bluuebunny/crossref_metadata_2025_split huggingface dataset:
Instrumented Versus Uninstrumented Posterolateral Fusion for Lumbar Spondylolisthesis
Authors: Andresen Andreas K. , Wickstrøm Line A. , Holm Randi B. , Carreon Leah Y. , Andersen Mikkel Østerheden 
Published: June 2023

Background:
In Scandinavia, spinal fusion is frequently performed without instrumentation, as use of instrumentation in the elderly can be complicated by poor bone quality and the risk of screw pull-out. However, uninstrumented fusion carries the risk of nonunion. We performed a randomized controlled trial in an attempt to determine if use of instrumentation leads to better outcomes and fusion rates when spinal fusion is performed for degenerative spondylolisthesis in the elderly.

Methods:
This was a randomized, single-center, open-label trial of patients with symptomatic single-level degenerative spondylolisthesis who were assigned 1:1 to decompression and fusion with or without instrumentation after at least 12 weeks of nonoperative treatment had failed. The primary outcome was the change in the Oswestry Disability Index (ODI), and secondary outcomes included fusion rates within 1 year, reoperation rates within 2 years, and changes in the EuroQol-5 Dimension-3 Level (EQ-5D) score.

Results:
Fifty-four subjects were randomized to each of the 2 groups, which had similar preoperative demographic and surgical characteristics. We found similar improvements in the ODI (p = 0.791), back pain, leg pain, and quality of life between groups at 1 and 2 years of follow-up. Solid fusion on computed tomography (CT) scans was noted in 94% of the patients in the instrumented group and 31% in the uninstrumented group (p < 0.001). One patient (2%) in the instrumented group and 7 (13%) in the uninstrumented group (p = 0.031) had a reoperation within 2 years after the index surgery.

Conclusions:
We found no difference in patient-reported outcomes when we compared instrumented with uninstrumented fusion in patients with degenerative spondylolisthesis. The uninstrumented group had a significantly higher rate of nonunion and reoperations at 2 years.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Cementless Versus Cemented Total Knee Arthroplasty
Authors: Hannon Charles P. , Salih Rondek , Barrack Robert L. , Nunley Ryan M. 
Published: June 2023

Background:
We previously reported the 2-year results of a prospective randomized controlled trial of cementless versus cemented total knee arthroplasty (TKA) implants of the same design. The purpose of the present study was to provide concise results at intermediate-term follow-up.

Methods:
The original study included 141 TKAs (76 performed without cement and 65 performed with cement). Since then, 8 patients died and 4 withdrew. Of the remaining 129 patients, 127 (98%) were available for analysis. Survivorship analysis was performed; Oxford Knee, Knee Society, and Forgotten Joint Scores were calculated; and radiographs reviewed. Mean follow-up was 6 years.

Results:
The survivorship free of any revision was 100% in both groups. There were no differences between the groups in any patient-reported functional outcome measure (p = 0.2 to 0.5). However, a higher percentage of patients in the cementless TKA group were either extremely or very satisfied with their overall function (p = 0.01). Radiographically, there was no evidence of implant loosening in either group.

Conclusions:
At 6 years, there were no differences between cementless and cemented TKA implants of the same design in terms of survivorship, clinical, or radiographic outcomes.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Osteochondral Lesion of the Tibial Plafond Induced by Malposition of Soft Suture Anchors Used for the Deltoid Ligament Repair
Authors: Ohta Yuichi , Sugimoto Kazuya , Ueda Shuichiro , Isomoto Shinji , Miura Kimio , Hyakuda Yoshinobu , Shoji Haruka , Tanaka Yasuhito 
Published: June 2023

Case:
A 24-year-old elite female rugby player complained of prolonged symptoms after a surgical repair of the deltoid ligament performed 2 years previously. Ankle arthroscopy revealed an osteochondral lesion in the tibial plafond at the medial gutter, with the fibers of the soft suture anchor exposed in the joint. The anchors were removed, and the cysts were filled with autogenous cancellous bone. The patient returned to the elite-level rugby games 5 months after the operation without any symptoms.

