bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative predictors of prolonged length of hospital stay following total knee arthroplasty: a retrospective study from a single center in China
Authors: Song Xiaoxiao , Xia Caiwei , Li Qiangqiang , Yao Chen , Yao Yao , Chen Dongyang , Jiang Qing
Published: February 2020

Background

Decreasing the length of hospital stay is an ideal course of action to appropriately allocate medical resources. The aim of this retrospective study was to identify perioperative factors that may decrease the length of hospital stay (LOS).

Methods

In this study, we collected the data on 1112 patients who underwent primary total knee arthroplasty surgery (TKAs) at our institution from Jan 1, 2011 to Nov 31, 2017. Based on the published literature, 16 potential factors (12 preoperative variables, 1 intraoperative variable, and 3 postoperative variables) were investigated. The patients requiring a hospital stay longer than the mean LOS (8 days) were defined as patients with a prolonged LOS. The factors with a P value less than 0.1 in the univariate analysis were further analysed in a multivariate model. An ordinal regression was used to determine independent risk factors for a prolonged LOS.

Results

The mean LOS was 8.3 days (±4.3), with a range of 2 to 30 days. Sixteen variables were analysed by univariate analysis, and 11 of them had p < 0.1 and were included in the multivariable model. Finally, 9 factors were found to be associated with a prolonged LOS. Among the 9 variables, 2 were surgery-related factors (operative time and intraoperative blood loss), and 3 were patient-related factors (age, ASA classification and neurological comorbidities).

Conclusion

In this study, we found that the clinical protocol, complications, the patient’s age, the ASA classification, neurological comorbidities, the operative time, the ward, intraoperative blood loss and the surgeon were all factors contributing to a prolonged LOS. In clinical practice, these factors provide important information for the surgeon and are useful for identifying patients with a high risk of a prolonged LOS.
Metabolic engineering of the cellulolytic thermophilic fungus Myceliophthora thermophila to produce ethanol from cellobiose
Authors: Li Jinyang , Zhang Yongli , Li Jingen , Sun Tao , Tian Chaoguang
Published: February 2020

Background

Cellulosic biomass is a promising resource for bioethanol production. However, various sugars in plant biomass hydrolysates including cellodextrins, cellobiose, glucose, xylose, and arabinose, are poorly fermented by microbes. The commonly used ethanol-producing microbe Saccharomyces cerevisiae can usually only utilize glucose, although metabolically engineered strains that utilize xylose have been developed. Direct fermentation of cellobiose could avoid glucose repression during biomass fermentation, but applications of an engineered cellobiose-utilizing S. cerevisiae are still limited because of its long lag phase. Bioethanol production from biomass-derived sugars by a cellulolytic filamentous fungus would have many advantages for the biorefinery industry.

Results

We selected Myceliophthora thermophila, a cellulolytic thermophilic filamentous fungus for metabolic engineering to produce ethanol from glucose and cellobiose. Ethanol production was increased by 57% from glucose but not cellobiose after introduction of ScADH1 into the wild-type (WT) strain. Further overexpression of a glucose transporter GLT-1 or the cellodextrin transport system (CDT-1/CDT-2) from N. crassa increased ethanol production by 131% from glucose or by 200% from cellobiose, respectively. Transcriptomic analysis of the engineered cellobiose-utilizing strain and WT when grown on cellobiose showed that genes involved in oxidation–reduction reactions and the stress response were downregulated, whereas those involved in protein biosynthesis were upregulated in this effective ethanol production strain. Turning down the expression of pyc gene results the final engineered strain with the ethanol production was further increased by 23%, reaching up to 11.3 g/L on cellobiose.

Conclusions

This is the first attempt to engineer the cellulolytic fungus M. thermophila to produce bioethanol from biomass-derived sugars such as glucose and cellobiose. The ethanol production can be improved about 4 times up to 11 grams per liter on cellobiose after a couple of genetic engineering. These results show that M. thermophila is a promising platform for bioethanol production from cellulosic materials in the future.
We need to think about data governance for dementia research in a digital era
Authors: Milne Richard , Brayne Carol
Published: February 2020

Background

Research into Alzheimer’s disease and other dementias increasingly involves large-scale data-sharing initiatives. The development of novel digital tools and assessments is likely to increase the need for these. This presents ethics and governance challenges to ensure the use of these data is able to maximise the benefit to patients and the public.

Discussion

We consider the challenges associated with informed consent and governance in the context of dementia research. We set out the potential of novel data governance approaches for the future of data sharing for dementia.

