What we know about the effectiveness of budget support: Evaluation Synthesis

For a number of years, budget support has been a preferred aid modality for implementing the principles of effective aid formulated in the 2005 Paris Declaration. Various evaluations find that aid provided through this modality contributes to increased budget allocation towards poverty reduction and improved development outcomes in a number of countries. Nonetheless, budget support has increasingly come under criticism in recent years, and many bilateral donors have either partly or fully stopped using this modality. Against this background, DEval conducted a comprehensive and systematic review of existing evidence on the effectiveness of budget support, based on a considerably larger number and greater variety of sources than previous synthetic work. To close important remaining knowledge gaps this evaluation synthesis draws together different perspectives on the impact of budget support from a total of 95 evaluations and studies. The findings substantiate existing knowledge on the effectiveness of budget support and at the same time generate new insights for decision makers in German and international development cooperation

Impact of Covid-19 on the global orthopaedic research output

The pandemic led to a significant change in the clinical routine of many orthopaedic surgeons. To observe the impact of the pandemic on scientific output all studies published in the fields of orthopaedics listed in the Web of Science databases were analysed regarding the scientific merit of the years 2019, 2020, and 2021. Subsequently, correlation analyses were performed with parameters of regional pandemic situation (obtained from WHO) and economic strength (obtained from the World Bank). The investigations revealed that the Covid-19 pandemic led to a decrease in the annual publication rate for the first time in 20 years (2020 to 2021: –5.69%). There were regional differences in the publication rate, which correlated significantly with the respective Covid-19 case count (r = –.77, p < 0.01), associated death count (r = –.63, p < 0.01), and the gross domestic product per capita (r = –.40, p < 0.01) but not with the number of vaccinations (r = .09, p = 0.30). Furthermore, there was a drastic decrease in funding from private agencies (relative share: 2019: 36.43%, 2020: 22.66%, 2021: 19.22%), and a balanced decrease in publication output for research areas of acute and elective patient care. The Covid-19 pandemic resulted in a decline in orthopaedic annual publication rates for the first time in 20 years. This reduction was subject to marked regional differences and correlated directly with the pandemic load and was associated with decreased research funding from the private sector

Comparison of the scientific performance in hip and knee arthroplasty between the leading continents

Background: Scientific progress in the field of knee and hip arthroplasty has enabled the preservation of mobility and quality of life in the case of patients with many primary degenerative and (post-) traumatic joint diseases. This comparative study aims to investigate differences in scientific performance between the leading continents in the field of hip and knee arthroplasty. Methods: Using specific search terms all studies published by the scientific leading continents Europe, North America, Asia and Oceania listed in the Web of Science databases were included. All identified publications were analysed and comparative conclusions were drawn regarding the qualitative and quantitative scientific merit of each continent. Results: Europe, followed by North America, Asia, and Oceania, had the highest overall number of publications in the field of arthroplasty. Since 2000, there has been a strong increase in knee arthroplasty publication rate, particular pronounced in Asia. Studies performed and published in North America and those on knee arthroplasty received the highest number of fundings. Publications regarding hip arthroplasty achieved the highest average citation rate. In contradistinction to the others, in North America most funding was provided by private agencies. Conclusion: Although Europe showed the highest total number of publications, authors and institutions, arthroplasty research from North America received greater scientific attention and financial support. Measured by citations, publications on hip arthroplasty attained higher scientific interest and studies on knee arthroplasty received higher economic affection

Beyond society's desire for a slowed‐down temporal experience: Toward a nomological network of individuals' need‐for deceleration

This study expands on past deceleration and slow consumption research by introducing and validating a measure of need-for-deceleration, an individual's motivational ability to engage in activities aimed at slowing down the perceived fast passage of time. Following initial scale development, two studies establish construct validity by placing need-for-deceleration into a nomological network. Results indicate that the measure correlated with, but was distinct from, variables involving negative affective states, such as state anxiety and neuroticism. Need-for-deceleration scores were not related to materialism, but negatively correlated with self-efficacy, life satisfaction, work-life balance, and conscientiousness. Correlations were positive with need-for-uniqueness, future time orientation, and susceptibility to normative influence. Need-for-deceleration was also associated with regulatory focus (positively with prevention, and negatively with promotion focus). To explore criterion validity, a third study establishes associations between need-for-deceleration and consumer lifestyle variables. Developing and validating the scale can help researching and managing products relating to the consumption of time, wellness, mindfulness, and simplicity

Subgroup analysis of scientific performance in the field of arthroplasty

Introduction: Arthroplasty is the final treatment option for maintaining mobility and quality of life in many primary degenerative and (post-) traumatic joint diseases. Identification of research output and potential deficits for specific subspecialties may be an important measure to achieve long-term improvement of patient care in this field. Methods: Using specific search terms and Boolean operators, all studies published since 1945 to the subgroups of arthroplasty listed in the Web of Science Core Collection were included. All identified publications were analysed according to bibliometric standards, and comparative conclusions were drawn regarding the scientific merit of each subgroup. Results: Most publications investigated the subgroups of septic surgery and materials followed by approach, navigation, aseptic loosening, robotic and enhanced recovery after surgery (ERAS). In the last 5 years, research in the fields of robotic and ERAS achieved the highest relative increase in publications In contrast, research on aseptic loosening has continued to lose interest over the last 5 years. Publications on robotics and materials received the most funding on average while those on aseptic loosening received the least. Most publications originated from USA, Germany, and England, except for research on ERAS in which Denmark stood out. Relatively, publications on aseptic loosening received the most citations, whereas the absolute scientific interest was highest for the topic infection. Discussion: In this bibliometric subgroup analysis, the primary scientific outputs focused on septic complications and materials research in the field of arthroplasty. With decreasing publication output and the least financial support, intensification of research on aseptic loosening is urgently recommended

