bluuebunny/crossref_metadata_2025_split huggingface dataset:
LONG-TERM HEALTH OUTCOMES OF PAEDIATRIC MULTIFOCAL MUSCULOSKELETAL SEPSIS: A 15-YEAR REVIEW
Authors: Crawford Haemish , Mcdonald Anna , Boyle Matthew , Byrnes Catherine 
Published: November 2023

This study aimed to identify long-term physical and psychosocial health outcomes in children with overwhelming musculoskeletal sepsis.Children admitted to the Paediatric Intensive Care Unit (PICU) from 1st January 2002 to 31st December 2017 with a musculoskeletal focus of infection were identified. A medical notes review was completed to determine survival and morbidity. Present-day clinical assessment of the musculoskeletal and respiratory systems along with questionnaires on health-related quality of life, mental health and sleep were performed.70 patients were identified over 15 years. Seven children died acutely (five Pasifika and two Māori children) indicating 10% mortality. Recurrence/chronic infection affected 23%. Growth disturbance affected 18%. The hip joint and proximal femur suffered the worst long-term complications. Children under 2 years most at risk of long-term disability. No patients had chronic respiratory illness beyond 90 days. Fifteen children had symptoms of acute neurological impairment, three of whom had permanent acquired brain injury. Twenty-six survivors (41%) were assessed a mean of 8.2 years (SD 4.5, range 2– 18 years) after discharge. Health-related quality of life scores were on par with normative data. All patients who underwent pulmonary function tests had normal results. Six patients and eight parents screened positive for moderate to severe post-traumatic stress disorder.Paediatric multifocal musculoskeletal sepsis can result in complex illness with multi-organ complications for some children. Māori and Pasifika children are most at risk. Children under 2 years and those with proximal femur and/or hip involvement are most likely to have chronic musculoskeletal sequelae and permanent disability. Other outcomes are favourable with no evidence of chronic lung disease or mean reduced quality of life. A period of rehabilitation for children with identified acquired brain injury should be part of discharge planning.
COMPARISON OF VISUAL ESTIMATIONS OF DISTAL RADIUS FRACTURE RADIOLOGICAL PARAMETERS BETWEEN DIFFERENT LEVELS OF ORTHOPAEDIC DOCTORS
Authors: Naidoo Vishad , Du Plessis Jason , Milner Brenda 
Published: November 2023

Distal radius fractures are common in South Africa. Accurate, decisive radiographic parameter interpretation is key in appropriate management. Digital radiographic facilities are rare in the public setting and goniometer usage is known to be low, thus, visual estimates are the primary form of radiographic assessment. Previous research associated orthopaedic experience with accuracy of distal radius fracture parameter estimation but, oftentimes, doctors treating orthopaedic patients are not experienced in orthopaedics.A cross-sectional questionnaire including four distal radius fracture radiographs administered to 149 orthopaedic doctors at three Johannesburg teaching hospitals. Participants grouped into ranks of: consultants (n=36), registrars (n=41), medical officers (n=20) and interns (n=52). Participants visually estimated values of distal radius fracture parameters, stated whether they would accept the position of the fractures and stated their percentage of routine usage of goniometers in real practice.The registrar group was most accurate in visually estimating radial height, whilst the interns were least accurate (p=0.0237). The consultant, registrar and medical officer groups were equally accurate in estimating radial inclination whilst the intern group was the least accurate (p<0.0001). The consultant and registrar group were equally accurate at estimating volar tilt, whilst the medical officer and intern groups were least accurate (p<0.0001). The Gwet's AC agreement was 0.1612 (p=0.047) for acceptance of position of the first radiograph, 0.8768 (p<0.0001) for the second, 0.8884 (p<0.0001) for the third and 0.8064 (p<0.0001) for the fourth. All groups showed no difference in goniometer usage, using them largely 0–25% of practice (p=0.1937).The study found that accuracy in visual estimations of distal radius fracture parameters was linked to orthopaedic experience but not linked to routine practice goniometer usage, which was minimal across all groups. Inter-rater agreement on acceptability of fracture position is potentially dependent on severity of deviation from acceptable parameters.
CLASSIFYING OPEN TIBIA AND FEMUR FRACTURES USING THE ORTHOPAEDIC TRAUMA SOCIETY (OTS) OPEN FRACTURE CLASSIFICATION SYSTEM IN A SETTING WITH HIGH INCIDENCE OF CIVILIAN GUNSHOT FRACTURES
Authors: Lunga Zamalunga , Laubscher Maritz , Held Michael , Magampa Ramanare , Maqungo Sithombo , Ferreira Nando , Graham Simon 
Published: November 2023

