bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery
Authors: Kanatli Ulunay , Özer Mustafa , Gem Mehmet , Öztürk Burak Yağmur , Ataoğlu Muhammet Baybars , Çetinkaya Mehmet , Ayanoğlu Tacettin 
Published: June 2019

Background: Being able to predict recurrence after the treatment of shoulder instability would be helpful in planning the appropriate treatment. Purpose: To define the multiple subscapularis tendon sign (MSTS) as a novel anatomic variant and a possible risk factor for the recurrence of shoulder instability after anterior stabilization and to evaluate it, together with the other risk factors as described in the literature. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 87 patients met the study criteria and underwent arthroscopic stabilization for anterior shoulder instability. The MSTS was evaluated in this study group. Age, sex, hand dominance, number of preoperative shoulder dislocations, history of overhead or contact sports participation, type of labral lesion, number of anchors used in surgery, presence of the drive-through sign, presence of the MSTS, Oxford Shoulder Score results, and the association of these parameters with recurrence were assessed. The mean follow-up time was 81.0 ± 27.9 months (range, 48-139 months). Results: Nine (10.3%) patients experienced recurrent instability. The presence of the MSTS ( P = .009), existence of an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion ( P = .04), and history of overhead or contact sports participation ( P = .04) were significant risk factors for recurrence. The recurrence rates were as follows: 30.7% with the MSTS; 40% with the MSTS and an ALPSA lesion; and 75% with the MSTS, an ALPSA lesion, and a history of overhead or contact sports participation. Conclusion: The MSTS is a variation of the anterior shoulder joint capsule. It is a sign of capsular insufficiency or thinning, which may be a risk factor for recurrence after anterior stabilization. Considering the low success rates of anterior capsulolabral repair in patients participating in overhead or contact sports, especially when an ALPSA lesion is present, encountering the MSTS during surgery in this at-risk group may be an indicator for the surgeon to choose the surgical procedure more carefully.
Arthroscopic Diagnosis and Treatment of Chronic Hip Pain After Total Hip Arthroplasty and the Role of Anterior Capsule Disruption in Iliopsoas Tendinopathy
Authors: Nazal Mark R. , Parsa Ali , Martin Scott D. 
Published: June 2019

Background: The use of hip arthroscopic surgery in patients suffering from chronic hip pain after total hip arthroplasty (THA) has a limited presence in the literature, with most studies having limited follow-up. Purpose: The first goal of this study was to evaluate hip arthroscopic surgery in the diagnosis and management of patients with chronic hip pain after THA. The second goal was to describe a new cause of iliopsoas tendinopathy (IPT) involving disruption of the anterior capsule. Study Design: Case series; Level of evidence, 4. Methods: We conducted a retrospective analysis with prospectively collected clinical outcomes of patients after THA who underwent hip arthroscopic surgery for chronic hip pain without an identifiable cause. The patients were at least 18 years old and had a minimum follow-up of 24 months. Results: The retrospective analysis found that hip arthroscopic surgery led to new diagnostic information in 8 patients (80%). Of the 10 patients diagnosed with IPT, 4 (40%) lacked an anatomic cause; however, these patients had a history of difficult exposure of the anterior capsule and/or a lack of capsular repair during index THA. The mean modified Harris Hip Score (mHHS) was 71.9 ± 15.6, and the mean 6-month postoperative visual analog scale (VAS) pain score was 0.8 ± 2.2, which was significantly lower than preoperatively ( P = .0055). There was also significantly improved forward flexion range of motion ( P = .0183) and straight leg raise (SLR) strength test results ( P = .0263). Hip arthroscopic surgery resulted in 8 patients (80%) continuing to be pain-free at a mean follow-up of 6.8 ± 1.4 years, while 2 patients (20%) progressed to revision arthroplasty. There were no major or minor complications. Conclusion: Hip arthroscopic surgery was found to have an important role in the diagnostic and therapeutic management of patients with chronic hip pain after THA, with good clinical outcomes at a mean follow-up of 6.8 years and no complications. We believe that disruption of the anterosuperior acetabular capsule, including the reflected head of the rectus femoris, can allow the iliopsoas tendon to move intra-articularly and precipitate IPT. This disruption may be appreciated on the SLR strength test. Although this study presents a small sample size that cannot substantiate a cause-effect relationship, orthopaedic surgeons performing THA should consider minimizing disruption and/or ensuring repair of the anterior capsule to decrease this potential cause of IPT.
Altered neural activity in brain cough suppression networks in cigarette smokers
Authors: Ando Ayaka , Mazzone Stuart B. , Farrell Michael J. 
Published: June 2019

