bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of Law Enforcement Response to Wrong-Way Driving Events in Florida
Authors: Kayes Md Imrul , Al-Deek Haitham , Sandt Adrian , Carrick Grady , Staves Corin , Gamaleldin Ghalia , Faruk Omar , Al-Sahili Omar
Published: May 2019

Wrong-way driving (WWD) can result in severe crashes. By responding quickly to WWD dispatch calls, law enforcement officers (LEOs) could stop the wrong-way vehicle before a crash occurs. This paper analyzed law enforcement (LE) response times to WWD dispatch calls in Florida between January 2003 and April 2018 to determine significant effects. The average LE response time was much lower for 2013 onward than before 2013. Average response time was lower during nighttime and in urban areas and was higher for county roads and toll roads. Two ordinal logit models were also developed. These models found that dispatch calls closer to regional traffic management centers or rest areas, in urban areas, or on state roads or local roads typically had lower response times than calls not in these locations. In addition, WWD dispatch calls on toll roads had lower response times than calls on non-toll limited access facilities. Intelligent transportation system (ITS) WWD countermeasures with flashing signs, detection devices, cameras, and direct communication with traffic management centers also help LEOs respond quickly to detected WWD events and more accurately identify the vehicle’s location. As of June 2018, these technologies located at 70 toll road exit ramps in Florida have prompted 307 wrong-way drivers to turn around, possibly preventing nine crashes and saving LEOs over 116 h. The results of this research can help identify locations where increasing LEO presence or installing ITS WWD countermeasure technologies could help reduce WWD response time and WWD crashes, potentially saving lives.
Developing a Process for Deploying Systemic Countermeasures at Unsignalized Intersections: Case Study of Virginia
Authors: Cottrell Benjamin H. , Lim In-Kyu
Published: May 2019

This paper discusses the process used to develop a safety improvement plan for unsignalized intersections using systemic low-cost countermeasures. The scope of this project focused on unsignalized intersections with stop sign control on the minor approaches. The first objective was to perform an assessment of Virginia’s unsignalized intersection crashes over a five-year period to determine predominant crash trends and collision types to target for treatment. The four focus collision types with the highest frequency of crashes and the greatest potential reduction in crashes were 3-leg angle, 3-leg fixed object off the road, 4-leg angle and 4-leg rear end. Chi-square automatic interaction detection decision tree analysis was used to perform a systemic analysis to identify a group of intersections associated with potential risk factors related to the focus collision types. A tiered list of systemic countermeasures to deploy was developed. The countermeasures were intended to warn of the stop ahead, make the stop sign and stop location more visible on a minor street, and to warn of the intersection ahead on a major street. The potential for safety improvement measure was used to prioritize the candidate treatment intersections. Before deployment, a study of the intersection by district traffic engineering staff was planned to finalize the plan. The output from the research was a safety improvement plan to systemically deploy treatments to unsignalized intersections as part of the safety program.
Evaluating the Safety Effectiveness of Advance Downgrade Warning Signs in Preventing Downgrade Truck Crashes using a Propensity Scores Framework
Authors: Moomen Milhan , Rezapour Mahdi , Raja Mustaffa N. , Wulff Shaun S. , Ksaibati Khaled
Published: May 2019

Truck crashes on steep downgrades exact devastating tolls on lives and property. An important intervention to reduce the frequency of truck crashes on downgrades has been to present quality information to drivers about upcoming downgrades through warning signs. The use of advance warning signs on downgrades to prevent truck crashes is the current state of practice for most highway agencies; thus, it is critical to assess the safety effectiveness of such warning signs. Though several studies have evaluated the efficacies of warning signs, the safety effectiveness of advance downgrade signs is less clear. This study uses a propensity scores framework to assess the effectiveness of current downgrade warning signs by matching treated and untreated downgrade segments in Wyoming. The advantage of propensity score matching over other traditional analysis techniques is that it reduces bias in safety evaluation by mimicking randomization and accounts for confounding factors. Using the risk ratio computed from the matched data, the study found that advance downgrade warning signs are effective in reducing downgrade truck crashes. The results indicate that truck crash risks on downgrades without advance warning signs are an estimated 15% higher than downgrades with advance downgrade signs. The 90% bootstrap confidence interval for the risk ratio was found to be from 1.04 to 1.53.
Is Cerebral Palsy Changing in High Resource Settings? Data From the Quebec Cerebral Palsy Registry
Authors: Hadjinicolaou Aristides , Ng Pamela , PhD Xun Zhang , Koclas Louise , Lamarre Céline , Malouin Francine , Pigeon Nicole , Richards Carol L. , Shevell Michael , Oskoui Maryam
Published: May 2019

Advances in maternal and perinatal care in developed countries have led to improved health outcomes for children. These changes may have impacted the profile of children with a cerebral palsy (CP) and groups at risk for CP over time. Using data from the Canadian CP Registry, the objectives of this retrospective cohort study were to describe the profile of children with CP in Quebec born between 1999 and 2010 and identify possible temporal variation in CP risk factors and phenotypic profile. Our sample consisted of 662 children with CP in Quebec. No change in profile or associated risk factors was observed across the birth cohorts 1999 to 2010. Prematurity remains the largest risk factor for CP in Quebec, and children with CP have multiple comorbidities that contribute to overall CP burden. CP registries offer a unique platform to study spectrum disorders and their longitudinal changes over time.
Self-Resolving Vulvar Breast Tissue Arising in the Post-Partum Setting: A Case Report and Review of Literature
Authors: Larson Stephanie , Yang Sara , Chacko-Stacey Alexandra , Mason Danielle , Hart Elaine
Published: May 2019

Introduction

During the postpartum period, breast engorgement in preparation for lactation may trigger the onset of vulvar labial nodules that present with pain and discomfort. These labial nodules may originate from ectopic breast tissue and can rarely present in women during the postpartum period in the labia majora.