The data trust model proposed in discussions of data governance may have potentially valuable application for dementia research. Such inclusive approaches to trustworthy data governance should be considered as data-sharing initiatives are established and develop.
Protocol for the development of guidance for stakeholder engagement in health and healthcare guideline development and implementation
Authors: Petkovic Jennifer , Riddle Alison , Akl Elie A. , Khabsa Joanne , Lytvyn Lyubov , Atwere Pearl , Campbell Pauline , Chalkidou Kalipso , Chang Stephanie M. , Crowe Sally , Dans Leonila , Jardali Fadi El , Ghersi Davina , Graham Ian D. , Grant Sean , Greer-Smith Regina , Guise Jeanne-Marie , Hazlewood Glen , Jull Janet , Katikireddi S. Vittal , Langlois Etienne V. , Lyddiatt Anne , Maxwell Lara , Morley Richard , Mustafa Reem A. , Nonino Francesco , Pardo Jordi Pardo , Pollock Alex , Pottie Kevin , Riva John , Schünemann Holger , Simeon Rosiane , Smith Maureen , Stein Airton T. , Synnot Anneliese , Tufte Janice , White Howard , Welch Vivian , Concannon Thomas W. , Tugwell Peter
Published: February 2020

Background

Stakeholder engagement has become widely accepted as a necessary component of guideline development and implementation. While frameworks for developing guidelines express the need for those potentially affected by guideline recommendations to be involved in their development, there is a lack of consensus on how this should be done in practice. Further, there is a lack of guidance on how to equitably and meaningfully engage multiple stakeholders. We aim to develop guidance for the meaningful and equitable engagement of multiple stakeholders in guideline development and implementation.

Methods

This will be a multi-stage project. The first stage is to conduct a series of four systematic reviews. These will (1) describe existing guidance and methods for stakeholder engagement in guideline development and implementation, (2) characterize barriers and facilitators to stakeholder engagement in guideline development and implementation, (3) explore the impact of stakeholder engagement on guideline development and implementation, and (4) identify issues related to conflicts of interest when engaging multiple stakeholders in guideline development and implementation.

Discussion

We will collaborate with our multiple and diverse stakeholders to develop guidance for multi-stakeholder engagement in guideline development and implementation. We will use the results of the systematic reviews to develop a candidate list of draft guidance recommendations and will seek broad feedback on the draft guidance via an online survey of guideline developers and external stakeholders. An invited group of representatives from all stakeholder groups will discuss the results of the survey at a consensus meeting which will inform the development of the final guidance papers.

Our overall goal is to improve the development of guidelines through meaningful and equitable multi-stakeholder engagement, and subsequently to improve health outcomes and reduce inequities in health.
Proposal and testing goals-guided interaction for occasional users
Authors: Carrillo Antonio L. , Falgueras Juan A.
Published: February 2020

The latest shifts in technology have brought about new kinds of users who occasionally access unfamiliar systems in new scenarios. This way of use should not request any learning curve. There have been many attempts to help this kind of users: agents, floating help, tooltips, direct video demonstrations, etc., elements that support the appealing direct manipulation style (DM), but add indeed an extra layer of supporting material over it. In this paper, we describe an analysegoals-guided Interaction, GGI, as the basis for a different approach. We do not expect the user to understand or use a metaphor but guide them throughout the whole interaction process. This help system is integrated in the interface. The user will be closely guided on the “what to do” and on the “how to do,” always according to their current goal. This no-previous-knowledge-required way of interaction shortens significantly the learning curve. In order to support this proposal, a complete study based on user testing is performed. The results show that, for non-expert occasional users, GGI is more efficient in time and less error prone than the classic Direct Manipulation. Participants also showed a strong preference for GGI. This research offers an alternative way of interaction for designers and developers of human-centric interactive systems who have occasional users as their main target users.
Thirlwall’s Law and uneven development under Global Value Chains: a multi-country input–output approach
Authors: Trigg Andrew B.
Published: February 2020

A notable macroeconomic explanation of uneven development, with particular relevance to developing countries, has been the problem of balance of payments constraints, as captured by Thirlwall’s Law: where relative growth rates are explained by differences between income elasticities for exports and imports. Araujo and Lima have formulated a one-country multisectoral disaggregation of this hypothesis using a vertically integrated input–output framework, which is extended here in two main ways. First, international trade in intermediate inputs—the basis for Global Value Chains—is introduced; second, the model is extended to multiple countries. The main outcome of the paper is the development of a new multisectoral method for modelling balance of payments constraints: a Multi-Country Sectoral Thirlwall Law (MCSTL) under which key sector relationships are nested in intercountry trading relationships that encompass both intermediate and final goods. The identification of this input–output structure is developed in analytical stages, moving from a one-country vertically integrated system, to two, three and finally multi-country systems. In addition to its theoretical contribution to understanding the industrial structure of trade, an implication of this multi-country/multi-sector approach is that it can also be tested in future empirical work using the recently available World Input–Output Database of national tables.
Canadian practice guidelines for the treatment of children and adolescents with eating disorders
Authors: Couturier Jennifer , Isserlin Leanna , Norris Mark , Spettigue Wendy , Brouwers Melissa , Kimber Melissa , McVey Gail , Webb Cheryl , Findlay Sheri , Bhatnagar Neera , Snelgrove Natasha , Ritsma Amanda , Preskow Wendy , Miller Catherine , Coelho Jennifer , Boachie Ahmed , Steinegger Cathleen , Loewen Rachel , Loewen Techiya , Waite Elizabeth , Ford Catherine , Bourret Kerry , Gusella Joanne , Geller Josie , LaFrance Adele , LeClerc Anick , Scarborough Jennifer , Grewal Seena , Jericho Monique , Dimitropoulos Gina , Pilon David
Published: February 2020

Objectives

Eating disorders are common and serious conditions affecting up to 4% of the population. The mortality rate is high. Despite the seriousness and prevalence of eating disorders in children and adolescents, no Canadian practice guidelines exist to facilitate treatment decisions. This leaves clinicians without any guidance as to which treatment they should use. Our objective was to produce such a guideline.

