bluuebunny/crossref_metadata_2025 huggingface dataset:
Significantly Increased Odds of Reporting Previous Shoulder Injuries in Female Marines Based on Larger Magnitude Shoulder Rotator Bilateral Strength Differences
Authors: Eagle Shawn R. , Connaboy Chris , Nindl Bradley C. , Allison Katelyn F.
Published: February 2018

Background:

Musculoskeletal injuries to the extremities are a primary concern for the United States (US) military. One possible injury risk factor in this population is side-to-side strength imbalance.

Purpose:

To examine the odds of reporting a previous shoulder injury in US Marine Corps Ground Combat Element Integrated Task Force volunteers based on side-to-side strength differences in isokinetic shoulder strength.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Male (n = 219) and female (n = 91) Marines were included in this analysis. Peak torque values from 5 shoulder internal/external rotation repetitions were averaged and normalized to body weight. The difference in side-to-side strength measurements was calculated as the absolute value of the limb difference divided by the mean peak torque of the dominant limb. Participants were placed into groups based on the magnitude of these differences: <10%, 10% to 20%, and >20%. Odds ratios (ORs) and 95% CIs were calculated.

Results:

When separated by sex, 13.2% of men reported an injury, while 5.5% of women reported an injury. Female Marines with >20% internal rotation side-to-side strength differences demonstrated increased odds of reporting a previous shoulder injury compared with female Marines with <10% strength differences (OR, 15.4; 95% CI, 1.4-167.2; P = .03 ) and female Marines with 10% to 20% strength differences (OR, 13.9; 95% CI, 1.3-151.2; P = .04). No significant ORs were demonstrated in male Marines.

Conclusion:

Marines with larger magnitude internal rotation strength differences demonstrated increased odds of reporting a previous shoulder injury compared with those with lesser magnitude differences. Additionally, female sex appears to drastically affect the increased odds of reporting shoulder injuries (OR, 13.9-15.4) with larger magnitude differences (ie, >20%) compared with those with lesser magnitude differences (ie, <10% and 10%-20%). The retrospective cohort design of this study cannot delineate cause and effect but establishes a relationship between female Marines and greater odds of larger magnitude strength differences after returning from an injury.
Editorial Special Topic: Neuroscience, Learning, and Educational Practice—Challenges, Promises, and Applications
Authors: Jaeggi Susanne M. , Shah Priti
Published: February 2018

There is growing interest in the contributions of neuroscience to educational practice; however, to date, neuroscience seems to have had little impact on education. Nonetheless, neuroscience has potential value for education on several fronts, as illustrated by the articles in this Special Topic. These articles provide excellent examples for how neuroscientific approaches can complement behavioral work, and they demonstrate how understanding the neural level can help researchers develop richer models of learning and development. These articles further show that, ideally, research efforts in neuroscience and education should be reciprocal. Specifically, education should encourage psychology and neuroscience to develop learning theories that are relevant in the real world and further improve our understanding of how specific instructional practices affect learning and achievement; in turn, psychology and neuroscience can provide insights into underlying neural and cognitive mechanisms of learning, with the overall goal to maximize human potential and learning for all.
Classroom Age Composition and Preschoolers’ School Readiness: The Implications of Classroom Quality and Teacher Qualifications
Authors: Purtell Kelly M. , Ansari Arya
Published: February 2018

Recent research has shown that the age composition of preschool classrooms influences children’s early learning. Building on prior research, this study examines whether the association between classroom age composition and children’s learning and development vary based on classroom quality and teacher characteristics using a subset of the Family and Child Experiences Survey (FACES), a nationally representative sample of 3- and 4-year-old children attending Head Start (n = 2,829). Results revealed that the association between age composition and children’s academic skills was dependent on classroom quality and that classroom quality was less predictive of children’s skills in mixed-age classrooms. Teacher education but not experience also moderated the influence of age composition such that mixed-age classrooms taught by a teacher with higher education were not associated with decreased literacy gains among older children.
Using OSF to Share Data: A Step-by-Step Guide
Authors: Soderberg Courtney K.
Published: February 2018

Sharing data, materials, and analysis scripts with reviewers and readers is valued in psychological science. To facilitate this sharing, files should be stored in a stable location, referenced with unique identifiers, and cited in published work associated with them. This Tutorial provides a step-by-step guide to using OSF to meet the needs for sharing psychological data.
Policy and the K–12 Music Teacher: A Literature Review
Authors: Kos Ronald P.
Published: February 2018

Music teaching lies at the intersection of policy, research, and practice. An awareness of policy context and how policies affect teachers is essential for those in the music education profession. In particular, such an understanding can allow teachers to better adapt to and implement policies so that they might maintain and grow their programs and feel more satisfied in their jobs. This review of literature investigates scholarly literature published in music education research journals with implications for teachers’ classroom practice and their professional lives. It includes studies of resources, organizations, and educational reform, teachers and teaching, institutions and actors, and access, in addition to descriptions of policy. Implications for teachers related to policy awareness, access for all students to a variety of musical activities, and music education advocacy are discussed.
Survival is influenced by approaches to local treatment of Ewing sarcoma within an international randomised controlled trial: analysis of EICESS-92
Authors: Whelan Jeremy , Hackshaw Allan , McTiernan Anne , Grimer Robert , Spooner David , Bate Jessica , Ranft Andreas , Paulussen Michael , Juergens Herbert , Craft Alan , Lewis Ian
Published: February 2018

Background

Two national clinical trial groups, United Kingdom Children’s Cancer and Leukaemia Group (CCLG) and the German Paediatric Oncology and Haematology Group (GPOH) together undertook a randomised trial, EICESS-92, which addressed chemotherapy options for Ewing’s sarcoma. We sought the causes of unexpected survival differences between the study groups.

