bluuebunny/crossref_metadata_2025 huggingface dataset:
Results of tenorrhaphy with early rehabilitation for acute tear of Achilles tendon
Authors: Ryu Chang Hyun , Lee Ho Seong , Seo Sang Gyo , Kim Ho Yeon
Published: October 2018

Background:

For the treatment of acute Achilles tendon rupture, early rehabilitation after surgical repair is believed to be a useful method. The purpose of this study was to evaluate the outcome of open tenorrhaphy followed by early rehabilitation.

Methods:

A total of 112 patients who underwent open repair and early rehabilitation for acute Achilles tendon rupture from January 2003 to March 2015 were retrospectively reviewed. These 112 patients (80 men, 32 women) had an average age of 43.1 years (22–62 years), and the mean follow-up period was 91.8 months (12–171 months). A short leg cast was applied postoperatively for an average of 16.5 days (12–20 days). The mean duration of bracing was 6.9 weeks (6–8 weeks). Each patient was assessed based on range of motion, single heel raising test, calf circumference compared to the contralateral limb, ability to return to previous activity, the Arner–Lindholm scale, and the American orthopaedic foot and ankle society (AOFAS) hind foot scale. Isokinetic plantar flexion power was also checked.

Results:

All patients were fully satisfied (AOFAS ≥ 90) with the treatment results, and 96 patients were able to return to their previous athletic activities. As assessed by the Arner–Lindholm scale, 103 cases were rated as excellent and the other 9 cases were rated as good. At the 1-year follow-up period, single heel raise and hopping was possible in every patient. Compared to the contralateral side, 10 subjects (8.9%) had minor limitation of dorsiflexion motion, and an average of 1.6 cm calf circumference difference without functional disabilities. There were no major complications such as re-rupture, nerve injury, or infection.

Conclusion:

For acute Achilles tendon ruptures, open surgical repair with optimal length restoration, followed by earlier rehabilitation results in good functional outcomes and a successful return to pre-injury levels of physical activity without major complications.

Level of evidence:

Level IV.
Stress Fractures of the Elbow in the Throwing Athlete: A Systematic Review
Authors: Smith Shelby R. , Patel Nirav K. , White Alex E. , Hadley Christopher J. , Dodson Christopher C.
Published: October 2018

Background:

Stress fractures of the elbow are rare in throwing athletes and present a challenge from both a management and rehabilitation perspective. Although the incidence of stress fractures of the elbow is increasing, there is a lack of data in the literature focused on throwers.

Purpose:

To evaluate studies regarding the management and outcomes of stress fractures of the elbow in throwing athletes.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review was conducted by searching the Scopus, PubMed, and Cochrane Library electronic databases to identify studies reporting on the management and outcomes of stress fractures in overhead-throwing athletes. Management data included nonoperative and operative modalities, and outcome data included return to play, encompassing the timing and level of activity. Studies were excluded if the stress fracture of the elbow was not a result of a sport injury attributed to throwing or if the study failed to report whether an athlete returned to play.

Results:

Fourteen studies met the inclusion criteria and were included in this analysis. There were 52 patients in total (50 male, 2 female) with a mean age of 19.7 years (range, 13-29.1 years). The olecranon was the most common location of the stress fracture (51 patients; 98.1%), followed by the distal humerus (1 patient; 1.9%). The majority of patients (n = 40; 76.9%) were treated operatively. Of the 40 patients who were treated surgically, 14 (35.0%) underwent a period of conservative treatment preoperatively that ultimately failed because of persistent nonunion or continued elbow pain. A total of 50 patients (96.2%) returned to sport either at or above their preinjury level. Of the 2 patients (3.8%) who did not return to sport, 1 did not return because of continued elbow pain postoperatively, and the other was lost to follow-up. Complications occurred in 9 patients (17.3%), all of whom were treated surgically.

Conclusion:

On the basis of this systematic review, the majority of elbow stress fractures were treated operatively and approximately one-third after a period of failed nonoperative management. The return-to-sport rate was high. Further, higher level studies are needed to optimize management and return-to-sport rates in this population.
De-unionization and Drug Death Rates
Authors: DeFina Robert , Hannon Lance
Published: October 2018

Drug death rates in the United States have risen dramatically in recent years, sparking urgent discussions about causes. Most of these discussions have centered on supply-side issues, such as doctors overprescribing pain killers. However, there is increasing recognition of the need to go beyond proximate causes and to consider larger social forces that bear on the demand for pain-relieving drugs. Informed by sociological research linking labor unions to community health, we empirically examined the relationship between union density and drug death rates for the years 1999 to 2016. We found that states experiencing greater declines in unionization also tended to experience greater increases in drug deaths. Estimates from our fixed-effects models suggested that a one standard deviation decrease in union density was associated with a 42 percent increase in drug death rates over the period. Although the incorporation of a variety of statistical controls reduced this association, it remained negative and significant. Beyond variation in the availability of substances to misuse, our findings underscore the importance of considering institutional decline and broader social conditions as deeply relevant for contemporary drug death trends.
Aneurysm characteristics and risk of rebleeding after subarachnoid haemorrhage
Authors: Koopman Inez , Greving Jacoba P , van der Schaaf Irene C , van der Zwan Albert , Rinkel Gabriel JE , Vergouwen Mervyn DI
Published: October 2018

Introduction

Knowledge of risk factors for rebleeding after aneurysmal subarachnoid haemorrhage can help tailoring ultra-early aneurysm treatment. Previous studies have identified aneurysm size and various patient-related risk factors for early (≤24 h) rebleeding, but it remains unknown if aneurysm configuration is also a risk factor. We investigated whether irregular shape, aspect- and bottleneck ratio of the aneurysm are independent risk factors for early rebleeding after aneurysmal subarachnoid haemorrhage.

