bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence and Prognostic Significance of the Segond Fracture in Patients Undergoing Anterior Cruciate Ligament Reconstruction
Authors: Slagstad Irene , Parkar Anagha P. , Strand Torbjørn , Inderhaug Eivind 
Published: March 2020

Background:The Segond fracture is an avulsion of the anterolateral tibia that can be found in patients with an anterior cruciate ligament (ACL) tear. It is currently unclear if the Segond fracture needs treatment or if it heals spontaneously and if it is associated with an increased risk of failure after ACL reconstruction.Purpose:To identify the incidence and spontaneous healing rate of Segond fractures in a consecutive cohort of patients undergoing ACL reconstruction and to examine the predictive value of the Segond fracture on the risk of undergoing revision surgery.Study Design:Cohort study; Level of evidence, 3.Methods:A retrospective review of a cohort undergoing isolated ACL reconstruction between 2002 and 2016 was performed. Radiographs from the time of injury and preoperative radiographs were evaluated for Segond fractures and healed Segond fractures. Descriptive data were extracted from an internal quality database. Statistical analyses were performed to investigate risk of revision surgery and to compare across subgroups of patients.Results:A total of 1364 patients were included in the study. The incidence of Segond fractures was 7.4%. In addition, 10.4% of patients displayed signs of healed Segond fractures. In total, 15.2% of patients had either 1 or both findings. The overall healing response of the fracture was 35.6%. Those with Segond fractures were older ( P = .014) and had a shorter interval from injury to surgery ( P = .003) as compared with the rest of the cohort. The incidence of Segond fractures was significantly higher in those injured during downhill skiing as compared with other injury mechanisms ( P = .04). The Segond fracture did not represent an increased risk of undergoing revision when compared with the control group (not significant).Conclusion:The incidence of conventional Segond fractures in patients with ACL injury was found to be in accordance with former studies. Accounting for the high incidence of healed Segond fractures, a much higher incidence (15%) was seen. Although the spontaneous healing rate from initial radiographs to preoperative imaging was only 36%, the presence of Segond fractures did not represent a higher risk of undergoing revision surgery.
Numerical study of fire resistance of stainless steel circular hollow section columns
Authors: Arrais Flávio , Lopes Nuno , Real Paulo Vila 
Published: March 2020

Stainless steel has countless desirable characteristics for a structural material. Although initially more expensive than conventional carbon steel, stainless steel structures can be competitive due to their smaller need for fire protection material and lower life-cycle cost, thus contributing to a more sustainable construction. The most common stainless steel groups used in structural applications are the austenitic, ferritic and austenitic–ferritic (also known as Duplex grades). This work presents a numerical study on the behaviour of stainless steel circular hollow section members under axial compression at elevated temperatures, with different cross-section slenderness. The numerically obtained ultimate load-bearing capacities are compared with simplified calculation formulae from Eurocode 3 for columns under fire situation. A parametric study, considering different stainless steel grades from the aforementioned groups, cross-sectional classes and slendernesses, is here presented for different elevated temperatures. The numerical analyses were performed with the finite element programme SAFIR, with material and geometric non-linear analysis considering imperfections. Comparisons between the numerical results and the Eurocode 3 rules demonstrated that a specific design approach must be developed for stainless steel columns under fire situation.
Evaluation of temporomandibular joint function after orthognathic surgery using a jaw tracker
Authors: Aslanidou Katarina , Xie Rongbing , Christou Terpsithea , Lamani Ejvis , Kau Chung H 
Published: March 2020