Main Issue

A 37-year-old African American female, gravida 1 para 1, presented to the Loma Linda University Medical Center with complaints of new onset labial swelling worsening 6 days following her full term spontaneous vaginal delivery. Additionally, our respondent complained of difficulty breastfeeding due to intermittent lack of milk production. She reported bilateral breast engorgement with tenderness, despite frequent attempts at breastfeeding. The respondent’s presentation did not meet the criteria for other common differentials due to the physical characteristics of the nodules. The location of the nodules along the milk line led physicians to believe that the respondent was presenting with engorged extra-mammary breast tissue in the labia majora.

Management

The participant was told to observe her course over the next few days as she began to have milk production and ejection. The respondent was seen in clinic for her 6-week postpartum visit, and was no longer complaining of difficulty with breastfeeding. The labial nodules had resolved spontaneously.

Conclusion

A literature search yielded no case reports that described a case of an extra-mammary vulvar mass that self-resolved with resolution of breast engorgement. The infrequent presentation of extra-mammary vulvar tissue makes it difficult to conclude a guideline for diagnosis and management.
Computational simulation of turbulent flows around a marine propeller by solving the partially averaged Navier–Stokes equation
Authors: Seok Woochan , Lee Sang Bong , Rhee Shin Hyung
Published: May 2019

This study concerns the characteristics of the partially averaged Navier–Stokes method for local flow analysis around a rotating propeller. Partially averaged Navier–Stokes, resolving crucial large-scale structures of turbulent flow at a given computational grid resolution, is a bridging turbulence closure model between the Reynolds-averaged Navier–Stokes equation and the direct numerical simulation. A detailed comparison between partially averaged Navier–Stokes and Reynolds-averaged Navier–Stokes models is made to achieve a better understanding of partially averaged Navier–Stokes characteristics for predicting the coherent structures in turbulent flow. The two-equation k-ω shear stress transport model and the seven-equation Reynolds stress model are selected for Reynolds-averaged Navier–Stokes computations. The problem of interest is the flow around a rotating KP505 propeller in open water conditions at an advance ratio of 0.7. Near the leading edge, the partially averaged Navier–Stokes results are similar to those of Reynolds stress model in terms of the vortical structures. Vorticity predicted by different turbulence models, however, shows significant differences. For a more detailed analysis, the velocity gradient constituting the vorticity is identified at the leading edge. It is proven that partially averaged Navier–Stokes is able to capture the anisotropic characteristics of the flow at the leading edge, where both the geometric and flow characteristics change abruptly.
Strategy on performance improvement of inverse Brayton cycle system for energy recovery in turbocharged diesel engines
Authors: Zhu Dengting , Lin Yun , Zheng Xinqian
Published: May 2019

The inverse Brayton cycle is a potential technology for waste heat energy recovery. It consists of three components: one turbine, one heat exchanger, and one compressor. The exhaust gas is further expanded to subatmospheric pressure in the turbine, and then cooled in the heat exchanger, last compressed in the compressor into the atmosphere. The process above is the reverse of the pressurized Brayton cycle. This work has presented the strategy on performance improvement of the inverse Brayton cycle system for energy recovery in turbocharged diesel engines, which has pointed the way to the future development of the inverse Brayton cycle system. In the paper, an experiment was presented to validate the numerical model of a 2.0 l turbocharged diesel engine. Meanwhile, the influence laws of the inverse Brayton cycle system critical parameters, including turbocharger speed and efficiencies, and heat exchanger efficiency, on the system performance improvement for energy recovery are explored at various engine operations. The results have shown that the engine exhaust energy recovery efficiency increases with the engine speed up, and it has a maximum increment of 6.1% at the engine speed of 4000 r/min (the engine rated power point) and the full load. At the moment, the absolute pressure was before final compression is 51.9 kPa. For the inverse Brayton cycle system development in the future, it is essential to choose a more effective heat exchanger. Moreover, variable geometry turbines are very appropriate to achieve a proper matching between the turbocharging system and the inverse Brayton cycle system.
Soil horizon development and the tempo and modes of vegetation change during the Holocene in a Sonoran Desert basin, USA
Authors: McAuliffe Joseph R
Published: May 2019