Patients and methods

From a prospectively collected institutional database, we investigated data from consecutive aneurysmal subarachnoid haemorrhage patients who were admitted ≤24 h after onset between December 2009 and January 2015. The admission computed tomographic angiogram was used to assess aneurysm size and configuration. With Cox regression, we calculated stepwise-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for irregular shape, aspect ratio ≥1.6 mm and bottleneck ratio ≥1.6 mm.

Results

Of 409 included patients, 34 (8%) patients had in-hospital rebleeding ≤24 h after ictus. Irregular shape was an independent risk factor for rebleeding (HR: 3.9, 95% CI: 1.3–11.3) after adjustment for age, sex, PAASH score, aneurysm location, aneurysm size and aspect- and bottleneck ratio. Aspect ratio ≥1.6 mm (HR: 2.3, 95% CI: 0.8–6.5) and bottleneck ratio ≥1.6 mm (HR: 1.7, 95% CI: 0.8–3.6) were associated with an increased risk of rebleeding, but were not independent risk factors after multivariable adjustment.

Conclusions

Irregular shape is an independent risk factor for early rebleeding. However, since the majority of subarachnoid haemorrhage patients have an irregular aneurysm, additional risk factors have to be found for aneurysm treatment prioritisation.
Oral dexamethasone for the prevention of acute migraine recurrence in pediatric patients presenting to the emergency department with migraine
Authors: Orr Serena L , Richer Lawrence , Barrowman Nick , Zemek Roger
Published: October 2018

Objective:

To assess the feasibility of a randomized controlled trial protocol that aims to determine the efficacy and safety of oral dexamethasone compared to placebo for the prevention of migraine recurrence in children and adolescents visiting the pediatric emergency department (ED) with migraine.

Methods:

This study was a two-arm, parallel-group, randomized, placebo-controlled, double-blind pilot trial of patients presenting to the pediatric ED with migraine. Eligible participants were randomized at 1:1 ratio to receive either oral dexamethasone 0.6 mg/kg (maximum 15 mg) or matched placebo as a single dose. Efficacy and safety outcomes were assessed at discharge, 48 h and 7 days after discharge. The primary outcome of the trial was feasibility and was assessed through participant recruitment rate, follow-up completion rates, participant satisfaction ratings and comparison of enrolled versus non-enrolled participants. Efficacy and safety outcomes were not analyzed given that this was a pilot study.

Results:

Twelve participants were enrolled over the 6-month recruitment period. This represents 60% of the planned sample size and a 10.5% recruitment rate. No other feasibility issues were identified and patients expressed high satisfaction rates with their treatment: 90.9% were satisfied with their treatment at discharge and at 48-h follow-up and 81.8% were satisfied with their treatment at 7-day follow-up (81.8%). There were no significant differences observed when comparing enrolled participants to those not enrolled.

Conclusion:

This pilot randomized controlled trial is the first to assess dexamethasone in the pediatric ED for the prevention of migraine recurrence. The protocol is feasible but recruitment in a single center was lower than expected. Future pediatric ED migraine studies may use innovative or pragmatic trial designs to maximize feasibility from a recruitment standpoint.
Prevalence of methicillin resistant Staphylococcus aureus, multidrug resistant and extended spectrum β-lactamase producing gram negative bacilli causing wound infections at a tertiary care hospital of Nepal
Authors: Upreti Narbada , Rayamajhee Binod , Sherchan Samendra P. , Choudhari Mahesh Kumar , Banjara Megha Raj
Published: October 2018

Background

Treatment and prevention of wound infection continues to be a challenging issue in clinical settings of Nepal especially in the context of globally growing problem of antimicrobial resistance. Study on opportunistic pathogens and sensitivity to commonly prescribed local antimicrobial agents are cardinal to reduce the disease burden of wound infections. The aim of this study was to determine the prevalence and antimicrobial susceptibility pattern of methicillin resistant Staphylococcus aureus (MRSA) and extended spectrum β-lactamase (ESBL) producing bacteria from wound infections of patients at a tertiary care hospital in Nepal.

Methods

Pus specimens were processed using standard microbiological procedures. Antimicrobial susceptibility test was performed following the modified Kirby Bauer disc diffusion technique. Clinical information of patients was obtained from preformed questionnaire and hospital record.

Results

One hundred eighty two pus specimens from wounds of different body parts: leg, hand, backside, abdominal part, foot, breast and chest, head and neck region were collected and analyzed; 113 bacterial isolates were isolated showing the overall bacterial growth rate of 62%, where the highest rate was among patients of ≤10 years age group (82.1%). A higher rate (68.5%) of bacterial isolates were from inpatients (p < 0.05). Among 116 bacterial isolates, Staphylococcus aureus was the most predominant bacteria (56.9%) followed by Escherichia coli (8.6%), coagulase negative staphylococci (7.8%), Acinetobacter spp. (5.2%), Klebsiella pneumoniae (5.2%), Pseudomonas aeruginosa (4.3%), Enterococcus spp. (4.3%), Citrobacter freundii (2.6%), Proteus vulgaris (1.6%) and P. mirabilis (0.9%). Both Gram positive (73.3%) and negative (78.8%) isolates showed high frequency of sensitive to gentamycin.

