bluuebunny/crossref_metadata_2025_split huggingface dataset:
Periprosthetic joint infection following hip hemiarthroplasty
Authors: Bourget-Murray Jonathan , Horton Isabel , Morris Jared , Bureau Antoine , Garceau Simon , Abdelbary Hesham , Grammatopoulos George 
Published: December 2022

Aims The aims of this study were to determine the incidence and factors for developing periprosthetic joint infection (PJI) following hemiarthroplasty (HA) for hip fracture, and to evaluate treatment outcome and identify factors associated with treatment outcome. Methods A retrospective review was performed of consecutive patients treated for HA PJI at a tertiary referral centre with a mean 4.5 years’ follow-up (1.6 weeks to 12.9 years). Surgeries performed included debridement, antibiotics, and implant retention (DAIR) and single-stage revision. The effect of different factors on developing infection and treatment outcome was determined. Results A total of 1,984 HAs were performed during the study period, and 44 sustained a PJI (2.2%). Multiple logistic regression analysis revealed that a higher CCI score (odds ratio (OR) 1.56 (95% confidence interval (CI) 1.117 to 2.187); p = 0.003), peripheral vascular disease (OR 11.34 (95% CI 1.897 to 67.810); p = 0.008), cerebrovascular disease (OR 65.32 (95% CI 22.783 to 187.278); p < 0.001), diabetes (OR 4.82 (95% CI 1.903 to 12.218); p < 0.001), moderate-to-severe renal disease (OR 5.84 (95% CI 1.116 to 30.589); p = 0.037), cancer without metastasis (OR 6.42 (95% CI 1.643 to 25.006); p = 0.007), and metastatic solid tumour (OR 15.64 (95% CI 1.499 to 163.087); p = 0.022) were associated with increasing PJI risk. Upon final follow-up, 17 patients (38.6%) failed initial treatment and required further surgery for HA PJI. One-year mortality was 22.7%. Factors associated with treatment outcome included lower preoperative Hgb level (97.9 g/l (SD 11.4) vs 107.0 g/l (SD 16.1); p = 0.009), elevated CRP level (99.1 mg/l (SD 63.4) vs 56.6 mg/l (SD 47.1); p = 0.030), and type of surgery. There was lower chance of success with DAIR (42.3%) compared to revision HA (66.7%) or revision with conversion to total hip arthroplasty (100%). Early-onset PJI (≤ six weeks) was associated with a higher likelihood of treatment failure (OR 3.5 (95% CI 1.2 to 10.6); p = 0.007) along with patients treated by a non-arthroplasty surgeon (OR 2.5 (95% CI 1.2 to 5.3); p = 0.014). Conclusion HA PJI initially treated with DAIR is associated with poor chances of success and its value is limited. We strongly recommend consideration of a single-stage revision arthroplasty with cemented components. Cite this article: Bone Jt Open 2022;3(12):924–932.
Planting the Seeds of Collaboration: A Pilot for School/Clinic Partnerships During Pediatric Clerkship
Authors: Sheppard Mary E. , Vitalone-Raccaro Nancy , Kaari Jacqueline M. 
Published: December 2022

Abstract
Although pediatricians and family physicians often refer children to early intervention (EI) and provide support and information to families, medical school training that provides information about special education policy and procedures is often limited. We piloted a program whereby medical students, during their pediatric clerkship, observed school classrooms that included young children with disabilities. Visit impact was measured through assessments of perceived competency and a written reflection. Students showed perceived competency growth across all areas measured. Written reflections demonstrated understanding of special education practices and collaborative opportunities. These findings suggest that incorporating experiential learning through facilitated school visits is a way to enhance the learning experience of medical students on topics essential to supporting children with disabilities and their families.
Polarization-insensitive 90° optical hybrid using silica-based PLC
Authors: Pan Pan , Wang Liangliang , Liu Qinghai , Zhan Shengbao , Wang Peng , Li Lingli , An Junming 
Published: December 2022

A 90° optical hybrid (OH) based on a

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multimode interference (MMI) coupler is characterized and analyzed using the silica-based planar light circuit. The OH is designed to be polarization-insensitive with an extremely low polarization-dependent loss (

