bluuebunny/crossref_metadata_2025 huggingface dataset:
Scaphoid fracture non-union: a systematic review of surgical treatment using bone graft
Authors: Ferguson D. O. , Shanbhag V. , Hedley H. , Reichert I. , Lipscombe S. , Davis T. R. C.
Published: October 2015

This systematic review assesses the quality and outcomes of published articles concerning bone graft surgery for scaphoid fracture non-union. Searches of the CENTRAL, MEDLINE, EMBASE, CINAHL and AMED databases captured 2710 articles. Each article was screened and 144 met our inclusion criteria. Data regarding source, study design, population, intervention, comparator and outcomes were extracted. There were 5464 scaphoid non-union outcomes within the 144 studies. Mean reported union rates for vascularized and non-vascularized bone graft were 84% and 80%, respectively. Avascular necrosis was diagnosed in several ways and, when present, the vascularized bone graft union rate was 74% compared with 62% with non-vascularized bone graft. Reported union rates vary considerably. These differences may be due to patient factors, fracture factors, treatment factors or study design failures or bias. We recommend that future researchers take into account the deficiencies of previous studies and use the suggested minimum data set in future studies.

Level of evidence: II
The Star Wars Scroll Illusion
Authors: Shapiro Arthur G.
Published: October 2015

The Star Wars Scroll Illusion is a dynamic version of the Leaning Tower Illusion. When two copies of a Star-Wars-like scrolling text are placed side by side (with separate vanishing points), the two scrolls appear to head in different directions even though they are physically parallel in the picture plane. Variations of the illusion are shown with one vanishing point, as well as from an inverted perspective where the scrolls appear to originate in the distance. The demos highlight the conflict between the physical lines in the picture plane and perspective interpretation: With two perspective points, the scrolling texts are parallel to each other in the picture plane but not in perspective interpretation; with one perspective point, the texts are not parallel to each other in the picture plane but are parallel to each other in perspective interpretation. The size of the effect is linearly related to the angle of rotation of the scrolls into the third dimension; the Scroll Illusion is stronger than the Leaning Tower Illusion for rotation angles between 35° and 90°. There is no effect of motion per se on the strength of the illusion.
Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy
Authors: Scahill Shane , Fowler Jane L , Hattingh H Laetitia , Kelly Fiona , Wheeler Amanda J
Published: October 2015

Objective:

Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information.

Methods:

This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science.

Results:

Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation.

Conclusion:

The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.
Self-harm as a means to manage the public and private selves: A qualitative study of help seeking by adults
Authors: Ogden Jane , Bennett Alice
Published: October 2015

Adults ( n = 25) completed online free text boxes about their self-harming behaviour. Thematic analysis identified three dominant themes: ‘managing the private self’, ‘managing the public self’ and ‘moving on’. Transcending these themes was the notion of thresholds of change. Self-harm enables people to manage both their private and public selves. When thresholds of change are surpassed, the public self communicates a need for help. Self-harm exists within a precarious balance of well-being and can be a form of self-care. Help seeking is instigated when this balance is disrupted and continued if it offers a better form of self-management than the individual’s own self-harming behaviour.
Lumbosacral intraspinal extradural ganglion cyst in a cat
Authors: de Strobel Francesca , Taeymans Olivier , Rosati Marco , Cherubini Giunio B
Published: October 2015

Case summary

A 16-year-old neutered female domestic shorthair cat was referred for chronic history of reluctance to jump, stiffness of the tail and lower back pain. Mild pelvic limb ataxia, reduced perianal reflex and lumbosacral discomfort were present on neurological examination. On magnetic resonance imaging, a well-defined rounded structure of 3 mm in diameter was identified on the right dorsal aspect of the epidural space at L7–S1, causing displacement of the cauda equina. The lesion was hyperintense to spinal cord parenchyma on T2-weighted images and hypointense on T1-weighted images, consistent with a fluid-filled structure. A Lumbosacral dorsal laminectomy was performed. A clear fluid-containing structure was identified between the right L7 nerve root and the cauda equina. Following surgical excision, histopathology confirmed the cystic nature of the lesion and revealed thick disorganised sheaths of fibrocollagenous tissue and flattened mesenchymal cells lining the luminal part of the cyst wall. A diagnosis of intraspinal ganglion cyst was made. The cat recovered uneventfully. Seven months after surgery euthanasia was performed for unrelated reasons; no neurological deficits were present.