Silt-rich and clay-rich vesicular horizons (V horizons) that develop beneath desert pavements limit infiltration and plant-available soil moisture. A radiocarbon date from buried charcoal constrains the timing of emplacement of a Sonoran Desert alluvial fan deposit to the very end of the Pleistocene (approximately 12.7 ka). The surface of the fan is dotted with 1.5–3 m light-colored plant scars that mark places once occupied by larger perennial plants. A few very large, ring-like clones of Larrea tridentata have persisted on the surface and represent plants that may have initially established as long ago as the early Holocene. The gravelly fan deposit initially would have possessed high infiltration capacities and fostered the establishment of vegetation. Two principal sets of factors have driven vegetation change over the course of the Holocene. During the first part of the Holocene, differences in life history attributes of various species (dispersal and colonization vs. competitive abilities) would have contributed to a succession of perennial plant occupants, culminating with the predominance of the slow-growing, long-lived, but competitively dominant L. tridentata. During the latter part of the Holocene and continuing to the present, continued development of the pavement and associated V horizon has increasingly diminished the capacity of the surface to absorb precipitation and is responsible for the more recent phase involving progressive elimination of vegetation. Development of soil features that markedly influence soil hydrology is a major component of vegetation change during the late Quaternary in the more arid portions of the Sonoran and Mojave deserts.
Attributable fraction for multiple risk factors: Methods, interpretations, and examples
Authors: Di Maso Matteo , Bravi Francesca , Polesel Jerry , Negri Eva , Decarli Adriano , Serraino Diego , La Vecchia Carlo , Ferraroni Monica
Published: May 2019

The attributable fraction is the candidate tool to quantify individual shares of each risk factor on the disease burden in a population, expressing the proportion of cases ascribable to the risk factors. The original formula ignored the presence of other factors (i.e. multiple risk factors and/or confounders), and several adjusting methods for potential confounders have been proposed. However, crude and adjusted attributable fractions do not sum up to their joint attributable fraction (i.e. the number of cases attributable to all risk factors together) and their sum may exceed one. A different approach consists of partitioning the joint attributable fraction into exposure-specific shares leading to sequential and average attributable fractions. We provide an example using Italian case–control data on oral cavity cancer comparing crude, adjusted, sequential, and average attributable fractions for smoking and alcohol and provide an overview of the available software routines for their estimation. For each method, we give interpretation and discuss shortcomings. Crude and adjusted attributable fractions added up over than one, whereas sequential and average methods added up to the joint attributable fraction = 0.8112 (average attributable fractions for smoking and alcohol were 0.4894 and 0.3218, respectively). The attributable fraction is a well-known epidemiological measure that translates risk factors prevalence and disease occurrence in useful figures for a public health perspective. This work endorses their proper use and interpretation.
Security in the balance: How Britain tried to keep its Iraq War secrets
Authors: Thomas Owen David
Published: May 2019

State secrecy is incompatible with the values of liberal democracy if there is no publicly reasonable justification for the concealment. So how can a liberal democracy continue to keep state secrets amidst suspicion that no such justification exists or that, worse, those secrets contain evidence of wrongdoing? This article maps and critiques the justificatory strategies that were used by the British state to refuse to disclose secret material related to the 2003 Iraq War, despite widespread accusations of hidden deception and illegality. Through an analysis of the legal discourse that underpins freedom of information (FOI) and disclosure protocols, the article shows how the law regulates disclosure through a metaphorical ‘balance’ of public interests. This balance, however, is no balance at all. It is profoundly one-sided because security only features on one side. The law explicitly recognizes that disclosure can create insecurity for public interests, but lacks any recognition of the opposite: the insecurity of secrecy. Rather than security trumping liberal values, this law allows enduring secrecy to be framed, paradoxically, as a means to secure liberal democratic accountability. The significance of this claim is far-reaching as FOI laws in many other countries employ a similar harm-based, one-sided justificatory strategy.
Wage Cost-Reducing Policies and Employment Stability for People With Disabilities in the Spanish Labor Market
Authors: Castro Núñez Rosa B. , Martín Barroso Víctor , Santero Sánchez Rosa
Published: May 2019

The strategies for integrating people with disabilities into the labor market have evolved toward a social approach, in which the objective is the integration with stable and decent jobs. This article analyzes how persons with disabilities enter the ordinary labor market by studying the factors that strengthen stability in that process. In particular, it analyzes the incentives to hire workers by means of Social Security contribution deductions, a wage cost-reducing measure, and studies whether or not reduced contributions affects the hiring of people with disabilities in stable positions, thus promoting the possibility of decent and stable jobs. We focus on people with disabilities entering the job market for the first time during the period 2004 to 2011, using the Continuous Sample of Working Histories Database for Spain and using as a control group people without disabilities. The results obtained show that reduced social security contributions constitute an incentive that effectively encourages the entry of workers with a disability into the labor market by means of stable employment.
Patients’ Needs Regarding Anxiety Management in Palliative Cancer Care: A Qualitative Study in a Hospice Setting
Authors: Zweers Danielle , de Graeff Alexander , Duijn Jette , de Graaf Everlien , Witteveen Petronella O. , Teunissen Saskia C. C. M.
Published: May 2019

Introduction:

Anxiety is a common symptom in the palliative phase, and symptom management depends on the competencies of individual professionals. This study aims to get insight into the needs of anxious hospice patients with advanced cancer regarding support.