Conclusion:
We must be aware that even soft anchors can cause arthritis if improperly positioned.
Single-Stage Correction of Genu Valgum Recurvatum by Distal Femoral and High Tibial Opening Wedge Osteotomies
Authors: Setliff Joshua C. , Engler Ian D. , Zsidai Bálint , Cong Guang-Ting , Musahl Volker 
Published: June 2023

Case:
A 32-year-old woman with genu valgum recurvatum presented to clinic complaining of long-standing anterior knee pain. Radiographs demonstrated a 13° anterior tibial slope and 15° valgus malalignment. She underwent a single-stage 2-level osteotomy at the distal femur and proximal tibia to simultaneously correct genu valgum and recurvatum. This procedure achieved precise correction in both planes. At 1 year, the patient was pain-free and ambulated without restriction.

Conclusion:
This procedure should be considered among the available surgical options when treating genu valgum recurvatum because it produced excellent results for the studied patient.
Diagnosis Dilemma, Culture-Negative Periprosthetic Hip Infection Versus Acute Gouty Arthritis
Authors: Mika Aleksander , Gilbert William , Martin John Ryan , Polkowski Gregory 
Published: June 2023

Case:
We report the case of acute gouty arthritis mimicking infection in a 59-year-old woman who had an extensive history of periprosthetic joint infection (PJI) and multiple revisions. Initial laboratory testing, examination, and recency bias suggested recurrent PJI, but aspiration revealed an acute gout attack without superimposed infection. The patient’s examination and serological markers improved off antibiotics, and she subsequently avoided an unnecessary revision surgery.

Conclusion:
Although rare, acute gouty arthritis should be considered in every patient, and complete workup should be performed, regardless of infectious or rheumatologic history.
A SAT Solver + Computer Algebra Attack on the Minimum Kochen-Specker Problem
Authors: Li Zhengyu , Bright Curtis , Ganesh Vijay 
Published: June 2023

Abstract
One of the foundational results in quantum mechanics is the Kochen--Specker (KS) theorem, which states that any theory whose predictions agree with quantum mechanics must be contextual, i.e., a quantum observation cannot be understood as revealing a pre-existing value. The theorem hinges on the existence of a mathematical object called a KS vector system. While many KS vector systems are known to exist, the problem of finding the minimum KS vector system has remained stubbornly open for over 55 years, despite significant attempts by leading scientists and mathematicians. In this paper, we present a new method based on a combination of a SAT solver and a computer algebra system (CAS) to address this problem. Our approach improves the lower bound on the minimum number of vectors in a KS system from 22 to 24, and is about 35,000 times more efficient compared to the previous best computational methods. The increase in efficiency derives from the fact we are able to exploit the powerful combinatorial search-with-learning capabilities of a SAT solver together with the isomorph-free exhaustive generation methods of a CAS. The quest for the minimum KS vector system is motivated by myriad applications such as simplifying experimental tests of contextuality, zero-error classical communication, dimension witnessing, and the security of certain quantum cryptographic protocols. To the best of our knowledge, this is the first application of a novel SAT+CAS system to a problem in the realm of quantum foundations.
Barriers and facilitators of implementing electronic monitors to improve adherence and health outcomes in tuberculosis patients: Protocol for a systematic review based on the Consolidated Framework for Implementation Research
Authors: Li Wenhui , Su Min , Zhang Weile , Fan Xiaojing , Li Renzhong , Gao Yulong , Wei Xiaolin 
Published: June 2023