Methods

647 patients were randomised. Cox regression analyses were used to compare event-free survival (EFS) and overall survival (OS) between the two study groups.

Results

5-year EFS rates were 43% (95% CI 36–50%) and 57% (95% CI 52–62) in the CCLG and GPOH patients, respectively; corresponding 5-year OS rates were 52% (95% CI 45–59%) and 66% (95% CI 61–71). CCLG patients were less likely to have both surgery and radiotherapy (18 vs. 59%), and more likely to have a single local therapy modality compared to the GPOH patients (72 vs. 35%). Forty-five percent of GPOH patients had pre-operative radiotherapy compared to 3% of CCLG patients. In the CCLG group local recurrence (either with or without metastases) was the first event in 22% of patients compared with 7% in the GPOH group. After allowing for the effects of age, metastases, primary site, histology and local treatment modality, the risk of an EFS event was 44% greater in the CCLG cohort (95% CI 10–89%, p = 0.009), and the risk of dying was 30% greater, but not statistically significant (95% CI 3–74%, p = 0.08).

Conclusions

Unexpected differences in EFS and OS occurred between two patient cohorts recruited within an international randomised trial. Failure to select or deliver appropriate local treatment modalities for Ewing’s sarcoma may compromise chances of cure.

Trial registration Supported by Deutsche Krebshilfe (Grants No. DKH M43/92/Jü2 and DKH 70-2551 Jü3), and European Union Biomedicine and Health Programme (Grants No. BMH1-CT92-1341 and BMH4-983956), and Cancer Research United Kingdom. Clinical trial information can be found for the following: NCT0000251
Evaluation of food intake in patients with mucopolysaccharidosis
Authors: Monteiro Vaneisse Cristina Lima , Araújo de Oliveira Silva José , Oliveira Renata Bernardes , Frangipani Beatriz Jurkiewicz , Dearo Patrícia Rossetti , Previdelli Ágatha Nogueira , Martins Ana Maria , de Cássia Aquino Rita , D’Almeida Vânia
Published: February 2018

Background

Mucopolysaccharidosis (MPS) are inborn errors of metabolism (IEM) recognized by deficient enzymes enrolled in glycosaminoglycans catabolism. The resulting accumulation of glycosaminoglycans leads to clinical progressive and generalized manifestations. Considering the severity of MPS and the relevance of establishing dietetic strategies to these patients, the present study was tailored to evaluate the food intake in patients with MPS types I, II, and VI.

Methods

Food intake in patients with MPS I, II, and VI was assessed. A descriptive cross-sectional study was conducted. Energetic demand based on estimated necessity of energy equations and reported food intake was analyzed. Total energetic value and nutrients (vitamins B1, B2, C, calcium, iron, and phosphate) were analyzed in accordance with the standardized interval for macronutrient distribution and the method of apparent adequacy for nutrient intake.

Results

Food intake of 17 patients (6- to 30-year-olds) was considered adequate regarding macronutrients. Children and adolescents failed in presenting this parameter. Macronutrients were satisfactory in both groups. Children and adolescents displayed increased intake of iron and vitamins B1 (p < 0.05), B2, B3, and C (p < 0.077) and probability of adequacy ≥ 50%. Calcium and phosphorus intake was greater in adults.

Conclusions

The results obtained demonstrated that patients with MPS have nutrition deficiency in their diet, which may directly or indirectly influence the course of the disease.
Prevalence and Survival Impact of Pretreatment Cancer-Associated Weight Loss: A Tool for Guiding Early Palliative Care
Authors: Gannavarapu Bhavani S. , Lau Steven K.M. , Carter Kristen , Cannon Nathan A. , Gao Ang , Ahn Chul , Meyer Jeffrey J. , Sher David J. , Jatoi Aminah , Infante Rodney , Iyengar Puneeth
Published: February 2018

Purpose:

Cancer-associated weight loss is associated with poor prognosis in advanced malignancy; however, its pretreatment prevalence and survival impact are inadequately described in large cohorts. Such data, stratified by tumor type and stage, may facilitate the optimal and timely allocation of complementary care, leading to improvements in patient survival and quality of life.

Methods:

We performed a retrospective cohort study of 3,180 consecutively treated adult patients with lung or GI (including colorectal, liver, and pancreatic) cancer. Pretreatment cancer-associated weight loss was based on the international consensus definition of cachexia. Prevalence and survival impact of pretreatment cancer-associated weight loss were evaluated using the Kaplan-Meier method and compared using log-rank test.

Results:

Cancer-associated weight loss was observed at the time of cancer diagnosis in 34.1% of patients. Pretreatment weight loss was documented in 17.6%, 25.8%, 36.6%, and 43.3% of stage I, II, III, and IV cancers, respectively. Wasting was common regardless of tumor type, with prevalence at diagnosis ranging from 27.3% in patients with colorectal cancer to 53.4% in patients with gastroesophageal cancer. Pretreatment weight loss was associated with reduced overall survival after adjusting for stage, size, grade, comorbidity, age, sex, and tobacco history (hazard ratio, 1.26; 95% CI, 1.13 to 1.39).