Method:

Semi-structured interviews were performed in admitted hospice patients with cancer. Patients admitted from May 2017 till May 2018 were eligible whether or not they were anxious. Interviews were analyzed and coded within predefined topics.

Results:

Fourteen patients were included: 10 females, median age 71, and median World Health Organization performance score 3. Most patients were highly educated. Thirteen patients were interviewed within 6 months before death. Information, open communication, sense of control, safety, adequate symptom management, and respect for patients’ coping strategy were the 6 main expressed needs.

Conclusion:

Assessing patients’ needs regarding anxiety provided important angles where health-care professionals can make a difference in order to support anxious patients in their final stage of life to realize tailored palliative care. Future research should focus on the development of a systematic approach for health-care professionals to manage anxiety in daily care of terminal patients.
Refining the Parenting Stress Index–Short Form (PSI-SF) in Chinese Parents
Authors: Luo Jie , Wang Meng-Cheng , Gao Yu , Zeng Hong , Yang Wendeng , Chen Wei , Zhao Shouying , Qi Shisan
Published: May 2019

The Parenting Stress Index–Short Form (PSI-SF) is a popular brief assessment of parenting stress. However, its latent structure and psychometric properties have not been extensively addressed, in particular in non-Western cultures. The present study is the first to examine the factor structure and psychometric properties of the PSI-SF in parents from Mainland China (683 mother–father dyads; mean age of mothers = 37.10 years, SD = 3.68; mean age of fathers = 39.81 years, SD = 4.13). Initial analyses revealed that previously proposed factor structure of the PSI-SF did not fit the data well. Exploratory and confirmatory factor analyses were then conducted to develop a psychometrically sound and efficient abbreviated version of the PSI-SF. In this new version of 15 items (PSI-SF-15), there are three factors (i.e., parental distress, parent–child dysfunctional interaction, and difficult child). This abbreviated scale showed strict measurement invariance across sex of parent and satisfactory internal consistency. The convergent validity of the PSI-SF-15 were supported by its expected relations with the original PSF-SF measures, the multitrait–multimethod procedure, and its expected relations with scores on parenting behavior, parental depressiveness, and children’s conduct problems. In conclusion, these results suggest that the PSI-SF-15 is a valid measure of parenting stress in Chinese parents, and that it holds promise as an informative and reliable alternative to the original PSI-SF when administration time is limited.
The static parallel distribution algorithms for hybrid density-functional calculations in HONPAS package
Authors: Qin Xinming , Shang Honghui , Xu Lei , Hu Wei , Yang Jinlong , Li Shigang , Zhang Yunquan
Published: May 2019

Hybrid density-functional calculation is one of the most commonly adopted electronic structure theories in computational chemistry and materials science because of its balance between accuracy and computational cost. Recently, we have developed a novel scheme called NAO2GTO to achieve linear scaling (Order-N) calculations for hybrid density-functionals. In our scheme, the most time-consuming step is the calculation of the electron repulsion integrals (ERIs) part, so creating an even distribution of these ERIs in parallel implementation is an issue of particular importance. Here, we present two static scalable distributed algorithms for the ERIs computation. Firstly, the ERIs are distributed over ERIs shell pairs. Secondly, the ERIs are distributed over ERIs shell quartets. In both algorithms, the calculation of ERIs is independent of each other, so the communication time is minimized. We show our speedup results to demonstrate the performance of these static parallel distributed algorithms in the Hefei Order-N packages for ab initio simulations.
Toward a modular precision ecosystem for high-performance computing
Authors: Anzt Hartwig , Flegar Goran , Grützmacher Thomas , Quintana-Ortí Enrique S
Published: May 2019

With the memory bandwidth of current computer architectures being significantly slower than the (floating point) arithmetic performance, many scientific computations only leverage a fraction of the computational power in today’s high-performance architectures. At the same time, memory operations are the primary energy consumer of modern architectures, heavily impacting the resource cost of large-scale applications and the battery life of mobile devices. This article tackles this mismatch between floating point arithmetic throughput and memory bandwidth by advocating a disruptive paradigm change with respect to how data are stored and processed in scientific applications. Concretely, the goal is to radically decouple the data storage format from the processing format and, ultimately, design a “modular precision ecosystem” that allows for more flexibility in terms of customized data access. For memory-bounded scientific applications, dynamically adapting the memory precision to the numerical requirements allows for attractive resource savings. In this article, we demonstrate the potential of employing a modular precision ecosystem for the block-Jacobi preconditioner and the PageRank algorithm—two applications that are popular in the communities and at the same characteristic representatives for the field of numerical linear algebra and data analytics, respectively.
Tattoo-associated panuveitis: A 10-year follow-up
Authors: Tiew Stephenie
Published: May 2019

Introduction:

There has been an increasing number of tattoo-related uveitis without evidence of systemic sarcoidosis. This finding may indicate a possible association of tattoos with uveitis.

Case description:

This report is a 10-year follow-up of a single case of tattoo-related uveitis with no proven systemic sarcoidosis.

