bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relación del nivel de actividad física y de la composición corporal en el control postural en adultos varones
Authors: Delfa de la Morena José Manuel , Rojo Tirado Miguel Ángel , Aparecida-de-Castro Eliane , Gil Arias Alexander , Miangolarra-Page Juan Carlos , Benito Peinado Pedro José 
Published: October 2018

Introducción: El equilibrio es crucial para el desempeño de actividades de la vida diaria como la bipedestación o la marcha. La actividad física y la composición corporal son algunos de los factores intrínsecos modificables más importantes que influyen en el equilibrio.Objetivo. Analizar la influencia del nivel de actividad física (PAL) y de diferentes variables corporales sobre el control postural de adultos varones.Métodos. Estudio observacional, transversal, con 63 varones entre 25 y 60 años, índice de masa corporal (IMC) entre 18 y 35 kg/m2. Se midieron variables antropométricas (i.e. peso, IMC, perímetro de cintura), de composición corporal y de su distribución (i.e. porcentaje de masa grasa de piernas: %MGP, androide: %MGA y total: %MGT), de actividad física (PAL) y de control postural (i.e. ratio somatosensorial: SOT-SOM). Se utilizó una regresión lineal múltiple para evaluar la relación de todas las variables con la SOT-SOM.Resultados. Los resultados de este estudio muestran una correlación entre %MGT (r = -0,384, p=0,002), %MGA (r = -0,421, p=0,001) y PAL (r = 0,291, p=0,021) con la SOT-SOM. Además, los individuos clasificados como obesos (%MGT ≥ 28) obtuvieron peores puntuaciones en la SOT-SOM que los individuos no obesos (97,33±2,52 vs. 96,37±1,54; p=0,013); y los individuos clasificados como activos (PAL ≥ 1,4) obtuvieron mejores puntuaciones en la SOT-SOM que los individuos sedentarios (97,13±2,33 vs. 96,18±1,38; p=0,035).Conclusiones. La masa grasa y el PAL parecen influir a nivel propioceptivo en el control postural, siendo el perímetro de cintura la variable que más predice la SOT-SOM.Palabras clave: Estilo de vida sedentario; Actividad física; Distribución grasa corporal; Índice de masa corporal.
Risk of Subsequent Joint Arthroplasty in Contralateral or Different Joint After Index Shoulder, Hip, or Knee Arthroplasty
Authors: Lamplot Joseph D. , Bansal Anchal , Nguyen Joseph T. , Brophy Robert H. 
Published: October 2018

Background:
The risk of subsequent joint replacement following an index joint replacement for osteoarthritis and the association of this risk with demographic and patient-specific factors are not well understood. The purpose of this study was to determine how demographic and other patient-specific factors are associated with the risk of subsequent joint replacement in the contralateral or a different joint following an index joint replacement for osteoarthritis.

Methods:
The Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) of New York was used to identify the first (primary) total hip arthroplasty (THA), total knee arthroplasty (TKA), or total shoulder arthroplasty (TSA) and the risk of subsequent joint replacement in the contralateral or a different joint over 5 to 8 years. The association of demographic and other patient-specific factors with subsequent joint replacement was assessed via multivariable Cox proportional hazards modeling. We also investigated the time between the index and subsequent joint replacement.

Results:
Of 85,616 patients, 20,223 (23.6%) underwent a subsequent replacement of the contralateral joint within 5 to 8 years (median, 343 days) after the index joint replacement. The strongest predictors were obesity (adjusted hazard ratio [HR] = 1.28; p < 0.001) and index TKA compared with THA (1.72; p < 0.001). A total of 3,197 patients (3.7%) underwent a subsequent replacement of a different joint within 5 to 8 years (median, 876 days) after the index joint replacement. The strongest predictors were obesity (adjusted HR = 1.41; p < 0.001) and index TSA compared with THA (adjusted HR = 2.52; p < 0.001).

