bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteotomy reconstruction surgery for Pilon fracture malunion
Authors: Shi Zhongmin
Published: September 2017

Category:

Ankle Arthritis, Trauma

Introduction/Purpose:

To evaluate the clinical outeonles of distal tibial osteotomy and alignment reconstruction for Pilon fracture malunion.

Methods:

Between January 2010 and May 2012, 15 cases of Pilon fracture malunion were treated with super-malleolar extra- articular or intra-articular osteotomy and alignment reconstruction.They were 12 males and 3 females with an average age of 30.8 years.The pre-operative X-ray and CT scan showed varus deformity in 9 cases and valgus in 6.All the patients complained about ankle pain, deformity, limited range of motion and walking difficulty.

Results:

13 cases obtained an average final follow-up of 23.8 months.The average VAS score declined significantly from 5.1±3.2 preoperatively to 1.4±0.8 postoperatively (P<0.05).A complete pain relief was achieved in 8 cases.The AOFAS ankle and hindfoot score, SF-36 score, ankle ROM at the last follow-up were improved significantly compared with the pre-operative ones (P<0.05).No implant failure, soft tissue complications occurred during the follow-up.

Conclusion:

Distal tibial osteotomy and alignment reconstruction is an effective treatment of Pilon fracture malunion, because this strategy can restore the lower limb alignment, relieve pain and decrease the rate of long-term post-traumatic arthritis.
Comparison of Clinical Outcomes after Modified Broström Procedure with or without Calcaneofibular Ligament Repair for Chronic Lateral Ankle Instability
Authors: Sung Ki Sun , Yim Hyun Seok
Published: September 2017

Category:

Sports

Introduction/Purpose:

Modified Brostrom procedure has been the choice of treatment for chronic lateral ankle instability(LAI). However, there is a controversy about the necessity for repair of calcaneofibular ligament(CFL). Thus, we designed a prospective randomized control study to investigate if there is any difference according to calcaneofibular repair.

Methods:

Between June 2012 and September 2015, 48 patients with chronic LAI were enrolled in this study after our IRB(file No. 2012-02-046-035) approved it. They were divided into two groups(24 for each) by a random manner. Inclusion criteria are as following: age of 20 to 60 and chronic mechanical LAI who had failed in conservative treatment for more than 6 months. Patients with inflammatory diseases and history of previous surgery for the same ankle were excluded. Modified Brostrom procedure was done for the patients with informed consent. For group A we repaired both ATFL and CFL, and for group B only ATFL was repaied. Postoperative rehabilitation protocol was the same after 2 week period of immobilization. For clinical and functional outcome, Karlsson-Petersson score was measured pre and post operatively. Stress radiographs were checked to evaluate objective stability. Isokinetic strength test was also recorded.

Results:

There was no difference in age, gender, BMI, and the number of combined intraarticular pathology between two groups. Forty three patients(22 in group A, 21 in group B) were followed up for more than 1 year after the index surgery. Karlsson score was improved from 55.8(17-80) to 78.4(32-100) in group A, from 56.4(37-82) to 83.6(49-100) without any statiscal difference between 2 groups. Anterior drawer and talar tilt in stress radiographs showed a significant improvement in both groups still without any difference between 2 groups. Similar result was found in isokinetic strength test.

Conclusion:

There was no clinical, radiographical and physical difference regardless of CFL repair in modified Brostrom procedure for chronic LAI. However, we cannot conclude that CFL repair is not necessary for chronic LAI. Further studies of high level of evidences with more patients and longer term follow-up are mandatory.
4-5 Year Results Following AMIC Procedure with Collagen Matrix in Cartilage Reconstruction of the Talus
Authors: Thermann Hajo
Published: September 2017

Category:

Ankle, Arthroscopy

Introduction/Purpose:

In recent years, the autologous matrix-induced chondrogenesis (AMIC) has established itself in the treatment of cartilage defects of the talus. In this prospective study, the 4-5 year results following arthroscopic AMIC technique at the Talus will be presented.

Methods:

97 patients has been treated with this method from August 2009 until September. 48 patients (26 F, 22 M) with a mean age of 36.5 ± 3.9 years (15-69) and a BMI of 24.8 ± 3.9 (19.1 to 39.6) met the inclusion criteria. The Hannover scoring system (HSS) and VAS score for pain, function and satisfaction at baseline and 1 year (FU1), 2 years (FU2) and 4.4 years (FU3) postoperatively have been evaluated. Following arthroscopic exploration to control the inclusion criteria, the cartilage defect was debrided thoroughly. Subsequently, microfracturing has been performed with a special swan neck awls and then PRP was injected over the subchondral plate. Afterwards, covering of the defect area was carried out with the collagen matrix (AMIC) which was impregnated with PRP, which was then fixed with fibrin glue.

Results:

The HSS improved from 55.6 ± 12.18 baseline to 82.3 FU1 ± 15.64 (p <0.05 compared to baseline.), FU2 88.8 ± 7,43 (p <0,05 see to baseline) and FU3 89.7 ± 8.3 (p <0.05 compared to baseline) with a significant improvement over the entire period of p = 0.008. VAS for pain was 4 ± 2.74 at the Baseline and improved at FU1 to 7.8 ± 2.73 (p <0.05, compared to baseline.), FU2 8.9 ± 1.01 (p <0.05) and FU3 9.3 ± 1.26 (p <0.05) with a significant improvement over the entire period of p = 0.001. Similar results were observed in the VAS scores for function and satisfaction. There were no infections or surgical complications.