Conclusion:

Literature review suggests possible pathogenesis and the patient’s management is discussed. This case highlights the importance of a good systemic history and physical examination, especially with regard to tattoos.
Capsular closure outweighs head size in preventing dislocation following revision total hip arthroplasty
Authors: Pedneault Christopher , Tanzer Dylan , Nooh Anas , Smith Karen , Tanzer Michael
Published: May 2019

Introduction:

The high dislocation rate following revision total hip arthroplasty (THA) has been shown to be significantly reduced by closing the posterior capsule and by the use of large diameter femoral heads. The relative importance of each of these strategies on the rate of dislocation remains unknown. We undertook a study to determine if increasing femoral head diameter, in addition to posterior capsular closure would influence the dislocation rate following revision THA.

Methods:

We retrospectively reviewed 144 patients who underwent a revision THA. We included all patients who underwent revision THA with closure of the posterior capsule and who had at least a 2-year minimum follow-up. 48 patients had a 28-mm femoral head, 47 had a 32-mm head and 49 patients had a 36-mm femoral head.

Results:

At a minimum follow-up of 2 years, there were 3 dislocations. There were no dislocations in the 28-mm group (0%), 2 in the 32-mm group (4%) and 1 in the 36-mm group (2%). Head size alone was not found to significantly decrease the risk of dislocation (28-mm versus 32-mm p = 0.12; 28-mm versus 36-mm p = 0.27; 32-mm versus 36-mm p = 0.40).

Conclusion:

Both large diameter heads and careful attention to surgical technique with posterior capsular closure can decrease the historically high dislocation rate after revision THA when utilising the posterolateral approach. Capsular closure outweighs the effect of femoral head diameter in preventing dislocation following revision THA through a posterolateral approach.
A New Look at the Forces Acting on the Hip Joint
Authors: Bombelli R , Kuller N. , Bombelli M.
Published: May 2019

A simple diagram of coronal plane forces about the hip is used to describe pathomechanics of coxa vara, coxa valga, coxarthrosis, femoral neck fracture, congenital coxa vara, slipped capital epiphysis, dislocation of the femoral head and acetabular loosening in total hip replacement.

A common pattern of abnormality is seen to be excessive shear against a cranio-laterally oblique plane with consequent cranio-lateral migration of the structure distal to that plane.

As soon as the plane is made horizontal with surgical treatment, the shearing forces disappear and the vertical compressive forces achieve healing.
Long-Term Evaluation of Hip Arthroplasty (Mid-Thigh Pain, Limp, Loosening and Failures)
Authors: Surace A. , Mineo G. , Micale C. , De Giovanni G. , Previtera A. M.
Published: May 2019

Two hundred and fifty arthroplasties performed from February 1982 to June 1990 at the 3rd Orthopedic Department of the University of Milan, were evaluated in the long term after operation. All patients were rated by a personal scoring system based on the analysis of hip motion. Twenty-one patients who had received cementless arthroplasties were examined by bony scintigraphy to check the time course of prosthetic fixation on the basis of bone metabolic state.

The excellent clinical results strongly support the correctness of the concept of arthroplasty, but various aspects of surgical technique must be studied and further improvements made in components.
Morphology and Biomechanics of the Hip. Study III: The Diseased Hip
Authors: Specchiulli F. , Laforgia R. , Nitti L. , Savino G. , Mastrosimone N. , Pellicani N. , Solarino G.
Published: May 2019

The aim of this study was to define the characteristics of the diseased hip through a series of roentgenographic parameters measured on X-rays taken from a group of patients suffering from primary osteoarthritis. The arthritic hips were divided into three groups: superolateral OA, concentric OA, and medial OA. In light of the anatomo-roentgenographic characteristics this study proposes a new classification of osteoarthritis based on the direction of migration of the femoral head. Analysis of the data has highlighted the extreme polymorphism which characterizes the course and evolution of osteoarthritis and the serious modifications brought about in the hip-joint region.

The clinical impression at the conclusion of this study is of a direct correlation between primary alterations of parameters of the hip and development of osteoarthritis.
The Morphobiomechanics of the Hip
Authors: Laforgia R. , Specchiulli F. , Solarino G. , Nitti L. , Mastrosimone N. , Savino G. , Pellicani N.
Published: May 2019

In this first, introductory study we established the parameters with which to develop an in-depth study of the mechanical interpretation of roentgenographic images of osteoarthritic hips.

Our choice of parameters, and in fact our whole approach, parted from the theories of morphobiomechanics advanced by Pauwels and by Bombelli
A Histological Evaluation of the Bone-Implant Interface Failure in Total Hip Arthroplasty Due to Aseptic Loosening
Authors: Moreschini O. , Margheritini F.
Published: May 2019

We report a study on how the bone-implant interface of 20 T.H.A. failed because of aseptic loosening. The aim of this study was to look for the mechanism that promotes the activation of the cell-population located in the tissues at the interface. We have demonstrated, with the help of cytochemical and enzymatic techniques, that cell-activation can be supported by similar agents for every type of implant (cemented or cementless). We believe that these agents could be identified with lymphokines, particularly with Interleukin 1 (IL-1), and that the production of these factors is stimulated by mechanical factors. These results evidence the importance of debris, in addition to micromotion, at the beginning of the process of aseptic loosening.
Immunophenotypic Analysis of Mononuclear Phagocyte Antigens in the Arthritic Synovium of the Hip Joint
Authors: Athanasou N.A.
Published: May 2019