Conclusion

Among S. aureus isolates, 60.6% were MRSA strains, whereas 40% of K. pneumoniae and 33.3% of C. freundii were ESBL producing bacteria followed by E. coli (25%). It is thus paramount to address the burden of silently and speedily increasing infections caused by drug resistant strains of MRSA and ESBL in Nepal.
Between Science and Politics: Science Fiction as a Critical Discourse in South Korea, 1960s–1990s
Authors: Park Sunyoung
Published: October 2018

A positivist vision of science fiction as a discourse closely bound to science and technology has been influential in South Korea ever since the first flourishing of the genre in the 1960s. Using that normative vision as a reference, the present essay investigates the ways in which select science-fictional texts have actually represented the technoscientific enterprise in South Korea in the period spanning the 1960s through the 1990s. As the analysis suggests, the heyday of positivist-oriented science fiction in the country was largely limited to the 1960s, which was a time when Koreans looked keenly upon science for its utopian promise of development and modernization for the nation. As later years brought dictatorship and forced industrialization, however, a marked shift toward dystopia and social protest became evident in cultural texts that critically depicted technoscience and modernization as tools of oppression rather than as progress and liberation. The historical existence of this more critical vein of science fiction, it is argued, attests to the genre’s hitherto underappreciated potential for fruitful engagement with the political and social challenges of modernization both globally and within South Korea’s technologically saturated society.
Distinct subsets of Eve-positive pericardial cells stabilise cardiac outflow and contribute to Hox gene-triggered heart morphogenesis in Drosophila
Authors: Zmojdzian Monika , de Joussineau Svetlana , Da Ponte Jean Philippe , Jagla Krzysztof
Published: October 2018

The Drosophila heart, composed of discrete subsets of cardioblasts and pericardial cells, undergoes Hox-triggered anterior-posterior morphogenesis, leading to a functional subdivision into heart proper and aorta, with its most anterior part forming a funnel-shaped cardiac outflow. Cardioblasts differentiate into Tin-positive ‘working myocytes’ and Svp-expressing ostial cells. However, developmental fates and functions of heart-associated pericardial cells remain elusive. Here, we show that the pericardial cells that express the transcription factor Even Skipped adopt distinct fates along the anterior-posterior axis. Among them, the most anterior Antp-Ubx-AbdA-negative cells form a novel cardiac outflow component we call the outflow hanging structure, whereas the Antp-expressing cells differentiate into wing heart precursors. Interestingly, Hox gene expression in the Even Skipped-positive cells not only underlies their antero-posterior diversification, but also influences heart morphogenesis in a non-cell-autonomous way. In brief, we identify a new cardiac outflow component derived from a subset of Even Skipped-expressing cells that stabilises the anterior heart tip, and demonstrate non-cell-autonomous effects of Hox gene expression in the Even Skipped-positive cells on heart morphogenesis.
Can hyperspectral imaging be used to map corrosion products on outdoor bronze sculptures?
Authors: Catelli Emilio , Randeberg Lise , Strandberg Helena , Alsberg Bjørn , Maris Assimo , Vikki Lily 
Published: October 2018

The application of hyperspectral imaging in the field of cultural heritage investigation is growing rapidly. In this
study, short wavelength infrared hyperspectral imaging (960–2500 nm) has been explored as a potential non-invasive
technique for in situ mapping of corrosion products on bronze sculptures. Two corrosion products, brochantite and
antlerite, commonly found on the surfaces of outdoor bronze monuments, were considered. Their spatial distribution was
investigated on the surface of the bronze sculpture The Man with the Key by Auguste Rodin in Oslo. The results
demonstrate that hyperspectral imaging combined with image analysis algorithms can display the distribution of the two
corrosion products in different areas (unsheltered and partially sheltered) of the sculpture.
Παράγοντες Πρόβλεψης της Ικανοποίησης των Φοιτητών του Ελληνικού Ανοικτού Πανεπιστημίου
Authors: Iliou Theodoros , Tamvakis Androniki , Anastassopoulos George , Giossos Yiannis
Published: October 2018

