bluuebunny/crossref_metadata_2025_split huggingface dataset:
RISK FACTORS FOR FRACTURE-RELATED INFECTION AFTER ANKLE FRACTURE SURGERY
Authors: Pilskog Kristian , Høvding Pål , Fenstad Anne Marie , Inderhaug Eivind , Fevang Jonas Meling , Dale Håvard 
Published: November 2023

AimAnkle fracture surgery comes with a risk of fracture-related infection (FRI). Identifying risk factors are important in preoperative planning, in management of patients, and for information to the individual patient about their risk of complications. In addition, modifiable factors can be addressed prior to surgery. The aim of the current paper was to identify risk factors for FRI in patients operated for ankle fractures.MethodA cohort of 1004 patients surgically treated for ankle fractures at Haukeland University hospital in the period of 2015–2019 was studied retrospectively. Patient charts and radiographs were assessed for the diagnosis of FRI. Binary logistic regression was used in analyses of risk factors. Regression coefficients were used to calculate the probability for FRI based on the patients’ age and presence of one or more risk factors.ResultsFRI was confirmed in 87 (9%) of 1004 patients. Higher age at operation (p < 0.001), congestive heart failure (CHF), p = 0.006), peripheral artery disease (PAD, p = 0.001), and current smoking (p = .006) were identified as risk factors for FRI. PAD and CHF were the risk factors displaying the strongest association with FRI with an adjusted odds ratio of 4.2 (95% CI 1.8–10.1) and 4.7 (95% CI 1.6–14.1) respectively.ConclusionsThe prevalence of FRI was 9% after surgical treatment of ankle fractures. The combination of risk factors found in this study demonstrate the need for a thorough, multidisciplinary, and careful approach when faced with an elderly or frail patient with an ankle fracture. The results of this study help the treating surgeons to inform their patients of the risk of FRI prior to ankle fracture surgery.
QUALITY OF LIFE IN OSTEOMYELITIS IS SIGNIFICANTLY WORSE COMPARED TO OTHER CHRONIC DISEASES
Authors: Hotchen Andrew , Tsang Shao-Ting Jerry , Dudareva Maria , Sukpanichy Sermsak , Corrigan Ruth , Ferguson Jamie , Stubbs David , McNally Martin 
Published: November 2023

AimPatient quality of life (QoL) in untreated bone infection was compared to other chronic conditions and stratified by disease severity.MethodPatients referred for treatment of osteomyelitis (including fracture related infection) were identified prospectively between 2019 and 2023. Patients with confirmed infection completed the EuroQol EQ-5D-5L questionnaire. Clinicians blinded to EQ-index score, grouped patients according to JS-BACH Classification into ‘Uncomplicated’, ‘Complex’ or ‘Limited treatment options’. A systematic review of the literature was performed of other conditions that have been stratified using EQ-index score.Results257 patients were referred, and 219 had suspected osteomyelitis. 196 patients had long bone infection and reported an average EQ-index score of 0.455 (SD 0.343). 23 patients with pelvic osteomyelitis had an average EQ-index score of 0.098 (SD 0.308). Compared to other chronic conditions, patients with long-bone osteomyelitis had worse QoL when compared to different types of malignancy (including bladder, oropharyngeal, colorectal, thyroid and myeloma), cardiorespiratory disease (including asthma, COPD and ischaemic heart disease), psychiatric conditions (including depression, pain and anxiety), endocrine disorders (including diabetes mellitus), neurological conditions (including Parkinson's disease, chronic pain and radiculopathy) and musculoskeletal conditions (including osteogenesis imperfecta, fibrous dysplasia and x-linked hypophosphataemic rickets). QoL in long-bone infection was similar to conditions such as Prada-Willi syndrome, Crohn's disease and juvenile idiopathic arthritis. Patients who had a history of stroke or multiple sclerosis reported worse QoL scores compared to long-bone infection. Patients who had pelvic osteomyelitis gave significantly lower QoL scores when compared to all other conditions that were available for comparison in the literature.In long bone infection, 41 cases (21.0%) were classified as ‘Uncomplicated’, 136 (69.4%) as ‘Complex’ and 19 (9.7%) as ‘Limited treatment options available’. Within classification stratification, patients with ‘Uncomplicated’ long bone infections reported a mean EQ-index score of 0.618 (SD 0.227) which was significantly higher compared to ‘Complex’ (EQ-index: 0.410 SD 0.359, p=0.004) and ‘Limited treatment options available’ (EQ-index: 0.400 SD 0.346, p=0.007).ConclusionsBone and joint infections have a significant impact on patient quality of life. It is much worse when compared to other common chronic conditions, including malignancy, cardiovascular and neurological diseases. This has not been previously reported but may focus attention on the need for more investment in this patient group.
FRAME TREATMENT IMPROVES QUALITY OF LIFE IN OSTEOMYELITIS BUT ONLY AFTER A PERIOD OF SIGNIFICANT IMPAIRMENT
Authors: Frank Florian , Hotchen Andrew , Ravn Christen , Pullinger Vicky , Eley Katherine , Stubbs David , Ferguson Jamie , McNally Martin 
Published: November 2023

