bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture
Authors: Dai Zhu , Chen Zhiwei , Liao Ying , Tang Zhengwu , Cui Juncheng 
Published: June 2018

Purpose: To compare the outcomes of contracture release by arthroscopic versus open surgical approach in patients with external snapping hip (ESH) caused by gluteal muscle contracture (GMC). Methods: Medical records of patients with ESH due to GMC who underwent open surgery (n = 44) or arthroscopic surgery (n = 48) between October 2008 and October 2014 were reviewed. Patients were followed up at 1, 3, 12, and 24 months postoperatively. Operation time, incision length, postoperative pain, postoperative complication rate, and recurrence rate were compared between the 2 groups. Hip adduction, and Harris Hip Scores (HHS) at 1 and 2 years postoperatively were compared between the groups and with preoperative data. Results: Mean operation time did not differ between the 2 groups (p>0.05). The arthroscopic surgery group had smaller incisions (p<0.05), less postoperative pain (p<0.05), lower complication rates (p<0.05) than did the open surgery group. The recurrence rates were similar for the 2 groups (p>0.05). Hip adduction, and HHS 1 year and 2 years postoperatively were significantly better postoperatively than they had been preoperatively for both groups (all p<0.01), and were similar for the 2 groups (all p>0.05). Conclusions: Arthroscopic release of contracture tissue is a safe and effective approach for the treatment of ESH caused by GMC, with the advantages of small scars, less postoperative pain, fewer complications compared with open surgery.
Higher UHMWPE wear-rate in cementless compared with cemented cups with the Saturne® Dual-Mobility acetabular system
Authors: Tabori-Jensen Steffan , Frølich Christina , Hansen Torben B. , Bøvling Søren , Homilius Morten , Stilling Maiken 
Published: June 2018

Introduction: Dual mobility (DM) total hip arthroplasty (THA) may reduce dislocation risk, but might increase the risk of high polyethylene (PE) wear due to double wearing surfaces. Methods: 127 patients (97 female) with 129 hips operated with THA after displaced femoral neck fracture FNF between 2005 and 2011, were seen for a cross-sectional clinical follow-up. Acetabular components were Saturne® DM cups with 28mm chrome-cobalt heads in UHMWPE. Cementless cups (n = 73) were hydroxyapatite coated. Radiographs were obtained for analysis of cup placement, 2D polyethylene wear and wear-rate (PolyWare 3D), and further radiological evaluation. Activity measurements included Timed Up and Go test (TUG) and walking distance from Harris Hip Score (HHS). Results: At a mean follow-up of 2.83 (1.0-7.7) years the mean wear was 0.82 mm (range 0.17-4.51, SD 0.50), and the wear-rate was 0.37 mm (range 0.06-1.90, SD 0.29). Wear-rate of 0.43 mm/year (SD 0.30) in cementless cups was higher (p = 0.004) than 0.30 mm/year (SD 0.27) in cemented cups. Mean age at time of surgery was 75.1 years (range 30-95). There was no correlation between age at time of surgery and wear (p = 0.56). There was no correlation between cup inclination and wear-rate (p = 0.35). TUG was mean 13.4 seconds (range 4.5-30.1) and correlated with wear rate (p = 0.03). Conclusions: At short term follow-up, the mean wear-rate in old and low demand patients was high, correlated to activity, and was above the generally accepted osteolysis threshold (0.1 mm/yr.). Cementless HA-coated cups had higher wear-rate than cemented cups.
3rd generation ceramic-on-ceramic cementless total hip arthroplasty: a minimum 10-year follow-up study
Authors: Lau Yeong J. , Sarmah Shashank , Witt Johan D. 
Published: June 2018

Introduction: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings. The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture. Methods: The database of the senior author (J.D.W.) was reviewed. A total of 126 hip replacements performed in 108 patients (average age 39.6 years) with an average follow-up of 12.1 years (10-16 years) was identified. Clinical notes and plain radiographs were reviewed. To measure function, patients were contacted and an Oxford Hip Questionnaire was completed. Patients were also directly questioned about the presence of squeaking or any other sounds from the hip. Radiographs were evaluated for signs of wear, osteolysis, loosening and heterotopic ossification. The abduction angle of the acetabular component was measured. Results: The average Oxford Hip Score was 39.8 out of 48. Survivorship at 10 years was 94.6% (95% CI) with revision for any cause as the endpoint. There was 1 femoral head fracture, no osteolysis, no squeaking and no detectable wear. Conclusions: The good clinical and radiographic results for this series of patients are similar to other recent long-term studies looking at 3rd generation ceramic-on-ceramic THA. The results compare favourably with other bearing surfaces. The lack of osteolysis associated with this articulation is encouraging and may also make it a good choice for younger patients requiring total hip replacement.
Transfusion rate using intravenous tranexamic acid in hip revision surgery
Authors: Mariani Pablo , Buttaro Martin A. , Slullitel Pablo A. , Comba Fernando M. , Zanotti Gerardo , Ali Pablo , Piccaluga Francisco 
Published: June 2018