Η παρούσα εργασία έχει σκοπό να καταγράψει το βαθμό στον οποίο συμμετέχουν στην πρόβλεψη της ικανοποίησης των φοιτητών του Ελληνικού Ανοικτού Πανεπιστημίου από τις σπουδές τους η αλληλεπίδραση που είχαν με τον/την καθηγητή/τρια σύμβουλο, η αποτελεσματικότητα του καθηγητή – συμβούλου και η αξιολόγηση του προγράμματος της θεματικής ενότητας. Για την έρευνα χρησιμοποιήσαμε τη μέθοδο του ερωτηματολογίου το οποίο διανείμαμε σε ενενήντα τέσσερις προπτυχιακούς και μεταπτυχιακούς φοιτητές του ΕΑΠ κατά τη διάρκεια των Ομαδικών Συμβουλευτικών Συναντήσεων σε Αθήνα και Θεσσαλονίκη. Η επιλογή του ερωτηματολογίου βασίστηκε σε προηγούμενη έρευνα που πραγματοποιήθηκε σε ξένο πανεπιστήμιο και η επεξεργασία και η ανάλυση των δεδομένων πραγματοποιήθηκε με το πρόγραμμα στατιστικής επεξεργασίας SPSS 20. Τα αποτελέσματα της έρευνας έδειξαν ότι η αξιολόγηση του προγράμματος ήταν υπεύθυνη για το 34% της διακύμανσης της ικανοποίησης ενώ οι υπόλοιπες μεταβλητές δεν ερμήνευσαν κάποιο επιπλέον ποσοστό της διακύμανσης. Τα ευρήματα της έρευνας αναφέρονται και  στις συσχετίσεις των παραπάνω παραγόντων με την ικανοποίηση των φοιτητών. Τα συμπεράσματα της έρευνας είναι σημαντικά για όλα τα πανεπιστήμια που παρέχουν μάθηση από απόσταση έτσι ώστε να βελτιώσουν τις παρεχόμενες υπηρεσίες και το επίπεδο σπουδών των φοιτητών τους. Επιπλέον, η συγκεκριμένη εργασία αποτελεί κίνητρο για περεταίρω έρευνα στο πεδίο της εξ αποστάσεως εκπαίδευσης από Ελληνικά και ξένα πανεπιστήμια.
Έντυπο και Ψηφιακό Βιβλίο (e-book) στην Ψηφιακή Εποχή
Authors: Ioakeimidou Vasiliki , Papadimitriou Sofia Theodor
Published: October 2018

Η ψηφιακή τεχνολογία επιφέρει μεταβολές και στον χώρο του βιβλίου με την εμφάνιση βιβλίων σε ψηφιακή μορφή. Η πολυμεσικότητα, πολυμορφικότητα και γενικότερα οι ολοένα αυξανόμενες δυνατότητες που προσφέρουν, μεταβάλλουν γοργά το τοπίο στην αγορά και διακίνηση του βιβλίου. Το άρθρο προσεγγίζει τα ισχυρά στοιχεία του έντυπου βιβλίου, την προστιθέμενη αξία του ψηφιακού βάσει των νέων λειτουργιών καθώς και τις κυρίαρχες πρακτικές και αναδυόμενες τάσεις των δυο μορφών με βιβλιογραφική ανασκόπηση στο πεδίο. Έμφαση δίνεται στην παιδαγωγική διάσταση έντυπου και ψηφιακού βιβλίου ενώ παρουσιάζονται εισαγωγικά τα νέα περιβάλλοντα ανάγνωσης. Οι προτιμήσεις των αναγνωστών σε συνδυασμό με τις μορφές και τα επιχειρηματικά πρότυπα που θα κυριαρχήσουν, θα καθορίσουν τη μορφή του βιβλίου τα επόμενα χρόνια.
Mean deviation based identification of activated voxels from time-series fMRI data of schizophrenia patients
Authors: Chatterjee Indranath
Published: October 2018

Background: Schizophrenia is a serious mental illness affecting different regions of the brain, which causes symptoms such as hallucinations and delusions. Functional magnetic resonance imaging (fMRI) is the most popular technique to study the functional activation patterns of the brain. The fMRI data is four-dimensional, composed of 3D brain images over time. Each voxel of the 3D brain volume is associated with a time series of signal intensity values. This study aimed to identify the distinct voxels from time-series fMRI data that show high functional activation during a task.

Methods: In this study, a novel mean-deviation based approach was applied to time-series fMRI data of 34 schizophrenia patients and 34 healthy subjects. The statistical measures such as mean and median were used to find the functional changes in each voxel over time. The voxels that show significant changes for each subject were selected and thus used as the feature set during the classification of schizophrenia patients and healthy controls.

Results: The proposed approach identifies a set of relevant voxels that are used to distinguish between healthy and schizophrenia subjects with high classification accuracy. The study shows functional changes in brain regions such as superior frontal gyrus, cuneus, medial frontal gyrus, middle occipital gyrus, and superior temporal gyrus.

Conclusions: This work describes a simple yet novel feature selection algorithm for time-series fMRI data to identify the activated brain voxels that are generally affected in schizophrenia. The brain regions identified in this study may further help clinicians to understand the illness for better medical intervention. It may be possible to explore the approach to fMRI data of other psychological disorders.
Proposals to Improve the Effectiveness of the State Program Implementation in the Russian Federation «Development of Education»
Authors: Ганеев А. , Ganeev A. , Власенко В. , Vlasenko V. , Василенко В. , Vasilenko V. , Сосфенов В. , Sosfenov V.
Published: October 2018

The article considers the problematic issues of the project subjects. It highlights the practical use and implementation of the government contracts results, concluded on the basis of competitive procurement procedures as part of the State Program of the Russian Federation «Development of Education» implementation. A range of proposals to increase the eff ectiveness of program implementation is formulated. This ensures transparency of procurement procedures in accordance with the current legislation in the fi eld of procurement, the actual project subjects in the Russian Federation in the fi eld of education development, practical use and implementation of the government contracts results.
Material loss at the femoral head taper
Authors: Langton D. J. , Wells S. R. , Joyce T. J. , Bowsher J. G. , Deehan D. , Green S. , Nargol A. V. F. , Holland J. P.
Published: October 2018

Aims

There are limited published data detailing the volumetric material loss from tapers of conventional metal-on-polyethylene (MoP) total hip arthroplasties (THAs). Our aim was to address this by comparing the taper wear rates measured in an explanted cohort of the widely used Exeter THA with those measured in a group of metal-on-metal (MoM) THAs.

