bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early patient-reported outcomes from primary hip and knee arthroplasty have improved over the past seven years
Authors: Sabah Shiraz A. , Knight Ruth , Alvand Abtin , Beard David J. , Price Andrew J. 
Published: May 2022

Aims Routinely collected patient-reported outcome measures (PROMs) have been useful to quantify and quality-assess provision of total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the UK for the past decade. This study aimed to explore whether the outcome following primary THA and TKA had improved over the past seven years. Methods Secondary data analysis of 277,430 primary THAs and 308,007 primary TKAs from the NHS PROMs programme was undertaken. Outcome measures were: postoperative Oxford Hip/Knee Score (OHS/OKS); proportion of patients achieving a clinically important improvement in joint function (responders); quality of life; patient satisfaction; perceived success; and complication rates. Outcome measures were compared based on year of surgery using multiple linear and logistic regression models. Results For primary THA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OHS (unstandardized coefficient (B) 0.15 points (95% confidence interval (CI) 0.14 to 0.17); p < 0.001) and higher EuroQol five-dimension index (EQ-5D) utility (B 0.002 (95% CI 0.001 to 0.002); p < 0.001). The odds of being a responder (odds ratio (OR) 1.02 (95% CI 1.02 to 1.03); p < 0.001) and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.03); p < 0.001) increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.98); p < 0.001). No trend was found for perceived success (p = 0.555). For primary TKA, multiple linear regression modelling found that more recent year of surgery was associated with higher postoperative OKS (B 0.21 points (95% CI 0.19 to 0.22); p < 0.001) and higher EQ-5D utility (B 0.002 (95% CI 0.002 to 0.003); p < 0.001). The odds of being a responder (OR 1.04 (95% CI 1.03 to 1.04); p < 0.001), perceived success (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001), and patient satisfaction (OR 1.02 (95% CI 1.01 to 1.02); p < 0.001) all increased with year of surgery, while the odds of any complication reduced (OR 0.97 (95% CI 0.97 to 0.97); p < 0.001). Conclusion Nearly all patient-reported outcomes following primary THA/TKA improved by a small amount over the past seven years. Due to the high proportion of patients achieving good outcomes, PROMs following THA and TKA may need to focus on better discrimination of patients achieving high scores to be able to continue to measure improvement in outcomes. Cite this article: Bone Joint J 2022;104-B(6):687–695.
A quantitative study to explore functional outcomes following laparoscopic ventral mesh rectopexy for rectal prolapse
Authors: Olatunbode O , Rangarajan S , Russell V , Viswanath YKS , Reddy A 
Published: May 2022

Introduction Rectal prolapse is a life-altering problem and laparoscopic ventral mesh rectopexy (LVMR) is emerging as the surgical intervention of choice. However, the literature is ambiguous on its effect on bowel function and sparse as regards bladder and sexual function. This study assesses short-term functional outcomes following LVMR. Materials and methods This quantitative retrospective study with a pretest–post-test design included 130 adults who had undergone LVMR from October 2010 to December 2018 in a tertiary centre. Analysis with paired-samples t-test and Wilcoxon matched pairs test was done using SPSS (v26). Results The median age was 58 years (interquartile range, 48–74 years); 123 (94.6%) were female. The median length of stay was two days (interquartile range, 1–2 days). A total of 104 (80%) sets of medical notes were reviewed. One patient had recurrence of rectal prolapse. Synthetic mesh was used in 24 patients (23.1%) and biological mesh in 80 (76.9%). One patient had extrusion of a synthetic mesh and required surgery; 31(23.8%) completed the Electronic Patient Assessment Questionnaire for Pelvic Floor. Overall, the improvement in bladder function was not statistically significant (p = 0.670). A statistically significant improvement was seen for all bowel symptoms (p = 0.002) excluding constipation (p = 0.295). Irritable bowel symptoms associated with rectal prolapse improved significantly following LVMR (p = 0.001). Vaginal prolapse (p < 0.0005), dyspareunia (p = 0.001) and bowel symptoms affecting sexual intercourse (p = 0.01) improved, but improvement in overall sexual function was not statistically significant (p = 0.081). Conclusions LVMR improves bowel function overall, although it can worsen constipation. It has the potential to improve sexual function but makes negligible difference to bladder function.
Safe provision of elective endocrine surgery operations amid the COVID-19 crisis
Authors: Christakis I , Parsons S , Chadwick D 
Published: May 2022