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. The fabricated chip exhibits an excess loss of 3.4 dB and 3.8 dB for TE and TM polarizations at 1550 nm. The measured phase error is

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over 50 nm in the

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band with a polarization-dependent error

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. The fabrication tolerance of the MMI width and waveguide sidewall angle is analyzed, which can well explain the deviation from the theoretical calculation.
Efficient X-ray Preionization of a XeCl Laser
Authors: Shields H. , Alcock A.J. 
Published: December 2022

The use of X-rays for gas discharge laser preionization offers the following potential advantages:
(i) a cleaner, higher penetration source of preionization electrons than that provided hy corona or uv spark sources, (ii) a more rugged, higher repetition rate source than electron beam preionization.
Digitale Lieferantennetzwerke – Einblicke in die Digitalisierungsfortschritte der Beschaffung
Authors: Hoffmann Marcel André , Wetsch Laura , Lasch Rainer 
Published: December 2022

ZusammenfassungDer Anteil der Wertschöpfung an Produkten durch Lieferanten hat in den vergangenen Jahren stetig zugenommen. Dies bedingt eine hohe Komplexität von Lieferketten und stellt das strategische und operative Beschaffungswesen vor große Herausforderungen. Gleichzeitig steht heute eine Vielzahl an Technologien zur Verfügung, um diese Komplexität zu bewältigen, Informationsasymmetrien abzubauen und transparente, fehlersichere Prozesse zu ermöglichen.Während die Potenziale digitaler Lieferantennetzwerke weitgehend evident sind, sind digitale Technologien wie Internet of Things (IoT), Blockchain oder künstliche Intelligenz (KI) bisher kaum praktisch in Unternehmen implementiert.Mit Hilfe einer empirischen Fallstudie wurde untersucht, inwieweit die Digitalisierung als strategisches Unternehmensziel verfolgt wird und welche Hindernisse bei der Einführung digitaler Lieferantennetzwerke bestehen. Dazu wurden elf Experten aus der strategischen und operativen Beschaffung von acht Unternehmen des produzierenden Gewerbes in Form einer leitfadengestützten Interviewstudie befragt und deren Erfahrungen ausgewertet.Die Ergebnisse implizieren, dass in vielen Fällen grundlegende Voraussetzungen für eine erfolgreiche digitale Transformation fehlen und in vielen Unternehmen keine ausreichenden Ressourcen dafür zur Verfügung stehen. Weiterhin wurde festgestellt, dass der Nutzen digitaler Technologien in der Beschaffung häufig sehr einseitig ist und bisher nur selten Netzwerkvorteile genutzt werden. Um dieser zögerlichen Entwicklung entgegenzuwirken, werden Handlungsempfehlungen für eine erfolgreiche Implementierung und stärkere Kooperation in der Lieferkette aufgestellt und weiterer Forschungsbedarf identifiziert.
Impact of non-pharmaceutical interventions targeted at the COVID-19 pandemic on the incidence of influenza-like illness in the UK Armed Forces
Authors: Otieno George , Rawlings Ngwa Niba 
Published: December 2022

Introduction
Non-pharmaceutical interventions (NPIs) such as lockdown, social distancing and use of face coverings was adopted by the United Kingdom (UK) Armed Forces (AF) during the COVID-19 pandemic. This study assessed the impact of the use of NPIs on the incidence of influenza-like illness (ILI) in the UK AF.

Methods
A longitudinal study design was adopted, and secondary data was analysed retrospectively. Clinical Read codes for ILI was used to generate data for flu seasons before and during the COVID-19 pandemic (September 2017 to April 2021).

