bluuebunny/crossref_metadata_2025 huggingface dataset:
The in vitro scavenging ability of anthocyanin extracts from roselle calyces against reactive nitrogen species and their potential use for nitrite reduction in meat
Authors: Pinsirodom Praphan , Parinyapatthanaboot Thanawoot , Taprap Ruchira , Kaewthong Pensiri
Published: August 2019

The in vitro scavenging ability of roselle anthocyanin extract (RAE) against reactive nitrogen species (RNS) was compared to anthocyanin extracted from black carrots and red grapes. These anthocyanin samples exhibited concentration and pH dependence on nitrite scavenging activity, with the activity decreasing as pH was increased over the range of 3.0 to 9.0. Concentration dependent activity was also observed for the nitric oxide scavenging and inhibition of peroxynitrite induced oxidation of Evans blue dyes. The potency of RNS scavenging activity for the anthocyanins tested was in the order of grapes > roselle > black carrots. The RAE was then evaluated for its capacity in nitrite reduction in Vienna pork sausage and traditional Thai fermented pork, called Nham. The residual nitrite in Vienna pork sausage treated with 0.3 % RAE at 125 or 250 mg/kg reduced nitrite to 65 and 168 mg/kg respectively, after being stored at 4±1 ๐C for 24 days. The residual nitrite in all Nham samples rapidly decreased around 90 % of the initial nitrite level after 3 days of fermentation at 30±1 ๐C. Overall results show that RAE was a good source of strong reactive nitrogen species scavengers and can potentially be used as a natural nitrite reduction agent in meat products.
Stability of Fried Fish Crackers as Influenced by Packaging material and Storage Temperatures
Authors: Ibadullah Wan Zunairah Wan , Idris Atiqah Aqilah , Shukri Radhiah , Mustapha Nor Afizah , Saari Nazamid , Abedin Nur Hanani Zainal
Published: August 2019

The objective of the study was to determine the stability of fried fish crackers during storage at different temperatures. The physicochemical properties and lipid stability were examined at 25, 40 and 60°C for three months. Fried fish crackers were packed into two types of packaging with four different layers; (i) polyethylene terephthalate-polyethylene-aluminium-linear low density polyethylene (PET-PE-ALU-LLDPE), and (ii) oriented polypropylene-polyethylene-metallized polyethylene terephthalate-linear low density polyethylene (OPP-PE-MPET-LLDPE). The linear expansion and oil absorption in control fried fish cracker was 75.67 ± 5.86% and 27.86 ± 0.79%, respectively. The initial moisture of cracker ranged from 4.41 to 5.40% and decreased to 2.76 to 3.75%. There were also reductions in water activity of crackers from 0.503 to 0.243. For color, the loss occurred gradually within the storage time from 64 to 47% (L*), from 27 to 19% (b*), and increased from 4 to 9% (a*) due to lipid degradation. For both packaging, the hardness of crackers decreased significantly at 25°C and 40°C, but increased at 60°C. Regardless of temperatures and types of packaging, crispiness increased significantly throughout the storage. This textural changes were possible cause by a decrease in moisture content. The lipid yield of the cracker was not stable within the storage time and the concentration of conjugated dienes and thiobarbituric acid reactive substances (TBARS) showed a gradual increase. These results showed that fried fish crackers in the storage study had undergone lipid oxidation where changes in physical and chemical properties were observed.
Effectiveness of combined acetic acid and ascorbic acid spray on fresh silver carp (Hypophthalmichthys molitrix) fish to increase shelf-life at refrigerated temperature
Authors: Monirul Islam , Yang Fang , Niaz Mahmud , Qixing Jiang , Wenshui Xia
Published: August 2019

This experiment was conducted to evaluate the efficacy of application of acetic acid and ascorbic acid spray on the surface decontamination and shelf-life of silver carp fish at refrigerated temperature (40C) during 9 days of storage period. Silver carp is one of the most abundant freshwater fish speciesin the world. However, the rapid quality degradation soon after post-mortem makes them highly putrefactive while reducing the nutritional attributes. In this regard, our study aimed at applying organic acids to extend shelf-life of silver carp fish while investigating the quality attributes such as sensory, peroxide values, pH and microbial loads of the fish fillets during 9 days of refrigerated temperature storage (40C). Acetic acid and ascorbic acid are found to have strong antibacterial activities against different microorganisms. Fish fillets samples were treated with alone or in combination with acetic acid and ascorbic acid spray while keeping one group of fish fillets untreated. Total Viable Count (TVC) was found greater in the samples kept untreated and treated alone with acetic acid and ascorbic acid. However, fish fillets treated with acetic acid and ascorbic acid in combination were reported with lesser number of microbial counts. Moreover, Peroxide Value (PV) and pH were significantly lower in the sample treated with in combination of acetic acid and ascorbic acid. Sensory analysis revealed that fish fillets treated with combined treatment had better quality retention at the end of 9 days storage period. The findings suggest that the application of acetic acid and ascorbic acid alone or in different combination have the potential to decrease microbial loads while facilitating the shelf-life of fish fillets during 9 days of refrigerated temperature (40C) storage period.
Development of sweet potato flour based high protein and low calorie gluten free cookies
Authors: A. Giri Namrata , Sakhale B. K.
Published: August 2019

