bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fixation of Transverse Olecranon Fractures by Suture Bridge Method Using Suture Anchor: Biomechanical Comparison with Tension Band Wiring Technique
Authors: Lee Hyun Il , Cho Jin Ho , Choi Jun Young , Lee Sung Sahn , Cho Sung Tan 
Published: June 2021

Background: Olecranon fractures are common in motorcycle accidents, falls, or in direct elbow injury. In cases of transverse olecranon fracture, surgery is frequently required in adults. The aim of this study is to compare the biomechanical durability of suture anchor fixation in olecranon fractures to conventional tension band wiring technique in saw bones. Methods: 12 plastic saw bones were divided into 3 groups: tension band wiring fixation, modified Cha-Batman method, and a modified simple suture method using a suture anchor. After fixation, cyclic load tests were conducted for 1,000 cycles, at 5 Hz with a force of 10 N to 250 N. After cycling loading, the extent of displacement was measured using a non-contact coordinate measuring instrument, and statistical analysis performed. Results: The average displacement was significantly smaller in the modified Cha-Bateman method (1.4 mm) than in the tension band wiring method (3.8 mm, p = 0.007) and the modified simple suture method using suture anchor (3.3 mm, p = 0.012). There was no significant difference in displacement between tension band wiring fixation and the modified simple suture method (p = 0.564). Conclusions: This study provides a biomechanical basis for the hypothesis that the suture anchor technique in weak bone model could obtain results comparable to those of conventional tension band wiring. In particular, the modified Cha-Bateman method, showed stronger biomechanical properties than the tension band wiring method and modified simple suture method using a suture anchor. The current study could also provide pilot data that can be used in future experiments.
Identification of Prognostic Factors in Spaghetti Wrist Injuries
Authors: De Moumita , Singhal Maneesh , Naalla Ravikiran , Dave Aniket 
Published: June 2021

Background: Spaghetti wrist injuries involve a complete transection of three or more structures at the wrist level (including tendons, nerves, or arteries). Few studies on spaghetti wrist trauma have been reported in the literature, and most of them have focused on functional recovery rather than the prognostic factors which affect the outcome. We attempted to address some of the lacunae in current knowledge. Methods: Patients who were operated between January 2017 to January 2019 for spaghetti wrist injuries at a level 1 trauma center were included in the study. Several variables such as age, gender, smoking, education level, mechanism of injury, time gap between the injury to surgery, number of damaged structures and pattern of neurovascular structure were selected as potential prognostic factors to be included in the analysis. Motor recovery, sensory recovery & QuickDash score were used for the outcome assessment. A Multivariate analysis was done to identify the prognostic factor(s). Results: Thirty patients were included in the study. The mean age was 30.5 years (range: 7–57 years). Male population was predominantly affected (93.33%). The dominant limb was injured in 73.33%. The most common mechanism of injury was accidental glass cut (n = 19,63.33%), the most frequently affected structure was flexor digitorum superficialis of the middle finger (n = 23, 76.6%). Combined nerve injury was present in 23.33%. Intrinsic muscle recovery was affected significantly by presence of crush injury (e = 7.189, std error = 2.425, p = 0.003), education significantly affected power grip recovery (p < 0.0001), age was associated with pinch grip recovery (e = 0.083, std error = 0.039, p = 0.034). Conclusions: Increasing age, low education level, and presence of crush injury were identified as negative prognostic factors in the study. These findings may be used for counselling of patients affected by spaghetti wrist injuries.
Antithrombotic Use with Collagenase Clostridium Histolyticum Injection to Treat Dupuytren Disease
Authors: Paynter Jessica A. , Tobin Vicky , Hurst Lawrence C. , Badalamente Marie A. , Hunter-Smith David J. , Rozen Warren M. 
Published: June 2021

