bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIFFERENCES IN MORTALITY AND COMPLICATION RATES FOLLOWING REVISION KNEE ARTHROPLASTY PERFORMED FOR URGENT VERSUS ELECTIVE INDICATIONS
Authors: Abram S. , Sabah S. , Alvand A. , Price A. 
Published: July 2023

Revision knee arthroplasty is a complex procedure with the number and cost of knee revision procedures performed per year expected to rise. Few studies have examined adverse events following revision arthroplasty.The objective of this study was to determine rates of serious adverse events in patients undergoing revision knee arthroplasty with consideration of the indication for revision (urgent versus elective indications) and to compare these with primary arthroplasty and re-revision arthroplasty.Patients undergoing primary knee arthroplasty were identified in the UK Hospital Episode Statistics. Subsequent revision and re-revision arthroplasty procedures in the same patients and same knee were identified. The primary outcome was 90-day mortality and a logistic regression model was used to investigate factors associated with 90-day mortality and secondary adverse outcomes including infection (undergoing surgery), pulmonary embolism, myocardial infarction, stroke. Urgent indications for revision arthroplasty were defined as infection or fracture, and all other indications were included in the elective indications cohort.939,021 primary knee arthroplasty cases were included of which 40,854 underwent subsequent revision arthroplasty, and 9,100 underwent re-revision arthroplasty. Revision surgery for elective indications was associated with a 90-day rate of mortality of 0.44% (135/30,826; 95% CI 0.37-0.52) which was comparable to primary knee arthroplasty (0.46%; 4,292/939,021; 95% CI 0.44-0.47). Revision arthroplasty for infection, however, was associated with a much higher mortality of 2.04% (184/9037; 95% CI 1.75-2.35; odds ratio [OR] 3.54; 95% CI 2.81-4.46), as was revision for periprosthetic fracture at 5.25% (52/991; 95% CI 3.94-6.82; OR 6.23; 95% CI 4.39-8.85). Higher rates of pulmonary embolism, myocardial infarction, and stroke were also observed in the infection and fracture cohort.These findings highlight the burden of complications associated with revision knee arthroplasty. They will inform shared decision-making for patients considering revision knee arthroplasty for elective indications. Patients presenting with infection of a knee arthroplasty or a periprosthetic fracture are at very high risk of adverse events. It is important that acute hospital services and tertiary referral centres caring for these patients are appropriately supported to ensure appropriate urgency and an anticipation for increased care requirements.
AUTOLOGOUS CHONDROCYTE IMPLANTATION: MULTILEVEL MODELLING OF 20-YEAR LONGITUDINAL OUTCOME DATA
Authors: Tierney L. , Kuiper J.H. , Williams M. , Roberts S. , Harrison P. , Gallacher P. , Jermin P. , Snow M. , Wright K. 
Published: July 2023

The objectives of the study were to investigate demographic, injury and surgery/treatment-associated factors that could influence clinical outcome, following Autologous Chondrocyte Implantation (ACI) in a large, “real-world”, 20 year longitudinally collected clinical data set.Multilevel modelling was conducted using R and 363 ACI procedures were suitable for model inclusion. All longitudinal post-operative Lysholm scores collected after ACI treatment and before a second procedure (such as knee arthroplasty but excluding minor procedures such as arthroscopy) were included. Any patients requiring a bone graft at the time of ACI were excluded. Potential predictors of ACI outcome explored were age at the time of ACI, gender, smoker status, pre-operative Lysholm score, time from surgery, defect location, number of defects, patch type, previous operations, undergoing parallel procedure(s) at the time of ACI, cell count prior to implantation and cell passage number.The best fit model demonstrated that for every yearly increase in age at the time of surgery, Lysholm scores decreased by 0.2 at 1-year post-surgery. Additionally, for every point increase in pre-operative Lysholm score, post-operative Lysholm score at 1 year increased by 0.5. The number of cells implanted also impacted on Lysholm score at 1-year post-op with every point increase in log cell number resulting in a 5.3 lower score. In addition, those patients with a defect on the lateral femoral condyle (LFC), had on average Lysholm scores that were 6.3 points higher one year after surgery compared to medial femoral condyle (MFC) defects. Defect grade and location was shown to affect long term Lysholm scores, those with grade 3 and patella defects having on average higher scores compared to patients with grade 4 or trochlea defects.Some of the predictors identified agree with previous reports, particularly that increased age, poorer pre-operative function and worse defect grades predicted poorer outcomes. Other findings were more novel, such as that a lower cell number implanted and that LFC defects were predicted to have higher Lysholm scores at 1 year and that patella lesions are associated with improved long-term outcomes cf. trochlea lesions.
A SIMULATION-BASED APPROACH FOR KINEMATICS EVALUATION AND WORST-CASE DETERMINATION IN HIGHLY DEMANDING ACTIVITIES KNEE WEAR TESTING
Authors: Maas A. , Puente Reyna A.L. , Grupp T.M. 
Published: July 2023

