bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying Criterion-Based Indications for Vascular Ultrasound Studies: Planning Quality Improvement
Authors: Wooster Douglas , Angelson Mary
Published: February 2018

Introduction

Although most ultrasound facilities rely on the referring physicians' request for testing, inappropriate indications for ultrasound studies have been cited as a quality metric and source of poor resource use. In 2015, the Intersocietal Accreditation Commission mandated that ultrasound facilities undertake educational and other strategies to address this as a quality improvement initiative, including education of referring physicians. We proposed to study the indications noted in referrals to develop such quality strategies.

Methods

Dedicated vascular ultrasound facilities were asked to participate. An electronic search of guidelines, standards, and criteria for testing was done. The indication for testing in consecutive patients was collated with adherence to standards and criteria for testing, type of referring physician, patient demographics, and findings. Care gaps were identified to serve as a “needs assessment” for educational and other strategies to address quality improvement.

Results

Three facilities agreed to participate (one academic, two community). A total of 4,654 studies were analyzed. The vascular domains included were: carotid (610), aorta (217), renal (52), upper extremity arteries (56), lower extremity arteries (1,465), lower extremity venous for deep venous thrombosis (1,377), and lower extremity venous for chronic venous insufficiency (877). Overall, appropriate criteria were cited for 76–96% of studies; the academic facility had higher adherence. There was no difference between family physician and specialist referrals. Diagnostic positive yields were found in 48–68% in different test categories; aortic screening yield was 8.1%. Specific “teaching points” included “headaches” and “neck pain” for carotid studies, aortic screening outside of “targets,” “numb toes,” and “swelling” for arterial duplex; no clear issues were identified for venous studies.

Conclusions

This study does identify inappropriate indications for vascular ultrasound with no systematic findings. There are specific teaching points that can be used to direct educational strategies for referring physicians.
Carotid Duplex Waveform Analysis of the Left Subclavian Flap Repair
Authors: Noh Cassey Y.
Published: February 2018

Extracranial carotid duplex ultrasound is a fast and effective way to study the patency of the extracranial system in most cases. The evaluation of the waveforms of the carotid system can provide valuable clinical information. In this case study, antegrade flow in the left vertebral artery in the absence or occlusion of the left subclavian artery reveals that this is not a subclavian steal case. The normal bi- to triphasic waveform in the left brachial artery, reconstituted with collateral in the thoracic region, supports this argument. The triphasic waveform in the bilateral internal carotid and vertebral arteries correlates with a severe case of congestive heart failure. This case study is a rarely reported extracranial carotid system of a patient status after subclavian flap repair for aortic coarctation in which a portion, if not all, of the subclavian artery has been used as a flap to expand the area of narrowing of the aorta.
Improved non-dimensional dynamic influence function method for vibration analysis of arbitrarily shaped plates with simply supported edges
Authors: Kang Sangwook
Published: February 2018

An analytical method for free vibration analysis of arbitrarily shaped plates with simply supported edges is presented using the non-dimensional dynamic influence function (NDIF) method, which was introduced by the author. A major difficulty in the theoretical formulation of the proposed method is to analytically measure the values of diagonal elements of the system matrix that gives the eigenvalues and mode shapes of the plate of interest. In addition, particular attentions are given to remove the spurious eigenvalues of the plate. Various case studies show that the proposed method yields very accurate eigenvalues and mode shapes compared with other analytical and numerical methods in spite of its theoretical simplicity.
Parametric L-systems-based modeling self-reconfiguration of modular robots in obstacle environments
Authors: Bie Dongyang , Wang Yulin , Zhang Yu , Liu Che , zhao Jie , Zhu Yanhe
Published: February 2018

Self-reconfiguration of modular self-reconfigurable robots is a fundamental function that can be used as part of higher-level functionality. Interaction with the environment is a key factor affecting the self-reconfiguration process of modular robots. In this article, a modeling framework that makes it possible to simulate and visualize the interactions at the level of decentralized modules will be introduced. The framework extends the formalism of Lindenmayer systems (L-systems) with constructs needed to model robotic information exchanged between decentralized modules and their surrounding environments. Both the construction of target configurations and environmental sensitive adaption can be handled by extending L-system symbols and reproduction rules. The proposed method is illustrated with simulations capturing the development of branching structures while adapting to environmental obstacles.
Nonanthropomorphic exoskeleton with legs based on eight-bar linkages
Authors: Godoy Jorge Curiel , Campos Ignacio Juárez , Pérez Lucia Márquez , Muñoz Leonardo Romero
Published: February 2018

This article presents the principles upon which a new nonanthropomorphic biped exoskeleton was designed, whose legs are based on an eight-bar mechanism. The main function of the exoskeleton is to assist people who have difficulty walking. Every leg is based on the planar Peaucellier–Lipkin mechanism, which is a one degree of freedom linkage. To be used as a robotic leg, the Peaucellier–Lipkin mechanism was modified by including two more degrees of freedom, as well as by the addition of a mechanical system based on toothed pulleys and timing belts that provides balance and stability to the user. The use of the Peaucellier–Lipkin mechanism, its transformation from one to three degrees of freedom, and the incorporation of the stability system are the main innovations and contributions of this novel nonanthropomorphic exoskeleton. Its mobility and performance are also presented herein, through forward and inverse kinematics, together with its application in carrying out the translation movement of the robotic foot along paths with the imposition of motion laws based on polynomial functions of time.
Treadmill walking exercise training and brain function in multiple sclerosis: Preliminary evidence setting the stage for a network-based approach to rehabilitation
Authors: Sandroff Brian M , Wylie Glenn R , Sutton Brad P , Johnson Curtis L , DeLuca John , Motl Robert W
Published: February 2018

