bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Different Anatomical Foot/ Ankle Arthritis Affect Functional Disability Differently?
Authors: Hakeem Samir , Nicolas Andrea Pujol , Porter Anna , Qasim Sultan , Chambers Simon , Ramaskandhan Jayasree R. , Torres Paulo , Siddique Malik 
Published: December 2023

Category: Ankle Arthritis; Ankle Introduction/ Purpose: There is paucity of literature comparing foot and general health status including quality of life between patients presenting with Ankle/ Hindfoot, Midfoot and 1st MTPJ arthritis. The aim of this study is to compare foot specific patient reported disability and quality of life satisfaction scores between patients presenting with arthritis of either the ankle/hindfoot, midfoot or 1st MTPJ. Methods: Patients who presented between 2020 and 2021 with a diagnosis of primary Osteoarthritis (OA) in either the ankle/hindfoot (AHA), midfoot (MA) or first MTPJ (MTPJA) were included in this study. Patients with associated foot problems, bilateral presentations, previous reconstructive surgery, or underlying neurological conditions were excluded. Differences in preoperative Patient Reported Outcome Measures (PROMs) including, MOX-FQ (Domains: Pain, Walking/Standing, Social activities), EQ-5D (UK) and Foot and Ankle outcomes scores (FAOS) (Domains: Pain, symptoms, ADL, sport, Recreation, Quality of Life) were analysed. Results: 94 patients (2020-2021) were included in this study (mean age 58.50). There were 45 patients with AHA, 21 with MA and 28 with MTPJA. The AHA group reported worse pain compared to the MTPJA group (p=0.03), and the MA group (p=0.004). AHA patients had more difficulty with Sports & Recreational Activities (p=0.029). Quality of Life scores was not significantly different between the groups. MTPJA patients had more difficulty with engaging in social activities compared the AHA patients (p=0.049). Conclusion: AHA patients suffer more pain that patients with arthritis in other areas of the foot. They appear to struggle with walking and standing and have difficulty participating in sports and recreational activities. Interestingly, MTPJA patients experience the most difficulty taking part in social activities. Patients with any type of foot or ankle arthritis experience similar difficulties with their mental health and their ability to carry out activities of daily living.
Does Perioperative use of Bisphosphonate Affect Implant Revision Rate of Total Ankle Arthroplasty?
Authors: Lee Dong-Oh , Kang Ho Won , Kim Dae-Yoo , Yoon Youngsik , Lee Doo Jae , Choi Yoon Hyo , Lee Kyoung Min , Kyung Min Gyu , Lee Dong Yeon 
Published: December 2023

Category: Ankle Arthritis; Other Introduction/Purpose: It is unknown whether perioperative bisphosphonate (BP) use reduces revision rates in total ankle replacement arthroplasty (TAR) although its effect has been demonstrated to be effective in reducing revision rates in total knee or hip replacement arthroplasty. Therefore, the purpose of this study was 1) to investigate whether there is a relationship between the use of BP and the revision rate of TAR, and (2) to determine the effect of BP medication period on the revision rate of TAR. Our hypothesis was that the use of BP would lower the revision rate of TAR. Methods: We reviewed National Health Insurance Service data based on national health insurance service claim data and health care utilization, health screening, socio-demographic variables, medication history, operation codes, and mortality data for 50 million Koreans. From 2002 to 2014, 6391 of 7300 patients who underwent TAR were BP non-users, while 909 patients were BP users. The revision rate according to BP medication and co-morbidities was investigated. The Kaplan-Meier estimate and extended Cox proportional hazard model were also used. Results: The revision rate of TAR was 7.9% for BP users and 9.5% for BP non-users, which showed no significant difference (p=0.251). Implant survival over time decreased constantly. Adjusted hazard ratio for hypertension was 1.242 (p=0.017), while other co-morbidities such as diabetes had no effect on revision rate of TAR. Conclusion: We found that the perioperative BP use do not reduce the revision rate of TAR. Co-morbidities except hypertension did not affect the revision rate of TAR. More research regarding various factor affecting revision of TAR could be warranted.
Does use of Allograft Affect Union Rates in Minimally Invasive Hallux Valgus Surgery?
Authors: Gil Jorge , Lopez Kyra E. , Guevara Christian , Callan Claire , Latta Steven , Chapman Cary 
Published: December 2023

