bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critically high metal ion levels found in metal-on-metal modular hinged knee arthroplasty
Authors: Gramlich Yves , Hofmann Line , Kress Sandra , Ruckes Christian , Kemmerer Matthias , Klug Alexander , Hoffmann Reinhard , Kremer Michael 
Published: March 2022

Aims This study compared the cobalt and chromium serum ion concentration of patients treated with two different metal-on-metal (MoM) hinged total knee arthroplasty (TKA) systems, as well as a titanium nitride (TiN)-coated variant. Methods A total of 63 patients (65 implants) were treated using either a MoM-coated (n = 29) or TiN-coated (n = 7) hinged TKA (GenuX mobile bearing, MUTARS; Implantcast, Germany) versus the BPKS (Brehm, Germany) hinged TKA (n = 27), in which the weight placed on the MoM hinge is diffused through a polyethylene (PE) inlay, reducing the direct load on the MoM hinge. Serum cobalt and chromium ion concentrations were assessed after minimum follow-up of 12 months, as well as functional outcome and quality of life. Results No differences in mean age (69 years, 40 to 86), mean age adapted Charlson Comorbidity Index (3.1 (SD 1.4)), mean BMI (29.2 kg/m2 (SD 5.8)), or number of other implants were observed between groups. Significant improvements in outcome scores and pain levels were achieved for all groups, and there was no difference in quality of life (12-Item Short-Form Health Survey questionnaire (SF-12)). Mean cobalt and chromium ion levels were significantly higher for the GenuX versus the BPKS hinged TKA (GenuX vs BPKS: cobalt: 16.3 vs 9.4 µg/l; chromium: 9.5 vs 5.2 µg/l). The TiN-coated implants did not appear to confer improvement in the metal ion levels. Metal ion concentrations above 7 µg/l were detected in 81%(29/36) of GenuX patients versus 41% (11/27) in the BPKS group. No GenuX patients had normal levels under 2 µg/l, versus 22% of BPKS patients. No significant reduction in outcome scores was observed regardless of the metal ion levels, whereas higher work-related activity was correlated with higher chromium concentrations. Conclusion Hinged TKA, using MoM hinges, resulted in critically high cobalt and chromium ion concentrations. The BPKS hinged TKA showed significantly lower metal ion concentrations compared with the GenuX TKA. No benefits were observed using TiN coating. The different weightbearing mechanics might influence the wear of the component materials. Higher workloads and physical activity could influence chromium levels. Cite this article: Bone Joint J 2022;104-B(3):376–385.
Pelvic incidence significance relative to spinopelvic risk factors for total hip arthroplasty instability
Authors: Kleeman-Forsthuber Lindsay , Vigdorchik Jonathan M. , Pierrepont Jim W. , Dennis Douglas A. 
Published: March 2022

Aims Pelvic incidence (PI) is a position-independent spinopelvic parameter traditionally used by spinal surgeons to determine spinal alignment. Its relevance to the arthroplasty surgeon in assessing patient risk for total hip arthroplasty (THA) instability preoperatively is unclear. This study was undertaken to investigate the significance of PI relative to other spinopelvic parameter risk factors for instability to help guide its clinical application. Methods Retrospective analysis was performed of a multicentre THA database of 9,414 patients with preoperative imaging (dynamic spinopelvic radiographs and pelvic CT scans). Several spinopelvic parameter measurements were made by engineers using advanced software including sacral slope (SS), standing anterior pelvic plane tilt (APPT), spinopelvic tilt (SPT), lumbar lordosis (LL), and PI. Lumbar flexion (LF) was determined by change in LL between standing and flexed-seated lateral radiographs. Abnormal pelvic mobility was defined as ∆SPT ≥ 20° between standing and flexed-forward positions. Sagittal spinal deformity (SSD) was defined as PI-LL mismatch > 10°. Results PI showed a positive correlation with parameters of SS, SPT, and LL (r-value range 0.468 to 0.661). Patients with a higher PI value showed higher degrees of standing LL, likely as a compensatory measure to maintain sagittal spine balance. There was a positive correlation between LL and LF such that patients with less standing LL had decreased LF ( r = 0.49). Similarly, there was a positive correlation between increased SSD and decreased LF ( r = 0.54). PI in isolation did not show any significant correlation with lumbar ( r = 0.04) or pelvic mobility ( r = 0.02). The majority of patients (range 89.4% to 94.2%) had normal lumbar and pelvic mobility regardless of the PI value. Conclusion The PI value alone is not indicative of either spinal or pelvic mobility, and thus in isolation may not be a risk factor for THA instability. Patients with SSD had higher rates of spinopelvic stiffness, which may be the mechanism by which PI relates to THA instability risk, but further clinical studies are required. Cite this article: Bone Joint J 2022;104-B(3):352–358.
The outcome of subsequent revisions after primary total hip arthroplasty in 1,049 patients aged under 50 years
Authors: Kuijpers Martijn F. L. , Colo Ena , Schmitz Marloes W. J. L. , Hannink Gerjon , Rijnen Wim H. C. , Schreurs B. Willem 
Published: March 2022