Conclusions:
There is a relatively high risk of subsequent replacement of the contralateral joint and a relatively low risk of subsequent replacement of a different joint within 5 to 8 years after an index THA, TKA, or TSA. Obesity was associated with a higher risk of subsequent replacement of the contralateral joint or a different joint.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Unaddressed Cam Deformity Is Associated with Elevated Joint Contact Stress After Periacetabular Osteotomy
Authors: Scott Elizabeth J. , Thomas-Aitken Holly D. , Glass Natalie , Westermann Robert , Goetz Jessica E. , Willey Michael C. 
Published: October 2018

Background:
Femoral cam deformity is frequently present in patients with acetabular dysplasia. Computational modeling can be used to identify how this deformity affects joint mechanics. Our purpose was to identify the relationship between cam deformity and joint contact stress after periacetabular osteotomy (PAO). We hypothesized that cam deformity is associated with an increase in peak joint contact stress after PAO.

Methods:
This was a retrospective review of patients treated for hip dysplasia with PAO without femoral osteochondroplasty. Patient-specific hip models created from preoperative and postoperative computed tomography (CT) scans were evaluated using discrete element analysis to determine maximum joint contact stress after PAO. Twenty hips with a postoperative increase in maximum contact stress were compared with 20 that demonstrated decreased maximum contact stress. Hips were assessed for cam deformity on cross-sectional imaging. Radiographic measures of acetabular dysplasia before and after PAO were assessed and compared with the change in maximum contact stress after PAO.

Results:
There was a moderate relationship between the change in maximum contact stress and the α angle (r = 0.31; p = 0.04), and the average α angle in the hips with increased maximum contact stress was significantly different from that in the hips with decreased joint contact stress (51° ± 11.4° versus 42° ± 5.1°; p = 0.04). All 6 hips with an α angle of >60° demonstrated increased joint contact stress.

Conclusions:
Cam deformity is common in patients with hip dysplasia. In our study, α angles of >60° were associated with increased postoperative joint contact stress. The α angle should be assessed preoperatively, and deformity should be addressed for optimal joint mechanics after PAO.

Clinical Relevance:
A reduction in joint contact stress is a proposed mechanism for the increased joint longevity following periacetabular osteotomy for hip dysplasia. Impingement from abnormal femoral offset negatively impacts clinical outcome, but this finding has not been evaluated from a biomechanical perspective previously and a threshold for performing femoral osteochondroplasty has not been established previously. This study provides biomechanical evidence supporting surgical management of femoral cam deformity for an α angle of >60°.
Home-Health-Care Physical Therapy Improves Early Functional Recovery of Medicare Beneficiaries After Total Knee Arthroplasty
Authors: Falvey Jason R. , Bade Michael J. , Forster Jeri E. , Burke Robert E. , Jennings Jason M. , Nuccio Eugene , Stevens-Lapsley Jennifer E. 
Published: October 2018

Background:
Home-health-care utilization after total knee arthroplasty (TKA) is increasing. Recent publications have suggested that supervised rehabilitation is not needed to optimize functional recovery after TKA; however, few studies have evaluated patients in home-health-care settings. The objectives of this study were to (1) determine whether physical therapy (PT) utilization is associated with functional improvements for patients in home-health-care settings after TKA and (2) determine which factors are related to utilization of PT.

Methods:
This study was an analysis of Medicare home-health-care claims data for patients treated with a TKA in 2012 who received home-health-care services for postoperative rehabilitation. Multivariable linear regression models were used to evaluate relationships between PT utilization and recovery in activities of daily living (ADLs). Negative binomial regression models were used to determine factors associated with PT utilization.

Results:
Records from 5,967 Medicare beneficiaries were evaluated. Low home-health-care PT utilization (≤5 visits) was associated with less improvement in ADLs compared with 6 to 9 visits, 10 to 13 visits, or ≥14 visits. Compared with low home-health-care utilization, utilization of 6 to 9 visits was associated with a 25% greater improvement in ADLs over the home-health-care episode (p < 0.0001); 10 to 13 visits, with a 40% greater improvement (p < 0.0001); and ≥14 visits, with a 50% greater improvement (p < 0.0001). The findings remained robust following adjustments for medical complexity, baseline functional status, and home-health-care episode duration. After adjustment, lower PT utilization was observed for patients receiving home health care from rural agencies (10.7% fewer visits, 95% confidence interval [CI] = 7.9% to 13.7%), those with depressive symptoms (4.8% fewer visits, 95% CI = 1.3% to 8.3%), and those with any baseline dyspnea (5.3% fewer visits, 95% CI = 3.1% to 7.5%).

