bluuebunny/crossref_metadata_2025_split huggingface dataset:
No difference in component migration at five years between the cemented cruciate-retaining ATTUNE and PFC-Sigma knee prosthesis: an update of a randomized clinical radiostereometry trial
Authors: Yüksel Yasin , Koster Lennard A. , Kaptein Bart L. , Nelissen Rob G. H. H. , den Hollander Peter 
Published: November 2023

AimsConflicting clinical results are reported for the ATTUNE Total Knee Arthroplasty (TKA). This randomized controlled trial (RCT) evaluated five-year follow-up results comparing cemented ATTUNE and PFC-Sigma cruciate retaining TKAs, analyzing component migration as measured by radiostereometric analysis (RSA), clinical outcomes, patient-reported outcome measures (PROMs), and radiological outcomes.MethodsA total of 74 primary TKAs were included in this single-blind RCT. RSA examinations were performed, and PROMs and clinical outcomes were collected immediate postoperatively, and at three, six, 12, 24, and 60 months’ follow-up. Radiolucent lines (RLLs) were measured in standard anteroposterior radiographs at six weeks, and 12 and 60 months postoperatively.ResultsAt five-year follow-up, RSA data from 61 patients were available and the mean maximum total point motion (MTPM) of the femoral components were: ATTUNE: 0.96 mm (95% confidence interval (CI) 0.79 to 1.14) and PFC-Sigma 1.37 mm (95% CI 1.18 to 1.59) (p < 0.001). The PFC-Sigma femoral component migrated more in the first postoperative year, but stabilized thereafter. MPTM of the tibial components were comparable at five-year follow-up: ATTUNE 1.12 mm (95% CI 0.95 to 1.31) and PFC-Sigma 1.25 mm (95% CI 1.07 to 1.44) (p = 0.438). RLL at the medial tibial implant-cement interface remained more prevalent for the ATTUNE at five-year follow-up compared to the PFC-Sigma (20% vs 3%). RLL did not progress over time, and varied between patients at different timepoints for both TKA systems. Clinical outcomes and PROMs improved compared with preoperative scores, and were not different between groups.ConclusionMTPM migration at five-year follow-up of the femoral and tibial component of the ATTUNE were similar and as low as that of the PFC-Sigma. MTPM migration of both knee implants did not significantly change from one year post-surgery, indicating stable fixation. Long-term ATTUNE performance may be expected to be comparable to the clinically well-performing PFC-Sigma. We have not found evidence of increased tibial component migration as measured by RSA to support concerns about cement debonding and a higher risk of aseptic loosening with the ATTUNE TKA.Cite this article: Bone Joint J 2023;105-B(11):1168–1176.
Effect of using a small baseplate on the radiological and clinical outcomes of reverse total shoulder arthroplasty in Asian patients
Authors: Kim Jae S. , Kim Seung H. , Kim Su C. , Park Jong H. , Kim Hyun G. , Lee Sang M. , Yoo Jae C. 
Published: November 2023

AimsThe aim of this study was to compare the clinical and radiological outcomes of reverse shoulder arthroplasty (RSA) using small and standard baseplates in Asian patients, and to investigate the impact of a mismatch in the sizes of the glenoid and the baseplate on the outcomes.MethodsThis was retrospective analysis of 50 and 33 RSAs using a standard (33.8 mm, ST group) and a small (29.5 mm, SM group) baseplate of the Equinoxe reverse shoulder system, which were undertaken between January 2017 and March 2021. Radiological evaluations included the size of the glenoid, the β-angle, the inclination of the glenoid component, inferior overhang, scapular notching, the location of the central cage in the baseplate within the vault and the mismatch in size between the glenoid and baseplate. Clinical evaluations included the range of motion (ROM) and functional scores. In subgroup analysis, comparisons were performed between those in whom the vault of the glenoid was perforated (VP group) and those in whom it was not perforated (VNP group).ResultsPerforation of the vault of the glenoid (p = 0.018) and size mismatch in height (p < 0.001) and width (p = 0.013) were significantly more frequent in the ST group than in the SM group. There was no significant difference in the clinical scores and ROM in the two groups, two years postoperatively (all p > 0.05). In subgroup analysis, the VP group had significantly less inferior overhang (p = 0.009), more scapular notching (p = 0.018), and more size mismatch in height (p < 0.001) and width (p = 0.025) than the VNP group.ConclusionIn Asian patients with a small glenoid, using a 29.5 mm small baseplate at the time of RSA was more effective in reducing size mismatch between the glenoid and the baseplate, decreasing the incidence of perforation of the glenoid vault, and achieving optimal positioning of the baseplate compared with the use of a 33.8 mm standard baseplate. However, longer follow-up is required to assess the impact of these findings on the clinical outcomes.Cite this article: Bone Joint J 2023;105-B(11):1189–1195.
Does the time to surgery influence outcomes for patients with a hip fracture who undergo total hip arthroplasty?
Authors: Farrow Luke , Clement Nick D. , Mitchell Lewis , Sattar Mariam , MacLullich Alasdair M. J. 
Published: November 2023