Introduction: Hip revision surgery is associated with a high probability of the necessity for a blood transfusion. Different studies support the use of tranexamic acid (TXA) to decrease the rate of transfusions in primary hip surgery. Nevertheless, the use of this drug in hip revision surgery has not yet been widely accepted. The aim of our study was to establish the rate of blood transfusion with and without TXA in hip revision surgery. Methods: We retrospectively studied 125 hip revision surgery patients operated on between 2011 and 2014. We divided our series into 2 groups: the TXA group with 61 patients (in which a 1000 mg dose of TXA was used before the skin incision and a second identical dose after skin closure) and a control group with 64 patients. We analysed the red blood cell (RBC) transfusion rates and their odds risk as well as the presence of collateral complications. Results: Average RBC transfusion was 2.7 units/patient (range 0-6) in the control group compared to 1.6 units/patient (range 0-6) in the TXA group. A 90.11% (odds ratio [OR] 0.098; confidence interval [CI] 0.02-0.04; p<0.0029) odds risk reduction for transfusion of at least 1 unit of erythrocyte blood cell was observed in the TXA group. Complications associated with the TXA were similar in both groups. Interpretation: The benefits of TXA have been shown in elective hip replacement. In this study, TXA proved to be safe and efficacious in reducing the need for transfusions following revision total hip arthroplasty.
Mohs Micrographic Surgery Dermatopathology Concordance in Canada: A Single-Institution Experience
Authors: Chia Justin C. , Abi Daoud Marie S. , Williamson Tyler S. , Kurwa Habib A. 
Published: June 2018

Background: Mohs micrographic surgery (MMS) is a surgical modality that achieves high cure rates of nonmelanoma skin cancers but is dependent on accurate histologic examination of surgical margins. Therefore, quality assurance is essential to ongoing assessment of histological margins. Objectives: To prospectively determine the concordance rate between a Mohs surgeon (MS) and dermatopathologist (DP) with respect to tumour status (ie, present or absent) and tumour type. Secondary end points were to determine the relationship between discordant interpretations and slide quality and to assess the feasibility of using an electronic webform for data collection. Methods: Ten percent (10%) of the planned MMS cases between January 2015 and March 2016 were randomly selected by a histotechnologist at the start of each month. The MS and DP were blinded to the chosen cases, and slides were reviewed independently at the beginning of the following month. Data were collected using an online webform. A blinded third party determined if there were discrepancies in interpretation, and any discordant slides were reviewed together and a consensus was reached. Results: A total of 270 slides from 54 total cases were reviewed. The overall tumour status concordance rate was 93.6%. Cohen’s κ was 0.86. Tumour type concordance was 98.9%. No discrepancy required a change in patient care. All discrepant slides were from cases that required multiple stages. Conclusions: This is the first study looking at MS-DP concordance in Canada, and our findings support the MS acting as his or her own pathologist.
Prevalence of subarachnoid haemorrhage among patients with cranial venous sinus thrombosis in the presence and absence of venous infarcts
Authors: Azeemuddin Muhammad , Awais Muhammad , Mubarak Fatima , Rehman Abdul , Baloch Noor Ul-Ain 
Published: June 2018