Patients and Methods

We examined an existing retrieval database to identify all Exeter V40 and Universal MoP THAs. Volumetric wear analysis of the taper surfaces was conducted using previously validated methodology. These values were compared with those obtained from a series of MoM THAs using non-parametric statistical methodology. A number of patient and device variables were accounted for using multiple regression modelling.

Results

A total of 95 Exeter MoP and 249 MoM THAs were examined. The median volumetric loss from the MoM cohort was over four times larger than that from the MoP cohort (1.01 mm3 vs 0.23 mm3, p < 0.001), despite a significantly shorter median period in vivo for the MoM group (48 months vs 90 months, p < 0.001). Multiple regression modelling indicated that the dominant variables leading to greater female taper material loss were bearing diameter (p < 0.001), larger female taper angles (p < 0.001), and male titanium stem tapers (p < 0.001).

Conclusion

Consistent with the long-term clinical success of the device, the volumetric material loss from Exeter femoral head tapers was, in general, small compared with that from larger-diameter MoM head tapers. Cite this article: Bone Joint J 2018;100-B:1310–9.
Antioxidant-stabilized highly crosslinked polyethylene in total knee arthroplasty
Authors: Ponzio D. Y. , Weitzler L. , deMeireles A. , Esposito C. I. , Wright T. M. , Padgett D. E.
Published: October 2018

Aims

The aim of this study was to evaluate the surface damage, the density of crosslinking, and oxidation in retrieved antioxidant-stabilized highly crosslinked polyethylene (A-XLPE) tibial inserts from total knee arthroplasty (TKA), and to compare the results with a matched cohort of standard remelted highly crosslinked polyethylene (XLPE) inserts.

Materials and Methods

A total of 19 A-XLPE tibial inserts were retrieved during revision TKA and matched to 18 retrieved XLPE inserts according to the demographics of the patients, with a mean length of implantation of 15 months (1 to 42). The percentage areas of PE damage on the articular surfaces and the modes of damage were measured. The density of crosslinking of the PE and oxidation were measured at loaded and unloaded regions on these surfaces.

Results

A-XLPE inserts had higher rates of burnishing and lower rates of pitting and scratching compared with XLPE. There were no differences in the density of crosslinking at loaded and unloaded regions. A-XLPE showed higher oxidation indices in the unloaded surface region compared with XLPE. There were no differences in the levels of oxidation in the loaded regions.

Conclusion

Retrieval analysis of A-XLPE did not reflect a clinically relevant difference in surface damage, density of crosslinking, or oxidation compared with XLPE tibial inserts at short-term evaluation. Cite this article: Bone Joint J 2018;100-B:1330–5.
Chopart amputation with tibiotalocalcaneal arthrodesis and free flap reconstruction for severe foot crush injury
Authors: Chiu Y-C. , Chung T-C. , Wu C-H. , Tsai K-L. , Jou I-M , Tu Y-K. , Ma C-H.
Published: October 2018

Aims

This study reports the outcomes of a technique of soft-tissue coverage and Chopart amputation for severe crush injuries of the forefoot.

Patients and Methods

Between January 2012 to December 2016, 12 patients (nine male; three female, mean age 38.58 years; 26 to 55) with severe foot crush injury underwent treatment in our institute. All patients were followed-up for at least one year. Their medical records, imaging, visual analogue scale score, walking ability, complications, and functional outcomes one year postoperatively based on the American Orthopedic Foot and Ankle Society (AOFAS) and 36-Item Short-Form Health Survey (SF-36) scores were reviewed.

Results

The mean length of follow-up was 18.6 months (13 to 28). Two patients had a local infection, flap necrosis was seen in one patient, and one patient experienced a skin graft wound healing delay. Of the 12 patients, one had persistent infection and eventually required below-knee amputation, but pain-free walking was achieved in all the other patients. The mean one-year postoperative AOFAS and SF-36 scores were 75.6 (68 to 80) and 82 (74 to 88), respectively.

Conclusion

Although our sample size was small, we believe that this treatment method may be a valuable alternative for treating severe foot crush injuries. Cite this article: Bone Joint J 2018;100-B:1359–63.
The effectiveness of ultra-clean air operating theatres in the prevention of deep infection in joint arthroplasty surgery
Authors: Thomas A. M. , Simmons M. J.
Published: October 2018

Deep infection was identified as a serious complication in the earliest days of total hip arthroplasty. It was identified that airborne contamination in conventional operating theatres was the major contributing factor. As progress was made in improving the engineering of operating theatres, airborne contamination was reduced. Detailed studies were carried out relating airborne contamination to deep infection rates.

In a trial conducted by the United Kingdom Medical Research Council (MRC), it was found that the use of ultra-clean air (UCA) operating theatres was associated with a significant reduction in deep infection rates. Deep infection rates were further reduced by the use of a body exhaust system. The MRC trial also included a detailed microbiology study, which confirmed the relationship between airborne contamination and deep infection rates.

Recent observational evidence from joint registries has shown that in contemporary practice, infection rates remain a problem, and may be getting worse. Registry observations have also called into question the value of “laminar flow” operating theatres.

Observational evidence from joint registries provides very limited evidence on the efficacy of UCA operating theatres. Although there have been some changes in surgical practice in recent years, the conclusions of the MRC trial remain valid, and the use of UCA is essential in preventing deep infection.