Exercise training has been identified as a highly promising approach for managing the cognitive consequences of multiple sclerosis (MS). This study represents a secondary analysis of resting-state functional connectivity (RSFC) magnetic resonance imaging data from a pilot treadmill walking exercise training intervention for improving cognitive processing speed (CPS) in MS. There were large intervention effects on RSFC between the thalamus and right superior frontal gyrus ( d = 1.92) and left medial frontal gyrus ( d = 1.70). There further were moderate-to-large intervention effects on CPS ( d = 0.72). Such preliminary data highlight FC within thalamocortical circuitry as a potential target for rehabilitation interventions for improving CPS in cognitively impaired individuals with MS.
Mindfulness-Based Coping With University Life: A Randomized Wait-List Controlled Study
Authors: Lynch Siobhán , Gander Marie-Louise , Nahar Ananda , Kohls Niko , Walach Harald
Published: February 2018

The benefits of mindfulness for a variety of clinical and nonclinical populations are well established and there is growing interest in the potential of mindfulness in higher education. This article reports on the results from a randomized wait-list controlled study of Mindfulness-Based Coping With University Life (MBCUL), an adaption of Mindfulness-Based Stress Reduction (MBSR) for university students. MBCUL is an 8-week program, which aims to help students bring mindful awareness to their academic work, stress management, approach to communication and relationships, and health. Participants were recruited from the general student body at the University of Northampton (United Kingdom) and were randomized into mindfulness or control groups. The mean age for students in the combined MBCUL group was M = 25.07, SD = 8.25 (18-50), and M = 28, SD = 7.26 (20-41) in the control group. A significant decrease in anxiety, F(1, 21) = 7.82, p = .01; depression, F(1, 22) = 4.15, p = .05; and perceived stress, F(1, 22) = 9.65, p = .01, was found in the MBCUL group compared with controls. Similarly, a significant increase in mindfulness was found in the MBCUL, F(1, 20) = 16.32, p = .001, compared with controls. Attrition was high, and the small numbers limit the generalizability of the data. However, the results suggest that MBCUL is an acceptable, useful mindfulness program for university students, which warrants further investigation with larger samples.
Correction to: Testing the effectiveness of a motivational interviewing-based brief intervention for substance use as an adjunct to usual care in community-based AIDS service organizations: study protocol for a multisite randomized controlled trial
Authors: Garner Bryan R. , Gotham Heather J. , Tueller Stephen J. , Ball Elizabeth L. , Kaiser David , Stilen Patricia , Speck Kathryn , Vandersloot Denna , Rieckmann Traci R. , Chaple Michael , Martin Erika G. , Martino Steve
Published: February 2018

Upon publication of the original article
Ethnic variations regarding clinical profiles and symptom representation in prisoners with psychotic disorders
Authors: Denzel A. Dorina , Harte Joke M. , van den Bergh Mattis , Scherder Erik J. A.
Published: February 2018

Background

Black and minority ethnic (BME) groups are known to have higher prevalences of psychotic disorders and are over-represented in western penitentiaries and forensic psychiatric institutions. Research from regular mental healthcare settings suggests that they could show different and more severe psychotic symptoms.

Aims

To explore ethnic variations in severity of symptomatology of BME and non-BME detainees with psychotic disorders.

Method

In this study, 824 patients with psychotic disorders from seven different ethnic groups, imprisoned in a penitentiary psychiatric centre in the Netherlands, were compared on symptom severity and symptom representation using the BPRS-E clinical interview. Data were analysed by means of a multilevel analysis.

Results

BME patients with psychotic disorders are over-represented in forensic psychiatry, and symptom profiles of prisoners with psychotic disorders vary by ethnicity. Additionally, severity levels of overall psychopathology differ between ethnic groups: patients with an ethnic majority status show more severe levels of psychopathology compared with BME patients.

Conclusions

There are differences in symptom severity and symptom profiles between BME patients and non-BME patients. Disregarding these differences could have an adverse effect on the outcome of the treatment. Possible explanations and clinical impact are discussed.

Declaration of interest

None.
BJPsych Open editorial transition: opportunity, challenge and vision
Authors: Kaufman Kenneth R.
Published: February 2018

BJPsych Open enters its fourth year with a transition in leadership and a new Editor-in-Chief (EIC). This editorial summarises the Journal's metrics through its first 36 months, provides insights into the Journal's history and growth, and shares the aspirations of the new EIC for BJPsych Open.