Results
Before the COVID-19 pandemic, the rate of reporting ILI was ~ 4% across all flu seasons. The count of ILI was 2.9%, 2.2% and 3.1% during 2017–18, 2018–19 and 2019–20 flu seasons respectively. During the COVID-19 pandemic, both the rate of reporting ILI (0.6%) and the count of ILI (0.5%) were significantly smaller (p < .001). The rate of reporting ILI was positively correlated with the count of ILI (r (2) = .97, p = .014). Influenza vaccination rate increased by 1.3% during the COVID-19 pandemic. Vaccination rate was negatively correlated with the rate of reporting ILI (r (2) = -.52, p = 0.24) and the count of ILI (r (2) = -.61, p = 0.19). However, this correlation was not significant. The use of NPIs was negatively correlated with the rate of reporting ILI (r (2) = -.99, p = < .001) and the count of ILI (r (2) = -.95, p = 0.026). The overall multiple regression performed was statistically significant (R2 = 0.94, F (1, 2) = 33.628, p = 0.028). The rate of reporting ILI significantly predicted the count of ILI (β = 0.609, p = 0.028) while vaccination rate did not significantly predict the count of ILI (β = -0.136, p = 0.677).

Conclusions
The incidence of ILI in the UK AF was significantly reduced during the COVID-19 pandemic. The use of NPIs and the rate of reporting ILI significantly reduced the count of ILI. Being vaccinated for influenza did not significantly reduce the count of ILI.
Face masks to prevent transmission of respiratory infections: Systematic review and meta-analysis of randomized controlled trials on face mask use
Authors: Ollila Hanna M. , Partinen Markku , Koskela Jukka , Borghi John , Savolainen Riikka , Rotkirch Anna , Laine Liisa T. 
Published: December 2022

Objectives
To examine the use of face mask intervention in mitigating the risk of spreading respiratory infections and whether the effect of face mask intervention differs in different exposure settings and age groups.

Design
Systematic review and meta-analysis. We evaluated the risk of bias using the Cochrane Risk of Bias 2 tool (ROB2).

Data sources
We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science were searched for randomized controlled trials investigating the effect of face masks on respiratory infections published between 1981 and February 9, 2022. We followed the PRISMA 2020 guidelines.

Eligibility criteria for selecting studies
We included randomized controlled trials investigating the use of face mask intervention in mitigating the risk of spreading respiratory infections across different exposure settings.

Results
We identified 2,400 articles for screening. 18 articles passed the inclusion criteria for both evidence synthesis and meta-analysis. There were N = 189,145 individuals in the face mask intervention arm and N = 173,536 in the control arm, and the follow-up times ranged from 4 days to 19 months. Our results showed between-study heterogeneity (p < 0.0001). While there was no statistically significant association over all studies when the covariate unadjusted intervention effect estimates were used (RR = 0.977 [0.858–1.113], p = 0.728), our subgroup analyses revealed that a face mask intervention reduced respiratory infections in the adult subgroup (RR = 0.8795 [0.7861–0.9839], p = 0.0249) and in a community setting (RR = 0.890 [0.812–0.975], p = 0.0125). Furthermore, our leave-one-out analysis found that one study biased the results towards a null effect. Consequently, when using covariate adjusted odds ratio estimates to have a more precise effect estimates of the intervention effect to account for differences at the baseline, the results showed that a face mask intervention did reduce respiratory infections when the biasing study was excluded from the analysis (OR = 0.8892 [0.8061–0.9810], p = 0.0192).

Conclusion
Our findings support the use of face masks particularly in a community setting and for adults. We also observed substantial between-study heterogeneity and varying adherence to protocol. Notably, many studies were subject to contamination bias thus affecting the efficacy of the intervention, that is when also some controls used masks or when the intervention group did not comply with mask use leading to a downward biased effect of treatment receipt and efficacy.

Trial registration
PROSPERO registration number CRD42020205523.
Physical and psychological health in intern paramedics commencing shift work: Protocol for an exploratory longitudinal study
Authors: Crowther Meagan E. , Ferguson Sally A. , Adams Robert J. , Kovac Katya , Paterson Jessica L. , Reynolds Amy C. 
Published: December 2022

Background
Paramedics are routinely exposed to shift work. Existing research shows that shift work exposure is associated with adverse mental and physical health outcomes. However, the current understanding of the impact of commencing shift work in a paramedic role on health is limited. This can be addressed by recruiting new paramedics before they commence shift work, and conducting regular follow-ups of potential biological, psychological and social changes. The present study aimed to examine changes in biological, psychological and social factors relative to pre-shift work baseline in a cohort of paramedics commencing intern employment with an Australian ambulance service.