AimsSurgery is often delayed in patients who sustain a hip fracture and are treated with a total hip arthroplasty (THA), in order to await appropriate surgical expertise. There are established links between delay and poorer outcomes in all patients with a hip fracture, but there is little information about the impact of delay in the less frail patients who undergo THA. The aim of this study was to investigate the influence of delayed surgery on outcomes in these patients.MethodsA retrospective cohort study was undertaken using data from the Scottish Hip Fracture Audit between May 2016 and December 2020. Only patients undergoing THA were included, with categorization according to surgical treatment within 36 hours of admission (≤ 36 hours = ‘acute group’ vs > 36 hours = ‘delayed’ group). Those with delays due to being “medically unfit” were excluded. The primary outcome measure was 30-day survival. Costs were estimated in relation to the differences in the lengths of stay.ResultsA total of 1,375 patients underwent THA, with 397 (28.9%) having surgery delayed by > 36 hours. There were no significant differences in the age, sex, residence prior to admission, and Scottish Index of Multiple Deprivation for those with, and those without, delayed surgery. Both groups had statistically similar 30-day (99.7% vs 99.3%; p = 0.526) and 60-day (99.2% vs 99.0%; p = 0.876) survival. There was, however, a significantly longer length of stay for the delayed group (acute: 7.0 vs delayed: 8.9 days; p < 0.001; overall: 8.7 vs 10.2 days; p = 0.002). Delayed surgery did not significantly affect the rates of 30-day readmission (p = 0.085) or discharge destination (p = 0.884). The results were similar following adjustment for potential confounding factors. The estimated additional cost due to delayed surgery was £1,178 per patient.ConclusionDelayed surgery does not appear to be associated with increased mortality in patients with an intracapsular hip fracture who undergo THA, compared with those who are treated with a hemiarthroplasty or internal fixation. Those with delayed surgery, however, have a longer length of stay, with financial consequences. Clinicians must balance ethical considerations, the local provision of orthopaedic services, and optimization of outcomes when determining the need to delay surgery in a patient with a hip fracture awaiting THA.Cite this article: Bone Joint J 2023;105-B(11):1201–1205.
Radiological assessment of hip disease in children with cerebral palsy: development of a core measurement set
Authors: Joseph Prince J. S. , Khattak Mohammed , Masudi Sundas T. , Minta Louise , Perry Daniel C. 
Published: November 2023

