bluuebunny/crossref_metadata_2025_split huggingface dataset:
AWARENESS OF THE POPULATION ABOUT CARDIOVASCULAR FACTORS OF THE DEVELOPMENT OF DISEASES AS A RESULT OF THE APPLICATION OF A POPULATION STRATEGY
Authors: Fedotkina Svetlana A. , Khugaeva Elsa V. 
Published: August 2023

At the state level, measures have been carried out in different years to form a sustainable understanding of the importance of health as a personal value by the population. This is due to the global strategic interests of the Russian Federation in preserving and strengthening the health of the population.
In our study, the awareness of working-age patients of primary health care about the risk factors for the development of cardiovascular diseases and their frequency of occurrence was analyzed, taking into account the standardization of statistical indicators for 5 years (2014-2018) in the office of prevention of hypertension.
Materials and methods. The study was conducted on the basis of urban clinics of the Krasnoselsky district of St. Petersburg in two stages. At the first stage, a sociological survey was conducted using a specially designed questionnaire. At the second stage, an analysis of 807 cases of patients aged 18 to 65 years in the office of prevention of arterial hypertension was carried out.
As a result of the sociological survey, respondents among both men and women are well informed about the influence of a number of behavioral risk factors on the occurrence and development of cardiovascular diseases.
Conclusion. There is a high awareness of risk factors for the development of non-communicable diseases, including cardiovascular diseases, in patients of working age, which is a positive result of the implementation of a population and high-risk strategy.
But there are significant reserves for improving behavior for those who are ready to change it in favor of choosing a healthy lifestyle.
Within the framework of primary health care, medical examinations and preventive medical examinations are aimed at increasing the awareness of the population about risk factors for the development of non-communicable, including cardiovascular diseases through medical consultations. The work of Health Centers, prevention offices, Health Schools should be aimed at low-informed patients, examine and determine the functional reserves of their body with the possibility of subsequent correction of the identified disorders.
In our work, low awareness was noted in 13% of respondents. Low awareness of patients creates a high risk of unfavorable outcomes of diseases. If the patient understands the essence of his illness and the importance of following the doctor’s recommendations, then the situation may change for the better.
AFFECTIVE DISORDERS IN WOMEN WITH ARTERIAL HYPERTENSION IN COMBINATION WITH METABOLIC SYNDROME
Authors: Yaskevich Roman A. , Moskalenko Olga L. 
Published: August 2023

Purpose. To study the features of affective disorders in women with comorbid chronic ischemic heart disease with metabolic syndrome.
Materials and methods. The study was performed with the participation of 160 female patients diagnosed with chronic ischemic heart disease. Metabolic syndrome verification was carried out using the clinical recommendations of the All-Russian Scientific Society of Cardiology (2009). Identification of the presence of anxiety-depressive states and assessment of their severity was carried out using The Hospital Anxiety and Depression scale.
Results. The study showed that 50,9% of the surveyed women with a combination of chronic ischemic heart disease and metabolic syndrome had elevated levels of anxiety. Anxiety disorders of a subclinically pronounced nature were found in 31,1% of the surveyed in this group, and clinically pronounced in 19,6%. Elevated levels of depression were detected in 35,7% of the examined patients with metabolic syndrome. Depressive disorders, which were subclinically pronounced, were found in 18,7% of the examined in this group, and clinically pronounced in 17,0%. The most frequent cluster of metabolic syndrome in the studied group of women, both with an increased level of anxiety and with an increased level of depression, was a three-component cluster of metabolic syndrome – 47,4% and 42,5%.
Conclusion. Among patients with chronic ischemic heart disease with a comorbid course with metabolic syndrome, the number of people with clinically pronounced anxiety and depression was generally higher in comparison with people without metabolic syndrome. At the same time, the number of patients with metabolic syndrome with clinically pronounced depression was twice as high – 17,0% and 8.0%. More often in both groups there was a cluster of metabolic syndrome, including a combination of hypertension with abdominal obesity and lipid disorders.
On the Linear Convergence of Extragradient Methods for Nonconvex–Nonconcave Minimax Problems
Authors: Hajizadeh Saeed , Lu Haihao , Grimmer Benjamin 
Published: August 2023

