bluuebunny/crossref_metadata_2025 huggingface dataset:
Proximal femoral allograft-prosthesis composites in revision hip replacement
Authors: Babis G. C. , Sakellariou V. I. , O’Connor M. I. , Hanssen A. D. , Sim F. H.
Published: March 2010

We report the use of an allograft prosthetic composite for reconstruction of the skeletal defect in complex revision total hip replacement for severe proximal femoral bone loss. Between 1986 and 1999, 72 patients (20 men, 52 women) with a mean age of 59.9 years (38 to 78) underwent reconstruction using this technique.

At a mean follow-up of 12 years (8 to 20) 57 patients were alive, 14 had died and one was lost to follow-up. Further revision was performed in 19 hips at a mean of 44.5 months (11 to 153) post-operatively. Causes of failure were aseptic loosening in four, allograft resorption in three, allograft nonunion in two, allograft fracture in four, fracture of the stem in one, and deep infection in five. The survivorship of the allograft-prosthesis composite at ten years was 69.0% (95% confidence interval 67.7 to 70.3) with 26 patients remaining at risk. Survivorship was statistically significantly affected by the severity of the pre-operative bone loss (Paprosky type IV; p = 0.019), the number of previous hip revisions exceeding two (p = 0.047), and the length of the allograft used (p = 0.005).
Combination joint-preserving surgery for forefoot deformity in patients with rheumatoid arthritis
Authors: Niki H. , Hirano T. , Okada H. , Beppu M.
Published: March 2010

Proximal osteotomies for forefoot deformity in patients with rheumatoid arthritis have hitherto not been described. We evaluated combination joint-preserving surgery involving three different proximal osteotomies for such deformities. A total of 30 patients (39 feet) with a mean age of 55.6 years (45 to 67) underwent combined first tarsometatarsal fusion and distal realignment, shortening oblique osteotomies of the bases of the second to fourth metatarsals and a fifth-ray osteotomy.

The mean follow-up was 36 months (24 to 68). The mean foot function index scores for pain, disability and activity subscales were 18, 23, and 16 respectively. The mean Japanese Society for Surgery of the Foot score improved significantly from 52.2 (41 to 68) to 89.6 (78 to 97). Post-operatively, 14 patients had forefoot stiffness, but had no disability. Most patients reported highly satisfactory walking ability. Residual deformity and callosities were absent. The mean hallux valgus and intermetatarsal angles decreased from 47.0° (20° to 67°) to 9.0° (2° to 23°) and from 14.1° (9° to 20°) to 4.6° (1° to 10°), respectively. Four patients had further surgery including removal of hardware in three and a fifth-ray osteotomy in one.

With good peri-operative medical management of rheumatoid arthritis, surgical repositioning of the metatarsophalangeal joint by metatarsal shortening and consequent relaxing of surrounding soft tissues can be successful. In early to intermediate stages of the disease, it can be performed in preference to joint-sacrificing procedures.
Analysis of wear of retrieved metal-on-metal hip resurfacing implants revised due to pseudotumours
Authors: Kwon Y. -M. , Glyn-Jones S. , Simpson D. J. , Kamali A. , McLardy-Smith P. , Gill H. S. , Murray D. W.
Published: March 2010

The presence of pseudotumours, which are soft-tissue masses relating to the hip, after metal-on-metal hip resurfacing arthroplasty has been associated with elevated levels of metal ions in serum, suggesting that pseudotumours occur when there is increased wear. We aimed to quantify the wear in vivo of implants revised for pseudotumours (eight) and of a control group of implants (22) revised for other reasons of failure.

We found that the implant group with pseudotumours had a significantly higher rate of median linear wear of the femoral component at 8.1 μm/year (2.75 to 25.4) than the 1.79 μm/year (0.82 to 4.15; p = 0.002) of the non-pseudotumour group. For the acetabular component a significantly higher rate of median linear wear of 7.36 μm/year (1.61 to 24.9) was observed in the pseudotumour group compared with 1.28 μm/year (0.81 to 3.33, p = 0.001) in the other group. Wear of the acetabular component in the pseudotumour group always involved the edge of the implant, indicating that edge-loading had occurred.

Our findings are the first direct evidence that pseudotumour is associated with increased wear at the metal-on-metal articulation. Furthermore, edge-loading with the loss of fluid-film lubrication may be an important mechanism of generation of wear in patients with a pseudotumour.
Below the radar: what does innovation in emerging economies have to offer other low-income economies?
Authors: Kaplinsky Raphael , Chataway Joanna , Clark Norman , Hanlin Rebecca , Kale Dinar , Muraguri Lois , Papaioannou Theo , Robbins P , Wamae Watu
Published: March 2010

Between 1970 and 2000, the proportion of global R&D occurring in low-income economies rose from 2 per cent to more than 20 per cent. However, this rising commitment to R&D does not easily translate into the emergence of a family of innovations meeting the needs of low-income
consumers at the bottom of the pyramid, since much of these technological resources are invested in outdated structures of innovation. A number of transnational corporations are targeting these markets, but it is our contention that much of the previously dominant innovation value chains are
either ignorant of the needs of consumers at the bottom of the pyramid or lack the technologies and organizational structures to meet these needs effectively. Instead, the firms and value chains which are likely to be most successful in these dynamic new markets are those which are emerging
in China and India and other developing countries, disrupting global corporate and locational hierarchies of innovation.
Improving access to health technologies by the poor: the social context in Tanzanian bed net production and delivery
Authors: Hanlin Rebecca , Muraguri Lois
Published: March 2010