Conclusion:

The arthroscopic AMIC procedure also shows good mid-term results in treatment of cartilage defects of the talus. It is a promising and safe procedure in the cartilage therapy with a low complication rate through an arthroscopic surgery.
Shortening of first metatarsalia after ReveL procedure depends on the osteotomy angle
Authors: Viehöfer Arnd , Wirth Stephan , Waibel Felix , Fürnstahl Philipp
Published: September 2017

Category:

Midfoot/Forefoot

Introduction/Purpose:

Recent studies have shown that Hallux valgus deformity can lead to transfermetatarsalgia due to an impairment and relative shortening of the first ray. During ReveL osteotomy the relative shortening of the MT I is not addressed. Furthermore, a posterior deviation of the osteotomy angle results in additional iatrogenic shortening of the MT I and might favor postoperative transfermetatarsalgia.

Methods:

A 3-dimensional model of a foot was obtained from CT scans of a cadaveric foot. The MT I of the 3-dimensional model was then pivoted medially to simulate a severe hallux valgus deformity of an intermetatarsal angle (IMA) of 18° and an intermediate hallux valgus deformity of an IMA of 13°. A ReveL operation was simulated to correct the IMA to 8° for the severe and the intermediate Hallux valgus. Therefore the osteotomy angle in the coronal plane (f=0) was chosen perpendicular to the axis of the second metatarsalia. Afterwards the length of MT I was measured. This procedure was repeated for an posterior altered osteotomy angle (f = 5°,10°, 15° and 20°).

Results:

The change in MT I length resulting from an osteotomy perpendicular to the axis of MT II was 0.6 mm for a severe hallux valgus (IMA correction from 18° to IMA 8°) and 0.3 mm for a moderate hallux valgus (IMA 13° to IMA 8°). A posterior deviation of the osteotomy angle led to additional shortening (max. 2.9 mm) with a total shortening of up to 3.5 mm (Figure 3). To avoid any shortening of MT I an osteotomy slightly pointing anterior (negative f) of 3.5° (IMA change of 10°) and 3° (IMA change of 5°) was found.

Conclusion:

ReveL procedure led only to a maximum shortening of 3.5 mm for a posterior deviation of 20°. Considering recently described MT I length cut off values of 2-3 mm for avoiding transfermetatarsalgia the osteotomy should be performed within an anterior directed cut angle of 4° and a posterior directed cut angle of 10° for the correction of a severe hallux valgus. However, further studies are needed to investigate the clinical impact of our findings.
Biomechanical Study of Screw Fixation and Plate Fixation of a Posterior Malleolar Fracture in Osteoporosis
Authors: Wang Xu
Published: September 2017

Category:

Ankle, Trauma

Introduction/Purpose:

Purpose of this research is to biomechanically compare the screw-fixed and plate-fixed posterior malleolus fracture in osteoporosis patients with fatigue loading system and space motion system in simulation gait cycle. And to give a theory evidence on how to choose a internal fixation in osteoporosis patients with posterior malleolus fracture.

Methods:

36 matched cadaveric pairs lower limbs (T＜-2.5) were prepared to simulate Haraguchi I posterior malleolus fracture and randomized into two groups. Models of group A were fixed with two paralleled 4.0 mm titanium partial thread cancellous screws from posterior to anterior. Models of group B were fixed with plate. Furthermore, 4 different conditions of gait cycle were simulated as follows:1. specimen was loaded with 3.2 body weight (BW) at dorsiflexion angle of 12°; 2. Start-up phase: dorsiflexion angle of 5°,3.6 BW; 3. neutral position,3.6 BW; 4. maximum plantar flexion, angle of 12°,4.5 BW. At the end of repeatedly, loading, the displacement of fracture fragment (X) was measureed with space motion system.

Results:

At 12°of dorsiflexion and 15°of plantar flexion, there was a significant difference of X between A and B group, no matter the S and H. When ankle was dorsiflexion of 5°, X of group A was more great than that of group B except A3a /B3a and A1b/B1b. At neutral positon, there was significant differenceof X in all the groups except group A2b and B2b.

Conclusion:

Compared with 2 paralleled 4.0 mm calcaneus screws from posterior to anterior, plate can provide stronger fixation for osteoporosis patients with posterior malleolus fracture. But both of the two methods cannot provide stable fixation for osteoporosis patients with posterior malleolus fragment S>1/3 and H>19.3 mm.
Quality Measures in Foot and Ankle Care
Authors: Xiong Grace , Chou Loretta , Bennett Chase , Kamal Robin
Published: September 2017

Category:

Ankle, Ankle Arthritis, Arthroscopy, Bunion, Diabetes, Hindfoot, Trauma

Introduction/Purpose:

National healthcare delivery systems are shifting to value-based models. Understanding quality measures used to assess performance is important as they may be operationalized in alternative payment models, such as bundled payment programs, or quality reporting programs, such as the Merit-Based Incentive Payment System. Previous literature has shown that quality measures in other orthopaedic subspecialties disproportionately focus on effective clinical care or processes of care, while ignoring patient outcomes. We completed a systematic review of quality measures and candidate quality measures that address foot and ankle care to identify gaps in current measures and to inform future measure development initiatives.