Abstract
Background
Tuberculosis (TB) has been regarded as “a relentless scourge” which considerably increases morbidity and mortality as well as bringing heavy burdens on the vulnerable populations. A novel approach to TB called “electronic monitors” seems promising as an intervention, improving adherence and health outcomes and overcoming the weaknesses of the traditional interventions. However, no review has systematically examined and synthesized the influencing factors of implementing electronic monitors. Implementation research offers the means to analyze the influencing factors of the implementation and its process, fitting well with the aim of this review. Therefore, framework-based implementation research will be adopted to systematically identify barriers and facilitators of the electronic monitors that aim to improve adherence and health outcomes in TB patients.
Methods and Analysis:
The systematic review will follow the PRISMA guidelines. Literature research will be conducted in five electronic databases (MEDLINE, CINAHL, EMBASE, Cochrane Library, and Web of Science) to identify the barriers and facilitators of implementing electronic monitors in TB patients. The Consolidated Framework for Implementation Research (CFIR) will be used as a guide for categorizing and synthesizing the barriers and facilitators. Study screening, data extraction, quality appraisal, and data analysis will be conducted by two independent reviewers. The use of additional reviewers will solve any disagreements between the two reviewers.
Discussion
Given the increased prominence of TB epidemiology and the adherence problem of electronic monitors, there is a solid rationale for synthesizing the existing studies via an implementation science framework (CFIR). The findings and conclusion of this review will lay bare the achievements and effectiveness of implementing electronic monitors, as well as the attendant gaps and limitations. Further strategies for facilitating the implementation of electronic monitors will also be explored. Information provided by the review will be of essential significance for research and practice, supporting future academic research initiatives centered on TB patients and aiding the design of electronic monitors in lowering the morbidity and mortality associated with TB disease.
Trial registration:
PROSPERO: CRD42023395747.
Quantifying Complex Urban Spillover Effects via Physics-based Deep Learning
Authors: Liu Tong , Fan Chao , Yabe Takahiro 
Published: June 2023

Abstract

Spillover effects are pervasive in a variety of natural, social, and physical environments, such as urban heat waves and human mobility dynamics. Quantifying spillover effects is crucial for understanding and predicting the complex processes that cascade through urban systems. Prior studies have relied on ad-hoc parameters and homogeneity assumptions in conventional physics of diffusion to capture spillover from immediate surroundings. These approaches, however, fall short of accounting for the spatial heterogeneity present in urban systems. Here, we introduce a novel physics-based deep learning model coupled with random diffusion, Deep Random Diffusion (DRD), that captures complex and nonlocal interactions by integrating observations from urban systems with the physics of diffusion derived from theoretical physics models. The proposed method, validated with natural and social system processes in five cities in the U.S., outperforms conventional models for all five cities. The experiments show that the spatial variances of complex natural environments and social systems are highly predictable at 60% − 86% by incorporating heterogenous spillovers. A general and consistent scale of spillover effects ranging from 0.7 to 1.2 km, is identified by the proposed model across cities, despite varying landscapes and geography. Integrating information from this scale of neighbors helps to reduce excessive reliance on individual variables in predictions, thereby preventing overestimation and underestimation at extreme values. The findings in this study not only untangle the complexity and improve the predictability of various urban phenomena but also provide transferrable new insights to inform effective solutions for adapting to urban stressors in different urban settings, such as extreme heat resulting from climate change.
Effect of the Enhancing Nutrition and Antenatal Infection Treatment (ENAT) intervention on birth weight in Ethiopia: A cluster randomized controlled trial
Authors: Mekonnen Y , Wolde E , Bekele A , Mehari Z , Abebe S , Hagos T , Tadesse Y , Taye T , Asire G , Nigatu T , Kumar S , Girma S , Salasibew M 
Published: June 2023