Conclusions:
Low home-health-care PT utilization was significantly associated with worse recovery in ADLs after TKA for Medicare beneficiaries, after controlling for medical complexity, baseline function, and home-health-care episode duration. Patients who are served by rural agencies or who have higher medical complexity receive fewer PT visits after TKA and may need closer monitoring to ensure optimal functional recovery.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Primary Cells Isolated from Human Knee Cartilage Reveal Decreased Prevalence of Progenitor Cells but Comparable Biological Potential During Osteoarthritic Disease Progression
Authors: Mantripragada V.P. , Bova W.A. , Boehm C. , Piuzzi N.S. , Obuchowski N.A. , Midura R.J. , Muschler G.F. 
Published: October 2018

Background:
Current decisions on cellular therapies for osteoarthritis are based primarily on clinical experience or on assumptions about preferred cell sourcing. They have not been informed by rigorous standardized measurements of the chondrogenic connective-tissue progenitors (CTP-Cs) or their intrinsic diversity of chondrogenic potential. The goal of this study was to quantitatively define the CTP-Cs resident in cartilage of different grades of osteoarthritis and to compare their concentration, prevalence, and biological potential.

Methods:
Twenty-three patients who had varus malalignment of the knee and were scheduled to undergo elective total knee arthroplasty for idiopathic osteoarthritis and who had grade 1-2 osteoarthritis on the lateral femoral condyle and grade 3-4 osteoarthritis on the medial femoral condyle were recruited for study of the cartilage removed during surgery. CTP-Cs were assayed by a standardized colony-forming-unit assay using automated image-analysis software based on ASTM standard test method F2944-12.

Results:
Cell concentration was significantly greater (p < 0.001) in grade 3-4 cartilage than in grade 1-2 cartilage. The prevalence of CTP-Cs varied widely, but it trended lower in grade 3-4 cartilage than in grade 1-2 samples (p = 0.078). The biological performance of CTP-Cs from grade 1-2 and grade 3-4 cartilage was comparable. Increased cell concentration was a significant predictor of decreased CTP-C prevalence (p = 0.002).

Conclusions:
Although grade 3-4 cartilage showed fewer CTP-Cs than grade 1-2 cartilage, the range of biological performance was comparable, which suggests that either may be used as a source for potent CTP-Cs. However, the biological reason for the heterogeneity of CTP-Cs in cartilage and the biological implications of that heterogeneity are not well understood and require further study.

Clinical Relevance:
In order to improve the efficacy of cartilage cell therapy procedures, it is key to characterize the quality and quantity of the cells and progenitors being administered. Additionally, understanding the heterogeneity in order to select appropriate subsets of populations will improve the rigor of decisions concerning cell sourcing and targeting for pharmacological and cellular therapies.
The Impact of Eccentric Diaphyseal Plate and Screw Placement on the Risk of Peri-Implant Fracture
Authors: Namm Joshua D. , Morris Randal P. , Speck Fred L. , Lindsey Ronald W. 
Published: October 2018

Background:
The objective of this study was to determine the impact of the type and orientation of peripheral screw placement in an eccentrically positioned locking plate on the structural integrity of the plate-diaphyseal bone interface. We hypothesized that central placement of the screw at the end of the plate in this setting is more important than screw type (locking versus nonlocking) to limiting the risk of subsequent fracture.

Methods:
Twenty osteoporotic fourth-generation composite left humeri were divided into 4 groups and plated with stainless-steel 6-hole locking plates and 4.5-mm screws. Group 1 (control group) consisted of a centrally positioned plate with a centrally placed non-locking end screw at the sixth, most-proximal hole. Group 2 consisted of an eccentrically positioned plate with a non-locking proximal end screw placed through the center of the bone. Group 3 consisted of an eccentrically positioned plate with a locking proximal end screw placed perpendicular to the plate and eccentrically across the cortex. Group 4 consisted of an eccentrically positioned plate with a non-locking proximal end screw placed perpendicular to the plate and eccentrically across the cortex. Each group was tested with a single load to failure in torsion at a rate of 1°/second.

