bluuebunny/crossref_metadata_2025_split huggingface dataset:
RADIOLOGICAL CLASSIFICATION OF THE PELVIS: A TOOL FOR TRAUMA SURGICAL PLANNING
Authors: Lee S.L.K. , Lin J.L. , Lynch J. , Smith P. 
Published: February 2023

Dysmorphic pelves are a known risk factor for malpositioned iliosacral screws. Improved understanding of pelvic morphology will minimise the risk of screw misplacement, neurovascular injuries and failed fixation. Existing classifications for sacral anatomy are complex and impractical for clinical use. We propose a CT-based classification using variations in pelvic anatomy to predict the availability of transosseous corridors across the sacrum. The classification aims to refine surgical planning which may reduce the risk of surgical complications.The authors postulated 4 types of pelves. The “superior most point of the sacroiliac joint” (sSIJ) typically corresponds with the mid-lower half of the L5 vertebral body. Hence, “the anterior cortex of L5” (L5a) was divided to reference 3 distinct pelvic groups. A 4th group is required to represent pelves with a lumbosacral transitional vertebra. The proposed classification:A – sSIJ is above the midpoint of L5aB – sSIJ is between the midpoint and the lowest point of L5aC – sSIJ is below the lowest point of L5aD – pelves with a lumbosacral transitional vertebraSpecific measures such as the width of the S1 and S2 axial and coronal corridors and the S1 lateral mass angles were used to differentiate between pelvic types.Three-hundred pelvic CT scans were classified into their respective types. Analysis of the specific measures mentioned above illustrated the significant difference between each pelvic type. Changes in the size of S1 and S2 axial corridors formed a pattern that was unique for each pelvic type. The intra- and inter-observer ratings were 0.97 and 0.95 respectively.Distinct relationships between the sizes of S1 and S2 axial corridors informed our recommendations on trans-sacral or iliosacral fixation, number and orientation of screws for each pelvic type. This classification utilises variations in the posterior pelvic ring to offer a planning guide for the insertion of iliosacral screws.
USE OF 3D-PRINTED FRACTURE MODELS VERSUS SAWBONES FOR SURGICAL RESIDENT TRAINING: A FEASIBILITY STUDY
Authors: Thai T. 
Published: February 2023

Conventional fracture courses utilise prefabricated sawbones that are not realistic or patient specific. The aim of this study is to determine the feasibility of creating 3D fracture models and utilising them in fracture courses to teach surgical technique.We selected an AO type 2R3C2 fracture that underwent open reduction internal fixation. De-identified CT scan images were converted to a stereolithography (STL) format. This was then processed using Computer Aided Design (CAD) to create a virtual 3D model. The model was 3D printed using a combination of standard thermoplastic polymer (STP) and a porous filler to create a realistic cortical and cancellous bone. A case-based sawbone workshop was organised for residents, unaccredited registrars, and orthopaedic trainees comparing the fracture model with a prefabricated T-split distal radius fracture. Pre-operative images aided discussion of fixation, and post-operative x-rays allowed comparison between the participants fixation. Participants were provided with identical reduction tools. We created a questionnaire for participants to rate their satisfaction and experience using a Likert scale.The 3D printed fracture model aided understanding and appreciation of the fracture pattern and key fragments amongst residents and unaccredited trainees. Real case-based models provided a superior learning experience and environment to aid teaching. The generic sawbone provided easier drilling and inserting of screws. Preliminary results show that the cost of 3D printing can be comparable to generic sawbones.It is feasible to create a fracture model with a real bone feel. Further research and development is required to determine the optimum material to use for a more realistic feel.The use of 3D printed fracture models is feasible and provides an alternative to generic sawbone fracture models in providing surgical training to residents.
A PROSPECTIVE MULTICENTRE RANDOMIZED COMPARATIVE STUDY ASSESSING A NEW MORPHOMETRIC-DESIGNED STEM FOR TOTAL HIP ARTHROPLASTY: BENCHMARKING AGAINST AN ESTABLISHED COMPARATOR
Authors: Tran T. , Driessen B. , Yap V. , Ng D.J. , Khorshid O. , Wall S. , Yates P. , Prosser G. , Wilkinson M. , Hazratwala K. 
Published: February 2023