Declaration of interest

K.R.K. is Editor-in-Chief of BJPsych Open; he took no part in the peer-review of this work.
Parametric Prediction from Parametric Agents
Authors: Luo Yuan , Shah Nihar B. , Huang Jianwei , Walrand Jean
Published: February 2018

We consider a problem of prediction based on opinions elicited from heterogeneous rational agents with private information. Making an accurate prediction with a minimal cost requires a joint design of the incentive mechanism and the prediction algorithm. To elicit heterogeneous agents’ private information and incentivize agents with different capabilities to act in the principal’s best interest, we design an optimal joint incentive mechanism and prediction algorithm called COPE (COst and Prediction Elicitation), the analysis of which offers several valuable engineering insights. First, when the costs incurred by the agents are linear in the exerted effort, COPE corresponds to a “crowd-contending” mechanism, where the principal only employs the agent with the highest capability. Second, when the costs are quadratic, COPE corresponds to a “crowdsourcing” mechanism that employs multiple agents with different capabilities at the same time. Numerical simulations show that COPE improves the principal’s profit (The improvement is 5%–30% in our simulations), comparing to those mechanisms that assume all agents have equal capabilities.

The online appendix is available at https://doi.org/10.1287/opre.2017.1681 .
Reflections of Research
Authors: Wilson Simon
Published: February 2018

The British Heart Foundation (BHF) annual image competition, Reflections of Research, provides a glimpse into the cutting-edge research that the BHF funds
Making transition right for young people like me
Authors: Phillips Hannah
Published: February 2018

Growing up is hard for anyone—but nowhere is this truer than for young people making the difficult transition from children's to adult healthcare services. In this Patient Perspective, Hannah Phillips reflects on her journey with a rare congenital heart disease. She shares the positive choices she has made, and continues to make daily, that allow her to not only cope—and even thrive—with her own reality, but also to provide support to the many young people who are struggling with their transition to adult cardiac care.
The need for consultation before a DNACPR order is made
Authors: Griffith Richard
Published: February 2018

Before a do-not-attempt cardiopulmonary resuscitation (DNACPR) notice is placed on file, the notice must be discussed with the patient or their relatives ( Tracey v. Cambridge University Hospitals NHS Foundation Trust and others [2014] ; Winspear v. City Hospitals Sunderland NHS Foundation Trust [2015] ). Failing to do so would be contrary to article 8 of the European Convention of Human Rights ( Council of Europe, 1950 ). In this article, Richard Griffith lays out the steps that cardiac nurses must take to ensure that proper consultation occurs before DNACPR notices are placed on file
Patients miss out on lifesaving aftercare via cardiac rehab
Authors: Palmer Sarah Jane
Published: February 2018

In this new monthly feature, Sarah Jane Palmer delves into topical news, the latest research and what the experts are saying on subjects related to cardiology and cardiac nursing practice.
HABITUAL DISLOCATION OF THE SHOULDER
Authors: Osmond-Clarke H.
Published: February 2018

1. The history of the genesis of the Putti-Platt operation for habitual dislocation of the shoulder is outlined so far as it is known.

2. The operation is described and briefly commented upon.

3. Since there is both gleno-labrial detachment and defect in the humeral head successful treatment depends upon: i) a block to the exit of the humeral head in front and ii) limitation of external rotation movement.
NOTE ON RECURRENT DISLOCATION OF THE SHOULDER JOINT
Authors: Watson-Jones Reginald
Published: February 2018

SummaryâFifty-two cases of exposure of the glenoid labrum are recorded. Fifty-one operations with anterior exposure, followed by capsular reefing and shortening of the subscapularis, were successful. One operation with superior exposure, and without capsular reefing or shortening of the subscapularis, was unsuccessful.
ARTHRODESIS IN TUBERCULOSIS OF THE HIP JOINT
Authors: Dobson J.
Published: February 2018

1. Fifty cases of arthrodesis of the hip joint in tuberculous arthritis are analysed; in forty cases the late end-result has been ascertained two or more years after operation.

2. The indications for arthrodesis are discussed. The operation should not be performed when disease is active; it should not be undertaken before the age of twelve to thirteen years; it is not advisable in elderly patients; it may be contra-indicated when there are multiple foci of infection. Subject to these limitations every patient with unsound ankylosis after adequate conservative treatment should be treated by arthrodesis; painful fibrous ankylosis and late onset of deformity are definite indications.

3. Three types of operation have been used: intra-articular arthrodesis; extra-articular ilio-femoral arthrodesis; combined intra- and extra-articular arthrodesis. Extra-articular ilio-femoral arthrodesis is preferred, deformity being first corrected by traction or osteotomy.

4. Post-operation complications were few; the mortality rate was low (2 per cent.).

5. There was bone ankylosis with solid incorporation of the graft in 87Â·5 per cent., failure of union of the graft (to the trochanter) in 10 per cent., and destruction of the graft in 2Â·5 per cent.

6. Late end-results show full working capacity in 87Â·5 per cent. of patients, part working capacity in 2Â·5 per cent. and inability to work in 7Â·5 per cent.