AimsHip disease is common in children with cerebral palsy (CP) and can decrease quality of life and function. Surveillance programmes exist to improve outcomes by treating hip disease at an early stage using radiological surveillance. However, studies and surveillance programmes report different radiological outcomes, making it difficult to compare. We aimed to identify the most important radiological measurements and develop a core measurement set (CMS) for clinical practice, research, and surveillance programmes.MethodsA systematic review identified a list of measurements previously used in studies reporting radiological hip outcomes in children with CP. These measurements informed a two-round Delphi study, conducted among orthopaedic surgeons and specialist physiotherapists. Participants rated each measurement on a nine-point Likert scale (‘not important’ to ‘critically important’). A consensus meeting was held to finalize the CMS.ResultsOverall, 14 distinct measurements were identified in the systematic review, with Reimer’s migration percentage being the most frequently reported. These measurements were presented over the two rounds of the Delphi process, along with two additional measurements that were suggested by participants. Ultimately, two measurements, Reimer’s migration percentage and femoral head-shaft angle, were included in the CMS.ConclusionThis use of a minimum standardized set of measurements has the potential to encourage uniformity across hip surveillance programmes, and may streamline the development of tools, such as artificial intelligence systems to automate the analysis in surveillance programmes. This core set should be the minimum requirement in clinical studies, allowing clinicians to add to this as needed, which will facilitate comparisons to be drawn between studies and future meta-analyses.Cite this article: Bone Jt Open 2023;4(11):825–831.
CTDNet: cartoon-texture decomposition-based gray image super-resolution network with multiple degradations
Authors: Shi Baoshun , Xu Wenyuan , Yang Xiuwei 
Published: November 2023

In the case of multiple degradations, current deep-learning-based gray image super-resolution (SR) methods equally process all components in an image, resulting in missing subtle details. To address this issue, we elaborate a cartoon-texture decomposition-based (CTD) module that can automatically decompose an image into a smooth cartoon component and an oscillatory texture component. The CTD module is a plug-and-play prior module that can be applied in solving imaging inverse problems. Specifically, for the SR task under multiple degradations, we apply CTD as a prior module to build an unfolding SR network termed CTDNet. For the SR task of real terahertz images, the boundary (i.e., the boundary between the object of interest and the carrier table) recovered by CTDNet has artifacts, which limits its realistic applications. To reduce these boundary artifacts, we post-process the SR terahertz images by using a boundary artifact reduction method. Experimental results on the synthetic dataset and real terahertz images demonstrate that the proposed algorithms can maintain subtle details and achieve comparable visual results. The code can be found at https://github.com/shibaoshun/CTDNet.
Emergency department visits and boarding for pediatric patients with suicidality before and during the COVID-19 pandemic
Authors: Zipursky Amy R. , Olson Karen L. , Bode Louisa , Geva Alon , Jones James , Mandl Kenneth D. , McMurry Andrew 
Published: November 2023

Objective
To quantify the increase in pediatric patients presenting to the emergency department with suicidality before and during the COVID-19 pandemic, and the subsequent impact on emergency department length of stay and boarding.

Methods
This retrospective cohort study from June 1, 2016, to October 31, 2022, identified patients ages 6 to 21 presenting to the emergency department at a pediatric academic medical center with suicidality using ICD-10 codes. Number of emergency department encounters for suicidality, demographic characteristics of patients with suicidality, and emergency department length of stay were compared before and during the COVID-19 pandemic. Unobserved components models were used to describe monthly counts of emergency department encounters for suicidality.

Results
There were 179,736 patient encounters to the emergency department during the study period, 6,215 (3.5%) for suicidality. There were, on average, more encounters for suicidality each month during the COVID-19 pandemic than before the COVID-19 pandemic. A time series unobserved components model demonstrated a temporary drop of 32.7 encounters for suicidality in April and May of 2020 (p<0.001), followed by a sustained increase of 31.2 encounters starting in July 2020 (p = 0.003). The average length of stay for patients that boarded in the emergency department with a diagnosis of suicidality was 37.4 hours longer during the COVID-19 pandemic compared to before the COVID-19 pandemic (p<0.001).

Conclusions
The number of encounters for suicidality among pediatric patients and the emergency department length of stay for psychiatry boarders has increased during the COVID-19 pandemic. There is a need for acute care mental health services and solutions to emergency department capacity issues.
A comparison of presentations and outcomes of salvage versus non-salvage abdominal free flap breast reconstructions—Results of a 15-year tertiary referral centre review
Authors: Bojanic Christine , Di Pace Bruno , Ghorra Dina T. , Fopp Laura J. , Rabey Nicholas G. , Malata Charles M. 
Published: November 2023

Introduction
Salvage breast reconstruction with autologous tissue is becoming more prevalent due to a resurgence in implant-based procedures. The latter has caused a commensurate rise in failed or treatment-resistant prosthetic cases requiring conversion to free tissue transfers. Salvage reconstruction is often considered more challenging, owing to patient presentation, prior treatments and intraoperative difficulties. The aim of the study was to test this hypothesis by comparing outcomes of salvage versus non-salvage autologous microsurgical breast reconstructions in a retrospective matched cohort study.