Clinical success of prostheses in joint arthroplasty is ultimately determined by survivorship and patient satisfaction. The purpose of this study was to compare (non-inferiority) a new morphometric designed stem for total hip arthroplasty (THA) against an established comparator.A prospective randomised multi-centre study of 144 primary cementless THA performed by nine experienced orthopaedic surgeons was completed (70 received a fully coated collarless tapered stem and 74 received a morphometric designed proximally coated tapered stem). PROMs and blood serum markers were assessed preoperatively and at intervals up to 2-years postoperatively. In addition, measures of femoral stem fit, fill and subsidence at 2-years post-operatively were measured from radiographs by three observers, with an intra-class correlation coefficient of 0.918. A mixed effects model was employed to compare the two prosthesis over the study period. A p-value <0.05 was considered statistically significant.Demographics, Dorr types and blood serum markers were similar between groups. Both stems demonstrated a significant improvement in PROMs between the pre- and post-operative measurements, with no difference at any timepoint (p > 0.05). The fully coated tapered collarless femoral stem had a non-significantly higher intra-operative femoral fracture rate (5.8% vs 1.4%, p = 0.24), with all patients treated with cable fixation and partial weight bearing. The mean subsidence at 2-years was 2.5mm +/− 2.3mm for the morphometric stem and 2.4mm +/− 1.8mm for the fully coated tapered collarless femoral stem (p = 0.879). There was one outlier in each group with increased subsidence (fully coated tapered collarless femoral stem 6.9mm, morphometric wedge stem 7.4mm), with both patients reporting thigh pain at 2 years.When compared with an established stem, the newer designed morphometric wedge stem performed well with comparable radiological and PROM outcomes at 2 year follow up. Continued follow-up is required for long term benchmarking.
FASTER IMPROVEMENT IN OUTCOME SCORES IN POSTERIOR-STABILIZED TOTAL KNEE ARTHROPLASTY COMPARED TO MEDIAL CONGRUENT SYSTEM WITH POSTERIOR CRUCIATE LIGAMENT RETAINED
Authors: Lee W.C. , Foong C.M.B. , Kunnasegaran R. 
Published: February 2023

Most studies comparing medial pivot to the posterior stabilised (PS) systems sacrifice the PCL. It is unknown whether retaining the PCL in the Medial Congruent (MC) system may provide further benefit compared to the more commonly used PS system.A retrospective review of a single-surgeon's registry data comparing 44 PS and 25 MC with PCL retained (MC-PCLR) TKAs was performed.Both groups had similar baseline demographics in terms of age, gender, body mass index, and American Society for Anaesthesiology score. There was no significant difference in their preoperative range of motion (ROM) (104º±20º vs. 102º±20º,p=0.80), Oxford Knee Score (OKS) (27±6 vs. 26±7,p=0.72), and Knee Society Scoring System (KS) Function Score (KS-FS) (52±24 vs. 56±24,p=0.62). The preoperative KS Knee Score (KS-KS) was significantly lower in the PS group (44±14 vs. 54 ± 18,p<0.05). At 3-months postoperation, the PS group had significantly better OKS (38±6 vs. 36±6,p=0.02) but similar ROM (111º±14º vs. 108º±12º,p=0.25), KS-FS (73±20 vs. 68±23, p=0.32) and KS-KS (87±10 vs. 86±9,p=0.26). At 12-months postoperation, both groups had similar ROM (115º±13º vs. 115º±11º,p=0.99), OKS (41±5 vs. 40±5,p=0.45), KS-FS (74±22vs.78±17,p=0.80), and KS-KS (89±10vs.89±11,p=0.75). There was statistically significant improvement in all parameters at 1-year postoperation (p<0.05). The PS group had significant improvement in all parameters from preoperation to 3-month postoperation (p<0.05), but not from 3-month to 1-year postoperation (p≥0.05). The MC-PCLR group continued to have significant improvement from 3-month to 1-year postoperation (p<0.05).The MC provides stability in the medial compartment while allowing a degree of freedom in the lateral compartment. Preserving the PCL when using MC may paradoxically cause an undesired additional restrain that slows the recovery process of the patients after TKA.In conclusion, compared to MC-PCLR, a PS TKA may expect significantly faster improvement at 3 months post operation, although they will achieve similar outcomes at 1-year post operation.
PATIENT-REPORTED OUTCOMES AND REVISION RATES AFTER PRIMARY ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITHOUT CONCOMITANT KNEE INJURY: A COMPARISON OF QUADRICEPS, HAMSTRING, AND BONE-PATELLA-TENDON-BONE AUTOGRAFTS WITH MINIMUM TWO-YEAR FOLLOW-UP
Authors: Zhou Y , Frampton C , Hirner M 
Published: February 2023

