bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing antibiotic stewardship using the surgical site infection prevention bundle
Authors: Mohamed Ryian , Wall Josh , Arumainathan Renuka , Fink Douglas , Sandhu Taranveer , Garg Suchika , Spiers Shabnamnaomi , Hughes Jonathan , Burdett Edward 
Published: November 2018

Background: Antibiotic prophylaxis is crucial in head and neck surgery to prevent infection from clean contaminated wounds. Scottish Intercollegiate Guidelines Network (SIGN) guidance, the gold standard of practice, recommends that administration of broad spectrum antibiotics is discontinued after 24 hours post-operation. A three-audit cycle quality improvement project was conducted to assess clinical practice against SIGN guidance at a large London teaching hospital. Methods: Three change initiatives were implemented to improve antibiotic stewardship. First, an update of Trust guidelines with an associated poster campaign to educate staff and improve awareness. Second, introduction of a specific ‘prophylactic antibiotics in head and neck surgery’ bundle on the electronic hospital-wide prescribing system. Third, an update to an antibiotic prescribing guide (Microguide). Results: Over a 3-year study period the number of patients receiving antibiotics beyond 24 hours declined significantly (88% in 2015, 76% in 2016, 25% in 2018), demonstrating improved compliance with SIGN guidelines overall. Despite this, staff documentation of indications for extended antibiotic use remains suboptimal (58% in 2016 and 44% in 2018) as does the number of specimens sent for microbiological analysis (52% in 2016 and 0% in 2018). Conclusions: Appropriate prophylactic antibiotic prescribing can improve morbidity and mortality rates in head and neck cancer patients. Three change initiatives have been demonstrated which can help to improve prescribing compliance in line with SIGN guidance. Ongoing auditing is required to maintain the longevity of improvements made and encourage staff documentation of indications for extended antibiotic use and microbiology specimen analysis.
The mean ten-year results of metal-on-metal hybrid hip resurfacing arthroplasty
Authors: Amstutz H. C. , Le Duff M. J. 
Published: November 2018

Aims This study presents the long-term survivorship, risk factors for prosthesis survival, and an assessment of the long-term effects of changes in surgical technique in a large series of patients treated by metal-on-metal (MoM) hip resurfacing arthroplasty (HRA). Patients and Methods Between November 1996 and January 2012, 1074 patients (1321 hips) underwent HRA using the Conserve Plus Hip Resurfacing System. There were 787 men (73%) and 287 women (27%) with a mean age of 51 years (14 to 83). The underlying pathology was osteoarthritis (OA) in 1003 (75.9%), developmental dysplasia of the hip (DDH) in 136 (10.3%), avascular necrosis in 98 (7.4%), and other conditions, including inflammatory arthritis, in 84 (6.4%). Results The mean follow-up time was 10.5 years (1 to 20). Using revision for any reason as the endpoint, the overall survivorship at 15 years was 89.4% (95% confidence interval (CI) 86.8 to 91.4). There was a substantial increase between the first and second generation of surgical technique (86.6% vs 90.1%; p = 0.05). Men with idiopathic OA had a 15-year survivorship of 94.5% and women, 82.2% (p = 0.001); gender was not a risk factor after stratification by component size and aetiology. Using revision for excessive wear (ion levels > 7 µg/l associated with symptoms or adverse local tissue reactions) as the endpoint, the 15-year survivorship was 98.5%. Risk factors for revision for all modes of failure were an underlying pathology of hip dysplasia, a contact patch to rim (CPR) distance of 7 mm or less, an age at surgery of 55 years or less, and a femoral component size of 46 mm or less. Specific risk factors for aseptic failure of the femoral component were early surgical technique, a cementless metaphyseal stem, and a body mass index of 24 kg/m2 or less. Conclusion HRA is a viable concept; metal-on-metal bearings are well suited for this procedure when a well-designed device is properly implanted. The best results were obtained in men with OA, but survivorship was better for other underlying pathologies and for women after changes were made to the technique of implantation. Lifetime durability is a possible outcome for many patients despite a high level of activity. Cite this article: Bone Joint J 2018;100-B:1424–33.
Radial head resection versus prosthetic arthroplasty in terrible triad injury: a retrospective comparative cohort study
Authors: Mazhar F. Najd , Ebrahimi H. , Jafari D. , Mirzaei A. 
Published: November 2018