Cough is important for airway defence, and studies in healthy animals and humans have revealed multiple brain networks intimately involved in the perception of airway irritation, cough induction and cough suppression. Changes in cough sensitivity and/or the ability to suppress cough accompany pulmonary pathologies, suggesting a level of plasticity is possible in these central neural circuits. However, little is known about how persistent inputs from the lung might modify the brain processes regulating cough.In the present study, we used human functional brain imaging to investigate the central neural responses that accompany an altered cough sensitivity in cigarette smokers.In nonsmokers, inhalation of the airway irritant capsaicin induced a transient urge-to-cough associated with the activation of a distributed brain network that included sensory, prefrontal and motor cortical regions. Cigarette smokers demonstrated significantly higher thresholds for capsaicin-induced urge-to-cough, consistent with a reduced sensitivity to airway irritation. Intriguingly, this was accompanied by increased activation in brain regions known to be involved in both cough sensory processing (primary sensorimotor cortex) and cough suppression (dorsolateral prefrontal cortex and the midbrain nucleus cuneiformis). Activations in the prefrontal cortex were highest among participants with the least severe smoking behaviour, whereas those in the midbrain correlated with more severe smoking behaviour.These outcomes suggest that smoking-induced sensitisation of central cough neural circuits is offset by concurrently enhanced central suppression. Furthermore, central suppression mechanisms may evolve with the severity of smoke exposure, changing from initial prefrontal inhibition to more primitive midbrain processes as exposure increases.
The microbiology of pleural infection in adults: a systematic review
Authors: Hassan Maged , Cargill Tamsin , Harriss Elinor , Asciak Rachelle , Mercer Rachel M. , Bedawi Eihab O. , McCracken David J. , Psallidas Ioannis , Corcoran John P. , Rahman Najib M. 
Published: June 2019

Background and objectivesPleural infection is a major cause of morbidity and mortality among adults. Identification of the offending organism is key to appropriate antimicrobial therapy. It is not known whether the microbiological pattern of pleural infection is variable temporally or geographically. This systematic review aimed to investigate available literature to understand the worldwide pattern of microbiology and the factors that might affect such pattern.Data sources and eligibility criteriaOvid MEDLINE and Embase were searched between 2000 and 2018 for publications that reported on the microbiology of pleural infection in adults. Both observational and interventional studies were included. Studies were excluded if the main focus of the report was paediatric population, tuberculous empyema or post-operative empyema.Study appraisal and synthesis methodsStudies of ≥20 patients with clear reporting of microbial isolates were included. The numbers of isolates of each specific organism/group were collated from the included studies. Besides the overall presentation of data, subgroup analyses by geographical distribution, infection setting (communityversushospital) and time of the report were performed.ResultsFrom 20 980 reports returned by the initial search, 75 articles reporting on 10 241 patients were included in the data synthesis. The most common organism reported worldwide wasStaphylococcus aureus. Geographically, pneumococci and viridans streptococci were the most commonly reported isolates from tropical and temperate regions, respectively. The microbiological pattern was considerably different between community- and hospital-acquired infections, where more Gram-negative and drug-resistant isolates were reported in the hospital-acquired infections. The main limitations of this systematic review were the heterogeneity in the method of reporting of certain bacteria and the predominance of reports from Europe and South East Asia.ConclusionsIn pleural infection, the geographical location and the setting of infection have considerable bearing on the expected causative organisms. This should be reflected in the choice of empirical antimicrobial treatment.
How Providing Cervical Cancer Screening Results via Cell Phone Affects Patient Follow-Up Rates in Western Kenya
Authors: Huchko Megan J. , Saduma Ibrahim , Blat Cinthia , Oketch Sandra , Bukusi Elizabeth A. 
Published: June 2019