Methods

Using systematic review, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and the assembly of a panel of diverse stakeholders from across the country, we developed high quality treatment guidelines that are focused on interventions for children and adolescents with eating disorders.

Results

Strong recommendations were supported specifically in favour of Family-Based Treatment, and more generally in terms of least intensive treatment environment. Weak recommendations in favour of Multi-Family Therapy, Cognitive Behavioural Therapy, Adolescent Focused Psychotherapy, adjunctive Yoga and atypical antipsychotics were confirmed.

Conclusions

Several gaps for future work were identified including enhanced research efforts on new primary and adjunctive treatments in order to address severe eating disorders and complex co-morbidities.
There is poor accuracy in documenting the location of labral and chondral lesions observed during hip arthroscopy
Authors: Hariri Sanaz , Sochacki Kyle R. , Harris Alex S. , Safran Marc R.
Published: February 2020

Purpose

To determine and compare the accuracy and interobserver reliability of the different methods for localizing acetabular labral, acetabular chondral, and femoral head chondral lesions with hip arthroscopy .

Methods

Three cadaver hips were placed in the supine position. Three labral, three femoral chondral, and six acetabular chondral lesions were made in each cadaver using electrocautery. Six surgeons classified the lesions according to different classification systems (clock-face, geographic, Method-G) using hip arthroscopy and standardized portals. Identification of each lesion was performed after conclusion of the study through open dissection and surgical hip dislocation to be used as the “gold-standard.” Accuracy was calculated as the number of correct answers divided by total number of responses for a given system. The interobserver reliability was calculated using the kappa coefficient. The different classification methods were compared. All P values were reported with significance set at P < 0.05.

Results

The clock-face method had an accuracy of 74% (95% CI, 60%–85%) and interobserver reliability of 0.19 (95% CI, 0.11–0.26) while the geographic method had an accuracy of 50% (95% CI, 36%–64%) and interobserver reliability of 0.21 (95% CI, 0.05–0.31) for acetabular labral lesion identification (P > 0.05). The acetabular chondral lesion identification accuracy was 56% (95% CI, 46%–65%) for Method G, 66% (95% CI, 56%–75%) for Method G-simp, and 63% (95% CI, 53%–72%) for the geographic system (P > 0.05) with an interobserver reliability of 0.31 (95% CI, 0.27–0.35), 0.34 (95% CI, 0.28–0.40), and 0.40 (95% CI, 0.34–0.45), respectively (P > 0.05). Femoral chondral lesion identification accuracy was 74% (95% CI, 60%–85%) for Method G, 43% (95% CI, 29%–57%) for the geographic method, and 59% (95% CI, 45%–72%) for the geographic-simp system with interobserver reliability of 0.37 (95% CI, 0.27–0.47), 0.34 (95% CI, 0.28–0.40), and 0.40 (95% CI, 0.29–0.51), respectively (P > 0.05). Method G was significantly more accurate than the geographic system (P = 0.001).

Conclusions

There was poor to fair accuracy and interobserver reliability of the reporting systems for localization of labral, acetabular chondral, and femoral chondral lesions encountered during hip arthroscopy. The study suggests there is a need for a new method that is easy to use, reliable, reproducible and accurate.
Safety and efficacy outcomes of the Xen45 Gel Stent use for refractory glaucoma: a surgery series from surgeon trainees at a tertiary teaching hospital
Authors: Hong Karen , Lind John , Sheybani Arsham
Published: February 2020

Background

To study the effect of an ab interno gelatin stent (XEN45 Gel Stent, Allergan Inc., Irvine, California, USA) on intraocular pressure (IOP) as placed by glaucoma fellowship trainees in eyes with refractory glaucoma.

Methods

A prospective noncomparative study at a tertiary training center on 28 unique eyes undergoing ab interno gelatin stent implantation by glaucoma fellowship trainees. Data was collected at baseline and postoperatively at day 1, week 1, and months 1, 3, 5, and 12. Primary outcome was mean IOP change. Secondary outcomes included change in number of glaucoma medication classes and visual acuity. Safety outcomes included needling rates. Surgical success was defined by achieving ≥20% reduction in IOP with the same or fewer classes of antiglaucoma medications from baseline without the need for secondary surgical intervention and/or stent removal.

Results

At baseline, 28.6% (8/28) of the subjects had prior failed incisional glaucoma surgery in a study population that was 54% African-American, with 78% with severe glaucoma (average mean deviation of − 14.58 dB). Thirteen subjects terminated their clinic visits before their 12-month postoperative visit, leaving 15 subjects for end point analysis. Average IOP went from 21.6 mmHg (range 12.0–31.0, SD 6.6) at baseline to 12.5 mmHg (range 7.0–19.0, SD 3.6), a 42.1% reduction (p < 0.007). All subjects decreased the number of medication classes they were taking with an average reduction of 3.8 (range 2–5, SD 0.9) to 1.3 (range 0–3, SD 1.0) classes, or a 65.8% decrease (p < 0.006). Crude surgical success was 80.0% for the 15 subjects that followed up at 12 months. The Kaplan-Meier cumulative probability of success for all 28 subjects at 12 months was 70.4% (95% CI: 44.7–85.8%). Regardless of the length of follow-up, 21.4% (6/28) met failure criteria: 3 subjects failed because they required secondary surgical intervention, and the other 3 did not have adequate IOP reduction. Initial bleb needling rate was 28.6% (8/28) and repeat was 17.9% (5/28).