Background: Collagenase Clostridium histolyticum (collagenase) is an injectable treatment option for Dupuytren disease. The current study was designed to investigate the safety and ensure the effectiveness of collagenase for the treatment of Dupuytren disease, with or without concomitant antithrombotic usage. Methods: One hundred and forty-eight patients with Dupuytren disease were treated with collagenase during this period; 49 taking antithrombotics and 99 not taking antithrombotics. The primary outcomes were clinical success (a reduction in joint contracture to < 5°) and clinical improvement (a reduction in joint contracture by equal to or more than 50%). Results: No statistically significant difference in either clinical success or clinical improvement was found between those taking and those not taking antithrombotics. No significant difference was found in the incidence of any adverse effects or skin splits between the two cohorts. Conclusions: Collagenase can be safely and effectively used to treat patients with Dupuytren disease who take antithrombotics.
Evaluation of Restricted Motion Area of the Median Nerve in Patients with Carpal Tunnel Syndrome: A New Measurement Method Using an Ultrasonographic Video Image
Authors: Hara Yukinori , Tajiri Yasuhito , Kawano Kenichi , Hoshikawa Shinya 
Published: June 2021

Background: The precise etiology of carpal tunnel syndrome (CTS) remains unclear. One of the accepted factors for CTS is the restriction of the median nerve. Previous reports using ultrasound had only observed and measured the movement of parts of the median nerve. In this study, we aimed to elucidate the difference in the movement of the entire median nerve in patients with CTS (before and after surgery) and healthy volunteers using a new measurement method. Methods: We expressed the amount of movement of the entire nerve by a new method creating the motion area of the median nerve (MAMn) from an ultrasonographic video image on the computer. We compared the MAMn, the real MAMn (RMMn) (the value obtained by subtracting the nerve cross-sectional area from the MAMn), and mobile ratio (MR) (the value obtained from dividing the MAMn by the nerve cross-sectional area) between six wrists of six cases of CTS (before and at an average of 3.5 months after surgery) and six wrists of six healthy volunteers. Results: During passive wrist flexion, the average MAMn, RMMn, and MR of healthy cases were 23.1 mm2, 16.4 mm2, and 3.52, respectively. The average MAMn, RMMn, and MR of cases of CTS were respectively 11.8 mm2, 5.4 mm2, and 1.86 preoperatively; and 16.2 mm2, 7.3 mm2, and 1.87, postoperatively. The MAMn, RMMn, and MR decreased more significantly in patients with CTS than in healthy volunteers (p < 0.01). The MAMn and RMMn increased postoperatively (p < 0.05), but the MR remained low. Conclusions: The new measurement method revealed that the mobility of the entire median nerve was significantly restricted in cases of CTS compared to healthy participants. However, after surgery, nerve restriction was not restored despite improvements in symptoms, suggesting that decreases in nerve mobility contribute to CTS but are not a direct cause of symptoms.
The Italian Version of the Michigan Hand Outcomes Questionnaire (MHQ): Translation, Cross-Cultural Adaptation and Validation
Authors: Passiatore Marco , De Vitis Rocco , Cilli Vitale , Milano Giuseppe , Saccomanno Maristella Francesca , Cotroneo Claudia , Brozzini Elisa , Vigliarolo Daniela , Taccardo Giuseppe 
Published: June 2021

Background: Patient-reported outcome measures are largely used in clinical practice and scientific community. Michigan hand questionnaire (MHQ) is widely recognized as a standardized reliable instrument for the assessment of any kind of hand disorders. Aim of the study: translation, cross-cultural adaptation and validation of the Italian version of MHQ. Methods: The study was composed by two phases. Phase 1 consisted in translation and cross-cultural adaptation of MHQ, from original language version (English) into Italian, according to the standard procedure of translation and back translation. The final Italian version of MHQ was tested on 136 Italian patients with hand disorders (Phase 2), in addition to Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Visual analogue scale (VAS) for pain assessment and grip strength, to psychometric properties of the new version, 55 patients repeated the questionnaire after 7 days for test-retest to assess the reproducibility of the questionnaire. All data were subsequently analyzed (descriptive statistics, multitrait analysis, reliability and construct validity assessment). Results: Phase 1 was performed without major problems, thus the final Italian version was approved for Phase 2. The questionnaire was clear and easily understood (missing data 0–2.9%). Multitrait analysis brought very good results for each outcome measure. High reliability (Cronbach’s alpha: 0.91–0.99) and very good reproducibility (Intraclass correlation coefficients: 0.83–0.98) were revealed. High to moderate correlation was found between MHQ and DASH, grip strength and VAS. Conclusions: The Italian version of MHQ has demonstrated to be reliable and valid.
Vascular Calcification as a Novel Risk Factor for Kidney Function Deterioration in the Nonelderly
Authors: Park Samel , Cho Nam‐Jun , Heo Nam Hun , Rhee Eun‐Jung , Gil Hyowook , Lee Eun Young 
Published: June 2021