Methods:

We conducted a systematic review of the National Quality Forum, the Agency for Healthcare Research and Quality, and the Physician Quality Reporting System for quality measures related to foot and ankle care. We also reviewed candidate quality measures from clinical practice guidelines (CPG) in the literature meeting Institute of Medicine CPG criteria. Measures were classified by clinical entity, Donabedian domain (structure, process, or outcome), and the National Quality Strategy (NQS) priority that they addressed.

Results:

We identified 12 quality measures and 16 candidate measures. Quality measures addressed NQS priorities of “Effective Clinical Care” (33%), “Communication and Coordination of Care” (58%), “Patient Safety” (25%), “Community and Population Health” (8%), and “Person and Caregiver Centered Experience and Outcomes” (8%). All candidate measures addressed “Effective Clinical Care”. Furthermore, 83% of quality measures and 94% of candidates were process measures, 17% of quality and 6% of candidate were outcome measures, and there were no structure measures. Diabetic foot care was the most commonly addressed clinical entity for both quality measures (58%) and candidate measures (69%).

Conclusion:

Foot and ankle quality measures and candidate measures disproportionately assess effective clinical care and processes of healthcare delivery. Additionally, few clinical disorders within the field are included, focusing primarily on diabetic foot care. Currently only two outcome measures exist, leaving an opportunity for outcome measure development. These patterns are reflected in candidate measures, suggesting that the narrow focus of quality measures will continue unless efforts are made to develop more comprehensive measures. Additional measures that address a broader array of clinical disorders across the spectrum of NQS priorities and Donabedian domains are needed to prepare for a quality-based healthcare system.
The Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures
Authors: Yang Yunfeng , Zhou Haichao , Zhang Yun
Published: September 2017

Category:

Hindfoot

Introduction/Purpose:

To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via sinus tarsi approach using medial distraction technique for intra-articular calcaneal fractures.

Methods:

We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015, including 32 cases of Sanders type? and 33 of Sanders type?. There were 49 men and 16 women. The mean age was 43.7 years old. They were divided into two groups: sinus tarsi approach group and extensile lateral approach group. No significant difference was found in gender, age, injury pattern, fracture classification between two groups (P>0.05). The Böhler angle, Gissane angle and calcaneal varus angle were measured before surgery, 1 week after surgery and at each follow-up visit respectively. The postoperative function was evaluated by the ankle and hind-foot score of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS).

Results:

All of the fractures were healed at about 10 weeks postoperatively. Böhler angle, Gissane angle and calcaneal varus angle were restored obviously, while there was no significant statistically difference between the two groups. Only the corrected value of calcaneal varus angle is statistically significant.At the last follow-up, the average AOFAS ankle and hind-foot score of minimal group was 88.4±6.6, and the VAS score was 1.9±0.7, while of extensile lateral approach group was 83.2±5.6 and 2.3±1.0 respectively.

Conclusion:

Limited open reduction via sinus tarsi approach for intra-articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful to correct the calcaneus varus deformity.
Comparison of postoperative outcomes between modified Mann procedure and modified Lapidus procedure for hallux valgus
Authors: Yui Akiyama , Hirano Takaaki , Mitsui Hiroyuki , Maeda Shingo , Niki Hisateru
Published: September 2017

Category:

Bunion

Introduction/Purpose:

Surgery for hallux valgus (HV) includes a variety of techniques based on the osteotomy site. We use the modified Mann technique in cases with deformity ranging from 30° to 40° and the modified Lapidus procedure in HV cases with deformity of over 40° or with metatarsalgia.

Methods:

Here we report our investigation of the appropriateness of the modified Mann technique and the modified Lapidus procedure based on a comparison of postoperative outcomes. In total, 73 feet of 58 cases who underwent surgery for HV with subsequent follow-up observation for at least 1 year were included in the study. The modified Mann technique was performed on 31 feet of 26 cases (M Group), and the modified Lapidus procedure was performed on 42 feet of 32 cases (L Group). Six cases in the M Group and 39 cases in the L Group also underwent concurrent surgery for metatarsalgia. The outcome measures were changes in the HV angle, the angle between the M1M2, the Japanese Society for Surgery of the Foot (JSSF) hallux scale, complications, and HV recurrence. These outcome measures were compared using the unpaired t-test on standing anteroposterior X-ray of the feet.

Results:

In the M Group, comparison of pre- and postoperative radiological changes indicated that the HV angle improved from 38.2° to 11.4°, M1M2 angle improved from 14.5° to 5.0° respectively. JSSF hallux score improved from 53.3 to 89.6. Postoperative hallux varus was confirmed in four cases, Osteoarthrosis of the MTP joint in six, and HV recurrence in two. In the L Group, comparison of pre- and postoperative radiological changes indicated that the HV angle improved from 46.0° to 16.9°, M1M2 angle improved from 15.2° to 6.6°respectivelty. JSSF hallux score improved from 47.8 to 94.7. Postoperative hallux varus was confirmed in two cases, Osteoarthrosis of the MTP in four, and HV recurrence in four. In both groups, only preoperative HV angle exhibited significant differences (p < 0.0001).