AimThis study assessed quality of life (QoL) in patients having external fixation for treatment of osteomyelitis and fracture-related infection (OM/FRI).MethodPatients who had surgery for OM/FRI and who completed the EuroQoL EQ-5D-5L or EQ-5D- 3L questionnaires, were identified between 2010 and 2020. Patients were followed-up for 2 years after surgery. QoL was compared between patients who had either an Ilizarov frame or a monolateral external fixator with those who did not receive external fixation.Results165 patients were included. Of these, 37 (22.4%) underwent application of external fixation which included 23 circular frames and 14 monolateral external fixators. Patients in the frame group had more BACH ‘Complex’ infections (34/37; 91.9%), compared to non-frame patients (57/81; 70.3%).Pre-operatively, the mean EQ-index score for patients planned to receive a frame (0.278 SD 0.427) was worse compared to other treatments (0.453 SD 0.338, p=0.083). At 6 weeks after surgery, the EQ-index score remained significantly lower in frame patients compared to non-frame patients (frame: 0.379 SD 0.363; no frame: 0.608 SD 0.326, p=0.016). By 6 months, 26/37 patients had undergone frame removal. The patients who had frames in situ at 6 months had lower EQ-index scores when compared to patients who had their frames removed (frame in situ: 0.187 SD 0.213; frame removed 0.674 SD 0.206, p=0.076).At one year, 36/37 (97.3%) patients had their frame removed. QoL had greatly improved, to levels similar to non-frame patients (no frame: 0.652 SD 0.357; frame removed: 0.657 SD 0.247, p=0.949).ConclusionsFrame treatment leads to significant improvement in Quality of Life in patients suffering from osteomyelitis, with similar results in EQ5D scores after 1 year compared to patients who did not need an external fixator. These effects cannot be felt until after the frame has been removed with impaired QoL during frame treatment, especially in those patients with frames in situ for more than 6 months. This underlines the need for close and professional patient support during frame treatment for bone infection.
THE EFFECT OF A NATIONAL INFECTION CONTROL PROGRAMME IN SWEDEN ON PROSTHETIC JOINT INFECTION INCIDENCE FOLLOWING PRIMARY TOTAL HIP ARTHROPLASTY
Authors: Wildeman Peter , Rolfson Ola , Wretenberg Per , Nåtman Jonatan , Gordon Max , Söderquist Bo , Lindgren Viktor 
Published: November 2023

AimProsthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA) entailing increased mortality, decreased quality of life, and high healthcare costs. In 2009 a nationwide, multidisciplinary infection control program was launched in Sweden, PRISS, which aimed to reduce the PJI burden by 50%.The primary aim was to investigate whether the PRISS project reduced PJI incidence after primary THA; the secondary aim was to evaluate other possible benefits of PRISS, such as shorter time to diagnosis.MethodWe obtained data on patients undergoing primary THA in Sweden (n = 45,723 patients, 49,946 THAs), 2012–2014. Using personal identity numbers, this cohort was matched with the Swedish Prescribed Drug Registry. Medical records of patients with ≥4 weeks antibiotic consumption were reviewed to verify PJI diagnosis (n = 2240, 2569 THAs).ResultsThe cumulative incidence of PJI following the PRISS project was 1.2% [95% CI 1.1–1.3] as compared to 0.9% [95% CI 0.8–1.0] before. Cox regression models for the PJI incidence post PRISS indicates there were no statistical significance difference versus pre PRISS (HR 1.1 [95% CI 0.9–1.3]. There were similar time to PJI diagnosis after the PRISS project 24 vs 23 days (p=0.5).ConclusionsDespite the comprehensive nationwide PRISS project, Swedish PJI incidence was higher after the project and time to diagnosis remained unchanged. Factors contributing to PJI, such as increasing obesity, higher ASA class, and more fractures as indications, explain the PJI increase among primary THA patients.
THE PREVALENCE OF MYCOBACTERIA IN BONE AND JOINT SAMPLES AT A TERTIARY ORTHOPAEDIC CENTRE IN A SETTING WITH A LOW BURDEN OF TUBERCULOSIS DISEASE
Authors: Yates Tom A. , Vahesan Olivier , Warren Simon , Scobie Antonia 
Published: November 2023