Background
The relationship between vascular calcification and chronic kidney disease is well known. However, whether vascular calcification affects renal function deterioration remains unclear. We investigated whether kidney function deteriorated more rapidly in individuals with higher vascular calcification indicated by the coronary artery calcium score (CACS).

Methods and Results

Individuals with a normal estimated glomerular filtration rate (>60 mL/min per 1.73 m
2
) who underwent cardiac computed tomography in our institution (a tertiary teaching hospital in Cheonan, Korea) from January 2010 to July 2012 were retrospectively reviewed. All participants were aged 20 to 65 years. Among 739 patients, 447, 175, and 117 had CACSs of 0, 1 to 99, and ≥100 units, respectively. The participants were followed for 7.8 (interquartile range, 5.5–8.8) years. The adjusted annual estimated glomerular filtration rates declined more rapidly in patients in the CACS ≥100 group compared with those in the CACS 0 group (adjusted‐β, −0.40; 95% CI, −0.80 to −0.03) when estimated using a linear mixed model. The adjusted hazard ratio in the CACS ≥100 group for Kidney Disease: Improving Global Outcomes criteria (a drop in estimated glomerular filtration rate category accompanied by a 25% or greater drop in estimated glomerular filtration rate) was 2.52 (1.13–5.61). After propensity score matching, more prevalent renal outcomes (13.2%) were observed in patients with a CACS of ≥100 compared with those with a CACS of 0 (1.9%), with statistical significance (
P
=0.004).

Conclusions
Our results showed that renal function declined more rapidly in patients with higher CACSs, suggesting that vascular calcification might be associated with chronic kidney disease progression.
Postoperative Myocardial Injury in Patients Classified as Low Risk Preoperatively Is Associated With a Particularly Increased Risk of Long‐Term Mortality After Noncardiac Surgery
Authors: Vasireddi Sunil K. , Pivato Erica , Soltero‐Mariscal Enrique , Chava Raghuram , James Laurence O. , Gunzler Douglas , Leo Peter , Kondapaneni Meera D. 
Published: June 2021

Background
Prior studies have shown an association between myocardial injury after noncardiac surgery (MINS) and all‐cause mortality in patients following noncardiac surgery. However, the association between preoperative risk assessments, Revised Cardiac Risk Index and American College of Surgeons National Surgical Quality Improvement Program, and postoperative troponin elevations and long‐term mortality is unknown.

Methods and Results
A retrospective chart review identified 548 patients who had a troponin I level drawn within 14 days of noncardiac surgery that required an overnight hospital stay. Patients aged 40 to 80 years with at least 2 cardiovascular risk factors were included, while those with trauma, pulmonary embolism, and neurosurgery were excluded. Kaplan–Meier survival and odds ratio (OR) with sensitivity/specificity analysis were performed to assess the association between preoperative risk and postoperative troponin elevation and all‐cause mortality at 1 year. Overall, 69%/31% were classified as low‐risk/high‐risk per the Revised Cardiac Risk Index and 66%/34% per American College of Surgeons National Surgical Quality Improvement Program. Comparing the low‐risk versus high‐risk groups, preoperative risk assessment was not associated with either postoperative troponin elevation or 1‐year mortality. MINS portended a 1‐year mortality of OR, 3.9 (95% CI, 2.44–6.33) in the total population. Patients classified as low risk preoperatively with MINS had the highest risk of 1‐year mortality (OR, 9.6; 95% CI, 4.27–24.38), with a low prevalence of statin use.