Aims The crucial role of the radial head in the stability of the elbow in terrible triad injury is acknowledged. This retrospective study aims to compare the results of resection of a severely comminuted radial head with or without prosthetic arthroplasty as part of the reconstruction for this injury. Patients and Methods The outcome of radial head resection was compared with prosthetic arthroplasty in 29 and 15 patients with terrible triad injuries, respectively. There were ten female patients (34.5%) in the resection group and six female patients (40%) in the prosthesis group. The mean age was 40.7 years (sd 13.6) in the resection group and 36 years (sd 9.4) in the prosthesis group. The mean follow-up of the patients was 24.4 months (sd 12) in the resection group and 45.8 months (sd 6.8) in the prosthesis group. Outcome measures included visual analogue scale (VAS) for pain, Mayo Elbow Performance Score (MEPS), Disabilities of Arm, Shoulder and Hand (DASH) Score, and range of movement. Postoperative radiological complications were also recorded. Results The mean ranges of extension, flexion, supination, and pronation were not significantly different between the two study groups (p = 0.75, p = 0.65, p = 0.82, and p = 0.68, respectively). The mean VAS score, DASH score, and MEPS of the two groups were also not statistically significantly different (p = 0.93, p = 0.19, and p = 0.32, respectively). At the final visit, the elbow was stable in all patients. No patient was found to have developed an Essex–Lopresti injury. Osteoarthritis grade I and II was observed in five and three patients of the resection group, respectively, and four and one patients of the arthroplasty group, respectively. Conclusion The outcome of patients undergoing treatment for terrible triad injuries is similar whether the patient’s radial head was excised or replaced. Cite this article: Bone Joint J 2018;100-B:1499–505.
Cup-cage reconstruction for severe acetabular bone loss and pelvic discontinuity
Authors: Hipfl C. , Janz V. , Löchel J. , Perka C. , Wassilew G. I. 
Published: November 2018

Aims Severe acetabular bone loss and pelvic discontinuity (PD) present particular challenges in revision total hip arthroplasty. To deal with such complex situations, cup-cage reconstruction has emerged as an option for treating this situation. We aimed to examine our success in using this technique for these anatomical problems. Patients and Methods We undertook a retrospective, single-centre series of 35 hips in 34 patients (seven male, 27 female) treated with a cup-cage construct using a trabecular metal shell in conjunction with a titanium cage, for severe acetabular bone loss between 2011 and 2015. The mean age at the time of surgery was 70 years (42 to 85) and all patients had an acetabular defect graded as Paprosky Type 2C through to 3B, with 24 hips (69%) having PD. The mean follow-up was 47 months (25 to 84). Results The cumulative five-year survivorship of the implant with revision for any cause was 89% (95% confidence interval (CI) 72 to 96) with eight hips at risk. No revision was required for aseptic loosening; however, one patient with one hip (3%) required removal of the ischial flange of the cage due to sciatic nerve irritation. Two patients (6%; two hips) suffered from hip dislocation, whereas one patient (one hip) required revision surgery with cement fixation of a dual-mobility acetababular component into a well-fixed cup-cage construct. Two patients (6%; two hips) developed periprosthetic infection. One patient was successfully controlled with a two-stage revision surgery, while the other patient underwent excision arthroplasty due to severe medical comorbidities. For the whole series, the Harris Hip Score significantly improved from a mean of 30 (15 to 51) preoperatively to 71 (40 to 89) at the latest follow-up (p < 0.001). Conclusion Our findings suggest that cup-cage reconstruction is a viable option for major segmental bone defects involving the posterior column and PD. It allows adequate restoration of the acetabulum centre with generally good stability and satisfactory postoperative function. Instability and infection remain drawbacks in these challenging revision cases. Cite this article: Bone Joint J 2018;100-B:1442–48.
Excellent results of large-diameter ceramic-on-ceramic bearings in total hip arthroplasty
Authors: Blakeney W. G. , Beaulieu Y. , Puliero B. , Lavigne M. , Roy A. , Massé V. , Vendittoli P-A. 
Published: November 2018