Aim of this study was the development of a dynamic FE-framework to identify worst-case size combinations and kinematics in a virtual wear simulator setup covering five daily activities and high, dynamic loads.Two cruciate sacrificing knee designs (D1 & D2) were tested physically on a wear-testing machine prior the model development using a high demanding, daily activity protocol (HDA) [1]. A simplified FE-setup was generated, reduced to the 3D geometries of the assembly whereas the representation of the mechanical wear simulator conditions and the load transmission was achieved by joint elements. Inertial and other time-related effects of the physical situation were compensated by a system of spring- and damper elements.Using a time-series signal optimization approach on the anterior-posterior translation and the internal-external rotation results for each activity, 38 variable parameters were varied in between pre-defined limits in a semiautomatic workflow. For each design, two consecutive cycles of a single activity were analysed and the results of the second cycle were used for the optimization. Based on the determined values, a single set of averaged parameter settings was identified that covers all activity cycles sufficiently.A total of 1010 dynamic analyses were carried out in order to find a sharable set of parameter values.In this study, an efficient simulation workflow for design evaluation was developed. Therefore, a HDA wear-testing machine was simplified to boundary conditions and stabilizing elements, using a single set of parameters for all activities. The calculated kinematics were in a comparable range to the machine output. Further applications of the method were found in systematic analyses of entire implant systems to achieve consistent kinematics over the size compatibility range in the design process of new implant systems.
NATURAL ACETABULAR DEVELOPMENT IN CHILDHOOD AMONG SAUDI POPULATION
Authors: Aljuaid M. , Alzahrani S. , Shurbaji S. 
Published: July 2023

Acetabular morphology and orientation differs from ethnic group to another. Thus, investigating the natural history of the parameters that are used to assess both was a matter of essence. Nevertheless, clarification the picture of normal value in our society was the main aim of this study. However, Acetabular head index (AHI) and center edge angle (CEA) were the most sensitive indicative parameters for acetabular dysplasia. Hence, they were the main variables used in evaluation of acetabular development.A cross-sectional retrospective study that had been done in a tertiary center. Computed tomography abdomen scouts’ radiographs of non-orthopedics patients were included. They had no history of pelvic or hips’ related symptoms or fractures in femur or pelvis. Images’ reports were reviewed to exclude those with tumors in the femur or pelvic bones.A total of 81 patients was included with 51% of them were males. The mean of age was 10.38± 3.96. CEA was measured using Wiberg technique, means of CEA were 33.71±6.53 and 36.50±7.39 for males and females, respectively. Nonetheless, AHI means were 83.81±6.10 and 84.66±4.17 for males and females, respectively. On the other hand, CEA was increasing by a factor 0.26 for each year (3-18, range). In addition, positive significant correlation was detected between CEA and age as found by linear regression r 2 0.460 (f(df1,79) =21.232, P ≤0.0001). Also, Body mass index (BMI) was positively correlated with CEA r 0.410, P 0.004).This study shows that obesity and aging are linked to increased CEA. Each ethnic group has its own normal values that must be studied to avoid premature diagnosis.
A NOVEL THREE-STITCH TECHNIQUE FOR ANTEGRADE HUMERUS NAILING IN OPEN DIAPHYSEAL FRACTURES
Authors: Kale S. , Singh S. , Dhar S. 
Published: July 2023