Gluten free (GF) protein enriched cookies with reduced calories were developed using sweet potato, rice, sorghum and corn flour. The level of sweet potato flour was standardized and found acceptable up to 55% with corn, sorghum and rice flour at the ratio of 1:3:5 respectively. High protein and low calorie gluten free cookies were developed by replacing sweet potato flour with whey protein concentrate (WPC) at 0, 5, 10 and 15% levels and sucrose with sucralose at 0, 30, 50, 70 and 100%. It’s physical, proximate and sensorial characteristics were considered and it was investigated that the thickness and hardness of GF cookies increased; weight, diameter, spread ratio and spread factor decreased with increasing levels of WPC while there was raise in protein and crude fiber content and reduction in fat, carbohydrate and calorie contents. The GF cookies with 15% and 70% replacement of WPC and sucralose respectively scored highest for the entire sensory characteristic.
Quality Characteristics and Consumer Acceptance of Bread from Wheat and Rice Composite Flour
Authors: S. A. O Adeyeye , O. T Bolaji , T. A Abegunde , A. O Adebayo-Oyetoro , H. K Tiamiyu , Adebayo Idowu
Published: August 2019

The quality characteristics and consumer acceptance of wheat-rice composite flour bread were evaluated. Substitution of rice flour was done in wheat flour from 0 to 100% and the composite flour was used to produce bread. The bread samples were subjected to proximate, physical, and sensory analyses. The results showed significant differences (p ≤ 0.05) between the proximate compositions of bread samples studied. Bread from control (100% wheat flour) had moisture content of 28.61±0.28%. Bread from 10-50% wheat-rice composite flour had moisture contents ranged from 28.04±0.41 - 24.81±0.40%. The oven spring of the samples from control (100% wheat flour) had the highest value of 1.12±0.28 cm. The oven spring of wheat-rice composite bread ranged between 1.00±0.22 and 0.82±0.38 cm. There was inverse relationship between loaf weight (g), loaf volume and specific volume and the quantities of rice flour added to the wheat flour. The results of consumer acceptance showed that bread with 70:30 wheat: rice flour ratio was acceptable to the consumers. In conclusion, bread of good quality and good consumer acceptance could be made from wheat-rice composite flour.
Development of Foxtail Millet and Flying Fish Flour-Based Cookies as Functional Food
Authors: Patimah Sitti , Arundhana Andi Imam , Mursaha Ansar , Syam Aminuddin
Published: August 2019

Foxtail millet (Setaria Italica) and flying fish (Hyrundicthysoxycephalus) are the most widely available food in West Sulawesi province, potentially to be developed into functional food as they contain many nutrients and bioactive components which may be beneficial for health. This study aimed to explore the nutrients content of foxtail millet and flying fish cookies as a functional food and to evaluate organoleptic aspects of the product. Design of this study was pre-experimental. Wheat, foxtail millet and flying fish were used as the component of the flour. There are five treatments were employed in this study, which were presented in %: F1=70:25:5, F2=70:20:10, F3=70:15:15, F4=70:10:20, and F5=70:5:25. The organoleptic test performed to girl students from three senior high schools in Mamuju, West Sulawesi province by a hedonic method used five scores and analyzed by Kruskall-Wallis test (α=0.05). The panellists were considered to accept the product when the score was in between 3 to 5. The findings indicated that the best combination of wheat flour: foxtail millet flour: flying fish flour ratio was F3 cookie. The score for colour, taste, and texture was above 3 (3.7 ± 0.9, 3.7 ± 0.9, and 3.5 ± 0.8, respectively). A proximate test showed that F3 cookies contained protein (11.89%), carbohydrate (45.19%), crude fibre (4.51%), and fat (21.30%), water (5.94%), and ash (1.26%).In conclusion, the use of foxtail millet and flying fish for cookies was acceptable and high nutrition content. A further study is needed to examine the health benefit of the cookies.
In vivo anti-hypercholesterolemic effect of buttermilk, milk fat globule membrane and Enterococcus faecium FFNL-12
Authors: ElSaadany Khaled , Abd-Elhaleem Heba-tallah
Published: August 2019

The present study was undertaken to evaluate the hypocholesterolemic activity of buttermilk, milk fat globule membrane (MFGM) and Enterococcus faecium FFNL-12 in rat model. Thirty-sixth male Abino rats were divided into six groups. The first one (coded as G1) was fed a standard diet containing 10% corn oil as fat source while remaining five (coded G2 to G6) were fed hypercholesterolemic diets in which oil was replaced with animal grease. Animals subjected to treatment G1 served as healthy control while those in G2 were assigned as hypocholesterolemic animals which did not receive any treatment. The remaining experimental groups were designed to assess the hypocholesterolemic effect of intragastric adminstartion of dose of 109 CFU/Kg body weight of Enterococcus faecium FFNL-12 (G3), Enterococcus faecium FFNL-12/butter milk (G4), buttermilk (G5) and milk fat globule membrane (MFGM). After four weeks, animals were evaluated in relation to growth, fecal pH, organs weight, serum lipid profile, antioxidant activity of liver tissue, liver and heart function and liver histopathological architecture. Results revealed that animals fed hypercholesterolemic diet (G2-G6) had significantly lower faecal pH and liver weight compared with those fed standard diet (G1). Treatments applied to animals fed hypercholesterolemic diet with the above mentioned additions (G3 to G6) appeared to improve both cardiac and hepatic functions, serum lipid profile and glucose concentration and liver histopathological architecture compared with animals subjected to G2 treatment. In most cases, treatment with MFGM appeared to be the most effective to avoid adverse effects associated to feeding hypercholesterolemic diet. MFGM fraction as well as E. faecium FFNL-12/buttermilk combination were effective in reducing serum lipids and glucose levels to the normal range. This combination also had potential antioxidant activity and ability to improve liver and heart functions.
The Effect of Incubation Time to The Physicochemical and Microbial Properties of Yoghurt with Local Taro (Colocasia Esculenta(L.) Schott) Starch as Stabilizer
Authors: Krisnaningsih Aju Tjatur , Purwadi Purwadi , Evanuarini Herly , Rosyidi Djalal
Published: August 2019