The writer wishes to express his thanks to Professor Harry Platt and Professor T. P.. McMurray for criticism and advice in the preparation of this paper, and to Dr F. C. S. Bradbury, Central Consultant Tuberculosis Officer of the Lancashire County Council, for permission to publish these cases.
PLASTIC SPLINTS AND APPLIANCES IN ORTHOPAEDIC SURGERY
Authors: Herschell Woolf , Scales John T.
Published: February 2018

The advantages of plastics are well known, but there are still some who maintain that these materials are costly and difficult to manipulate. It is not usually remembered, however, that plastics already have their place in orthopaedic splint manufacture, for example in celluloid appliances of many kinds which are in everyday use. They are much lighter than plaster of Paris; they are unaffected by water and body secretions; and some are radiolucent. With the rapid development of modern plastics now taking place there is a wide field for research into their application in orthopaedic surgery. In describing a range of plastic splints and appliances, and outlining the details of their construction, we have tried to show that such research is worth while.
THE MOVEMENTS OF BONES AND JOINTS
Authors: MacConaill M. A.
Published: February 2018

1. Two successive movements at a joint, if not in one and the same plane, constitute a diadochal movement.

2. Diadochal movements impose conjunct rotation upon the bone which has been moved. This may be countered by a rotation of opposite sense.

3. All muscles of a given joint are, therefore, rotators in some degree.

4. Upon the basis of these principles diagnostic and therapeutic suggestions are made.
TREATMENT OF PATHOLOGICAL DISLOCATION OF THE HIP JOINT AFTER SUPPURATIVE ARTHRITIS IN INFANTS
Authors: Bryson A. F.
Published: February 2018

Arthrodesis of the hip joint performed between the ages of twelve and fifteen years, is the most satisfactory treatment for cases of pathological dislocation after acute suppurative arthritis in infants.
ETIOLOGY OF PERONEAL SPASTIC FLAT FOOT
Authors: Harris R. I. , Beath Thomas
Published: February 2018

1. Peroneal spastic flat foot is a term loosely and often inaccurately used to describe rigid valgus feet developing from widely different causes.

2. The most common causes are two anomalies of the bones of the tarsusâthe calcaneonavicular bar, and the talocalcaneal bridge. The first was described in 1921 by Sloman and in 1927 by Badgley; the other is described for the first time in this paper as an etiological factor in rigid flat foot though it has been recognised by anatomists for fifty years as a skeletal variation. The term peroneal spastic flat foot, as applied to these cases, is inaccurate since there is no spasm of the peroneal muscles. The deformity is a fixed structural deformity due to anomalous bone structure, and the apparent spasm of peroneal muscles is in reality an adaptive shortening. A better term would be rigid flat foot due to talocalcaneal bridge or calcaneonavicular bar.

3. The smaller group of patients who suffer from inflammatory lesions of the tarsal joints, chiefly due to rheumatoid arthritis, do in fact develop valgus deformity from peroneal spasm. The resemblance between the two groups is superficial and it is limited to the apparent similarity of the deformity. Though it might be justifiable to designate this type as peroneal spastic flat foot, it would be better to use the more accurate titleâarthritic flat foot with peroneal spasm.

4. Lipping of the upper margin of the talonavicular joint strongly suggests the existence of one or other of the congenital anomalies. Both anomalies are visualised only by special radiological projections.
THE CONGENITAL DISCOID MENISCUS
Authors: Smillie I. S.
Published: February 2018

1 . A personal series of twenty-nine discoid menisci is reviewed.

2. Three anatomical types are recognised and described.

3. The characteristic lesions incurred by each type is recorded.

4. The anatomical and pathological features of the specimens are compared with those of cases previously recorded.

5. A discoid medial meniscus is described, and compared with the only other specimen known to be recorded in the literature.
RETROSTERNAL DISLOCATION OF THE CLAVICLE
Authors: Kennedy John C.
Published: February 2018

Retrosternal dislocation of the clavicle is an unusual injury. Serious complications may arise from damage to the trachea, the great vessels of the mediastinum, the oesophagus, and the thoracic duct. Operative reduction and reconstruction of the ligaments is the most reliable treatment.
TYPES OF DISPLACEMENT IN FRACTURES OF THE FEMORAL NECK
Authors: Linton Per
Published: February 2018

1. Various types of fracture of the femoral neck represent different stages of one and the same displacing movement.

2. The displacement first produces an "abduction fracture" and terminates in an "adduction fracture," passing through the stage of an " intermediary fracture" which is less well recognised.

3. These three types of fracture occur in response to the same injury and they differ only in the degree of displacement.

4. It is a mistake to believe that in " adduction fractures" the femoral head lies medially to the collum : it lies posteriorly.

5. "Impaction" is no more than the first stage of displacement of fractures in which there is limited displacement, with contact still maintained between the fragments.

6. An "impacted fracture" is not necessarily stableâif there is additional strain it may progress to the next stage of a displaced and unstable fracture.

7. These principles apply not only to fractures of the femoral neck but to all other fractures at the ends of long bones.
SKIN GRAFTING BY CROSS-LEG FLAPS
Authors: Braithwaite Fenton , Moore F. T.
Published: February 2018

1. After limb injuries with loss of skin and subcutaneous tissue, full-thickness skin flaps afford the most satisfactory cover. It is particularly important to replace unstable and scarred skin before attempting bone reconstruction and similar operations.

2. In the leg and foot, full-thickness skin cover is conveniently obtained by the cross-leg flap technique. The blood supply of such flaps is considered and the technique of operation is described. Free excision of avascular scar tissue is essential.

3. "Delayed transfer" of the flap is advisable unless conditions are favourable; two methods are considered.