To evaluate the functional outcome of open humerus diaphyseal fractures treated with the Three-stitch technique of antegrade humerus nailing.This is a retrospective study conducted at the Department of Orthopaedics in D. Y. Patil University, School of Medicine, Navi Mumbai, India. The study included 25 patients who were operated on from January 2019 to April 2021 and follow-ups done till May 2022. Inclusion criteria were adult patients with open humerus diaphyseal fractures (Gustilo-Anderson Classification). All patients with closed fractures, skeletally immature patients, and patients with associated head injury were excluded from the study. All patients were operated on with a minimally invasive Three-stitch technique for antegrade humerus nailing. All patients were evaluated based on DASH score.Out of the 25 patients included in the study, all patients showed complete union. The mean age of the patients was 40.4 years (range 23–66 years). The average period for consolidation of fracture was 10.56 weeks (range 8–14 weeks). The DASH score ranged from 0 to 15.8 with an average score of 2.96. Five patients reported complications with three patients of post-operative infection and delayed wound healing and two patients with screw loosening. All complications were resolved with proper wound care and the complete union was noted. None of the patients had an iatrogenic neurovascular injury.Three-stitch antegrade nailing technique is a novel method to treat diaphyseal humerus fractures and provides excellent results. It has various advantages such as minimal invasiveness, minimal injury to the rotator cuff, fewer infection rates, minimal iatrogenic injuries, and good functional outcomes. Therefore, this treatment modality can be effectively used for open humerus diaphyseal fractures.
The revolution of values and the crisis of liberal democracy
Authors: Whitham Ben 
Published: July 2023

One domain of global political economy (GPE) that warrants more serious scholarly attention is the plane of what Jessop (2010) calls ‘cultural political economy’ (CPE). This article connects GPE and CPE, through an exploration of the production and exchange of meaning (semiosis) in the global politics of ‘values’. The point of departure for this exploration is a series of overlapping crises in GPE. From the Great Recession to the global COVID-19 pandemic, these crises are often associated with the rise of dangerous new reactionary forces. Conspiracist far-right and increasingly authoritarian centre-right movements continue their ascendancy. Meanwhile, a (neo)liberal self-proclaimed ‘centre’ decries this ‘rise of populisms’, lamenting a perceived backlash against liberal democracy itself.
This article offers a novel reading of the present conjunctural crisis, through the cultural theory of bell hooks. Specifically, hooks’ ([1984] 2000) identification of ‘white supremacist capitalist patriarchy’ as the real Western social model, her analyses of the political-economic crises of the 1990s and her development of Martin Luther King’s notion of a ‘revolution of values’ are all crucial to explaining the present crisis, and exploring the potential of progressive politics today. Reframing ‘liberal democracy’ as white supremacist capitalist patriarchy, it is argued, enables a number of further insights. In particular, this analysis allows us to understand our present moment as a confrontation between truly progressive values – including anti-racist, anti-capitalist and feminist values – and what turn out to be the shared regressive and reactionary values of (neo)liberalism and the far right. The aim of the article is to show, in the terms of Stuart Hall’s Gramscian analysis, ‘how different forces come together, conjuncturally, to create the new terrain, on which a different politics must form up’ (Hall, 1987: 16).
Abortion assistance fund staff and volunteers as patient navigators following an abortion ban in Texas
Authors: White Kari , Leyser‐Whalen Ophra , Whitfield Brooke , Dane'el Asha , Andrea Alexis , Rupani Anna , Kumar Bhavik , Moayedi Ghazaleh 
Published: July 2023

AbstractContextAbortion assistance funds constitute an important part of the healthcare safety net by covering some of abortion patients' out‐of‐pocket costs. Few studies have examined the other ways abortion assistance fund staff and volunteers support callers who need help obtaining care.MethodsBetween June and September 2020, we conducted in‐depth interviews with 23 staff and volunteers at 11 local abortion assistance funds that helped Texans seeking abortion care following a March 2020 state executive order that prohibited most abortions. Interviewers explored respondents' experiences with callers whose appointments had been canceled or who traveled out of state and subsequent operational changes. We used both inductive and deductive codes in the thematic analysis.ResultsAbortion assistance fund staff and volunteers bridged callers' information gaps about the services and financial resources available and helped create plans to secure care that accounted for callers' specific needs. They provided emotional support so callers felt it was possible to overcome logistical hurdles to get an abortion, even if that required out‐of‐state travel. Respondents described greater collaboration between Texas‐based abortion assistance funds and out‐of‐state organizations to support callers' more complex logistical needs and increased costs. Some callers who encountered multiple barriers to care, including interpersonal violence, were unable to obtain an abortion, even with additional supports.ConclusionsLocal abortion assistance funds worked with Texas callers to co‐create person‐centered plans for care and expanded inter‐organization collaborations. Initiatives that bolster local assistance funds' infrastructure and capacity will be needed as the abortion access landscape becomes further restricted and complex.
Genomic alterations involved in fluoroquinolone resistance development in Staphylococcus aureus
Authors: Huynh Thuc Quyen , Tran Van Nhi , Thai Van Chi , Nguyen Hoang An , Nguyen Ngoc Thuy Giang , Tran Minh Khang , Nguyen Thi Phuong Truc , Le Cat Anh , Ho Le Thanh Ngan , Surian Navenaah Udaya , Chen Swaine , Nguyen Thi Thu Hoai 
Published: July 2023