The effect of incubation time by using three culture starters (Lactobacillus acidophilus, Lactobacillus bulgaricus and Streptococcus thermophiles) and Taro (Colocasia Esculenta) starch as a stabilizer on the physicochemical and microbial characteristics of yoghurt were investigated. One of the problems in making yoghurt is the occurrence of syneresis caused by the unstable casein micelles. The addition of natural stabilizers is known to be able to solve the problem. In this research, local taro was added to the yoghurt as stabilizers followed by different incubation time (18-h, 24-h, 30-h, 36-h and 42-h). The results showed that incubation time had a highly significant effect (p<0.01) on viscosity, whey holding capacity (WHC), moisture content, carbohydrates, pH value, total acidity, and total lactic acid bacteria. During the fermentation process, the prolonged incubation time resulted in increased acidity, viscosity, WHC, and total lactic acid bacteria, while simultaneously decreased the pH value, moisture and carbohydrate content. The research concluded that 36 h incubation time produced the best yoghurt characteristics made with Lactobacillus acidophilus, Lactobacillus bulgaricus and Streptococcus thermophiles as culture starters and taro starch as a local Indonesia stabilizer.
Textural Properties, Resistant Starch, and in Vitro Starch Digestibility as Affected by Parboiling of Brown Glutinous Rice in a Retort Pouch
Authors: Wiruch Pornpun , Naruenartwongsakul Srisuwan , Chalermchart Yongyut
Published: August 2019

The effects that two preparation methods (parboiling with different degrees of gelatinization and parboiling with enzymatic hydrolysis) have on the qualities of brown glutinous rice were investigated in order to optimize the pretreatment conditions of brown glutinous rice for the ready-to-eat product in retort pouch. The brown glutinous rice was parboiled at various temperatures (50, 70 and 90C) and steamed at atmospheric pressure until the gelatinize level of 60, 80 and 100%. For the parboiling with enzymatic hydrolysis, the brown glutinous rice was immersed in xylanase before steamed. Results showed that parboiling not only affected the nutritional composition, color, and texture of glutinous rice but also decreased the Glycemic index (GI) to 61.3 ± 0.03 and raised the Resistance starch (RS) to 2.9 ± 0.02. There was interaction among RS, GI, and the amylopectin content of brown glutinous rice during parboiling without enzymatic hydrolysis. Amylopectin is directly proportional to GI but inversely proportional to RS. Enzymatic hydrolysis improved both the texture and the physical and chemical properties. In addition, the GI value of enzyme treated samples decreased to 62.7 ± 0.24 and the RS increased to 2.9 ± 0.05. The highest overall preference score was attained by parboiled rice which was soaked in water at 90°C and then steamed until 100%gelatinization.
Effect of Probiotic Fermented Milk (Kefir) on Some Blood Biochemical Parameters Among Newly Diagnosed Type 2 Diabetic Adult Males in Gaza Governorate
Authors: El-Bashiti Tarek A. , M. Zabut Baker , Abu Safia Fedaa F.
Published: August 2019

Kefir is natural probiotic milk. It is a complex mixture of bacteria, yeasts, many vitamins, minerals, amino acids, and enzymes. Previous studies reported that Kefir has a hypoglycemic effect, and it may have an antitumor effect, intestinal immunity, antimicrobial effect and regulate cholesterol. The aim of this study was to evaluate the effect of kefir intake on some blood biochemical parameter among newly diagnosed type 2 diabetic adult male patients in Gaza Government. It was a case-control study experiment and was carried out on the 42 newly diagnosed diabetic male patients aged from 37-65 years. They were divided into two groups (control and case). The control group received Metformin only. The case group are patients who intake a cup of Kefir daily with a Metformin. Blood collection sample for biochemical analysis was carried out at the beginning of the study and after 10 weeks. The results of the study showed that there were no statistically significant differences in fasting blood sugar (FBS) at the beginning of the study between the two groups (P=0.22). After an intervention with Kefir milk, fasting blood glucose was significantly decreased among patients taking Kefir milk (P< 0.05). After the intervention, glycohemoglobin (HbA1c) was reduced significantly (P=0.001). Also, there was an increase in calcium concentration correlated with a decrease in phosphorus and no significant differences in Kidney functions except uric acid. There was an improvement in cholesterol and triglyceride (TG) only in lipid profile. On conclusion, kefir has potential effect in the reduction of FBS, HbA1c and phosphorous with increase in calcium among diabetic adult males.
Nutritional Composition and Heavy Metal Profile of Nigerian Rice Varieties
Authors: ADEYEYE, Samuel Ayofemi Olalekan , Bolaji Olushola Timothy , Abegunde Titilope Adebusayo , Idowu-Adebayo Folake , Tiamiyu Hussana Kehinde , Adebayo-Oyetoro Abiodun Omowonuola
Published: August 2019