Conclusion:

Pretreatment cancer-associated weight loss is common, even in early-stage disease, and is independently associated with reduced survival. Minimal weight loss represents a clinically distinct entity with an associated overall survival intermediate to that of no weight loss and overt wasting. Early diagnosis and treatment of cancer-associated wasting offers a novel therapeutic avenue for reducing cancer mortality.
Oncologists’ Use of Genomic Sequencing Data to Inform Clinical Management
Authors: Gornick Michele C. , Cobain Erin , Le Lan Q. , Bartnik Natalie , Stoffel Elena , Schuetze Scott , Talpaz Moshe , Chinnaiyan Arul , Roberts J. Scott ,   for the Michigan Oncology Sequencing Study
Published: February 2018

Purpose

To determine whether oncologists intended to change treatment as a result of tumor sequencing, and subsequently, whether patients experienced an alteration of clinical management or derived clinical benefit.

Patients and Methods

A prospective survey of oncologists referring adult patients with rare, advanced, or refractory cancer to the Michigan Oncology Sequencing program was conducted from June 2014 to March 2015 to assess the use of and intent to disclose sequencing findings. Oncologists’ responses were compared with the referred patients’ self-reported survey responses, and a content analysis of disclosure documented in the medical record was performed. Medical records were reviewed retrospectively to determine if clinical management was informed or changed by sequencing results.

Results

Oncologists (response rate, 93%) referring 112 consecutive patients were surveyed. Medical records of patients were reviewed for changes in clinical management on the basis of sequencing findings. Oncologists intended to change the treatment of 22% of patients (n = 24) on the basis of sequencing findings. Of these patients, 37.5% (n = 9) had an actual change in clinical management. Thirty-four patients with postsequencing survey data reported that a results disclosure discussion did not occur, despite documentation of disclosure by the physician in the medical record.

Conclusions

Findings demonstrate that many oncologists view next-generation sequencing results to be potentially valuable in directing subsequent therapy for their patients; however, barriers in communicating results to patients and implementing them in clinical management remain.
Metabolism of the Pacific oyster,Crassostrea gigas, is influenced by salinity and modulates survival to the Ostreid herpesvirus OsHV-1
Authors: Fuhrmann Marine , Delisle Lizenn , Petton Bruno , Corporeau Charlotte , Pernet Fabrice
Published: February 2018

The Pacific oyster, Crassostrea gigas, is an osmoconforming bivalve exposed to wide salinity fluctuations. The physiological mechanisms used by oysters to cope with salinity stress are energy demanding and may impair other processes, such as defense against pathogens. This oyster species has been experiencing recurrent mortality events caused by the Ostreid herpesvirus 1 (OsHV-1). The objectives of this study were to investigate the effect of salinity (10, 15, 25 and 35‰) on energetic reserves, key enzyme activities and membrane fatty acids, and to identify the metabolic risk factors related to OsHV-1-induced mortality of oysters. Acclimation to low salinity led to increased water content, protein level, and energetic reserves (carbohydrates and triglycerides) of oysters. The latter was consistent with lower activity of hexokinase, the first enzyme involved in glycolysis, up-regulation of AMP-activated protein kinase, a major regulator of cellular energy metabolism, and lower activity of catalase, an antioxidant enzyme involved in management of reactive oxygen species. Acclimation to salinity also involved a major remodeling of membrane fatty acids. Particularly, 20:4n-6 decreased linearly with decreasing salinity, likely reflecting its mobilization for prostaglandin synthesis in oysters. The survival of oysters exposed to OsHV-1 varied from 43% to 96% according to salinity (Fuhrmann et al., 2016). Risk analyses showed that activity of superoxide dismutase and levels of proteins, carbohydrates, and triglycerides were associated with a reduced risk of death. Therefore, animals with a higher antioxidant activity and a better physiological condition seemed less susceptible to OsHV-1.
Ecdysone signaling regulates specification of neurons with a male-specific neurite inDrosophila
Authors: Zhang Binglong , Sato Kosei , Yamamoto Daisuke
Published: February 2018

Some mAL neurons in the male brain form the ipsilateral neurite (ILN[+]) in a manner dependent on FruBM, a male-specific transcription factor. FruBM represses robo1 transcription, allowing the ILN to form. We found that the proportion of ILN[+]-mALs in all observed single cell clones dropped from ∼90% to ∼30% by changing the heat-shock timing for clone induction from 4-5 days after egg laying (AEL) to 6-7 days AEL, suggesting that the ILN[+]-mALs are produced predominantly by young neuroblasts. Upon EcR-A knockdown, ILN[+]-mALs were produced at a high rate (∼60%), even when heat shocked at 6-7 days AEL, yet EcR-B1 knockdown reduced the proportion of ILN[+]-mALs to ∼30%. Immunoprecipitation assays in S2 cells demonstrated that EcR-A and EcR-B1 form a complex with FruBM. robo1 reporter transcription was repressed by FruBM and ecdysone counteracted FruBM. We suggest that ecdysone signaling modulates the FruBM action to produce an appropriate number of male-type neurons.
Sustained exercise-trained juvenile black carp (Mylopharyngodon piceus) at a moderate water velocity exhibit improved aerobic swimming performance and increased postprandial metabolic responses
Authors: Li Xiuming , Zhang Yaoguang , Li Xiaojin , Zheng Hua , Peng Jianglan , Fu Shijian
Published: February 2018

