Explore the vast range of titles available.

Background One of the causes of patient dissatisfaction after total hip arthroplasty (THA) is leg length discrepancy (LLD). Even when radiographic LLD (R-LLD) is within 5 mm, some people perceive the affected side to be longer, while others perceive it is shorter. The purpose of this study was to investigate the relationship between perceived LLD (P-LLD), R-LLD, and Forgotten Joint Score (FJS-12) after THA. Methods A retrospective study of 164 patients with unilateral hip disease was conducted. Based on P-LLD after THA, they were classified into three categories: perceived short (PS 21 patients), no LLD (PN 121 patients), and perceived long (PL 22 patients). On the other hand, based on R-LLD after THA, they were divided into <  − 5 mm (RS 36 patients), − 5 mm ≤ x < 5 mm (RN 99 patients), and 5 mm ≥ (RL 29 patients), respectively. The proportion of P-LLD in the RN group was also evaluated. In each group, the relationship between P-LLD, R-LLD and FJS-12 was investigated. Results After THA, the PL group had significantly worse FJS-12 (PS: 68.3 ± 26.2, PN: 75.0 ± 20.9, PL: 47.3 ± 25.2, P  < .0001). In the R-LLD evaluation, there was no difference in FJS-12 among the three groups (RS: 73.7 ± 21.1, RN: 70.0 ± 24.5, RL: 67.7 ± 25.4, P  < .53). The RN group perceived leg length to be longer (RN-PL) in 12.1% of cases, and the RN-PL groups had significantly worse FJS-12 (RN-PS: 65.4 ± 24.8, RN-PN: 73.8 ± 23.1, RN-PL: 41.8 ± 27.6, P  < .0001). Conclusion One year after THA, patients with longer P-LLD had worse FJS-12, even if the R-LLD was less than 5 mm.

Purpose As the relationship between leg-length discrepancy (LLD) and scoliosis has not been clearly defined, the purpose of this study was to explore the impact and severity of LLD in children and adolescents with scoliosis and the consistency between lower limb length discrepancy and pelvic height difference. Methods This retrospective study was conducted using prospectively collected data from 63 patients with functional scoliosis-associated LLD who received treatment at our hospital from March 2021 to July 2024. The inclusion criteria included: ①Children or adolescents with functional scoliosis complicated with LLD; ②Scoliosis classified as thoracolumbar or lumbar curve; ③A bilateral acetabular dome line parallel to the superior sacral endplate. The patients’ whole-spine posteroanterior and full lower limb radiographs were obtained to collect data on age, sex, LLD, Cobb angle, and pelvic height difference. Correlation analysis evaluated the relationship between LLD, leg-length discrepancy ratio (LLDR), Cobb angle, and the pelvic height difference. Univariate regression analysis was used to analyze the data using the SPSS software. Results In all cases, the convex side of the scoliosis corresponded to the shorter leg side. Female patients constituted 67% of the cohort. The patients’ mean age was 11.79 ± 3.52 years (range: 4 to 19 years). The average Cobb angle was 14.78 ± 4.99°, the average LLD was 11.22 ± 12.74 mm, and the mean pelvic height difference was 12.41 ± 10.32 mm. Significant correlations were observed when the bilateral acetabular dome line was parallel to the superior sacral endplate, and the scoliosis was thoracolumbar or lumbar, indicating associations between LLD and the Cobb angle ( R  = 0.440, P <0.05) and between LLDR and the Cobb angle ( R  = 0.445, P <0.05). Additionally, a strong positive correlation was identified between LLD and pelvic height difference ( R  = 0.874, P <0.05), indicating a high level of concordance between pelvic height difference and LLD. Conclusions In children and adolescents with functional scoliosis complicated by LLD, the Cobb angle significantly correlated with LLD. Additionally, LLDR also showed a significant correlation with the Cobb angle. A concordance was also observed between the pelvic height difference and LLD. Clinical trial number Not applicable.

Background The COVID-19 pandemic has placed an unprecedented strain on health systems, with rapidly increasing demand for healthcare in hospitals and intensive care units (ICUs) worldwide. As the pandemic escalates, determining the resulting needs for healthcare resources (beds, staff, equipment) has become a key priority for many countries. Projecting future demand requires estimates of how long patients with COVID-19 need different levels of hospital care. Methods We performed a systematic review of early evidence on length of stay (LoS) of patients with COVID-19 in hospital and in ICU. We subsequently developed a method to generate LoS distributions which combines summary statistics reported in multiple studies, accounting for differences in sample sizes. Applying this approach, we provide distributions for total hospital and ICU LoS from studies in China and elsewhere, for use by the community. Results We identified 52 studies, the majority from China (46/52). Median hospital LoS ranged from 4 to 53 days within China, and 4 to 21 days outside of China, across 45 studies. ICU LoS was reported by eight studies—four each within and outside China—with median values ranging from 6 to 12 and 4 to 19 days, respectively. Our summary distributions have a median hospital LoS of 14 (IQR 10–19) days for China, compared with 5 (IQR 3–9) days outside of China. For ICU, the summary distributions are more similar (median (IQR) of 8 (5–13) days for China and 7 (4–11) days outside of China). There was a visible difference by discharge status, with patients who were discharged alive having longer LoS than those who died during their admission, but no trend associated with study date. Conclusion Patients with COVID-19 in China appeared to remain in hospital for longer than elsewhere. This may be explained by differences in criteria for admission and discharge between countries, and different timing within the pandemic. In the absence of local data, the combined summary LoS distributions provided here can be used to model bed demands for contingency planning and then updated, with the novel method presented here, as more studies with aggregated statistics emerge outside China.