AimsThis study reports the mid-term results of total hip arthroplasty (THA) performed using a monoblock acetabular component with a large-diameter head (LDH) ceramic-on-ceramic (CoC) bearing.Patients and MethodsOf the 276 hips (246 patients) included in this study, 264 (96%) were reviewed at a mean of 67 months (48 to 79) postoperatively. Procedures were performed with a mini posterior approach. Clinical and radiological outcomes were recorded at regular intervals. A noise assessment questionnaire was completed at last follow-up.ResultsThere were four re-operations (1%) including one early revision for insufficient primary fixation (0.4%). No hip dislocation was reported. The mean University of California, Los Angeles (UCLA) activity score, 12-Item Short-Form Health Survey (SF-12) Mental Component Summary (MCS) score, SF-12 Physical Component Summary (PCS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Forgotten Joint Score (FJS) were 6.6 (2 to 10), 52.8 (25.5 to 65.7), 53.0 (27.2 to 66.5), 7.7 (0 to 63), and 88.5 (23 to 100), respectively. No signs of loosening or osteolysis were observed on radiological review. The incidence of squeaking was 23% (n = 51/225). Squeaking was significantly associated with larger head diameter (p < 0.001), younger age (p < 0.001), higher SF-12 PCS (p < 0.001), and UCLA scores (p < 0.001). Squeaking did not affect patient satisfaction, with 100% of the squeaking hips satisfied with the surgery.ConclusionLDH CoC THAs have demonstrated excellent functional outcomes at medium-term follow-up, with very low revision rate and no dislocations. The high incidence of squeaking did not affect patient satisfaction or function. LDH CoC with a monoblock acetabular component has the potential to provide long term implant survivorship with unrestricted activity, while avoiding implant impingement, liner fracture at insertion, and hip instability. Cite this article: Bone Joint J 2018;100-B:1434–41.
Acetabular retroversion
Authors: Direito-Santos Bruno , França Guilherme , Nunes Jóni , Costa André , Rodrigues Eurico Bandeira , Silva A. Pedro , Varanda Pedro 
Published: November 2018

Acetabular retroversion (AR) consists of a malorientation of the acetabulum in the sagittal plane. AR is associated with changes in load transmission across the hip, being a risk factor for early osteoarthrosis. The pathophysiological basis of AR is an anterior acetabular hyper-coverage and an overall pelvic rotation. The delay or the non-diagnosis of AR could have an impact in the overall management of femoroacetabular impingement (FAI). AR is a subtype of (focal) pincer deformity. The objective of this review was to clarify the pathophysiological, diagnosis and treatment fundaments inherent to AR, using a current literature review. Radiographic evaluation is paramount in AR: the cross-over, the posterior wall and ischial spine signs are classic radiographic signs of AR. However, computed tomography (CT) evaluation permits a three-dimensional characterization of the deformity, being more reliable in its recognition. Acetabular rim trimming (ART) and periacetabular osteotomy (PAO) are the best described surgical options for the treatment of AR. The clinical outcomes of both techniques are dependent on the correct characterization of existing lesions and adequate selection of patients.Cite this article: EFORT Open Rev 2018;3:595-603. DOI: 10.1302/2058-5241.3.180015
The best possible option of impossible worlds: Hybrid Modal Realism
Authors: Tuboly Tamás Ádám 
Published: November 2018

In this paper I reconstruct the merits and drawbacks of the concretist and abstractionist theories of possible worlds and face them with the challenge of impossible worlds. I show how these two types of theories deal with the problem of impossibilities, and argue that the best option is two advance the so-called hybrid modal realism, namely concret possible worlds and abstract impossible worlds. Finally, as a conclusion, I highlight some of the disadvantages of this view as well and note the possibility of a Carnap-like solution.
Pengaruh Variasi Jenis Pelarut pada Rendemen Sintesis Senyawa Kompleks Bis-Asetilasetonatodiaquonikel(II)
Authors: Mintari Novia , Suhartana Suhartana , Sriatun Sriatun 
Published: November 2018