This study was carried to assess the nutritional composition and heavy metal profile of Nigerian rice varieties. A total of one hundred samples consisting of twenty five samples each of four varieties of white unpolished Nigerian local rice Oryzaglaberrima (Ofada rice, Abakaliki rice, Ekpoma rice and Igbimo rice) were purchased from Ofada in Ogun State, Nigeria. Flour samples produced from the rice varieties were evaluated for nutritional (proximate, amino acids and vitamins profile analyses) qualities and heavy metal profile. Results showed (P≤0.05) that the protein contents in % ranged from 6.72±0.05 – 6.93±0.06% while the concentration (μg/g) of Ar, Pb and Cd ranged from1.30±0.05 to 1.45±0.05, 0.89±0.02 to 0.98±0.04 and 1.12±0.01 to 1.30±0.03, respectively.The protein contents were relatively high, although, all the four Nigerian rice varieties were deficient in lysine; arginine and methionine while the non-essential amino acids glycine and glutamic acid, although lysine and methionine were detected in very low quantities.The quantity of heavy metals obtained in the four Nigerian rice varieties flour samples were generally below the maximum acceptable limits and therefore constitute health risk to the consumers.
Effect of knife-fish bone powder addition on characteristics of starch and seaweed kerupuk as calcium and crude fiber sources
Authors: Asikin Andi Noor , Kusumaningrum Indrati , Hidayat Taufik
Published: August 2019

Knife-fish bone is waste processing of kerupuk and amplang that have not been utilized optimally and potentially cause environmental pollution. Processing into a fish bone powder is one way to reduce environmental pollution and provide added value.It can be used as a fortification source of calcium in food products. Seaweed species are widely used in food processing as crude fiber and iodine sources. Therefore, it is necessary to do the processing of kerupuk with fortification of knife fish bone powder and seaweed as calcium and crude fiber sources. The objective of this research was to determine the effect of adding knife fish bone powder on characteristics of starch and seaweed kerupuk. The treatment in this study wasthe percentage of addition of knife fish bone powder: 0%, 5%, 10.15%, 20%. Calcium and crude fiber of both starch and seaweed kerupuk values varied significantly (p<0.05).Proximate values varied significantly (p<0.05) of both starch and seaweed kerupuk, except for protein and fat content. Phosphorous and whiteness level values significantly (p<0.05) for both starch and seaweed kerupuk.
Characteristic Ice Cream using Stevia (Stevia rebaudiana) Leaf Powder as Natural Sweetener
Authors: Mayangsari Asri Suko , Wahyuni Lilis Sri , Evanuarini Herly , Purwadi Purwadi
Published: August 2019

Sweetener is one of important factors which affect consumer acceptance as it affects the ice cream texture. Research on an alternative and healthier sweetener to substitute sugar in ice cream production has begun to emerge as consumers’ awareness on healthy food has been increasing. One of the promising alternatives was the utilization of Stevia leaf powder as it is known to have no calorie content. In this research, the best proportion of stevia leaf powder to substitute sugar in ice cream production was determined based on its physicochemical properties (viscosity, overrun, melting rate, sugar and total calories) and antioxidant activity. The research was done through laboratory experiment with a Completely Randomized Design consisted of four sugar and stevia leaf powder combinations and four replications. The treatments were P0 (20% sugar + 0% steviea leaf powder); P1 (17.5% sugar + 0.3% stevia leaf powder); P2 (16.25% sugar + 0.45% stevia leaf powder); and P3 (15% sugar + 0.6% stevia leaf powder). The obtained data was analyzed by ANOVA and further tested by Duncan’s Multiple Range Test upon significant effect.The results showed that the utilization of stevia leaf powder as sugar substitution gave highly significant effects (P<0.01) on ice cream viscosity, overrun, melting rate, sugar content, total calories and antioxidant activity. It can be concluded that the combination of 15% sugar and 0.6% stevia leaf powder (P3) produced the best ice cream characteristics with the viscosity of 1336.25 cP, overrun of 30.01%, melting rate of 37.24 minutes/50 g, sugar content of 34.63%, total calorie of 4.99 kcal and antioxidant activity of 81.92%.
Tranexamic acid or epsilon-aminocaproic acid in total joint arthroplasty? A randomized controlled trial
Authors: Bradley Kendall E. , Ryan Sean P. , Penrose Colin T. , Grant Stuart A. , Wellman Samuel S. , Attarian David E. , Green Cynthia L. , Risoli Thomas , Bolognesi Michael P.
Published: August 2019

Aims

Antifibrinolytic agents, including tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA), have been shown to be safe and effective for decreasing perioperative blood loss and transfusion following total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, there are few prospective studies that directly compare these agents. The purpose of this study was to compare the benefits of intraoperative intravenous TXA with EACA.

Patients and Methods

A total of 235 patients (90 THA and 145 TKA) were enrolled in this prospective, randomized controlled trial at a single tertiary-care referral centre. In the THA cohort, 53.3% of the patients were female with a median age of 59.8 years (interquartile range (IQR) 53.3 to 68.1). In the TKA cohort, 63.4% of the patients were female with a median age of 65.1 years (IQR 59.4 to 69.5). Patients received either TXA (n = 119) or EACA (n = 116) in two doses intraoperatively. The primary outcome measures included change in haemoglobin level and blood volume, postoperative drainage, and rate of transfusion. Secondary outcome measures included postoperative complications, cost, and length of stay (LOS).

Results

TKA patients who received EACA had greater drainage (median 320 ml (IQR 185 to 420) vs 158 ml (IQR 110 to 238); p < 0.001), increased loss of blood volume (891 ml (IQR 612 to 1203) vs 661 ml (IQR 514 to 980); p = 0.014), and increased haemoglobin change from the preoperative level (2.1 ml (IQR 1.7 to 2.8) vs 1.9 ml (IQR 1.2 to 2.4); p = 0.016) compared with patients who received TXA. For the THA cohort, no statistically significant differences were observed in any haematological outcome measure. One patient in the EACA group required transfusion. No patient in the TXA group required transfusion. There were no statistically significant differences in number or type of postoperative complications or LOS for either THA or TKA patients regardless of whether they received TXA or EACA.