There is evidence that if UCA operating theatres are not used correctly, they may have poor microbiological performance. Current UCA operating theatres have limitations, and further research is required to update them and improve their microbiological performance in contemporary practice.

Cite this article: Bone Joint J 2018;100-B:1264–9.
Repeat epidural steroid injections for radicular pain due to lumbar or cervical disc herniation
Authors: Joswig H. , Neff A. , Ruppert C. , Hildebrandt G. , Stienen M. N.
Published: October 2018

Aims

The aim of this study was to determine the efficacy of repeat epidural steroid injections as a form of treatment for patients with insufficiently controlled or recurrent radicular pain due to a lumbar or cervical disc herniation.

Patients and Methods

A cohort of 102 patients was prospectively followed, after an epidural steroid injection for radicular symptoms due to lumbar disc herniation, in 57 patients, and cervical disc herniation, in 45 patients. Those patients with persistent pain who requested a second injection were prospectively followed for one year. Radicular and local pain were assessed on a visual analogue scale (VAS), functional outcome with the Oswestry Disability Index (ODI) or the Neck Pain and Disability Index (NPAD), as well as health-related quality of life (HRQoL) using the 12-Item Short-Form Health Survey questionnaire (SF-12).

Results

A second injection was performed in 17 patients (29.8%) with lumbar herniation and seven (15.6%) with cervical herniation at a mean of 65.3 days (sd 46.5) and 47 days (sd 37.2), respectively, after the initial injection. All but one patient, who underwent lumbar microdiscectomy, responded satisfactorily with a mean VAS for leg pain of 8.8 mm (sd 10.3) and a mean VAS for arm pain of 6.3 mm (sd 9) one year after the second injection, respectively. Similarly, functional outcome and HRQoL were improved significantly from the baseline scores: mean ODI, 12.3 (sd 12.4; p < 0.001); mean NPAD, 19.3 (sd 24.3; p = 0.041); mean SF-12 physical component summary (PCS) in lumbar herniation, 46.8 (sd 7.7; p < 0.001); mean SF-12 PCS in cervical herniation, 43 (sd 6.8; p = 0.103).

Conclusion

Repeat steroid injections are a justifiable form of treatment in symptomatic patients with lumbar or cervical disc herniation whose symptoms are not satisfactorily relieved after the first injection. Cite this article: Bone Joint J 2018;100-B:1364–71.
Increased complications in geriatric patients with a fracture of the hip whose postoperative weight-bearing is restricted
Authors: Ottesen T. D. , McLynn R. P. , Galivanche A. R. , Bagi P. S. , Zogg C. K. , Rubin L. E. , Grauer J. N.
Published: October 2018

Aims

The aims of this study were to evaluate the incidence of postoperatively restricted weight-bearing and its association with outcome in patients who undergo surgery for a fracture of the hip.

Patients and Methods

Patient aged > 60 years undergoing surgery for a hip fracture were identified in the 2016 National Surgical Quality Improvement Program (NSQIP) Hip Fracture Targeted Procedure Dataset. Analysis of the effect of restricted weight-bearing on adverse events, delirium, infection, transfusion, length of stay, return to the operating theatre, readmission and mortality within 30 days postoperatively were assessed. Multivariate regression analysis was used to adjust for confounding demographic, comorbid and procedural characteristics.

Results

Of the 4918 patients who met inclusion criteria, 3668 (63.53%) were allowed to weight-bear as tolerated postoperatively. Controlling for patient and procedural factors, multivariate odds of any adverse event, major adverse event, delirium, infection, transfusion, length of stay ≥ 75th percentile (six days) and mortality within 30 days were all higher in patients with weight-bearing restrictions. Notably, there were no differences for thromboembolic events, return to the operating theatre or readmission within 30 days between the groups.

Conclusion

Elderly patients with a fracture of the hip with postoperative weight-bearing restrictions have a significantly greater risk of developing most adverse events compared with those who are encouraged to weight-bear as tolerated. These findings emphasize the importance of immediate weight-bearing as tolerated to optimize the outcome in these frail patients; however nearly 25% of surgeons fail to meet this evidence-based guideline. Cite this article: Bone Joint J 2018;100-B:1377–84.
French tragedy in the Hungarian theatre
Authors: Gausz Ildikó
Published: October 2018

The drama is one of the important historical sources of early modern national self-interpretations. After the Long Turkish War (1591–1606) historical dramas are able to enhance patriotism and patriotic education. The tragedy entitled Mercuriade written in 1605 by Dominique Gaspard puts on stage Philippe-Emmanuel de Lorraine, Duke of Mercœur (1558–1602) when he, after the conciliation with Henry IV and leaving the Catholic League, entered into the service of Rudolf II in 1599 and joined the anti-Turkish fights in Hungary. After his death Duke of Mercœur became a mythical hero and his memory was even mentioned at the end of 17th century. Mercuriade can be considered a masterpiece of 17th century school drama, through which it is possible to study the particularities of plays written with a didactic purpose for the students.
Kiszombor veszteségei az elsõ világháborúban az anyakönyvi vizsgálatok alapján
Authors: Kõrös Ákos
Published: October 2018