Aim
Fluoroquinolone (FQ) is a potent antibiotic class. However, resistance to this class emerges quickly which hinders its application. In this study, mechanisms leading to the emergence of multidrug-resistant (MDR) Staphylococcus aureus (S. aureus) strains under FQ exposure were investigated.

Methodology
S. aureus ATCC 29213 was serially exposed to ciprofloxacin (CIP), ofloxacin (OFL), or levofloxacin (LEV) at sub-minimum inhibitory concentrations (sub-MICs) for 12 days to obtain S. aureus -1 strains and antibiotic-free cultured for another 10 days to obtain S. aureus-2 strains. The whole genome (WGS) and target sequencing were applied to analyze genomic alterations; and RT-qPCR was used to access the expressions of efflux-related genes, alternative sigma factors, and genes involved in FQ resistance.

Results
A strong and irreversible increase of MICs was observed in all applied FQs (32 to 128 times) in all S. aureus-1 and remained 16 to 32 times in all S. aureus-2. WGS indicated 10 noticeable mutations occurring in all FQ-exposed S. aureus including 2 insdel mutations in SACOL0573 and rimI; a synonymous mutation in hslO; and 7 missense mutations located in an untranslated region. GrlA, was found mutated (R570H) in all S. aureus-1 and -2. Genes encoding for efflux pumps and their regulator (norA, norB, norC, and mgrA); alternative sigma factors (sigB and sigS); acetyltransferase (rimI); methicillin resistance (fmtB); and hypothetical protein BJI72_0645 were overexpressed in FQ-exposed strains.

Conclusion
The emergence of MDR S. aureus was associated with the mutations in the FQ-target sequences and the overexpression of efflux pump systems and their regulators.
Different levels of hypoglycemia in patients with type 2 diabetes, their achieved mean HbA1c vs. all-cause and cardiovascular mortality
Authors: Ooi Seng-Wei , Yeh Shu-Tin , Chang Ya-Hui , Li Chung-Yi , Chen Hua-Fen 
Published: July 2023

Aim
In patients with type 2 diabetes (T2D), levels of hypoglycemia and their risk of mortality are not well understood. The aim of this study was to ascertain the correlation among disparate levels of hypoglycemia and patients with T2D’s achieved mean glycated hemoglobin A1c (HbA1c) with all-cause and cardiovascular mortality.

Methods
27,932 T2D patients taking hypoglycemic medications at outpatient visits for more than 6 months between 2008 and 2018 were linked to Taiwan’s National Death Registry. We determined the respective mortality rates with Poisson assumption, and explored the relative risks of all-cause and cardiovascular mortality according to dissimilar levels of hypoglycemia with their achieved mean HbA1c by Cox proportional hazard regression model with adjustment of potential confounders.

Results
T2D patients with level 3 hypoglycemia had the highest rates of all-cause and cardiovascular mortality. Compared with those who never encountered hypoglycemia, study subjects with level 1 and level 2 hypoglycemia did not show excessive risks of either all-cause or cardiovascular mortality. Only those with level 3 hypoglycemia revealed marginal risk of all-cause (Hazard ratio [HR]: 1.18; 95% Confidence Interval [CI] 1.04–1.33) but not cardiovascular mortality (HR: 1.16; 95% CI 0.88–1.53). In T2D patients with hypoglycemia, only those with mean HbA1c ≥9.0% increased all-cause mortality in level 3 hypoglycemia, and cardiovascular mortality in level 1 hypoglycemia.