Conclusion

For hip and knee arthroplasty procedures, EACA is associated with increased perioperative blood loss compared with TXA. However, there is no significant difference in transfusion rate. While further prospective studies are needed to compare the efficacy of each agent, we currently recommend orthopaedic surgeons to select their antifibrinolytic based on cost and regional availability. Cite this article: Bone Joint J 2019;101-B:1093–1099.
Tibial nailing using a suprapatellar rather than an infrapatellar approach significantly reduces anterior knee pain postoperatively: a multicentre clinical trial
Authors: MacDonald D. R. W. , Caba-Doussoux P. , Carnegie C. A. , Escriba I. , Forward D. P. , Graf M. , Johnstone A. J.
Published: August 2019

Aims

The aim of this study was to compare the incidence of anterior knee pain after antegrade tibial nailing using suprapatellar and infrapatellar surgical approaches

Patients and Methods

A total of 95 patients with a tibial fracture requiring an intramedullary nail were randomized to treatment using a supra- or infrapatellar approach. Anterior knee pain was assessed at four and six months, and one year postoperatively, using the Aberdeen Weightbearing Test – Knee (AWT-K) score and a visual analogue scale (VAS) score for pain. The AWT-K is an objective patient-reported outcome measure that uses weight transmitted through the knee when kneeling as a surrogate for anterior knee pain.

Results

A total of 53 patients were randomized to a suprapatellar approach and 42 to an infrapatellar approach. AWT-K results showed a greater mean proportion of weight transmitted through the injured leg compared with the uninjured leg when kneeling in the suprapatellar group compared with the infrapatellar group at all timepoints at all follow-up visits. This reached significance at four months for all timepoints except 30 seconds. It also reached significance at six months at 0 seconds, and for one year at 60 seconds.

Conclusion

The suprapatellar surgical approach for antegrade tibial nailing is associated with less anterior knee pain postoperatively compared with the infrapatellar approach Cite this article: Bone Joint J 2019;101-B:1138–1143
Physeal-preserving endoprosthetic replacement with short segment fixation in children with bone sarcomas
Authors: Tsuda Y. , Fujiwara T. , Sree D. , Stevenson J. D. , Evans S. , Abudu A.
Published: August 2019

Aims

The aim of this study was to report the results of custom-made endoprostheses with extracortical plates plus or minus a short, intramedullary stem aimed at preserving the physis after resection of bone sarcomas in children.

Patients and Methods

Between 2007 and 2017, 18 children aged less than 16 years old who underwent resection of bone sarcomas, leaving ≤ 5 cm of bone from the physis, and reconstruction with a custom-made endoprosthesis were reviewed. Median follow-up was 67 months (interquartile range 45 to 91). The tumours were located in the femur in 11 patients, proximal humerus in six, and proximal tibia in one.

Results

The five-year overall survival rate was 78%. No patient developed local recurrence. The five-year implant survival rate was 79%. In all, 11 patients (61%) developed a complication. Seven patients (39%) required further surgery to treat the complications. Implant failures occurred in three patients (17%) including one patient with aseptic loosening and two patients with implant or periprosthetic fracture. The preserved physis continued to grow at mean 3.3 cm (0 to 14). The mean Musculoskeletal Society score was 88% (67% to 97%).

Conclusion

Custom-made endoprostheses that aim to preserve the physis are a safe and effective option for preserving physeal growth, limb length, and joint function with an acceptable rate of complications. Cite this article: Bone Joint J 2019;101-B:1144–1150
Cemented humeral stemversuspress-fit humeral stem in total shoulder arthroplasty
Authors: Uy M. , Wang J. , Horner N. S. , Bedi A. , Leroux T. , Alolabi B. , Khan M.
Published: August 2019

Aims

The aim of this study was to evaluate the differences in revision and complication rates, functional outcomes, and radiological outcomes between cemented and press-fit humeral stems in primary anatomical total shoulder arthroplasty (TSA).

Materials and Methods

A comprehensive systematic review and meta-analysis was conducted searching for studies that included patients who underwent primary anatomical TSA for primary osteoarthritis or rheumatoid arthritis.

Results

There was a total of 36 studies with 927 cemented humeral stems and 1555 press-fit stems. The revision rate was 5.4% (95% confidence interval (CI) 3.9 to 7.4) at a mean of 89 months for cemented stems, and 2.4% (95% CI 1.1 to 4.7) at a mean of 40 months for press-fit stems. A priori subgroup analysis to control for follow-up periods demonstrated similar revision rates: 2.3% (95% CI 1.1 to 4.7) for cemented stems versus 1.8% (95% CI 1.4 to 2.9) for press-fit stems. Exploratory meta-regression found that longer follow-up was a moderating variable for revision (p = 0.003).

Conclusion

Cement fixation had similar revision rates when compared to press-fit stems at short- to midterm follow-up. Rotator cuff pathology was a prevalent complication in both groups but is likely not related to fixation type. Overall, with comparable revision rates, possible easier revision, and decreased operative time, humeral press-fit fixation may be an optimal choice for primary anatomical TSA in patients with sufficient bone stock. Cite this article: Bone Joint J 2019;101-B:1107–1114.
Alternating operating theatre utilization is not associated with differences in clinical or economic outcome measures in primary elective knee arthroplasty
Authors: Murphy William S. , Harris Samantha , Pahalyants Vartan , Zaki Mark M. , Lin Ben , Cheng Tony , Talmo Carl , Murphy Stephen B.
Published: August 2019

Aims

The practice of alternating operating theatres has long been used to reduce surgeon idle time between cases. However, concerns have been raised as to the safety of this practice. We assessed the payments and outcomes of total knee arthroplasty (TKA) performed during overlapping and nonoverlapping days, also comparing the total number of the surgeon’s cases and the total time spent in the operating theatre per day.