This article considers the factors that determine the ability to innovate health technologies in order to make them available to those who need them most in developing countries and rid populations of disease. It uses the case of Tanzanian bed/mosquito nets particularly those treated
with insecticide which are promoted as a key prevention mechanism in the fight against malaria. Reviewing the success story of Tanzania in the production, distribution and use of bed nets, the article asks questions regarding the future ability to sustain progress. Using the concept of social
technologies, the article highlights the importance of understanding the social context of the bed net innovation process. It therefore highlights the need to consider the bed net story as one not merely of effective distribution but, more significantly, of the whole innovation value chain
from inputs to the textile factories making the nets to consumer needs and demands. It enriches our understanding of the complex nature in which the physical technologies (bed nets) are accessed by the poor and how this relates to the overall health system.
Societal beliefs, scientific technologies and HIV/AIDS in Africa: facing the challenge of integrating local communities in Kenya and Zimbabwe
Authors: Kilonzo Susan M , Mugwagwa Julius T
Published: March 2010

Of the many challenges that Africa is facing, the HIV/AIDS pandemic ranks amongst the most threatening. This article draws attention to local community settings and focuses on village set-ups, probing into the nature of the approaches to combat the pandemic. Given the issues surrounding
the spread of the virus, including, for example, stigmatisation/discrimination, sexuality, modes of transmission, cultural beliefs and practices, trauma, health-care services, aid organisations as well as governance issues, we raise questions that cut across the societal belief terrains on
the one hand, and scientific/technological advancements on the other. The article explores questions relating to: the extent to which cultural practices are part of the unbreakable barriers in the effort to combat the pandemic; the extent to which cultural contexts of local communities are
understood or misunderstood; how focus on participatory approaches and not diagnostic measures can help; and how best a sustainable integration of scientific and social aspects can be achieved in the search for solutions. To address these and other related questions, the argument will be informed
by examples from Kenya and Zimbabwe, looking at how particular scientific and local communities have strived to integrate their efforts to combat HIV/AIDS.
Collaboration in biotechnology governance: why should African countries worry about those among them that are technologically weak?
Authors: Mugwagwa Julius
Published: March 2010

African countries are at different stages in the use and regulation of modern biotechnologies. A three-year case study of efforts towards cross-national cooperation in the development of policies and regulatory measures for biotechnology in southern Africa revealed that these differences
were seen as one ingredient that could give positive impetus towards coordinated development and management of the technology through experience-sharing among the countries. Cooperation would help to build the necessary scale economies to position the region not only as a strong force to resist
technology and product dumping and other malpractices, but also as an attractive region for favourable technologies and products. Even in the face of countries enjoying different bilateral and multilateral partnerships, many argued that those separate partnerships would benefit from the backdrop
of a united and coherent region. This article traces some of the arguments, presenting a case for why African countries whether weak or strong with respect to biotechnology may still find cooperation a viable option for strengthening their various positions around this technology and its regulation.
Reference intervals for brain natriuretic peptide in healthy newborns and infants measured with an automated immunoassay platform
Authors: Cantinotti Massimiliano , Storti Simona , Parri Maria Serena , Prontera Concetta , Murzi Bruno , Clerico Aldo
Published: March 2010

Background: In order to assess the reference intervals for B-type natriuretic hormone (BNP) in the first days of life, we measured peptide concentrations using the fully automated Access platform.

Methods: Plasma BNP was measured in 188 apparently healthy newborns and infants throughout the first month of extra-uterine life, as well as in 245 healthy infants ranging from 1 month to 12 years of age.

Results: BNP showed the highest concentrations in the first 2 days of life, with a progressive decline afterwards. Moreover, BNP values in the first week of life were significantly higher (p<0.0001) than values observed in the next periods. As a result, a significant negative correlation was found between BNP and age values when considering all 433 samples (ρ=–0.816, p<0.0001 by the Spearman rank correlation test). There was no significant difference between BNP values found in males and females.

Conclusions: According to this data, our study indicates that at least two reference intervals should be used for newborns and infants. The first, with higher BNP values for neonates in the first week of extra-uterine life, and the other, with lower BNP values for infants aged 2 weeks to 12 years.

Clin Chem Lab Med 2010;48:697–700.
Socioeconomic status, birth weight, maternal smoking during pregnancy and adiposity in early adult life: an analysis using structural equation modeling
Authors: Silva Antônio Augusto Moura da , Vasconcelos Ana Glória Godoi , Bettiol Heloisa , Barbieri Marco Antonio
Published: March 2010

We describe here an example of structural equation modeling in epidemiology. The association between birth weight and adiposity in early adult life, adjusted for the number of cigarettes smoked during pregnancy and socioeconomic status at birth, was evaluated. Data involving 2,063 adults from the 1978/1979 Ribeirão Preto cohort study were used. Adiposity was measured by body mass index (BMI), waist circumference (WC) and the sum of triceps and subscapular skinfolds (STSS). Models were submitted to maximum likelihood estimation, separately for men and women. Birth weight had a small and significant effect on adiposity in men (standardized coefficient, SC = 0.08) and women (SC = 0.09). Smoking during pregnancy did not influence adiposity in men (SC = 0.004), but its effect was marginally significant in women (SC = 0.07; P = 0.056). Socioeconomic status at birth had a small and positive effect on adiposity in men (SC = 0.08) and a moderate and negative effect in women (SC = -0.16). In this young adult population, BMI, WC and STSS used alone or in combination were valid estimators of body adiposity.
Ocorrência de quedas em idosos residentes em instituições de longa permanência em Pelotas, Rio Grande do Sul, Brasil
Authors: Álvares Liege Mata , Lima Rosângela da Costa , Silva Ricardo Azevedo da
Published: March 2010