Purpose Human papillomavirus (HPV) testing is being more widely used in simplified cervical cancer screening protocols in low-resource settings. One challenge to successful implementation is the multiple visits necessary to provide results and follow-up. mHealth strategies may reduce visit burden by providing information through text message. Methods As part of a cluster-randomized trial to compare HPV testing in clinics and community health campaigns in western Kenya, we carried out a mixed-methods study to assess women’s preferences and experiences with different strategies to receive their results. Women could opt to receive their HPV results via text message, cell phone call, home visit, or return clinic visit. We examined overall receipt of results, follow-up rates, and acceptability by notification method. Results Among the 4,947 women who underwent HPV-based cervical cancer screening, 1,596 (32%) received results via text message, 1,181 (24%) via cell phone call, 1,563 (32%) via clinic visit, and 605 (12%) via home visit. Women opting for texts or calls were younger and had higher rates of prior cervical cancer screening, HIV testing, and modern contraceptive use ( P < .001 for all). Home visits were associated with a significantly higher rate of treatment acquisition (45%) than texts (38%), cell phone calls (38%), and clinic visits (23%; P < .001). In a model controlling for age, prior screening, HIV testing, and contraceptive use, clinic visits remained significantly associated with decreased odds of treatment (adjusted odds ratio, 0.45; 95% CI, 0.29 to 0.69) compared with texts. Among treated women, there was no difference in time to treatment by notification method. Conclusion Cell phone–based results notification strategies were preferred by women with greater health-seeking behavior; however, HPV-positive women who received results via home visit were more likely to pursue for treatment.
Association of Inpatient Glucose Measurements With Amputations in Patients Hospitalized With Acute Diabetic Foot
Authors: Peled Shahar , Pollack Rena , Elishoov Ofer , Haze Amir , Cahn Avivit 
Published: June 2019

Abstract

Context
The association of inpatient glucose measurements with amputations in patients admitted with acute diabetic foot has not been described.

Objective
To evaluate the relationship of hyperglycemia, hypoglycemia, and glucose variability during hospitalization with amputations in patients hospitalized with acute diabetic foot.

Design
Retrospective cohort study.

Setting
Academic tertiary hospital.

Patients
We reviewed demographic, clinical, laboratory, and point-of-care glucose data in patients hospitalized with acute diabetic foot in the Diabetic Foot Unit during 2015 through 2017.

Main Outcome Measures
The primary outcomes were any or major amputations during hospitalization. Secondary outcomes included length of hospitalization and in-hospital mortality.

Results
During the study period, 418 patients were hospitalized in the Diabetic Foot Unit and 45,496 glucose measurements were taken. Patients experiencing any hyperglycemia and any or severe hypoglycemia were more likely to undergo any or major amputations during hospitalization. High glycemic variability was associated with major amputations. Peripheral vascular disease (PVD), high Wagner score, and hypoglycemia were independent predictors of amputations. Older age, PVD, previous amputation, elevated white blood cell level, high Wagner score, and hypoglycemia were independent predictors of major amputations.

Conclusions
In-patient hypoglycemia emerged as an independent risk factor for any and major amputations. Although it is unclear whether hypoglycemia directly contributes to adverse outcomes or is simply a biomarker of disease severity, efforts to minimize in-hospital hypoglycemic events are warranted.
Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography
Authors: Ozen Ozkan , Gunaydın Mucahit , Tosun Alptekin , Coskun Zafer Unsal , Aytekin Kursad , Takir Selcuk 
Published: June 2019