Conclusions
Current preoperative risk stratification tools do not prognosticate the risk of postoperative troponin elevation and all‐cause mortality at 1 year. Interestingly, patients classified as low risk preoperatively with MINS had a markedly higher 1‐year mortality risk compared with the general population, and most of them are not taking a statin. Our results suggest that evaluating preoperatively low‐risk patients for MINS presents an opportunity for prognostication, risk reclassification, and initiating therapies such as statins to mitigate long‐term risk.
Compliance in Primary Prevention With Statins and Associations With Cardiovascular Risk and Death in a Low‐Risk Population With Type 2 Diabetes Mellitus
Authors: Malmborg Morten , Schmiegelow Michelle D. S. , Gerds Thomas , Schou Morten , Kistorp Caroline , Torp‐Pedersen Christian , Gislason Gunnar 
Published: June 2021

Background
We examined whether primary prevention with statins and high adherence to statins reduce the associated risk of cardiovascular events or death in a low‐risk population with type 2 diabetes mellitus (T2D).

Methods and Results

Using Danish nationwide registers, we included patients with new‐onset T2D, aged 40 to 89 years, between 2005 and 2011, who were alive 18 months following the T2D diagnosis (index date). In patients who purchased statins within 6 months following T2D diagnosis, we calculated the proportion of days covered (PDC) within 1 year after the initial 6‐month period. We studied the combined end point of myocardial infarction, stroke, or all‐cause mortality, whichever came first, with Cox regression. Reported were standardized 5‐year risk differences for fixed comorbidity distribution according to statin treatment history, stratified by sex and age. Among 77 170 patients, 42 975 (56%) were treated with statins, of whom 31 061 (72%) had a PDC ≥80%. In men aged 70 to 79 years who were treated with statins, the standardized 5‐year risk was 22.9% (95% CI, 21.5%–24.3%), whereas the risk was 29.1% (95% CI, 27.4%–30.7%) in men not treated, resulting in a significant risk reduction of 6.2% (95% CI, 4.0%–8.4%),
P
<0.0001. The risk reduction associated with statins increased with advancing age group (women: age 40–49 years, 0.0% [95% CI, −1.0% to 1.0%]; age 80–89 years, 10.8% [95% CI, 7.2%–14.4%]). Standardizing to all patients treated with statins, PDC <80% was associated with increased risk difference (reference PDC ≥80%; PDC <20%, 4.2% [95% CI, 2.9%–5.6%]).

Conclusions
This study supports the use of statins as primary prevention against cardiovascular diseases or death in 18‐month surviving low‐risk patients with T2D, with the highest effect in the elderly and adherent patients.
Functional Assessment of Myocardial Bridging With Conventional and Diastolic Fractional Flow Reserve: Vasodilator Versus Inotropic Provocation
Authors: Aleksandric Srdjan B. , Djordjevic‐Dikic Ana D. , Dobric Milan R. , Giga Vojislav L. , Soldatovic Ivan A. , Vukcevic Vladan , Tomasevic Miloje V. , Stojkovic Sinisa M. , Orlic Dejan N. , Saponjski Jovica D. , Tesic Milorad B. , Banovic Marko D. , Petrovic Marija T. , Juricic Stefan A. , Nedeljkovic Milan A. , Stankovic Goran , Ostojic Miodrag C. , Beleslin Branko D. 
Published: June 2021

Background
Functional assessment of myocardial bridging (MB) remains clinically challenging because of the dynamic nature of the extravascular coronary compression with a certain degree of intraluminal coronary reduction. The aim of our study was to assess performance and diagnostic value of diastolic‐fractional flow reserve (d‐FFR) during dobutamine provocation versus conventional‐FFR during adenosine provocation with exercise‐induced myocardial ischemia as reference.