Most previous studies investigating autograft options (quadriceps, hamstring, bone-patella-tendon-bone) in primary anterior cruciate ligament (ACL) reconstruction are confounded by concomitant knee injuries. This study aims to investigate the differences in patient reported outcome measures and revision rates for quadriceps tendon in comparison with hamstring tendon and bone-patella-tendon-bone autografts. We use a cohort of patients who have had primary ACL reconstruction without concomitant knee injuries.All patients from the New Zealand ACL Registry who underwent a primary arthroscopic ACL reconstruction with minimum 2 year follow-up were considered for the study. Patients who had associated ipsilateral knee injuries, previous knee surgery, or open procedures were excluded. The primary outcome was Knee Injury and Osteoarthritis Outcome Score (KOOS) and MARX scores at 2 years post-surgery. Secondary outcomes were all-cause revision and time to revision with a total follow-up period of 8 years (time since inception of the registry).2581 patients were included in the study; 1917 hamstring tendon, 557 bone-patella-tendon-bone, and 107 quadriceps tendon. At 2 years, no significant difference in MARX scores were found between the three groups (2y mean score; 7.36 hamstring, 7.85 bone-patella-tendon-bone, 8.05 quadriceps, P = 0.195). Further, no significant difference in KOOS scores were found between the three groups; with the exception of hamstring performing better than bone-patella-tendon-bone in the KOOS sports and recreation sub-score (2y mean score; 79.2 hamstring, 73.9 bone-patella-tendon-bone, P < 0.001). Similar revision rates were reported between all autograft groups (mean revision rate per 100 component years; 1.05 hamstring, 0.80 bone-patella-tendon-bone, 1.68 quadriceps, P = 0.083). Autograft revision rates were independent of age and gender variables.Quadriceps tendon is a comparable autograft choice to the status quo for primary ACL reconstruction without concomitant knee injury. Further research is required to quantify the long-term outcomes for quadriceps tendon use.
SACRALIZAÇÃO DO CORPO, DA POESIA E DO EROTISMO EM ADÉLIA PRADO
Authors: Vieira Júnior Paulo Antônio , Pereira do Nascimento Mônica 
Published: February 2023

Este estudo desenvolve leitura de cinco poemas de Adélia Prado constantes em sua Poesia reunida: “Do amor”, “Enredo para um tema”, “Rute no campo”, “A maçã no escuro” e “Gregoriano”. Tais composições servem para evidenciar como a poesia adeliana elabora formulações constradiscursivas ao (re)estabelecer a harmonia entre corpo e alma, erótico e sagrado, logo, investiga-se o seu fazer poético na combinação do erotismo, da religiosidade e da sacralidade do corpo envolvido no rito de celebração do erotismo sagrado. Em Adélia Prado, o erótico emerge numa combinação crítica com o religioso, elucidado a partir da mística cristã, em confluente presença de elementos bíblicos e teológicos. A reconfiguração das visões tradicionais sobre o corpo feminino surge na obra da autora através da sacralização desse corpo. A reconciliação é uma estratégia revolucionária nas composições de Adélia, porque evita a violência que se situa como a característica central da ideologia patriarcal. O suporte teórico que orienta nossas leituras consiste nas obras de Octavio Paz (1982, 1994), Georges Bataille (1987), Elizabeth Grosz (2000), Michelle Perrot (2003) e Elódia Xavier (2021). No decorrer das análise recorremos, ainda, à fortuna crítica que explorou as categorias corpo, erotismo e sagrado, a exemplo de Angélica Soares (1999), Nelly Novaes Coelho (1993) e Rita de Cássia Olivieri (1994).
“COM LICENÇA POÉTICA”:
Authors: Gomes da Silva Mônica 
Published: February 2023