ObjectivesOpen fracture classification systems are limited in their use. Our objective was to classify open tibia and femur fractures using the OTS classification system in a region with high incidence of gunshot fractures.One hundred and thirty-seven patients with diaphyseal tibia and femur open fractures were identified from a prospectively collected cohort of patients. This database contained all cases (closed and open fractures) of tibial and femoral intramedullary nailed patients older than 18 years old during the period of September 2017 to May 2021. Exclusion criteria included closed fractures, non-viable limbs, open fractures > 48 hours to first surgical debridement and patients unable to follow up over a period of 12 months (a total of 24). Open fractures captured and classified in the HOST study using the Gustilo-Anderson classification, were reviewed and reclassified using the OTS open fracture classification system, analysing gunshot fractures in particular.Ninety percent were males with a mean age of 34. Most common mechanism was civilian gunshot wounds (gsw) in 54.7% of cases. In 52.6% of cases soft tissue management was healing via secondary intention, these not encompassed in the classification. Fracture classification was OTS Simple in 23.4%, Complex B in 24.1% and 52.6% of cases unclassified.The OTS classification system was not comprehensive in the classification of open tibia and femur fractures in a setting of high incidence of gunshot fractures. An amendment has been proposed to alter acute management to appropriate wound care and to subcategorise Simple into A and B subdivisions; no soft tissue intervention and primary closure respectively. This will render the OTS classification system more inclusive to all open fractures of all causes with the potential to better guide patient care and clinical research.
REMOVAL OF RETAINED BULLETS FROM THE HIP JOINT IN CIVILIAN GUNSHOT INJURIES
Authors: Maqungo Sithombo , Antoni Anna , Swanepoel Stefan , Nicol Andrew , Kauta Ntambue , Laubscher Maritz , Graham Simon 
Published: November 2023

Removal of bullets retained within joints is indicated to prevent mechanical blockade, 3rd body wear and resultant arthritis, plus lead arthropathy and systemic lead poisoning. The literature is sparse on this subject, with mostly sporadic case reports utilizing hip arthroscopy. We report on the largest series of removal of bullets from the hip joints using open surgical.We reviewed prospectively collected data of patients who presented to a single institution with civilian gunshot injuries that breached the hip joint between 01 January 2009 and 31 December 2022.We included all cases where the bullet was retained within the hip joint area. Exclusion criteria: cases where the hip joint was not breached, bullets were not retained around the hip area or cases with isolated acetabulum involvement.One hundred and eighteen (118) patients were identified. One patient was excluded as the bullet embedded in the femur neck was sustained 10 years earlier. Of the remaining 117 patients, 70 had retained bullets around the hip joint. In 44 patients we undertook bullet removal using the followingsurgical hip dislocation (n = 18), hip arthrotomy (n = 18), removal at site of fracture fixation/replacement (n = 2), posterior wall osteotomy (n = 1), direct removal without capsulotomy (tractotomy) (n = 5).In 26 patients we did not remove bullets for the following reasons: final location was extra-capsular embedded in the soft tissues (n=17), clinical decision to not remove (n=4), patients’ clinical condition did not allow for further surgery (n= 4) and patient refusal (n=1). No patients underwent hip arthroscopy.With adequate pre-operative imaging and surgical planning, safe surgical removal of retained bullets in the hip joint can be achieved without the use of hip arthroscopy; using the traditional open surgical approaches of arthrotomy, tractotomy and surgical hip dislocation.
GUNSHOT-INDUCED FRACTURE OF THE PROXIMAL FEMUR: OUTCOMES OF MANAGEMENT AT A TERTIARY HOSPITAL IN SOUTH AFRICA
Authors: Mokoena Thabo 
Published: November 2023