Recently, minimax optimization has received renewed focus due to modern applications in machine learning, robust optimization, and reinforcement learning. The scale of these applications naturally leads to the use of first-order methods. However, the nonconvexities and nonconcavities present in these problems, prevents the application of typical gradient descent/ascent, which is known to diverge even in bilinear problems. Recently, it was shown that the proximal point method (PPM) converges linearly for a family of nonconvex–nonconcave problems. In this paper, we study the convergence of a damped version of the extragradient method (EGM), which avoids potentially costly proximal computations, relying only on gradient evaluation. We show that the EGM converges linearly for smooth minimax optimization problems satisfying the same nonconvex–nonconcave condition needed by the PPM. Funding: H. Lu was supported by The University of Chicago Booth School of Business Benjamin Grimmer was supported by Johns Hopkins Applied Mathematics and Statistics Department.
Sociodemographic determinants of structural empowerment and organisational commitment among critical care nurses in Saudi Arabia: a comparative cross-sectional study
Authors: Aljarameez Faiza , Saha Chandni , Sinan Mohammed , Rajan Loveson , Ahmed Gasmelseed Y , Mutair Abbas Al 
Published: August 2023

Background/Aims Improving retention of critical care nurses requires a better understanding of the perceptions and attitudes of this staff group towards structural empowerment and organisational commitment. This study aimed to assess the relationships between structural empowerment, organisational commitment and sociodemographic factors among critical care nurses. Methods The study used a descriptive, cross-sectional, correlational research design. A convenience sample of 198 critical care nurses working in Saudi Arabia responded to a questionnaire, comprising the Conditions of Work Effectiveness Questionnaire-II, the Three-Component Commitment Model and a sociodemographic survey. Descriptive statistics and correlational analyses were conducted using the Statistical Package for the Social Sciences version 25, with a P value equal to or less than 0.05 considered statistically significant. Results Structural empowerment was significantly associated with organisational commitment. Employment in a private healthcare organisation, non-Saudi Arabian nationality, greater length of experience in nursing, more time spent in current working unit and average weekly working hours were significantly associated with higher organisational commitment and structural empowerment. Respondents in the higher salary bracket (over 15000 Saudi riyals per month) had significantly lower levels of organisational commitment and structural empowerment. Conclusions Structural empowerment is a key predictor of organisational commitment and must be considered by managers and leaders seeking to improve retention. Further exploration of how factors such as nationality, salary and experience on empowerment and commitment is needed, so that policies can be developed accordingly.
EARLY TIBIAL SUBSIDENCE OF THE CEMENTLESS OXFORD UNICOMPARTMENTAL KNEE ARTHROPLASTY
Authors: Arthur Lachlan , Amin Ali , Rahman Azmi , Tu Shihfan Jack , Mellon Stephen , Murray David 
Published: August 2023

AbstractIntroductionAnecdotal reports suggest some cementless Oxford Unicompartmental Knee Replacements (OUKRs) have painful early subsidence of the tibial component with valgus rotation and/or posterior tilting. The incidence of subsidence and its association with pain is poorly understood. This radiographic study aimed to evaluate the incidence of tibial subsidence and five-year patient reported outcome measures (PROMs) of a cementless OUKR cohort.MethodologyCementless OUKRs from a high-volume centre with acceptable post-operative and five-year radiographs were included. Subsidence was determined by measuring the angle of the tibial tray/tibial axis angle and distance between the tibial tray axis and fibula head on anteroposterior and lateral radiographs using a custom MATLAB program. Analysis of 5-year PROMs assessed the relationship between subsidence and pain. Radiographs indicating tibial subsidence were validated by two observers.ResultsRadiographs of 94 cementless OUKRs were analysed of which five tibial components had subsided (incidence=5%) with an average of 1.92° varus rotation and 2.97° posterior tilt. Subsidence appeared to occur within the first post-operative year with all tibial components fixed securely at 5 years. Two subsiders had moderate pain (ICOAP=20.5,15.9, AKSS Pain=20,45) and lower Oxford Knee Scores (OKS=26,31) compared to the cohort means (ICOAP=3.91, AKSS Pain=45.9, OKS = 43.6). These two subsiders had BMIs greater than 30.ConclusionThis study found 5% of cementless OUKRs in the cohort underwent tibial subsidence. Subsidence with moderate pain occurred in 2% of cases, and pain may be associated with obesity. A larger study is needed to study subsidence in greater detail.
MEDIAL UNICOMPARTMENTAL KNEE ARTHROPLASTY: BENEFITS AND RISKS OF SIMULTANEOUS BILATERAL KNEE SURGERY
Authors: Petsiou Dioni , Nicholls Kate , Wilcocks Katharine , Matthews Andrew , Vachtsevanos Leonidas 
Published: August 2023