AimAt our tertiary orthopaedic centre, mycobacterial cultures are routinely performed on bone and joint samples sent for bacterial culture. We have previously described the prevalence Mycobacterium tuberculosis Complex (MTBC) in these samples. Here, we describe the prevalence of non-tuberculous mycobacteria (NTM). We calculate the number needed to test to identify one previously undiagnosed mycobacterial bone or joint infection.MethodsSamples taken during a single procedure were pooled in one BACTEC MGIT culture. From laboratory records, we ascertained the number of mycobacterial cultures performed, the number positive for MTBC or NTM, and characteristics of individuals from whom mycobacteria were isolated. We collected the same data from 100 individuals with negative mycobacterial cultures. Results presented here are from interim analysis.ResultsExcluding sample types that were clearly not bone or joint samples, 6162 mycobacterial cultures were performed between 4 July 2017 and 30 September 2022. Twenty-two patients had MTBC and 6 patients had NTM newly isolated from bone or joint samples placed in mycobacterial culture, with a further patient having both M. tuberculosis and M. avium isolated. In both patients with M. abscessus, the organism also grew in routine bacterial cultures. In one further patient, M. fortuitum was isolated from a sample not put into mycobacterial culture.To identify one new mycobacterial infection of bone or joint (MTBC or NTM) that would not be detected with routine bacterial cultures, 228 (95% CI 157 – 346) mycobacterial cultures were needed. The laboratory cost per additional patient identified using MGIT cultures was €12,540 (95% CI €8,635 - €19,030).Mycobacterial cultures were much less likely to be positive in samples taken from prosthetic joints. They were more likely to be positive in spinal samples and in samples taken from patients with suspected sarcoma. In patients for whom we had contemporaneous histological specimens, these demonstrated granulomatous inflammation in 86% (18/21) of patients from whom MTBC had been isolated but in neither of the two patients from whom only NTM was isolated. Ascertaining the clinical significance of NTM isolates is challenging, although in 2/8 cases the same organism was isolated following repeat sampling.ConclusionsTargeted rather than routine mycobacterial culture of bone and joint specimens should be considered in settings with a low burden of tuberculosis. NTM are rarely isolated from bone and joint specimens at our centre and fast growers may be isolated using routine bacterial culture.
BONY SEQUESTRUM IN CHRONIC OSTEOMYELITIS: CHARACTERISTIC ON 18F-FDG-PET-CT IMAGES
Authors: Elsheikh Ahmed 
Published: November 2023

AimThe localization of sequestrum in chronic osteomyelitis (COM) is crucial in preoperative planning. The identification of sequestrum on plain X-ray could be difficult. CT and MRI were reported to show the sequestrum. We aimed to analyze the sequestrum characteristics on 18F-FDG-PET-CT images.MethodsA prospective study included all patients diagnosed with long-bone chronic osteomyelitis. All patients had preoperative 18F-FDG-PET-CT. Images were analyzed using RadiAnt DICOM Viewer. Axial cuts were used to measure the Standard Uptake Ratio (SUV)max in the Region of Interest (ROI) in the sequestrum, the surrounding area, and the normal bone in the same cut. Surgical debridement was done as standard; samples were taken for microbiology and histopathology, and the intraoperative finding was documented.ResultsNineteen patients (17 males/2 females) were operated on in one center between October/2021 and Jan/2023 at a mean age of 32±18. There were 10 tibias, 7 femurs, one ulna, and one fibula. Ten had postoperative COM, six open fractures, and three hematogenous OM. They all showed sequestrum on PET-CT; the dead bone appeared void, surrounded by a halo of increased uptake. There was a trend of lower uptake in the sequestrum compared to the halo around. The mean SUVmax at the sequestrum was 4.18±3.16, compared to the surrounding halo, 7.08±5.81. The normal bone has a mean SUVmax of 1.61±1.42. Sequestrum was removed successfully in all cases.Conclusion18F-FDG-PET-CT can precisely localize the sequestrum preoperatively, it has a lower uptake than tissues around it. This would facilitate planning and improve the quality of debridement.
CALPROTECTIN: AN IMPORTANT SYNOVIAL MARKER FOR THE DIAGNOSIS OF PERIPROSTHETIC JOINT INFECTION
Authors: d'Epenoux Louise Ruffier , Robert Manon , Caillon Hélène , Crenn Vincent , Dejoie Thomas , Lecomte Raphael , Tessier Eve , Corvec Stephane , Bemer Pascale 
Published: November 2023