Gunshot-induced fractures of the proximal femur typically present with severe comminution and bone loss. These fractures may also be associated with local damage to soft tissue, neurovascular structures and injuries to abdominal organs. The aim was to evaluate the outcomes of civilian gunshot injuries to the proximal femur at a major trauma center in South AfricaA retrospective review of all patients who sustained gunshot-induced proximal femur fractures between January 2014 and December 2017 was performed. Patients with gunshot injuries involving the hip joint, neck of femur or pertrochanteric fractures were included. Patient demographics, clinical- treatment and outcome data were collected. Results are reported as appropriate given the distribution of continuous data or as frequencies and counts.Our study included 78 patients who sustained 79 gunshot-induced proximal femur fractures. The mean age of patients was 31 ± 112, and the majority of patients were male (93.6%). Pertrochantenteric fractures were the most common injuries encountered (73.4%). Treatment included cephalomedullary nail (60.8%), arthrotomy and internal fixation (16.4%) and interfragmentary fixation with cannulated screws (6%). One case of complete neck of femur fracture had fixation failure, which required conversion to total hip arthroplasty. The overall union rate was 69.6%, and 6.3% of patients developed a fracture-related infection in cases who completed follow-up.The study shows an acceptable union rate when managing these fractures and a low risk of infection. As challenging as they are, individual approaches for each fracture and managing each fracture according to their merits yield acceptable outcomes.
THE DIRECT COSTS OF HIP FRACTURE CARE IN SOUTH AFRICA: A PUBLIC HEALTHCARE SYSTEM PERSPECTIVE
Authors: Paruk Farhanah , Cassim Bilkish , Mafrakureva Nyasha , Lukhele Mkhululi , Gregson Celia , Noble Sian 
Published: November 2023

Fragility fractures are an emerging healthcare problem in Sub-Saharan Africa and hip fractures (HFs) are associated with high levels of morbidity, prolonged hospital stays, increased healthcare resources utilization, and mortality. The worldwide average healthcare cost in the first-year post HF was US$43,669 per patient in a 2017 systematic review, however there are no studies quantifying fracture-associated costs within SSA. We estimated direct healthcare costs of HF management in the South African public healthcare system.We conducted a prospective ingredients-based costing study in 200 consecutive consenting HF patients to estimate costs per patient across five regional public sector hospitals in KwaZulu-Natal (KZN). Resource use including staff time, consumables, laboratory investigations, radiographs, operating theatre time, surgical implants, medicines, and inpatient days were collected from presentation to discharge. Counts of resources used were multiplied by relevant unit costs, estimated from KZN Department of Health hospital fees manual 2019/20, in local currency (South African Rand, ZAR). Generalised linear models were used to estimate total covariate adjusted costs and cost predictors.The mean unadjusted cost for HF management was ZAR114,179 (95% CI; ZAR105,468–125,335). The major cost driver was orthopaedics/surgical ward costs ZAR 106.68, contributing to 85% of total cost. The covariate adjusted cost for HF management was ZAR114,696 (95% CI; ZAR111,745–117,931). After covariate adjustment, total costs were higher in patients operated under general anaesthesia compared to surgery under spinal anaesthesia and no surgery.Direct healthcare costs following a HF are substantial: 58% of the gross domestic per capita (US$12,096 in 2020), and six-times greater than per capita spending on health (US$1,187 in 2019) in SA. As the population ages, this significant economic burden to the health system will increase. Further research is required to evaluate direct non-medical, and the indirect costs incurred post HF.
EVALUATION OF THE SELF-DRILLING, SELF-TAPPING SCHANZ PIN THREAD PATTERNS ON THE NEAR CORTEX WHEN INSERTED IN BONE WITHOUT PRE-DRILLING
Authors: Mkhize Emmanuel Nkosinathi , Blake Craig 
Published: November 2023

The external fixator is an invaluable device when treating acute complex trauma and in limb reconstruction. It is therefore important to ensure its efficient and safe application to avoid complications. A lot of research has been done to evaluate the factors around external fixator stability, pin site infections and more is still being done to understand pin loosening. The purpose of this study was to evaluate other factors that may contribute in external fixator pin loosening. The aim was to evaluate if the different Schanz pin insertion techniques contribute to pin loosening.Two tibia diaphyses from two cadavers were each divided into three sections. Three different drilling techniques were repeated in each of the sections. A total of 36 Schanz pins were inserted and a section cut out of the bone in front of the pins was done allowing visual inspection of the pin hole for features of thread stripping. These features were predefined as thread pattern disruption, smoothening and shallow imprint on the cortex.Evidence of pin thread stripping was seen in all of the pin insertion techniques. The first method where the hole was pre-drilled and pin inserted with the drill showed 100% thread stripping. The second method of pre-drilling and hand insertion showed the least amount with 16.7% of pin stripping noted and 66.7% pin thread stripping was observed when inserting the pin with power without pre-drilling the pilot hole using the third method.Different pin insertion techniques result in varying amounts of pin thread stripping. The most amount of thread stripping occurs when a Schanz pin is inserted with power after pre-drilling. This finding, although not measured scientifically, supports the current recommendation of pre-drilling and manual insertion of the pin. In future, more scientific measurement are necessary to quantify these findings and assess their clinical significance.
QUALITY ASSESSMENT OF LABORATORY CADAVERIC AND BIOMECHANICAL STUDIES: THE DEVELOPMENT AND VALIDATION OF A NEW BASIC SCIENCE QUALITY SCORE
Authors: Hohmann Erik , Paschos Nikolaos , Keough Natalie , Molepo Maketo , Oberholster Abrie , Erbulut Deniz , Tetsworth Kevin , Glat Vaida , Gueorguiev Boyko 
Published: November 2023