Introduction The aim of this study was to determine the impact of the COVID-19 pandemic on the provision of clinical services (perioperative clinical outcomes and productivity) of the department of endocrine and general surgery at a teaching hospital in the UK. Methods A retrospective chart review was conducted of all patients who were operated in our department during two periods: 1 April to 31 October 2019 (pre-COVID-19 period) and 1 April to 31 October 2020 (COVID-19 period). The perioperative clinical outcomes and productivity of our department for the two time periods were compared. Results In the pre-COVID-19 period, 130 operations were carried out, whereas in the COVID-19 group, this reduced to 89. The baseline characteristics between the two groups did not significantly differ. Parathyroid operations decreased significantly by 68% between the two study periods. Overall, during the COVID-19 phase, the department maintained 68% of its operating workload compared with the respective 2019 time period. The clinical outcomes for the patients who had a thyroid/parathyroid/adrenal operation were not statistically different for the two study periods. There were no COVID-19 related perioperative complications for any of the operated patients and no patient tested positive for COVID-19 while an inpatient. For the COVID-19 group, the department maintained 67% of its outpatient appointments for endocrine surgery and 26% for general surgery pathologies. Conclusions The COVID-19 pandemic significantly reduced the clinical activity of our department. However, it is possible to continue providing clinical services for urgent/cancer cases with the appropriate safety measures in place.
Surgical training during the COVID-19 pandemic at a designated ‘cold’ site: are we meeting the challenge?
Authors: Hamid M , Naumann DN , Digne-Malcolm H , Kanwal A , Puventhiranathan P , Phelan L , Dilworth M 
Published: May 2022

Introduction There has been a marked reduction in surgical operative training opportunities during the COVID-19 pandemic. This may be improved by the establishment of ‘cold’ sites for NHS elective surgery. We investigated the training opportunities at a newly designated elective surgery cold site in the West Midlands, UK. Methods An observational retrospective study was undertaken to include all gastrointestinal and urological elective surgery at a single ‘cold’ site during the first peak of the COVID-19 pandemic. Patient demographics, details of surgery and data relating to surgical training such as primary surgeon and portfolio index procedure were collected. Factors affecting the likelihood of trainees being the primary surgeon were analysed using logistic regression models. Results There were 880 patients, with a median (interquartile range) age of 62 (48–74). Some 658 (74.8%) procedures were defined as ‘index procedures’ for specialty training year 4 (ST4) level: 409/509 (80.4%) for urology, 155/235 (66%) for colorectal and 94/136 (69.1%) for upper gastrointestinal (GI). Only 253/880 (28.8%) procedures were performed by a trainee as the primary surgeon: 201/509 (39.4%) for urology, 21/235 (8.9%) for colorectal and 31/136 (22.8%) for upper GI. The likelihood of a trainee being the primary surgeon was reduced for major surgery (p<0.001) and for GI surgery when compared with urology (p<0.001). Conclusions Surgical training was facilitated at an elective surgery ‘cold’ site during the COVID-19 pandemic, but at lower levels than anticipated. Type of surgery influenced trainee participation. Surgical training should be incorporated into ‘cold’ site elective surgical services if trainees are to be prepared for the future.
Hashimoto’s thyroiditis on outcomes in papillary thyroid cancer revisited: experience from South East Asia
Authors: Lau J , Lee J , Mahipal M , Yang SP , Tan WB , Yuan NK , Parameswaran R 
Published: May 2022