Methods and Results

This prospective study includes 60 symptomatic patients (45 men, mean age 57±9 years) with MB on the left anterior descending artery and systolic compression ≥50% diameter stenosis. Patients were evaluated by exercise stress‐echocardiography test, and both conventional‐FFR and d‐FFR in the distal segment of left anterior descending artery during intravenous infusion of adenosine (140 μg/kg per minute) and dobutamine (10–50 μg/kg per minute), separately. Exercise–stress‐echocardiography test was positive for myocardial ischemia in 19/60 patients (32%). Conventional‐FFR during adenosine and peak dobutamine had similar values (0.84±0.04 versus 0.84±0.06,
P
=0.852), but d‐FFR during peak dobutamine was significantly lower than d‐FFR during adenosine (0.76±0.08 versus 0.79±0.08,
P
=0.018). Diastolic‐FFR during peak dobutamine was significantly lower in the exercise‐stress‐echocardiography test –positive group compared with the exercise‐ stress‐echocardiography test –negative group (0.70±0.07 versus 0.79±0.06,
P
<0.001), but not during adenosine (0.79±0.07 versus 0.78±0.09,
P
=0.613). Among physiological indices, d‐FFR during peak dobutamine was the only independent predictor of functionally significant MB (odds ratio, 0.870; 95% CI, 0.767–0.986,
P
=0.03). Receiver‐operating characteristics curve analysis identifies the optimal d‐FFR during peak dobutamine cut‐off ≤0.76 (area under curve, 0.927; 95% CI, 0.833–1.000;
P
<0.001) with a sensitivity, specificity, and positive and negative predictive value of 95%, 95%, 90%, and 98%, respectively, for identifying MB associated with stress‐induced ischemia.

Conclusions
Diastolic‐FFR, but not conventional‐FFR, during inotropic stimulation with high‐dose dobutamine, in comparison to vasodilatation with adenosine, provides more reliable functional significance of MB in relation to stress‐induced myocardial ischemia.
The Mind as Container
Authors: Marcinkowska-Rosół Maria , Sellmer Sven 
Published: June 2021

Abstract
One of the most widespread and natural ways of conceiving of the human mind in European culture is the image of the mind as a container for thoughts, images, memories, reasonings, etc. In this article, we explore the evidence of this metaphor in the Ancient Greek epic poems, Homer’s Iliad and Odyssey as well as Hesiod’s Theogony and Works and Days, and, for comparative purposes, the evidence of the analogous metaphor in the Ancient Indian epics, the Mahābhārata and the Rāmāyaṇa. We examine how the metaphor is used, what its functions are and what it implies for the conception of mind in both ancient traditions. Additionally, we offer a brief comparison with the image of the mind-container that emerges from the use of this metaphor in modern English.
Natural Disasters in Medieval Greek Apocalypses
Authors: Kraft András 
Published: June 2021

Abstract
Natural calamities form a standard theme in Byzantine apocalypses. This paper discusses their function and meaning by surveying more than a dozen medieval Greek apocalyptic narratives from the sixth to the fifteenth century. It is shown that natural disasters were understood as ambiguous epiphenomena, whose ultimate meaning revolved around human agency and intentionality. Furthermore, it is argued that Byzantine apocalypses offered an intellectual strategy for coping with natural calamities by placing them into an eschatological context. This eschatologization restored epistemological control of the – seemingly uncontrollable – phenomena. Finally, it is suggested that the understanding of natural disasters as anthropogenic events is not only characteristic of medieval Greek apocalypticism but also of modern-day environmental alarmism. The paper closes with a preliminary comparison of these two hermeneutic paradigms.
The Religious Market Theory and Religious Change in the United States and China
Authors: Yang Fenggang 
Published: June 2021

Abstract
In this combined interview, Rodney Stark and Roger Finke share their thoughts on the development of the religious market theory, religious change in the United States, and Christian growth in China. The interview with Rodney Stark was conducted by telephone in late December 2020 and the interview with Roger Finke by email in early January 2021.
The Problem of Power in Confucian Political Thought
Authors: Crane Sam 
Published: June 2021

Abstract
In this brief reflection on Shaun O’Dwyer’s book, Confucianism’s Prospects, I accept his central arguments regarding the implausibility of “Confucian democracy,” and I suggest a further reason for the inapplicability of Confucianism as a perfectionist doctrine for modern pluralistic East Asian societies. Beyond the elitist paternalism that is the focus of O’Dwyer’s analysis, I suggest that Confucianism’s theory of power, as illustrated by reference to the Mencius and the Analects, is insufficient to the task of constituting and reproducing modern democratic practice. Thus, for democracy to develop in East Asia, it must be grounded in liberalism.