Methods
The demographics, risk factors, operative details and outcomes of patients who underwent free flap salvage of implant-based reconstructions by a single operator (2005–2019) were retrospectively evaluated. For each salvage reconstruction, the consecutive non-salvage abdominal free flap reconstruction was selected for comparison. The clinical outcomes including intraoperative blood loss, operative time, flap survival and complication rates were compared.

Results
Of 442 microsurgical patients, 35 (8.0%) had salvage reconstruction comprising 41 flap transfers (29 unilateral, 6 bilateral) and 42 flaps (28 unilateral, 7 bilateral) in nonsalvage reconstruction. Deep inferior epigastric perforator (DIEP) flaps comprised the commonest autologous tissue used in both groups at 74% and 71% respectively. Most patients (83%) underwent salvage reconstruction for severe capsular contractures. There was a significant difference in radiation exposure between groups (salvage reconstruction 89%, non-salvage reconstruction 26%; p<0.00001). All 83 flaps were successful with similar reoperation rates and intraoperative blood losses. Unilateral salvage reconstruction took on average two hours longer than non-salvage reconstruction (p = 0.008). Overall complication rates were similar (p>0.05).

Conclusion
This 15-year study shows that despite salvage autologous free flap breast reconstruction requiring longer operation times, its intra and postoperative outcomes are generally comparable to non-salvage cases. Therefore, salvage breast reconstruction with free flaps provides a reliable option for failed or suboptimal implant-based reconstructions.
Evaluation of lay health workers on quality of care in the inpatient setting
Authors: Basnight Ramona , Berry Peter , Capes Kellie , Pearce Sherri , Thompson Julie , Allen Deborah H. , Granger Bradi B. , Reynolds Staci S. 
Published: November 2023

Aims
To evaluate the impact of a lay health worker support role in the inpatient setting.

Background
Healthcare systems are facing critical nursing and nurse assistant staffing shortages. These disciplines can be challenging to recruit and retain, leading healthcare leaders to identify innovative staffing models. Whereas lay health workers have been used in the community and low-income setting, there is scant evidence of their use in the inpatient setting. We implemented a lay health worker role, called Patient Attendant Service Aides (PASAs), on two medical/surgical units at a community hospital.

Methods
A pre/post-implementation design was used for this study. An online survey was provided to nurses, nursing assistants, and PASAs on the two medical/surgical units to assess their satisfaction and perceptions of the role. Nursing quality metrics, patient satisfaction, and nursing and nursing assistant turnover were evaluated before and after implementing the role.

Results
The online survey showed that nurses and nursing assistants felt that PASAs helped offload their workload, allowing them to focus on nursing-related tasks. PASAs felt supported by the team and believed they were making a meaningful contribution to the unit. There were slight improvements in patient satisfaction, although not significant. There was a significant improvement in nursing turnover on Unit A, from 71.1% to 21.6% (p = 0.009).

Conclusions
This is one of the first studies to evaluate the use of lay health workers in the inpatient setting; we found this role to be a feasible way to offload tasks from clinical staff. This role may serve as a pathway for workforce development, as several PASAs are now enrolled in nursing assistant training. Nurse managers may consider using lay health workers in the inpatient setting as they face severe clinical staff shortages.
A review on semi-crystalline polymer bead foams from stirring autoclave: Processing and properties
Authors: Brütting Christian , Standau Tobias , Meuchelböck Johannes , Schreier Peter , Ruckdäschel Holger 
Published: November 2023

