bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radial Tears of the Lateral Meniscus—Two Novel Repair Techniques: A Biomechanical Study
Authors: Stender Zachary C. , Cracchiolo Allison M. , Walsh Michael P. , Patterson David P. , Wilusz Matthew J. , Lemos Stephen E. 
Published: April 2018

Background: A common treatment for radial tears of the meniscus has historically been partial meniscectomy. Owing to the poor outcomes associated with partial meniscectomy, repair of the meniscus is an important treatment option. It is important to evaluate different repair techniques for radial tears of the meniscus. Purpose/Hypothesis: The purpose of this study was to evaluate 2 novel techniques to repair radial tears of the lateral meniscus. The 2 techniques were compared biomechanically with the cross-suture method with an inside-out technique. The authors hypothesized that novel repair techniques would result in less displacement after cyclic loading, increased load required to displace the repair 3 mm, greater load to failure, decreased displacement at load to failure, and increased stiffness of the repair, resulting in a construct that more closely re-creates the function of the intact meniscus. Study Design: Controlled laboratory study. Methods: A total of 36 fresh-frozen cadaveric tibial plateaus containing intact menisci were obtained. The menisci were divided into 3 groups (n = 12 in each group), and each meniscus was repaired simulating an inside-out technique. The 3 repairs completed were the hashtag, crosstag, and cross-suture techniques. Radial tears were created at the midbody of the lateral meniscus and repaired via the 3 techniques. The repaired menisci were attached to an axial loading machine and tested for cyclic and failure loading. Results: After cyclic loading, the cross-suture repair displaced 4.78 ± 1.65 mm; the hashtag, 2.42 ± 1.13 mm; and the crosstag, 3.13 ± 1.77 mm. The hashtag and cross-tag repairs both resulted in significantly less displacement ( P = .003 and .024, respectively) as compared with the cross-suture repair. The cross-suture technique had a load to failure of 81.43 ± 14.31 N; the hashtag, 86.08 ± 23.58 N; and the crosstag, 62.50 ± 12.15 N. The cross-suture and hashtag repairs both resulted in a greater load to failure when compared with the crosstag ( P = .009 and .009, respectively). There was no difference comparing the load required to displace the cross-suture technique 3 mm versus the hashtag or crosstag technique ( P = .564 and .094, respectively). However, when compared with the crosstag technique, the hashtag technique required a significantly greater load to displace the repair 3 mm ( P = .015). Conclusion: This study introduced 2 novel repair techniques—hashtag and crosstag—that did not demonstrate superiority in terms of load to failure or stiffness, but both repairs were statistically superior to the cross-suture repair in terms of displacement after cyclic loading. Considerations that may influence the validity of these techniques include cost, surgical time, and increased technical demand. Clinical Relevance: Radial tears of the meniscus are difficult to repair. Further research into more stable constructs is necessary.
Options to reduce the need of stored blood in Total Joint Arthroplasty (TJA)
Authors: Mai Sabine 
Published: April 2018