Reappraisal of clinical trauma trials: the critical impact of anthropometric parameters on fracture gap micro-mechanics-observations from a simulation-based study

The evidence base of surgical fracture care is extremely sparse with only few sound RCTs available. It is hypothesized that anthropometric factors relevantly infuence mechanical conditions in the fracture gap, thereby interfering with the mechanoinduction of fracture healing. Development of a fnite element model of a tibia fracture, which is the basis of an in silico population (n= 300) by systematic variation of anthropometric parameters. Simulations of the stance phase and correlation between anthropometric parameters and the mechanical stimulus in the fracture gap. Analysis of the infuence of anthropometric parameters on statistical dispersion between in silico trial cohorts with respect to the probability to generate two, with respect to anthropometric parameters statistically diferent trial cohorts, given the same power assumptions. The mechanical impact in the fracture gap correlates with anthropometric parameters; confrming the hypothesis that anthropometric factors are a relevant entity. On a cohort level simulation of a fracture trial showed that given an adequate power the principle of randomization successfully levels out the impact of anthropometric factors. From a clinical perspective these group sizes are difcult to achieve, especially when considering that the trials takes advantage of a „laboratory approach “, i.e. the fracture type has not been varied, such that in real world trials the cohort size have to be even larger to level out the diferent confgurations of fractures gaps. Anthropometric parameters have a signifcant impact on the fracture gap mechanics. The cohort sizes necessary to level out this efect are difcult or unrealistic to achieve in RCTs, which is the reason for sparse evidence in orthotrauma. New approaches to clinical trials taking advantage of modelling and simulation techniques need to be developed and explored

Comparison of the Accuracy of 2D and 3D Templating for Revision Total Hip Replacement

Introduction: Revision hip arthroplasty is a challenging surgical procedure, especially in cases of advanced acetabular bone loss. Accurate preoperative planning can prevent complications such as periprosthetic fractures or aseptic loosening. To date, the accuracy of three-dimensional (3D) versus two-dimensional (2D) templating has been evaluated only in primary hip and knee arthroplasty. Methods: We retrospectively investigated the accuracy of 3D personalized planning of reinforcement cages (Burch Schneider) in 27 patients who underwent revision hip arthroplasty. Personalized 3D modeling and positioning of the reinforcement cages were performed using computed tomography (CT) of the pelvis of each patient and 3D templates of the implant. To evaluate accuracy, the sizes of the reinforcement cages planned in 2D and 3D were compared with the sizes of the finally implanted cages. Factors that may potentially influence planning accuracy such as gender and body mass index (BMI) were analyzed. Results: There was a significant difference (p = 0.003) in the accuracy of correct size prediction between personalized 3D templating and 2D templating. Personalized 3D templating predicted the exact size of the reinforcement cage in 96.3% of the patients, while the exact size was predicted in only 55.6% by 2D templating. Regarding gender and BMI, no statistically significant differences in planning accuracy either for 2D or 3D templating were observed. Conclusion: Personalized 3D planning of revision hip arthroplasty using Burch Schneider reinforcement cages leads to greater accuracy in the prediction of the required size of implants than conventional 2D templating

Concepts and clinical aspects of active implants for the treatment of bone fractures

Nonunion is a complication of long bone fractures that leads to disability, morbidity and high costs. Early detection is difficult and treatment through external stimulation and revision surgery is often a lengthy process. Therefore, alternative diagnostic and therapeutic options are currently being explored, including the use of external and internal sensors. Apart from monitoring fracture stiffness and displacement directly at the fracture site, it would be desirable if an implant could also vary its stiffness and apply an intervention to promote healing, if needed. This could be achieved either by a predetermined protocol, by remote control, or even by processing data and triggering the intervention itself (self-regulated ‘intelligent’ or ‘smart’ implant). So-called active or smart materials like shape memory alloys (SMA) have opened up opportunities to build active implants. For example, implants could stimulate fracture healing by active shortening and lengthening via SMA actuator wires; by emitting pulses, waves, or electromagnetic fields. However, it remains undefined which modes of application, forces, frequencies, force directions, time durations and periods, or other stimuli such implants should ideally deliver for the best result. The present paper reviews the literature on active implants and interventions for nonunion, discusses possible mechanisms of active implants and points out where further research and development are needed to build an active implant that applies the most ideal intervention

Mechanisms of Psychological Distress following War in the Former Yugoslavia: The Role of Interpersonal Sensitivity

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.This study was funded by a grant from the European Commission, contract number INCO-CT-2004-509176. AN was supported by a Clinical Early Career Research Fellowship (113295) and a Project Grant (104288