O objetivo deste estudo foi descrever a ocorrência de quedas e fatores associados em idosos residentes em instituições de longa permanência para idosos em Pelotas, Rio Grande do Sul, Brasil. Foi utilizado um questionário estruturado com perguntas sobre características demográficas, morbidade, uso de psicotrópicos e ocorrência de quedas. Em dezembro de 2006, foram visitadas todas as 21 instituições de longa permanência para idosos registradas na cidade. Dentre elas, 19 consentiram em participar do estudo. Foram identificados 377 idosos, mas 96 não tinham condições de responder o questionário e 38 foram recusas. Dos 243 idosos incluídos no estudo, a maioria era mulheres (72,8%) e tinha, em média, 77,7 (DP = 8,9) anos. Cerca de um terço dos idosos (32,5%) sofreu pelo menos uma queda no último ano. A ocorrência de quedas foi duas vezes maior nas mulheres, nos idosos com reumatismo ou doença da coluna e naqueles que utilizavam medicação psicotrópica. Pretende-se que as informações obtidas possibilitem discussões sobre a saúde dos idosos residentes em instituições de longa permanência.
Diabetes auto-referido em idosos: prevalência, fatores associados e práticas de controle
Authors: Francisco Priscila Maria Stolses Bergamo , Belon Ana Paula , Barros Marilisa Berti de Azevedo , Carandina Luana , Alves Maria Cecília Goi Porto , Goldbaum Moises , Cesar Chester Luiz Galvão
Published: March 2010

O objetivo do estudo foi avaliar a prevalência de diabetes auto-referido em idosos, identificando fatores associados, conhecimento e práticas quanto às opções de tratamento. Trata-se de estudo transversal de base populacional, com amostra estratificada por conglomerados e em dois estágios, em municípios do Estado de São Paulo, Brasil. Dos 1.949 idosos, 15,4% referiram diabetes. O índice de massa corporal e a prática de exercício físico estiveram associados à doença. Houve diferença entre diabéticos e não diabéticos quanto à auto-avaliação da saúde, internação, morbidade auto-referida nos últimos 15 dias, e relato das seguintes doenças: hipertensão, anemia, doença renal e cardiovascular. Não houve desigualdade em relação à renda familiar per capita quanto à visita ao médico/serviço de saúde, à participação em grupos de discussão e às práticas de controle da doença. O estudo sugere a importância de mudanças comportamentais, como estratégias de prevenção e controle da doença e suas complicações, bem como a necessidade de oferta de intervenções educativas com ampliação da cobertura de cuidados aos diabéticos.
Ocorrência de flebotomíneos (Diptera, Psychodidae) em focos de leishmanioses, em área de ecoturismo do entorno do Parque Nacional dos Lençóis Maranhenses, Brasil
Authors: Rebêlo José Manuel Macário , Assunção Júnior Antonildes Nascimento , Silva Orleans , Moraes Jorge Luiz Pinto
Published: March 2010

A freqüência e distribuição das espécies de flebotomíneos foram estudadas no Município de Barreirinhas, Maranhão, Brasil, no entorno do Parque Nacional dos Lençóis Maranhenses, no período de janeiro a junho/2005, agosto/2004, julho/2005 e setembro/2008. Foram capturados 6.658 indivíduos distribuídos em dez espécies. As mais freqüentes foram Lutzomyia whitmani (46,6%), L. longipalpis (29,9%), L. evandroi (17,1%) e L. lenti (4,8%), enquanto L. termitophila, L. flaviscutellata, L. migonei, L. infraspinosa, L. sordellii, L. wellcomei, L. antunesi e L. trinidadensis representaram juntas 1,6% da amostra total. A presença de espécies transmissoras de Leishmania justifica o elevado coeficiente de detecção de leishmaniose tegumentar nos anos de 2000 (308,2), 2001 (310,9), 2002 (338,2) e 2005 (313,6) e focos ativos de leishmaniose visceral humana, no Município de Barreirinhas.
THE EFFECT OF FEEDBACK ON THE ACCURACY OF CHECKLIST COMPLETION DURING INSTRUMENT FLIGHT TRAINING
Authors: Rantz William G. , Dickinson Alyce M. , Sinclair Gilbert A. , Houten Ron Van
Published: March 2010

This study examined whether pilots completed airplane checklists more accurately when they receive postflight graphic and verbal feedback. Participants were 8 college students who are pilots with an instrument rating. The task consisted of flying a designated flight pattern using a personal computer aviation training device (PCATD). The dependent variables were the number of checklist items completed correctly. A multiple baseline design across pairs of participants with withdrawal of treatment was employed in this study. During baseline, participants were given postflight technical feedback. During intervention, participants were given postflight graphic feedback on checklist use and praise for improvements along with technical feedback. The intervention produced near perfect checklist performance, which was maintained following a return to the baseline conditions.
PREVENTING BACK INJURIES IN HOSPITAL SETTINGS: THE EFFECTS OF VIDEO MODELING ON SAFE PATIENT LIFTING BY NURSES
Authors: Nielsen Don , Sigurdsson Sigurdur O. , Austin John
Published: March 2010