Stored blood units are limited and will become even scarcer in the future, as the high-birthrate age group is getting older and the number of blood donors is decreasing. Stored blood also involves risks: transmission of diseases, immunological shock, side effects. Which are the options to reduce the perioperative need of stored blood? Based on published studies, the pre-, peri- and postoperative actions and their practical application in order to prevent anemia, bleeding and the need of stored blood were compiled and evaluated. Own experiences are presented. In-house statistics were evaluated and show obvious effects. The following actions should be taken into account: -Preoperative anemia has to be avoided as the risk of complications and mortality is increased. It is to be detected by blood samples and the reason for it needs to be treated. Iron deficiency is quite often the cause. The oral substitution of iron needs several weeks/months. It can also be given intravenous 2-3 weeks preoperatively. -The preoperative setting and discontinuation of anticoagulants and platelet aggregation inhibitors should be reflected. -The operation should be performed at normal temperature of the patient to allow normal function of enzyme systems and platelets. -Careful haemostasis is self-evident. -A tourniquet prevents bleeding during surgery of the knee, but reactive hyperemia may be unfavorable. -The use of a cell saver is worthwhile in blood-rich surgeries. With a drainage blood can also be collected postoperatively. -Tranexamic acid prevents fibrinolysis thus reducing bleeding. It is given preoperatively, if necessary again after 2-4 hours. Although the application is off-label in TJA, it has become established, particularly as there is good experience in other surgeries since many years. -Intra- and postoperative coagulation management is of importance. -Rational use of blood units should be standard (see guidelines). -The frequency and amount of blood samples should be restricted (1 mg of iron is lost per 2 ml of blood). In-house statistics show a clear reduction in the consumption of stored blood units after the introduction of the cell saver and the tranexamic acid. In Total hip arthroplasty the need decreased from 10 to 2.6% and in Total knee arthroplasty from 5 to 1.4%. With the help of an interdisciplinary collaboration of all professional groups, which should already start with the family doctor and before admission to the hospital, the demand for stored blood can be decreased and the perioperative risk for the patient will be reduced.
LIA with vs. without an additional intraarticular catheter- Results of a RCT
Authors: Merz Cornelia , Burkhardt Patrick , Wiedmann Marleen , Köck Albert , Beckmann Johannes 
Published: April 2018

Local infiltration analgesia (LIA) is meanwhile worldwide established and scientifically proven in perioperative treatment of TKA. Single-shot is the mostly used option. However, after the local analgesia has subsided, at the latest after the day of surgery, the pain is usually present and affects rapid mobilization and rehabilitation. Long-acting medications for LIA have not proved to be effective and there are barely data on intra-articular continuous analgesia. We present a randomized controlled trial which compares the LIA with and without additional continuous analgesia using an intraarticular catheter. 50 patients with TKA were randomized and included in the study. All patients received the same implant system without patellar resurfacing, without tourniquet or drains. The operation was performed by the same surgeon and postoperative treatment was identical. Both groups received a general anesthesia with laryngeal mask. A group of 25 patients received a single-shot LIA containing 150 ml bupivacaine (0.2%) and morphine (20 mg). The other group, also 25 patients, received the same single-shot LIA and an intraarticular catheter (350 ml) for 3 days with continuous infiltration (8ml/h) of bupivacaine (0.2%) and morphine (20 mg per 200 ml bupivacaine) . The following parameters were recorded preoperatively and postoperatively: VAS, additionally analgetics / opioids. Also included were complications such as infections, postoperative falls and DVT. The average operating time was 46 min. There were no complications or reinterventions. The results were not significantly different during the first day, but for day 2 to 4 VAS was significantly better and additional analgetics / opioids were significantly less (p <0.05) in the group with additional catheters. On days 5 and 6, the results again were comparable. There was a superiority of the additional intra-articular catheter for some days in the perioperative treatment of TKA.
A Tomahawk Shape of the Femur Predicts Greater Rotatory Knee Laxity in Patients with Anterior Cruciate Ligament Ruptures
Authors: Pfeiffer Thomas , Burnham Jeremy , Herbst Elmar , Shafizadeh Sven , Musahl Volker 
Published: April 2018