Conclusion:

Surgical technique was selected based on HV severity and metatarsalgia whether were present; however, both groups showed satisfactory results. In cases of severe HV or in cases accompanied by metatarsalgia, we performed the modified Lapidus procedure that reduced pronation and valgus of first metatarsal. The X-ray and clinical findings of the present study showed that the results of the L Group were not inferior when compared to those of the M Group. Surgical technique should be selected based on both HV severity and lessor toe symptoms.
Osteochondral autograft transfer combined with supramalleolar osteotomy for the treatment of osteochondral defect of the talus in varus ankle
Authors: Zhu Yuan , Xu Xiangyang
Published: September 2017

Category:

Ankle, Ankle Arthritis, Arthroscopy, Sports

Introduction/Purpose:

Osteochondral lesion of the talus (OLTs) is among the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (> 15 mm in diameter) involving posteromedial aspect of talar dome, osteochondral autograft transplantation is usually warranted. This article highlights the distal tibial double osteotomy for the management of patient with concomitant large OLTs and varus ankle malalignment.

Methods:

From January 2012 to July 2015, 15 patients (8 males, 7 females) received the surgery in our department. The average age was 55.4 (range, 34 to 69) years old. Oblique medial malleolar osteotomy was performed to expose the talar lesion, following by osteochondral autograft transplantation and distal tibial opening-wedge osteotomy. Weight bearing X-rays were obtained for the measurement of tibial articular surface (TAS) angle and tibial lateral surface (TLS) angle. The American Orthopaedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) questionnaires and Visual Analog Scale (VAS) were evaluated for ankle function. In 5 cases arthroscopy was performed 12 months postoperatively and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society.

Results:

Thirteen patients completed the follow-up with a mean of 21.2 months. The average talar lesion was 170.0mm2, and the average depth was 11.4 mm. The mean time of bone healing was 8.5 weeks. No patient reported donor site morbidity by the last follow-up. The mean AOFAS-AH score and VAS score improved from 53 to 90 points (p < 0.05), 6.7 to 1.9 points (p < 0.05), respectively. The mean TAS angle improved from 83.1 to 90.3 degrees (p < 0.05). The radiolucent area of the cysts disappeared on the plain radiographs in all cases. The mean International Cartilage Repair Society arthroscopic score from follow-up arthroscopy was (9±1) points.

Conclusion:

The use of osteochondral autograft transfer combined with supramalleolar osteotomy is an effective option for the treatment of osteochondral defect of the talus in varus ankle. It provides excellent visualization of the talar defect and favorable biomechanical environment for the ankle joint.
Evaluating the “Leeds criteria” forPseudomonas aeruginosainfection in a cystic fibrosis centre
Authors: Proesmans M. , Balinska-Miskiewicz W. , Dupont L. , Bossuyt X. , Verhaegen J. , Høiby N. , de Boeck K.
Published: September 2017

Four separate categories of chronicPseudomonas aeruginosa(Pa) infection in children with cystic fibrosis (CF) have been previously defined, based on airway cultures taken over the previous year.

The aim of the present study was to evaluate this definition in the current authors' paediatric and adult CF clinic using clinical, immunological and lung function parameters.

During follow-up, out of 193 patients, 55 (34%) CF patients had never been infected withPa, 27 (17%) were free ofPa, 29 (18%) were intermittently infected and 51 (31%) were chronically infected. Disease severity markers, such as lung function, were significantly worse in the chronic group, especially in the paediatric population. Differences in adult patients were smaller and no longer significant.Paantibodies differed strongly between the groups, and were very high (mean±sd55.4±5.5) and highly statistically significant from all other groups in the chronic group. They were low and different from all other groups in the never group (1.8±0.6).Paantibodies did not differ between the free ofPaand the intermittent group.

In conclusion, the current authors confirmed an agreement betweenPseudomonas aeruginosastatus according to the new definition and clinical status, as well as with the level ofPseudomonas aeruginosaantibodies.
Neuropsychiatric adverse drug reactions in children initiated on montelukast in real-life practice
Authors: Benard Brigitte , Bastien Valérie , Vinet Benjamin , Yang Roger , Krajinovic Maja , Ducharme Francine M.
Published: September 2017

Although montelukast is generally well tolerated, postmarketing studies have reported serious neuropsychiatric adverse drug reactions (ADRs) leading to a United States Food and Drug Administration warning. The objective of this study was to determine the incidence of neuropsychiatric ADRs leading to discontinuation of montelukast in asthmatic children.

We conducted a retrospective cohort study in children aged 1–17 years initiated on montelukast. In a nested cohort study, children initiated on montelukast as monotherapy or adjunct therapy to inhaled corticosteroids (ICS) were matched to those initiated on ICS monotherapy. A non-leading parental interview served to ascertain the occurrence of any ADRs with any asthma medication, and circumstances related to, and evolution of, the event.

Out of the 106 participants who initiated montelukast, most were male (58%), Caucasian (62%) with a median (interquartile range) age of 5 (3–8) years. The incidence (95% CI) of drug cessation due to neuropsychiatric ADRs was 16 (10–26)%, mostly occurring within 2 weeks. Most frequent ADRs were irritability, aggressiveness and sleep disturbances. The relative risk of neuropsychiatric ADRs associated with montelukastversusICS was 12 (2–90).