Introduction The association between Hashimoto Thyroiditis (HT) and papillary thyroid cancer (PTC) remains uncertain. HT, the most common inflammatory condition of the thyroid, is postulated to increase the risk of PTC and yet confer cancer-retarding effects. In this study, we aim to evaluate the prevalence of HT in patients surgically treated for PTC and evaluate the long-term prognostic implications. Methods This is a retrospective study of 521 patients with PTC who underwent hemi- or total thyroidectomy between January 2000 and December 2018 at a tertiary referral centre. Patients were categorised into two group: group A (n=402) consists of patients with PTC without HT, whereas group B (n=119) consists of patients with PTC and HT. Demographic and clinicopathological details, recurrence rates and overall survival were collected. Univariate and multivariate analyses were performed to evaluate for clinical factors associated with HT. Results A total of 521 patients with a mean age of 46.7 years were evaluated. HT was detected in 22.8% of patients with PTC. On multivariate analysis, presence of HT was associated with a lower incidence of extrathyroidal extension (hazard ratio: 0.59, 95%confidence interval 0.37–0.95). Also, patients with HT tend to have fewer cycles of radioactive iodine and correspondingly have excellent response to treatment. However, no differences in recurrence rates and overall survival were detected. Conclusions One-fifth of patients with PTC have coexisting HT. These patients tend to have less-aggressive tumour features such as extrathyroidal extension. However, the effect of HT on recurrence and overall survival appears to be inconsequential clinically.
One-year follow-up of conservative management of appendicitis: results from a single centre during extended lockdown in the COVID-19 pandemic
Authors: West H , Garcea G 
Published: May 2022

Introduction Conservative management with antibiotics was recommended by the UK Surgical Royal Colleges early in the COVID-19 pandemic as the first-line treatment for acute uncomplicated appendicitis. Methods This is a prospective single-centre cohort study of patients aged 16 years or over, diagnosed clinically and confirmed radiologically with acute appendicitis in a secondary care setting who were initially treated conservatively with antibiotics. The primary outcome was the response to conservative management with antibiotics. Secondary outcomes were: antibiotic duration; operative rates; surgical approach (open, laparoscopic or conversion to open); complication rates; COVID-19 positive rate; rates of readmission within 12 months; and length of hospital stay. Results A total of 109 patients were included in the study, 67 of whom were male. Median age was 37 (range 17–93) years. A further 28 patients were excluded because of a decision to manage operatively on the index admission or because of other diagnoses. Thirty-three patients (30.3%) had surgery on the index admission after failed conservative management and 15 (13.8%) had surgery on readmission. On histology, 32/48 patients (66.7%) had a diagnosis of complicated appendicitis and 18/48 (37.5%) had a confirmed appendicolith. Conclusions There was a high readmission rate (47/109; 43.1%) for surgery, a radiological drain or conservative management within the first year following initial conservative management. There is a significant risk of recurrence of symptoms, particularly in the presence of an appendicolith. Laparoscopic appendicectomy should be the first-line treatment, with conservative management reserved for patients with acute uncomplicated appendicitis who are COVID-19 positive or have comorbidities.
Leisure Participation Opportunities for Adults With Intellectual Disability With Moderate Levels of Impairment Residing in Community Apartments
Authors: Keller Aviva , Weintraub Naomi 
Published: May 2022

Abstract
The purpose of this study was to examine the leisure and recreation opportunities available in community apartments for adults with intellectual disability (ID), and their association with leisure participation. The study included 38 adults with ID with moderate levels of impairment residing in 19 apartments. Apartment coordinators reported on apartment characteristics, as well as leisure and recreation schedule and opportunities. Findings revealed diverse leisure and recreation activities. We found correlation between the number of activities (rs = .392 , p = .015; rs = .433, p = .007, respectively) as well as a visible daily schedule (Z = 2.143, p = .035) and leisure participation. Findings suggest that diverse leisure activities and a visible schedule may be associated with improved leisure participation.
3D-printed actuator-based beam-steering approach for improved physical layer security in visible light communication
Authors: Erdem Mehmet Can , Gürcüoğlu Oğuz , Panayirci Erdal , Kurt Güneş Karabulut , Ferhanoğlu Onur 
Published: May 2022