Materials and Methods

A retrospective analysis was performed on the Centers for Medicare & Medicaid Services (CMS) Limited Data Set (LDS) on all primary elective TKAs performed at the New England Baptist Hospital between January 2013 and June 2016. Using theatre records, episodes were categorized into days where a surgeon performed overlapping and nonoverlapping lists. Clinical outcomes, economic outcomes, and demographic factors were calculated. A regression model controlling for the patient-specific factors was used to compare groups. Total orthopaedic cases and aggregate time spent operating (time between skin incision and closure) were also compared.

Results

A total of 3633 TKAs were performed (1782 on nonoverlapping days; 1851 on overlapping days). There were no differences between the two groups for length of inpatient stay, payments, mortality, emergency room visits, or readmission during the 90-day postoperative period. The overlapping group had 0.74 fewer skilled nursing days (95% confidence interval (CI) -0.26 to -1.22; p < 0.01), and 0.66 more home health visits (95% CI 0.14 to 1.18; p = 0.01) than the nonoverlapping group. On overlapping days, surgeons performed more cases per day (5.01 vs 3.76; p < 0.001) and spent more time operating (484.55 minutes vs 357.17 minutes; p < 0.001) than on nonoverlapping days.

Conclusion

The study shows that the practice of alternating operating theatres for TKA has no adverse effect on the clinical outcome or economic utilization variables measured. Furthermore, there is opportunity to increase productivity with alternating theatres as surgeons with overlapping cases perform more cases and spend more time operating per day. Cite this article: Bone Joint J 2019;101-B:1081–1086.
Posterior cruciate ligament injury is influenced by intercondylar shape and size of tibial eminence
Authors: van Kuijk K. S. R. , Reijman M. , Bierma-Zeinstra S. M. A. , Waarsing J. H. , Meuffels D. E.
Published: August 2019

Aims

Little is known about the risk factors that predispose to a rupture of the posterior cruciate ligament (PCL). Identifying risk factors is the first step in trying to prevent a rupture of the PCL from occurring. The morphology of the knee in patients who rupture their PCL may differ from that of control patients. The purpose of this study was to identify any variations in bone morphology that are related to a PCL.

Patients and Methods

We compared the anteroposterior (AP), lateral, and Rosenberg view radiographs of 94 patients with a ruptured PCL to a control group of 168 patients matched by age, sex, and body mass index (BMI), but with an intact PCL after a knee injury. Statistical shape modelling software was used to assess the shape of the knee and determine any difference in anatomical landmarks.

Results

We found shape variants on the AP and Rosenberg view radiographs to be significantly different between patients who tore their PCL and those with an intact PCL after a knee injury. Overall, patients who ruptured their PCL have smaller intercondylar notches and smaller tibial eminences than control patients.

Conclusion

This study shows that differences in the shape of the knee are associated with the presence of a PCL rupture after injury. A smaller and more sharply angled intercondylar notch and a more flattened tibial eminence are related to PCL rupture. This suggests that the morphology of the knee is a risk factor for sustaining a PCL rupture. Cite this article: Bone Joint J 2019;101-B:1058–1062.
Surgical repair versus conservative treatment and subacromial decompression for the treatment of rotator cuff tears
Authors: Schemitsch C. , Chahal J. , Vicente M. , Nowak L. , Flurin P-H. , Lambers Heerspink F. , Henry P. , Nauth A.
Published: August 2019

Aims

The purpose of this study was to compare the effectiveness of surgical repair to conservative treatment and subacromial decompression for the treatment of chronic/degenerative tears of the rotator cuff.

Materials and Methods

PubMed, Cochrane database, and Medline were searched for randomized controlled trials published until March 2018. Included studies were assessed for methodological quality, and data were extracted for statistical analysis. The systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

Results

Six studies were included. Surgical repair resulted in a statistically significantly better Constant–Murley Score (CMS) at one year compared with conservative treatment (mean difference 6.15; p = 0.002) and subacromial decompression alone (mean difference 5.81; p = 0.0004). In the conservatively treated group, 11.9% of patients eventually crossed over to surgical repair.

Conclusion

The results of this review show that surgical repair results in significantly improved outcomes when compared with either conservative treatment or subacromial decompression alone for degenerative rotator cuff tears in older patients. However, the magnitude of the difference in outcomes between surgery and conservative treatment may be small and the ‘success rate’ of conservative treatment may be high, allowing surgeons to be judicious in choosing those patients who are most likely to benefit from surgery. Cite this article: Bone Joint J 2019;101-B:1100–1106.
Long-term outcomes of an extracorporeal irradiated autograft for limb salvage operations in musculoskeletal tumours
Authors: Oike N. , Kawashima H. , Ogose A. , Hatano H. , Ariizumi T. , Kaidu M. , Aoyama H. , Endo N.
Published: August 2019

Aims

We analyzed the long-term outcomes of patients observed over ten years after resection en bloc and reconstruction with extracorporeal irradiated autografts

Patients and Methods

This retrospective study included 27 patients who underwent resection en bloc and reimplantation of an extracorporeal irradiated autograft. The mean patient age and follow-up period were 31.7 years (9 to 59) and 16.6 years (10.3 to 24.3), respectively. The most common diagnosis was osteosarcoma (n = 10), followed by chondrosarcoma (n = 6). The femur (n = 13) was the most frequently involved site, followed by the tibia (n = 7). There were inlay grafts in five patients, intercalary grafts in 15 patients, and osteoarticular grafts in seven patients. Functional outcome was evaluated with the Musculoskeletal Tumor Society (MSTS) scoring system.