This study evaluated video scoring and feedback about scoring as a safety intervention among 6 nursing staff. The dependent variable was safety behavior on one‐person transfers. Following baseline, 5 nursing staff participated in an information phase. A video scoring phase was then introduced for all 6. A feedback phase was added for 2 participants. All participants experienced treatment withdrawal. Information resulted in improvements for all 5 participants who received it. Further improvements were observed during video scoring for the 5 participants who improved following information. No improvements were observed for the participant who received only video scoring. Safety feedback further improved safety for the 2 participants who received it. However, participants' behavior returned to video scoring levels during withdrawal.
EVALUATION OF THE MULTIPLE‐STIMULUS WITHOUT REPLACEMENT PREFERENCE ASSESSMENT METHOD USING ACTIVITIES AS STIMULI
Authors: Daly Edward J. , Wells Nikki J. , Swanger‐Gagné Michelle S. , Carr James E. , Kunz Gina M. , Taylor Ashley M.
Published: March 2010

The current study examined the accuracy of the multiple‐stimulus without replacement (MSWO) preference assessment for identifying preferred common classroom activities as reinforcers with children with behavioral disorders. The accuracy of predictions from the MSWO regarding high, medium, and low stimulus preference was tested by providing contingent access to activities for completing math problems within an independent seatwork format. Overall, there was an interaction effect between preference ranking (high, medium, or low) and number of problems completed. The results confirm and extend previous findings regarding the accuracy of predictions with the MSWO. The findings also reveal, however, some individual differences that may account for instances in which student behavior did not conform to predictions of stimulus preference assessments.
EQUIVALENCE CLASS FORMATION: A METHOD FOR TEACHING STATISTICAL INTERACTIONS
Authors: Fields Lanny , Travis Robert , Roy Deborah , Yadlovker Eytan , Aguiar‐Rocha Liliane de , Sturmey Peter
Published: March 2010

Many students struggle with statistical concepts such as interaction. In an experimental group, participants took a paper‐and‐pencil test and then were given training to establish equivalent classes containing four different statistical interactions. All participants formed the equivalence classes and showed maintenance when probes contained novel negative exemplars. Thereafter, participants took a second paper‐and‐pencil test. Participants in the control group received two versions of the paper‐and‐pencil test without equivalence‐based instruction. All participants in the experimental group showed increased paper‐and‐pencil test scores after forming the interaction‐indicative equivalence classes. Class‐indicative responding also generalized to novel exemplars and the novel question format used in the paper‐and‐pencil test. Test scores did not change with repetition for control group participants. Implications for behavioral diagnostics and teaching technology are discussed.
CONSUMPTION AND RESPONSE OUTPUT AS A FUNCTION OF UNIT PRICE: MANIPULATION OF COST AND BENEFIT COMPONENTS
Authors: Delmendo Xeres , Borrero John C. , Beauchamp Kenneth L. , Francisco Monica T.
Published: March 2010

We conducted preference assessments with 4 typically developing children to identify potential reinforcers and assessed the reinforcing efficacy of those stimuli. Next, we tested two predictions of economic theory: that overall consumption (reinforcers obtained) would decrease as the unit price (response requirement per reinforcer) increased and that the cost and benefit components that defined unit price would not influence overall consumption considerably when unit price values were equal. We tested these predictions by arranging unit price such that the denominator was one (e.g., two responses produced one reinforcer) or two (e.g., four responses produced two reinforcers). Results showed that consumption decreased as unit price increased and that unit price values with different components produced similar consumption.
THE EFFECTS OF PARENT‐IMPLEMENTED PECS TRAINING ON IMPROVISATION OF MANDS BY CHILDREN WITH AUTISM
Authors: Chaabane Delia B. Ben , Alber‐Morgan Sheila R. , DeBar Ruth M.
Published: March 2010

The present study examined the extent to which mothers were able to train their children, 2 boys with autism, to exchange novel pictures to request items using the picture exchange communication system (PECS). Generalization probes assessing each child's ability to mand for untrained items were conducted throughout conditions. Using a multiple baseline design, results demonstrated that both children improvised by using alternative symbols when the corresponding symbol was unavailable across all symbol categories (colors, shapes, and functions) and that parents can teach their children to use novel pictorial response forms.
A COMPARISON OF FOUR STRATEGIES FOR TEACHING A SMALL FOREIGN‐LANGUAGE VOCABULARY
Authors: Petursdottir Anna Ingeborg , Hafliđadóttir Rakel Dögg
Published: March 2010

We compared the effects of tact training, listener training, and two types of intraverbal training on 2 children's acquisition of foreign‐language tact, listener, and intraverbal relations. The children received all four types of training simultaneously with different stimulus sets. Native‐foreign intraverbal training presented the greatest difficulty with acquisition for both children. All types of training generated increases in correct responding on tests for emergent relations, and some emerged to criterion. However, no type of training resulted in criterion‐level performance on all relations.
A FURTHER ANALYSIS OF THE VALUE OF CHOICE: CONTROLLING FOR ILLUSORY DISCRIMINATIVE STIMULI AND EVALUATING THE EFFECTS OF LESS PREFERRED ITEMS
Authors: Schmidt Anna C. , Hanley Gregory P. , Layer Stacy A.
Published: March 2010