Category: Bunion; Basic Sciences/Biologics Introduction/Purpose: Hallux valgus is a common foot deformity that can cause significant discomfort. Surgical correction of hallux valgus can be achieved through various techniques with minimally invasive surgery (MIS) gaining popularity amongst surgeons. The use of allograft in traditional open approaches has been proposed to improve the outcomes of hallux valgus repair by expediting time to union. We performed a retrospective analysis of patients undergoing MIS hallux valgus correction with and without the allograft at time of surgery. The primary aim of our study was to determine if use of allograft in hallux valgus MIS correction led to different time to union as well as rate of unions. Methods: A retrospective analysis was conducted to compare outcomes of patients who underwent hallux valgus correction with or without allograft. Patients included in the analysis underwent primary hallux valgus correction using third generation minimally invasive techniques and had postoperative weightbearing x-rays. Exclusion criteria included revision surgery, open surgeries, and loss-to-follow up. All surgeries were performed by three fellowship trained Foot and Ankle Orthopaedic surgeons at a single center from September 2019 to December 2022. All patients had similar post operative protocols. The allograft group received 2- 5 cc’s of a demineralized bone matrix (DBM) gel. Radiographs were evaluated by two independent orthopedic surgeons who were blinded to the patient's group allocation. The primary outcome of this study was time to radiographic union and rate of union. The data was analyzed using the independent t- test for continuous variables and the Fisher Exact test for categorical variables. Results: Seventy-two patients (77 feet) met inclusion criteria: allograft group (n=25) and a control group (n=52). Demographics between both groups were similar; the overall demographics can be found in Table 1. In our study, all 77 feet obtained complete union and no malunions or non-unions were observed in either group. The average time to complete union for the allograft group was 3.52 months (± 1.58) and the control group was 4.36 months (± 2.20); union times between groups did not reach statistical significance (p = 0.09) but did demonstrate a trend towards significance (Figure 1.) Maintenance of surgical correction was observed in all patients. Conclusion: While there was no statistically significant difference in union time and/or rates between the allograft group and control group, the allograft recipients had a reduction in the average time to union post MIS hallux valgus correction. No differences were observed with regards to radiographic recurrence nor complications between the two groups. This study suggests that demineralized bone matrix allograft may potentially decrease time to union but further studies are needed to confirm this.
Early Outcomes after Minimally Invasive Percutaneous Zadek Osteotomy for the Treatment of Insertional Achilles Tendinitis and Haglund’s Deformity
Authors: Phillips Tammy , Encinas Rodrigo , Edelman David , Jackson J. Benjamin , Gonzalez Tyler 
Published: December 2023

Category: Hindfoot; Other Introduction/Purpose: Zadek dorsal closing wedge calcaneal osteotomy (DCWCO) has been increasingly investigated as an effective technique for the treatment of Insertional Achilles Tendinopathy and Haglund’s deformity. More recently, this strategy has been modified using minimally invasive techniques. A percutaneous approach, in comparison to the standard open DCWCO, allows for reduced postoperative complication, improved clinical function, and decreased pain. This retrospective chart review aims to evaluate the postoperative outcomes of patients undergoing Zadek osteotomy via a minimally invasive percutaneous approach to assess early functional outcomes, complication rates, and revision rates. Methods: Two fellowship-trained foot and ankle orthopaedic surgeons at one academic institution performed minimally invasive percutaneous Zadek osteotomies on 21 patients. All cases were completed between March 2021 and February 2023. Patient charts were reviewed for outcome data including complication rate, union rate, revision rate, and Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Results: Average age of patients was 54 years. Average BMI was 39.4. Average follow up was 111.6 days. Complications included 1/21 (4.7%) superficial infection that resolved with oral antibiotics, 1/21 (4.7%) tibial neuritis that resolved 3 months after surgery, and 1/21 (4.7%) postoperative plantar fasciitis that resolved with home stretching by 6 months. There were no revisions to open procedures or hardware removal. All participants achieved union. 20/21 (95%) were very satisfied with their surgery. Average preoperative PROMIS scores regarding physical function, pain interference, and mobility were 38.3 (27-51), 65.1 (55-75), and 35.0 (25-46), respectively. Average postoperative PROMIS scores in these same domains were 38.5 (19-54), 58.8 (39-72), and 36.8 (22- 51). There was an average improvement in PROMIS scores in all domains (0.23, -6.35, and 1.76). Conclusion: Minimally invasive percutaneous Zadek osteotomy appears to be an efficacious and safe treatment option for insertional Achilles tendinitis and Haglund’s deformity with low complication profile, high union rate of the osteotomy and high patient satisfaction. Early functional outcome data shows trends in improvements in PROMIS scores. However, longer term data will be needed to assess long term functional outcomes and revision rates.
Accuracy of 3D facial scans: a comparison of three different scanning system in an in vivo study
Authors: Pellitteri Federica , Scisciola Fabrizio , Cremonini Francesca , Baciliero Matilde , Lombardo Luca 
Published: December 2023