Sintesis Senyawa Kompleks Bis-Asetilasetonatodiaquonikel(II) telah dilakukan. Penelitian ini bertujuan untuk untuk mensintesis senyawa kompleks bis-asetilasetonatodiaquonikel(II) ([Ni(acac)2(H2O)2]) dengan menggunakan pelarut metanol, etanol dan aseton serta membandingkan pengaruh pelarut yang digunakan terhadap hasil sintesis senyawa kompleks. Senyawa kompleks [Ni(acac)2(H2O)2] dibuat dengan memodifikasi metode Pawlikowski dengan perbandingan mol ion pusat dengan ligan adalah 1:3. Karakterisasi senyawa kompleks dilakukan menggunakan Fourier Transform-Infra Red (FT-IR), Atomic Absorption Spectroscopy (AAS), dan Spektrofotometer UV-Vis. Hasil FTIR menunjukkan adanya gugus O pada asetil aseton yang terkoordinasi pada ion pusat Ni2+ membentuk kompleks [Ni(acac)2(H2O)2]. Spektra UV-Vis menghasilkan serapan maksimum untuk kompleks [Ni(acac)2(H2O)2] dalam pelarut metanol pada panjang gelombang 294,5 nm, dengan energi transisi sebesar 406,72 KJmol-1, dan rendemen 19,26%. Kompleks [Ni(acac)2(H2O)2] dalam pelarut etanol memiliki panjang gelombang maksimum pada 294,5 nm, dengan energi transisi sebesar 406,72 KJmol-1, dan rendemen 18,69%. Sedangkan kompleks [Ni(acac)2(H2O)2] dalam pelarut aseton mempunyai panjang gelombang maksimum pada 293 nm, dengan energi transisi sebesar 408,80 KJmol-1, dan rendemen 16,99%.
An Investigation of the Predictors of Comfortable and Fast Gait Speed in Community-Dwelling Older Adults
Authors: Mantel Alison , Trapuzzano Ashleigh , Chizmar Sara , Haffke Lauren , Dawson Nicole 
Published: November 2018

Background/Purpose:
To identify the unique predictors of comfortable and fast gait speed in community-dwelling older adults using measures of physical performance (eg, lower extremity strength and balance), self-reported balance confidence, and global cognitive function.

Methods:
Demographic information was collected from 60 healthy, community-dwelling older adults older than 60 years. Participants completed the following assessments: Mini-Mental State Examination; Activities-Specific Balance Confidence Scale; 30-second Chair Stand (30-SCS); Functional Reach (FR); and gait speed (comfortable and fast) using the GAITRite system. Hierarchical linear regression was used to examine the relationship of both fast and comfortable gait speeds with functional performance (CST and FR), cognition (Mini-Mental State Examination), Activities-Specific Balance Confidence Scale, and demographic information (age, gender, and body mass index).

Results and Discussion:
Functional performance measures (30-SCS and FR) explained 55.4% and 64.7%, respectively, of the variance in comfortable and fast gait speed. Unique predictors for comfortable gait speed included 30-SCS, FR, and body mass index. Unique predictors of fast gait speed included 30-SCS, FR, gender, body mass index, and Activities-Specific Balance Confidence Scale score. These predictors explained 68.5% and 80.4% of the total variance in comfortable and fast gait speed, respectively. Global cognition was not a unique predictor of gait speed when performance measures were statistically controlled. However, the current study measured global cognitive status rather than the specific cognitive constructs, such as processing speed or executive function. Further research is needed to determine the role of cognition in the composition of gait speed.

Conclusions:
Gait speed is an important indicator for many outcomes such as fall risk, mortality, and functional status. Understanding that key variables of strength and balance comprise a large portion of gait speed allows clinicians to better direct their care and optimize rehabilitation outcomes. This study specifically used functional measures of strength and balance that can be easily implemented in the clinical setting.
The effect of loss-limit reminders on gambling behavior: A real-world study of Norwegian gamblers
Authors: Auer Michael , Hopfgartner Niklas , Griffiths Mark D. 
Published: November 2018

Background
Over the past two decades, problem gambling has become a public health issue and research from many countries indicates that a small but significant minority of individuals are problem gamblers. In Norway, the prevalence of problem gambling among adults is estimated to be just less than 1%. To help minimize the harm from gambling, the Norwegian government’s gambling operator (Norsk Tipping) has introduced several responsible gambling initiatives to help protect players from developing gambling problems (e.g., limit-setting tools, voluntary self-exclusion, personalized feedback, etc.).

Aim
The aim of this study was to determine whether the receiving of personalized feedback exceeding 80% of a personally set monetary personal limit had an effect on subsequent playing behavior compared to those gamblers who did not receive personalized feedback.

Methods
Out of 54,002 players, a total of 7,884 players (14.5%) received at least one piece of feedback that they had exceeded 80% of their personal global monthly loss limit between January and March 2017.

Results
Using a matched-pairs design, results showed that those gamblers receiving personalized feedback in relation to limit-setting showed significant reductions in the amount of money gambled.