Conclusions

Compared to the reported literature with experienced ocular surgeons, ab interno gel stent placements by glaucoma fellowship trainees have similar mean IOP, topical medication reduction, surgical success, and needling rates at 12-month follow-up.
Potential impact of 2018 Korean Society of Hypertension guidelines on Korean population: a population-based cohort study
Authors: Kwun Ju-Seung , Kim Sun-Hwa , Kang Si-Hyuck , Yoon Chang-Hwan , Lee Hae-Young , Kim Kwang-Il , Youn Tae-Jin , Chae In-Ho , Kim Cheol-Ho
Published: February 2020

Background

The Korean Society of Hypertension (KSH) revised the local guidelines for hypertension in 2018. The present study sought to evaluate the potential impact of the 2018 KSH guidelines on hypertension management status among the Korean population in terms of prevalence of hypertension, antihypertensive medical treatment recommendations, and control status in Korean adults.

Methods

We used data from the Korea National Health and Nutrition Examination Survey to estimate the number and percentage of Korean adults who have hypertension according to blood pressure (BP) classification, are recommended to receive antihypertensive medical treatment, and are receiving medical treatment and have BP in the optimal range according to the new recommendations. Adults aged 30 years or older who participated in the survey between 2013 and 2015 were selected for this study.

Results

The prevalence of hypertension was 30.5% among Korean adults aged 30 years or older. The percentage of subjects who are recommended to be treated with antihypertensive medications substantially increased from 32.5 to 37.8%, which translates to 1.6 million adults. Among the hypertensive patients who were receiving medical treatment, 38.6% were shown to have adequate BP levels as recommended by the 2018 KSH guidelines compared with 51.8% according to the previous 2013 guidelines.

Conclusions

The present study reports the potential impact of the 2018 KSH guidelines on the prevalence of hypertension, antihypertensive medical treatment recommendations, and control status for Korean adults. The 2018 KSH guidelines recommend more intensive BP control compared with previous guidelines. This study suggests that there is large scope for improvement in hypertension management in the Korean population.
Comparison of urinary parameters, biomarkers, and outcome of childhood systemic lupus erythematosus early onset-lupus nephritis
Authors:   for the Brazilian Childhood-onset Systemic Lupus Erythematosus Group, Miguel Daniele Faria , Terreri Maria Teresa , Pereira Rosa Maria Rodrigues , Bonfá Eloisa , Silva Clovis Artur Almeida , Corrente José Eduardo , Magalhaes Claudia Saad
Published: February 2020

Background

Urinary parameters, anti-dsDNA antibodies and complement tests were explored in patients with childhood-Systemic Lupus Erythematosus (cSLE) early-onset lupus nephritis (ELN) from a large multicenter cohort study.

Methods

Clinical and laboratory features of cSLE cases with kidney involvement at presentation, were reviewed. Disease activity parameters including SLEDAI-2 K scores and major organ involvement at onset and follow up, with accrued damage scored by SLICC-DI, during last follow up, were compared with those without kidney involvement. Autoantibodies, renal function and complement tests were determined by standard methods. Subjects were grouped by presence or absence of ELN.

Results

Out of the 846 subjects enrolled, mean age 11.6 (SD 3.6) years; 427 (50.5%) had ELN. There was no significant difference in the ELN proportion, according to onset age, but ELN frequency was significantly higher in non-Caucasians (p = 0.03). Hematuria, pyuria, urine casts, 24-h proteinuria and arterial hypertension at baseline, all had significant association with ELN outcome (p < 0.001). With a similar follow up time, there were significantly higher SLICC-DI damage scores during last follow up visit (p = 0.004) and also higher death rates (p < 0.0001) in those with ELN. Low C3 (chi-square test, p = 0.01), but not C3 levels associated significantly with ELN. High anti-dsDNA antibody levels were associated with ELN (p < 0.0001), but anti-Sm, anti-RNP, anti-Ro, anti-La antibodies were not associated. Low C4, C4 levels, low CH50 and CH50 values had no significant association. High erythrocyte sedimentation rate (ESR) was associated with the absence of ELN (p = 0.02).

Conclusion

The frequency of ELN was 50%, resulting in higher morbidity and mortality compared to those without ELN. The urinary parameters, positive anti-dsDNA and low C3 are reliable for discriminating ELN.
Identification of QTLs and candidate genes for physiological traits associated with drought tolerance in cotton
Authors: MAGWANGA Richard Odongo , LU Pu , KIRUNGU Joy Nyangasi , CAI Xiaoyan , ZHOU Zhongli , AGONG Stephen Gaya , WANG Kunbo , LIU Fang
Published: February 2020

Background

Cotton is mainly grown for its natural fiber and edible oil. The fiber obtained from cotton is the indispensable raw material for the textile industries. The ever changing climatic condition, threatens cotton production due to a lack of sufficient water for its cultivation. Effects of drought stress are estimated to affect more than 50% of the cotton growing regions. To elucidate the drought tolerance phenomenon in cotton, a backcross population was developed fromG. tomentosum,a drought tolerant donor parent andG. hirsutumwhich is highly susceptible to drought stress.