Relevance and novel information

This is the first reported case of intraspinal ganglion cyst in a cat. Intraspinal extradural cysts should be considered among other differential diagnoses for cats with lumbosacral myelopathy/radiculopathy.
Researching Social Media as if the Social Mattered
Authors: Couldry Nick , van Dijck José
Published: October 2015

The institutions we have come to call “media” have been involved for over a century in providing an infrastructure for social life and have invested in a quite particular and privileged way of re-presenting the world as “social.” The dialectic between “media” and “social” has become more urgent to understand in an era when media and information infrastructures have expanded, converged, and become embedded more deeply in the texture of everyday life, while at the same time the claims of “media” to be social have become explicit, indeed insistent. This article asks what it would mean to address this new social/media dialectic head on—as if the social mattered. The word “social” is our necessary term for thinking about the complex interdependencies out of which human life really is made and the claims to represent that interdependent reality made from particular positions of power. All forms of power have invested in certain representations of the social. This battle matters, and now “social media”—the infrastructures of web 2.0—are at the heart of that battle. The article seeks to offer a plausible agenda for a collaborative program of research to address this struggle over the definition of “the social.”
Thinking of You: Vernacular Affordance in the Context of the Microsocial Relationship App, Couple
Authors: McVeigh-Schultz Joshua , Baym Nancy K.
Published: October 2015

The concept of “affordance” stakes out a middle ground between social constructivism and technological determinism, seeking to account for how material qualities of technologies constrain or invite practices while also accommodating emergent meanings. Yet we know little about how people themselves understand affordances in their encounters with technology. This article treats vernacular accounts of material structure and practice as clues to the ways that people understand and negotiate technology in their everyday lives. We studied the experiences of romantic partners who use Couple, a relationship app touted as a “social network of two,” and part of an emerging class of “microsocial” platforms. Partners who use Couple have limited knowledge of how others use the app, which offered us a unique lens for witnessing how people make sense of the relationship between practice and material structure. We conducted qualitative interviews with romantic pairs who use Couple, attending to how interviewees conceived of its capabilities, features, and position within larger media ecologies. We argue that affordances simultaneously exist for people at multiple levels of scale, for example: infrastructure, device, app, feature, and so on. These levels are theoretically distinct but can intersect conceptually as people make sense of technological systems and adapt their practices, or create new ones. This approach opens up new ways of understanding the relationship between technologies and practices by drawing attention to how different vernacular frames, such as “choice” or “constraint,” reflect particular ways of accounting for material structure.
Health Effects of Vanpooling to Work
Authors: Robbins Wendie A. , Berman Barbara A. , Stone Dawn S.
Published: September 2015

Shared commutes to work, such as vanpooling, benefit the environment and provide economic gain for riders in terms of fuel costs, parking fees, and personal vehicle wear and tear. Although ride sharing is commonly believed to promote health through stress reduction, published evidence on this topic is limited, and findings vary. This study explored the perceived health and well-being of vanpoolers using a qualitative, descriptive design. Five focus groups of vanpoolers and two individual interviews with drivers were conducted ( N = 40 participants). Stress, change in sleep patterns, and interpersonal relationships emerged as major themes. Employee insights about the impact of vanpooling on work productivity and how employer commitment to the vanpool program influences the vanpool experience also were important findings.
Using Behavioral Insights to Increase Vaccination Policy Effectiveness
Authors: Betsch Cornelia , Böhm Robert , Chapman Gretchen B.
Published: October 2015

Even though there are policies in place, and safe and effective vaccines available, almost every country struggles with vaccine hesitancy, that is, a delay in acceptance or refusal of vaccination. Consequently, it is important to understand the determinants of individual vaccination decisions to establish effective strategies to support the success of country-specific public health policies. Vaccine refusal can result from complacency, inconvenience, a lack of confidence, and a rational calculation of pros and cons. Interventions should, therefore, be carefully targeted to focus on the reason for non-vaccination. We suggest that there are several interventions that may be effective for complacent, convenient, and calculating individuals whereas interventions that might be effective for those who lack confidence are scarce. Thus, efforts should be concentrated on motivating the complacent, removing barriers for those for whom vaccination is inconvenient, and adding incentives and additional utility for the calculating. These strategies might be more promising, economic, and effective than convincing those who lack confidence in vaccination.
Deeper Learning With Advances in Discourse Science and Technology
Authors: Graesser Arthur C.
Published: October 2015

The need for improving learning at deeper levels has been recognized in the national and international arena because language literacy, numeracy, and other core skills will not go the distance in handling 21st-century tasks. The challenge is aggravated by major gaps in school curricula and professional development of instructors. There is inadequate training of strategies for comprehending technical material, generating inferences, metacognition, integrating information from multiple documents, detecting misinformation, self-regulated learning, communicating through different media, collaborative problem solving, and other 21st-century skills. Some of these gaps can be filled with advances in discourse science and technology. Discourse scientists have identified the mental representations and processing mechanisms associated with different discourse levels. These levels stretch beyond word decomposition, vocabulary, and syntax (called basic literacy skills) into the deeper realms of semantics, situation (mental) models, rhetorical structure, and pragmatics. Computer tools automatically scale discourse on many levels so that individuals can get immediate multilevel feedback on text complexity, essay quality, and answers to questions. Discourse scientists have also identified effective strategies for training students how to improve comprehension of difficult material and mastery of a broad array of 21st-century competencies. These strategies have been implemented in intelligent, adaptive computer technologies, including those with conversational agents that take on different roles (e.g., peers, tutors, mentors). Future challenges lie in creating a curriculum for 21st-century skills that embrace discourse science and in scaling up discourse technologies that facilitate deeper learning.
Meeting Three Challenges in Risk Communication
Authors: Rakow Tim , Heard Claire L. , Newell Ben R.
Published: October 2015