Results:
The control group (Group 1) failed at significantly higher peak torque values (51.62 ± 7.35 Nm) than Group 2 (38.98 ± 6.78 Nm; p = 0.006), Group 3 (34.75 ± 1.81 Nm; p < 0.001), and Group 4 (31.55 ± 1.23 Nm; p < 0.001). Failure energy absorbed in Group 1 (2,591.49 ± 819.63 Nm/degree) was significantly higher than Group 3 (1,430.51 ± 449.99 Nm/degree; p = 0.04) and Group 4 (952.49 ± 123.52 Nm/degree; p = 0.004), but not significantly higher than Group 2 (1,847.73 ± 827.35 Nm/degree; p = 0.27).

Conclusions:
Eccentrically placed plating of humeral shaft fractures significantly increases the risk of peri-implant fracture compared with a centrally placed plate. Directing the proximal-end screw centrally in an eccentrically placed plate may help to mitigate this risk at the proximal end.

Clinical Relevance:
When possible, care should be taken to place the plate centrally on the bone to avoid increased risk of peri-implant fracture at the proximal plate-bone interface.
Pediatric Lawn-Mower Injuries Presenting at a Level-I Trauma Center, 1995 to 2015
Authors: Fletcher Amanda Nicole , Schwend Richard M. , Solano Mitchell , Wester Christopher , Jarka Dale E. 
Published: October 2018

Background:
Unintentional injuries are the leading cause of morbidity and mortality among children 0 to 18 years of age in the U.S. An estimated 9,400 to 17,000 pediatric lawn-mower injuries occur each year. The aims of this study were to better define the epidemiology of lawn-mower injuries and to identify predictors of severe lawn-mower injuries to optimize public education and injury prevention.

Methods:
All patients 0 to 18 years of age who presented to Children’s Mercy Hospital (CMH), Kansas City, Missouri, during the period of 1995 to 2015 after sustaining a lawn-mower injury were identified using International Classification of Diseases, 9th Revision (ICD-9) codes. Demographic information and data regarding primary outcome measures (death, amputation, need for prosthesis, Injury Severity Score [ISS]) and secondary outcome measures were collected. Bivariate and multivariate analyses were used to identify risk factors for severe lawn-mower injuries.

Results:
One hundred and fifty-seven patients were identified, with a bimodal age distribution peaking at 4 and 15 years of age. Seventy-five percent of the subjects were male. Sixty-six percent of the patients were admitted to the hospital, with a mean length of stay of 6 days. An average of 3 operations were performed. Nineteen percent of the patients lived in a nonmetro/rural location. Lower-extremity injuries were most prevalent, affecting 84% of the patients. Forty percent of the patients experienced at least 1 traumatic amputation. Thirteen percent of the patients required a prosthesis after the injury. The average ISS was 8. Significant predictors of a higher ISS included an age of 0 to 9 years, a riding lawn mower, a grandparent operator, and a nonmetro/rural location. Younger children were more likely to be injured from a riding lawn mower, be the passenger of the mower or a bystander, be injured with a grandparent operator, and live in a nonmetro/rural location. Younger children also had a higher ISS and amputation rate, longer LOS, and more surgical procedures.

Conclusions:
Education to protect younger patients should target parent, grandparent, and older sibling operators. Education for the older, teenage group should include safe mowing techniques. Efforts should also target nonmetro/rural populations and grandparents, specifically highlighting the severe dangers of riding lawn mowers when young children are passengers or bystanders.

Level of Evidence:
Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Improving Care in Orthopaedics
Authors: Wolfstadt Jesse Isaac , Ward Sarah E. , Kim Scott , Bell Chaim M. 
Published: October 2018

* Knowledge of the basics of quality improvement is essential for orthopaedic surgeons practicing in the era of health-care funding reform.* Quality improvement allows multidisciplinary teams to identify gaps in clinical care by comparing current care with established best practices.* Teams set at least 1 goal for improvement, perform root cause analysis, and develop a set of change ideas.* The team selects a set of appropriate measures and undertakes incremental tests of change using the Model for Improvement.* Once improvements have been realized, gains must be sustained. Monitoring ensures that care does not revert to previous patterns.* Fostering a culture supportive of change and involving a wide range of stakeholders is critical throughout this process.
Raising Employee Competency and Productivity through Best Practices in Promotion and Goal Setting
Authors: Lau Hon Chung , Pang Michael 
Published: October 2018

