOverall, 43% of patients with unilateral DDH-OA without femoral length asymmetry had whole LL asymmetry of ≥ 5 mm. Thus, both the femur length and whole LL should be measured to accurately assess LL discrepancy in patients with unilateral DDH-OA.Cite this article: Bone Jt Open 2024;5(2):79–86.
Association of ideal cardiovascular health metrics with incident low estimated glomerular filtration rate: More than a decade follow-up in the Tehran Lipid and Glucose Study (TLGS)
Authors: Alizadeh Fatemeh , Tohidi Maryam , Hasheminia Mitra , Hosseini-Esfahani Firoozeh , Azizi Fereidoun , Hadaegh Farzad 
Published: February 2024

Aims
To evaluate the association between ideal cardiovascular health metrics (ICVHM) and incident low estimated glomerular filtration rate (eGFR) among the Iranian population.

Methods
The study population included 6927 Iranian adults aged 20–65 years (2942 male) without prevalent low eGFR [i.e., eGFR < 60 ml/min/1.73 m2] and free of cardiovascular disease. The ICVHM was defined according to the 2010 American Heart Association. The multivariable Cox proportional hazards regression analysis was used to calculate the hazard ratios (HRs) of ICVHM both as continuous and categorical variables.

Results
Over the median of 12.1 years of follow-up, we found 1259 incident cases of low eGFR among the study population. In this population, ideal and intermediate categories of body mass index (BMI) and blood pressure (BP) and only the ideal category of fasting plasma glucose (FPG) significantly decreased the risk of developing low eGFR; the corresponding HRs and (95% confidence intervals) were (0.87, 0.77–0.99), (0.84, 0.76–0.99), (0.79, 0.68–0.93), (0.70, 0.60–0.83) and (0.76, 0.64–0.91). Also, one additional ICVHM was associated with a reduced risk of low eGFR for the global (0.92, 0.88–0.97) and biological cardiovascular health (0.88, 0.82–0.93) in these participants. A sensitivity analysis using the interval-censoring approach demonstrated that our method is robust, and results remained essentially unchanged. In a subgroup population with dietary data (n = 2285), we did not find the beneficial impact of having intermediate/ideal categories of nutrition status compared to its poor one on incident low eGFR.

Conclusion
We found a strong inverse association between having higher global ICVHM with incident low eGFR among the non-elderly Iranian population; the issue is mainly attributable to normal BP, BMI, and FPG levels.
Understanding Community Capacity for Bottom-up Management of Mount Hakusan UNESCO Biosphere Reserve
Authors: Mammadova Aida , Harada Seira , Azhar Tuba , Phisbien Romain Milesi 
Published: February 2024

The aim of the study was to understand the potential of Shiramine villagers for bottom-up administration of Mount Hakusan UNESCO Biosphere Reserve (MHBR). We investigated the various aspects of community capability using data from numerous sources, including interviews, surveys, and published reports. 23 people participated in a survey. Results has showed that the issues such as depopulation (35%), accessibility problems (especially for the elderly), difficulties with tourism, and the effects of school and municipal mergers were the biggest concern for the locals. However, the biggest values of Shiramine was rated as interpersonal interactions (56%), followed by the environment and traditional culture. Most of the residents expressed the high level of happiness by living inside the community (87%), which was related to the strong community bonds and natural surroundings.
The survey showed the presence of a variety of jobs, such as farmers, students, freelancers, housewives, and people working in administrative and governmental positions. These results showed a wide range of community involvement and the possibility of utilizing this diversity to boost the bottom-up management strategy. For the effective and sustainable management of BR, developing inclusivity and active participation, by using variety of talents and knowledge will play crucial role.
Keywords: Community development, UNESCO Biosphere Reserve, Bottom-Up approach, Regional management, Sustainability
The Role of Family Associations in Promoting Empowerment of Divorced Women for Sustainable Community Development: A Case Study from Ha’il
Authors: Alanazi Abdullah A. , Ahmed Ahmed A. , Helal Ibrahim E. 
Published: February 2024

The current research determined the role of family development associations in reducing the phenomenon of divorce in Ha'il. The current research was an analytical descriptive social survey. Data was collected through a questionnaire applied to a sample of (98) participants who were frequent visitors to the family development associations in Ha'il. The research concluded that the role of family development associations was average in qualifying those about to get married, treating the problems of the newlyweds, and satisfying social, psychological, economic and legal needs of divorcees. Results, also, revealed that the role of family development associations in satisfying the social needs of divorced women ranked first compared to other roles
Keywords: Roles - Family development associations - Family development – Divorce
Trends and Focuses for ESG Investment Support: A Cross Country Comparative Analysis
Authors: Gernego Iuliia , Petrenko Liudmyla , Lavrynenko Valentyna , Dyba Mykhailo 
Published: February 2024