Abstract
Bead foams have been widely used for more than 70 years, with expandable polystyrene and expanded polypropylene (EPP) being the main materials. There are different processes for producing bead foams, depending heavily on the material used (e.g., their thermal behavior). EPP is usually produced by a discontinuous stirring autoclave process, which is the main subject of this study. In this process, thermal treatment during the saturation phase leads to the formation of a second melt peak, which is considered an important prerequisite for the subsequent welding process, in which the individual foamed beads are welded into complex shaped parts by applying saturated steam to the beads in a cavity (so-called steam chest molding). To date, EPP is one of the main bead foams used industrially, but other materials such as polylactide and thermoplastic polyurethane can also be processed using the same technique. This review focuses on the important thermal and physical mechanisms during saturation and expansion and the parameters (material and process) that affect them. The process itself provides multiple possibilities to influence thermal behavior (i.e., crystallization) and expansion. Typical properties of resulting bead foams, which are found in many applications, are also considered.
Bounds on Choquet risk measures in finite product spaces with ambiguous marginals
Authors: Ghossoub Mario , Saunders David , Zhang Kelvin Shuangjian 
Published: November 2023

Abstract
We investigate the problem of finding upper and lower bounds for a Choquet risk measure of a nonlinear function of two risk factors, when the marginal distributions of the risk factors are ambiguous and represented by nonadditive measures on the marginal spaces and the joint nonadditive distribution on the product space is unknown.
We treat this problem as a generalization of the optimal transport problem to the setting of nonadditive measures.
We provide explicit characterizations of the optimal solutions for finite marginal spaces, and we investigate some of their properties.
We further discuss the connections with linear programming, showing that the optimal transport problems for capacities are linear programs, and we also characterize their duals explicitly.
Finally, we investigate a series of numerical examples, including a comparison with the classical optimal transport problem, and applications to counterparty credit risk.
Effizienz und soziale Ungleichheit in strikt leistungsdifferenzierenden Bildungssystemen. Eine kritische Betrachtung des Model of Ability Tracking (MoAbiT)
Authors: Lorenz Georg , Lenz Sarah , Rjosk Camilla 
Published: November 2023

Zusammenfassung
Inwieweit Leistungsdifferenzierung (bzw. ability tracking) Bildungsungleichheit beeinflusst, wird kontrovers diskutiert. Die vorliegende Studie untersucht, wie die Stringenz von Leistungsdifferenzierung (z. B. erzeugt durch verbindliche Übergangsempfehlungen) mit der Effizienz von Lernprozessen und sozialer Ungleichheit in der Sekundarstufe zusammenhängt. Den theoretischen Ausgangspunkt bildet eine kritische Betrachtung des „Model of Ability Tracking“ (MoAbiT) von Hartmut Esser. Empirische Analysen von Daten aus zwei IQB-Bildungstrendstudien stellen folgende Hauptannahmen des MoAbiT in Frage: Erstens, dass Sekundarschulklassen bei strikter Leistungsdifferenzierung kognitiv homogener zusammengesetzt sind und zweitens, dass kognitive Homogenität mit höheren schulischen Kompetenzen assoziiert ist. In Bezug auf die Auswirkungen von Leistungsdifferenzierung auf soziale Disparitäten zeichnet die vorliegende Arbeit ein gemischtes Bild. Ob strikte Leistungsdifferenzierung – wie im MoAbiT postuliert – Lernprozesse erleichtert und Bildungsungleichheit reduziert, bleibt angesichts der Befunde fraglich.
La descomposición de la hojarasca de Ochroma pyramidale (Malvaceae)
Authors: Morón Ríos Alejandro , Levy Tacher Samuel 
Published: November 2023

The tree Ochroma pyramidale is used to recover jungle areas that have been cultivated. This native species generates a thick layer of leaf litter that remains for several years. The objectives of this study were: 1) to know how much leaf litter is produced, 2) to estimate how long it persists in the soil, and 3) to identify the role of soil fauna in its decomposition. Leaf litter production was estimated at 11 Mg/ha/year, while over the course of 13 years the biomass and depth of the leaf litter layer measured in three sites previously planted with Ochroma showed a decrease of over 60%. In a leaf litter decomposition experiment, 37% of biomass was lost in 180 days. Soil mesofauna reduced the concentration of cellulose in leaf litter, while lignin decreased due to the time of permanence of the leaf litter in the soil. The high C:N proportion of the leaves, together with high lignin concentrations, could explain the low levels of loss and accumulation of biomass.