Abstract
This paper identifies several best practices for improving employee competency and productivity. They include aligning reward and promotion practices with company core values, promoting those who are already leading and have the capacity to perform at the next level, and using both internal and external benchmarking to help employees to set stretch goals for competency training and improving productivity.
Characterizing Methane Hydrate Formation in Horizontal Water-Dominated Bubbly Flow
Authors: Fu Weiqi , Sun Baojiang , Wang Zhiyuan , Zhang Jianbo , Wang Junqi 
Published: October 2018

Abstract
Methane hydrate formation in water-based drilling mud is the great important issue for well control during the drilling operation in deep-water environment. However, most of researchers focus on hydrate formation in oil-dominated system and gas-dominated system. Few researchers pay enough attentions to hydrate formation in water-dominated system, especially for bubbly flow. In this work, groups of experiments of methane hydrate formation in horizontal water-dominated bubbly flow are performed at liquid fluid velocities of 0.95 to 1.4m/s and void fractions from 2.5% to 5.0%. According to experimental observations, methane hydrates does not form hydrate shells on gas bubbles in bubbly flow and no complete hydrate shells or plates are observed in experiments. Hydrate particles formed on the surface of bubbles prefers to slough off immediately by high motion of liquid fluid, which results in appearance of tiny bubbles in flow loop. According to analysis of the reaction rate factor, the intrinsic kinetic mainly dominates the hydrate formation at the high subcooling condition but the mass transfer dominates the hydrate formation at the low subcooling condition. A hydrate kinetic model is developed for the horizontal water-dominated bubbly flow, as a function of reaction rate factor, liquid fluid velocity, subcooling temperature and interfacial area. In the new model, the multiphase flow concept of interfacial area concentration is firstly brought in predicting interfacial areas for methane hydrate formation in bubbly flow. Another 8 groups of hydrate formation experiment are conducted to validate the new model and the maximum discrepancy is less than 8%.Ppa
Real-Time Fiber-Optic Integrated System with Retrievable Packer Enables Single-Trip Dual-Zone Evaluation: Case Study, Eastern Foothills, Colombia
Authors: Vera Vanessa , Torres Carlos A. , Delgado Eduardo , Pacheco Carlos , Higuera Josue , Torres Monica 
Published: October 2018

Abstract
To measure and analyze reservoir pressure, conductivity, gas/oil ratio (GOR), and skin value, it is necessary to run a pressure buildup (PBU) test to the corresponding zone of interest in the well. This paper describes how the implementation of a coiled tubing (CT) real-time fiber-optic (RTFO) integrated system and a retrievable packer were determining factors to successfully develop both PBU in an upper formation and a pressure evaluation in the lower formation in the same run.
To help ensure isolation and evaluation of each high potential zone in the well, conventional methods involve multiple procedures requiring multiple runs. Using the CT RTFO (Vera et al. 2018) integrated system with a retrievable packer, only one run was necessary to complete the PBU program, which involves the isolation and corresponding log of two reservoirs.
This new technology helped the operator overcome challenges and deliver improved service quality. Real-time data acquisition during the packer setting helps ensure correct inflation, and continuous monitoring of the isolated zone during the PBU process helps ensure data accuracy and defines the end of data acquisition time once radial flow has been observed in the pressure transient analysis; therefore, the points previously discussed strongly impact production by optimizing operation time. Avoiding the use of materials such as cement to isolate the mentioned zones made this operation environmentally friendly. The greatest value of this technology is that it makes real-time monitoring of both the upper and lower zones possible at the same time.
The PBU test was successfully developed by determining reservoir pressure, skin, and flow regime of the near zone formation with precision and confidence, which helps the operator make decisions about future stimulations. High-pressure stimulation was achieved, which resulted in 460 BOPD over the initial production. Finally, a downhole ball-drop tool was effectively used to help ensure that packer setup was accurate and to reduce intervention time.