In this study, we present the design, manufacture, and implementation of a 3D-printed lens scanner-based beam steering for use in visible light communication (VLC) applications. The5cm×5cmscanner is designed for low-cost 3D printing with fused deposition modeling using polylactic acid. Scanning is facilitated through electromagnetic actuation of the lens frame, carrying a conventional 25 mm lens, from two nearly orthogonal directions. The serpentine spring that connects the lens frame to the external frame is tailored to offer similar spring constants in the directions of actuation and has minimal (<1.5mm) sag due to the mass of the lens. The manufactured actuator was integrated on a miniaturized VLC test bed (70cm×40cm×40cm). Using the test bed, we characterized the applied voltage versus beam displacement behavior of the actuator in the lateral plane and demonstrated beam steering on a moving target with face-recognition feedback. The proposed scheme was targeted to offer an improved security measure in VLC through tracking the legitimate receiver (i.e., via face recognition) and uses the feedback to steer the focused light onto the targeted device. The joint use of focusing and steering features allows for the legitimate receiver to roam within the room while enjoying the improved secrecy due to the focused light. We calculate the secrecy capacity for the demonstrated approach, which compares favorably with a number of jamming, spatial modulation, and beam-forming counterparts. The presented actuator can be used with larger room dimensions, yet upscaling to larger illumination units will require the use of a lens having smaller focus to address a larger total steering angle.
Comparison of individual and common wavelength-operation for 785  nm Y-branch DBR ridge waveguide diode lasers with adjustable spectral distance
Authors: Theurer Lara Sophie , Sumpf Bernd , Maiwald Martin , Müller André , Fricke Jörg , Ressel Peter , Knigge Andrea , Tränkle Günther 
Published: May 2022

An experimental comparison between individual and common wavelength-operation of a Y-branch distributed Bragg reflector (DBR) ridge waveguide (RW) laser at 785 nm with an electrically adjustable spectral distance is presented. The dual-wavelength Y-branch laser combines two laser cavities via a Y-section to a common output section. DBR gratings with different grating periods are associated with the two cavities, which set the emission wavelengths of the two branches. Implemented resistive heater elements allow separate wavelength tuning of the two branches, which can be operated individually for alternating emission wavelengths in applications such as differential absorption spectroscopy or shifted excitation Raman difference spectroscopy. Common wavelength operation simultaneously generates two emission lines suitable for the generation of THz radiation using difference frequency mixing. Hereby, the devices could potentially be used as single-chip light sources for a combination of Raman and THz applications. For the wavelength-operation comparison presented, the devices were operated up to optical output powers of about 105 and 185 mW in individual and common wavelength-operation mode, respectively. In individual operation mode, the devices show spectral single-mode emission over the whole operation range. In common operation mode, the spectral emission is predominantly single mode up to an optical output power of 65 mW. In both operation modes, mode hops typical for DBR lasers occur. At an optical output power of 50 mW, tuning of the spectral distance between the two wavelengths using the implemented resistor heaters is demonstrated. In both modes of wavelength operation, a flexible frequency difference between 0 and 0.8 THz (0 and 1.6 nm) with predominantly single-mode spectral emission is obtained.
Transforming workplaces into performing workspaces—Holistic evaluation concept for managing workspace change projects
Authors: Kämpf-Dern Annette , Will-Zocholl Mascha 
Published: May 2022

AbstractTransforming traditional workplaces into high-performing workspaces is a complex venture, not only in terms of design and preparation, but also in terms of implementation and management with regard to the realization of the intended goals. To be successful, holistic management is essential.Starting with the definition of goals and performance metrics, evaluation must be established from the very beginning and then continuously be applied to the project.The evaluation concept—like a controlling system, only with workspace-specific aspects and KPIs—covers two areas: The main dimensions of workspace design with the involved stakeholders and their performance parameters, and the processes of implementation, the change management aspects. The interaction of these areas must also be considered.The overall study discusses both success factors and potential pitfalls regarding the content and processes of designing and implementing modern office work environments in Germany. The study excerpt presented here addresses the evaluation of transformation projects in the field of working environments. Conceptually, instruments of marketing research are combined with components of controlling systems to develop an evaluation concept, which was then applied in a first empirical concept test at a German financial institution.An evaluation concept supports those responsible for the workspace project to keep on track by deducting and tracking relevant KPIs, offering tools and methods for group and team processes regarding the change project, and providing those.To combine design and change management of workspace projects in one evaluation concept and to provide a structured list of possible instruments/methods for evaluation over the different phases of such a project is new and thus original for workspace management.
Publicidad de alimentos ultra procesados en youtubers preescolares durante la COVID-19
Authors: López Bolás Alba , Feijoo Fernández Beatriz , Fernández Gómez Erika 
Published: May 2022