Background Previous designs of internal bone lengthening devices have been fraught with imprecise distraction, resulting in nerve injuries, joint contractures, nonunions, and other complications. Recently, a magnet-operated PRECICE ® nail (Ellipse Technologies, Inc, Irvine, CA, USA) was approved by the FDA; however, its clinical efficacy is unknown. Questions/purposes We evaluated this nail in terms of (1) accuracy and precision of distraction, (2) effects on bone alignment, (3) effects on adjacent-joint ROM, and (4) frequency of implant-related and non-implant-related complications. Methods We reviewed medical and radiographic records of 24 patients who underwent femoral and/or tibial lengthening procedures using the PRECICE ® nail from August 2012 to July 2013 for conditions of varied etiology, the most common being congenital limb length discrepancy, posttraumatic growth arrest, and fracture malunion. This group represented 29% of patients (24 of 82) who underwent a limb lengthening procedure for a similar diagnosis during the review period. At each postoperative visit, the accuracy and precision of distraction, bone alignment, joint ROM, and any complications were recorded by the senior surgeon (SRR). Accuracy reflected how close the measured lengthening was to the prescribed distraction at each postoperative visit, while precision reflected how close the repeated measurements were to each other over the course of total lengthening period. No patients were lost to followup. Minimum followup from surgery was 3 weeks (mean, 14 weeks; range, 3–29 weeks). Results Mean total lengthening was 35 mm (range, 14–65 mm), with an accuracy of 96% and precision of 86%. All patients achieved target lengthening with minimal unintentional effects on bone alignment. The knee and ankle ROM were minimally affected. Of the complications requiring return to the operating room for an additional surgical procedure, there was one (4%) implant failure caused by a nonfunctional distraction mechanism and six (24%) non-implant-related complications, including premature consolidation in one patient (4%), delayed bone healing in two (8%), delayed equinus contracture in two (8%), and toe clawing in one (4%). Conclusions We conclude that this internal lengthening nail is a valid option to achieve accurate and precise limb lengthening to treat a variety of conditions with limb shortening or length discrepancy. Randomized, larger-sample, long-term studies are required to further confirm clinical efficacy of these devices, monitor for any late failures and complications, and compare with other internal lengthening devices with different mechanisms of operation. Level of Evidence Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

There has been significant work recently on integer programs (IPs) $$\\min \\{c^\\top x :Ax\\le b,\\,x\\in \\mathbb {Z}^n\\}$$ minc⊤x:Ax≤b,x∈Zn with a constraint marix A with bounded subdeterminants. This is motivated by a well-known conjecture claiming that, for any constant $$\\Delta \\in \\mathbb {Z}_{>0}$$ Δ∈Z>0, $$\\Delta $$ Δ-modular IPs are efficiently solvable, which are IPs where the constraint matrix $$A\\in \\mathbb {Z}^{m\\times n}$$ A∈Zm×n has full column rank and all $$n\\times n$$ n×n minors of A are within $$\\{-\\Delta , \\dots , \\Delta \\}$$ -Δ,⋯,Δ. Previous progress on this question, in particular for $$\\Delta =2$$ Δ=2, relies on algorithms that solve an important special case, namely strictly $$\\Delta $$ Δ-modular IPs, which further restrict the $$n\\times n$$ n×n minors of A to be within $$\\{-\\Delta , 0, \\Delta \\}$$ -Δ,0,Δ. Even for $$\\Delta =2$$ Δ=2, such problems include well-known combinatorial optimization problems like the minimum odd/even cut problem. The conjecture remains open even for strictly $$\\Delta $$ Δ-modular IPs. Prior advances were restricted to prime $$\\Delta $$ Δ, which allows for employing strong number-theoretic results. In this work, we make first progress beyond the prime case by presenting techniques not relying on such strong number-theoretic prime results. In particular, our approach implies that there is a randomized algorithm to check feasibility of strictly $$\\Delta $$ Δ-modular IPs in strongly polynomial time if $$\\Delta \\le 4$$ Δ≤4.

This meta-analysis evaluated the effectiveness of data-driven learning (DDL) among low-proficiency L2 English learners, addressing the mixed results found in previous meta-analyses. The study incorporated 38 studies involving 2085 participants, yielding 37 effect sizes from control-experimental (C/E) studies and 42 from pre- and post-test (P/P) studies. The findings demonstrated that DDL had a medium effect in C/E studies (g = 0.71) and a large effect in P/P studies (g = 1.43). The moderator analyses, based on the corpus-based language pedagogy (CBLP) framework by Ma et al. (2022), examined 7 pedagogical moderators. The results reaffirmed the efficacy of DDL in teaching lexicogrammatical items and suggested DDL’s curriculum flexibility; the duration of DDL did not significantly impact its effectiveness. Unique to this meta-analysis were findings that DDL was more effective for low-proficiency L2 learners of English when employing the following pedagogical strategies that cater to the cognitive-social nature of DDL: (1) utilizing paper-based concordancing to facilitate the pedagogical processing of corpus resources, (2) leveraging learners’ first language (L1) to improve comprehension of concordance meanings, (3) applying interactive communication with teacher verbal guidance or teacher verbal feedback attuned to learner responsiveness, and (4) providing teacher support in collaborative work to reduce the collaborative cognitive load on learners. Finally, this study proposed a holistic approach to CBLP design tailored to low-proficiency L2 learners, which presents an essential frontier for future research.