We sought to address limitations of prior research that has isolated choice as an independent variable. Children's preferences for the opportunity to choose were evaluated in a concurrent‐chains arrangement in which identical consequences were available in choice and no‐choice conditions. Results demonstrated that preference for choice, in and of itself, was (a) evident in children, (b) not controlled by illusory discriminative stimuli such as the amount from which to choose, and (c) generally unaffected by less preferred and potentially unimportant consequences.
DECREASING ERRORS IN READING‐RELATED MATCHING TO SAMPLE USING A DELAYED‐SAMPLE PROCEDURE
Authors: Doughty Adam H. , Saunders Kathryn J.
Published: March 2010

Two men with intellectual disabilities initially demonstrated intermediate accuracy in two‐choice matching‐to‐sample (MTS) procedures. A printed‐letter identity MTS procedure was used with 1 participant, and a spoken‐to‐printed‐word MTS procedure was used with the other participant. Errors decreased substantially under a delayed‐sample procedure, in which the choice stimuli were presented first and the sample was presented only after 5 s without a response to the choice stimuli.
ALTERING RESPONSE CHAINS IN PATHOLOGICAL GAMBLERS USING A RESPONSE‐COST PROCEDURE
Authors: Johnson Taylor E. , Dixon Mark R.
Published: March 2010

Two pathological gamblers could choose between emitting or having the dealer emit the response options when playing each of three casino games. A response‐cost procedure was introduced in a multiple baseline design across games in which the participant had to pay to perform the responses himself, which was somewhat effective at reducing many of the initial irrational choices made by each participant.
Serum Levels of Cytokines in Subjects With Generalized Chronic and Aggressive Periodontitis Before and After Non‐Surgical Periodontal Therapy: A Pilot Study
Authors: Duarte Poliana Mendes , da Rocha Marcelo , Sampaio Eduardo , Mestnik Maria Josefa , Feres Magda , Figueiredo Luciene Cristina , Bastos Marta Ferreira , Faveri Marcelo
Published: March 2010

Background: The emergence of periodontal medicine has increased interest in defining the serologic profiles of inflammatory mediators in subjects with periodontitis. Thus, the aim of this pilot study is to evaluate the serum levels of tumor necrosis factor‐alpha (TNF‐α), interferon‐γ, and interleukin (IL)‐4, ‐17, and ‐23 in subjects with generalized chronic periodontitis (GCP) and generalized aggressive periodontitis (GAgP) before and after non‐surgical periodontal therapy.

Methods: Cytokines were measured by enzyme‐linked immunosorbent assay in serum samples taken from 42 systemically healthy subjects divided according to periodontal status into subjects with GAgP (n = 14) and GCP (n = 14) and periodontally healthy (PH) subjects (n = 14). In addition, the levels of cytokines were reassessed at 6 months after periodontal therapy in the periodontitis groups. Clinical parameters were also evaluated at baseline and 6 months post‐therapy.

Results: After therapy, both periodontitis groups demonstrated a significant improvement in clinical periodontal status (P <0.05). At baseline, concentrations of TNF‐α (P = 0.0006) and IL‐17 (P = 0.02) were significantly higher in the GAgP group compared to the other groups. There was a significant decrease in serum concentrations of TNF‐α (P = 0.03) and IL‐17 (P = 0.04) at 6 months post‐therapy in the GAgP group (P <0.05). The concentration of TNF‐α remained elevated in the GAgP group compared to the PH group at 6 months post‐therapy (P = 0.04).

Conclusions: Subjects with GAgP presented higher levels of TNF‐α and IL‐17 than subjects with GCP and PH subjects. In addition, although the serum levels of these cytokines improved significantly as a result of periodontal therapy, the levels of TNF‐α remained higher in subjects with GAgP compared to PH subjects.
Realignment and Extended Fusion with Use of a Medial Column Screw for Midfoot Deformities Secondary to Diabetic Neuropathy
Authors: Assal Mathieu , Ray Adrien , Stern Richard
Published: March 2010

BACKGROUND:

The failure of nonsurgical treatment of patients with midfoot and hindfoot deformity secondary to diabetic Charcot arthropathy may lead to a rocker-bottom foot deformity with recurrent or persistent plantar ulceration. We report our experience with realignment and extended fusion with primary use of a medial column screw for this midfoot deformity.

METHODS:

From July 2001 through July 2005, we performed reconstructive surgery on fifteen adults with diabetes mellitus who had a severe neuropathic midfoot deformity consisting of a collapsed plantar arch with a rocker-bottom foot deformity. Thirteen had a nonhealing midfoot plantar ulcer. All underwent realignment and arthrodesis with a medial column screw; some required additional fixation techniques depending on the extent of the deformity. Outcome measures included ulcer and surgical wound-healing, radiographic results, complications, and the need for amputation.

RESULTS:

The mean duration of clinical follow-up was forty-two months. Fourteen patients were able to walk, and there were no recurrent plantar ulcers. Thirteen patients were able to wear custom-made extra-depth, wide-toed shoes with molded inserts. One patient without prior ulceration had development of a deep infection that necessitated an amputation. Four feet had a nonunion, one of which was symptomatic requiring a revision to obtain union.