AbstractIntroductionIn patients with bilateral unicompartmental knee osteoarthritis, simultaneous bilateral surgery is cost effective, with both patient-specific and wider socioeconomic benefits. There are concerns however regarding higher complication rates with bilateral knee surgery. This study compares simultaneous bilateral unicompartmental knee arthroplasty (UKA), to single side UKA in terms of complications and outcomes.MethodologyThis is a retrospective case-control study of single side medial UKA patients (controls) and simultaneous bilateral medial UKA patients (cases). All patients underwent surgery between 2018 and 2022 by a single surgeon. The two cohorts were compared for perioperative blood loss (PBL), length of stay (LOS), complications (infections, blood clots, wound problems), Oxford Knee Score improvement (OKS) and revision surgery, with a follow-up period of up to 5 years.Results64 patients were followed up comprising 55 controls and 9 cases. Average length of stay for controls was 1.55 days and 2.22 days for cases (p=0.03). Average haemoglobin drop was 7.5g/l in controls and 12.8g/l in cases (p=0.04). The OKS improvement was comparable in both groups (p=0.95) with no complications and no revision surgery in either group.ConclusionThe statistically significant differences in PBL and LOS were not clinically relevant. There were no blood transfusions and postoperative haemoglobin was within normal range in more than 60% of cases. Simultaneous bilateral unicompartmental knee arthroplasty is a financially favourable and safe option for patients with bilateral knee medial unicompartmental osteoarthritis.
SURVIVAL OF CEMENT-LINKED CUSTOM IMPLANTS AND THEIR MEDIUM-TERM OUTCOMES SUPPORT THEIR USE IN COMPLEX AND SALVAGE ARTHROPLASTY
Authors: Ali Asad , Ahmed Iftikaar , Shearman Alexander , McCulloch Robert 
Published: August 2023

AbstractIntroductionPatients presenting with loosening or a fracture between ipsilateral hip and knee replacements provide a unique reconstructive challenge. We present mid-term results of the cement-over megaprosthesis (COM) when managing these complex cases. A COM is cement-linked to the stem of a well-fixed existing implant. We report the largest series to date and show that this may be preferable to total femoral replacement in a cohort of patients who often have significant co-morbidities.MethodologyA retrospective analysis of patients undergoing COM between 2002–2022 was performed. Primary outcomes were defined as implant survival, displayed with survival analysis. Secondary outcomes included mortality and surgical complications. Functional outcomes included Visual Analogue Score (VAS), EuroQol-5D-3L and Musculoskeletal Tumour Society (MSTS) score at one year post operatively.Results34 patients underwent reconstructive cement-over technique. There were 20 custom distal femur replacements and 10 custom proximal femoral replacements. Two patients were revised, with a ten year implant survival of 94%. Fifteen patients died during the study period with an mean time to death of 66 months (25–109). The mean follow up was 75 months. 11 patients (32%) developed surgical complications. Mean VAS score was 4.9 (1–10), EuroQol-5D-3L index 0.45 (−0.59 – 0.88) and MSTS score was 16.8 (2–27) in 29 patients.ConclusionThe COM technique provides good implant survivorship in complex cases with compromised bone stock and this series confirms this as an established alternative to total femoral replacement in these cases.
DO BODY MASS INDEX (BMI) AND PATELLOFEMORAL WEAR IMPACT ON FUNCTIONAL OUTCOMES OF UNICOMPARTMENTAL KNEE ARTHROPLASTY?
Authors: Myatt Darren , Marshall Morgan , Ankers Thomas , Robb Curtis 
Published: August 2023