Objective: It has been reported that temporomandibular joint (TMJ) function after orthognathic surgery differs from normal patients. Dysfunction of the joints occurs often even in the general public, with an incidence in the range of 20%–25%. Population-based studies among adults report that approximately 10%–15% have symptoms of pain and 5% of them had a perceived need for treatment. To date, no studies have reported on the evaluation of TMJ function after orthognathic surgery through the use of four-dimensional jaw tracking. Design and setting: This study evaluated TMJ function using such a device and information from a TMJ questionnaire. Sixteen orthognathic surgery patients and 17 controls were included in this study. Four-dimensional jaw tracking information was obtained using the SiCAT JMT device. Clinical signs and jaw function were evaluated. Results: Within the limitations of the study, the following results were seen using the SICAT JMT+ jaw tracking device: (1) no significant differences were found in any of the millimetric measurements between the surgery patients and controls; (2) no significant difference was found in subjective reported symptoms of pain, clicking, crepitation, locking, stiffness, headaches and migraines between the groups; and (3)there was a significant difference in the popping of the joints for surgery and non-surgery groups. Conclusion: Jaw tracking did not detect significant differences in jaw function, but some clinical symptoms were present.
In search of healthy policy ecologies for education in relation to sustainability: Beyond evidence-based policy and post-truth politics
Authors: Stratford Robert , Wals Arjen E 
Published: March 2020

There is a rational assumption built into some research projects that policy contexts are influenced by the quality of the evidence. This is, at best, only somewhat true some of the time. Through policy ethnographies, two education researchers working in the context of sustainability discuss their experiences with evidence-based policy. Central to both accounts is how critical messages about such issues as race, wellbeing and sustainability can become diluted and even lost. In the existing ‘politics of unsustainability’, and at a time of ‘post-truth’ politics, these accounts also show the limits of evidence-based policy. We argue that those working with ‘the evidence’ need to be open about how evidence-based approaches can end up supporting the ‘status quo’. Moreover, while approaches such as knowledge mobilisation emphasise the relational qualities of policy contexts, and the importance of simple compelling narratives for decision-makers, they, like many other practices, do not sufficiently theorise the power structures surrounding knowledge and the policy context. In addition to the careful use of evidence, we argue that there needs to be greater emphasis on building healthy policy ecologies – including far more emphasis on building critical and creative policy alternatives, especially in areas like sustainability and education.
Recanalization following Endovascular treatment and imaging of PErfusion, Regional inFarction and atrophy to Understand Stroke Evolution—NA1 (REPERFUSE-NA1)
Authors: Tariq Sana , Sah Rani Gupta , Chan Leona , Rajashekar Deepthi , McTaggart Ryan , Butcher Kenneth , Aviv Richard , Swartz Rick , Field Thalia , Tarpley Jason , Shah Ruchir , Hill Michael , Demchuk Andrew , Goyal Mayank , d’Esterre Christopher D , Barber Philip A 
Published: March 2020

Rationale Following endovascular treatment, poor clinical outcomes are more frequent if the initial infarct core or volume of irreversible brain damage is large. Clinical outcomes may be improved using neuroprotective agents that reduce stroke volume and improve recovery. Aim The aim of the REPERFUSE NA1 was to replicate the preclinical neuroprotection study that significantly reduced infarct volume in a primate model of ischemia reperfusion. Specifically, REPERFUSE NA1 will determine if administration of the neuroprotectant NA1 prior to endovascular therapy can significantly reduce early (Day 2 subtract Day 1 diffusion-weighted imaging volume) and delayed secondary infarct (90-day whole brain atrophy plus FLAIR volume—Day 1 diffusion-weighted imaging volume) growth, as measured by magnetic resonance imaging. Methods and design REPERFUSE-NA1 is a magnetic resonance imaging observational substudy of ESCAPE-NA1 (ClinicalTrialGov NCT02930018). A total of 150 acute stroke patients will be recruited (including 20% attrition) that have been randomized to either NA1 or placebo in the ESCAPE-NA1 trial. Study outcomes Primary—Early infarct growth measured using diffusion-weighted imaging will be at least 30% smaller in patients receiving NA1 compared to placebo. Secondary—Delayed secondary stroke injury at 90 days will be significantly reduced in patients receiving NA1 compared to placebo, as well as delayed secondary growth at 90 days. Conclusion REPERFUSE-NA1 will demonstrate the effect of NA1 neuroprotection on reducing the early and delayed stroke injury after reperfusion treatment.
Timing of Early Complications Following Open Reduction and Internal Fixation of Closed Ankle Fractures
Authors: Bohl Daniel D. , Idarraga Alexander J. P. , Lee Simon , Hamid Kamran S. , Lin Johnny , Holmes George B. 
Published: March 2020