Este trabalho propõe a leitura comparativa entre as poesias de Adélia Prado, Ana Cristina César e Hilda Hilst, destacando como as escritoras dialogam com a tradição literária brasileira, especificamente, o legado poético de Carlos Drummond de Andrade. Conforme a constatação provocadora da poeta mineira — “Todos fazem um poema a Carlos Drummond de Andrade” (PRADO, 2014, p. 56) — explicita-se a primazia da poética drummondiana na literatura brasileira do século XX, fundando, com sua inquietude gauche, uma forte marca temática e estilística. Ressaltamos, na análise do corpus, os significados atribuídos, pela escrita feminina, à poética pétrea drummondiana, com o auxílio da clave interpretativa de Gaston Bachelard (2008), cujos estudos abordam os arquétipos sublimados nas imagens literárias da terra. Dentre as imagens psíquicas abordadas por Bachelard, voltamo-nos para os valores carreados pela representação da pedra no imaginário literário. Para o percurso de leitura desenvolvido são utilizados, ademais, os estudos de Antonio Candido (2011), Maria Lúcia de Barros Camargo (1990), Marlene de Castro Correia (2012), Nelly Novaes Coelho (1999) e Paulo Franchetti (2007). Desse modo, selecionamos um corpus poético em que a incontornável pedra drummondiana é ressignificada pelas escritoras que, tensionando com a máquina poética do poeta itabirano e se utilizando de distintas estratégias, desde a emulação, o pastiche até a paródia, buscam instaurar suas vozes autorais, contemplando as questões do feminino e da própria criação artística na literatura brasileira.
Palavras-chave: Autoria feminina; Pedra; Poética; Intertextualidade.
EXPANSÃO DA LINGUAGEM NA POESIA DE ALBERTO PUCHEU
Authors: Macedo Taise Teles Santana , Hoisel Evelina de Carvalho Sá 
Published: February 2023

Em tempos coevos, a poesia brasileira contemporânea mostra-se em plena produtividade, ampliando tanto o corpus de escritores e escritoras que desejam deixar suas intervenções no/para nosso tempo quanto a inclusão de novos meios e suportes que permitem a circulação e a disseminação dos textos poéticos. Um desses poetas em atividade é o professor Alberto Pucheu. No conjunto de suas obras – de 1993 até o presente instante – Pucheu tem se preocupado, principalmente, em mostrar a potência do pensamento da poesia e a sua dimensão filosófico-política. Pela leitura dos escritos de Pucheu, compreende-se que o poeta é o sujeito que mantém relação com o outro - seres, objetos, pessoas – no intuito de convocá-los para estabelecer contatos, esbarros, alianças. Parte-se do seguinte entendimento: a linguagem poética abre-se, nesse vir a ser, para o impróprio, para a possibilidade de novos sensíveis, novas proposições do existir. Para tal análise, o presente estudo toma como ponto de partida textos poéticos-literários, direcionados pelo eixo temático proposto. Nessa perspectiva, este trabalho problematiza, a partir de poemas de Pucheu, a linguagem enquanto instauradora de vidas que são planejadas para serem extintas, esquecidas, apagadas. Cabe, ainda, destacar que o estímulo que movimenta o desenvolvimento desta investigação se deve à oportunidade de percorrer escolhas, estratégias poéticas e procedimentos de escrita da poesia, bem como da apreensão de que a poesia sempre está em processo de feitura. Nesse bojo, a poesia condiciona-se a negar-se, recusar-se ou suprimir-se para se situar como tal. Sendo assim, a própria noção de poesia se pluraliza.
Implementation of postpartum navigation for low-income individuals at an urban academic medical center
Authors: Green Hannah M. , Carmona-Barrera Viridiana , Diaz Laura , Yeh Chen , Williams Brittney , Davis Ka’Derricka , Kominiarek Michelle A. , Feinglass Joe , Grobman William A. , Zera Chloe , Yee Lynn M. 
Published: February 2023