The objectives of this study were to examine whether sustained exercise training at four water velocities, i.e. nearly still water (control), 1 body length (BL) s−1, 2 BL s−1 and 4 BL s−1, has effects on swimming performance and digestive metabolism in juvenile black carp (Mylopharyngodon piceus). The results demonstrated that fish subjected to sustained training at 2 and 4 BL s−1 showed significantly higher critical swimming speed (Ucrit) and maximum metabolic rate (MMR) over the control group. Fish subjected to sustained training at 1 and 2 BL s−1 showed a significantly (30 and 54%) prolonged duration, 14 and 17% higher postprandial ṀO2 increment (i.e. ṀO2peak), and 62 and 92% more energy expended on specific dynamic action (SDA), respectively, after consuming a similar meal over fish kept in nearly still water. These results suggest that (1) sustained exercise training at a higher speed (2 or 4 BL s−1) had a positive influence on the aerobic swimming performance of juvenile M. piceus, which may be associated with improved aerobic metabolism; and (2) sustained exercise training at a lower speed (1 or 2 BL s−1) resulted in elevated postprandial metabolic responses in juvenile M. piceus.
Fitness consequences of plasticity in an extended phenotype
Authors: Blamires Sean J. , Martens Penny J. , Kasumovic Michael M.
Published: February 2018

Like regular phenotypes, extended phenotypes have demonstrable fitness advantages and their properties may vary plastically across environments. However, the fitness advantages of plasticity are only known for a select few extended phenotypes. It is known that the form and functions of spider orb webs can be manipulated by laboratory experiments. For instance, the physical and chemical properties of the spiral and gluey silks vary in property as protein intake varies. Orb web spiders thus represent good models for extended phenotypic plasticity studies. We performed experiments manipulating the protein intake of two vertically aligned orb web building spiders to determine whether variations in the chemical and physical properties of their spiral and gluey silk affect prey retention in their webs. We found in both spider species that individuals deprived of protein had a greater gluey silk glycoprotein core volume, and this correlated strongly with spiral thread stickiness and increased prey retention by the webs. Moreover, we found strong positive correlations between glue droplet volume and glycoprotein core volume for spiders in the protein deprived treatment, but weaker correlations for protein fed spiders. We interpreted these findings as the spiders investing more in glycoprotein when nutrient deprived. We attribute the associated increase in prey retention capacity as a fitness consequence of plasticity in the spiral properties.
Knowledge discovery for Deep Phenotyping serious mental illness from Electronic Mental Health records
Authors: Jackson Richard , Patel Rashmi , Velupillai Sumithra , Gkotsis George , Hoyle David , Stewart Robert
Published: February 2018

Background: Deep Phenotyping is the precise and comprehensive analysis of phenotypic features, where the individual components of the phenotype are observed and described. In UK mental health clinical practice, most clinically relevant information is recorded as free text in the Electronic Health Record, and offers a granularity of information beyond that expressed in most medical knowledge bases. The SNOMED CT nomenclature potentially offers the means to model such information at scale, yet given a sufficiently large body of clinical text collected over many years, it’s difficult to identify the language that clinicians favour to express concepts.

Methods: Vector space models of language seek to represent the relationship between words in a corpus in terms of cosine distance between a series of vectors. When utilising a large corpus of healthcare data and combined with appropriate clustering techniques and manual curation, we explore how such models can be used for discovering vocabulary relevant to the task of phenotyping Serious Mental Illness (SMI) with only a small amount of prior knowledge.

Results: 20 403 n-grams were derived and curated via a two stage methodology. The list was reduced to 557 putative concepts based on eliminating redundant information content. These were then organised into 9 distinct categories pertaining to different aspects of psychiatric assessment. 235 (42%) concepts were found to be depictions of putative clinical significance. Of these, 53 (10%) were identified having novel synonymy with existing SNOMED CT concepts. 106 (19%) had no mapping to SNOMED CT.

Conclusions: We demonstrate a scalable approach to discovering new depictions of SMI symptomatology based on real world clinical observation. Such approaches may offer the opportunity to consider broader manifestations of SMI symptomatology than is typically assessed via current diagnostic frameworks, and create the potential for enhancing nomenclatures such as SNOMED CT based on real world depictions.
DISLOCATION AND FRACTURE-DISLOCATION OF THE PELVIS
Authors: Holdsworth F. W.
Published: February 2018

1. Fifty dislocations and fracture-dislocations of the pelvis have been reviewed.

2. Complications were unusual. Two patients with rupture of the bladder died; two with rupture of the urethra survived. Of eight patients with retroperitoneal haemorrhage four died; the treatment advised is controlled blood transfusion maintaining a blood-pressure of not more than 100 mm.

3. Two types of pelvic disruption should be distinguished: 1) pubic injury with sacro-iliac dislocation; 2) pubic injury with fracture near the sacro-iliac joint. The first is twice as common as the second.

4. In each type, displacement is maintained by extension of the hip and outward roll of the limb. This may be controlled by the Watson-Jones plaster method but the pelvic sling technique is preferred and was used in all cases in this series.

5. The prognosis in fracture-dislocations is very good; nearly all patients went back to heavy work.

6. The prognosis in sacro-iliac dislocations is not so good; only half the patients went back to heavy work and there was often persistent sacro-iliac pain. Sacro-iliac arthrodesis is advised in those cases.
THE CONSERVATIVE TREATMENT OF SCIATIC PAIN BY IMMOBILISATION IN A PLASTER JACKET
Authors: Durbin F. C.
Published: February 2018

1. Between 1936 and 1945, 525 patients with sciatic pain were treated at the Princess Elizabeth Orthopaedic Hospital, Exeter. Of these, 225 had neurological signs and they were selected for review; 147 were traced.