In the real-life setting, asthmatic children initiated on montelukast experienced a notable risk of neuropsychiatric ADRs leading to drug cessation, that is significantly higher than that associated with ICS.
Contributions of a hand-held fan to self-management of chronic breathlessness
Authors: Luckett Tim , Phillips Jane , Johnson Miriam J. , Farquhar Morag , Swan Flavia , Assen Teresa , Bhattarai Priyanka , Booth Sara
Published: September 2017

This study explored the benefits of a hand-held fan as perceived by patients with chronic breathlessness and their carers.

A secondary multimethod analysis was conducted of interview data collected in three clinical trials. Two researchers independently coded level of benefit qualitatively reported by each patient. Univariate and multivariate statistics were used to explore perceived benefit as a factor of sex, age and diagnosis. Qualitative analysis used an integrative method.

133 patients commented on the fan, of whom 72 had a carer. Diagnoses included nonmalignant (n=91, 68.4%) and malignant (n=21, 15.8%) conditions. Of 111 patients who provided codable data, four (3.6%) perceived no benefit, 16 (14.4%) were uncertain, 80 (72.0%) perceived some benefit and 11 (10.0%) perceived very substantial benefit. Multivariate analysis was inconclusive. Benefit was described in terms of shorter recovery time, especially after activity. 10 (7.5%) patients said the fan reduced their need for home oxygen or inhaled β-agonist medications. Negative perceptions of a few included dislike of the cooling sensation and embarrassment in public.

Findings suggest that a hand-held fan is a portable intervention with few disadvantages from which most patients with chronic breathlessness will derive benefit alongside other nonpharmacological and pharmacological strategies. Research is needed to optimise guidance on fan administration.
Expression of Concern to: Evaluation of patients with multiple sclerosis using reverse nutech functional score and expanded disability status scale after human embryonic stem cell therapy
Authors: Shroff Geeta
Published: September 2017

The Editors‐in‐Chief of Clinical and Translational Medicine are issuing an editorial expression of concern to alert readers that concerns have been raised regarding the ethics of this study [1]. Appropriate editorial action will be taken once this has been fully investigated. The author disagrees with this notice.
Mesoporous Alumina as an Effective Adsorbent for Molybdenum (Mo) toward Instant Production of Radioisotope for Medical Use
Authors: Saptiama Indra , Kaneti Yusuf Valentino , Suzuki Yumi , Suzuki Yoshitaka , Tsuchiya Kunihiko , Sakae Takeji , Takai Kimiko , Fukumitsu Nobuyoshi , Alothman Zeid Abdullah , Hossain Md Shahriar A , Ariga Katsuhiko , Yamauchi Yusuke
Published: September 2017

Mesoporous materials with high surface area and pore volume have attracted significant attention as adsorbents as they can provide extensive reaction sites for molybdenum (Mo) adsorption. In this study, we have prepared mesoporous alumina (MA) materials using a soft-templated approach. By changing the applied calcination temperatures, the mesostructural ordering, surface areas, and crystallinity of the MA materials can be varied. Furthermore, the effects of these parameters on their molybdenum (Mo) adsorption properties have been carefully investigated. The findings in this study will provide guidance for designing effective Mo adsorbents using mesoporous materials toward the next 99Mo/99mTc generator preparation.
Ganglionic and non-ganglionic neurons in frog heart: do they differ?
Authors: Batulevičius Darius , Skripkienė Gertrūda , Graužinytė Greta , Grigaitė Augustina , Skripka Valdas
Published: September 2017

This study was designed to compare the morphology of neurons in relation to their distance from the major nerve trunks in the heart of the frog Rana temporaria. Seventy-nine intracardiac neurons were labelled intracellularly with fluorescent markers Lucifer Yellow CH and Alexa Fluor 568. The neurons located on the extensions of the vagus nerve were considered as ganglionic, while neurons spread loosely at further distance from these extensions were considered as non-ganglionic. The mean area of the soma in ganglionic neurons was about 25% larger than in non-ganglionic neurons. Ganglionic neurons had a higher soma area/nucleus area ratio than non-ganglionic neurons. Although both the total number and the total length of dendrite-like processes was similar between the two groups, ganglionic neurons had significantly fewer dendrite-like processes from the soma (1.5±0.3 vs. 3.9±1.0; P<0.05) and shorter total length of these processes from the soma (63±18 μm vs. 178±51 μm; P<0.05). In conclusion, ganglionic and non-ganglionic frog intracardiac neurons exhibit substantial morphological differences. We hypothesize that these differences may indicate different projections or variations in the number of their preganglionic inputs.
Molecular events in the Wharton’s jelly and blood vessels of human umbilical cord
Authors: Sidhom Elga , Pilmane Māra , Kreicberga Ilze
Published: September 2017