Interindividual variations in knee laxity are poorly understood. Utilizing novel pivot shift arthrometers and patients in our ACL registry the magnitude of the pivot shift was found to vary between 0-14 mm of anterior translation in the lateral compartment. Increased tibial slope was found to influence the magnitude of the pivot shift, however, it is unclear if femur morphology might influence the magnitude of the pivot shift. Therefore, the purpose of this study was to determine the relationship between anterior translation of the lateral compartment during a quantitative pivot shift test and the posterior femoral offset, quantified as the “tomahawk ratio”, in patients with complete ACL rupture. It was hypothesized that the “tomahawk ratio” would correlate with increased anterior translation of the lateral compartment of the knee. Consecutive patients with no history of prior knee surgeries undergoing primary ACL reconstruction were analyzed. A standardized pivot shift test was performed preoperatively under anesthesia on both knees and quantified using tablet technology as previously described. Radiographic measurements were made using standard lateral knee radiographs. The long axis of the femur shaft was determined by a line through the center of two circles centered on the femoral shaft. The axis of the femoral condyle was determined by a line between the most posterior and most anterior points of the lateral condyle. The distance from the intersection of these lines to the posterior end of the condyle was divided by the total anteroposterior length of the condyle. This ratio was defined as “tomahawk ratio”. Pearson correlation coefficient was used to analyze correlations (p- value < 0.05). Data sets were successfully obtained for 32 female and 25 male patients. The mean anterior translation of the lateral compartment during the pivot shift test was found to be 3.96 ±2.38 mm and 1.27±0.89 mm for the involved and uninvolved knees, respectively, with a mean side-to-side difference of 2.70±2.25 mm. The mean length of the lateral femoral condyle on x-ray was 68.36±5.31 mm, and the mean tomahawk ratio was 63.16±4.53%. There was a significant correlation between the tomahawk ratio and the absolute quantitative (r = 0.370 p < 0.05) and side-to-side differences in anterior translation of the lateral compartment (r =0.419 p < 0.05). The main finding from this study is that ACL-deficient patients with larger posterior femoral offsets quantified as the “tomahawk ratio” were found to have higher lateral translations of the knee during the pivot shift test. This suggests that variation in knee instability may be significantly affected by femoral bony morphology characterized by a larger posterior portion of the lateral condyle. This study may assist clinicians in evaluating ACL injuries and identifying patients at greater risk for increased rotational knee instability.
InsP3R-SEC5 interaction on phagosomes modulates innate immunity to Candida albicans by promoting cytosolic Ca2+ elevation and TBK1 activity
Authors: Yang Long , Gu Wenwen , Cheung King-Ho , Yan Lan , Tong Benjamin Chun-Kit , Jiang Yuanying , Yang Jun 
Published: April 2018

AbstractBackgroundCandida albicans(C. albicans) invasion triggers antifungal innate immunity, and the elevation of cytoplasmic Ca2+levels via the inositol 1,4,5-trisphosphate receptor (InsP3R) plays a critical role in this process. However, the molecular pathways linking the InsP3R-mediated increase in Ca2+and immune responses remain elusive.ResultsIn the present study, we find that duringC. albicansphagocytosis in macrophages, exocyst complex component 2 (SEC5) promotes InsP3R channel activity by binding to its C-terminal α-helix (H1), increasing cytosolic Ca2+concentrations ([Ca2+]c). Immunofluorescence reveals enriched InsP3R-SEC5 complex formation on phagosomes, while disruption of the InsP3R-SEC5 interaction by recombinant H1 peptides attenuates the InsP3R-mediated Ca2+elevation, leading to impaired phagocytosis. Furthermore, we show thatC. albicansinfection promotes the recruitment of Tank-binding kinase 1 (TBK1) by the InsP3R-SEC5 interacting complex, leading to the activation of TBK1. Subsequently, activated TBK1 phosphorylates interferon regulatory factor 3 (IRF-3) and mediates type I interferon responses, suggesting that the InsP3R-SEC5 interaction may regulate antifungal innate immune responses not only by elevating cytoplasmic Ca2+but also by activating the TBK1-IRF-3 pathway.ConclusionsOur data have revealed an important role of the InsP3R-SEC5 interaction in innate immune responses againstC. albicans.
Clinical lipidomics: a new way to diagnose human diseases
Authors: Lv Jiapei , Zhang Linlin , Yan Furong , Wang Xiangdong 
Published: April 2018