Aims The aim of this study was to determine the outcome of all primary total hip arthroplasties (THAs) and their subsequent revision procedures in patients aged under 50 years performed at our institution. Methods All 1,049 primary THAs which were undertaken in 860 patients aged under 50 years between 1988 and 2018 in our tertiary care institution were included. We used cemented implants in both primary and revision surgery. Impaction bone grafting was used in patients with acetabular or femoral bone defects. Kaplan-Meier analyses were used to determine the survival of primary and revision THA with the endpoint of revision for any reason, and of revision for aseptic loosening. Results The mean age of the patients at the time of the initial THA was 38.6 years (SD 9.3). The mean follow-up of the THA was 8.7 years (2.0 to 31.5). The rate of survival for all primary THAs, acetabular components only, and femoral components only at 20 years’ follow-up with the endpoint of revision for any reason, was 66.7% (95% confidence interval (CI) 60.5 to 72.2), 69.1% (95% CI 63.0 to 74.4), and 83.2% (95% CI 78.1 to 87.3), respectively. A total of 138 revisions were performed. The mean age at the time of revision was 48.2 years (23 to 72). Survival of all subsequent revision procedures, revised acetabular, and revised femoral components at 15 years’ follow-up with the endpoint of revision for any reason was 70.3% (95% CI 56.1 to 80.7), 69.7% (95% CI 54.3 to 80.7), and 76.2% (95% CI 57.8 to 87.4), respectively. A Girdlestone excision arthroplasty was required in six of 860 patients (0.7%). Conclusion The long-term outcome of cemented primary and subsequent revision THA is promising in these young patients. We showed that our philosophy of using impaction bone grafting in patients with acetabular and femoral defects is a very suitable option when treating young patients. Surgeons should realize that knowledge of the outcome of subsequent revision surgery, which is inevitable in young patients, must be communicated to this group of patients prior to their initial THA. Cite this article: Bone Joint J 2022;104-B(3):368–375.
Survivorship, complications, and outcomes following distal femoral arthroplasty for non-neoplastic indications
Authors: Sobol Keenan Rhys , Fram Brianna R. , Strony John T. , Brown Scot A. 
Published: March 2022

Aims Endoprosthetic reconstruction with a distal femoral arthroplasty (DFA) can be used to treat distal femoral bone loss from oncological and non-oncological causes. This study reports the short-term implant survivorship, complications, and risk factors for patients who underwent DFA for non-neoplastic indications. Methods We performed a retrospective review of 75 patients from a single institution who underwent DFA for non-neoplastic indications, including aseptic loosening or mechanical failure of a previous prosthesis (n = 25), periprosthetic joint infection (PJI) (n = 23), and native or periprosthetic distal femur fracture or nonunion (n = 27). Patients with less than 24 months’ follow-up were excluded. We collected patient demographic data, complications, and reoperations. Reoperation for implant failure was used to calculate implant survivorship. Results Overall one- and five-year implant survivorship was 87% and 76%, respectively. By indication for DFA, mechanical failure had one- and five-year implant survivorship of 92% and 68%, PJI of 91% and 72%, and distal femur fracture/nonunion of 78% and 70% (p = 0.618). A total of 37 patients (49%) experienced complications and 27 patients (36%) required one or more reoperation. PJI (n = 16, 21%), aseptic loosening (n = 9, 12%), and wound complications (n = 8, 11%) were the most common complications. Component revision (n = 10, 13.3%) and single-stage exchange for PJI (n = 9, 12.0 %) were the most common reoperations. Only younger age was significantly associated with increased complications (mean 67 years (SD 9.1)) with complication vs 71 years (SD 9.9) without complication; p = 0.048). Conclusion DFA is a viable option for distal femoral bone loss from a range of non-oncological causes, demonstrating acceptable short-term survivorship but with high overall complication rates. Cite this article: Bone Jt Open 2022;3(3):173–181.
The creative co-design of low back pain education resources
Authors: Webber Richard , Partridge Rebecca , Grindell Cheryl 
Published: March 2022