The umbilical cord is seen as the main junction between the developing embryo or fetus and placenta. We studied the antimicrobial response, the presence of undifferentiated cells and TGF-α, as well as tissue degeneration and compensatory remodelling processes in the cells of human umbilical cord.Seven umbilical cord tissue samples obtained during premature and full term births were stained with hematoxylin and eosin and by immunohistochemistry for human beta defensin 2 (hBD-2), hematopoietic progenitor cell antigen CD34, matrix metalloproteinase 2 (MMP-2), the tissue inhibitor of matrix metalloproteinase 2 (TIMP-2), nestin and transforming growth factor alpha (TGF-α). The intensity of staining was graded semiquantitatively.Antimicrobial response was more prominent in the Wharton’s jelly – we found numerous hBD-2-containing cells, while hBD-2 positive cells in the walls of arteries and vein varied from moderate to abundance. Numerous cells in the Wharton’s jelly contained CD34, while in the walls of blood vessels few to moderate stained positive for CD34. MMP-2, TIMP-2 and nestin positive cells were found in all the tissue samples and varied from numerous in the walls of blood vessels to abundance in the Wharton’s jelly and the inflammation region. The abundance of TGF-α-containing cells was found in Wharton’s jelly and moderate to numerous cells of blood vessels contained TGF-α.Conclusions: The human umbilical cord possesses antimicrobial activity and shows the presence of undifferentiated cells. The striking distribution and the expression of MMP-2, TIMP-2 and nestin suggest their role in the very effective and extensive tissue degeneration and compensatory remodelling processes. TGF-α seems to be an important growth factor for extra-embryonic tissue development.
Some Questions of Introduction of Federal Financial Accounting Standards in Russian Public Sector
Authors: Смирнов Е. , Smirnov E.
Published: September 2017

Efficiency of asset management highly depends on reliability, completeness and timeliness of information about the items of accounting, received by preparers of financial statements. In this article, some matters of assets initial recognition and subsequent accounting are analysed in their connection with peculiarities of registry accounting of state property items in the Russian Federation public sector.
R is for Ribs, floating and true…
Authors: Hammond Paula , Lillie Stephen
Published: September 2017

This month, we continue our series that takes the form of an extended alphabetical adventure around the body, helping children to get to know themselves a little better.
Following the ‘lore’ of the land
Authors: Garner Lynne
Published: September 2017

Being outdoors has many health benefits as well providing many learning opportunities. You can extend these by providing a sense of place, or belonging, within the landscape.
Implementing a culture of learning in the care home
Authors: Hurtley Rosemary
Published: September 2017

The Care Quality Commission has said that the best care homes are those that adopt a culture of learning. In this article, Rosemary Hurtley discusses a case study where a care home in Betchworth used the 360 Standard Framework to help embed such a culture
Employment law in 2017: things the care home needs to know
Authors: Themistocleous Chloe
Published: September 2017

Keeping up to date with employment law can be tricky—particularly if you do not follow the updates personally. In this article, Chloe Themistocleous rounds-up the most important changes to employment law in 2017
Preserving safety within the care home environment
Authors: Ashurst Adrian
Published: September 2017

The Nursing and Midwifery Council's code of conduct demands that registered nurses do what they can to make sure that the safety of those in their care is protected. In this article, Adrian Ashurst discusses what this means in the context of revalidation
How to … develop an effective anti-bullying strategy
Authors: Ashurst Adrian
Published: September 2017

There is no excuse for bullying in the care home, regardless of whether it is between staff, or staff and residents. In this article, Adrian Ashurst discusses the importance of protecting everyone in the home from bullying
THE CHARACTERISTICS OF VETIVER GRASS AS A PHYTOREMEDIATOR PLANT IN DOMESTIC GREYWATER TREATMENT
Authors: Astuti Jovita Tri , Sriwuryandari Lies
Published: September 2017

Source separation of domestic wastewater into greywater (GW) and blackwater (BW) streams is important in decentralizing treatment due to its different characteristics. GW is generated from bathroom, washing machine,kitchen sink, and vehicle washing. Meanwhile, BW is produced from toilet, urinal or bidet. In developing countries, untreated wastewater is widely used in agricultural and risk to human health and living organisms. The appropriate treatment is required to prevent water degradation. Phytoremediation is a sustainable way to mitigate pollution with using plant. This study was conducted to observe the characteristics of vetiver grass as phytoremediator for GW. There are two factors of treatment. First is growth media (M), i.e. tap water (TW) as control (M0) and GW (M1). The second is vetiver (V), i.e. without (V0) as control and with planting (V1). Three glass aquariums are used for each treatment as replicates. Eight individual stem bases of vetiver were placed at aquarium and allowed hydroponically growing. At harvesting (49th day), vegetative organs were collected and observed separately, i.e. root, stem and leaf. Pollutant removal was calculated by comparing the content before and after treatment of media with vetiver. Cultivation of vetiver in GW (M1V1) could increase the root number, total root length, and total root diameter as much as 54%, 92.2%, and 51%, respectively. Individual root length was in the range of 2.3-78.5cm and root diameter was 0.35-2.10mm. Compared to the initial, stem number increased 99%, while leaf number increased 4 times. Root/Shoot (R/S) ratio was 0.80±0.14. Polutant removal of GW by vetiver achieved 72.86% BOD5; 65.51% COD; 66.55% TN; 67.67% TP; 80.77% Fe; 71.43% Zn; 60% Pb; 65.81% detergent, and 100% phenol. Vetiver could reduced TPC 29.13%, MPN coliform 78.18%, and MPN fecal coli 91.54%. After treated with vetiver, GW complied to criteria of water Class IV that can used for irrigation in agricultural.
FRICTION BUFFER STOP DESIGN
Authors: Guziur Petr
Published: September 2017