Introduction: There is increasing interest in the early identification and treatment of adverse medical events following orthopaedic procedures. The purpose of this study is to characterize the timing of 8 early adverse events following open reduction and internal fixation of closed fractures of the ankle. Methods: A retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program. A total of 17 318 patients undergoing open reduction and internal fixation of closed ankle fractures were identified. 48.4% of patients were discharged on the day of surgery. For each of 8 different early adverse events, the median postoperative day of diagnosis, interquartile range for day of diagnosis, and middle 80% for day of diagnosis were determined. Timing was compared between unimalleolar and bi-/trimalleolar fractures and between inpatient and outpatient procedures. Results: The median day of diagnosis (and interquartile range; middle 80%) for myocardial infarction was 2 (1-5; 0-17), pneumonia 3 (2-7; 1-19), acute kidney injury 6.5 (2-18; 2-20), urinary tract infection 7 (2-14; 0-24), pulmonary embolism 10 (3-21; 0-27), sepsis 15 (4-22; 1-28), deep vein thrombosis 17 (10-22; 3-27), and surgical site infection 19 (14-25; 8-28). Patients with bi-/trimalleolar fractures had earlier occurrence of myocardial infarction (day 2 vs 10), urinary tract infection (day 6.5 vs 9.5), and sepsis (day 10 vs 20.5). Inpatients had later occurrence of acute kidney injury (day 7 vs 3), but earlier occurrence of urinary tract infection (day 6 vs 15). Conclusions: These precisely described time periods for occurrence of specific adverse events enable heightened awareness among orthopaedic surgeons during the first month following open reduction and internal fixation of the ankle. Orthopaedic surgeons should have the lowest threshold for testing for each adverse event during the time period of greatest risk. Levels of Evidence: Therapeutic, Level III: Retrospective cohort study
Computed tomography assessment of anterior ethmoidal canal dehiscence: An interobserver agreement study and review of the literature
Authors: Guarnizo Angela , Nguyen Thanh B , Glikstein Rafael , Zakhari Nader 
Published: March 2020

Purpose The anterior ethmoidal artery can be injured in functional endoscopic sinus surgery. The ability of computed tomography (CT) to identify dehiscence of the anterior ethmoidal canal (AEC) has not been widely evaluated. The aim of this study was to evaluate the interobserver agreement in the CT assessment of AEC dehiscence. Methods We conducted a retrospective review of consecutive CT scans of the paranasal sinuses (PNS) between January 1, 2012, and December 31, 2012. Two neuroradiologists separately assessed the presence of AEC dehiscence, the presence of PNS opacification, and the best CT plane to evaluate the AEC. Statistical analysis included descriptive analysis and interobserver agreement (kappa coefficient). Results The AEC was below the skull base in 199 (22.3%) cases. Dehiscence of the AEC was found in 13.2% for reader 1 and in 7.3% for reader 2. The interobserver agreement for identification of AEC dehiscence was only fair (κ = 0.246). The interobserver agreement for the AEC dehiscence in cases with opacification of ethmoidal air cells was substantial (κ = 0.754). Conclusion The suboptimal interobserver agreement could potentially limit the usefulness of CT scans for routine assessment of AEC dehiscence. In patients with PNS opacification, CT scans could still add valuable information regarding AEC dehiscence.
A portable pneumatic compression device to prevent venous thromboembolism in orthopedic patients with the highest risks of both venous thrombosis and bleeding: A case series study
Authors: Takahashi Yoshiki , Takahira Naonobu , Shibuya Manaka , Uchiyama Katsufumi , Fukushima Kensuke , Iwase Dai , Kawamura Tadashi , Miyagi Masayuki , Higashiyama Reiji , Moriya Mitsutoshi , Sakai Kenta , Tsuda Kouji , Sakamoto Miki , Akamine Akihiko , Takaso Masashi 
Published: March 2020