CONCLUSIONS:

Surgical reconstruction of a collapsed neuropathic foot deformity is technically demanding, but a successful outcome can result in a plantigrade foot that is free of ulceration and abnormal pressure points and a patient who is able to walk. The procedure described has an acceptable degree of complications although it has a high rate of nonunion.

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION:

“Realignment and Extended Fusion with Use of a Medial Column Screw for Midfoot Deformities Secondary to Diabetic Neuropathy” (2009;91:812-20).
Open Reduction and Internal Fixation of Proximal Humeral Fractures with Use of the Locking Proximal Humerus Plate
Authors: Konrad G. , Bayer J. , Hepp P. , Voigt C. , Oestern H. , Kääb M. , Luo C. , Plecko M. , Wendt K. , Köstler W. , Südkamp N.
Published: March 2010

BACKGROUND:

The treatment of unstable displaced proximal humeral fractures, especially in the elderly, remains controversial. The objective of the present prospective, multicenter, observational study was to evaluate the functional outcome and the complication rate after open reduction and internal fixation of proximal humeral fractures with use of a locking proximal humeral plate.

METHODS:

One hundred and eighty-seven patients (mean age, 62.9 ± 15.7 years) with an acute proximal humeral fracture were managed with open reduction and internal fixation with a locking proximal humeral plate. At the three-month, six-month, and one-year follow-up examinations, 165 (88%), 158 (84%), and 155 (83%) of the 187 patients were assessed with regard to pain, shoulder mobility, and strength. The Constant score was determined at each interval, and the Disabilities of the Arm, Shoulder and Hand (DASH) score was determined for the injured and contralateral extremities at the time of the one-year follow-up.

RESULTS:

Between three months and one year, the mean range of motion and the mean Constant score for the injured shoulders improved substantially. Twelve months after surgery, the mean Constant score for the injured side was 70.6 ± 13.7 points, corresponding to 85.1% ± 14.0% of the score for the contralateral side. The mean DASH score at the time of the one-year follow-up was 15.2 ± 16.8 points. Sixty-two complications were encountered in fifty-two (34%) of 155 patients at the time of the one-year follow-up. Twenty-five complications (40%) were related to incorrect surgical technique and were present at the end of the operative procedure. The most common complication, noted in twenty-one (14%) of 155 patients, was intraoperative screw perforation of the humeral head. Twenty-nine patients (19%) had an unplanned second operation within twelve months after the fracture.

CONCLUSIONS:

Surgical treatment of displaced proximal humeral fractures with use of the locking proximal humeral plate that was evaluated in the present study can lead to a good functional outcome provided that the correct surgical technique is used. Because many of the complications were related to incorrect surgical technique, it behooves the treating surgeon to perform the operation correctly to avoid iatrogenic errors.

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.

ORIGINAL ABSTRACT CITATION:

“Open Reduction and Internal Fixation of Proximal Humeral Fractures with Use of the Locking Proximal Humerus Plate. Results of a Prospective, Multicenter, Observational Study” (2009;91:1320-8).
3D modelling of the flow distribution in the delta of Lake Øyeren, Norway
Authors: Zinke Peggy , Olsen Nils Reidar Bøe , Bogen Jim , Rüther Nils
Published: March 2010

A 3D numerical model was used to compute the discharge distribution in the channel branches of Lake Øyeren's delta in Norway. The model solved the Navier–Stokes equations with the k–ɛ turbulence model on a 3D unstructured grid. The bathymetry dataset for the modelling had to be combined from different data sources. The results for three different flow situations in 1996 and 1997 showed a relative accuracy of the computed discharges within the range of 0 to±20% compared with field measurements taken by an ADCP at 13 cross sections of the distributary channels. The factors introducing the most error in the computed results are believed to be uncertainties concerning the bathymetry. A comparison between the computational results of the older morphology data from 1985–1990 and the model morphology from 1995–2004 indicated that morphological changes in this period had already had consequences for the flow distribution in some channels. Other important error sources were the inevitable use of averaged water level gradients because of unavailable water level measurements within the delta.
Relationship between the Atlantic Multidecadal Oscillation index and variability of mean annual flows for catchments in the St. Lawrence watershed (Quebec, Canada) during the past century
Authors: Assani Ali A. , Landais David , Mesfioui Mhamed , Matteau Martin
Published: March 2010

This paper, based on an analysis of the mean annual flow (MAF) of 16 natural rivers over the period 1934–2000, has the following goals: (1) to determine the different temporal variability modes of the MAF in the St. Lawrence watershed, (2) to describe the temporal variability of the streamflow in each mode and (3) to analyze the influence of the AMO (Atlantic Multidecadal Oscillation) on the interannual and interdecadal variability of mean annual flows in this Quebec watershed.