Abstract
Background
The aim of the study was to compare the accuracy and reproducibility of three different 3D facial scanning systems, relying, respectively, on stereophotogrammetry, structured light and a smartphone app and camera.

Methods
Thirty subjects have been scanned with three different facial scanning systems, stereophotogrammetry, structured light and a smartphone app and camera. Linear measurements were compared with direct anthropometries measured on the patient's face, while the study of areas (forehead, tip of the nose, chin, right and left cheek) was evaluated by overlapping scans using the Geomagic Control X program. Statistical analyses were conducted using IBM SPSS v28 software.

Results
The ANOVA test was used to compare linear distances and direct anthropometry measurements, revealing statically significant values for all distances investigated, especially for the Face Hunter scanner, except for the Prn–Pog′ distance (p = 0.092). The three facial scans were superimposed pairwise almost the 100 per cent of the overlapping areas fell within the tolerance limits for all three comparisons analysed. The chin was the most accurately reproduced, with no differences among scanners, while the forehead proved to be the least accurately reproduced by all scanners.

Conclusions
All three acquisition systems proved to be effective in capturing 3D images of the face, with the exception of the Face Hunter scanner, that produced statistically significant differences in linear measurements for the distances Tr–Na′ and Zyg–Zyg with respect to direct anthropometric measurements.
Long-term results of treatment of patients with monosegmental stenosis of the spinal canal in the lumbar spine
Authors: Akhmetyanov Sh. A. , Azizkhonov A. A. , Mushkachev E. A. , Sanginov A. J. , Isakov I. D. , Peleganchuk A. V. 
Published: December 2023

Objective.To evaluate the long-term results of surgical treatment of patients with monosegmental stenosis of the lumbar spine after using minimally invasive and standard open techniques.Material and Methods.The open cohort randomized prospective study included 132 patients. Long-term results were assessed in 110 patients, some patients discontinued participation in the study for natural reasons. Patients were operated on in 200–2011 in the volume of minimally invasive decompression and stabilization surgery (Group 1) and decompression and stabilization surgery through conventional posteromedial approach (Group 2). The following parameters were analyzed: Oswestry Disability Index and VAS pain intensity. Formation of an interbody block was assessed using the Tan scale, and the fatty degeneration of the paravertebral muscles – according to the Goutallier scale. Development or aggravation of the course of degeneration of the adjacent segment was also evaluated. Statistical analysis was performed using the R packages for data processing and plotting.Results.At long-term follow-up (144 months), when assessing back pain according to VAS and ODI, a statistically significant difference p < 0.001 in favor of minimally invasive interventions was revealed. Both surgical methods resulted in high rates of fusion and low reoperation rates. In the group of minimally invasive surgical interventions, there is a lower incidence of fatty degeneration of the paravertebral muscles and damage to the adjacent segment.Conclusions.Open and minimally invasive surgical interventions have comparable long-term clinical and morphological results. Open surgical interventions in the long term are fraught with aggravation of fatty degeneration of the paravertebral muscles and more frequent development of the adjacent level syndrome. Minimally invasive techniques are an effective and safe alternative to traditional open surgery and can reduce trauma, preserve the intact posterior support complex of the spine at adjacent levels, while performing adequate decompression and stabilization, followed by the formation of a bone block.
Microbiological spectrum of SSI pathogens in patients with chronic infectious spondylitis requiring revision surgery: results of continuous monocentric 5-year monitoring
Authors: Naumov D. G. , Vishnevskiy A. A. , Solovieva N. S. , Masalova N. Yu. , Yablonsky P. K. , Karpushin A. A. 
Published: December 2023