The antigenic phenotype of lining and subintimal mononuclear phagocytes (MPs) of the synovium in osteoarthritis (OA) and rheumatoid arthritis (RA) was characterised, using monoclonal antibodies directed against a range of monocyte/macroph-ageassociated antigens, in order to determine the role of MPs in the pathobiology of OA and RA of the hip. A major proportion of synovial lining cells (SLCs) and subintimal cells in RA and OA consisted of CD68 positive MPs which expressed a wide range of macrophage-associated antigens. The monocyte marker, CD14, was downregulated on SLCs in RA while OA and early markers of MP activation predominated in the OA synovium which was independent of the level of inflammation. In contrast, synovial MPs in RA showed increased expression of activation, maturation and functional antigens such as CD11a, CD11b, CD11c, CD16, CD32, CD54, CD64. Moreover, MP recruitment did not correlate with the degree of lymphocytic infiltration in RA. Thus, synovial MPs in RA are rapidly and fully activated with upregulation of activation, differentiation, and functional antigens occurring in situ. There was also no difference in antigenic phenotype of synovial MPs in inflammatory and non-inflammatory OA.
Is the RM- Uncemented Coated Acetabular Cup a Reliable Component in Total Hip Replacement?
Authors: Avai A. , Bombelli M.
Published: May 2019

From August 1987 to the Ist of March 1993 1,477 RM.-isoelastic, uncemented cup components (257 HA, 1,220 Titanium coated) were inserted for T.H.R., matched with the RM- isoelastic and isotitan stem components.

At a 4 year mean follow-up (7-1 years) 1,302 cups were clinically and radiographically assessed; 6.2% of cups could not be controlled, because at follow-up time the patients had died; 5.6% could not be traced.

All the cups were fixed with 3.2 mm peripheral screws (mean number of screws: 6). The cups more than 60 mm in diameter were fixed with 2 additional cancellous (6.5 mm) screws.

The Charnley score is: - 9 - (97.5%) - 8- (2.43%);

1 cup was removed because of infection (0.07%);

3 cups were revised because of malposition and reinserted in proper position.

The results with a similar number of RM.-uncoated cups, fixed with only one or two screws from 1979 to 1985, at a mean 4 year follow-up were: 7% revision and 9% impending loosening. Even bone reaction at the bone-cup interface signifies no osteolisis, neither around the cup nor around the screws. The satisfactory clinical results suggest to proceed with the use of this cup
Extracapsular Hip Fractures Treated with the Titanium Captured Hip Screw System
Authors: Caniggia M. , Maniscalco P. , Picinotti A. , Bocchi L.
Published: May 2019

The Authors discuss their experience with the titanium captured hip screw system for extracapsular fractures.

The present review of the results is based on a case group of 93 patients treated with this method at the Orthopedic and Trauma Clinic of the University of Siena, Italy, from March 1991 to August 1993.
Extruding Synovitis of the Hip in Childhood: A Case Report
Authors: Vavalle G. , Molfetta L. , Capozzi M. , Simone C.
Published: May 2019

The authors describe an unusual case of extrusive synovitis of the hip that they believe is an anatomo-clinical variant of transient synovitis of the infantile hip. Transient synovitis of the hip (TSH) is a benign pathology of the hip with complete healing within a few days after onset of the disease. The case reported distinguishes itself for the expulsive tendency of the femoral head from the acetabular cavity with potential ischemic disturbances due to an increased pressure inside the articular joint causing stretching of the circumflex vessels supplying the femoral head.
The Rationale for CAD-CAM Uncemented Custom Hips: An Interim Assessment
Authors: Hua J. , Walker P.S. , Muirhead-Allwood W. , Bentley G. , McCullough C.J.
Published: May 2019

The purpose of this paper is to examine whether the rationale for CAD-CAM Custom Hips is realised in clinical practice. Previous studies demonstrated that custom uncemented stems, with a close fit proximally and a sliding fit distally, produced stresses closer to normal than for other stem types, which should result in the preservation of proximal bone. Custom stems showed less micromotion, especially in torsional loading, and hence should demonstrate interface osseointegration. The hips are designed and manufactured using specially written software. The standard design includes proximal macro-grooves with HA coating, an anterior flare, a lateral flare, a collar, and a smooth distal stem for a sliding fit. Elective features are added such as proximal stem twist and neck retroversion in CDH, increased stem length to bypass defects, curvatures in AP and ML views, and distal cutting flutes when extra torsional stability is required. From 1989 to 1994, 411 cases were carried out, approximately one-third in each of the categories of OA, JCA/CDH, and revision. Studies were made of the available radiographs at yearly intervals, while DEXA scans were taken of the RNOHT patients pre-operatively, at 6 months and then yearly. There were four failures requiring revision, three of the early primary design without HA coating, and one a revision design. The radiographs in primary hips showed complete proximal bone-implant apposition in 81% of all cases. The DEXA scans showed that the mean bone mass after two years for all seven Gruen zones was greater than 90%. It was concluded that the CAD-CAM HA-coated Custom Hips showed bone and interface stability up to this time. The hip has played a useful role in providing the ideal stem for each particular case, which may result in an improvement of long-term results, compared with the use of off-the-shelf implants.
Avascular Necrosis in Congenital Dislocation of the Hip: Long-Term Results and Proposed new Classification
Authors: Specchiulli F. , Scialpi L. , Solarino G. , Laforgia R.
Published: May 2019

A new classification is proposed for post-reduction necrosis of the femoral epiphysis based on retrospective analysis of 54 cases with a mean follow-up of 15 years. Necrosis can be divided under two main headings:

A) partial, involving only the epiphysis

B) total, involving the metaphyseal cartilage.