In this paper, I examined how a medium-sized Hungarian village affected by the First World War. I had two questions about the damage. How many casualties did the settlement have during the war? How did the demographic impact of the losses look like in the village? Kiszombor was a Hungarian, Catholic village in the middle of the Great Plain in Hungary between two cities: Szeged and Makó. 4000 people had lived there around the beginning of the 20th century, most of them made a living lived from agriculture. The village was the center of the Rónay family’s estate. I counted 101 dead in 1916–1920 in the burial registers. Most of them died in 1917. The most common month was the December because the author of the records could not know the exact date of their death. Therefore they used the 31st of December formula. The deceased distribution by profession or religion is following the rate of the village’s population. The soldiers’ age were between 18 and 48 years, most of the dead (9%) were 31 years old. The majority of the deceased were married. This issue caused the most crucial problem in the village. 10% of the men between 20–60 died in the war; therefore the number of the 0–6 years old population decreased by 35%. The population growth stopped in the 1910s, as the community reached the carrying capacity of the land and stagnation started in the late 1900’s. Although after the war, the growth of the population increased significantly. Naturally, there were slightly more women than men in the village. During the war, this rate increased and reached six percentage points of difference. In 1920 there were 240 more women than men, even though the disparity decreased at the end of the decade. The regional comparison is quite impressive. Looking at settlements in the 30 kilometer radius of Kiszombor. The average loss was 3% of the whole population of Hungary, however Kiszombor’s result is much higher (5%). We can say that one quarter of the population was enlisted and 5% of the population died in the war from this region.
Hadifoglyok és a Nagy Háború
Authors: Gorcsa Oszkár
Published: October 2018

The study presents the evolution of the international laws of war, focusing especially on the Geneva and Hague Conventions, which were the first multilateral treaties that addressed the conduct of warfare. Furthermore, I attempt to answer the question of why men kept fighting, why they didn’t choose surrender instead. I also deal with the moment of capture, and the legislations regarding prisoners of war in Austria–Hungary. I also expound on introducing the situations in the austro–hungarian POW camps. Furthermore, the study depicts in detail the economic capability of the state after the outbreak of the Great War.
DAMPAK SOSIAL EKONOMI PEMBEBASAN LAHAN PEMBANGUNAN BANDAR UDARA (NEW YOGYAKARTA INTERNATIONAL AIRPORT)
Authors: Azizah Nur
Published: October 2018

Yogyakarta Merupakan daerah yang memiliki banyak potensi, baik potensi ekonomi, pariwisata dan budaya. Berbagai potensi yang dimiliki oleh Yogyakarta menjadikan daerah tersebut sebagai daerah yang memiliki kemajuan ekonomi dan pariwisata yang sangat pesat. Dengan demikian, daerah ini dapat mendatangkan wisatawan baik regional maupun internasional. Akibatnya, Bandara Adi Sucipto menjaid sangat padat. Oleh karena itu pemeirntah daerah Yogyakarta mengeluarkan kebijakan untuk membangun bandara baru dan menetapkan lokasi penetapan lahan pembangunan berada di Kecamatan Temon, Kabupaten Kulonprogo. Pembangunan bandara ini juga merupakan proyek MP3EI (Masterplan Percepatan Perluasan Pembangunan Ekonomi Indonesia). Setiap kebijakan sudah pasti memiliki kekurangan dan kelebihan begitu juga dengan pro dan kontra yang dialami oleh masyarakat Kecamatan Temon, sebagai warga terdampak dari implementasi kebijakan tersebut. Dalam hal ini pemerintah juga perlu memperhatikan tingkat keefektivan dari kebijakan tersebut, menyingkat implementasi kebijakan ini mengangkut hajat hidup orang banyak. Pembangunan bandara NYIA merupakan suatu pembangunan yang bersifat mendesak dan diperuntukkan sebagai kepentingan umum.
Social Dilemmas in Environmental Economics and Policy Considerations: A Review
Authors: Cerutti Nicola
Published: October 2018

Many crucial environmental issues lead to social dilemmas, in which the personally optimal solution, and the socially optimal solution diverge. Finding a solution to this dilemma is extremely important to allow a good and sustainable management of many exhaustible natural resources. This is especially true when the resource users need to develop collectively a set of rules or practices, and the institutions are unable to provide, or enforce, effective regulations. A few examples are forests, and fisheries, but also carbon emissions. This review presents a selected number of results coming from field observations, laboratory experiments, and theoretical work, which pinpoint some of the more crucial aspects of these decision environments. Knowing which incentives and situational aspects may motivate resource users to adopt a more or less cooperative behavior can potentially be of pivotal importance to develop effective policies and regulations. At the same time, the research we present is also of great interestfor any diagnostic or explorative study that aims to study direct resource users, and their development of cooperative attitudes and practices.
The Struggle of Educating. And of Being “A Grown-up”
Authors: Zamengo Federico
Published: October 2018

In the face of contemporary educational transformations, this contribution aims to analyze the educational role that can still be played by the adult educator. Without restoring old categories of the past, today's adults continue to have a responsibility in the growth of younger generations. Accepting this task means first of all critically and reflectively recognizing one's role and, secondly, accepting the challenges posed by the complexity of today's landscape in terms of credibility and consistency.
Nihilism and the Problem of Future: Biodiversity Destruction As One of the Great Dangers of Technology?
Authors: Oliveira Jelson
Published: October 2018