Introduction In patients with cranial venous sinus thrombosis, the occurrence of subarachnoid haemorrhage in association with haemorrhagic venous infarcts is a well described phenomenon. However, the presence of subarachnoid haemorrhage in patients with cranial venous sinus thrombosis in the absence of a haemorrhagic venous infarct is exceedingly rare. Methods We retrospectively reviewed charts and scans of all patients who had cranial venous sinus thrombosis confirmed by magnetic resonance venography at our hospital between September 2004 and May 2015. The presence of subarachnoid haemorrhage was ascertained on fluid-attenuated inversion recovery, susceptibility-weighted imaging and/or unenhanced computed tomography scans by a single experienced neuroradiologist. Statistical analysis was performed using the Statistical Package for Social Sciences version 20. Differences in the proportion of haemorrhagic venous infarcts among patients with subarachnoid haemorrhage versus those without subarachnoid haemorrhage were compared using the chi-square test. A P value of less than 0.05 was considered significant. Results A total of 138 patients who had cranial venous sinus thrombosis were included in the study. Seventy-three (52.9%) were women and the median age of subjects was 35 (interquartile range 22–47) years. Venous infarcts and haemorrhagic venous infarcts were noted in 20/138 (14.5%) and 62/138 (44.9%) cases, respectively. Subarachnoid haemorrhage was present in 15/138 (10.9%) cases and, in three cases, subarachnoid haemorrhage occurred in the absence of a venous infarct. Haemorrhagic venous infarcts were more prevalent ( P = 0.021) among patients with subarachnoid haemorrhage (11/15) than in those without subarachnoid haemorrhage (51/123). Conclusion In patients with cranial venous sinus thrombosis, subarachnoid haemorrhage can occur even in the absence of a haemorrhagic venous infarct. The recognition of cranial venous sinus thrombosis as the underlying cause of subarachnoid haemorrhage is important to avoid misdiagnosis and inappropriate management.
Anatomic reconstruction of anterior talofibular ligament with tibial tuberosity–patellar tendon autograft for chronic lateral ankle instability
Authors: Chen Can , Lu Hongbin , Hu Jianzhong , Qiu Xuqiang , Li Xiong , Sun Deyi , Qu Jin , Zhang Tao , Xu Daqi 
Published: June 2018

Introduction: Anatomic repair of the anterior talofibular ligament (ATFL) is challenging when the local ligamentous tissue is severely attenuated. Anatomic reconstruction of the ATFL with tibial tuberosity–patellar tendon (TT-PT) autograft is a feasible choice that can avoid the complicated tendon–bone healing and restore ankle stability. Materials and methods: From 2009 to 2015, 31 chronic lateral ankle instability (CLAI) patients (31 ankles), who had a serious injury on the ATFL only, were treated with anatomic reconstruction of ATFL with TT-PT. American orthopedic foot and ankle society ankle–hindfoot score (AHS), visual analog scale for pain score (VAS), Karlsson–Peterson score, Tegner activity level, and objective examination comprehending range of motion were used to evaluate the clinical outcomes before and after operation. Radiographically, talar tilt angles and anterior drawer were assessed in pre- and postoperative ankle stress views. Results: Among the 31 ankles, 17 ankles with single-bundle ATFL and 14 ankles with double-bundle ATFL were found at operation. At a mean follow-up of 42 months (24–82 months), all patients were satisfied with the procedure. Mean AHS significantly increased from 60.5 ± 8.2 to 93.5 ± 4.8. Mean Karlsson–Peterson score significantly increased from 55.2 ± 11.0 preoperatively to 91.2 ± 6.9 at final follow-up. Average VAS significantly decreased from 5.9 ± 1.6 preoperatively to 1.4 ± 1.0 at the latest follow-up. Mean Tegner activity level was 3.7 ± 0.9 before operation, compared with 7.0 ± 0.8 after operation. On stress radiographs, mean talar tilt angle was 17.0 ± 3.4° before operation and 3.8 ± 2.1° at the latest follow-up. In addition, mean anterior tibiotalar translation was 7.5 ± 2.2 mm before operation and 1.8 ± 1.1 mm at the latest follow-up. Conclusion: Anatomic reconstruction of the ATFL using a TT-PT autograft allows bone–bone healing in talus and tendon–tendon/periosteum healing in fibula rather than requiring tendon–bone healing, which is an alternative choice for treating CLAI caused by single ATFL insufficiency.
Determinación de rangos de movimiento del miembro superior en una muestra de estudiantes universitarios mexicanos
Authors: Peña Ayala Laura Esmeralda , Gómez Bull Karla Gabriela , Vargas Salgado María Marisela , Ibarra Mejía Gabriel , Máynez Guaderrama Aurora Irma 
Published: June 2018