Four total forms have been identified:

B1: eventually resulting in coxa valga

B2: eventually resulting in a short stubby neck, oval head and coxa magna

B3: eventually resulting in coxa vara and severe acetabular dysplasia

B4: eventually resulting in hypoplasia of the whole hip joint.

This classification system comprises all the aspects of necrosis, while at the same time providing guidelines for treatment and long-term planning.
Arthroplasty of the Hip. Experiences over more than Thirty Years
Authors: Willert H.G. , Semlitsch M.
Published: May 2019

After a short historical introduction several factors which may in the long run influence the results of joint replacements are listed. Amongst these, the topics fixation and materials are discussed in more detail. By discussion of various experiences of success and failure, the progress and improvements, but also considerable setbacks which have come about in the field of hip replacement are illustrated.
The in vitro Measurement of Bone-Cement Interface Pressures and Shear Strengths in the Femur: A Comparison of two Cementation Methods
Authors: Ward A. J. , Smith E. J. , Barlow J. W. , Powell A. , Halawa M. , Learmonth I. D.
Published: May 2019

Two differing cementation methods were investigated in an in vitro simulation of hip arthroplasty.

The bone-cement interface pressures were recorded during cement injection and stem insertion in matched pairs of fresh cadaveric femora. Reduced viscosity cement injected with a cement gun and proximal seal was compared with injection of high viscosity cement and finger-packing in each pair. The resultant shear strength of the bone-cement interface was measured by push-out tests. Results were analysed using the Wilcoxon ranked sum test for paired samples.

The Exeter method of cementation produced significantly higher mean and maximum pressures above the bleeding pressure of femoral bone at all interface levels during cement injection. This was associated with significantly greater mean shear strengths. The authors conclude that the Exeter pressurization system for cementation overcomes the effect of femoral bone bleeding and improves the quality of the bone-cement interface. This may contribute to reduction in the incidence of loosening in cement hip arthroplasty.
Three-year Results with the Cementless Bicontact total Hip Arthroplasty Femoral Component
Authors: Gusso M.I. , Piso L. , Caddeo B. , Capone A. , Pintus C. , Nicola F.
Published: May 2019

Between 1990 and 1993, 65 consecutive primary total hip arthroplasties were performed using the cementless Bicontact femoral component. Of these, 56 hips in 51 patients were clinically and radiologically reviewed at an average follow-up of 35.4 months (24-53 m). The patients’ mean age was 65.9 years. There were three revision procedures (5.4%) with an average time to failure of 18.2 months. Using the Hospital for Special Surgery hip rating system, 67.9% of the hips were rated excellent, 17.9% as good, 10.7% as fair and 1.8% as poor at final evaluation.

At follow-up four patients (12.5%) had mid-thigh pain and 38 hips (67.9%) were free from any observable limp. Radiolucent lines greater than 2 mm were identified in seven femora (12.5%) and stress shielding was seen in nine (16.1%). Using the fixation scale assessment of Engh the femoral component was classified as fixed by bone ingrowth or stable fibrous fixation in 87.5% of hips. Retrospective analysis of these results showed the efficacy of the Bicontact cementless stem and confirmed the importance of patient's age and femur morpho-cortical index in clinical and radiographic results with the cementless total hip.
Muscular Activity and the Biomechanics of the Hip
Authors: Ling R.S.M. , O'Connor J.J. , Lu Tung-Wu , Lee A.J.C.
Published: May 2019

The interactions between the forces transmitted by the muscles and by the bones are central to the understanding of load transmission in the musculoskeletal system. A reasonable concept of the biomechanics of the hip can only be grasped when the activities of all the major muscle groups acting across the hip and proximal femur are considered.
Boneloc versus Simplex Cement for Fixation of Femoral Components. An Interim Report of a Prospective Randomized Study of THRs with a 2,5 Year Mean Follow-Up Time
Authors: Klyver H. , Jacobsen K , Kofoed H.
Published: May 2019

A prospective randomized study of femoral stem fixation comparing Boneloc and Simplex cements was carried out. A collarless double-tapered femoral component was used in all cases. The material consisted of 94 patients representing 97 THRs (3 bilateral cases). Their mean age was 76 years (range 58-88). Clinico-radiographic follow-ups were carried out after 3 months, 12 months and 2 to 3 years. The mean follow up time was 2.5 years.