2. Of these, 123 were treated by means of plaster jackets and twenty-four were treated by other methods. The late results of treatment in the two groups were about the same, roughly one-third being "cured," one-third "relieved," and one-third "not relieved."

3. Nevertheless examination of the immediate results suggests that protection by means of a plaster jacket had at least a palliative effect, relieving acute symptoms and allowing early rehabilitation. Moreover it should be emphasised that in limiting the investigation to cases of sciatica with evidence of nerve root pressure only the more severe cases have been included.

4. Permanent relief after immobilisation in plaster was greatest when the duration of symptoms was short, and when the patient was treated during his first attack. It was least in patients who showed all three signs of nerve root pressureâdiminished ankle jerks, hypo-aesthesia, and muscle hypotonicity.

5. Absence of tendon reflexes due to nerve root pressure, and areas of hypo-aesthesia, tend to remain permanently; but diminution of reflexes and loss of muscle power may recover.
BONE LENGTHENING
Authors: Allan F. G.
Published: February 2018

1. Two inches of lengthening may be gained in the femur, and three inches in the tibia and fibula, without complication.

2. More than this may be secured at the risk of temporary external popliteal paresis.

3. Lengthening of the tibia and fibula is more certain and more easy to control than lengthening of the femur.

4. Traction, and counter-traction through the bone, with complete lateral rigidity, are essential to success.

5. In applying this technique to the femur there is a danger of knee stiffness. The farther from the knee the skeletal traction pins are inserted, the less is the risk. The operation should therefore be planned as high as possible in the shaft of the femur.

6. The most delicate structure, and the one least tolerant of stretching, is the external popliteal nerve.

7. An oblique osteotomy, started by closely spaced drill-holes, is the best.

8. Certain vascular complications experienced by other surgeons are attributable to subperiosteal bone exposure, and to dividing the periosteum and fascial structures transversely.
ARTHRODESIS OF THE ANKLE JOINT
Authors: Adams J. Crawford
Published: February 2018

The technique of the transfibular approach for arthrodesis of the ankle joint is described. The results of this operation in a series of thirty cases shows that the procedure is reliable if the technique is carried out faithfully. The two cases in which a first operation failed can both be explained by errors of technique or after-treatment.
SPINAL EXTRADURAL CYSTS
Authors: Du Toit J. G. , Fainsinger M. H.
Published: February 2018

1. Two types of spinal extradural cyst are discussed: 1) the type which occurs in adolescents in the dorsal spine with evidence of kyphosis juvenilis; 2) the type which occurs in adults in the dorso-lumbar spine without kyphosis.

2. A fifth case of dorso-lumbar spinal extradural cyst in the adult without deformity is reported. Cysts in this region present common features distinguishing them from the more frequent type which occurs in adolescents.

3. The relationship between spinal extradural cysts, venous drainage of vertebral bodies, and spinal deformity, is discussed.
DENERVATION OF THE ELBOW JOINT FOR THE RELIEF OF PAIN
Authors: Bateman James E.
Published: February 2018

1. A method of denervating the elbow joint, based upon observations on the articular branches of the main nerve trunks, is presented.

2. In a small group of cases with post-traumatic arthritis and osteoarthritis, relief of pain and restoration of painless movement has been gained.

3. There was recurrence of pain after six months in one patient with acute rheumatoid arthritis; in such cases denervation is not recommended until further study is completed.

4. Denervation must be as complete as possible and full exposure with stripping of nerve trunks is recommended. There have been no complications.

5. The results in this small series of cases are encouraging, but patients should be warned that there will be no significant increase in the range of movement, and that a normal joint is not to be expected.

6. Articular neurectomy is still on trial. If the limitations are recognised, the procedure may have a useful place in the relief of pain in the elbow joint.
POSTERIOR DISLOCATION OF THE SHOULDER JOINT
Authors: Warrick C. K.
Published: February 2018

Posterior dislocation of the shoulder is an unusual injury and there is often much delay before the diagnosis is made. Nevertheless, if the condition is borne in mind when examining the patient and studying the X-ray films the diagnosis should not be missed. A single antero-posterior radiograph of the shoulder joint is inadequate. For the radiologist a pair of stereoscopic films is desirable; but for routine emergency work in hospital other projections are necessary. A vertical view should be taken, either with the limb abducted and the tube in the axilla, or with the tube above the shoulder and a curved cassette in the axilla. When this is impossible a profile or posterior oblique view of the scapula may be substituted.
HORIZONTAL APPROACH TO THE MEDIAL SEMILUNAR CARTILAGE
Authors: Charnley John
Published: February 2018

1. It is suggested that slow recovery and post-operative effusion after meniscectomy may often be due to "scar friction" when the incision in the synovial membrane is in contact with the non-articular surface of the femoral condyle.