Purpose: There is a pressing need for safe venous thromboembolism (VTE) prophylaxis in orthopedic patients with the highest risks of both venous thrombosis and bleeding. Portable intermittent pneumatic compression device (IPCD) has proven to be effective and safe in patients with a high risk of venous thrombosis and low bleeding risk. Therefore, this study examined the effectiveness, safety, and wearing compliance of portable IPCD for postoperative VTE prophylaxis in patients with the highest risks of both venous thrombosis and bleeding. Methods: The cases consisted of 38 patients who had used a portable IPCD and had the highest risks of both venous thrombosis and bleeding. We examined the incidence of VTE to assess the effectiveness of the portable IPCD, the presence of hemorrhagic adverse events to assess safety, and the wearing rate to assess wearing compliance. Results: The incidences of asymptomatic and symptomatic deep vein thrombosis were 5.3% and 2.6%, respectively. The incidence of hemorrhagic adverse events was 21.1% in patients who received anticoagulants and wore an IPCD simultaneously and 0% in patients who wore an IPCD but did not receive anticoagulants. The wearing rate (i.e. ≥18 h/day) was 100%. Conclusion: Portable IPCD has the potential for safe VTE prophylaxis in patients at high risks for both venous thrombosis and bleeding. Therefore, we suggest that such patients use a portable IPCD for VTE prophylaxis.
Arthroscopic procedures could delay the need for a subsequent knee arthroplasty in older patients with end-stage osteoarthritis
Authors: Phua Jonathan Kia-Sheng , Razak Hamid Rahmatullah Bin Abd , Mitra Amit Kanta 
Published: March 2020

Background/objective: Arthroscopic surgery in knee osteoarthritis is controversial with many studies refuting its efficacy in recent literature. This study aims to evaluate the mean duration to knee arthroplasty, and the effect of microfracture on the need for subsequent knee arthroplasty in patients above the age of 55 undergoing arthroscopic procedures for osteoarthritis. Methods: One hundred and nine consecutive patients with diagnosed osteoarthritis who underwent arthroscopic surgery performed from January 2000 to December 2012 on patients aged 55 years and above by a single surgeon were reviewed retrospectively. Demographic data, age at operation, comorbidities, perioperative details and information of subsequent total knee arthroplasty were collected and analysed. Results: There were 38 males and 71 females in our study group. The group was predominantly Chinese (51.38%), with hypertension and hyperlipidaemia being the most common comorbidities, each affecting 57.8% of our study cohort. All patients had a preoperative radiograph and a magnetic resonance imaging confirming the diagnosis of osteoarthritis associated with meniscal tears. Fifty-eight knees underwent microfracture along with arthroscopic meniscectomy. The mean follow-up duration was 127.5 months (10.5 years, range: 67–212 months). Twenty three patients (20.91%) underwent knee arthroplasties subsequently, with the mean duration to arthroplasty being 65.0 months (5.5 years, range: 7–166 months). The odds ratio of avoiding knee arthroplasty with microfracture was 1.03 (95% CI = 0.410–2.581). Conclusion: Arthroscopic procedures could possibly delay the need for subsequent knee arthroplasty for approximately 65 months in older patients with osteoarthritis. However, microfracture does not affect the duration between therapeutic arthroscopy and subsequent arthroplasty. Our long-term retrospective study provides an additional step in the understanding of the impact of arthroscopic procedures and a prospective case–control study would be an ideal follow-up to fully justify the application of arthroscopic procedures to delay knee arthroplasty.
Neutrophil activation and neutrophil derived neutrophil extracellular trap formation in patients with coronary artery ectasia
Authors: Guo Yuchao , Liu Ruifeng , Chen Lianfeng , Wu Wei , Zhang Shuyang 
Published: March 2020

Abstract
Background
This study investigated neutrophil activation and neutrophil-derived extracellular traps formation in coronary artery ectasia.

Methods
We enrolled 90 patients who underwent coronary angiography, and included 30 patients with coronary artery ectasia (CAE), 30 patients with obstructive coronary artery disease (CAD) and 30 patients with normal coronary arteries (CON). Intra-neutrophil mean myeloperoxidase index (MPXI) was determined using an automated blood cell counter (ADVIA2120 Hematology System). Serum concentrations of plasma adhesion molecules, cytokines, and neutrophil-derived extracellular traps were quantified.