Results

A genetic map of 10 888 SNP markers was developed from 200 BC2F2populations. The map spanned 4 191.3 centi-Morgan (cM), with an average distance of 0.104 7 cM, covering 51% and 49% of At and Dt sub genomes, respectively. Thirty stable Quantitative trait loci (QTLs) were detected, in which more than a half were detected in the At subgenome. Eighty-nine candidate genes were mined within the QTL regions for three traits: cell membrane stability (CMS), saturated leaf weight (SLW) and chlorophyll content. The genes had varied physiochemical properties. A majority of the genes were interrupted by introns, and only 15 genes were intronless, accounting for 17% of the mined genes. The genes were found to be involved molecular function (MF), cellular component (CC) and biological process (BP), which are the main gene ontological (GO) functions. A number of miRNAs were detected, such as miR164, which is associated withNACandMYBgenes, with a profound role in enhancing drought tolerance in plants. Through RT-qPCR analysis, 5 genes were found to be the key genes involved in enhancing drought tolerance in cotton. Wild cotton harbors a number of favorable alleles, which can be exploited to aid in improving the narrow genetic base of the elite cotton cultivars. The detection of 30 stable QTLs and 89 candidate genes found to be contributed by the donor parent,G. tomentosum, showed the significant genes harbored by the wild progenitors which can be exploited in developing more robust cotton genotypes with diverse tolerance levels to various environmental stresses.

Conclusion

This was the first study involving genome wide association mapping for drought tolerance traits in semi wild cotton genotypes. It offers an opportunity for future exploration of these genes in developing highly tolerant cotton cultivars to boost cotton production.
Should instrumented spinal fusion in nonambulatory children with neuromuscular scoliosis be extended to L5 or the pelvis?
Authors: Tøndevold Niklas , Lastikka Markus , Andersen Thomas , Gehrchen Martin , Helenius Ilkka
Published: February 2020

Aims

It is uncertain whether instrumented spinal fixation in nonambulatory children with neuromuscular scoliosis should finish at L5 or be extended to the pelvis. Pelvic fixation has been shown to be associated with up to 30% complication rates, but is regarded by some as the standard for correction of deformity in these conditions. The incidence of failure when comparing the most caudal level of instrumentation, either L5 or the pelvis, using all-pedicle screw instrumentation has not previously been reported. In this retrospective study, we compared nonambulatory patients undergoing surgery at two centres: one that routinely instrumented to L5 and the other to the pelvis.

Methods

In all, 91 nonambulatory patients with neuromuscular scoliosis were included. All underwent surgery using bilateral, segmental, pedicle screw instrumentation. A total of 40 patients underwent fusion to L5 and 51 had their fixation extended to the pelvis. The two groups were assessed for differences in terms of clinical and radiological findings, as well as complications.

Results

The main curve (MC) was a mean of 90° (40° to 141°) preoperatively and 46° (15° to 82°) at two-year follow-up in the L5 group, and 82° (33° to 116°) and 19° (1° to 60°) in the pelvic group (p < 0.001 at follow-up). Correction of MC and pelvic obliquity (POB) were statistically greater in the pelvic group (p < 0.001). There was no statistically significant difference in the operating time, blood loss, or complications. Loss of MC correction (> 10°) was more common in patients fixated to the pelvis (23% vs 3%; p = 0.032), while loss of pelvic obliquity correction was more frequent in the L5 group (25% vs 0%; p = 0.007). Risk factors for loss of correction (either POB or MC) included preoperative coronal imbalance (> 50 mm, odds ratio (OR) 11.5, 95%confidence interval (CI) 2.0 to 65; p = 0.006) and postoperative sagittal imbalance (> 25 mm, OR 11.0, 95% CI1.9 to 65; p = 0.008).

Conclusion

We found that patients undergoing pelvic fixation had a greater correction of MC and POB. The rate of complications was not different. Preoperative coronal and postoperative sagittal imbalance were associated with increased risks of loss of correction, regardless of extent of fixation. Therefore, we recommend pelvic fixation in all nonambulatory children with neuromuscular scoliosis where coronal or sagittal imbalance are present preoperatively. Cite this article: Bone Joint J 2020;102-B(2):261–267.
The lateral ligament is injured preferentially in posterolateral dislocation of the elbow joint
Authors: Lee Sung H. , Nam Dae J. , Yu Hyun K. , Kim Jeong W.
Published: February 2020

Aims

The purpose of this study was to evaluate the relationships between the degree of injury to the medial and lateral collateral ligaments (MCL and LCL) and associated fractures in patients with a posterolateral dislocation of the elbow, using CT and MRI.

Methods

We retrospectively reviewed 64 patients who presented between March 2009 and March 2018 with a posterolateral dislocation of the elbow and who underwent CT and MRI. CT revealed fractures of the radial head, coronoid process, and medial and lateral humeral epicondyles. MRI was used to identify contusion of the bone and collateral ligament injuries by tear, partial or complete tear.