BackgroundThe diagnosis of periprosthetic joint infection (PJI) remains a challenge in clinical practice and the analysis of synovial fluid (SF) is a useful diagnostic tool. Recently, two synovial biomarkers (leukocyte esterase (LE) strip test, alpha-defensin (AD)) have been introduced into the MSIS (MusculoSkeletal Infection Society) algorithm for the diagnosis of PJI. AD, although promising with high sensitivity and specificity, remains expensive. Calprotectin is another protein released upon activation of articular neutrophils. The determination of calprotectin and joint CRP is feasible in a routine laboratory practice with low cost.PurposeOur objective was to evaluate different synovial biomarkers (calprotectin, LE, CRP) for the diagnosis of PJI.MethodsIn this monocentric study, we collected SF from hip, knee, ankle and shoulder joints of 42 patients who underwent revision or puncture for diagnostic purposes. Exclusion criteria included a joint surgery in the previous 3 months and a diagnosis of a systemic inflammatory disease. PJI was diagnosed in a multidisciplinary consultation meeting (RCP) of the Reference Centers for Osteoarticular Infections of the Great West (CRIOGO). SF was analysed for LE, CRP and calprotectin. The cut-off values used were 50 mg/L for calprotectin, 8.8 mg/L for CRP and 125 WBC/µL for LE. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for these different synovial markers.ResultsOf the 42 patients included, 28 were considered as infected and 14 uninfected. The statistical parameters are presented in Table 1.ConclusionThe present study shows that the synovial calprotectin assay has an excellent sensitivity and a 100% NPV for the diagnosis of PJI, suggesting that a result < 50 mg/L could exclude PJI. This promising study suggests that calprotectin should be included with synovial CRP in a new decision algorithm for the diagnosis of PJI.For any tables or figures, please contact the authors directly.
PREVENTION OF PROSTHETIC JOINT INFECTION USING ELECTRICAL FIELDS: PROOF OF CONCEPT IN AN EXPERIMENTAL IN VIVO MODEL
Authors: Bernaus Marti , Carmona Francisco , De Espinosa Vázquez de Sola José María Lamo , Valentí Andrés , Abizanda Gloria , Cabodevilla Ana Ramos , Torres Diego , Calero Jose Antonio , Font Lluis , Del Pozo Jose Luis 
Published: November 2023

AimTo provide proof of concept in an in vivo animal model for the prevention of prosthetic joint infection prevention using electric fields along with conventional antibiotic prophylaxis.Corresponding Author: Marti BernausMethodFirst, we standardized the animal model to simulate implant contamination during the surgical procedure. We then implanted cobalt-chrome prostheses adapted to both knees of two New Zealand White rabbits, under standard aseptic measures and antibiotic prophylaxis with cefazolin. Prior to implantation, we immersed the prostheses in a 0.3 McFarland inoculum of S. aureus (ATCC 25923) for 30 seconds. In the first animal (control), the joint was directly closed after washing with saline. In the second animal (case), both prostheses were treated with electric current pulses for 30 seconds, washed with saline, and the joint was closed. After 72 hours, both animals were reoperated for the collection of periprosthetic tissue and bone samples, and prosthesis removal. In all samples, we performed quantitative cultures prior to vortexing and sonication, as well as prolonged cultures of the sonication broth. We confirmed the absence of contamination by identification with MALDI-TOF (VITEK-MS) and automated antibiotic susceptibility testing of the isolated colonies (VITEK-2).ResultsIn the “control” animal, we isolated S. aureus in all studied samples. The bacterial count expressed as log10 (cfu/cm2) in the prostheses of the right and left legs was 9.38 and 8.86, respectively. The bacterial count expressed as log10 (cfu/mL) in bone and periprosthetic tissue biopsies was 2.70 and 2.72 in the right leg and 3.24 and 3.87 in the left leg, respectively. In the “case” animal, where an electric field was applied to the implant after placement in addition to cefazolin prophylaxis, all samples (prosthesis, bone, and periprosthetic tissue) were negative, and no isolation of the inoculated strain of S. aureus was obtained after incubation of the sonication broth for 14 days.ConclusionsThis in vivo model suggests the potential effectiveness of applying an electric field to a prosthetic implant in combination with cefazolin for the prevention of PJI development, after exposure of the implant to an inoculum of S. aureus (ATCC 25923). Our findings need to be confirmed using a larger sample size.
„Fisch sucht Falle“: 11. Tag der Bestandserhaltung des KBE zum Thema „Integrierte Schädlingsbekämpfung (IPM) in Archiven und Bibliotheken“
Authors: Cejchan Vendulka 
Published: November 2023