En crisis sanitarias como la de la COVID-19, en la que aumenta el consumo de YouTube por parte de la audiencia preescolar y empeoran sus hábitos alimenticios, resulta primordial mantener un mayor control de la publicidad que consume este público en esta red social. Este artículo tiene como propósito identificar y analizar la publicidad de marcas de alimentos ultraprocesados emitida por los populares youtubers infantiles Vlad y Niki durante el estado de alarma por la COVID-19. Se realizó un análisis de contenido de 802 marcas detectadas en 249 vídeos publicados en el canal en español desde su apertura (diciembre de 2018) hasta enero de 2021. Se encontró que durante la COVID-19 los youtubers promocionaron un mayor número de marcas de alimentos ultraprocesados sin revelar el vínculo con el anunciante en un lugar visible y comprensible, y que expresaron emociones positivas al consumirlos. Esto pone en riesgo la salud del colectivo al constatar en estudios previos que existe una relación entre este tipo de publicidad y la obesidad infantil.
Alfabetização e Letramento: Concepções e práticas pedagógicas no âmbito escolar / Literacy And Initial Reading Instruction: Conceptions and Pedagogical Practices in the School Environment
Authors: Santos Silvia Alexandre Moura , Miguel Joelson Rodrigues 
Published: May 2022

Resumo: A presente pesquisa aborda a temática sobre Alfabetização e Letramento: Concepções e práticas pedagógicas no âmbito escolar. Contextualiza e enfatiza como o docente vem trabalhando as práticas pedagógicas no processo de ensino aprendizagem referente à alfabetização no ensino fundamental I das escolas da rede pública municipal da cidade de Miraíma/CE. A amostra não probabilística, contou com 24 professores que atuam no ensino fundamental I da rede municipal de ensino, 04 gestores e 04 coordenadores pedagógicos, que atuam, respectivamente, na zona urbana e rural do referido município. Seu aporte teórico foi construído na perspectiva dos autores: Freire (1981;1983); Ferreiro (2013); Dowing, 1990) e Soares (2017), dentre outros. Os resultados expressaram que existe, em certa medida, uma visão conjunta em relação à importância de se adotar práticas pedagógicas mais lúdicas e interativas. Entretanto, alguns obstáculos e dificuldades foram mencionados, especialmente no tocante à participação dos pais no processo de educação dos filhos e o acesso a materiais pedagógicos variados na escola. Palavras-chave: Ensino. Aprendizagem. Práticas pedagógicas. Formação. Abstract: This research addresses the issue of literacy and initial reading instruction: Conceptions and pedagogical practices in the school environment. It contextualizes and emphasizes how the teacher has been working with pedagogical practices in the teaching-learning process regarding literacy in elementary school I of municipal public schools in the city of Miraíma/CE. The non-probabilistic sample had 24 teachers who work in elementary school I of the municipal school system, 04 managers and 04 pedagogical coordinators, who work, respectively, in the urban and rural areas of that municipality. Its theoretical contribution was built from the perspective of the authors: Freire (1981;1983); Blacksmith (2013); Dowing, 1990) and Soares (2017), among others. The results expressed that there is, to a certain extent, a joint vision regarding the importance of adopting more playful and interactive pedagogical practices. However, some obstacles and difficulties were mentioned, especially regarding the participation of parents in the process of educating their children and access to varied pedagogical materials at school. Keywords: Teaching. Learning. Pedagogical practices. Formation.