Results

A total of 54 patients had a fracture; some had more than one. Radial head fractures were found in 25 patients and coronoid fractures in 42. Lateral and medial humeral epicondylar fractures were found in eight and six patients, respectively. Contusion of the capitellum was found in 43 patients and rupture of the LCL was seen in all patients (partial in eight and complete in 56), there was complete rupture of the MCL in 37 patients, partial rupture in 19 and eight had no evidence of rupture. The LCL tear did not significantly correlate with the presence of fracture, but the MCL rupture was complete in patients with a radial head fracture (p = 0.047) and there was significantly increased association in those without a coronoid fracture (p = 0.015).

Conclusion

In posterolateral dislocation of the elbow, LCL ruptures are mostly complete, while the MCL exhibits various degrees of injury, which are significantly associated with the associated fractures. Cite this article: Bone Joint J 2020;102-B(2):227–231.
Functional outcomes of tendon transfer for brachial plexus birth palsy using the Hoffer technique
Authors: Alluri Ram K. , Lightdale-Miric Nina , Meisel Erin , Kim Gina , Kaplan Jesse , Bougioukli Sofia , Stevanovic Milan
Published: February 2020

Aims

To describe and analyze the mid-term functional outcomes of a large series of patients who underwent the Hoffer procedure for brachial plexus birth palsy (BPBP).

Methods

All patients who underwent the Hoffer procedure with minimum two-year follow-up were retrospectively reviewed. Active shoulder range of movement (ROM), aggregate modified Mallet classification scores, Hospital for Sick Children Active Movement Scale (AMS) scores, and/or Toronto Test Scores were used to assess functional outcomes. Subgroup analysis based on age and level of injury was performed. Risk factors for subsequent humeral derotational osteotomy and other complications were also assessed. A total of 107 patients, average age 3.9 years (1.6 to 13) and 59% female, were included in the study with mean 68 months (24 to 194) follow-up.

Results

All patients demonstrated statistically significant improvement in all functional outcomes and active shoulder abduction and external rotation ROM (p < 0.001). Patients < 2.5 years of age had higher postoperative AMS, abduction ROM and strength scores, and aggregate postoperative Toronto scores (p ≤ 0.035) compared to patients ≥ 2.5 years old. There were 17 patients (16%) who required a subsequent humeral derotational osteotomy; lower preoperative AMS external rotation scores and external rotation ROM were predictive risk factors (p ≤ 0.016).

Conclusion

Patients with BPBP who underwent the Hoffer procedure demonstrated significant improvement in postoperative ROM, strength, and functional outcome scores at mid-term follow-up. Patients younger than 2.5 years at the time of surgery generally had better functional outcomes. Limited preoperative external rotation strength and ROM were significantly associated with requirement for subsequent humeral derotational osteotomy. In our chort significant improvements in shoulder function were obtained after the Hoffer procedure for BPBP. Cite this article: Bone Joint J 2020;102-B(2):246–253.
Primary aneurysmal bone cysts
Authors: Puri Ajay , Hegde Prateek , Gulia Ashish , Parikh Mishil
Published: February 2020

Aims

The aim of this study was to analyze the complications and outcomes of treatment in a series of previously untreated patients with a primary aneurysmal bone cyst (ABC) who had been treated by percutaneous sclerosant therapy using polidocanol.

Methods

Between January 2010 and December 2016, 56 patients were treated primarily with serial intralesional sclerosant injections. Their mean age was 20 years (1 to 54). The sites involved were clavicle (n = 3), humeri (n = 11), radius (n = 1), ulna (n = 3), hand (n = 2), pelvis (n = 12), femur (n = 7), tibia (n = 13), fibula (n = 3), and foot (n = 1). After histopathological confirmation of the diagnosis, 3% polidocanol (hydroxypolyaethoxydodecan) was injected into the lesion under image intensifier guidance. Patients were evaluated clinically and radiologically every six to eight weeks. In the absence of clinical and/or radiological response, a repeat sclerosant injection was given after eight to 12 weeks and repeated at similar intervals if necessary.

Results

There were no complications of treatment. One patient was lost to follow-up. Overall, 46/55 (84%) of lesions healed after one or more injections of polidocanol: 24/55 (44%) patients healed with a single injection, and 43/55 (78%) within two injections. Of these 46, four (9%) patients developed local recurrence, two of whom healed with a repeat sclerosant injection. Thus, 44/55 (80%) patients of primary ABC healed with sclerotherapy. The mean follow-up was 62 months (20 to 111). The local recurrence free survival (LRFS) with percutaneous sclerosant therapy with polidocanol was 100%, 98% (95% confidence interval (CI) 85 to 100) and 93% (95% CI 78 to 98) at two, three, and five years, respectively.