Clinically there was no difference between the groups. Radiolucencies at the bone-cement interface and metal-cement interface, cement cracks, and subsidence of the femoral component were compared. No significant differences could be proven between the fixation patterns of the bone cements during this short-term follow-up.
Results of Trochanteric Wire Removal Surgery and Its Relation to Revision Hip Arthroplasty
Authors: Deshmukh S.C. , Murphy J.C.M. , Casserly H.R. , Marcovic L.
Published: May 2019

Local trochanteric symptoms can occur after Total Hip Arthroplasty through any approach but are said to be more common after the transtrochanteric approach. Most of these symptoms subside spontaneously or after a local anaesthetic and steroid injection. Unremitting symptoms can be indicative of persistent trochanteric bursitis, septic loosening or aseptic loosening. In cases of hip arthroplasties performed through a transtrochanteric approach, the trochanteric wires are commonly incriminated as a cause of persistent trochanteric pain. In this retrospective study of 92 patients who underwent trochanteric wire removal surgery, 32 patients (34.78%) had an unsatisfactory result. 24 patients (26.09%) underwent revision surgery at an average of 36.75 months after wire removal surgery. This study suggests that signs of early loosening need to be carefully looked for and ruled out before advising trochanteric wire removal for persistent trochanteric discomfort.
The Mechanical Cement Extractor: An Original Device for Cement Extraction in total Hip Arthroplasty Revision
Authors: Vidalain J.P.
Published: May 2019

A variety of instruments and techniques have been developed to facilitate cement removal in THA revisions. Many of these methods can lead to femoral fractures or uncontrolled cortical perforation, increasing bone damage. The purpose of this brief report is to present a new device that particularly facilitates the extraction of the cement plug from the femoral canal. The basic characteristic of this system is to guide different specific tools, with a high reliability, through the middle of the cement plug. In our experience, this device has always permitted femoral cement extraction without serious complications.
Taonsayontenhroseri:ye’ne: the power of art in Indigenous research with youth
Authors: Whitlow Kawennakon Bonnie , Oliver Vanessa , Anderson Kim , Brozowski Kari , Tschirhart Stephanie , Charles Danielle , Ransom Kaienkwinehtha
Published: May 2019

Through artistic, spiritual, and ceremonial practices, and cultural bridging between Indigenous communities, our project sought to create a social environment that fostered an exchange of cultural traditions, created opportunities for internationalized decolonization, and fostered pride in Indigenous identities. This arts-based research project used and invoked symbols and images from Haudenosaunee culture, making them relevant to young people through graffiti art created by and for young Indigenous people. This article reflects on the ways in which our project relied on art to engage young people in research, but, perhaps more importantly, to communicate complex symbolism, cultural values, Indigenous solidarity, and community healing through artistic expression. Using art as research was an endeavor to aspire to Kayanere’kowa [the Great Law of Peace] by manifesting sken:nen [peace], ka’hsatstenshera [power], and ka’nikonhri:yo [the Good Mind].
Superselective Transcatheter Arterial Embolization in the Treatment of Angiodysplasia
Authors: Leite Túlio Fabiano de Oliveira , Pereira Osvaldo Ignacio
Published: May 2019

Acute nonvariceal upper gastrointestinal hemorrhage is a frequent condition associated with significant morbidity and mortality. Angiodysplasia is a common cause of bleeding in the gastrointestinal tract in the elderly. This case report discusses about a 75-year-old woman clinically stable with melena for 2 years due to arteriovenous fistula of upper mesenteric artery branches without adequate clinical and therapeutic treatment. The goal of this article is to report the safety and efficacy of superselective transcatheter arterial embolization with coils in treating lower gastrointestinal bleeding caused by angiodysplasia that was unresponsive to internal medicine treatment and enteroscopy management.
Imiquimod 5% Cream Versus Cryotherapy in Classic Kaposi Sarcoma
Authors: Odyakmaz Demirsoy Evren , Bayramgürler Dilek , Çağlayan Çiğdem , Bilen Nilgün , Şikar Aktürk Aysun , Kıran Rebiay
Published: May 2019

Background:

Classic Kaposi sarcoma usually remains on the skin and has a slow progression; thus, local treatment methods are preferable. Imiquimod is an immunomodulatory agent with antiviral, antitumoural, and antiangiogenic properties that is expedient against Kaposi sarcoma.

Objectives:

We aimed to clarify whether imiquimod is effective on classic Kaposi sarcoma lesions by comparing imiquimod treatment with cryotherapy, which is the most-used treatment method in our department for this disease.

Method:

Patients with classic Kaposi sarcoma were included. All lesions of each patient were evaluated and measured by the blinded investigator considering infiltration and surface diameters. Then, lesions were categorized into 2 groups by the other investigator (nonblinded), and imiquimod 5% cream was administered 3 times per week without occlusion in 1 group. Cryotherapy was performed every 3 weeks in the other group. All lesions were reevaluated and measured at the end of 12 weeks by the blinded investigator. Initial and last measurements were compared between the treatment methods.

Results:

Fifty lesions of 8 patients were included in this study. Imiquimod and cryotherapy were applied to 26 and 24 lesions, respectively. At the end of the study, statistically significant decreases were detected in all scores between weeks 0 and 12 with both treatment methods. Mean percentages of change in scores were not significantly different between the methods.

Conclusions:

Based on a limited number of patients and lesions treated, we believe imiquimod may be a suitable option to use for the treatment of classic Kaposi sarcoma.