Conclusions
Elevated risk of all-cause mortality was exclusively found in patients with level 3 hypoglycemia. In T2D patients with hypoglycemia, mean HbA1c ≥ 9% increased all-cause or cardiovascular mortality. Aggressive treatment of accompanying serious illness in severe hypoglycemia may help reduce mortality in patients with T2DM.
Transparency of COVID-19-related research: A meta-research study
Authors: Sofi-Mahmudi Ahmad , Raittio Eero , Uribe Sergio E. 
Published: July 2023

Background
We aimed to assess the adherence to five transparency practices (data availability, code availability, protocol registration and conflicts of interest (COI), and funding disclosures) from open access Coronavirus disease 2019 (COVID-19) related articles.

Methods
We searched and exported all open access COVID-19-related articles from PubMed-indexed journals in the Europe PubMed Central database published from January 2020 to June 9, 2022. With a validated and automated tool, we detected transparent practices of three paper types: research articles, randomized controlled trials (RCTs), and reviews. Basic journal- and article-related information were retrieved from the database. We used R for the descriptive analyses.

Results
The total number of articles was 258,678, of which we were able to retrieve full texts of 186,157 (72%) articles from the database Over half of the papers (55.7%, n = 103,732) were research articles, 10.9% (n = 20,229) were review articles, and less than one percent (n = 1,202) were RCTs. Approximately nine-tenths of articles (in all three paper types) had a statement to disclose COI. Funding disclosure (83.9%, confidence interval (CI): 81.7–85.8 95%) and protocol registration (53.5%, 95% CI: 50.7–56.3) were more frequent in RCTs than in reviews or research articles. Reviews shared data (2.5%, 95% CI: 2.3–2.8) and code (0.4%, 95% CI: 0.4–0.5) less frequently than RCTs or research articles. Articles published in 2022 had the highest adherence to all five transparency practices. Most of the reviews (62%) and research articles (58%) adhered to two transparency practices, whereas almost half of the RCTs (47%) adhered to three practices. There were journal- and publisher-related differences in all five practices, and articles that did not adhere to transparency practices were more likely published in lowest impact journals and were less likely cited.

Conclusion
While most articles were freely available and had a COI disclosure, adherence to other transparent practices was far from acceptable. A much stronger commitment to open science practices, particularly to protocol registration, data and code sharing, is needed from all stakeholders.
Factors influencing the severity of COVID-19 course for patients with diabetes mellitus in tashkent: a retrospective cohort study
Authors: Alieva A. V. , Djalilov A. A. , Khaydarova F. A. , Alimov A. V. , Khalilova D. Z. , Talenova V. A. , Alimova N. U. , Aripova M. D. , Sadikova A. S. 
Published: July 2023

BACKGROUND: Since the very first outbreak, scientists have been trying to determine the most critical pathogenetic mechanisms for the development of COVID-19 and related complications, analyze individual subpopulations of patients with chronic diseases and develop optimal tactics to combat not only the infection itself but also its acute and chronic complications.AIM: to assess the COVID-19 course among patients with Type 1 and Type 2 DM.MATERIALS AND METHODS: A retrospective cohort study of Tashkent inhabitants, who had COVID-19 from April to D ecember 2020, was performed. The data were obtained from the single electronic database of registered cases of COVID-19. All data were analyzed using a logistic regression in STATA 17.0 software. Further, the matched case-control study was performed for patients with type 2 DM and no DM based on age, gender, and BMI.RESULTS: Of the 5023 analyzed subjects, 72.63% had no diabetes mellitus (DM), 4.24% had type 1 DM, 15.19% had type 2 DM, and 7.94% was diagnosed with DM during the COVID-19 infection. DM, overweight, and obesity were associated with severe COVID-19; the most significant risk of a severe course was found in persons with type 2 DM. The risk of a lethal outcome and the need for prescription of glucocorticoids did not show a significant association with diabetes in Tashkent. The clinical features of COVID-19 were more common in patients with type 2 DM, especially for shortness of breath, chest pain, and arrhythmia. The persons receiving SU have complained of dyspnea significantly more often than matched patients without DM. Metformin and DPP4i were the groups of drugs that were not associated with significantly increased risk of hospitalization of patients because of COVID-19. The matched case-control study did not reveal statistically significant differences in the disease course severity, need for hospitalization and glucocorticoids, and death depending on the glucose-lowering therapy preceding the onset of COVID-19.CONCLUSION: Diabetes, age and overweight/obesity were associated with severe course of COVID-19 in Tashkent. There was no statistical difference in COVID-19 severity depending on initial glucose-lowering therapy.