Conclusion

Percutaneous sclerotherapy using polidocanol is a safe, effective, minimally invasive and inexpensive method of treating a primary ABC of the limbs or pelvis. Cite this article: Bone Joint J 2020;102-B(2):186–190.
Rogue stem cell clinics
Authors: Murray Iain R. , Chahla Jorge , Frank Rachel M. , Piuzzi Nicolas S. , Mandelbaum Bert R. , Dragoo Jason L. ,   Members of the Biologics Association
Published: February 2020

Cell therapies hold significant promise for the treatment of injured or diseased musculoskeletal tissues. However, despite advances in research, there is growing concern about the increasing number of clinical centres around the world that are making unwarranted claims or are performing risky biological procedures. Such providers have been known to recommend, prescribe, or deliver so called ‘stem cell’ preparations without sufficient data to support their true content and efficacy. In this annotation, we outline the current environment of stem cell-based treatments and the strategies of marketing directly to consumers. We also outline the difficulties in the regulation of these clinics and make recommendations for best practice and the identification and reporting of illegitimate providers.

Cite this article: Bone Joint J 2020;102-B(2):148–154
Seasonal changes
Authors: Glass Jonathan
Published: February 2020

We turn our focus to the challenges, changes and choices faced by trainees.
Mid-infrared diffraction-free space-time wave packets
Authors: Yessenov Murat , Ru Qitian , Schepler Kenneth L. , Meem Monjurul , Menon Rajesh , Vodopyanov Konstantin L. , Abouraddy Ayman F.
Published: February 2020

Joint structuring of the spatio-temporal spectrum of a pulsed optical beam can lead to a host of unusual properties, such as diffraction-free propagation and tunable group velocities in free space. Such ‘space-time’ wave packets have been synthesized exclusively in the visible and near-infrared spectral regions. Here we synthesize the first space-time wave packet in the mid-infrared exploiting a transmissive phase plate fabricated via gray-scale lithography. A mid-infrared wave packet having a bandwidth of ∼60 nm at a wavelength of 2.35 μm is synthesized such that its transverse width is ∼300 μm and is monitored for a propagation distance of 7 m, corresponding to 80 × the Rayleigh range of a Gaussian beam at the same wavelength and having the same initial transverse spatial width. The experimental methodology presented here and the reported results will help appropriate spatio-temporally structured light in the mid-infrared for a wide variety of applications including imaging, sensing, and metrology.
Green Corridors in Urban Landscapes, Case Study Nicosia Pedieos River
Authors: İnançoğlu Selda , Özden Özge , Kara Can
Published: February 2020

Due to increasing population and expansion of cities, urban planning issues are becoming more important worldwide. It is realized that biological methodologies ought to be coordinated into urban arranging activities. Particularly in European cities, creating greenways and green corridors is a very recent phenomenon. The advancement of green space along urban waterways could moderate urban warmth island impacts, improve the physical and mental prosperity of city occupants, improve flood resilience and could also sustain biodiversity. The Pedieos River is the longest river in Cyprus. Like most of streams on the island, it is a non-enduring waterway, of fleeting nature that for the most part streams during the blustery winter months or after overwhelming precipitation occasions. A literature review was undertaken to discover the importance of rivers within the urbanized areas. It is known that the Pedieos River is firmly connected to the historical backdrop of Nicosia as it is one reason for the city's presence at the site. The increase of impermeable areas as a result of urbanization is also one of the main causes for flooding in recent years. In this research, the current situation of the river was investigated and its possible rehabilitation discussed for more sustainable city. The aim of this study is to recommend a feasible proposition by examining green territory zones and reason green passages along the Pedieos River so as to improve the living condition of Nicosia city.

 Keywords: Greenway, river, Pedieos River, urban planning
The Decorative Orientations in the Mediterranean Architecture and its Influence on the Development of Cultural Sustainability
Authors: Hukmat Sara , Uzunahmet Havva Arslangazi
Published: February 2020

This paper attempts to describe the different orientations in architectural decoration that arose as a result of human existence and its relation to his environment. Throughout history, decoration has been a bridge connecting the building to the environment, connecting people with history and culture. And it has been an instrument of the local identity of the building and the whole environment within the framework of the idea of sustainability, which consists of three foundations (economic, environmental and cultural). Within this texture in this study, decorative details and patterns are evaluated, in order to understand the effects of factors on cultures. From one culture to another, it is discussed in connection with the comparison of the Moorish and Greek decoration. As a result, this study has determined decorative orientations in the Mediterranean architecture and its influence on sustainable development.

Keywords: Decoration, Cultural Sustainability, Style, Identity, Greek, Moorish
Impact of Decentralization on Sustainable Development of the Newly Created Amalgamated Territorial Communities in the Regions of Ukraine
Authors: Halhash Ruslan , Semenenko Inna , Bilous Yana , Burko Iaroslav
Published: February 2020

This article analyses the reform of decentralization in Ukraine and its role in the sustainable development of regions and newly created amalgamated territorial communities (ATCs). The reasons of the reform's implementation and the problems connected with the local management are specified. The study of foreign experience in reforming the administrative and territorial system has made it possible to draw conclusions about the effectiveness of decentralization as an instrument of change. With the beginning of the reform in Ukraine, the processes involving citizens' participation in managing sustainable development of the regions and the ATCs became more active. The analysis of financial decentralization in Ukraine showed the positive dynamics in local budgets' revenues. The development of a new governance model in a community implies involvement of the civil society in management and allocation of local budgets. The participatory budget is shown as a modern and effective instrument of local democracy. The advantages and the main effects of the participatory budgeting in ATCs for the purpose of their sustainable development were defined.