Risk communication takes many forms, can serve a number of different purposes, and can inform people about a wide variety of risks. We outline three challenges that must often be met when communicating about risk, irrespective of the form or purpose of that communication, or the type of risk that this involves. The first challenge is how best to help people understand the phenomenology of the risks that they are exposed to: The nature of the risk, the mechanism(s) by which they arise, and, therefore, what can be done to manage these risks. Each risk has its own phenomenology; therefore, rather than offering generic guidance, we illustrate with the case of climate change risk how evidence from behavioral science can guide the design of messages about risk. The second challenge is how best to present quantitative risk information about risk probabilities. Here, there is potential for: Ambiguity, difficulty in evaluating quantitative information, and weak numeracy skills among those being targeted by a message. We outline when each of these difficulties is most likely to arise as a function of the precision of the message and show how messages that cover multiple levels of precision might ameliorate these difficulties. The third challenge is the role played by people’s emotional reactions to the risks that they face and to the messages that they receive about these risks. Here, we discuss the pros and cons of playing up, or playing down, the emotional content of risk communication messages.
Accuracy of Intelligence Forecasts From the Intelligence Consumer’s Perspective
Authors: Mandel David R.
Published: October 2015

Accurate forecasting is a vital part of intelligence assessment. Only recently has intelligence forecast accuracy been quantitatively tracked. Mandel and Barnes reported on a long-term study of intelligence forecasts that examined accuracy from the analysts’ perspective using numerical probabilities that were not reported to intelligence consumers. The present research reassessed the accuracy of those forecasts from an intelligence consumer’s perspective using findings from an experiment that elicited from subjects’ numerical probability equivalents for the linguistic probabilities that consumers would have read in intelligence reports. Forecast accuracy was undiminished when assessed from the consumers’ perspective (inferred from subjects’ median numerical equivalents) because the intended meaning of the probability terms used by the intelligence unit corresponded well to the average meaning assigned by subjects. The findings also showed that interpretations of linguistic probabilities are context-dependent. Linguistic probabilities were discriminated better when applied to outcomes that represented successes rather than failures.
High ΔNp73/TAp73 ratio is associated with poor prognosis in acute promyelocytic leukemia
Authors: Lucena-Araujo Antonio R. , Kim Haesook T. , Thomé Carolina , Jacomo Rafael H. , Melo Raul A. , Bittencourt Rosane , Pasquini Ricardo , Pagnano Katia , Glória Ana Beatriz F. , Chauffaille Maria de Lourdes , Athayde Melina , Chiattone Carlos S. , Mito Ingrid , Bendlin Rodrigo , Souza Carmino , Bortolheiro Cristina , Coelho-Silva Juan L. , Schrier Stanley L. , Tallman Martin S. , Grimwade David , Ganser Arnold , Berliner Nancy , Ribeiro Raul C. , Lo-Coco Francesco , Löwenberg Bob , Sanz Miguel A. , Rego Eduardo M.
Published: October 2015

Key Points

High ΔNp73/TAp73 expression ratio is associated with lower overall survival and higher cumulative incidence of relapse in APL. ΔNp73/TAp73 expression ratio is an independent prognostic marker in APL.
Could Marcus Aurelius be the missing link in the insanity
defence?
Authors: Crichton John H. M.
Published: October 2015

It is accepted that Modestinus (c. 320 CE) is the earliest
source of the insanity defence, but Walker posed the question, ‘[w]here did
Modestinus get his doctrine and his reasoning?’ (Annals of the
American Academy of Political and Social Science 1985). The
surviving writing of Modestinus reveals a clue as to its origin:
Experiences of ward rounds among in-patients on an acute mental health ward: a qualitative exploration
Authors: Cappleman Reed , Bamford Zandra , Dixon Clare , Thomas Hayley
Published: October 2015

Aims and method

To address the gap in qualitative research examining patients' experiences of ward rounds. In-depth interviews were conducted with five in-patients on an acute mental health ward. Data were analysed using thematic analysis.

Results

Data were organised into three first-order themes, positioned within an overarching theme relating to patients' perceptions of the use of power and control within ward rounds.