Background:Evidence-based guidelines provide clinicians with best practice recommendations but not the means to implement them. Although co-design is increasingly promoted as a way to improve implementation there is frequently insufficient detail provided to understand its contribution. The presented case study addresses this by providing a detailed account of how a specific co-design approach contributed to an improving back pain education project in line with national guidance.
Aim:The aim was to use creative co-design to produce prototype evidence-based back pain educational resources that were sensitive to context.
Objectives:
Assemble a group of relevant stakeholders for a series of workshops.
Use creative activities that encourage divergent and convergent thinking to iteratively understand the problem and develop prototype solutions.
Thematically analyse outputs of each workshop to determine content of subsequent workshops.
Present a final prototype ready for implementation.

Key conclusions:
This approach produced an innovative system of thematically linked back pain educational resources that were contextually sensitive, evidence-based and ready for implementation.
Research knowledge was successfully blended with stakeholder experiential knowledge.
The creative methods helped diverse stakeholders develop trusting relationships and ensured everyone’s experiences and ideas were included.
The process of co-creation and the objects created had vital roles in surfacing and understanding stakeholder knowledge, promoting innovation and facilitating implementation.
The design process facilitated an evolving understanding of a complex problem alongside prototype development.
It is recommended that these methods be considered by other project teams.
Leveraging joint allocation of multidimensional resources for distributed task assignment
Authors: Li Jialong , Hua Nan , Zhu Kangqi , Zhao Chen , Pan Guanqin , Li Yanhe , Zheng Xiaoping , Zhou Bingkun 
Published: March 2022

Edge computing has changed the landscape of telecommunication networks. Different from cloud computing in which thousands of servers are centralized in a remote site, computation and storage resources are deployed at the network edge in edge computing, reducing the end-to-end latency and the amount of transmitting data in metro/backbone networks significantly. Due to the limited resource capacity in a single edge node and the requirements of distributed applications, some applications are supposed to be decomposed into multiple interdependent tasks and executed in distributed resource-constrained nodes. Assigning tasks to geographically distributed edge nodes is quite challenging because of the allocation of multidimensional resources (i.e., computation, storage, and transmission) as well as constraints of the interdependency between different tasks. Strategies that take only one factor into account for optimization will cause improper task assignments, leading to higher end-to-end latency and lower resource utilization efficiency. To solve this problem, we formulate a mathematical model aiming at minimizing the job completion time by jointly considering the availability of multidimensional resources and the interdependency among different tasks. We obtain optimal results in small topology by using optimization software that validates the correctness of the proposed mathematical model. Furthermore, we analyze the complexity and design of a practical algorithm by narrowing the searching space in large-scale topology. Simulation results present its effectiveness over greedy algorithms. Finally, we conduct a proof-of-concept experiment to validate the feasibility of the proposed strategy.
Intense optical parametric amplification in dispersion-engineered nanophotonic lithium niobate waveguides
Authors: Ledezma Luis , Sekine Ryoto , Guo Qiushi , Nehra Rajveer , Jahani Saman , Marandi Alireza 
Published: March 2022