Zusammenfassung
Am 12. und 13. September 2023 fand in der Zentral- und Landesbibliothek (ZLB) – Haus Berliner Stadtbibliothek in Berlin-Mitte der „11. Tag der Bestandserhaltung“ statt. Die Veranstaltung wurde vom Kompetenzzentrum Bestandserhaltung für Archive und Bibliotheken in Berlin und Brandenburg (KBE) organisiert und durchgeführt. In diesem Tagungsbericht wird ein kurzer Abriss über die gehaltenen Vorträge und Workshops gegeben. Das große Thema lautete „Integrated Pest Management“ (IPM) und gliederte sich in Theorie und Praxisberichte, sowie der Biozidbelastung am zweiten Nachmittag.
Zwischen Tradition und Moderne – die Dag-Hammarskjöld-Bibliothek der Vereinten Nationen in New York
Authors: Pickardt Janine 
Published: November 2023

Zusammenfassung
Die Dag-Hammarskjöld-Bibliothek am Hauptquartier der Vereinten Nationen (VN) in New York unterstützt die Mitarbeitenden des VN-Sekretariats und der ständigen Vertretungen der Mitgliedstaaten mit Recherche- und Informationsdiensten. Doch ihre Services stehen Interessierten auf der ganzen Welt zur Verfügung. Mit dem Online-Repositorium „Digitale Bibliothek der Vereinten Nationen“ bietet sie weltweit freien Zugriff auf die offizielle VN-Dokumentation und andere Publikationen der Organisation. Dieser Artikel gibt einen Überblick über die Geschichte der Bibliothek sowie ihre Informations- und Serviceangebote, mit denen sie die Auffindbarkeit und den offenen Zugang zu verlässlichen VN-Informationen fördert.
„Free to all“? – Zu soziopolitischen Einflüssen auf die amerikanischen Public Libraries im Spiegel der Zeit
Authors: Gawor Tabea 
Published: November 2023

Zusammenfassung
Zum Selbstverständnis der Public Libraries in den USA gehört es seit ihrer Entstehung, dass sie frei für alle nutzbar sind. Dennoch war der Zugang zu ihnen für bestimmte Bevölkerungsgruppen im Lauf der Geschichte durch soziopolitische Strömungen und Ereignisse nur eingeschränkt oder gar nicht möglich. Der Beitrag betrachtet die Zugangsmöglichkeiten für Frauen und für Afroamerikaner*innen von der Entstehung der Public Libraries um 1850 bis etwa in die Mitte des 20. Jahrhunderts. Das geschieht insbesondere vor dem Hintergrund des viktorianischen Frauenbilds sowie der New South Era und der Jim-Crow-Gesetze.
Die Kunst das Unmögliche zu versuchen und dabei nicht zu scheitern
Authors: Berg-Weiß Alexander , Spenger Martin 
Published: November 2023

Abstract
The impact of digital transformation extends to libraries, including academic institutions. In addition to their traditional roles, academic libraries are increasingly embracing new areas and integrating them into their service offerings. This article utilizes the University Library at LMU Munich as a case study to illustrate these evolving roles, such as digitization and research data management, and the overarching challenges that libraries face. Within this context, it may seem impossible to fully address all the emerging academic needs. Therefore, libraries must make strategic decisions about their further development. Factors like new work methodologies, human resources, and project sustainability are pivotal in this decision-making process. This article outlines the available tools for libraries and how they can be effectively applied in the context of digital transformation.
Arakelov inequalities in higher dimensions
Authors: Kovács Sándor J. , Taji Behrouz 
Published: November 2023

AbstractWe develop a Hodge theoretic invariant for families of projective manifolds that measures the potential failure of an Arakelov-type inequality in higher dimensions, one that naturally generalizes the classical Arakelov inequality over regular quasi-projective curves. We show that, for families of manifolds with ample canonical bundle, this invariant is uniformly bounded. As a consequence, we establish that such families over a base of arbitrary dimension satisfy the aforementioned Arakelov inequality, answering a question of Viehweg.