Results

There were no recurrences in the irradiated autograft and the autograft survived in 24 patients (88.9%). Major complications included nonunion (n = 9), subchondral bone collapse (n = 4), and deep infection (n = 4). Although 34 revision procedures were performed, 25 (73.5%) and four (11.8%) of these were performed less than five years and ten years after the initial surgery, respectively. The mean MSTS score at the last follow-up was 84.3% (33% to 100%).

Conclusion

Considering long-term outcomes, extracorporeal irradiated autograft is an effective method of reconstruction for malignant musculoskeletal tumours Cite this article: Bone Joint J 2019;101-B:1151–1159
Risk factors for the development of avascular necrosis after femoral neck fractures in children
Authors: Wang Wentao T. , Li Yiqiang Q. , Guo Yueming M. , Li Ming , Mei Haibo B. , Shao Jingfan F. , Xiong Zhu , Li Jin , Canavese Federico , Chen Shunyou Y.
Published: August 2019

Aims

The aim of this study was to clarify the factors that predict the development of avascular necrosis (AVN) of the femoral head in children with a fracture of the femoral neck.

Patients and Methods

We retrospectively reviewed 239 children with a mean age of 10.0 years (sd 3.9) who underwent surgical treatment for a femoral neck fracture. Risk factors were recorded, including age, sex, laterality, mechanism of injury, initial displacement, the type of fracture, the time to reduction, and the method and quality of reduction. AVN of the femoral head was assessed on radiographs. Logistic regression analysis was used to evaluate the independent risk factors for AVN. Chi-squared tests and Student’s t-tests were used for subgroup analyses to determine the risk factors for AVN.

Results

We found that age (p = 0.006) and initial displacement (p = 0.001) were significant independent risk factors. Receiver operating characteristic (ROC) curve analysis indicated that 12 years of age was the cut-off for increasing the rate of AVN. Severe initial displacement (p = 0.021) and poor quality of reduction (p = 0.022) significantly increased the rate of AVN in patients aged 12 years or greater, while in those aged less than 12 years, the rate of AVN significantly increased only with initial displacement (p = 0.048). A poor reduction significantly increased the rate of AVN in patients treated by closed reduction (p = 0.026); screw and plate fixation was preferable to cannulated screw or Kirschner wire (K-wire) fixation for decreasing the rate of AVN in patients treated by open reduction (p = 0.034).

Conclusion

The rate of AVN increases with age, especially in patients aged 12 years or greater, and with the severity of displacement. In patients treated by closed reduction, anatomical reduction helps to decrease the rate of AVN, while in those treated by open reduction, screw and plate fixation was preferable to fixation using cannulated screws or K-wires. Cite this article: Bone Joint J 2019;101-B:1160–1167
Long-term rates of knee arthroplasty in a cohort of 834 393 patients with a history of arthroscopic partial meniscectomy
Authors: Abram Simon G. F. , Judge Andrew , Beard David J. , Carr Andrew J. , Price Andrew J.
Published: August 2019

Aims

The aim of this study was to determine the long-term risk of undergoing knee arthroplasty in a cohort of patients with meniscal tears who had undergone arthroscopic partial meniscectomy (APM).

Patients and Methods

A retrospective national cohort of patients with a history of isolated APM was identified over a 20-year period. Patients with prior surgery to the same knee were excluded. The primary outcome was knee arthroplasty. Hazard ratios (HRs) were adjusted by patient age, sex, year of APM, Charlson comorbidity index, regional deprivation, rurality, and ethnicity. Risk of arthroplasty in the index knee was compared with the patient’s contralateral knee (with vs without a history of APM). A total of 834 393 patients were included (mean age 50 years; 37% female).

Results

Of those with at least 15 years of follow-up, 13.49% (16 256/120 493; 95% confidence interval (CI) 13.30 to 13.69) underwent subsequent arthroplasty within this time. In women, 22.07% (95% CI 21.64 to 22.51) underwent arthroplasty within 15 years compared with 9.91% of men (95% CI 9.71 to 10.12), corresponding to a risk ratio (RR) of 2.23 (95% CI 2.16 to 2.29). Relative to the general population, patients with a history of APM were over ten times more likely (RR 10.27; 95% CI 10.07 to 10.47) to undergo arthroplasty rising to almost 40 times more likely (RR 39.62; 95% CI 27.68 to 56.70) at a younger age (30 to 39 years). In patients with a history of APM in only one knee, the risk of arthroplasty in that knee was greatly elevated in comparison with the contralateral knee (no APM; HR 2.99; 95% CI 2.95 to 3.02).

Conclusion

Patients developing a meniscal tear undergoing APM are at greater risk of knee arthroplasty than the general population. This risk is three-times greater in the patient’s affected knee than in the contralateral knee. Women in the cohort were at double the risk of progressing to knee arthroplasty compared with men. These important new reference data will inform shared decision making and enhance approaches to treatment, prevention, and clinical surveillance. Cite this article: Bone Joint J 2019;101-B:1071–1080.
Blood metal levels, leucocyte profiles, and cytokine profiles in patients with a modular dual-mobility hip prosthesis
Authors: Markel David C. , Bou-Akl Therese , Rossi Mario D. , Pizzimenti Natalie , Wu Bin , Ren Weiping
Published: August 2019

Aims

The aim of this study was to evaluate blood metal ion levels, leucocyte profiles, and serum cytokines in patients with a total hip arthroplasty (THA) involving modular dual-mobility components.