Clinical implications

Systemic factors may make it difficult to facilitate ward rounds in a manner which leaves patients feeling fully empowered or in control, but there are practical measures to address these issues, drawn from participants' accounts.
Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome
Authors: Dumesic Daniel A. , Oberfield Sharon E. , Stener-Victorin Elisabet , Marshall John C. , Laven Joop S. , Legro Richard S.
Published: October 2015

Polycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of oligo-ovulation, hyperandrogenism, and the presence of polycystic ovaries. Criteria that require hyperandrogenism tend to identify a more severe reproductive and metabolic phenotype. The phenotype can vary by race and ethnicity, is difficult to define in the perimenarchal and perimenopausal period, and is exacerbated by obesity. The pathophysiology involves abnormal gonadotropin secretion from a reduced hypothalamic feedback response to circulating sex steroids, altered ovarian morphology and functional changes, and disordered insulin action in a variety of target tissues. PCOS clusters in families and both female and male relatives can show stigmata of the syndrome, including metabolic abnormalities. Genome-wide association studies have identified a number of candidate regions, although their role in contributing to PCOS is still largely unknown.
Synchronization of business cycles in Poland and the euro zone – the wavelet domain approach
Authors: Bruzda Joanna
Published: September 2015

In the paper time-scale (wavelet) analysis is suggested as a tool for examining business cycle synchronization. Wavelet analysis enables to examine stochastic processes simultaneously in the time and frequency domains. Due to this the approach makes it possible to investigate time varying frequency components of economic processes. Among such components one can distinguish cycles of length over one year up to twelve years, which are known as business cycles (see Burns and Mitchell, 1946). In the paper this approach is illustrated with an examination of business cycle synchronization between Poland and its main trading partners in the euro zone: Germany, France, Italy and the Netherlands. The empirical analysis confirms the stylized facts on the Polish business cycle: its length, similarity with the German cycle and the lead-lag relations with national cycles in the euro zone. Besides, verification of the OCA endogenity hypothesis has been undertaken, but the results obtained are ambiguous.
The Role of Social Capital in the Activities of Internationalized Food Processing SMEs. Confrontation of Theoretical Findings with Empirical Ones
Authors: Gajowiak Małgorzata
Published: October 2015

The main objective of this paper is to identify the role of intangible factors in the process of enterprise internationalization. In particular, in the era of turbo-capitalism, the informal institution of social capital becomes of global significance and covers both social norms and values such as trust, loyalty and reliability. These resources can significantly reduce the uncertainty and distrust in the activities of business entities. In addition, they constitute the foundation of business networks, including in particular those of an informal nature, which (in the case when a company does not possess sufficient resources and skills) can become an important method to gain new knowledge about unknown foreign markets. The partnership within networks also allows for the reduction of transaction costs. Thus, it can forego gaining competitive advantage in the international arena. Therefore, the article raises three fundamental questions about the role of social capital in the internationalized business. The answers to these questions are based on the results of empirical research conducted in the years 2011-2012 among food processing SMEs in selected districts of Greater Poland.
“Gaming the System”: Decision Making by Interdependent Critical Infrastructure
Authors: Reilly Allison C. , Samuel Andrew , Guikema Seth D.
Published: October 2015

Supporting strong, resilient, and integrated critical infrastructure is vital to upholding the U.S. economy and its national security. Arguably, no sector of the economy could exist without the reliable and predictable networks on which it depends. To date, the research on interdependent infrastructure has concentrated on describing the sources of the dependencies and developing models for predicting performance and cascading disruptions after a hazardous event. However, these models fail to capture the perspective of the operators of these networks and how competing, independent objectives lead to suboptimal investment decisions and hence suboptimal network performance. Rather than focus on how interdependent infrastructures operate and possibly fail, we take the perspective of their operators and ask why they make the decisions that they do. The goal of this paper is to demonstrate how strategic interdependencies may impact performance of coupled systems by shifting investments away from what is collectively best toward decisions that are more myopic and optimal from the perspective of a single infrastructure. Through our model, we make inferences on the level of investments networks make, relate this to performance, and provide policy recommendations on how to promote reliable infrastructure.
On The Inverse Of A Class Of Bipartite Graphs With Unique Perfect Matchings
Authors: Panda Swarup , Pati Dr. Sukanta
Published: October 2015

Let G be a simple, undirected graph and Gw be the weighted graph obtained from G by giving weights to its edges using a positive weight function w. A weighted graph Gw is said to be nonsingular if its adjacency matrix A(Gw) is nonsingular. In [9], Godsil has given a class $\mathcal{G }$of connected, unweighted, bipartite, nonsingular graphs G with a unique perfect matching, such that A(G)â1 is signature similar to a nonnegative matrix, that is, there exists a diagonal matrix D with diagonal entries Â±1 such that DA(G)â1D is nonnegative. The graph associated to the matrix DA(G)â1D is called the inverse of G and it is denoted by G+. The graph G+ is an undirected, weighted, connected, bipartite graph with a unique perfect matching. Nonsingular, unweighted trees are contained inside the class G. We first give a constructive characterization of the class of weighted graphs Hw that can occur as the inverse of some graph Gâ\mathcal{ G}. This generalizes Theorem 2.6 of Neumann and Pati[13], where the authors have characterized graphs that occur as inverses of nonsingular, unweighted trees. A weighted graph Gw is said to have the property (R) if for each eigenvalue Î» of A(Gw), 1âÎ» is also an eigenvalue of A(Gw). If further, the multiplicity of Î» and 1âÎ» are the same, then Gw is said to have property (SR). A characterization of the class of nonsingular, weighted trees Tw with at least 8 vertices that have property (R) was given in [13] under some restriction on the weights. It is natural to ask for such a characterization for the whole of G, possibly with some weaker restrictions on the weights. We supply such a characterization. In particular, for trees it settles an open problem raised in [13].
Impact of lumbar instrumented circumferential fusion on the development of adjacent vertebral compression fracture
Authors: Li Y-C. , Yang S-C. , Chen H-S. , Kao Y-H. , Tu Y-K.
Published: October 2015