Abstract

BackgroundThe Enhancing Nutrition and Antenatal Infection Treatment (ENAT) intervention was implemented in Ethiopia to improve newborn birth weight by strengthening the contents and quality of antenatal care (ANC), especially point-of-care testing for maternal infections. This study examined the effect of the ENAT intervention on birth weight.MethodsWe conducted a cluster randomized controlled trial of 22 clusters (health centers), randomized equally between 11 intervention and 11 control clusters. This study enrolled and followed pregnant women from ANC booking to the end of pregnancy or loss to follow-up. The primary outcome of this study was mean birth weight, and the incidence of low birth weight (LBW) was the secondary outcome. We presented univariate comparisons of outcomes between the intervention and control arms using cluster-adjusted t tests for mean birth weight and cluster-weighted chi-square tests for LBW. Multilevel analyses using random effects models were performed to adjust for clustering and individual-level covariates.ResultsWe enrolled and followed up 4,868 and 4,821 pregnant women in the intervention and control arms, respectively, from March 2021-July 2022. During follow-up, 3445 and 3192 pregnant women delivered in the health centers, and birth weight measurements of their babies were recorded within 48 hours. The mean birth weight was 3,152 grams (standard deviation (SD) = 339.8 grams) in the intervention and 3,044 grams (SD = 353.8 grams) in the control arms (mean difference, 108 grams; 95% confidence interval (CI): 91.3-124.6; P = 0.000). Adjusting for clustering and several covariates, the mean birth weight remained significantly higher in the intervention arm than in the control arm (adjusted ß coef., 114.3; p = 0.011). The incidence of LBW was 4.7% and 7.3% in the intervention and control arms, respectively. The adjusted risk of LBW was significantly lower by 36% in the intervention arm than in the control arm (adjusted relative risk, 0.645; p = 0.027).ConclusionThis study provided sufficient evidence of the effectiveness of the ENAT intervention in improving birth weight in the study population. The intervention demonstrated that an increase in birth weight can be attained by availing point-of-care testing and strengthening infection prevention within the ANC platform of public health facilities in a low-income setting.Trial Registration:The study was retrospectively registered at Pan African Clinical Trial Registry (PACTR) database dated 09/05/2023. The unique identification number for the registry is PACTR202305694761480. The PACTR is the WHO recognized clinical trials registry in Africa. It can be accessed at https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25493.
Experimental and numerical investigation of compressive behaviour for SS316L bioinspired cores fabricated by powder bed fusion
Authors: Gunasegeran Muthukumaran , P Edwin Sudhagar , Barathan venugopal , Rajamohan vasudevan , Raja Haribaskar , T sampath kumar 
Published: June 2023

Abstract
Bio-inspired structures have been commonly used in robotics, aerospace, and bioengineering because of their extraordinary qualities. The present study investigates compressive behavior for bioinspired cores. The experimental compression behavior of the bioinspired cores is supported with numerical analysis. As bioinspired structures are complex in nature, it is difficult to fabricate with the conventional technique. powder bed fusion (PBF) is employed to overcome this difficulty. Further specific energy absorption due to the compression behavior of the bioinspired cores and residual stress induced during the manufacturing process is investigated in detail, and the best-performing bioinspired core is reported in this study.
Multivariate analyses of immune markers reveal increases in plasma EN-RAGE in first-episode psychosis patients
Authors: Korhonen Laura , Paul Elisabeth , Wåhlen Karin , Haring Liina , Vasar Eero , Vaheri Antti , Lindholm Dan 
Published: June 2023

Abstract
Immune cells and cytokines are largely recognized as significant factors in the pathophysiology of neuropsychiatric disorders. The possible role of other blood cells such as leukocytes in events of acute psychosis is in contrast only emerging. To study blood-born markers in acute psychosis we here evaluated plasma proteins inof drug-naïve first episode psychosis (FEP) patients and healthy controls using a multiplex proximity extension assay-technique. We analyzed a panel of 92 immune markers and plasma samples from 60 FEP patients and 50 controls, and evaluated the changes obtained using multivariate statistical methods followed by protein pathway analyses . Data showed that 11 proteins are significantly different between FEP patients and healthy controls We observed increases in pro-inflammatory proteins such as interleukin-6, oncostatin-M, and transforming growth factor-alpha in FEP patients compared with controls. Likewise, the EN-RAGE that regulates expression of various cytokines was also elevated in the plasma of FEP patients. The results indicate that neutrophil-derived EN-RAGE could play an important role during the early phase of acute psychosis by stimulating cytokines and the immune response targeting thereby likely also the brain vasculature.
Acoustic realization of projective mirror Chern insulators
Authors: Li Tianzi , Liu luohong , Zhang Qicheng , Qiu Chunyin 
Published: June 2023