Results
The intra-neutrophil mean myeloperoxidase index was reduced in CAE patients compared to CAD and CON patients (1.02 ± 3.01, 3.22 ± 3.03, 3.52 ± 4.25, respectively; CAE vs CAD, p = 0.016 and CAE vs CON, p = 0.007). Multiple logistic regression analysis showed that MPXI and dsDNA were independent factors that predicted the presence of CAE. CAE patients had higher levels of plasma adhesion molecules (P-selectin glycoprotein ligand-1, E-selectin, L-selectin) and interleukin 1 beta levels. Neutrophil extracellular trap concentrations were significantly higher in the CAE group compared to CAD and CON patients (284.31(258.33–449.91) ng/mL, 225.12(203.34–257.13) ng/mL, and 247.37(231.04–273.01) ng/mL, respectively; CAE vs CAD, p = 0.000 and CAE vs CON, p = 0.001).

Conclusions
Peripheral neutrophils from CAE patients were activated and neutrophil extracellular traps were elevated in the plasma. IL-1β and soluble adhesion molecules may be the causal factors for neutrophil activation.
Distorted body weight perception and its gender differences in middle-aged adults: population based study
Authors: Song Youngshin , Kwon Myoungjin , Kim Sun Ae 
Published: March 2020

Abstract
Background
Increasing interest in appearance and the growing preference for a beautiful body can lead to physical and psychological problems due to an inappropriate body image perception. As such, there is a need to identify what factors may contribute to an inappropriate body image. The purpose of this study was to examine the presence of distorted body weight perception among middle-aged Koreans and identify gender differences and other factors that contribute to a distorted body image regarding body weight.

Methods
Data on 8363 middle-aged adults (aged 45–64 years) from the Korea National Health and Nutrition Examination Survey were analyzed using complex samples analysis considering weight, stratification variables, and cluster variables. The difference between perceived body image regarding body weight and actual body mass index was used to assess distorted body weight perception. Socioeconomic status, health behaviors, daily energy consumption, and psychological status (depression and stress) were assessed for their relationship to distorted body weight perception.

Results
Results showed that a distorted body image regarding body weight was more prevalent among middle-aged men (45.3%) than women (25.7%). Age, income, perceived health status, and health behaviors were significantly associated with distorted body weight perception in middle-aged men, whereas psychological factors were associated with distorted body weight perception in middle-aged women.

Conclusions
Further research on distorted body weight perception is needed to gain understanding of the gender differences between middle-aged men and women in Korea. Furthermore, to the results of the study can be used as a basis for developing various education, health mediation, and public health promotion interventions and programs to address body weight perception in middle-aged adults.
Jaw reconstruction with vascularized fibular flap: The 11-year experience among 104 patients
Authors: Shao Shengjie , Wang Weihong , Xu Biao , Liu Yu , Zhang Zhe 
Published: February 2020

Abstract
Background
A vascularized fibular osteomyocutaneous flap with severe vascular crisis often results in serious consequences. This study aims to examine the clinical effect of non-vascularized fibular graft on patients with severe vascular crisis after reconstruction of the defect jaw with vascularized fibular osteomyocutaneous flap.

Materials and methods
From December 2007 to December 2018, a total of 104 patients with jaw neoplasms that underwent reconstruction with free vascularized fibular flap were retrospectively analyzed; seven of these cases had postoperative vascular crisis during mandibular reconstruction.

Results
Of the seven cases with postoperative vascular crisis, the vascularized fibular flaps in three patients survived completely, thanks to early detection; two cases were completely necrotic and removed in the end, and the remaining two cases had severe vascular crisis after the removal of the soft tissue attached to the fibular flap. The non-vascular fibular grafts were retained regardless of the severe absorption after follow-ups for 25 and 69 months, respectively.

Conclusions
If vascular crisis occurs following jaw reconstruction with a vascularized fibular osteomyocutaneous flap, early re-surgical exploration effectively improves the salvage rate. In addition, when a severe vascular crisis occurs, the vascularized fibular flap can be changed to a non-vascular fibular graft to reconstruct the mandibular defect, thus avoiding the serious consequences resulting from the complete failure of fibular graft.