BackgroundPatient navigation, a patient-centered intervention to promote comprehensive health care, is an emerging innovation in obstetrics to optimize postpartum care. We aimed to evaluate the implementation of a novel postpartum patient navigation program at an urban academic medical center.MethodsThis mixed-methods study analyzed the implementation of a postpartum patient navigation program within an ongoing randomized control trial. This study analyzed three navigators’ logs of interactions with 50 patients, care team members, and community organizations throughout patients’ first year postpartum. We categorized and quantified interactions by topic addressed, care team member interacted with, and communication mode used. We also conducted semi-structured interviews with each navigator every three months (5 interviews per navigator), emphasizing navigation experiences, relationships with patients and care teams, integration in the care team, and healthcare system gaps. Interview data were analyzed using the constant comparative method to identify themes using the constructs of the Consolidated Framework for Implementation Research (CFIR).ResultsAnalysis of navigator logs revealed a high patient need level, especially in the first 3 months postpartum. CFIR-guided analysis of intervention characteristics revealed positive perceptions of navigation’s utility due to its adaptability. Navigation’s complexity, however, posed an early obstacle to implementation that diminished over time. Outer setting analysis indicated navigators addressed patient needs through interactions with multiple systems. Despite clinicians’ initial unfamiliarity with navigation, inner setting analysis suggested ongoing communication and electronic medical record use facilitated integration into the care team. Regarding individual and process characteristics, findings emphasized how navigator self-efficacy and confidence increased with experience (individual) and was facilitated by comprehensive training and reflection (process). Overall, barriers to implementation included unfamiliarity, varied patient engagement, and innovation complexity. Facilitators included high patient need, communication with outside organizations, medical record usage, navigator characteristics (self-efficacy, communication skills, and personal growth), a comprehensive training period, consistent reflection, high relative advantage, and high adaptability to patient need.ConclusionPatient navigation is a promising innovation to improve postpartum care coordination and support care team efforts. The successful implementation of navigation in this study indicates that, if shown to improve patient outcomes, obstetric navigation could be a component of patient-centered postpartum care.
Smoke-free status of homes and workplaces among Indian people: Evidence from Global Adult Tobacco SurveyData-2016/2017
Authors: Ali Mohammad , Khatun Most. Farida , Yasmin Tasnuva , Talukder Ashis , Maniruzzaman Md. , Alauddin Sharlene 
Published: February 2023

Aims
This study aimed to determine the impact of correlates on tobacco control/smoke-free status of homes and workplace among Indian people. To assess the magnitude of the problem, the relationship between smoke-free status and secondhand smoke (SHS) exposure was also explored.

Methods
Data was extracted from the Global Adult Tobacco Survey Data (GATS)-2017. It was a household survey that included people aged 15 years or older and covered all 30 states and 2 Union Territories (UTs) of India. A logistic regression model was used to determine the correlates of smoke-free status of homes and workplaces. Additionally, the Pearson correlation was used to explore the relationship between smoke-free status and the proportion of participants exposed to SHS both at homes and in the workplaces.

Results
The overall prevalence of smoke-free status in the home and workplace was 62.8% and 51.7%, respectively. Results of multivariate analysis (Logistic regression) illustrated that indicators like tobacco smoking status, place of residence, region, education, occupation, wealth quintile, and knowledge status about children’s illness were significantly associated with the respondent’s intention to live in a completely smoke-free environment both at home and in the workplace in India. This study revealed that SHS exposure was significantly negatively associated with a smoke-free status.

Conclusion
This study will help the policymakers to promote efficient policies for improving smoke-free status and to ensure a better environment both at home and in the workplace in India.
Radiation therapists’ perceptions of thermoplastic mask use for head and neck cancer patients undergoing radiotherapy at Ocean Road Cancer Institute in Tanzania: A qualitative study
Authors: Yoram Furahini , Dharsee Nazima , Mkoka Dickson Ally , Maunda Khamza , Kisukari Jumaa Dachi 
Published: February 2023

Introduction
A thermoplastic mask is the most widely used immobilization device for head and neck cancer patients undergoing radiotherapy. The radiation therapist is the staff responsible to prepare these masks and set-up the patients for treatment, a procedure that requires time, patience, and precision. An understanding of Radiation therapists’ perceptions regarding thermoplastic mask use will help design interventions to address challenges encountered in its use. This study explored Radiation therapists’ perceptions of thermoplastic mask use for head and neck cancer patients undergoing radiotherapy at Ocean Road Cancer Institute in Tanzania.

Material and methods
An exploratory qualitative study design was used to explore thermoplastic mask use for head and neck cancer patients undergoing radiotherapy. Semi-structured in-depth interviews were conducted, involving fifteen Radiation therapists from Ocean Road Cancer Institute in Tanzania between March and May 2021. A thematic analysis method was used to identify themes from data scripts.

Results
Four themes emerged that reflected radiation therapists’ perceptions of thermoplastic mask use for head and neck cancer immobilization among patients undergoing radiotherapy. Emerged themes were (1) Perceived benefits and limitations of thermoplastic mask use, (2) Refresher training and supervision requirements for effective use, (3) Proper storage for quality maintenance, and (4) Increased financial support and proper budgeting.

Conclusion
Participants perceived better patient immobilization with a thermoplastic mask use. However, too often recycling of thermoplastic masks and the long waiting time between thermoplastic mask preparation and treatment delivery limits their effective use. For efficient use of thermoplastic masks, there is a need for Radiation therapists’ refresher training and proper supervision, improving the storage system and increasing financial support for procuring new thermoplastic masks.