Currently, the modern society faces a measure of challenges, connected with the lack of balance between the economic and social development issue. This has caused the growing recognition of sustainable and responsible practices within the financial decisions making process, providing a measure of transformations of both financial and business landscape, contributing to a more equitable and environmentally conscious society. The modern researches in finance are significantly influenced by the increasing demand for ESG, the strengthening of ESG principles implementation in wealth and assets management. According to PwC researches, the ESG-oriented assets under management market in Europe is already about 172 % in compartment with 2021 year, the forecasted increase till 2026 year will be nearly 50 % comparing to the current volume. Thereby, there is an urgent need to summarize the theoretical descriptions of ESG investing along with the current trends of particular ESG components transformation along with the considering analytical research on trends and focuses for ESG investing’s support. The current research problem lays in the highlighting the functionality of ESG-oriented activity and its investment attractiveness trough the overview of theoretical definitions of ESG, comparing with the Trends and focuses for ESG investing’s support within the representative sampling on countries from the World Bank’s databases. The study is focused on the detailed analysis of separate indicators within a group of ten different countries. “Agricultural land”, “Electricity production from coal sources” and “CO2 emissions” indicators are analyzed within the environmental component. The social component of ESG is represented by the “Government expenditure on education” and “Individuals using the Internet” indicators. The “Regulatory Quality”, “Rule of Law” and “Voice and Accountability” indicators are considered as a part of governmental component. The chosen countries (Denmark, Finland, France, Germany, Japan, Norway, Poland, Ukraine, United Kingdom and the United States of America) represent deferent environment and approaches to ESG management and its investment support. The current research aims to represent the possibility to balance the ESG components, creating synergetic effect in case of their combinations. In particular, the attention is paid to the instruments of monetary and fiscal policy to balance ESG in the COVID-19 time. The elaboration of possible scenarios of ESG’s components balancing is possible in case of implementation of systematic measures to monitor debt sustainability and increase the transparency of banking institutions' balance sheets along with the developing the targeted measures to maintain an adequate level of liquidity and solvency of national economies, and coordination of national strategies and policies
Keywords: sustainable development, sustainable finance, ESG investing, social-responsible business
Sustainable Digital Evolution: Transforming the Ukrainian Customs Service
Authors: Ishchuk Mykhailo , Ishchuk Olena , Khrypko Svitlana , Shnitser Mariia , Vasylchukù Tetyana , Syhyda Halyna , Hotsalyuk Alla 
Published: February 2024

The evolving landscape of information technologies has spurred a profound digital revolution across cultural, societal, organizational, and governmental domains. This article examines the transformative impact of Information and Communications Technology (ICT) and electronic systems within Ukrainian customs operations and their broader societal implications. At the core of this exploration lies the pivotal role of ICT integration in modernizing the Ukrainian Customs Service amidst global challenges, exemplified by the COVID-19 pandemic. The study assesses the benefits, challenges, and implications of “electronic customs” and IT-driven reforms, focusing on the three pillars of sustainability, customs operations, and digital culture. Objectives encompass an evaluation of ICT’s significance in enhancing border management efficiency, addressing challenges, and leveraging opportunities through technology-driven customs initiatives. Synthesizing academic publications and governmental reports, the article provides comprehensive insights into the transformative potential of technology in customs management. Notably, the implementation of anti-corruption measures, particularly through the Single Window system, emerges as a successful endeavor in curbing malpractices while streamlining customs procedures. However, challenges persist, including swift adoption, cyber fraud risks, and systemic issues within customs authorities, necessitating phased implementation and continuous improvement. Ethical reflections on technology integration into governance mechanisms, educational reforms, and inclusivity discussions underscore the broader societal and philosophical shifts catalyzed by electronic customs. This sustainable digital evolution emphasizes ongoing ethical considerations to navigate the evolving role of technology in shaping governance, societal integration, sustainable customs operations, and the inherent alignment of digital technologies with the key objectives of sustainable development.
Keywords: customs operations, digital culture, sustainable development, Single Window, cybersecurity, Information and Communication Technology, societal impact, ethical framework, cultural shifts
Innovative Customs System and its Impact on the Sustainability of the Transit Potential
Authors: Abuselidze George , Meladze Aleko 
Published: February 2024

Georgia, due to its geopolitical location, has the potential to become a transit hub connecting the West and the East, the North and the South, which will bring the country the greatest economic benefits and give it a significant political advantage on the international scale. In such conditions, the use of innovative tools of the customs system focused on stimulating financial and economic development is vital. Today's existing customs system cannot fully ensure the effective use of the country's potential, because cargo turnover carried out by road, rail, sea transport, and pipelines is not characterized by a significant growth trend. The paper proposes a model of an innovative customs system that ensures the growth of economic income for the country, which is mainly based on the growth of the country's transit potential and its effective use.
Keywords: innovative customs system, transit potential, transit attraction, economic income, economic effect
Methodology and Engineering of a Sustainable Market Model
Authors: Lohosha Roman , Krychkovskyi Vadim , Moroz Yevheniia , Kolesnyk Tetiana , Vakar Tetiana 
Published: February 2024

The article presents the authors’ approach to the methodology (logic of cognition) of the market, the process of modelling a representative market with the proof of the possibility of appropriate management of the market state. The study was tested on the example of Ukraine’s vegetable market according to the development trends of the last 30 years. The functional model of the market was considered by the set of its functional factors and the possibility to identify market efficiency. It is substantiated that regulations should be considered through manipulation of a set of indicators and restrictions, which allows reducing market management to an essentially engineering task, the feasibility of which is determined by the dynamics of increase in the effects of market functioning.
Keywords: market, market model, market functionality, market efficiency, market management