Objective. To analyze the results of the continuous monocentric 5-year microbiological monitoring of causative agents of surgical site infection (SSI) in patients who underwent primary surgery for chronic infectious spondylitis and required revision surgery.Material and Methods. The study included patient data from 2018 to 2022. The primary cohort included 569 consecutively operated patients with chronic infectious spondylitis of nonspecific (n1 = 214) and tuberculous (n2 = 355) etiology. The analyzed sample was formed taking into according to inclusion and exclusion criteria. Thus, in 99 patients who required revision surgical interventions due to the development of SSI, a continuous microbiological monitoring of pathogens was performed, including the assessment of drug resistance and the timing of the development of infectious complications. Periodization of the time of SSI development was performed according to the accepted classification of Prinz et al. (2020), the assessment of drug resistance spectrum was performed according to the EUCAST recommendations (2020) and taking into account the approved methodological recommendations.Results. In the general structure of surgical interventions for chronic infectious spondylitis, the share of revision interventions due to the development of SSI was 17.4 %. The highest incidence of complications was noted in the late postoperative period (χ2 = 9.237; p = 0.009). Bacterial detection from the material of vertebral localization was noted in 43 cases (48.3 %), pathogen strains were isolated in urine in 28 (60.8 %), in decubital ulcers in 11 (23.9 %) and in hemoculture in 7 (15.2 %) patients. Culture negative SSI was detected in 10 cases (10.1 %) in the late period. Infectious complications in the setting of chronic non-specific spondylitis were detected more frequently than in spondylitis of tuberculous etiology (χ2 = 21.345; p < 0.001). Gram-positive multidrug-resistant and Gram-negative bacteria with extreme resistance prevailed in the microbiological landscape of late SSI, and Gram-positive strains without drug resistance in that of early and delayed SSI (χ2 = 17.516; p = 0.0032).Conclusion. Drug-resistant Gram-positive bacteria predominate in the structure of SSI with a significantly higher frequency of complication development. Nonspecific etiology of spondylitis is associated with a significantly higher incidence of SSI. In the absence of a positive result of bacteriological examination of the material of vertebral localization, it is advisable to collect blood, decubital ulcer secretion and urine sampling.
Evaluation of diagnostic criteria and choice of treatment tactics for patients with infectious spondylodiscitis based on a case series
Authors: Lyubimova L. V. , Preobrazhenskaya E. V. , Nikolaev N. S. , Pchelova N. N. , Lyubimov E. A. 
Published: December 2023

Objective. To present a brief description of a series of clinical cases of infectious spondylodiscitis with an assessment of the used diagnostic criteria in terms of their influence on the choice of sanifying treatment tactics.Material and Methods. A continuous retrospective study of 39 cases of spondylodiscitis was carried out. Level of evidence is IIIC. The level of ESR, serum C-reactive protein, the results of the study of biopsy materials, and CT and MRI data were evaluated. Criteria of neurological deficit, instability of the spinal motion segment, and recommendations for assessing the clinical and radiological severity of the disease were used to select the treatment tactics. Treatment success was defined as primary wound healing, absence of recurrent infection and/or death, and satisfaction with treatment according to the EQ-5D and EQ-VAS scales at a follow-up period of 22.5 months.Results. The average age of patients was 57.4 years. Primary spondylodiscitis accounted for 82 %, the predominant localization of the pathological focus was the lumbar spine (56.4 %), and staphylococci were predominant etiologic agents (59.1 %). On average, the increase in ESR was 45 mm/h, C-reactive protein – 57 ng/l, and D-dimer – 1235 pg/ml. The level of pain before sanation according to the VAS scale was 6.79 points, after the operation it was 2.3 points (p < 0.05). Instability of the spinal motion segment according to the SINS scale was revealed in 36 cases, paravertebral abscess according to MRI – in 51.3 % of cases, and neurological deficit – in 38.5 % of cases. Severe spondylodiscitis according to the SponDT scale was noted in 53.8 %, moderate – in 43.6 %, and mild – in 2.6 % of patients. According to the clinical and radiological classification of infectious spondylodiscitis severity (SSC), grade I was present in 2 patients, grade II – in 21, and grade III – in 6. Compliance of the chosen treatment tactics with current recommendations was noted in 94,9 % of cases. Recurrence of infection was observed in 7.7 %; lethal outcome – in 5.1 %. Satisfaction with the quality of life according to EQ-5D was 0.74 points, and according to EQ-VAS – 73.88 points.Conclusions. The integrated use of criteria for neurological deficit, instability of spinal motion segments, and severity of the disease according to the SponDT classification with the account of Pola’s recommendations on treatment tactics made it possible to choose the optimal treatment tactics and achieve satisfactory results in the sanation of patients with infectious spondylodiscitis.
Radiation doses to patients during pedicle screw fixation of the spine
Authors: Kubasov M. V. , Kravtsov M. N. , Golubin A. V. , Malakhovsky V. N. , Svistov D. V. 
Published: December 2023