We evaluated the impact of lumbar instrumented circumferential fusion on the development of adjacent level vertebral compression fractures (VCFs). Instrumented posterior lumbar interbody fusion (PLIF) has become a popular procedure for degenerative lumbar spine disease. The immediate rigidity produced by PLIF may cause more stress and lead to greater risk of adjacent VCFs. However, few studies have investigated the relationship between PLIF and the development of subsequent adjacent level VCFs.

Between January 2005 and December 2009, a total of 1936 patients were enrolled. Of these 224 patients had a new VCF and the incidence was statistically analysed with other covariants. In total 150 (11.1%) of 1348 patients developed new VCFs with PLIF, with 108 (72%) cases at adjacent segment. Of 588 patients, 74 (12.5%) developed new subsequent VCFs with conventional posterolateral fusion (PLF), with 37 (50%) patients at an adjacent level. Short-segment fusion, female and age older than 65 years also increased the development of new adjacent VCFs in patients undergoing PLIF. In the osteoporotic patient, more rigid fusion and a higher stress gradient after PLIF will cause a higher adjacent VCF rate.

Cite this article: Bone Joint J 2015;97-B:1411–16.
Acetabular revision with impaction bone grafting and a cemented polyethylene acetabular component
Authors: te Stroet M. A. J. , Keurentjes J. C. , Rijnen W. H. C. , Gardeniers J. W. M. , Verdonschot N. , Slooff T. J. J. H. , Schreurs B. W.
Published: October 2015

We present the results of 62 consecutive acetabular revisions using impaction bone grafting and a cemented polyethylene acetabular component in 58 patients (13 men and 45 women) after a mean follow-up of 27 years (25 to 30). All patients were prospectively followed. The mean age at revision was 59.2 years (23 to 82).

We performed Kaplan–Meier (KM) analysis and also a Competing Risk (CR) analysis because with long-term follow-up, the presence of a competing event (i.e. death) prevents the occurrence of the endpoint of re-revision.

A total of 48 patients (52 hips) had died or had been re-revised at final review in March 2011. None of the deaths were related to the surgery. The mean Harris hip score of the ten surviving hips in ten patients was 76 points (45 to 99).

The KM survivorship at 25 years for the endpoint ‘re-revision for any reason’ was 58.0% (95% confidence interval (CI) 38 to 73) and for ‘re-revision for aseptic loosening’ 72.1% (95% CI 51 to 85). With the CR analysis we calculated the KM analysis overestimates the failure rate with respectively 74% and 93% for these endpoints. The current study shows that acetabular impaction bone grafting revisions provide good clinical results at over 25 years.

Cite this article: Bone Joint J 2015;97-B:1338–44.
Arthroscopy of the hip for patients with mild to moderate developmental dysplasia of the hip and femoroacetabular impingement
Authors: Fukui K. , Trindade C. A. C. , Briggs K. K. , Philippon M. J.
Published: October 2015

The purpose of this study was to determine patient-reported outcomes of patients with mild to moderate developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI) undergoing arthroscopy of the hip in the treatment of chondrolabral pathology. A total of 28 patients with a centre-edge angle between 15° and 19° were identified from an institutional database. Their mean age was 34 years (18 to 53), with 12 female and 16 male patients. All underwent labral treatment and concomitant correction of FAI. There were nine reoperations, with two patients requiring revision arthroscopy, two requiring periacetabular osteotomy and five needing total hip arthroplasty.

Patients who required further major surgery were more likely to be older, male, and to have more severe DDH with a larger alpha angle and decreased joint space.

At a mean follow-up of 42 months (24 to 89), the mean modified Harris hip score improved from 59 (20 to 98) to 82 (45 to 100; p < 0.001). The mean Western Ontario and McMaster Universities Osteoarthritis Index score improved from 30 (1 to 61) to 16 (0 to 43; p < 0.001). Median patient satisfaction was 9.0/10 (1 to 10). Patients reported excellent improvement in function following arthroscopy of the hip.

This study shows that with proper patient selection, arthroscopy of the hip can be successful in the young patient with mild to moderate DDH and FAI.

Cite this article: Bone Joint J 2015;97-B:1316–21.
Hemiarthroplasty for irreparable distal humeral fractures
Authors: Nestorson J. , Ekholm C. , Etzner M. , Adolfsson L.
Published: October 2015

We report our experience of performing an elbow hemiarthroplasty in the treatment of comminuted distal humeral fractures in the elderly patients.