The purpose of this study was to develop a quality appraisal tool for the assessment of laboratory basic science biomechanical studies.Materials andScore development comprised of the following phases: item identification/development, item reduction, content/face/criterion validity, weighting, test-retest reliability and internal consistency. For item identification/development, the panel was asked to independently list criteria and factors they considered important for cadaver study and generate items that should be used to appraise cadaver study quality. For content validity, the content validity ratio (CVR) was calculated. The minimum accepted content validity index (CVI) was set to 0.85. For weighting, equal weight for each item was 6.7% [15 items]. Based on these figures the panel was asked to either upscale or downscale the weight for each item ensuring that the final sum for all items was 100%. Face validity was assessed by each panel member using a Likert scale from 1–7. Strong face validity was defined as a mean score of >5. Test-retest reliability was assessed using 10 randomly selected studies. Criterion validity was assessed using the QUACS scale as standard. Internal consistency was assessed using Cronbach's alpha.Five items reached a CVI of 1 and 10 items a CVI of 0.875. For weighting five items reached a final weight of 10% and ten items 5%. The mean score for face validity was 5.6. Test-retest reliability ranged from 0.78–1.00 with 9 items reaching a perfect score. Criterion validity was 0.76 and considered to be strong. Cronbach's alpha was calculated to be 0.71 indicating acceptable internal consistency.The new proposed quality score for basic science studies consists of 15 items and has been shown to be reliable, valid and of acceptable internal consistency. It is suggested that this score should be utilised when assessing basic science studies.
RISCO DE SUICÍDIO ENTRE UNIVERSITÁRIOS DA ÁREA DA SAÚDE E OS FATORES ASSOCIADOS
Authors: Tinti de Andrade Maria Betânia , Vieira Coelho Ferreira Luana , Da Cruz Sequeira Carlos Alberto , Olímpia Barbosa Felipe Adriana , Guidorizzi Zanetti Ana Carolina , Alves Nogueira Denismar , Marilda Rodrigues Resck Zélia , Graziani Giacchero Vedana Kelly 
Published: November 2023

INTRODUÇÃO: O suicídio é apontado como a quarta causa de morte entre jovens na faixa etária de 15 a 29 anos. Nesta faixa etária encontram-se os universitários, que podem vivenciar em sua vida acadêmica um período marcado por angustias, incertezas, desafios e sofrimentos que somados a outros fatores podem favorecer o risco de suicídio. OBJETIVO: Identificar os fatores de risco para o suicídio em estudantes universitários da área da saúde. MATERIAIS E MÉTODO: Estudo de abordagem quantitativa, desenvolvido com estudantes universitários matriculados a partir do 5° período nos cursos de graduação em Biomedicina, Enfermagem, Farmácia, Fisioterapia, Medicina, Nutrição e Odontologia de uma instituição de ensino superior localizada no Sul de Minas Gerais. Foram autoaplicados cinco instrumentos: Questionário sociodemográfico, educacional e clínico; Avaliação do Risco de Suicídio; Escala de Esperança de Herth; Inventário de Depressão Maior e Escala de Autoestima de Rosenberg. RESULTADOS: Participaram do estudo 747 universitários, 27,6% apresentavam risco de suicídio. Os preditores de risco de suicídio foram ter sintomas depressivos, baixa autoestima, diagnóstico de transtorno mental, uso de psicofármacos e insatisfação com o apoio social. CONCLUSÃO: O estudo poderá subsidiar referencial para intervenções, investigações e políticas públicas para o apoio aos estudantes universitários e para a prevenção do suicídio nessa população.
SITGES 2022. 55 FESTIVAL INTERNACIONAL DE CINE FANTÁSTICO DE CATALUNYA
Authors: VALENCIA JAVIER J. 
Published: November 2023