4. Immobilisation in plaster is the most satisfactory method of fixation of the limbs after attachment of the flap. Muscle exercises are performed throughout the period of treatment in order to minimise joint stiffness and shorten convalescence.

5. The cross-leg flap technique should not usually be used in children, young women, or the aged and mentally infirm. Contra-indications include arthritis of the knee and hip joints because there is danger of joint stiffness.

6. Vascular complications of cross-leg skin grafting are discussed.
TREATMENT OF GIANT-CELL TUMOURS OF BONE
Authors: Prossor T. M.
Published: February 2018

1. Twenty-five cases of benign giant-cell tumour of bone, treated at Westminster Hospital, London, are reported.

2. The diagnosis can often be made on clinical and radiographic grounds alone but biopsy is sometimes necessary and seldom, if ever, contra-indicated.

3. Some cases may best be treated by excision, but in general irradiation is the treatment of choice.

4. Details of treatment by irradiation are given.
SOLITARY PLASMOCYTOMA OF THE SPINE
Authors: Raven Ronald W. , Willis R. A.
Published: February 2018

1. A case of solitary plasmocytoma of the thoracic part of the spine, verified by necropsy, is described.

2. A brief review is given of eighteen acceptable cases of solitary plasmocytoma of bone.

3. Of the eighteen patients, fifteen were men; the five spinal tumours were all in men.

4. Diagnosis requires: a) biopsy identification of plasmocytoma; b) exclusion of the possibility of generalised myelomatosis by complete radiography of the skeleton, repeated if necessary at intervals during the ensuing two or three years or longer.

5. A tumour of brief duration, proved to be solitary by careful necropsy, cannot be placed with certainty in the group of truly solitary plasmocytomas; it might have been a precocious first lesion of myelomatosis.
NATURAL HISTORY AND TREATMENT OF PULP SPACE INFECTION AND OSTEOMYELITIS OF THE TERMINAL PHALANX
Authors: Bolton Harold , Fowler P. J. , Jepson R. P.
Published: February 2018

The pathology of pulp space infection is discussed. It is recommended that a direct incision which is localised precisely to the abscess site, even if the incision is in the tactile pad, is better than a lateral incision, which fails to maintain drainage, causes longer incapacity, and may injure the digital nerve and give rise to causalgia. Fifty cases of pulp space infection in which a direct incision was used are reviewed.
INTER-METACARPAL BONE GRAFT FOR THENAR PARALYSIS
Authors: Brooks Donal M.
Published: February 2018

1. Sixteen cases of thenar paralysis are reviewed in which a bone graft was inserted between the first and second metacarpals to maintain fixed abduction and opposition of the thumb.

2. The technique of the operation is described and the causes of failure are discussed.

3. The operation is intended for those cases in which tendon transplantation to restore active opposition of the thumb is unsuitable. Rotation of the first metacarpal into full opposition is the most important feature of the operation.
THE ENDOCRINE BASIS FOR SLIPPING OF THE UPPER FEMORAL EPIPHYSIS
Authors: Harris W. Robert
Published: February 2018

1. An apparatus was designed to determine the shearing strength of the upper tibial epiphysis in the rat. Observations were made with this instrumenton normal animals, on animals receiving growth-hormone, and on animals receiving oestrogen.

2. When the epiphysis separates from the diaphysis, the plane of cleavage is constant, passing through the third layer of the epiphysial plate.

3. Growth-hormone decreases and sex-hormone increases the shearing strength of the epiphysial plate. These changes are due to alterations produced by these two hormones in the thickness of the third layer of the epiphysial plate.

4. It is suggested that these findings may be of significance in providing an anatomical basis for slipping of the upper femoral epiphysis in man, especially when it is associated with the adiposo-genital syndrome or with rapid adolescent growth.
CONGENITAL TORTICOLLIS
Authors: Hulbert K. F.
Published: February 2018

1. One hundred cases of torticollis and 117 cases of sternomastoid tumour have been reviewed.

2. Congenital torticollis can be sub-divided into two groups: postural and muscular.

3. Congenital postural torticollis is present at birth; it is not associated with a sternomastoid tumour; it is transient in nature; and it does not require operation for its relief.

4. Congenital muscular torticollis is preceded by a sternomastoid tumour which is clinically evident in one-fifth of all cases.

5. The ischaemic theory of the causation of sternomastoid tumours is not supported by recent histological investigations. Some other cause, which probably is operative before birth, must be sought.

6. Four-fifths of all cases of sternomastoid tumours resolve spontaneously and leave no deformity. Excision of the tumour in infancy is therefore unjustifiable.

7. Open division of the muscle and of the cervical fascia in congenital muscular torticollis cures the deformity but leaves an unsightly scar.

8. Subcutaneous tenotomy can be relied upon to cure the deformity if post-operative treatment is carried out skilfully and assiduously over a prolonged period.

9. If complete correction is not gained at the time of subcutaneous tenotomy a better result can be assured by open division of the upper end of the muscle through an incision within the hair line.
AN EXPERIMENTAL STUDY OF TENDON GROWTH IN THE RABBIT
Authors: Crawford G. N. C.
Published: February 2018

1. Small indian ink marks were made at intervals along the length of tendons in the limbs of young rabbits, and the distance between the marks was measured during the operation. The rabbits were killed two to three months later, and the amount of longitudinal growth that had occurred was determined by re-measuring the distance between the marks.