A cohort of 42 patients (three men and 39 women, mean age 72; 56 to 84) were reviewed at a mean of 34.3 months (24 to 61) after surgery. Functional outcome was measured with the Mayo Elbow Performance Score (MEPS) and range of movement. The disabilities of the arm, shoulder and hand questionnaire (DASH) was used as a patient rated evaluation. Complications and ulnar nerve function were recorded. Plain radiographs were obtained to assess prosthetic loosening, olecranon wear and heterotopic bone formation.

The mean extension deficit was 23.5° (0° to 60°) and mean flexion was 126.8° (90° to 145°) giving a mean arc of 105.5° (60° to 145°). The mean MEPS was 90 (50 to 100) and a mean DASH score of 20 (0 to 63). Four patients had additional surgery for limited range of movement and one for partial instability. One elbow was revised due to loosening, two patients had sensory ulnar nerve symptoms, and radiographic signs of mild olecranon wear was noted in five patients.

Elbow hemiarthroplasty for comminuted intra-articular distal humeral fractures produces reliable medium-term results with functional outcome and complication rates, comparable with open reduction and internal fixation and total elbow arthroplasty.

Cite this article: Bone Joint J 2015;97-B:1377–84.
The five-year radiological results of the uncemented Oxford medial compartment knee arthroplasty
Authors: Hooper N. , Snell D. , Hooper G. , Maxwell R. , Frampton C.
Published: October 2015

This study reports on the first 150 consecutive Oxford cementless unicompartmental knee arthroplasties (UKA) performed in an independent centre (126 patients). All eligible patients had functional scores (Oxford knee score and high activity arthroplasty score) recorded pre-operatively and at two- and five-years of follow-up. Fluoroscopically aligned radiographs were taken at five years and analysed for any evidence of radiolucent lines (RLLs), subsidence or loosening. The mean age of the cohort was 63.6 years (39 to 86) with 81 (53.1%) males. Excellent functional scores were maintained at five years and there were no progressive RLLs demonstrated on radiographs. Two patients underwent revision to a total knee arthroplasty giving a revision rate of 0.23/100 (95% confidence interval 0.03 to 0.84) component years with overall component survivorship of 98.7% at five years. There were a further four patients who underwent further surgery on the same knee, two underwent bearing exchanges for dislocation and two underwent lateral UKAs for disease progression. This was a marked improvement from other UKAs reported in New Zealand Joint Registry data and supports the designing centre’s early results.

Cite this article: Bone Joint J 2015;97-B:1358–63.
Age-related differences in the use of total shoulder arthroplasty over time
Authors: Singh J. A. , Ramachandran R.
Published: October 2015

We assessed the age-related differences in the use of total shoulder arthroplasty (TSA) and outcomes, and associated time-trends using the United States Nationwide Inpatient Sample (NIS) between 1998 and 2010. Age was categorised as < 50, 50 to 64, 65 to 79 and ≥ 80 years. Time-trends in the use of TSA were compared using logistic regression or the Cochran Armitage test.

The overall use of TSA increased from 2.96/100 000 in 1998 to 12.68/100 000 in 2010. Significantly lower rates were noted between 2009 and 2010, compared with between 1998 and 2000, for: mortality, 0.1% versus 0.2% (p = 0.004); discharge to an inpatient facility, 13.3% versus 14.5% (p = 0.039), and hospital stay > median, 29.4% versus 51.2% (p < 0.001).

The rates of use of TSA/100 000 by age groups, < 50, 50 to 64, 65 to 79 and ≥ 80 years were: 0.32, 4.62, 17.82 and 12.56, respectively in 1998 (p < 0.001); and 0.65, 17.49, 75.27 and 49.05, respectively in 2010 (p < 0.001) with an increasing age-related difference over time (p <  0.001). Across the age categories, there were significant differences in the proportion: discharged to an inpatient facility, 3.2% versus 4.2% versus 14.7% versus 36.5%, respectively in 1998 (p < 0.001) and 1.8% versus 4.3% versus 12.5% versus 35.5%, respectively in 2010 (p <  0.001) and the proportion with hospital stay > median, 39.7% versus 40.2% versus 53% versus 69%, respectively in 1998 (p < 0.001) and 17.2% versus 20.6% versus 28.7% versus 50.7%, respectively in 2010 (p < 0.001).

In a nationally representative sample, we noted a time-related increase in the use of TSA and increasing age-related differences in outcomes indicating a changing epidemiology of the use of TSA. Age-related differences in outcomes suggest that attention should focus on groups with the worst outcomes.

Cite this article: Bone Joint J 2015;97-B:1385–9.
Evidence-based surgical training in orthopaedics
Authors: Price A. J. , Erturan G. , Akhtar K. , Judge A. , Alvand A. , Rees J. L.
Published: October 2015

Despite being one of the most common orthopaedic operations, it is still not known how many arthroscopies of the knee must be performed during training in order to develop the skills required to become a Consultant. A total of 54 subjects were divided into five groups according to clinical experience: Novices (n = 10), Junior trainees (n = 10), Registrars (n = 18), Fellows (n = 10) and Consultants (n = 6). After viewing an instructional presentation, each subject performed a simple diagnostic arthroscopy of the knee on a simulator with visualisation and probing of ten anatomical landmarks. Performance was assessed using a validated global rating scale (GRS). Comparisons were made against clinical experience measured by the number of arthroscopies which had been undertaken, and ROC curve analysis was used to determine the number of procedures needed to perform at the level of the Consultants.