AbstractLipidomics is a measurement of a large scale of lipid species to understand roles of their carbon atoms, dual bonds, or isomerism in the lipid molecule. Clinical lipidomics was recently defined “as a new integrative biomedicine to discover the correlation and regulation between a large scale of lipid elements measured and analyzed in liquid biopsies from patients with those patient phenomes and clinical phenotypes”. The first step to translate lipidomics into clinical lipidomics is to settle a number of standard operation procedures and protocols of lipidomics performance and measurement. Clinical lipidomics is the part of clinical trans‐omics which was coined as a new emerging scientific discipline where clinical phenomes are integrated with molecular multiomics. We believe it is the time to translate lipid science and lipidomics into clinical application and to understand the importance of clinical lipidomics as one of the most helpful approaches during the design and decision‐making of therapeutic strategies for individuals. We emphasize here that clinical lipidomics should be merged with clinical phenomes, e.g. patient signs and symptoms, biomedical analyses, pathology, images, and responses to therapies, although it is difficult to integrate and fuse the information of clinical lipidomics with clinical phenomes. It will be a great achievement if we can draw the networks of lipidomic species fused with networks of genes and proteins to describe the molecular mechanisms of the disease in multi‐dimensions.
Preparation of Polyhedral Oligomeric Silsesquioxanes Containing Carboxyl Side-Chain Groups and Isolation of a Cage-Like Octamer Using Clay Mineral
Authors: Liu Jiahao , Kaneko Yoshiro 
Published: April 2018

Abstract
The hydrolytic condensation of 3-(triethoxysilyl)propyl succinic anhydride (TESPSA) in water using bulky base or acid catalysts such as tetra-n-butylammonium hydroxide (n-Bu4NOH) or trifluoromethanesulfonic acid, respectively, afforded mixtures containing polyhedral oligomeric silsesquioxanes (POSSs) as main products. The mixture obtained under basic conditions contained cage-like octamer (T8-POSS) and that from acidic conditions contained cage-like decamer (T10-POSS) and dodecamer (T12-POSS). On the other hand, polysilsesquioxanes with number average molecular weights of 1.25 × 104 or 1.43 × 104 were obtained when the hydrolytic condensation of TESPSA was performed in the presence of non-bulky base (sodium hydroxide) or acid (hydrochloric acid) catalysts, respectively, in water as a solvent. In addition, only T8-POSS could be isolated from the silsesquioxane mixture obtained via the hydrolytic condensation of TESPSA using n-Bu4NOH by sequential treatment with a clay mineral such as montmorillonite in water and acetone.
Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients
Authors: Cavero Victoria , Diez-Canseco Francisco , Toyama Mauricio , Flórez Salcedo Gustavo , Ipince Alessandra , Araya Ricardo , Miranda J. Jaime 
Published: April 2018

Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities. Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients’ feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases, while psychologists provide one-to-one consultations. Significant limitations in the care provided are discussed.
Arenas for implicit education: Looking at leftovers
Authors: Marsico Giuseppina , He Min , Valsiner Jaan 
Published: April 2018

Suur osa koolis ja lasteaedades omandatavast haridusest jõuab lasteni kõrvaliste kohtade ehk selliste paikade kaudu, mis asuvad küll haridusasutuste territooriumil, kuid ei ole otseselt õppetegevuseks ette nähtud. Samas puutuvad kõik kooliskäijad nendega oma igapäevaste toimetuste käigus tahes-tahtmata kokku. Hiina lasteaedades ja koolides saadud etnograafilisele kogemusele toetudes analüüsime hariva sisuga semiootiliselt kodeeritud salakirja õppeasutuste sissepääsude, koridoride ja trepikodade seintel ning sellistele kõrvalistele kohtadele seatud eesmärke. Näitame, et selline kodeerimine viib keskkonna kultuurilise organiseerituse täiuseni, mille puhul muutuvad otsesed hariva suunitlusega sõnumid üleliigseks.
Full text
Perception of Step by Step and non-Step by Step preschool teachers about the child-centred activities
Authors: Tuul Maire , Õun Tiia , Botvina Uljana 
Published: April 2018