This paper shows that the interannual variability of mean annual flow was not synchronous on both sides of the river. During the period analyzed, MAF variability was characterized by a tendency to decrease on the south shore (right bank) but to increase on the north shore (left bank). A correlation analysis reveals that the influence of the AMO was limited exclusively to the north shore of the river, which is characterized by a continental climate. This correlation is negative. On the south shore, streamflow is correlated negatively to the AO (Arctic Oscillation).
Investigation of the performance of a simple rainfall disaggregation scheme using semi-distributed hydrological modelling of the Lee catchment, UK
Authors: Segond Marie-Laure , Wheater Howard S. , Onof Christian
Published: March 2010

A simple and practical spatial–temporal disaggregation scheme to convert observed daily rainfall to hourly data is presented, in which the observed sub-daily temporal profile available at one gauge is applied linearly to all sites over the catchment to reproduce the spatially varying daily totals. The performance of the methodology is evaluated using an event-based, semi-distributed, nonlinear hydrological rainfall–runoff model to test the suitability of the disaggregation scheme for UK conditions for catchment sizes of 80–1,000 km2. The joint procedure is tested on the Lee catchment, UK, for five events from a 12 year period of data from 16 rain gauges and 12 flow stations. The disaggregation scheme generally performs extremely well in reproducing the simulated flow for the natural catchments, although, as expected, performance deteriorates for localized convective rainfall. However, some reduction in performance occurs when the catchments are artificially urbanised.
Winter bloom of coccolithophore Emiliania huxleyi and environmental conditions in the Dardanelles
Authors: Turkoglu Muhammet
Published: March 2010

Following a summer bloom of coccolithophore Emiliania huxleyi (Lohmann) Hay & Mohler, 1967, in 2003, a winter bloom was observed for the first time between late December 2003 and early January 2004 in the Dardanelles. Microscopic observations showed that the cell dimensions of E. huxleyi (Ehux) varied from 9.85 to 13.50 μm in diameter (mean: 11.20±1.38 μm). While Ehux revealed a relatively small population density (1.60 × 104 cells L−1) in early December 2003, the bloom started in middle December 2003 (7.86 × 106 cells L−1) and then peaked in early January 2004 (5.03 × 107 cells L−1) in the superficial layer. The peak dramatically decreased in late January 2004 (7.50 × 106 cells L−1). Ehux was the dominant species and represented about 90.0% of the phytoplankton assemblage. The bloom started flourishing after the diatom and dinoflagellate blooms under nitrogen depletion and moderate light, temperature and salinity conditions. Water temperature (10.31±1.14°C) and salinity values (27.05±0.88 ppt) were usually stabile. Surface chlorophyll-a concentrations ranged from 1.23 to 2.32 μg L−1 during the bloom. The ratios of N:P (mean: 4.12±2.22) and Si:P (40.35±16.25) of the bloom period were lower than those of the non-bloom periods.
Postmortem evaluation of surgery site leakage by use of in situ isolated pulsatile perfusion after partial liver lobectomy in dogs
Authors: Risselada Marije , Polyak Maximilian M. R. , Ellison Gary W. , Bacon Nicholas J. , Van Gilder James M. , Coomer Alastair R. , Thieman Kelley E.
Published: March 2010

Objective—To evaluate postmortem surgery site leakage by use of in situ isolated pulsatile perfusion after partial liver lobectomies.

Animals—10 healthy mixed-breed male dogs.

Procedures—Dogs were anesthetized, and 5 surgical techniques (pretied suture loop, energy-based sealer-divider, harmonic scalpel, suction with clip application, or suction with use of a thoracoabdominal stapler) were used to perform 5 partial liver lobectomies in each dog. Dogs were euthanatized, and the portal vein and hepatic artery were cannulated and perfused with a modified kidney perfusion machine (pulsatile flow for arterial perfusion and nonpulsatile flow for portal perfusion). Lobectomy sites were inspected for leakage of perfusate, and time until detection of leakage was recorded. The techniques in each dog were ranked on the basis of time until leakage. Time until leakage and rankings for each surgical technique were analyzed by use of an ANOVA.

Results—Leakage of perfusate was recorded in 44 lobes at supraphysiologic pressures. Of the 6 lobes without leakage, a pretied suture loop procedure was performed in 5 and a harmonic scalpel procedure was performed in 1. Time until leakage and the ranking differed significantly between the pretied suture loop and the other techniques. Time until leakage and ranking did not differ significantly among the other techniques.

Conclusions and Clinical Relevance—Time until leakage of perfusate was greater for the pretied suture loop technique than for the other techniques, and that technique did not fail in 5 of 10 lobes. However, all techniques appeared to be safe for clinical use.
Effects of aspirin, carprofen, deracoxib, and meloxicam on platelet function and systemic prostaglandin concentrations in healthy dogs
Authors: Blois Shauna L. , Allen Dana G. , Wood R. Darren , Conlon Peter D.
Published: March 2010

Objective—To determine effects of therapeutic dosages of aspirin, carprofen, deracoxib, and meloxicam on platelet function and systemic prostaglandin concentrations in healthy dogs.

Animals—10 hound-crossbred dogs.

Procedures—Aspirin (10 mg/kg, PO, q 12 h), carprofen (4.4 mg/kg, PO, q 24 h), deracoxib (2 mg/kg, PO, q 24 h), meloxicam (0.1 mg/kg, PO, q 24 h), and a placebo were administered for 7 days in a random order to each of 10 healthy dogs; there was a 21-day washout period between subsequent treatments. One-stage prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, and plasma concentrations of thromboxane (TX)B2 and 6-keto prostaglandin (PG)F1α were measured before and after treatment administration. Platelet function was assessed by use of a platelet-function analyzer and aggregation.

Results—Aspirin, carprofen, and meloxicam did not significantly affect platelet function. Deracoxib caused a mild decrease in platelet aggregation induced by 50μM ADP. Platelet number, Hct, PT, aPTT, and plasma TXB2 and 6-keto PGF1α concentrations were unchanged after NSAID administration. Meloxicam administration resulted in a significant decrease in fibrinogen concentration, but results remained within the laboratory reference interval.