Objective: Medications are generally administered by either the enteric or parenteral route. With parenteral administration, intramuscular (IM) is the preferred approach because it increases the bioavailability of the drug, acts more quickly than the enteric route. The aim of this study was to determine the rate of true dorsogluteal intramuscular drug injection and to determine the causes for application failures in practice by ultrasonography (US).
Methods: The study was conducted from May 1 to May 30, 2017 in Giresun University Education and Research Hospital, Giresun, Turkey. We examined 60 patients who were administered dorsogluteal IM injection with a 38.1mm length needle. After the injection, localization of medications (whether intramuscular or subcutaneous adipose tissue [SAT]) was evaluated by Ultrasound.
Results: Female/male ratio of the patients was 27/33, with a mean age of 39.78±2.16 years. Obese/normal weight ratio was 20/40. The mean dorsogluteal area SAT thickness of obese and normal weight patients were 32.34±2.17 mm and 20.85±1.20 mm, respectively. In 23 of the patients, IM injected drug was observed in the SAT, while it was observed in the IM area in 37 patients. Medication was observed in IM area in 37 of 50 patients who dorsogluteal region SAT thickness was appropriate (SAT thickness lower than 33.1mm) for IM injection while it was seen in SAT area in 13 patients.
Conclusions: SAT thickness values are important if IM drug injection is to be administered correctly. Unsuccessful IM injections may be seen even in patients with appropriate SAT thicknesses.
doi: https://doi.org/10.12669/pjms.35.4.313
How to cite this:Ozen O, Gunaydin M, Tosun A, Coskun ZU, Aytekin K, Takir S. Assessment rate of true dorsogluteal intramuscular drug injection using ultrasonography. Pak J Med Sci. 2019;35(4):1132-1137. doi: https://doi.org/10.12669/pjms.35.4.313
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Impaired renal functions in Pakistani cohort of rheumatoid arthritis
Authors: Wagan Dr Abrar Ahmed , Nasir Dr Sadia , Rahim Dr Abdul , Khan Dr Daim 
Published: June 2019

Objective: To determine the frequency of impaired renal functions and hypertension in rheumatoid arthritis.
Methods: This study was conducted between May 1st 2018 to February 1st 2019 at Rheumatology Division, Department of Medicine Central Park Medical College Lahore, total 260 study participants were selected, demographic detail were asked in detail, disease duration of RA and hypertension, DMARD’s, self-use NSAID’s,/hakeem medications, smoking were asked in detail, BMI and blood pressure were measured,5 ml of blood was taken by trained phlebotomist, and sent for the estimation of serum urea and creatinine on (COBAS-III) machine, after availability of results each individuals eGFR (creatinine clearance) was calculated by Cockroft Gualt (CG) and Modification in diet in renal disease method (MDRD).
Results: In this study the mean age of study participants was 42.4 (± 9.5) years with disease duration of 7.7(±4.8) years, prevalence of Impaired renal functions of 14.6% (n=38) and hypertension in 53.5% (n=139).Regression analysis shows there is significant association between hypertension, smoking and self/hakeem medications with impaired renal functions (p-0.5). Kappa analysis shows both (MDRD & CG methods) had uniformity in picking up cases of impaired renal functions 75.6% (p-0.05).
Conclusion: In RA decline in renal functions is seen with self-use NSAID’s/hakeem medications along with other modifiable factors like smoking and hypertension, while conventional DMARD’s don’t show association with decline. There is very high prevalence of hypertension in rheumatoid arthritis.
doi: https://doi.org/10.12669/pjms.35.4.564
How to cite this:Wagan AA, Nasir S, Rahim A, Khan D. Impaired renal functions in Pakistani cohort of rheumatoid arthritis. Pak J Med Sci. 2019;35(4):905-910. doi: https://doi.org/10.12669/pjms.35.4.564
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
FASCISMO DE ESTADO E MICROFASCISMO
Authors: Rocha Jorge Alberto Da Costa , Sales Deivisson Warlla Miranda 
Published: June 2019

No século XX iríamos assistir ao advento de uma terceira alternativa política entre o capitalismo e o marxismo: o fascismo. Mussolini buscará soerguer a Itália em meio a crises profundas, ao mesmo tempo mostrando a viabilidade teórica da sua posição, denunciando as falhas dos sistemas anteriores. Mas só poderíamos ficar restritos a uma abordagem política do termo “Fascismo”? Por um lado, esse artigo tentará mostrar um pouco o nascimento histórico deste movimento político, concentrando-se nos fundamentos teóricos da sua proposta através do entendimento do próprio Mussolini. Por outro, buscamos mostrar que houve uma apropriação filosófica interessante do termo “Fascismo”, alargando o seu conceito através das perspectivas de Deleuze e Guattari. Esses autores vão trabalhar com o conceito de microfascismo, não mais tomando o Estado como foco principal, mas os sujeitos e a constituição de sua subjetividade.
Evaluation Criteria and Approach to Voyage Planning in Ice. Verification on the Example of German Ship Activity During the Second World War
Authors: Pastusiak Tadeusz 
Published: June 2019