AbstractUnicompartment knee replacement (UKR) has been an effective treatment of isolated medial compartment osteoarthritis (OA). There has been several studies which suggest that patellofemoral (PFJ) wear may not be a relative contraindication for UKR with no statistical difference in failure rates. There is currently conflicting evidence on the role of BMI.We will review if BMI and PFJ wear impacts on the post operative functional scores following UKR.A retrospective review of a prospectively collected database was performed. Data was collected between 26/6/2014 and 25/8/2022. 159 UKR procedures were identified. BMI and PFJ cartilage wear were collected. Oxford knee scores (OKS) were collected at > 2 years. PFJ wear was split into International Cartilage Research Society (ICRS) grades I&II and III&IV.159 UKR procedures were identified, of these 115 had 2 year follow up. There were 77 who had OKS recorded at 2 years. For PFJ wear there was no statistical difference in the median OKS at 2 years 45 vs 43.5 (p=0.408). Assessing the BMI the median was 29kg/m2, range 20–43kg/m2. Spearman's rank was performed to assess the correlation between BMI and >2 year OKS, this demonstrated a moderately negative correlation p(df)=−0.339 (CI 95% −0.538, −0.104) p=0.004.There is no statistically significant difference in >2 year OKS following UKR regardless of PFJ wear. There is a moderately negative correlation between BMI and >2 year OKS which was significant p=0.004. Therefore BMI is a more important consideration when counselling patients for UKR.
IMPLEMENTATION AND EVOLUTION OF THE REGIONAL REVISION KNEE ARTHROPLASTY MULTIDISCIPLINARY TEAM MEETING IN SOUTH WEST LONDON
Authors: Afzal Irrum , Radha Sarkhell , Mitchell Philip 
Published: August 2023

AbstractMultidisciplinary team (MDT) meetings in orthopaedic surgery are evolving. The goals include patient optimisation, surgical planning and discharge arrangements, individually on a patient specific basis. In line with British Association Surgery of the Knee and GIRFT guidelines, we report our regional experience on the implementation and evolution of our regional Revision Knee Arthroplasty MDT.We undertook a retrospective review of the process, cases discussed and quality assurance conducted in the weekly MDT.Since implementation of the MDT meeting in January 2019, 550 patients with painful joint replacements have been discussed. In May 2021, we formalised our ‘terms of reference’ and ‘standard operating procedures’ which are adhered to by the consultants operating within the network, all of whom attend the meeting. A proforma has been developed and is completed for all cases capturing all pertinent information. All cases are graded according to R1, R2, or R3 complexity scale. Since its inception, the MDT has looked at all post-operative imaging, we now describe a new classification system for grading the appearances. Confirmation of the pre-operative plan and actual surgical intervention is reviewed and audited. In addition, confirmation of indication of revision at the time of operation is reviewed and validated for accuracy with benefits to the unit, individual surgeon and the NJR.In conclusion, the implementation of the revision MDT facilitating pre-operative revision arthroplasty discussion and post-operative quality assurance processes enable surgeons to educate, reflect on their practice and ensure that the highest standards of care are being provided.
ARE GOOD OUTCOMES IN TOTAL KNEE ARTHROPLASTY PREDICTIVE OF SUCCESS IN SEQUENTIAL CONTRALATERAL SURGERY?
Authors: Haque Seraj , Downie Samantha , Ridley David , Dalgleish Stephen , Nicol Graeme 
Published: August 2023

AbstractIntroductionThere is little published literature to support the claim that a successful total knee replacement (TKR) is predictive of future good outcomes on the contralateral side. The objective was to identify whether outcome from the first of staged TKRs could be used to predict the outcome of the contralateral TKR.MethodologyThis was a retrospective cohort study of 1687 patients over a 25-year period undergoing staged bilateral TKRs in a UK arthroplasty centre. A control group of 1687 patients undergoing unilateral TKR with matched characteristics was identified.Primary outcomes: satisfaction and Knee Society Score (KSS) at one year.ResultsPreoperative status was comparable for pain, ROM and KSS (mean 41, 45, 43±14).At one year, dissatisfaction was similar for all groups (4% first of staged TKR, 4% second of staged TKR, 5% controls). If the first TKR had a good outcome, the relative risk of a contralateral bad outcome was 20% less than controls (95% CI 0.6–1.2). If the first TKR had a poor outcome, the risk of a second poor outcome was 4 times higher (95% CI 2.8–6.1), increasing from 6% to 28% (absolute risk).ConclusionPatients undergoing the second of staged TKRs with a previous good outcome are likely to do well in their second procedure (94 in 100 will go on to have a second good outcome). Of those with a previous poor outcome, 28 in 100 will have a second poor outcome. The trend was persistent despite correcting for gender, age, BMI, and diagnosis.
DIFFERENCES IN EARLY RECOVERY FOLLOWING UNICOMPARTMENTAL KNEE ARTHROPLASTY WITH DAY-CASE AND STANDARD CARE PATHWAYS, ASSESSED USING NOVEL PATIENT-REPORTED MEASURES
Authors: Rahman Azmi , Strickland Louise , Pandit Hemant , Jenkinson Crispin , Murray David 
Published: August 2023