Method and analysis
This observational, mixed-methods, longitudinal study aims to recruit 40 interns from one Australian ambulance service. Data collection will occur at baseline (standard day schedule for initial training), and subsequently at three months, six months, nine months and twelve months, to measure biological, psychological and social changes relative to baseline measurements. Changes in cardiometabolic markers (cholesterol, triglycerides, fasting glucose), microbiome (self-collected stool samples), sleep and physical activity (actigraphy) will be measured. Interns will also complete a battery of self-report questionnaires, sleep diaries and qualitative interviews to explore various psychological and social variables over time. Statistical analyses will be conducted using mixed effects regression, specifying a random effect of subject on the intercept, allowing participants to vary according to individual baseline levels, as well as tracking progress over time, appropriately accounting for serial correlation. Qualitative study components will be analysed via coding and thematic analysis procedures.

Discussion
The present study protocol is a comprehensive outline of the observational study planned. The study will allow for greater knowledge of any changes in biological, psychological and social factors during a 12-month transition to shift work. The findings from the proposed study will have implications for the development of strategies to support early-career shift workers.
PNPLA3 allele frequency has no impact on biliary bile acid composition or disease course in patients with primary sclerosing cholangitis
Authors: Färkkilä Martti , Kautiainen Hannu , Tenca Andrea , Jokelainen Kalle , Arola Johanna 
Published: December 2022

Background and aims
Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease that leads to bile duct strictures, cholestasis, and biliary cirrhosis. PNPLA3 (patatin-like phospholipase domain containing 3), regulates cellular lipid synthesis by converting lysophosphatidic acid into phosphatidic acid. Isoleucine mutation to methionine at position 148 (I148M) causes a loss of this function. Only two studies, with contradictory results, have evaluated the role of PNPLA3 in PSC. The rs738409(G) variant of PNPLA3 has been associated with an increased risk for transplantation in male patients with dominant strictures (DS). The study aimed to evaluate the PNPLA3 allele frequency effect on the clinical outcomes, progression, and prognosis of PSC. Furthermore, we analyzed the impact of PNPLA3 on phospholipid and bile acid composition to evaluate the effect of the PNPLA3 status on UDCA response.

Patients and methods
We recruited 560 patients prospectively and collected clinical and laboratory data as well as liver histology and imaging findings. PNPLA3 (CC, CG, GG) alleles were analyzed with TaqManTM. We also analyzed bile acids (BA), cholesterol and phospholipids and individual BA from a sample aspirated during endoscopic retrograde cholangiography (ERC).

Results
Among the recruited patients, 58.4%, 35.7% and 5.9% had the wild (CC), heterozygous (CG) and homozygous (GG) alleles, respectively. The PNPLA3 haplotype did not impact bile composition or individual BA. In addition, we found no differences in age at diagnosis, disease progression, liver fibrosis or survival between the cohorts.

Conclusions
The PNPLA3 I148M variant had no significant impact on on bile composition, including UDCA content, clinical outcomes, progression of liver fibrosis, hepatobiliary cancer risk, liver transplantation, or overall survival.
The use of 3D digital anatomy model improves the communication with patients presenting with prostate disease: The first experience in Senegal
Authors: Diao Babacar , Bagayogo Ndèye Aissatou , Carreras Nayra Pumar , Halle Michael , Ruiz-Alzola Juan , Ungi Tamas , Fichtinger Gabor , Kikinis Ron 
Published: December 2022

Objectives
We hypothesized that the use of an interactive 3D digital anatomy model can improve the quality of communication with patients about prostate disease.

Methods
A 3D digital anatomy model of the prostate was created from an MRI scan, according to McNeal’s zonal anatomy classification. During urological consultation, the physician presented the digital model on a computer and used it to explain the disease and available management options. The experience of patients and physicians was recorded in questionnaires.