Introducción: esta investigación se realizó en la Universidad Autónoma de Ciudad Juárez, en la División Multidisciplinaria de la Ciudad Universitaria, con una muestra de estudiantes del programa de Ingeniería Industrial y de Sistemas. Su objetivo fue crear una base de datos que contuviera información sobre los rangos de movimientos (ROMS) del miembro superior de una muestra de jóvenes estudiantes. Materiales y métodos: Se utilizó un inclinómetro de burbuja marca Baseline® y el kit antropométrico Rosscraft®. El diseño de la investigación fue de tipo descriptivo, cuantitativo y transversal, y se tomó una muestra de 50 estudiantes; la determinación de los ROMS consistió en medir a cada uno de los participantes para, posteriormente, capturar y analizar los datos a través del software Minitab17®, para determinar medidas de tendencia central y la existencia de diferencia signi cativa entre los ROMS de hombres y mujeres. Resultados: Se determinó el límite de rango de movimiento para las articulaciones del codo, hombro, muñeca y antebrazo, encontrando que no existe evidencia de diferencia signi cativa entre los ROMS de los hombres y las mujeres del estudio, a excepción de la abducción en el hombro derecho. Discusión: Los datos recopilados en esta investigación pueden ser utilizados para el diseño de áreas de trabajo que se adecúen a las necesidades del usuario, de forma que se evite la presencia de lesiones músculo-esqueléticas y se logre la reducción de la fatiga física en los trabajadores.
Value-based surgical care: a view from the surgeon's knife
Authors: Murray Alice CA 
Published: June 2018

NHS trusts across the country are facing unprecedented financial pressures, along with rising levels of demand and widespread variation in surgical quality and cost. There is a moral and financial imperative to provide the most efficient use of resources in order to ensure sustainability of a system that is free at the point of use, and provide consistently high-value care for patients across the country. Delivering ‘value’ does not mean any reduction in the quality of care – it means achieving the same or higher quality at the same or lower cost. Avoidable and costly incidents in surgery occur every day: patients do not receive the right care, procedures or tests are performed without real benefit, complications lead to prolonged hospital stays, to readmissions and re-interventions. Put simply: poor quality surgical care is expensive. The concept of value-based health care is well known in the UK, yet its principles are not yet fully embedded in the health-care system, surgical training or practice. The shift towards better value-based care with a focus on delivery system reform (Getting It Right First Time), outcomes-based commissioning and payment reform (accountable care systems and integrated care systems) provides an opportunity to make significant improvements in surgical care. Radical and immediate change is required, and everyone, from trainees at the frontline, to clinical leaders, trust chief executives, local commissioners and policy-makers, has vital roles to play. The health-care system needs to be designed, organized and paid for differently to deliver better surgical value for patients.
Orthodoxy and Incarnation: A Reply to Mullins
Authors: Flint Thomas P. 
Published: June 2018

R. T. Mullins’s “Flint’s Molinism and the Incarnation is too Radical,” published by this journal in 2015, attempts to summarize some speculations I have offered regarding Christology and eschatology, to show that these speculations are independently implausible, and to demonstrate that they are at odds with the pronouncements of the Fifth Ecumenical Council and hence incompatible with orthodox Christianity. In this reply, I argue that Mullins’s essay fails in all three of these endeavors: its summaries are inaccurate, its arguments for implausibility are unconvincing, and its ascriptions of heresy are baseless.
How Modern Biological Taxonomy Sheds Light on the Incarnation
Authors: Dumsday Travis 
Published: June 2018

One question asked repeatedly in the history of Christology is the following: given that the incarnation was God’s chosen method of redeeming us, why did God become human by the cooperation of the Blessed Virgin Mary? Why not just create a human body and soul ex nihilo and simultaneously with that creation have God the Son assume this new instance of human nature? In answer, Augustine for instance (De Trinitate, bk. 13, ch. 18) argues that the latter option would have been a legitimate means of incarnation, but that it was not as fitting as the method actually employed. Aquinas agrees (Summa Theologica IIIa, q. 4, art. 6). By contrast, John of Damascus (De Fide Orthodoxa, bk. 3, ch. 12) seems to think that the ex nihilo option would not have constituted a genuine assumption of human nature, such that redemption required the cooperation of the Theotokos. I argue that insights provided by contemporary biology support St. John’s perspective, insofar as modern biological taxonomy suggests that lineal descent is a necessary condition for belonging to a species. As such, to take on a genuinely human nature God had to enter into the existing human lineage; creating a new ‘human’body and soul ex nihilo would not have sufficed.
Social Trinitarianism Unscathed
Authors: Davis Stephen T. , Yang Eric T. 
Published: June 2018