There were marked differences between the groups. There was significant improvement in performance with increasing experience (p < 0.05).

ROC curve analysis identified that approximately 170 procedures were required to achieve the level of skills of a Consultant.

We suggest that this approach to identify what represents the level of surgical skills of a Consultant should be used more widely so that standards of training are maintained through the development of an evidenced-based curriculum.

Cite this article: Bone Joint J 2015;97-B:1309–15.
Prediction of hip displacement in children with cerebral palsy
Authors: Hermanson M. , Hägglund G. , Riad J. , Rodby-Bousquet E. , Wagner P.
Published: October 2015

Hip displacement, defined in this study as a migration percentage (MP) of more than 40%, is a common, debilitating complication of cerebral palsy (CP). In this prospective study we analysed the risk of developing hip displacement within five years of the first pelvic radiograph.

All children with CP in southern and western Sweden are invited to register in the hip surveillance programme CPUP. Inclusion criteria for the two groups in this study were children from the CPUP database born between 1994 and 2009 with Gross Motor Function Classification System (GMFCS) III to V. Group 1 included children who developed hip displacement, group 2 included children who did not develop hip displacement over a minimum follow-up of five years. A total of 145 children were included with a mean age at their initial pelvic radiograph of 3.5 years (0.6 to 9.7).

The odds ratio for hip displacement was calculated for GMFCS-level, age and initial MP and head-shaft angle. A risk score was constructed with these variables using multiple logistic regression analysis. The predictive ability of the risk score was evaluated using the area under the receiver operating characteristics curve (AUC).

All variables had a significant effect on the risk of a MP > 40%. The discriminatory accuracy of the CPUP hip score is high (AUC = 0.87), indicating a high ability to differentiate between high- and low-risk individuals for hip displacement. The CPUP hip score may be useful in deciding on further follow-up and treatment in children with CP.

Cite this article: Bone Joint J 2015;97-B:1441–4.
The constraints on day-case total knee arthroplasty: the fastest fast track
Authors: Thienpont E. , Lavand'homme P. , Kehlet H.
Published: October 2015

Total knee arthroplasty (TKA) is a major orthopaedic intervention. The length of a patient's stay has been progressively reduced with the introduction of enhanced recovery protocols: day-case surgery has become the ultimate challenge.

This narrative review shows the potential limitations of day-case TKA. These constraints may be social, linked to patient’s comorbidities, or due to surgery-related adverse events (e.g. pain, post-operative nausea and vomiting, etc.).

Using patient stratification, tailored surgical techniques and multimodal opioid-sparing analgesia, day-case TKA might be achievable in a limited group of patients. The younger, male patient without comorbidities and with an excellent social network around him might be a candidate.

Demographic changes, effective recovery programmes and less invasive surgical techniques such as unicondylar knee arthroplasty, may increase the size of the group of potential day-case patients.

The cost reduction achieved by day-case TKA needs to be balanced against any increase in morbidity and mortality and the cost of advanced follow-up at a distance with new technology. These factors need to be evaluated before adopting this ultimate ‘fast-track’ approach.

Cite this article: Bone Joint J 2015;97-B(10 Suppl A):40–4.
Decoronation as an alternative procedure for dental ankylosis after dental reimplantation due to trauma in growing children: case report
Authors: Rebouças Pedro Diniz , Santiago-Barbosa Adriana , Gondim Juliana , Moreira-Neto José Jeova Siebra
Published: October 2015

Dental ankylosis occurs by fusion of the root surface with the alveolar bone due to necrosis of the periodontal ligament. Local trauma, periapical infection, endocrine and metabolic disorders, excessive masticatory effort, poor eruptive force of the permanent successor and genetic alterations are some factors that can lead to ankylosis. Although there is not a known treatment for dentoalveolar ankylosis, there are alternative procedures, such as keeping the ankylosed tooth or its root, extraction followed by orthodontic closure, autotransplantation, implant, dento-osseous unit osteotomy or decoronation. The decoronation is a procedure which the crown of the ankylosed tooth is surgically removed below the cemento-enamel junction and the root is buried. After the procedure, a aesthetic maintainer of space is installed to prevent the space loss until the opportunity to provide a definitive rehabilitative treatment. Our aim is to report the case of patient LSM, female, 8 years-old, who came to the Oraldental Trauma Center of Federal University of Ceará after colliding against a wall. Avulsion of the dental element 21 occured and the tooth was stored in milk. The reimplantation occurred one hour after the injury. The treatment performed was decoronation and installation of a aesthetic and functional space maintainer. This case report presents a clinical follow-up of 6 months and 3 years of radiografic follow-up.
Flexural strength of composites: effects of the activation techniques and fiber reinforcement.
Authors: Mauro Silvio José , Machado Lucas Silveira , Almeida Leticia Cunha Amaral Gonzaga , Vieira Amanda Galves , Dos Santos Paulo Henrique
Published: October 2015