Friction buffer stops are the favoured construction of buffer stop, mainly due to its high resistance and variety of layout. Last but not least is its manner of deceleration induced upon impact and during the braking what makes it smart solution in railway transport safety. The general approach of designing buffer stops is via usage of the kinetic energy and its conversion into work. Paper describes input parameters such as train velocity or buffer stop vicinity which is expressed by the safety coefficient implanted within the calculation. Furthermore, the paper shows the principle of calculation the friction buffer stop work, or to be more precise, the work of its braking jaws and optionally the work of additional braking jaws located behind the buffer stop. Last section of the paper is focused on the examples of designing friction buffer stops, points out the main complications and shows the charts of relation amongst braking distance, kinetic energy and braking force and the charts of relation between deceleration rate and braking distance.
POSSIBLE WAYS OF IMPROVING RAILWAY OPERATION AND INFRASTRUCTURE IN AREA BETWEEN DECÍN AND RUMBURK
Authors: Purkart Pavel , Vodák David , Hoření Tomáš , Javořík Tomáš
Published: September 2017

This paper is dealing with improving the railway transport on axis Decín – Rumburk. This journey can be undertaken in two possible ways (as an interstate one or an international one through Germany), however the connections between trains are limited (especially problematic is the Rumburk junction, where the connection would be desired). The aim of this paper is to improve the connections in the whole area, in order to reach the maximal effectiveness of a railway passenger transport.
MEASUREMENT METHODS OF INTERNAL STRESS IN CONTINUOUS WELDED RAIL
Authors: Vnenk Petr , Culek Bohumil
Published: September 2017

This paper deals with the problem of internal rail stress estimation. It is based on a detailed research of contemporary situation in the field, presents basic outlines of the problem and sums up the major research areas and their possible applications in the current state of railway infrastructure management. The directions are divided into four categories in the paper: Displacement Methods, Rail Shifting Methods, Methods Based on Acoustoelastic Effect and Methods Based on Magnetoelastic Effect. Particular methods, both scientific and industrial, are presented in their section respectively. Every method that is presented within the scope of this paper is briefly described and its advantages and disadvantages are mentioned. In the end, potential of application of some of the presented methods in the practical use is discussed.
COMPARISON OF PARAMETERS OF SURFACE INTEGRITY OF MACHINED DUPLEX AND AUSTENITE STAINLESS STEELS IN RELATION TO TOOL GEOMETRY
Authors: Čapek Jiří , Pitrmuc Zdeněk , Kolařík Kamil , Beránek Libor , Ganev Nikolaj
Published: September 2017

The goal of this contribution was to describe parameters of surface integrity of two machined materials; austenite and duplex stainless steel. Residual stresses and presence of straininduced martensite were studied as a function of the side rake angle. Residual stresses of surface and sub-surface layers were determined using X-ray diffraction techniques and hole-drilling method. By using X-ray diffraction, it is possible to determine residual stresses in each phase separately, in comparison with hole-drilling method. The presence of strain-induced martensite was investigated using Barkhausen noise and optical microscope.
INFLUENCE OF MACHINING TECHNOLOGIES ON VALUES OF RESIDUAL STRESSES OF OXIDE CUTTING CERAMICS
Authors: Němeček Jakub , Kolařík Kamil , Čapek Jiří , Ganev Nikolaj
Published: September 2017

Currently, the intensive development of engineering ceramic and effort to replace sintered carbides as cutting materials are in progress. With the development of the sintering technology it is now possible to produce compact ceramic cutting samples with very good mechanical properties. The advantage of these materials is their easy accessibility and low purchase price. In this work, the influence of the finishing machine technology on the values of surface residual stresses of cutting ceramic samples Al2O3+TiC were studying. The samples were supplied by Moscow State University of Technology STANKIN. Measurements made in the X-ray diffraction laboratory at the Department of solid state engineering were performed for both the phases. The influence of the parameters of machining to residual stresses was studied and the resulting values were compared with each other.
REMOVAL OF DIQUATERNARY AMMONIUM CATIONS FROM AS-SYNTHESIZED SSZ-16 ZEOLITE
Authors: Supinkova Tatana , Jirka Ivan , Drahokoupil Jan , Langmaier Jan , Fila Vlastimil , Brabec Libor , Kocirik Milan
Published: September 2017

Zeolites are stable microporous aluminosilicates with numerous applications in chemical technology such as separation of species and catalytic transformations. Our study is focused on a weakly explored zeolite SSZ-16 with pore constrictions defined by 8-membered oxygen rings. Key results are the preparation of Et6-diquat-5 dication used as a structure directing agent (SDA) and finding the optimum synthesis conditions with respect to zeolite phase purity. Stability of SDA was examined in conditions similar to those of autoclave synthesis (concentration, pH, temperature). Moreover, the content and location of SDA species in zeolite phase and conditions of SDA decomposition were investigated.
Criminal: journalistic rigour, gothic tales and philosophical heft
Authors: Loviglio Jason
Published: September 2017