AbstractBackgroundDaycase pathways which aim to discharge patients the same day following Unicompartmental Knee Replacement have been introduced in some centres, though most continue with Standard pathways. While Daycase pathways have cost savings, recovery data comparing pathways is limited. This study aims to compare patient-reported early recovery between Daycase and Standard pathways following UKR.MethodThis study was carried out in two centres that originally used the same Standard recovery pathway for UKR. In one centre, the Standard pathway was modified into a Daycase pathway. 26 Daycase-Outpatient, 11 Daycase-Inpatient, and 18 Standard patients were recruited. Patients completed the Oxford Arthroplasty Early Recovery Score (OARS) and SF-36 (Acute) measure between Days 1–42.ResultsStandard patients had significantly better Day-1 scores than Daycase patients, but this difference rapidly diminished, and from Day-3 onwards both groups had near-identical scores (OARS Day-1, 59 vs 37, p=0.002, stemming from differences in Pain, Nausea/Feeling-Unwell, Function/Mobility subscores p=0.003,0.014,0.011. OARS Day-3 48 vs 49, p=0.790).Daycase-Outpatients had a higher overall OARS (p=0.002), recovering 1–2 weeks faster than Daycase-Inpatients. OARS subscores demonstrated that Daycase-Outpatients had better Pain, Nausea/Feeling-Unwell, Fatigue/Sleep scores (p=0.020,0.0004,0.019 respectively). SF-36 scores corroborate OARS scores.ConclusionThe Standard cohort had better Day-1 scores than the Daycase cohort, likely due to later mobilisation and stronger inpatient analgesia; these differences diminished by Day-3. Daycase-Outpatients recovered substantially faster than Daycase-Inpatients – likely due to the factors that delayed their discharge. The convergence of scores at 6 weeks demonstrates that both pathways have similar early recovery outcomes.
INTERFERENCE AND KEEL DESIGN SIGNIFICANTLY INFLUENCE SAGITTAL MICROMOTION IN CEMENTLESS UNICOMPARTMENTAL KNEE ARTHROPLASTY
Authors: Rahman Azmi , Heath David , Mellon Stephen , Murray David 
Published: August 2023

AbstractIntroductionIn cementless UKR, early post-operative tibial fractures are 7x more common in very small tibias. A smaller keel has been shown to reduce this fracture risk, but its effect on fixation is unassessed. This mechanical study assesses the effect of keel interference and size on sagittal micromotion of the tibial component in physiological loading positions.MethodA high-resolution Digital Image Correlation setup was developed and validated to an accuracy of 50 micrometres. Variants of tibial components were 3D-printed: standard, no-interference, no-keel, and a new small keel. Components were implanted into bone-analogue foam which was machined to a CT-reconstructed small tibia, using surgical technique. Tibias were loaded to 200N in physiological loading positions: 8mm (step-up) and 15mm (lunge) posterior to midpoint, and micromotion was assessed.ResultsIn all tests, anterior lift-off was the largest micromotion observed. In ‘step-up’, a standard keel moved more than the no-interference and no-keel variants (340μm-vs-63μm-vs-30μm, p=0.002). In ‘lunge’ loading, the no-interference and no-keel variants moved more than the standard (826μm-vs-1003μm-vs-521μm, p=0.039).The small keel experienced less micromotion in ‘step-up’ (245μm-vs-340μm p=0.233, overall p=0.009) and ‘lunge’ (378μm-vs-521μm p=0.265, overall p=0.006) than the standard keel.ConclusionThe keel protects against large tibial micromotion during lunge movement. Counterintuitively, interference increases micromotion during step-up movement, likely due to implant pivoting around the bone-keel interface. Results suggest patients should be advised against lunge movements early post-operatively. The new smaller keel fixes similarly or better than the standard keel, making it viable for replacing the standard keel to potentially reduce fracture risk.