Objective: To evaluate the flexural strength of direct (Charisma) and indirect (Solidex) composites, with or without fiber reinforcements (Ribbond), cured with LED or Stroboscopic Xenon Light.MaterialandMethods: Resin bars made with or without fiber reinforcements, with 25mm x 2mm x 2mm were distributed in groups (n=10): GDL– Direct Resin/LED; GDX–Direct Resin/Stroboscopic Xenon; GDFL– Direct Resin/Fiber/LED; GDFX– Direct Resin/Fiber/Stroboscopic Xenon; GIL– Indirect Resin/LED; GIX– Indirect Resin/Stroboscopic Xenon; GIFL– Indirect Resin/Fiber/LED; GIFX– Indirect Resin/Fiber/Stroboscopic Xenon. The specimens were connected to a universal test machine and submitted to a compression load (2 kN).Results: The obtained results were submitted to Analysis of Variance tests (p < 0.01), and Tukey (5% significance level) tests. The flexural strength of groups that used polyethylene fiber reinforcement (96.39) was similar (p = 0.58) to group without fiber reinforcement (92.47). Direct composites (107.79) showed higher values of flexural strength than indirect composites (81.07), and stroboscopic xenon light curing (108.71) resulted in better flexural strength results than LED (80.15), for both kinds of composites experimented. Conclusion: The fiber reinforcement did not improve the composites’ flexural strength, direct composites showed higher flexural strength values, and stroboscopic xenon light showed better flexural strength results. KeywordsComposite resins; Curing Lights; Fiber reinforcements; Physical properties.
Anatomical study of palato-gingival groove in maxillary central incisors
Authors: Neves Felipe Lucas , Silveira Camila Augusto , Faig-Leite Horácio
Published: October 2015

Palatogingival groove (PGG) is a developmental anomaly affecting mainly the maxillary incisors. PGG incidence, depth, and length are clinically important because it may cause severe and localized periodontitis; and it may divide the root canal resulting in accessory foramina. This study aimedto analyze the presence, shape, length, and depth of the palatogingival groove in maxillary central incisors. 1,668 maxillary central incisors wereused. Each tooth had its root portion inspected in order to verify PGG presence and depth. The found palatogingival grooves were classified according to the system proposed by Gu [5], as follows: Type I (short and superficial), Type II (long and superficial), and Type III (long and deep). All teeth that showed the grooves were radiographed; five teeth had theirroot surface analyzed through Scanning Electron Microscopic (SEM); and four teeth corresponding to each PGG type were sent to obtain histologicalsections and then submitted to microscopic analysis. Of the 1.668 analyzed incisors, 27 (1.61%) showed the palatogingival groove: 8 (29.6%) Type I, 17 (63%) type II, and 2 (7.4%) Type III. Microscopic analysis revealed no communication between PGG and root canal. In conclusion, our results showed that PGG can be clinically and radiographically diagnosed on maxillary central incisors, with the type II being the most common. The professionalsshould be aware of the features of this groove due to its severe clinical consequences. KEYWORDSIncisor; Anatomical variation; Palatogingival groove
INTERAÇÕES MEDICAMENTOSAS POTENCIAIS EM DIABÉTICOS TIPO 2 PARTICIPANTES DE UM PROGRAMA DE EDUCAÇÃO EM SAÚDE
Authors: Lima Rodrigo Fonseca , Machado Alexandre Vaz , Rebelo Fernanda Maciel , Naves Janeth de Oliveira Silva , Lavich Tatiana Ramos , Dullius Jane
Published: October 2015

Estudo transversal com objetivo de identificar frequência, impacto clínico e fatores associados a Interações Medicamentosas Potenciais (IMP) em portadores de diabetes mellitus tipo 2 (DM2) participantes de um programa de educação em saúde. O estudo envolveu 71 diabéticos e as IMP foram classificadas utilizando a base UpToDate®. Os participantes com e sem IMP foram comparados considerando variáveis sócio-demográficas e clínicas através dos testes qui-quadrado e t student. Foram utilizados 4,6 medicamentos em média e mais de 70% apresentaram alguma IMP (total de 140 interações).  Mais de 70% requeriam monitoramento da farmacoterapia e em 6,4% havia necessidade de considerar alteração da prescrição. As IMP aumentaram conforme número de medicamentos prescritos (p<0,001) e não variou quanto ao gênero, idade e tempo de diagnóstico.
Conservative Management of Cardiac Hemangioma for 11 Years
Authors: Gribaa Rym , Slim Mehdi , Neffati Elyes , Boughzela Essia
Published: October 2015

Cardiac hemangiomas are benign tumors with an unpredictable natural history. Surgical resection is the treatment of choice; however, conservative management can be an alternative in some patients.

We report a case of a left-sided cardiac hemangioma that we managed conservatively for 11 years without obvious major complications in the patient, an adult woman.