Lapsekesksele kasvatusele üleminek on alushariduse valdkonnas olnud üks olulisimaid eesmärke alates Eesti taasiseseisvumisest. Selle eesmärgi täitmisel on õpetajatele abiks olnud Hea Alguse programm, milles rõhutatakse lapse individuaalsuse toetamist valikute võimaldamise ja last toetava pedagoogilise praktika kaudu. 2008. aastal tehtud kirjaliku küsitlusega selgitati välja, milliseid erinevusi esineb Hea Alguse programmi rakendavate ja mitterakendavate õpetajate hinnangutes oma tegevusele lapsekeskse kasvatuse kontekstis. Küsimustiku koostamise aluseks oli rahvusvahelise Hea Alguse Ühingu õpetajate hindamise standard. Uuringu tulemustest ilmneb, et Hea Alguse rühmade õpetajad rakendasid enda hinnangul oma tegevuses lapsekeskset kasvatust enam kui nende lasteaedade õpetajad, mis ei kuulu Hea Alguse programmi. 2016. aastal tehti sama uurimisvahendiga võrdlusuuring, et välja selgitada, kas Hea Alguse programmi rakendavate ja mitterakendavate õpetajate hinnangutes on varasema uuringuga võrreldes erinevusi. Küsitluse tule mustest selgub, et 2016. aastal olid Hea Alguse programmi mitterakendavate õpetajate hinnangud oma tegevusele lapsekeskse kasvatuse kontekstis oluliselt kõrgemad kui 2008. aastal ning ei erinenud enam statistiliselt olulisel määral Hea Alguse õpetajate hinnangutest.
Summary
Level of transferable skills according to three assessment tools in three and four-year-old Estonian children
Authors: Häidkind Pille , Schults Astra , Palts Kaili 
Published: April 2018

Eesti lasteaiaõpetajatel on kohustus hinnata igal õppeaastal laste individuaalset arengut ning anda lapsevanematele selle kohta tagasisidet. 3–4aastaste laste üldoskuste tasemele hinnangut andes saavad õpetajad lähtuda koolieelse lasteasutuse õppekavast, milles nad on riiklikele juhendmaterjalidele toetudes ära kirjeldanud laste eakohase arengutaseme. Tõenduspõhist teavet 3–4aastaste eesti laste üldoskuste taseme kohta on aga vähe. Aastatel 2014–2016 Tartu Ülikoolis tehtud rakendusuuringu käigus kogusime andmeid 3–4aastaste eesti laste teadmiste ja oskuste kohta. Andmekogumiseks kasutasime sotsiaalsete oskuste küsimustikku (N = 450), Strebeleva metoodikat (N = 262) ja PEP-3 testi (N = 127). Uuringu tulemusena täpsustus teave 3–4aastaste laste üldoskuste taseme kohta ning sellele tuginedes saab eakohase arengutaseme kirjeldusi koolieelsete lasteasutuste õppekavades sõnastada konkreetsemalt.
Summary
Management of extra-articular segmental defects in long bone using a titanium mesh cage as an adjunct to other methods of fixation
Authors: Attias N. , Thabet A. M. , Prabhakar G. , Dollahite J. A. , Gehlert R. J. , DeCoster T. A. 
Published: April 2018

Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to intramedullary nail or plate reconstruction of an extra-articular segmental long bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years) treated for a segmental long bone defect by nail or plate fixation and an adjunctive TMC were included. The bone defects treated were in the tibia (nine), femur (six), radius (one), and humerus (one). The mean length of the segmental bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was 8.3 cm (2.6 to 13). The clinical and radiological records of the patients were analyzed retrospectively. Results The mean time to follow-up was 55 months (12 to 126). Overall, 16 (94%) of the patients achieved radiological filling of their bony defect and united to the native bone ends proximally and distally, resulting in a functioning limb. Complications included device failure in two patients (12%), infection in two (12%), and wound dehiscence in one (6%). Four patients (24%) required secondary surgery, four (24%) had a residual limb-length discrepancy, and one (6%) had a residual angular limb deformity. Conclusion A titanium mesh cage is a useful adjunct in the treatment of an extra-articular segmental defect in a long bone. Cite this article: Bone Joint J 2018;100-B:646–51.