Strong amplification in integrated photonics is one of the most desired optical functionalities for computing, communications, sensing, and quantum information processing. Semiconductor gain and cubic nonlinearities, such as four-wave mixing and stimulated Raman and Brillouin scattering, have been among the most studied amplification mechanisms on chip. Alternatively, material platforms with strong quadratic nonlinearities promise numerous advantages with respect to gain and bandwidth, among which nanophotonic lithium niobate is one of the most promising candidates. Here, we combine quasi-phase matching with dispersion engineering in nanophotonic lithium niobate waveguides and achieve intense optical parametric amplification. We measure a broadband phase-sensitive on-chip amplification larger than 50 dB/cm in a 6-mm-long waveguide. We further confirm high gain operation in the degenerate and nondegenerate regimes by amplifying vacuum fluctuations to macroscopic levels, with on-chip gains exceeding 100 dB/cm over 600 nm of bandwidth around 2 µm. Our results unlock new possibilities for on-chip few-cycle nonlinear optics, mid-infrared photonics, and quantum photonics.
Prevalence of hypertension and its associated factors in Hawassa city administration, Southern Ethiopia: Community based cross-sectional study
Authors: Paulose Tsegab , Nkosi Zerish Zethu , Endriyas Misganu 
Published: March 2022

Background
In association with the epidemiological, nutritional and demographic transition, many research findings showed that the number of risk factors that leads to increased prevalence of hypertension in low and middle income countries like Ethiopia is increasing. Several urban specific studies conducted in Ethiopia showed varying prevalence of hypertension. The aim of this study was to determine prevalence of hypertension and to identify factors associated with hypertension in Hawassa city administration, Southern Ethiopia.

Methods
A community-based cross sectional study was carried out in Hawassa city administration in 2017. A multi-stage sampling technique was used to select 612 study participants. Descriptive statistics was used to describe socio-demographic, behavioral and anthropometric variables. The economic status of household, ‘wealth index’, was constructed by running principal component analysis. Binary logistic regression analysis was performed to assess factors associated with hypertension at 95%CI.

Results
The overall prevalence of hypertension was 21.2% (95% CI: 18.1–24.7), (24.5% for urban and 14.7% for peri-urban). About two fifths of hypertension cases (42.3%) were newly diagnosed with elevated blood pressure during data collection. Age, occupation, wealth status, consuming vegetables and animal fat, usual mode of transport, body mass index (BMI), family history of hypertension and existence of diabetes were associated with presence of hypertension at 95%CI. The average diastolic blood pressure for urban was 2.18mmHg higher than that of peri-urban groups (p-0.01).

Conclusion
More than one fifth of study participants had hypertension and about two fifths of hypertension cases were newly diagnosed. Health communication should be strengthened focusing on identified risk factors and attention should be given to early detect and tackle the effects of hypertension in resource limited setting.
Analytic approaches to clinical validation of results from preclinical models of glioblastoma: A systematic review
Authors: Fitt Beth , Loy Grace , Christopher Edward , Brennan Paul M. , Poon Michael Tin Chung 
Published: March 2022

Introduction
Analytic approaches to clinical validation of results from preclinical models are important in assessment of their relevance to human disease. This systematic review examined consistency in reporting of glioblastoma cohorts from The Cancer Genome Atlas (TCGA) or Chinese Glioma Genome Atlas (CGGA) and assessed whether studies included patient characteristics in their survival analyses.

Methods
We searched Embase and Medline on 02Feb21 for studies using preclinical models of glioblastoma published after Jan2008 that used data from TCGA or CGGA to validate the association between at least one molecular marker and overall survival in adult patients with glioblastoma. Main data items included cohort characteristics, statistical significance of the survival analysis, and model covariates.

Results
There were 58 eligible studies from 1,751 non-duplicate records investigating 126 individual molecular markers. In 14 studies published between 2017 and 2020 using TCGA RNA microarray data that should have the same cohort, the median number of patients was 464.5 (interquartile range 220.5–525). Of the 15 molecular markers that underwent more than one univariable or multivariable survival analyses, five had discrepancies between studies. Covariates used in the 17 studies that used multivariable survival analyses were age (76.5%), pre-operative functional status (35.3%), sex (29.4%) MGMT promoter methylation (29.4%), radiotherapy (23.5%), chemotherapy (17.6%), IDH mutation (17.6%) and extent of resection (5.9%).