Objective. To analyze the radiation doses to patients during spinal decompression and stabilization surgery under optical CT navigation and fluoroscopy.Material and Methods. Study design: retrospective cohort study. The sample consisted of 164 patients who underwent transpedicular fixation of the spine performed by percutaneous or open techniques. In the O-arm group (n = 109), cone-beam CT combined with optical navigation was used; in the C-arm group, fluoroscopy (n = 55) was used. The effective dose equivalent (EDE) and the maximum absorbed dose (MAD) in the skin were evaluated.Results. EDE in the O-arm group was Me 9.1 mSv, [IQR: 7.1–11.6], and in the C-arm group –Me 1.8 mSv [IQR: 1.8–5.6], p < 0.0001. Maximum absorbed dose in the skin in the O-arm group was Me 49.3 mGy [IQR: 27.0–96.9], and in the C-arm group – Me 36.1 mGy [IQR: 16.6–111.5], p = 0.424.Conclusion. The use of CT navigation and fluoroscopy during pedicle screw fixation of the spine is not associated with the risk of developing deterministic effects. The use of intraoperative CT navigation during pedicle screw fixation is associated with a greater patient EDE compared with that of fluoroscopy (p < 0.05). Differences in EDE received by patients undergoing open and percutaneous techniques of pedicle screw fixation are statistically insignificant, regardless of the type of beam guidance and the number of fixation levels. The number of intraoperative CT scans is proportional to the patient EDE (p = 0.018).
Cláusulas de modificación contractual: una alternativa para el equilibrio de los contratos a largo plazo
Authors: Fernández Mónica , Gual José , Acosta Joaquín 
Published: December 2023

Ante la variedad de cláusulas el presente escrito propone la identificación precisa de las cláusulas de modificación contractual y su importancia dentro de la amplia tipología de las cláusulas de adaptación contractual. A fin de destacar su utilidad en favor del mantenimiento del contrato entre empresas, en especial si son de larga duración, cuando enfrentan el advenimiento de ciertos riesgos que suelen ser ajenos a su voluntad, sin que se piense que per se son abusivas, éstas cláusulas enfrentan disyuntivas ante principios como la autonomía privada, el pacta sunt servanda, el rebus sic stantibus y la buena fe, al funcionar como un mecanismo tanto preventivo como efectivo en favor del equilibrio de las prestaciones contractuales.
La Naturaleza como sujeto de derechos en el constitucionalismo democrático
Authors: Guio Barreto Valentina , Moreno González Laura Victoria 
Published: December 2023

El presente libro es un recopilado de artículos que abordan el tema de demostrar que actualmente el mundo se encuentra frente a una crisis en la civilización, como consecuencia del enfrentamiento del modelo de organización estatal impuesto desde hace décadas y el nuevo paradigma del Buen vivir que busca dejar a un lado ese modelo capitalista saliendo del statu quo, para propender a una visión biocéntrica y así, a través de un constitucionalismo democrático proteger la Naturaleza desde un sentido plurinacional e intercultural además de los derechos inherentes y una paz territorial.