2. The advantages of a horizontal incision are discussed, particularly with regard to early recovery.

3. The results of one hundred and three cases of meniscectomy are analysed. An attempt to trace the cause of incompletely successful results in 25 per cent. of cases failed to show any relation to minor coincident lesions discovered at operation, or to the amount of meniscus removed.
CERVICAL PLEXUS INJURIES
Authors: Kerr A. Sutcliffe
Published: February 2018

Two cases are described in which a traction lesion of the brachial plexus was complicated by sensory loss and anhidrosis in the second, third, and fourth cervical dermatomes. Both patients recovered spontaneously, though in one the recovery of muscle power in the limb was incomplete. It is believed that both were examples of a traction lesion of the cervical plexus. No similar case appears to have been recorded.
ARTHROPLASTY OF THE KNEE
Authors: Speed J. S. , Trout Philip C.
Published: February 2018

1. Arthroplasty of the knee joint should be performed only in carefully selected cases. Criteria for the operation are outlined.

2. In our experience, 70 per cent. of properly selected patients secure good or fair results. An additional 12 per cent., whose anatomical or functional results were classified as poor, preferred the movement which had been gained to ankylosis of the joint.

3. The major functional adaptation of the knee joint takes place during the first five years after arthroplasty. Several patients who had a poor range of movement after one or two years developed an excellent range by the end of five years.

4. Instability, when present, usually became apparent within the first five years.

5. Joints which were still stable at the end of five years usually remained so over a long period of time. Four patients have been traced for twenty to twenty-five years, and three have been traced for over twenty-five years.

6. Since the incidence of ankylosis of the knee joint from gonococcal and pyogenic infections has been reduced by the use of antibiotics, fewer patients are suitable subjects for arthroplasty.
PREMATURE EPIPHYSIAL FUSION AT THE KNEE JOINT IN TUBERCULOUS DISEASE OF THE HIP
Authors: Parke W. , Colvin G. S. , Almond A. H. G.
Published: February 2018

1. In tuberculous disease of the hip, premature epiphysial fusion at the knee joint is due to rupture of the epiphysial cartilaginous plates consequent upon resorption of cancellous support and suppression of osteogenesis.

2. In the tibia, premature fusion is usually preceded by near-central "bulging" of the metaphysial and tibial marrow through the epiphysial plate. In the femur, epiphysial changes preceding fusion are of a fragmentary type.

3. Injury, in quiescent disease, plays little or no part in the causation of premature epiphysial fusion.

4. The factors which are responsible for these changesâlocal toxaemia and prolonged immobilisationâmust exist for not less than two years.

5. In cases which are treated conservatively for long periods the incidence of premature fusion, with serious shortening of the limb, is so high that the wisdom of such treatment must be reconsidered.
ISCHIO-FEMORAL ARTHRODESIS OF THE HIP BY POSTERIOR OPEN APPROACH
Authors: Foley W. B.
Published: February 2018

1. An operation is described for ischio-femoral extra-articular arthrodesis of the hip joint by posterior open approach, based on the techniques of Trumble and Brittain.

2. The operation has the advantages of affording adequate exposure of the sciatic nerve trunk and permitting visual control of the alignment and penetration of the chisel and graft.

3. The operation has been performed successfully without serious shock or subsequent complications in eighteen cases, mostly of tuberculosis of the hip.
EXCISION OF THE ACROMION IN TREATMENT OF THE SUPRASPINATUS SYNDROME
Authors: Armstrong J. R.
Published: February 2018

1. The supraspinatus group of lesions constitutes one of the two common causes of the painful shoulder.

2. Most, but not all, of these lesions resolve either spontaneously or after conservative treatment.

3. When conservative treatment fails symptoms can be relieved by excision of the acromion process, provided that sufficient bone is removed to relieve all pressure on the tendon throughout a full range of shoulder movement.

4. Excision of the acromion is contra-indicated if there is doubt as to the diagnosis or if there is true limitation of shoulder movement.
INTER-CARPAL DISLOCATIONS AND FRACTURE-DISLOCATIONS
Authors: Russell T. B.
Published: February 2018

1. Fifty-nine patients with various inter-carpal dislocations have been reviewed.

2. In this series trans-scapho-perilunar fracture-dislocation was the commonest injury. Early cases can be reduced by closed manipulation but in late cases operative reduction is usually advisable. When the injury is more than three months old, arthrodesis of the wrist joint is indicated.

3. When trans-scapho-perilunar fracture-dislocation was complicated by avascular necrosis of the proximal scaphoid fragment, the results in a small series treated by early excision were approximately equal to those treated by continued immobilisation. The results of grafting the scaphoid were poor.

4. Dislocations of the lunate seen within ten days of injury could usually be reduced with good results; no such case developed KienboÌck's disease within the period of review. In late cases excision gave satisfactory results.

5. Forward dislocation of the lunate with half the scaphoid gave good results when manual reduction succeeded, but the results of excision of fragments were less satisfactory.

6. There was one case of forward dislocation of the lunate together with the distal half of the scaphoid.

7. Subluxation of the scaphoid is disclose in antero-posterior radiographs by a typical gap between it and the lunate bone. The subluxation may become recurrent and present a characteristic syndrome.