Conclusion
Preclinical glioblastoma studies that used TCGA for validation did not provide sufficient information about their cohort selection and there were inconsistent results. Transparency in reporting and the use of analytic approaches that adjust for clinical variables can improve the reproducibility between studies.
Percentage of body fat is associated with increased risk of diverticulosis: A cross sectional study
Authors: Shih Chi-Wei , Chen Yu-Hsin , Chen Wei-Liang 
Published: March 2022

Background
Obesity has been indicated to be a risk factor of diverticulosis. However, plausible relationship remained controversial. This cross-sectional study elucidated the association between percentage of body fat and the risk of diverticulosis.

Methods
The study was conducted at a single medical center in Taiwan from 2000–2016 which enrolled 5557 adults with age above 20 years old receiving a health examination including self-reported questionnaires, measurement of percentage of body fat (PBF), blood test and colonoscopy at the Tri-Service General Hospital (TSGH). Logistic regressions were used to analyze the association between PBF and diverticulosis. Further stratification of participants was based on age and gender and three extended models were established for multivariable adjustment.

Results
243 of 3141 males and 103 of 2416 females were diagnosed with having diverticulosis. After covariates adjustment, only participants in the highest quartile of PBF (Q4 ≥33.8%) showed significantly positive association with the risk diverticulosis (OR 2.089, p <0.001). In subgroup analysis, the odds ratio for having diverticulosis in females was significantly higher than in males. In addition, We found that the odds ratio of having diverticulosis was higher in the group older than 60 years old compared to the younger group (OR 1.052; p<0.001; OR 1.043; p<0.001).

Conclusions
In conclusion, PBF was a potential risk factor of diverticulosis. Individuals with higher PBF exhibits increased risk of diverticulosis, especially in females. Furthermore, bioelectrical impedance analysis may create a simple, available and radiation-free way to assess the risk of diverticulosis.
Autoconhecimento sob a perspectiva da Gestalt-Terapia / Self-knowledge through the perspective of Gestalt therapy
Authors: Hack Josias Ricardo 
Published: March 2022

O ensaio investiga nuances da abordagem gestáltica sobre a integralidade da pessoa no aqui e agora, instância na qual tomam forma diferentes figura/fundo. O intuito é provocar o leitor a refletir sobre o autoconhecimento em uma perspectiva ancorada na Gestalt-Terapia. Na primeira seção, apresento algumas conexões introdutórias que sinalizam os caminhos que percorri para chegar ao presente texto. Na segunda seção, destaco alguns aspectos teóricos da prática psicoterapêutica pensada por Fritz Perls e colaboradores, bem como enuncio a possibilidade de interlocução entre a abordagem gestáltica e o olhar integral para a pessoa em seu meio. Na terceira seção, explicito a contribuição da Gestalt-Terapia ao autoconhecimento e consequente integração equilibrada do organismo (corpo/psique) ao meio. Por fim, na última seção, exponho algumas conexões que visam demonstrar outros insights advindos de minha caminhada como psicoterapeuta e investigador da psique, bem como do uso que tenho feito das compreensões sobre a ampliação da consciência no acompanhamento clínico e na intersecção entre as partes e o todo no processo de autoconhecimento. Abstract: This essay investigates nuances of the gestalt view of a person's integrality in the here-and-now, an instance in which a person takes on different figure-backgrounds. The article aim is to provoke the reader to reflect on self-knowledge using a perspective anchored in Gestalt-Therapy. In the first section, I present a few introductory connections to indicate the paths I took to write this text. In the second section, I highlight a few theoretical aspects of the psychotherapeutic practice thought out by Fritz Perls and collaborators; as well as the possibility of a dialogue between the gestalt approach and the holistic look at a person in their environment. In the third section I explain the contribution of Gestalt therapy to self-knowledge and the resulting balanced integration of the organism (body/psyche) into its environment. And finally, in the last section, a few more connections are shown in order to demonstrate insights which have arisen from my journey as a psychotherapist and researcher of the Psyche; as well as the use I have made of my understanding about the expansion of consciousness, in the process of self-knowing, through clinical practises and through awareness of the intersection between parts and their whole.Keywords: Self-knowledge; Gestalt therapy; Figure-background; Here-and-now; Wholeness of the organism.