Keywords: decentralization, reform, sustainable development, region, amalgamated territorial community, participatory budget
Legal Forest Management Problems: EU Experience
Authors: Liubchych Anna , Savchuk Olena , Vrublevska-Misiuna Kateryna
Published: February 2020

The work contains the analysis of forestry management legal problems in Ukraine and the European Union, highlighting the problematic points in the national legislation and the possibility of implementing the experience of developed countries.

There are singled out the ways to improve forestry legislation, with accentuating the need in developing a nation-wide forestry program which would regulate forestry management with accounting for preservation of the forest’s ecology function and biologic potential. It is proved that a woodcutting site has attributes of a forestry relations object as a plot of the forest fund of Ukraine with established borders.

Also, there arises the need in revising the Regulation on territorial offices of the central executive power body that carries out state policies in forestry and in bringing it to the correspondence with the requirements of standing legislation of Ukraine and the Regulation on State forest inspection of Ukraine, granting it plenary powers similar to those in the leading European countries, for instance “forest guard” of the Republic of Poland.

 Key words: Forest; Woodcutting; Timber harvesting; Forest resources; Woodcutting site; Forestry management; Forest site; Forestry.
Main Fundamentals of Economic Judiciary of Ukraine
Authors: Koverznev Vadym
Published: February 2020

The article deals with the principles of judicial proceedings by economic courts of Ukraine and their legal nature is disclosed. The relation between the concepts of "jurisdiction" and "justice" is determined; the author formulates the principle of the rule of law and outlines its main elements; the legal nature of the principle of justice and its variants is disclosed; criteria for determining the reasonableness of the terms of the court's consideration of the case are proposed; it is substantiated that the enforcement of the judgment is the final stage of the administration of justice and one of the main criteria for determining the effectiveness of judicial protection of individual rights. The author has proved that the current economic procedural legislation of Ukraine is based on the international legal principles of activity of judicial bodies and ways of its improvement are suggested.

Keywords: fundamentals of economic judiciary, jurisdiction, justice, the rule of law, ratability, binding nature of court decisions
Migration as a Factor of the Sustainable Economic Development
Authors: Kurmaiev Petro , Seliverstova L. , Seliverstova L. , Husarevych N. , Kolisnichenko P.
Published: February 2020

The problem of the interplay between migration and the achievement of the sustainable development goals is one of the main topics in modern scientific debate. The theoretical basis of the study is the understanding of migration as a continuous process caused by the interaction of a complex of factors, the result of which is the formation of a new quality globalized society. The methods used were: Comparative analysis and Content analysis. The authors note that the effectiveness of national policies depends significantly on the extent to which global migration trends are taken into account. The main factors that determine the dynamics of migration flows are identified in the article. The dominance of economic and security-humanitarian motives for migration is mentioned. It is noted that modern migration processes as a whole have a positive impact on the achievement of sustainable development goals. In modern world, migration is the driver of the country's demographic, economic and socio-cultural situation. For most countries in the world, the main objectives of immigration policy are to meet the need for labor, balance the labor markets, reduce the rate of depopulation and an aging population. The research made it possible to identify the types of immigration policy of governments of the world countries and their characteristics. The authors indicate that 73% of governments search to increase or maintain the current level of immigration of highly skilled workers. The thesis is substantiated that the impact of migrants on the wages of highly skilled workers in the country of destination is minimal. The impact of emigration on the socio-economic situation of the donor country is analyzed. The study found that emigration alone is not a destructive factor for the donor country. Significant deterioration in the country is influenced by a set of factors, among which migration is only one of them.

 Keywords: migration, sustainable economic development, donor-countries
Legal Regulation of Ensuring Nuclear Safety and Security in Ukraine on the Way to European Integration
Authors: Dubchak Sergiy , Goshovska Valentyna , Goshovskyi Volodymyr , Svetlychny Oleksandr , Gulac Olena
Published: February 2020

The article is devoted to the analysis of legal regulation of the sphere of nuclear safety and security of Ukraine on the way to European integration. The authors drew attention to the importance of Ukraine achieving the necessary level of and nuclear sefaty and security adopted in the EU member states. The emphasis was placed on the fact that the prospects for fulfilling national obligations in the field of nuclear safety in accordance with European standards directly depend on solving the problems of ensuring the functioning of nuclear facilities, the physical protection of nuclear materials and installations as well as radioactive waste management. The main directions of ensuring the nuclear safety and secutiry in the world within the international law are considered. The role and activities of the International Atomic Energy Agency (IAEA) in setting up a regulatory framework for nuclear safety and security are analyzed. The international legal framework for nuclear safety and security was discused.The legislative basis for nuclear safety and secutiry in the EU IS characterized. The issue of legal norms unification in the field of nuclear safety regulation of EU member states was considered. The principles of legal regulation of nuclear a safety and security in Ukraine are characterized.

Key words: nuclear safety, nuclear security, public administration of nuclear safety and security, legal regulation of nuclear safety and security, European integration, sustainable development in the field of ensuring nuclear safety and security.

UDC 35:574:339.9:349.6        JEL Classification: K 23, K 32, K 33,  Q 5