8. Other rare dislocations of the carpal bones are described.
EXCISION OF THE TRAPEZIUM FOR OSTEOARTHRITIS OF THE TRAPEZIO-METACARPAL JOINT
Authors: Gervis W. Harvey
Published: February 2018

1. The technique of excision of the trapezium for osteoarthritis of the trapezio-metacarpal joint is described.

2. The results of eighteen operations in fifteen patients are analysed.

3. The operation is of value particularly when the arthritis is monarticular. Results have been less satisfactory when the affection of the joint is part of a generalised arthritis.
A CONGENITAL ABNORMALITY OF THE TRAPEZIUM AND FIRST METACARPAL BONE
Authors: Rushforth A. F.
Published: February 2018

A bilateral congenital abnormality of the trapezium and first metacarpal is described. The condition may be related to abnormal ossification of the trapezium in accordance with Pfitzner's plan. It is quite distinct from osteoarthritis of the trapezio-metacarpal joints.
NEONATAL SCIATIC PALSY
Authors: Fahrni W. H.
Published: February 2018

1. It is possible that neonatal sciatic palsy occurs more often than is suggested by perusal of the literature: paralysis of a foot may easily be overlooked in the new-born infant; it may be regarded as a temporary paresis due to mild birth trauma; or in later months it may be attributed to poliomyelitis.

2. Eleven cases of neonatal sciatic palsy are reported. Autopsy in one suggested that the paralysis was due to direct pressure on the sciatic nerve before birth.

3. A hypothesis is advanced by which to explain how pressure on the nerve trunk may arise in utero.
THE POPLITEUS MUSCLE AND THE LATERAL MENISCUS
Authors: Last R. J.
Published: February 2018

1. The movements of flexion and extension at the knee joint take place above the menisci; the movements of rotation take place below the menisci.

2. The popliteus muscle consists of two halves, one being attached by tendon to the femur, the other by aponeurosis to the lateral meniscus. The action of the muscle is to rotate the knee and retract the posterior arch of the lateral meniscus. The flexing action of the muscle is quite negligible.

3. The effects of rotation of the knee joint on the two menisci are dissimilar. The medial meniscus is distorted during rotation; its horns move with the tibia, but the intervening arch moves with the femur, and the distortion renders it liable to injury during rotation. The lateral meniscus does not become distorted during rotation; it follows the lateral condyle of the femur by reason of the attachments of the ligaments of Humphry and Wrisberg and the popliteus muscle. It is thus relatively immune from injury daring rotation.
OPEN OPERATION FOR CONGENITAL DISLOCATION OF THE HIP
Authors: Platou Eivind
Published: February 2018

1. The indications for open reduction in congenital dislocation of the hip are discussed.

2. The technique of the operation and the post-operative treatment are briefly described.

3. The results of the operation in fifty hips are presented.

4. The function and the radiographic appearances of the hip were usually good in the early years after open reduction, but there was a marked tendency to deterioration ten to thirteen years afterwards.

5. The indications for the shelf operation and for rotation osteotomy after open reduction are discussed.
JOINT DEBRIDEMENT FOR OSTEOARTHRITIS OF THE KNEE
Authors: Isserlin Bruno
Published: February 2018

Joint deÌbridement, by excision of synovial membrane, osteophytes, degenerate cartilage, loose bodies, and frequently the patella, has relieved the symptoms of osteoarthritis of the knee joint twenty-three times in a series of thirty-five operations reviewed after periods of one to nine years. The operation is considered a useful measure when symptoms resist conservative treatment.
PROGNOSIS IN TUBERCULOSIS OF THE HIP
Authors: DoBson J.
Published: February 2018

1. Three hundred and twenty cases of tuberculosis of the hip joint have been analysed and the late results assessed three or more years after discharge from hospital.

2. The primary bone focus involved the acetabulum alone in 39Â·3 per cent; the acetabulum and femoral head in 34Â·1 per cent; the head of femur alone in 19Â·2 per cent, and the femoral neck alone in 7Â·4 per cent. In 101 cases widespread destruction of the joint had taken place by the time the patient first came under observation.

3. Premature epiphysial fusion round the knee joint of the affected side occurred in 23 per cent of all patients under the age of fifteen years.

4. When hip disease was complicated by multiple foci of active tuberculosis or by secondarily infected abscesses and sinuses, the prognosis was seriously worsened.

5. Significant late deformity occurred in 38Â·3 per cent of patients discharged with "sound" fibrous ankylosis, and in 60Â·5 per cent of those with an unstable fibrous ankylosis.

6. Of 187 patients observed for more than three years after discharge from hospital 174 returned to full activity, seven were partly incapacitated and six were totally incapacitated.

7. Analysis of the late results suggests that the prognosis is best when an adequate period of conservative treatment is followed by some form of arthrodesis operation.
CONGENITAL FUSION OF THE LUNATE AND TRIQUETRAL BONES IN THE SOUTH AFRICAN BANTU
Authors: Minnaar A. B. DeVilliers
Published: February 2018

Twelve cases of congenital fusion of the lunate and triquetral bones have been found in South African Bantu patients. The fusion occurs in four types, an incomplete "pseudarthrosis," bony fusion with a dividing notch at one or both surfaces, or as a complete compound bone with or without other carpal anomalies.

The suggestion favoured is that this fusion represents the persistence of a primitive characteristic in African (negro) peoples.
CHANGES IN THE FEMORAL NECK IN CONTACT WITH AN ACRYLIC PROSTHESIS
Authors: Laing P. Gowans , Ross H. Douglas
Published: February 2018

A Judet-type arthroplasty of the hip was performed. The patient died fourteen days after the operation. The upper end of the femur was examined and showed extensive necrosis surrounding the stem of the prosthesis.
ON THE FORM AND STRUCTURE OF MUSCLES
Authors: Last R. J.
Published: February 2018

There are a host of other muscles in both upper and lower limbs whose form and structure will repay careful study. Study of a macerated bone can at most teach one the precise bony attachment of a muscle. It tells nothing of other non-osseous attachments, nothing of the form of the living muscle that gives shape to the limb, and nothing of the surface structure of the muscles, knowledge of which can be used not only to recognise them at operation but to understand their normal function in relation to neighbouring parts.
NAVICULO-CUNEIFORM FUSION IN THE TREATMENT OF FLAT FOOT
Authors: Jack Ewen A.
Published: February 2018

1. Radiological investigation of cases of flat foot shows that they form three distinct anatomical types according to the precise level of the break in the arch.