Crónica de la 55 edición del Festival Internacional de Cine de Catalunya - Sitges 2022, edición cuyo tema central giró en torno al Metaverso y a los multiversos digitales. El artículo centra su atención en algunas de las películas más destacadas, como la sorprendente ganadora del premio a la mejor película "Sisu,"del finalndés Jalmari Helander, la excelente "Pearl" de Ti West, comedia negra filmada como si se tratara de un melodrama del "viejo Hollywood" protagonizada por una imponente Mia Goth, o la enigmática y atmosférica "Enys Men" de Mark Jenkin. Además se comentan algunas de las películas presentadas en las diferentes secciones retrospectivas o en la semana de la crítica, "Seven Chances", así como algunas de las películas españolas más remarcables.
LA SOMBRA DE STALIN EN LA PANTALLA OCCIDENTAL
Authors: ALONSO GUTIÉRREZ JUAN MANUEL 
Published: November 2023

Tras el comienzo de la guerra en Ucrania, desencadenada por el líder ruso Vladimir Putin, se hace necesario revisar la naturaleza del poder en Rusia tal y como la ha retratado el cine de ficción occidental. En este artículo queremos aproximarnos a la figura del líder soviético Iosif Stalin, tal y como se retrata en dos películas separadas por más de veinte años. Apoyándonos inicialmente en el telefilme norteamericano Stalin (Passer, 1992), que repasa los principales episodios de la vida del dictador, pasaremos a comentar también la película británica La muerte de Stalin (Iannucci, 2017), una comedia de humor negro sobre su muerte que desnuda las relaciones e interioridades de los personajes del Kremlin. Se pretende así ofrecer una reflexión sobre los mecanismos del poder, el totalitarismo y la influencia que Stalin ha tenido en Rusia.
Can bone scintigraphy reflect the progression of osteoarthritis after unicompartmental knee arthroplasty?
Authors: Lim Sumin , Kim Tae Hun , Park Do Young , Lee Jong Min , Chung Jun Young 
Published: November 2023

Background
Bone scintigraphy (BS) has been reported to be a useful predictor of osteoarthritis (OA) progression in primary knee OA. However, no previous studies have explored the relationship between BS and OA progression in the retained compartments after unicompartmental knee arthroplasty (UKA). Thus, we evaluated whether OA progresses to other compartments in patients who undergo UKA and if increased uptake on BS is associated with OA progression in other compartments after UKA.

Methods
A total of 41 patients with knee BS at least five years after UKA were included. Radiographic OA progression in other compartments was assessed by grading and comparing OA severity in each patient using the Kellgren–Lawrence grading system (K-L grade) and Osteoarthritis Research Society International (OARSI) atlas score. After UKA, the correlation between BS uptake and radiographic OA progression was analyzed in each retained compartment. A correlation analysis was also performed to evaluate the association between BS uptake and OA progression grades.

Results
A significant progression of OA was observed in both contralateral tibiofemoral and patellofemoral compartments after UKA at 98.5 ± 26.0 months of follow-up (all p<0.001). No correlation was found between BS uptake and radiographic OA progression nor between BS uptake and radiographic OA progression grade in the contralateral and patellofemoral compartments.

Conclusions
Following UKA, OA progresses in the retained contralateral tibiofemoral and patellofemoral compartments over a minimum five-year follow-up period. Thus, BS is ineffective in assessing the progression of OA in these compartments.
Uniqueness of asymptotically conical higher codimension self-shrinkers and self-expanders
Authors: Khan Ilyas 
Published: November 2023

Abstract
Let 𝐶 be an 𝑚-dimensional cone immersed in

R

n
+
m

\mathbb{R}^{n+m}

.
In this paper, we show that if

F
:

M
m

→

R

n
+
m

F\colon M^{m}\rightarrow\mathbb{R}^{n+m}

is a properly immersed mean curvature flow self-shrinker which is smoothly asymptotic to 𝐶, then it is unique and converges to 𝐶 with unit multiplicity.
Furthermore, if

F
1

F_{1}

and

F
2

F_{2}

are self-expanders that both converge to 𝐶 smoothly asymptotically and their separation decreases faster than

ρ

−
m

−
1

⁢

e

−

ρ
2

/
4

\rho^{-m-1}e^{-\rho^{2}/4}

in the Hausdorff metric, then the images of

F
1

F_{1}

and

F
2

F_{2}

coincide.
The Prussian Army’s First Spymaster: Colonel Heinrich von Brandt and the Nachrichtenbüro, 1866–1876
Authors: Stone James 
Published: November 2023

Abstract
Heinrich von Brandt was the father of German military intelligence. He was responsible for conducting espionage operations for the General Staff in the period of the foundation of the German Empire and made a significant contribution to Prussia’s victory over France in 1871. Yet his important role has been completely neglected in histories of the Prussian army during this period. This study uses source material believed to have been lost during the Second World War to reconstruct the life and work of the first chief of the Nachrichtenbüro from 1866 to 1876.