Conclusion
The findings of this study will be of great value to many stakeholder groups including researchers in the gambling studies field, the gambling industry, regulators, and policymakers.
Transcranial direct current stimulation for online gamers: A prospective single-arm feasibility study
Authors: Lee Sang Hoon , Im Jooyeon Jamie , Oh Jin Kyoung , Choi Eun Kyoung , Yoon Sujung , Bikson Marom , Song In-Uk , Jeong Hyeonseok , Chung Yong-An 
Published: November 2018

Aim
Excessive use of online games can have negative influences on mental health and daily functioning. Although the effects of transcranial direct current stimulation (tDCS) have been investigated for the treatment of addiction, it has not been evaluated for excessive online game use. This study aimed to investigate the feasibility and tolerability of tDCS over the dorsolateral prefrontal cortex (DLPFC) in online gamers.

Methods
A total of 15 online gamers received 12 active tDCS sessions over the DLPFC (anodal left/cathodal right, 2 mA for 30 min, 3 times per week for 4 weeks). Before and after tDCS sessions, all participants underwent 18F-ﬂuoro-2-deoxyglucose positron emission tomography scans and completed the Internet Addiction Test (IAT), Brief Self Control Scale (BSCS), and Beck Depression Inventory-II (BDI-II).

Results
After tDCS sessions, weekly hours spent on games (p = .02) and scores of IAT (p < .001) and BDI-II (p = .01) were decreased, whereas BSCS score was increased (p = .01). Increases in self-control were associated with decreases in both addiction severity (p = .002) and time spent on games (p = .02). Moreover, abnormal right-greater-than-left asymmetry of regional cerebral glucose metabolism in the DLPFC was partially alleviated (p = .04).

Conclusions
Our preliminary results suggest that tDCS may be useful for reducing online game use by improving interhemispheric balance of glucose metabolism in the DLPFC and enhancing self-control. Larger sham-controlled studies with longer follow-up period are warranted to validate the efficacy of tDCS in gamers.
Association of Blood Pressure Trajectories in Early Life with Subclinical Renal Damage in Middle Age
Authors: Zheng Wenling , Mu Jianjun , Chu Chao , Hu Jiawen , Yan Yu , Ma Qiong , Lv Yongbo , Xu Xianjing , Wang Keke , Wang Yang , Deng Ying , Yan Bo , Yang Ruihai , Yang Jun , Ren Yong , Yuan Zuyi 
Published: November 2018

Background
Although high BP is one of the most important factors affecting renal function, whether longitudinal BP trajectories in early life course are associated with renal function damage in later life is unclear.

Methods
To investigate the correlation between BP trajectories from childhood to adulthood and renal function in middle age, we used group-based trajectory models to identify BP trajectories in 2430 individuals (aged 6–15 years old at baseline) participating in the ongoing Hanzhong Adolescent Hypertension Cohort. We tested the association between these trajectories and subclinical renal damage in middle age, adjusting for several covariates.

Results
We identified four distinct systolic BP trajectories among 2430 subjects: low stable, moderate stable, high stable, and moderate increasing on the basis of systolic BP levels at baseline and during the 30-year follow-up period. The urinary albumin-to-creatinine ratio (uACR) was higher in moderate stable, high stable, and moderate increasing groups compared with the low stable group. A total of 228 individuals had subclinical renal disease by 2017. Compared with the low stable trajectory group, the other groups had increasingly greater odds of experiencing subclinical renal disease in middle age. These associations were not altered after adjustment for other covariates, except for in the moderate stable group. Analyzed results were similar for the mean arterial pressure and diastolic BP trajectory groups.

Conclusions
Higher BP trajectories were correlated with higher of uACR levels and risk of subclinical renal disease in middle age. Identifying long-term BP trajectories from early age may assist in predicting individuals’ renal function in later life.
Research on speed sensorless control of Maglev train with double-end power supply
Authors: Sun Pengkun , Ge Qiongxuan , Li Yaohua , Wang Xiaoxin 
Published: November 2018

Background: The core technology of the stable operation of the maglev train is how to accurately obtain the train speed, position and motor angle information.
Aim: Using speed sensorless control method to estimate the speed and position of the maglev train.
Methods of the studies: In the double-end power supply mode of the maglev train, the principle of the extended back electromotive force (EEMF) of the AC motor is extended to the control of the long stator permanent magnet synchronous linear motor.
Results: The mathematical model for the power supply system of long-stator permanent magnet linear synchronous motor is established; based on the principle of EEMF of rotating motor, the EEMF observer is designed. The speed of the maglev train and the rotor angle are obtained by the method of phase locked loop (PLL).
Conclusion: Through the semi-physical simulation experiment, the speed sensorless control method is verified to be effective.