2. When the break occurs at the naviculo-cuneiform joint alone, fusion of this joint in normal alignment should correct the deformity.

3. The results of operation on forty-six feet are analysed. Eighty-two per cent proved satisfactory. Failures are discussed and are considered avoidable by careful selection and operative technique.
A SIGN OF SCIATIC NERVE ROOT PRESSURE
Authors: Cram R. H.
Published: February 2018

Experiments have shown that the tension of the sciatic nerve roots is increased when the posterior tibial nerve is pressed upon in the popliteal space. A refinement of the straight leg raising test, based on this observation, is described.
BILATERAL GLENOID HYPOPLASIA
Authors: Owen R.
Published: February 2018

1. Five cases of bilateral glenoid hypoplasia are described. Flattening of the humeral heads and sometimes other skeletal abnormalities coexisted.

2. The condition is considered to be congenital.

3. The differential diagnosis and etiology are discussed.
THE MOVEMENTS OF BONES AND JOINTS
Authors: MacConaill M. A.
Published: February 2018

1. The dynamics of synovial joints depends upon the geometry of the articular surfaces, which are always curved.

2. There are two types of articular curvature: ovoid (synclastic) and sellar (anticlastic).

3. The sellar type is mechanically more suited to movements in which sliding is combined with medial or lateral rotation (monodal conjunct rotation).

4. The movement of any hinge-joint is accompanied by a monodal conjunct rotation. This carries the moving part along a path that approximates (at least) to a path of minimal wear. The same is true of the paths of habitual effort-movement (ergodes) of other kinds of joint.

5. Evidence for the foregoing statements is drawn from both normal and abnormal joints, and a clinical application is suggested.
OSTEOARTHRITIS OF THE HIP: A STUDY OF THE NATURE AND EVOLUTION OF THE DISEASE
Authors: Harrison M. H. M. , Schajowicz F. , Trueta J.
Published: February 2018

Osteoarthritis, as seen in the hip, is a disease which eventually embraces all the tissues of the joint but begins as a reaction of the juxta-chondral blood vessels to a degeneration of the articular cartilage; this reaction results in a hyperaemia of the bone. To our surprise we found that daily use preserves rather than "wears out" articular cartilage; indeed inadequate use is the commonest cause of cartilage degeneration and ensuing vascular invasion. To this factor are added the effects of excessive pressure in the many patients who require surgical treatment for advanced osteoarthritis of a hip the seat of some anatomical incongruity. This etiology based on cartilage suffering does not exclude, but indeed explains, the osteoarthritis implanted on joints of a normal shape which have been previously affected by acute or chronic inflammation or by hormonal dysfunction, such as acromegalic osteoarthritis. The stimulus to vessel growth and invasion is the same in all these casesânamely cartilage damage. Once the vessels have entered the cartilage the bone and marrow of the osteophyte are inevitably laid down. What is so damaging in osteoarthritis seems to be not the degeneration of the cartilage but the vigorous and persistent attempt at repair, an attempt which aggravates the already disordered function of the joint not only by osteophyte formation but by the hypervascularity which weakens the structure of the bone beyond the point where it can carry its increased load. The collapse that follows provokes further reparative efforts with the same deplorable results. The osteoarthritic process thus appears to be an attempt to transform a decaying joint into a youthful one and for this, as in the miraculous rejuvenation depicted in Goethe's Faust, a high price must ultimately be paid.
HYPEREXTENSION INJURY OF THE NECK WITH PARAPLEGIA
Authors: Berkin C. R. , Hirson Cedric
Published: February 2018

1. The clinical and post-mortem findings are described of a patient who sustained a hyperextension injury of the neck with paraplegia.

2. There was no radiological evidence of fracture: osteoarthritis of the spine was present.

3. Evidence is presented that the cord was damaged from behind by the lamina of the vertebra below a tear in the anterior longitudinal ligament.
COMPLETE DISLOCATION OF THE ACROMIO-CLAVICULAR JOINT
Authors: Kennedy John C. , Cameron Howard
Published: February 2018

1. Screw fixation of clavicle to coracoid process, with subsequent calcification and ossification along the conoid and trapezoid ligaments, creates an extra-articular fusion of the acromio-clavicular joint.

2. Though the follow-up is admittedly early, excellent results can be obtained in the young healthy adult. It is possible to return an athlete to competitive sports and a heavy labourer to full work in a surprisingly short time.

3. The operation is of doubtful value in older patients.

4. A precise operative technique is most important in producing a successful result.

5. Screw fixation introduces a new movement into the abduction mechanism of the shoulder: synchronous scapulo-clavicular rotation.
ARTHROPLASTY OF THE HIP
Authors: Devas M. B.
Published: February 2018

All the cup and replacement arthroplasties of the hip at the Middlesex Hospital performed two or more years agoâ110 casesâhave been reviewed. Cup arthroplasty was the more successful.