2. The experiments showed that the whole of the tendon grows interstitially in length, but that maximal growth occurs near the muscle-tendon junction.

3. Histological examination of the tendons and control experiments involving adult tendons indicated that growth was not significantly interfered with by marking the tendons.
THE MOVEMENTS OF BONES AND JOINTS 3. The Synovial Fluid and its Assistants
Authors: MacConaill M. A.
Published: February 2018

1. Synovial fluid acts mechanically by forming a convergent lubricant film between the fixed and the moving joint surfaces. This term and the underlying theory are explained.

2. The fatty pads assist lubrication by reducing the "mechanical curvature" in joints with more highly curved surfaces.

3. The intra-articular discs and menisci increase the "mechanical curvature" in joints with surfaces of small curvature.

4. Sesamoid bones exert a "bow-string pressure" upon the bones with which they articulate. This is a corollary from the theory of lubrication.
CHERUBISMâA FAMILIAL FIBROUS DYSPLASIA OF THE JAWS
Authors: Jones W. A. , Gerrie John , Pritchard Joseph
Published: February 2018

1. A condition of fibrous dysplasia of the jaws occurring in four brothers and a sister has been under observation since 1931.

2. Three of the five patients have been operated upon for correction of grotesque deformity, with satisfactory results.

3. The pathological nature of the disorder is discussed.
PSEUDARTHROSIS OF THE TIBIA IN CHILDHOOD
Authors: McFarland Bryan
Published: February 2018

1. The results of the by-pass grafting operation in eleven cases of pseudarthrosis of the tibia in childhood are presented.

2. The operation was successful in securing sound bone union in nine cases, and unsuccessful in two.

3. The causes of failure in the two unsuccessful cases are analysed.

4. The possible causes of occurrence and persistence of tibial pseudarthrosis in childhood are discussed.

5. It is suggested that the pseudarthrosis results from a fatigue fracture of a congenitally abnormal tibia, but that its persistence depends entirely on mechanical factors.

6. There is evidence to suggest that the underlying congenital abnormality may arise from dysplasia of the mesenchyme.
THE MANUBRIO-STERNAL JOINT IN ANKYLOSING SPONDYLITIS
Authors: Savill Douglas L.
Published: February 2018

1. Pathological changes occurred in the manubrio-sternal joint in 72 per cent of a series of sixty-one cases of ankylosing spondylitis.

2. In all the twenty-one patients over the age of thirty-five years the joint was undergoing a process of fusion that was found in only seven of sixty healthy persons in the same age group.

3. In the age groups twenty-five to forty-four, thirty-five out of forty-three patients with ankylosing spondylitis showed abnormality that was noted in but three of the forty healthy controls.

4. The changes in the manubrio-sternal joint are similar to those which occur in the sacro-iliac joint.

5. The accessibility of the manubrio-sternal joint makes it a convenient source of pathological material for the further histological study of the disease.
SOME EXPERIENCES IN THE TREATMENT OF OSTEOMYELITIS OF INFANTS
Authors: Athanassiadis Ch. N.
Published: February 2018

1. The clinical findings and results in seventeen patients under two years of age, suffering from acute osteomyelitis, have been studied and compared with forty-eight similar cases treated without penicillin.

2. The results in the penicillin-treated group were not greatly superior to those in the control group and did not justify the high hopes that have been entertained for penicillin as a certain cure for osteomyelitis.
THE CAUSATIVE MECHANISM IN MORTON'S METATARSALGIA
Authors: Mulder J. D.
Published: February 2018

1. A clinical test of diagnostic significance in Morton's metatarsalgia is described.

2. Findings at operation in twelve cases are recorded.

3. The causation of the digital neuroma is discussed.
TROCHANTERIC FRACTURES
Authors: Evans E. Mervyn , Wales Swansea S.
Published: February 2018

1. A series of 110 cases of trochanteric fractures treated by internal fixation with the Capener-Neufeld nail-plate is presented. The age incidence, mortality, complications and functional results are discussed in detail.

2. The results are compared with those of two series of cases treated conservatively: a) 101 cases treated conservatively in hospital; b) 25 cases sent home by reason of shortage of hospital beds.

3. From a consideration of these three series, and from study of similar series of cases reported in the literature, it is concluded that routine operative treatment of trochanteric fractures offers the advantages of lowered mortality, improved function, economy of hospital beds, and greater comfort and mobility of the patient.

4. Certain points in the management of cases during the operation and in the convalescent period are discussed.
INFECTION OF WOUNDS WITH ACTINOMYCES
Authors: Cullen C. H. , Sharp M. E.
Published: February 2018

1. Six cases of infection of wounds with actinomyces are described alld tile cultural characteristics of tile organisms are discussed.

2. In three patients the infecting organism was an unusual aerobic form.

3. Possible sources of infection are considered.

4. The chronicity of the condition and the difficulty in treatment are stressed.

5. Penicillin and X-radiation hold out most hope of cure.
THE MOVEMENTS OF BONES AND JOINTS
Authors: MacConaill M. A.
Published: February 2018

1. All articulating cartilages are fibrocartilages.

2. The articular cartilages of the synovial joints are largely composed of collagen fibres.

3. These fibres form a dense network, the fibres of which run obliquely between the articular surface and the bone.

4. This network is operative when the parts are at rest and in contact under pressure. It takes the tensile component of the resultant shear stress, and is a postural mechanism of the joint.