Results
The main findings were as follows: 308 patients and 47 physicians participated in the study. In the patient group, 96.8% reported an improved level of understanding of prostate disease and 90.6% reported an improved ability to ask questions during consultation. Among the physicians, 91.5% reported improved communication skills and 100% reported an improved ability to obtain patient consent for subsequent treatment. At the same time, 76.6% of physicians noted that using the computer model lengthened the consultation.

Conclusion
This exploratory study found that the use of a 3D digital anatomy model in urology consultations was received overwhelmingly favorably by both patients and physicians, and it was perceived to improve the quality of communication between patient and physician. A randomized study is needed to confirm the preliminary findings and further quantify the improvements in the quality of patient-physician communication.
Exploring the quality of life of adolescents with Cerebral Palsy participating in conductive education around the Pannonian Basin
Authors: Mladoneczki-Leszkó Dóra , Surányi Rebeka , Kelemen Anna 
Published: December 2022

IntroductionQuality of life (QoL) is a concept that includes physical, psychological, social, spiritual, and other domains of functioning. Good QoL is a fundamental goal of treatment for Cerebral Palsy (CP), therefore it is an outstanding goal of Conductive Education (CE) as well. CE is a Hungarian method that combines special education and rehabilitation for people living with CP.ObjectiveWe aimed to compare the opinions and views about the life of teenagers from the perspective of adolescents and their caregivers from different socio-cultural backgrounds.MethodIt was a descriptive, cross-sectional study. We used the Cerebral Palsy Quality of Life for the adolescent questionnaire (CP QoL -Teen) to measure QoL, which was translated into Hungarian and validated by Semmelweis University in 2017. Our study included 20 young adolescents (mean age 16) with CP and their caregivers living in Hungary (n1= 40) and 20 Hungarian-speaking families (n2= 40) from surrounding countries: Slovakia, Romania, and Ukraine (mean age 14.5). All the families are participating in CE.ResultsThere was no significant divergence in the whole QoL score between the groups. Nonetheless, we found an outstanding difference in the Hungarian groups’ ‘Feelings about functioning’ domain between teens and caregivers. A significant proportion of Hungarian teens–although living with greater pain–are less concerned about their illness (R = -0.754). 85% of responders study at segregated schools offering CE.ConclusionThe study shed new light on the importance of a personalized form of education and on the weight of the positive effects of segregated education. Personalized education can develop the patients’ QoL.
Patient perspectives on cervical cancer screening interventions among underscreened women
Authors: Des Marais Andrea C. , Brewer Noel T. , Knight Suzanne , Smith Jennifer S. 
Published: December 2022

Background
Cervical cancer is highly preventable with regular screening, yet over 4,000 women die from it annually in the United States. Over half of new cervical cancer cases in the U.S. are attributable to insufficient screening.

Methods
Participants were 23 low-income, uninsured or Medicaid-insured women in North Carolina who were overdue for cervical cancer screening according to national guidelines. Semi-structured interviews examined perspectives on barriers to cervical cancer screening and on interventions to reduce these barriers. We also elicited feedback on three proposed evidence-based interventions: one-on-one education, coupons to reduce out-of-pocket costs, and self-collection of samples for detection of high-risk human papillomavirus (HPV) infection, the primary cause of cervical cancer.

Results
Reported barriers included high cost, inconvenient clinic hours, lack of provider recommendation, poor transportation, difficulty finding a provider, fear of pain, and low perceived need. Participants suggested interventions including reducing cost, improving convenience through community-based screening or extended clinic hours, strengthening provider recommendations, and providing one-on-one counseling and education outreach. HPV self-collection was most frequently selected as the “most helpful” of 3 proposed interventions (n = 11), followed by reducing out-of-pocket costs (n = 7) and one-on-one education (n = 5).

Conclusion
Cost was the most reported barrier to cervical cancer screening, although women experience multiple simultaneous barriers. Novel interventions such as HPV self-collection promise to reduce some, but not all, barriers to primary screening. Interventions that work on reducing multiple barriers, including obstacles to receiving follow-up care, may be most effective to prevent cervical cancer among these high-risk women.