Social Trinitarianism (ST) is a family of views that bear some resemblance to each other in a way that distinguishes them from other Trinitarian accounts. In this paper, we address recent objections by Carl Mosser against ST, objections which have not received much attention by defenders of ST. Mosser claims that proponents of ST offer a narrative that is historically inaccurate, employs concepts of personhood and perichoresis that are incompatible, upholds dubious hermeneutical assumptions, and is unable to preclude Mormon theology within its fold. We argue that all four criticisms fail, especially for a specific version of ST: Perichoretic Monotheism.
DIÁLOGO Y EMPATÍA EN ESTUDIANTES DE 10 A 14 AÑOS
Authors: De la Caba Collado María Ángeles , López Atxurra Rafael 
Published: June 2018

INTRODUCCIÓN. Saber dialogar es una competencia compleja, que es clave tanto para el desarrollo cognitivo y afectivo como para la convivencia democrática en una sociedad culturalmente diversa. MÉTODO. Este trabajo se plantea con tres objetivos: 1) examinar la estructura factorial y fiabilidad de un cuestionario para la evaluación de habilidades de diálogo en estudiantes de10 a 14 años; 2) analizar si el alumnado de secundaria muestra niveles más altos de habilidad para dialogar en comparación con primaria y ver si aparece un patrón diferencial entre hombres y mujeres; 3) analizar las posibles correlaciones entre dimensiones de diálogo y empatía. Los participantes en el estudio fueron 434 estudiantes del último ciclo de primaria (223) y primerciclo de secundaria (211), de 6 centros educativos de la Comunidad Autónoma Vasca. Como instrumentos se emplearon la escala de empatía, en su versión para estudiantes, de Eisenberg y colaboradores y un cuestionario para evaluar habilidades de diálogo, construido ad hoc por el equipo investigador. RESULTADOS. El análisis factorial exploratorio permitió identificar tresfactores en el cuestionario de habilidades de diálogo: 1) facilitación de la comprensión del mensaje, 2) reconocimiento y búsqueda de colaboración en la interacción y 3) cortesía-descortesía. Los análisis de varianza de dos factores —género y etapa— mostraron un perfil diferencial del género, especialmente en los cursos de secundaria, con puntuaciones más altas en las mujeres en el segundo factor. Asimismo, se encontraron correlaciones positivas con empatía en los dos primeros factores de diálogo. DISCUSIÓN. Queda patente la necesidad de entrenamiento educativo. Por un lado, las diferencias fueron especialmente relevantes en aquellos aspectos básicos más relacionados con las habilidades de diálogo que implican reconocimiento y empatía, particularmenteen secundaria. Por otro lado, no se encontraron diferencias significativas en habilidades complejas de colaboración en el diálogo, en donde las puntuaciones fueron particularmente bajas.
Use of Health Insurance Among Clients Seeking Contraceptive Services at Title X–Funded Facilities in 2016
Authors: Kavanaugh Megan L. , Zolna Mia R. , Burke Kristen L. 
Published: June 2018

CONTEXTAs federal initiatives aim to fundamentally alter or dismantle the Affordable Care Act (ACA), evidence regarding the use of insurance among clients obtaining contraceptive care at Title X–funded facilities under ACA guidelines is essential to understanding what is at stake.METHODSA nationally representative sample of 2,911 clients seeking contraceptive care at 43 Title X–funded sites in 2016 completed a survey assessing their characteristics and insurance coverage and use. Chi‐square tests for independence with adjustments for the sampling design were conducted to determine differences in insurance coverage and use across demographic characteristics and facility types.RESULTSMost clients (71%) had some form of public or private health insurance, and most of these (83%) planned to use it to pay for their services. Foreign‐born clients were less likely than U.S.‐born clients to have coverage (46% vs. 75%) and to use it (78% vs. 85%). Clients with private insurance were less likely than those with public insurance to plan to use their insurance (75% vs. 91%). More than one‐quarter of clients not planning to use existing insurance for services indicated that the reason was that someone might find out.CONCLUSIONCoverage gaps persist among individuals seeking contraceptive care within the Title X network, despite evidence indicating increases in health insurance coverage among this population since implementation of the ACA. Future research should explore the impact of altering or eliminating the ACA both on the Title X provider network and on the individuals who rely on it.