Patients and Methods

A total of 39 patients were recruited, with clinical follow-up of up to two years. Outcome was assessed using the Harris Hip Score (HHS, the 12-Item Short-Form Health Survey (SF-12), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a visual analogue scale (VAS) for pain. Blood concentrations of cobalt (Co), chromium (Cr), and serum cytokines were measured. Subpopulations of leucocytes were analyzed by flow cytometry.

Results

The clinical performance was good. Blood Co levels (ref 1.0 µg/l) were mildly elevated in seven patients at three months, and two patients at two years’ follow-up. The preoperative Cr levels were normal except for one patient with a detectable Cr (1.2 µg/l). Cr levels were detectable in three patients at three months, two patients at one year, and three patients at two years’ follow-up. No patients had symptoms suggestive of failure. Although flow cytometry showed constant circulating leucocyte profiles, there was a significant reduction of serum interleukin (IL)-4, IL-5, and interferon gamma (IFNγ) postoperatively compared with the preoperative levels (p < 0.05).

Conclusion

These results suggest that THA using modular dual-mobility components is safe. This allows an opportunity to use a large femoral head and a thick polyethylene bearing surface, which is especially useful in revision procedures or high-risk situations when added stability is required. Cite this article: Bone Joint J 2019;101-B:1035–1041.
Waiting lists and the ageing surgeon
Authors: Alderson Derek
Published: August 2019

The effect of early retirement on waiting times and what can be done.
Champions of patient safety in the non-surgical aesthetic sector
Authors: Mikhail MM , Saxby CE , Armstrong ACG
Published: August 2019

The importance of statutory regulation for non-surgical cosmetic procedures to ensure patient safety.
Women in surgery
Authors: Skinner H , Bhatti F
Published: August 2019

Where are we now?
Credentialing in surgery
Authors: Wilkins A
Published: August 2019

Are we heading for a shift towards specialism, and what does that mean for trainees?
The role of medical technology in surgical innovation
Authors: Bolton WS , Ng S , Kinch J , Glasbey J , Stewart ME , Kitchen WR , Lam A , Cummins G , Knight SR , Culmer PR , Jayne DG
Published: August 2019

How can we achieve widespread adoption of surgical innovations into clinical practice quickly and frugally?
Surgery and the law: an alternative approach to practice
Authors: Rivers CM
Published: August 2019

How one trainee surgeon’s LLM distance learning course in medical law and ethics has proven beneficial to her and her patients.
Human factors – they don’t apply to surgeons, right?
Authors: Brennan PA , Morris S
Published: August 2019

Minimising human error in surgery.
Impacto de medidas para estímulo ao uso da bicicleta em viagens ao trabalho: estudo de caso envolvendo funcionários da Companhia Riograndense de Saneamento
Authors: Rodrigues Fernando Schultz Peña , Uriarte Ana Margarita Larrañaga , Cybis Helena Beatriz Bettella
Published: August 2019

O objetivo deste estudo é identificar as questões mais valorizadas pelos potenciais usuários de bicicleta em viagens a trabalho e avaliar o impacto de medidas de estímulo ao uso da bicicleta. Para isto, foi realizado um estudo de caso com os funcionários da Companhia Riograndense de Saneamento (CORSAN), na cidade de Porto Alegre, por meio de um estudo de Preferência Declarada. Modelos logit ordenados foram utilizados para estimar a probabilidade de uso da bicicleta em diferentes cenários. Os resultados mostraram que a implantação de vestiários, bicicletários, empréstimo de bicicletas, treinamento para funcionários e a presença de ciclovias para o acesso à CORSAN, estimulam a utilização de bicicleta. A disponibilidade de vestiário mostrou-se a variável mais importante. A implantação conjunta de vestiário, bicicletário e bicicletas para empréstimo aumentaria a demanda em 65%. Os procedimentos adotados podem ser facilmente aplicados em outros contextos, expandindo pesquisas desta natureza.
Simulação computacional do ensaio de módulo complexo em misturas asfálticas
Authors: Pereira de Almeida Francisco José , Lima Babadopulos Lucas Feitosa de Albuquerque , Soares Jorge Barbosa , Parente Junior Evandro
Published: August 2019

Considerando-se as heterogeneidades inerentes e utilizando-se o Método dos Elementos Finitos juntamente com a Teoria da Viscoelasticidade Linear é simulado computacionalmente, para materiais asfálticos, o ensaio de módulo complexo (que se traduz em um valor absoluto chamado de módulo dinâmico e em um ângulo de fase). O ensaio consiste na aplicação de solicitação (tensão ou deformação) senoidal e na leitura da resposta mecânica (deformação ou tensão). Os materiais estudados são uma Matriz de Agregados Finos (MAF) e uma Mistura Asfáltica Completa (MAC) composta por agregados graúdos, ar e MAF. Tomam-se como dados de entrada os parâmetros de dosagem e as propriedades dos materiais constituintes da mistura. Os resultados das simulações são comparados aos obtidos em ensaios realizados em laboratório. Avalia-se a influência do módulo de elasticidade dos agregados e do volume de vazios sobre o módulo dinâmico da MAC analisada. Os resultados mostraram que para baixas frequências da solicitação, a variação na rigidez do agregado interfere pouco na variação do módulo dinâmico da mistura, tornando-se mais significativa para as frequências mais altas. Ademais, foi possível obter o módulo dinâmico da MAC a partir da simulação, estimando-se o módulo de elasticidade dos agregados. O módulo dinâmico da mistura diminui com o aumento do volume de vazios e apresenta um comportamento aproximadamente linear, principalmente nas frequências mais baixas.