5. The articular cartilage is most heavily chondrified at its centre, between the juxta-synovial and juxta-osseous parts.

6. The technique for demonstrating the fibrous structure is described.
TARSAL MOVEMENTS
Authors: Shephard Edmund
Published: February 2018

1) Supination and pronation are the only material tarsal movements; other terms describe their hypothetical components only.

2) The subtalar and talo-navicular joints form a single joint functionally, which may be called the peritalar joint.

3) Peritalar movement comprises a wide range of supination and pronation of the foot about an axis which passes from the tuberosity of the calcaneum upwards, forwards and slightly medially to the neck of the talus.

4) Midtarsal movement comprises a narrow range of supination and pronation of the foot about an axis similar to that of peritalar movement.

5) Tile peritalar and midtarsal joints are thus oblique hinge joints.
HOMOGRAFTS AND THE BONE BANK
Authors: Herbert J. J.
Published: February 2018

The technique of storing bone by refrigeration is described and the following advantages are indicated: 1) A patient avoids a second wound and the loss of bone from some other part of the body; this is a very important matter for patients in whom poliomyelitis has affected both legs. 2) Almost unlimited bone is available to the surgeon and he is consequently able to insert very large grafts and so obtain better results.
OBSERVATIONS ON HALLUX VALGUS
Authors: Hardy R. H. , Clapham J. C.R.
Published: February 2018

A survey of this type cannot be used to point to any definite factor or factors predisposing to the development of hallux valgus. Nevertheless, a comparison of measurements in the morbid and control groups shows several outstanding differences:

1) There was a high degree of correlation between valgus and intermetatarsal angle in the two groups combined (coefficient, 0Â·7) but the correlation was higher in those cases with a degree of valgus greater than 25 degrees than in the remainder (coefficients, 0Â·36 and 0Â·53).

2) In the control group the first metatarsal was longer than tile second by a mean measure of 2 millimetres; in the morbid group by a mean measure of 4 millimetres. For a high degree of valgus and a low intermetatarsal angle the first metatarsal tends to be longer than the second by a significantly greater amount than when the high valgus is associated with iligh intermetatarsal angle.

3) In 90 per cent of the control cases there was a lateral displacement of the medial sesamoid of the first metatarsal of 3 degrees or less, whereas 88 per cent of the morbid group showed a displacement of 4 degrees or more. There was very little overlap in the distributions of this observation in the two groups. There was a high correlation between the degree of this displacement and the severity of hallux valgus.

4) Rotation of the hallux was not observed among the controls; in the morbid group those cases showing rotation had an average degree of valgus of 36 degrees while the rest had an average of 19 degrees. The mean degree of valgus in the morbid group was 32Â·0 degrees and that of the controls 15Â·5 degrees. The mean angle between the axes of the first and second metatarsals was 13Â·0 degrees in the morbid group and 8Â·5 degrees in the controls.

Since tile morbid group consisted largely of women (98 per cent) it is important to know that in the control group the only measure showing a statistically significant sex difference is that of intermetatarsal angle, but that, even so, the mean difference is only 1Â·3 degrees. Thus tile sex difference between the two groups is probably only of minor importance. The role of age in influencing the observations cannot be clearly elucidated from the data at present available. It can only be stated that there is no positive indication that age is a controlling factor in the departure observed in the morbid group from the control observations.
THE UNSUITABILITY OF POLYTHENE FOR MOVABLE WEIGHT-BEARING PROSTHESES
Authors: Newman P. H. , Scales J. T.
Published: February 2018

In addition to its orthopaedic interest, this case illustrates the special behaviour of fine particles of a synthetic material when implanted in the human body. These results may interest those engaged in the control of dusts in the plastics industry, for the inhalation of such dusts may well result in "implantation" of the material in the lung, with consequent histological changes.
TWO CURVE PATTERNS IN IDIOPATHIC STRUCTURAL SCOLIOSIS
Authors: James J. I.P.
Published: February 2018

Infantile idiopathic scoliosis is a structural scoliosis seen in infants, usually boys, with the major curve to the left in almost all cases, and almost invariably in the mid-or lower thoracic region. It occasionally disappears, but in general the curve tends to increase. In the absence of any discoverable etiology it is termed "idiopathic" and it is believed not to differ in essentials from the more common adolescent scoliosis.

Lumbar idiopathic scoliosis has a good prognosis as to deformity, but leads more often than any other curvature to degenerative arthritis and pain in later life.
AN IRREGULAR, FAMILIAL CHONDRO-OSSEOUS DEFECT
Authors: Jackson W. P.U.
Published: February 2018

Three elderly sibling dwarfs are reported from a large and otherwise normal family. Their condition is an unusual and irregular form of cartilaginous defect, combined with club-feet, and bearing some resemblance to the Morquio type.