Abstract
Symmetry plays a key role in classifying topological phases. Recent theory shows that in the presence of gauge fields, the algebraic structure of crystalline symmetries needs to be projectively represented, which enables unprecedented topological band physics. Here, by exploiting the concept of projective symmetry, we report an acoustic realization of mirror Chern insulators that are widely believed to be impossible in spinless systems. More specifically, we introduce a simple but universal recipe for constructing projective mirror symmetry, and conceive a minimal model for achieving the projective symmetry-enriched mirror Chern insulators. Based on our selective-excitation measurements, we demonstrate unambiguously the projective mirror eigenvalue-locked topological nature of the bulk states and associated chiral edge states. More importantly, we extract the non-abelian Berry curvature and identify the mirror Chern number directly, as conclusive experimental evidence for this exotic topological phase. All experimental results agree well with the theoretical predictions. Our findings will shine new light on the topological systems equipped with gauge fields.
Factors that influence evidence-informed meso-level regional primary health care planning: a qualitative examination and conceptual framework
Authors: Windle Alice , Javanparast Sara , Freeman Toby , Baum Fran 
Published: June 2023

Abstract
Background: While evidence-based clinical practice, and evidence-informed health policy-making have received much research attention, little is known about evidence-informed primary health care (PHC) planning in decentralised, meso-level regional organisations. In this paper we examine the factors that influence planning within this environment, and present a conceptual framework.
Methods: We employed a mixed methods approach: case studies of five Australian Primary Health Networks (PHNs), involving 29 primary interviews and secondary analysis of 38 prior interviews; and analysis of planning documents from all 31 PHNs. The analysis was informed by a WHO framework of evidence-informed policy-making, and institutional theory.
Results: We identified a broad range of actors and factors that influence evidence-informed PHC planning, at different levels of context: organisational/internal, regional, and national. The additional regional layer of context adds to the complexity of planning. Some distal factors influence more proximal factors, as well as directly influencing PHC planning, and some factors span the levels of context, but may be conflicting, such as ideology and values.
Conclusions: This research has identified a wide range of factors that influence evidence-informed meso-level PHC planning, acting at various levels of context. Like national health policy-making, meso-level PHC planning occurs in a complex environment, but with additional regional factors and influences. We have developed a conceptual framework of the meso-level PHC planning environment, which can be employed by similar regional organisations to elucidate influential factors and actors, and develop strategies and tools to promote transparent, evidence-informed PHC planning for better health outcomes.
Nature-Inspired Spider Web Shaped UHF RFID Reader Antenna for IoT and Healthcare Applications
Authors: Sharif Abubakar , kumar Rajesh , Arshad Kamran , Assleh Khalid , Chattha Hassan Tariq , Imran Muhammad , Abbasi Qammer hussain 
Published: June 2023

Abstract
This paper proposes a nature-inspired spider web-shaped ultra-high frequency (UHF) radio frequency identification (RFID) reader antenna and battery-free sensor-based system for healthcare applications. This antenna design consists of eight concentric decagons of different sizes and five straight microstrip lines that are connected to the ground using 50 Ω resistors from both ends except one microstrip line, which is left for connecting a feeding port. The reader antenna design features fairly strong and uniform electric and magnetic field characteristics. Likewise, it also poses wideband characteristics by covering whole UHF RFID band (860 – 960 MHz) and tag reading volume of 200 × 200 × 20 mm 3. Additionally, it has low gain characteristics, which are necessary for the majority of nearfield applications to prevent the misreading of other tags. Moreover, the symmetric current distribution throughout the structure in this design addresses the orientation sensitivity issues associated with low-cost linearly polarized tag antennas. The measurement results show that the reader antenna can read medicine pills tagged using low-cost passive/battery-free RFID tags, tagged expensive jewelry, intervenes solution, and blood bags positioned in various orientations. As a result, the proposed reader antenna-based system is a strong contender for near-field RFID, healthcare, and IoT applications.