Starting from the example of the Amazon, in Brazil, we intend to analyse how technology (mainly in its biotechnological face) appears as a threat to biodiversity, insofar as it acts through a reduction and standardization: technology needs to reduce diversity to something knowable to be able to control and exploit, in view of human necessities. In this sense, according to Hans Jonas, it is necessary to ask about the horizon of the future giving preference to the negative prognosis (fear rather than hope) to avoid that the harmful consequences of nihilism (marked by the absence of criteria capable of guiding technological action) affect life decisively. In this case, the Enhancement project proposed by transhumanism appears as yet another chapter in the history of risks represented by modern technology.
Instantaneous Midbrain Control of Saccade Velocity
Authors: Smalianchuk Ivan , Jagadisan Uday K. , Gandhi Neeraj J.
Published: October 2018

The ability to interact with our environment requires the brain to transform spatially represented sensory signals into temporally encoded motor commands for appropriate control of the relevant effectors. For visually guided eye movements, or saccades, the superior colliculus (SC) is assumed to be the final stage of spatial representation, and instantaneous control of the movement is achieved through a rate code representation in the lower brain stem. We investigated whether SC activity in nonhuman primates (Macaca mulatta, 2 male and 1 female) also uses a dynamic rate code, in addition to the spatial representation. Noting that the kinematics of amplitude-matched movements exhibit trial-to-trial variability, we regressed instantaneous SC activity with instantaneous eye velocity and found a robust correlation throughout saccade duration. Peak correlation was tightly linked to time of peak velocity, the optimal efferent delay between SC activity and eye velocity was constant at ∼12 ms both at onset and during the saccade, and SC neurons with higher firing rates exhibited stronger correlations. Moreover, the strong correlative relationship and constant efferent delay observation were preserved when eye movement profiles were substantially altered by a blink-induced perturbation. These results indicate that the rate code of individual SC neurons can control instantaneous eye velocity and argue against a serial process of spatial-to-temporal transformation. They also motivated us to consider a new framework of saccade control that does not incorporate traditionally accepted elements, such as the comparator and resettable integrator, whose neural correlates have remained elusive.

SIGNIFICANCE STATEMENTAll movements exhibit time-varying features that are under instantaneous control of the innervating neural command. At what stage in the brain is dynamical control present? It is well known that, in the skeletomotor system, neurons in the motor cortex use dynamical control. In the oculomotor system, in contrast, instantaneous velocity control of saccadic eye movements is not thought to be enforced until the lower brainstem. Using correlations between residual signals across trials, we show that instantaneous control of saccade velocity is present earlier in the visuo-oculomotor neuraxis, at the level of superior colliculus. The results require us to consider alternate frameworks of the neural control of saccades.
Leveraging sex change in parrotfish to manage fished populations
Authors: Pavlowich Tyler , Webster D. G. , Kapuscinski Anne R.
Published: October 2018

Healthy parrotfish (family Scaridae) communities fulfill the essential ecosystem process of herbivory in coral reefs, but artisanal fisheries that target parrotfish have degraded their populations. Outright bans and gear restrictions that do not allow parrotfish capture can effectively protect and restore parrotfish populations. As these management actions would be unfeasible in many places, options that allow some fishing but still encourage population rebuilding need to be considered. The life history of parrotfish complicates management decisions because they transition from a mostly female “initial phase” to an all-male “terminal phase.” Size-selective fishing on the largest fish can lead to unnaturally low proportions of males in a population, potentially leading to losses in reproduction. At the same time, these visually distinct life phases could present an opportunity to employ a type of catch restriction that would be easy to understand and monitor. We built an agent-based model of the stoplight parrotfish, Sparisoma viride, which included three possible mechanisms of life-phase transitioning, to predict how this species and others like it might react to catch restrictions based on life phase. We found that restricting catch to only terminal-phase (male) fish typically led to populations of greater abundance and biomass and less-disturbed life-phase ratio, compared to a similar fishing mortality applied to the whole population. This model result highlights a potentially important lesson for all exploited protogynous hermaphrodites: a robust population of initial-phase fish may be key to maximizing reproductive potential when the size at life-phase transition compensates for changes in population structure.
Multi-trait, Multi-environment Deep Learning Modeling for Genomic-Enabled Prediction of Plant Traits
Authors: Montesinos-López Osval A , Montesinos-López Abelardo , Crossa José , Gianola Daniel , Hernández-Suárez Carlos M , Martín-Vallejo Javier
Published: October 2018

Multi-trait and multi-environment data are common in animal and plant breeding programs. However, what is lacking are more powerful statistical models that can exploit the correlation between traits to improve prediction accuracy in the context of genomic selection (GS). Multi-trait models are more complex than univariate models and usually require more computational resources, but they are preferred because they can exploit the correlation between traits, which many times helps improve prediction accuracy. For this reason, in this paper we explore the power of multi-trait deep learning (MTDL) models in terms of prediction accuracy. The prediction performance of MTDL models was compared to the performance of the Bayesian multi-trait and multi-environment (BMTME) model proposed by Montesinos-López et al. (2016), which is a multi-trait version of the genomic best linear unbiased prediction (GBLUP) univariate model. Both models were evaluated with predictors with and without the genotype×environment interaction term. The prediction performance of both models was evaluated in terms of Pearson’s correlation using cross-validation. We found that the best predictions in two of the three data sets were found under the BMTME model, but in general the predictions of both models, BTMTE and MTDL, were similar. Among models without the genotype×environment interaction, the MTDL model was the best, while among models with genotype×environment interaction, the BMTME model was superior. These results indicate that the MTDL model is very competitive for performing predictions in the context of GS, with the important practical advantage that it requires less computational resources than the BMTME model.