A brief consideration of the literature of the generahised developmental bony syndromes shows confusion of thought and nomenclature. A plea is therefore made for simplification and a rational and simple grouping of these conditions is attempted. It seems particularly desirable that many confusing names for particular syndromes should be scrapped (for example, dyschondroplasia, chondro-osteodystrophy), although quite evidently the terms achondroplasia and osteogenesis imperfecta must remain because of their long-standing and general usage. Incidentally I have suggested elsewhere (Jackson 1951) that the name cleido-cranial dysostosis should be dropped, because it tends to lead the investigator away from the clinically more important lesions in the teeth and the cartilage bones of the pelvis and legs. It seems reasonable to confine the nomenclature of these various syndromes to the names used in the above classification, or something on those lines.
TISSUE DIFFERENTIATION IN MALIGNANT SYNOVIAL TUMOURS
Authors: King E. S. J.
Published: February 2018

1. A series of twenty-one cases of synovial tumour is tabled and the histological appearances are discussed.

2. The characteristic histological forms, (a) mucin formation, (b) synovial spaces, (c) endothelial and "gland" spaces and (d) epithelium-like tissue, are described.

3. These all arise by differentiation of connective tissue cells which occur throughout the connective tissue part of the limbs.

4. Though more commonly found in regions where synovial membrane is present, they are not confined to such special areas.

5. The tumours are classified on a histological and not a histogenetic basis.
BONE CHANGES IN THE SKULL IN DYSTROPHIA MYOTONICA
Authors: Caughey J. E.
Published: February 2018

Fourteen patients with dystrophia myotonica and a post-mortem report of another case are reported. All had radiological or other evidence of abnormalities of the skull. The most constant were a thickened calvarium, hyperostosis interna, small to very small pituitary fossa and extensive sinuses. It is believed that the high incidence of these changes cannot be coincidental and it is held that they should be accepted as some of the variable features of dystrophia myotonica.
NERVE COMPRESSION BY SIMPLE GANGLIA
Authors: Brooks Donal M.
Published: February 2018

1. Thirteen cases are reported of nerve compression by a ganglion. At operation a connection between the ganglion and the neighbouring joint was established in many instances.

2. It is suggested that so-called ganglia of the nerve sheath and simple ganglia are anatomical varieties of the same entity.

3. The treatment of choice is excision of the ganglion. If this procedure is technically difficult, puncture is advisable.

4. Recovery of sensibility after operation was good. Motor recovery was poor when damage to motor fibres occurred during excision of the ganglion or when paralysis had been present for more than eighteen months.
RETARDED CALLUS FORMATION IN RABBITS TREATED WITH SODIUM CITRATE
Authors: Labdoff G. A.
Published: February 2018

The experiments showed that the administration of sodium citrate retards fracture healing. This is probably due to a change in the solubility of the calcium or to a relative calcium deficiency on account of the excretion in the urine, or to a combination of both factors. Other reasons cannot, however, be excluded, such as a biochemical effect on the ground substance or an enzyme deficiency.
ACUTE HAEMATOGENOUS OSTEITIS IN CHILDHOOD
Authors: White Matthew , Dennison Wallace M.
Published: February 2018

1 . Two hundred and twelve cases of acute haematogenous osteitis treated between 1936 and 1950 have been reviewed.

2. The cases are described in three groups: Group IâSeventy-five cases treated before the introduction of effective chemotherapy; Group IIâFifty-five cases treated with sulphathiazole and Group IIIâEighty-two cases treated with penicillin.

3. The problems of penicillin therapy are discussed.
MAN WITH THREE LEGS
Authors: Smillie I. S. , Murdoch J. H.
Published: February 2018

1 . The extraordinary background and circumstances of discovery of a man, aged fifty, the subject of the rare congenital anomaly of posterior dichotomy, taking the form of a hemipelvis and complete lower limb is reported.

2. The appendage is described and illustrated.

3. Investigations and treatment are described and the result illustrated.

4. Reference is made to previous recorded cases in the literature.
CERVICAL HYPEREXTENSION INJURIES WITH PARAPLEGIA
Authors: Kaplan C. J.
Published: February 2018

1. The literature on paraplegia complicating hyperextension injuries of the cervical spine is reviewed, and the lack of any definite explanation of the mode of interference with cord function is noted.

2. A case is described in which a detailed dissection of the post-mortem specimen was carried out. On the basis of the findings it is suggested that one cause of the suppression of cord function in such injuries is thrombosis of the spinal arteries and liquefaction-necrosis of the cord.
LEONTIASIS OSSEA
Authors: Evans John
Published: February 2018

1. One hundred and forty-nine cases of leontiasis ossea reported in the literature have been reviewed.

2. The clinical, radiographic and pathological features of the condition are discussed.

3. Four additional personal cases are reported in detail.

4. A new classification of leontiasis ossea is suggested, by which the condition is divided into true leontiasis and false (or symptomatic) leontiasis, True leontiasis is a clinical syndrome caused by two distinct types of disease, whose pathology, however, is related. False leontiasis gives a superficially similar picture but on detailed examination is found to be distinct; it may be caused by a variety of different conditions.

5. Classified in this way, ninety-seven of the total of 153 cases considered were classified as true leontiasis (forty-five Type 1 and fifty-two Type 2); forty were classified as false leontiasis; and sixteen did not fall into either category.