AbstractVessels designed for navigation in ice can perform voyage with the assistance of icebreaker in the navigation season in case an ice cover area is less than 20%. Whereas the same vessels could carry out successfully completed voyage through the NSR with intensive icebreaker help at the ice-covered area lower than 42%. Navigation of the same vessel at ice covered area above 80% is possible with intensive icebreaker help, but it threatens to damage the hull, rudder or propeller.Excessive generalization of data analyzed may cause to wrong, even opposite conclusions. Using only basic statistical information in the form of average values and standard deviation may be not sufficient for the purpose of vessel’s voyage planning in areas covered with ice. Much more opportunities for the assessment of navigation in ice covered regions provides cumulative distribution, which should be related to the time and geographical space distribution. It allows to determine the duration of time window for given area covered with ice in a particular region and predetermined probability of its occurrence. It is thus possible to plan approximate date of departure and duration of voyage for assumed safety criteria. Also, it is possible to plan a number of consecutive voyages in a navigation season.Mathematical approach to voyage planning in ice based on a cumulative distribution is presented in the paper. It allows creation of an advisory computer application to support decision-making by the commander of a vessel. It will reduce the human factor in data processing and reduce possibility of making a mistake. By this way, can be enhanced the safety of maritime transport. Novell approach is verified on the example of historical data about the German Navy ship activity during the Second World War.
The Risk of Collision Assessment with Graphic Forms of Target Data Presentation Use
Authors: Juszkiewicz Wiesław 
Published: June 2019

AbstractGuarantee of the ship safety is the primary task posed for modern navigation systems. This concerns monitoring the proper ship position as well as providing accurate information about the collision threat. The proper interpretation of this information belongs to the navigator. He must take into account many variables affecting the assessment of the situation and then make the right decision regarding anti-collision manoeuvres. This assessment could be made easier for him with use some form of graphic target data presentation methods other than currently required and described in IMO performance standards. Other possible graphic presentation methods of collision information are described in the article along with the concept of their usage.
Determination of the Risk of Location the Quay for Large Steel Components Handling in Vicinity of the Fairway Using the Fast-Time Simulation Method
Authors: Marcjan Krzysztof , Gucma Lucjan 
Published: June 2019

AbstractThe paper presents the use of the Fast-Time navigational simulator to verify the location of designed elements of navigational infrastructure in vicinity of a high traffic fairway. The aim of the study is to perform the analysis of navigational safety in vicinity of newly constructed quay placed to the east of the island Ostrow Brdowski. The Quay is intended handling of large steel structures. The Fast-Time simulation is performed to evaluate the safety of the navigation passage through the fairway along the quay for the future use of vessels which length may exceed 260 m. This kind of simulation method has been implemented to make a statistical analysis based on a large amount of data, the collection of which would be very expensive and time consuming using a Real-Time simulator.
A Broadband Differential Antenna Based on Common-Gate/Common-Source Active Balun Feed
Authors: Zhou Jian-Mei , Hu Hao , Li Chaoyi , Ren Yi , Luo Wei 
Published: June 2019

Abstract
In this paper, a novel broadband differential antenna is designed. An active balun is utilized to realize the wideband differential feed to achieve low cross- polarization antenna radiation within the working frequency of 1.0–1.6 GHz. The active balun uses a common-gate/common-source structure to achieve two equal-amplitude signals with 180° phase difference. The differential antenna is composed of rectangular slot floor and symmetrical radiation patch. The antenna is fed by the out-of-phase output of the active balun. The tested results in 1.0–1.6 GHz show the cross-polarization of E and H plane of the proposed differential antenna are lower than −22 dB, with maximum radiation direction gain is 2.3 dBi. The measured reflection coefficient of the proposed differential antenna based on the active balun feed is in good agreement with the simulation data.