Like many of the shows in PRX’s Radiotopia catalogue of podcasts, Criminal’s sensibility and sound partake of the US public radio formula made famous by This American Life: journalistic rigour and gothic yarns. The show tells “stories of people who’ve done wrong, been wronged, or got caught somewhere in the middle”. But it’s moved beyond mere crime journalism to something that aspires to a bit more philosophical heft. Most of the stories unspool through the elegant co-narration between host Phoebe Judge and each episode’s central protagonist. The effect is almost always seamless, thanks to the expert mixing of Rob Byers, and the painstaking interviewing and editing process necessary to produce a coherent and tonally appropriate narrative. While we get the who-what-where details upfront, the when is not as clear, a key distinction between the daily crime beat of a journalist and the story-first imperative of non-fiction narrative podcasting.
This review focuses on the first eight episodes to air after the milestone 50th landed in 2016, listening for signs of how the show is evolving as it matures and moves into its next fifty.
Empathy, ethics and aesthetics in Love + Radio
Authors: Macklem Michelle
Published: September 2017

The podcast Love + Radio thrives on cultivating a kind of emotional tightrope, where the listener wavers from curiosity to contempt to empathy. The episodes “Jack and Ellen” and “The Living Room” have stark differences, particularly in terms of sound design, but their aesthetic and production values have a coherency that is exemplary of Love + Radio’s style. Sound is used to distinguish between ‘Ellen’, the subject, and ‘Jack’ her paedo-baiting alter ego. ‘Jack’ is created by pitch-shifting the voice of ‘Ellen’ down, instantly giving the story intrigue and also alluding to the clandestine nature of their work. “Jack and Ellen” is caught somewhere between a radio documentary and a swirling sample-based composition as the skilled musicality of the piece communicates a specific editorial perspective, that is perhaps a glimpse of how the producers were affected during its creation. “The Living Room”, on the other hand, is sparse and neat. Silence is used as strategically as sound. Love + Radio’s use of sound continues to distinguish it from most other podcasts, where music can feel slapped on, repetitive and unintentional.
The process of making a Love + Radio episode starts with an initial interview, then uses a first rough cut as a means of illuminating gaps and further questions in the story. Interview subjects/storytellers are re-interviewed two or three more times. Love + Radio is a mostly non-narrated format, but the interviewer is almost always included, however briefly. With “Jack and Ellen” the story becomes focused on the murky moral boundaries of extortion and paedophilia; it is a difficult piece because, depending on your personal morality, Ellen may seem like a pretty disreputable character. In “The Living Room”, Diane is more likeable off the top, but her voyeurism puts her in a questionable position. And it’s this tension that makes both “Jack and Ellen” and “The Living Room” a cut above other radio documentaries. There is no didactic purpose. But there is a genuine attempt to try to convey a facet of the human experience.
We as listeners are more likely to be empathetic towards someone of the same social and racial background. Can empathy then, be a dangerous force? Can we ever truly understand someone else’s embodied experience in the world? These are all valuable questions. Through “Jack and Ellen” and “The Living Room” in particular, Love + Radio crafts a tone that leaves the listener continually questioning the role of story in relating to other people, a force that continues to distinguish the show in the now over-abundance of confessional first-person driven podcasts.
The Arts of Amnesia: The Case for Audio Drama, Part One
Authors: Verma Neil
Published: September 2017

This article examines what the relationship between audio drama and radio drama might illuminate about both forms. Drawing on some 40 podcasts and other audio forms that take a serial structure, I explore the rise of audio drama podcasts since 2015 and situate them in both a more recent historical context since the late 1990s and in a broader history stretching back to the first Golden Age of radio. By listening closely to key works on Serendipity, Homecoming and other podcasts, I argue that contemporary audio has profound potential to change both how we listen and how we relate to the sound media of the past. This is Part One of a two-part series.
1912 Parliamentary elections Armenians and Armenian deputies
1912 Meclis-i Mebusan seçimlerinde Ermeniler ve Ermeni milletvekilleri
Authors: Olgun Kenan
Published: September 2017

As soon as 1908 Parliament was extingwished in the result of struggle for power the preparations for the new parliamentary elections began. The elections of 1912 between the Party of Union and Progress and their political opponent Party of Liberty and Mutual Agreement have been known as “elections of clubs”. Before the elections the majority of Armenians and Tashnaktsutyun supported Party of Union and Progress while Hinchak stood for Party of Liberty and Mutual Agreement.  Armenian patriarchate informed the Ottoman Government that according to the low number of Armenians according to the total population of the Empire they had little chance to become deputies and asked for separation. İn the result of the elections 10 Armenians took place in the list of Party of Union and Progress were chosen deputies in 1912 Parliament.Extended English abstract is in the end of PDF (TURKISH) file.Özet1908 Meclis-i Mebusan’ı, iktidar mücadelesi yüzünden feshedilmiş, yeni meclis için seçimlere hemen başlanmıştır. İttihat ve Terakki Fırkası ile ittihatçılar karşısındaki muhalefetin tamamını bünyesinde toplamış olan Hürriyet ve İtilaf Fırkası arasında geçen 1912 seçimleri, tarihte “sopalı seçim” olarak da anılmaktadır. Seçimler öncesi Ermenilerin çoğunluğu ve Taşnak, İttihat ve Terakki’yi desteklerken, Hınçak, Hürriyet ve İtilaf Fırkası ile anlaşmıştır. Ermeni Patrikhanesi, nüfuslarına göre Ermeni milletvekili sayısının az olacağını ifade ile Başbakanlıktan ayrıcalık istemiştir. Seçimler sonucunda İttihat ve Terakki listesinde yer alan 10 Ermeni, milletvekili olarak 1912 Meclis-i Mebusan’ına seçilmiştir.