Conclusions and Clinical Relevance—Oral administration of commonly used NSAIDs at therapeutic dosages in healthy dogs did not alter plasma TXB2 and 6-keto PGF1α concentrations. Deracoxib administration resulted in a minor abnormality in platelet aggregation. Anti-inflammatory doses of aspirin did not affect platelet function as measured by use of optical aggregometry and a platelet-function analyzer. Further evaluation of the effects of aspirin and cyclooxygenase-2–selective inhibitors on hemostasis should be performed.
Comparison of strength of the human-animal bond between Hispanic and non-Hispanic owners of pet dogs and cats
Authors: Schoenfeld-Tacher Regina , Kogan Lori R. , Wright Mary L.
Published: March 2010

Objective—To assess differences in strength of the human-animal bond between Hispanic and non-Hispanic owners and determine whether these variations were associated with differences in medical care for pets.

Design—Survey.

Sample Population—419 pet owners presenting a dog or cat for veterinary services at private veterinary clinics in Aurora, Colo; Chula Vista, Calif; and Mexico City.

Procedures—Owner and pet demographic information was obtained via open-ended interview questions. The human-animal bond was assessed through the Lexington Attachment to Pets Scale. Pet health data were obtained from medical records for the specific visit observed, and a body condition score was assigned.

Results—Hispanics were more likely to own sexually intact dogs and cats as pets than were individuals of other race-ethnicity groups. Overall, owners were most likely to classify their pets as providing companionship. When data for the 2 US locations were examined separately, no significant difference existed between how non-Hispanic White and Hispanic owners viewed their pets, and scores for the Lexington Attachment to Pets Scale did not differ significantly among race-ethnicity groups.

Conclusions and Clinical Relevance—There was a strong human-animal bond among Hispanic respondents, and Hispanic pet owners in the United States and Mexico verbalized this attachment in similar ways to non-Hispanic White owners. There was no observed association between owner race-ethnicity and strength of the human-animal bond for Hispanic and non-Hispanic White pet owners in the United States. Thus, other factors must be considered to explain the observed difference in percentages of neutered animals between groups.
Ovarian remnant syndrome in dogs and cats: 21 cases (2000–2007)
Authors: Ball Rebecca L. , Birchard Stephen J. , May Lauren R. , Threlfall Walter R. , Young Gregory S.
Published: March 2010

Objective—To describe signalment, clinical findings, diagnostic tests, and results of treatment of dogs and cats with ovarian remnant syndrome (ORS).

Design—Retrospective case series.

Animals—19 dogs and 2 cats with ORS.

Procedures—Medical records for animals examined between June 2000 and October 2007 were reviewed for signalment, clinical signs, age at time of ovariohysterectomy (OHE), surgical findings during OHE, experience of the surgeon (veterinary student vs veterinarian), interval from OHE until diagnosis of ORS, results of diagnostic tests, surgical findings, and results of histologic examination of excised tissues.

Results—21 animals (19 dogs and 2 cats) with ORS were identified. The most common clinical signs were those associated with proestrus and estrus. More dogs than cats were affected, and all residual ovarian tissues were found in the region of the ovarian pedicles. The right ovary in dogs was affected significantly more often than the left ovary. Seven animals had neoplasms of the reproductive system. These animals had a significantly longer interval between OHE and diagnosis of ORS than did the 14 animals without neoplasms. Long-term follow-up of 18 animals revealed resolution of clinical signs following exploratory laparotomy.

Conclusions and Clinical Relevance—Ovarian remnants were found in typical locations for ovaries and were not considered ectopic tissue; thus, surgical error during OHE was suspected as the cause of ORS. Anatomic differences may account for differences between species, and clinical signs may not be recognized until years after OHE. Surgical removal of residual ovarian tissue resulted in resolution of clinical signs.
Successful treatment of a Vietnamese potbellied pig with an ovarian leiomyoma
Authors: Baumwart Chad A. , Prado Tulio M. , Anderson Megan P. , Coffman Elizabeth A. , Simpson Katie M. , Campbell Gregory A.
Published: March 2010

Case Description—An adult sexually intact female Vietnamese potbellied pig was examined because of abdominal distention of 5 months' duration.

Clinical Findings—The pig was moderately anemic, and its abdomen was greatly distended. A freely movable abdominal mass was detected during palpation and ultrasonographic examination of the abdomen. Examination of abdominal and thoracic radiographs revealed faint, ill-defined, linear and curvilinear mineralized opacities in the region of the mass and that the gastrointestinal tract was displaced craniodorsally. Results of radiographic exami-nation suggested that the cause of distention was a single abdominal mass (possibly a neoplasm).

Treatment and Outcome—Surgery was performed, and the mass, which was identified as the right ovary, was removed. The left ovary had a normal appearance, but it was also removed during surgery. The pig was administered a transfusion (314 mL of plasma and 296 mL of packed RBCs) before and during surgery. The mass, which accounted for ap-proximately one-third of the pig's body weight, was identified histologically as an ovarian leiomyoma.

Clinical Relevance—Pigs can safely be administered a transfusion of RBCs and plasma. Ovarian tumors can be removed from Vietnamese potbellied pigs, which allows them to be used as pets or for reproduction when only 1 ovary is affected. Uterine masses in older sexually intact Vietnamese potbellied pigs are more common than are ovarian tumors; thus, complete ovariohysterectomy should be considered when the primary purpose of the pig is to serve as a pet.