bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shortening of first metatarsalia after ReveL procedure depends on the osteotomy angle
Authors: Viehöfer Arnd , Wirth Stephan , Waibel Felix , Fürnstahl Philipp 
Published: September 2017

Category: Midfoot/Forefoot Introduction/Purpose: Recent studies have shown that Hallux valgus deformity can lead to transfermetatarsalgia due to an impairment and relative shortening of the first ray. During ReveL osteotomy the relative shortening of the MT I is not addressed. Furthermore, a posterior deviation of the osteotomy angle results in additional iatrogenic shortening of the MT I and might favor postoperative transfermetatarsalgia. Methods: A 3-dimensional model of a foot was obtained from CT scans of a cadaveric foot. The MT I of the 3-dimensional model was then pivoted medially to simulate a severe hallux valgus deformity of an intermetatarsal angle (IMA) of 18° and an intermediate hallux valgus deformity of an IMA of 13°. A ReveL operation was simulated to correct the IMA to 8° for the severe and the intermediate Hallux valgus. Therefore the osteotomy angle in the coronal plane (f=0) was chosen perpendicular to the axis of the second metatarsalia. Afterwards the length of MT I was measured. This procedure was repeated for an posterior altered osteotomy angle (f = 5°,10°, 15° and 20°). Results: The change in MT I length resulting from an osteotomy perpendicular to the axis of MT II was 0.6 mm for a severe hallux valgus (IMA correction from 18° to IMA 8°) and 0.3 mm for a moderate hallux valgus (IMA 13° to IMA 8°). A posterior deviation of the osteotomy angle led to additional shortening (max. 2.9 mm) with a total shortening of up to 3.5 mm (Figure 3). To avoid any shortening of MT I an osteotomy slightly pointing anterior (negative f) of 3.5° (IMA change of 10°) and 3° (IMA change of 5°) was found. Conclusion: ReveL procedure led only to a maximum shortening of 3.5 mm for a posterior deviation of 20°. Considering recently described MT I length cut off values of 2-3 mm for avoiding transfermetatarsalgia the osteotomy should be performed within an anterior directed cut angle of 4° and a posterior directed cut angle of 10° for the correction of a severe hallux valgus. However, further studies are needed to investigate the clinical impact of our findings.
Biomechanical Study of Screw Fixation and Plate Fixation of a Posterior Malleolar Fracture in Osteoporosis
Authors: Wang Xu 
Published: September 2017

Category: Ankle, Trauma Introduction/Purpose: Purpose of this research is to biomechanically compare the screw-fixed and plate-fixed posterior malleolus fracture in osteoporosis patients with fatigue loading system and space motion system in simulation gait cycle. And to give a theory evidence on how to choose a internal fixation in osteoporosis patients with posterior malleolus fracture. Methods: 36 matched cadaveric pairs lower limbs (T＜-2.5) were prepared to simulate Haraguchi I posterior malleolus fracture and randomized into two groups. Models of group A were fixed with two paralleled 4.0 mm titanium partial thread cancellous screws from posterior to anterior. Models of group B were fixed with plate. Furthermore, 4 different conditions of gait cycle were simulated as follows:1. specimen was loaded with 3.2 body weight (BW) at dorsiflexion angle of 12°; 2. Start-up phase: dorsiflexion angle of 5°,3.6 BW; 3. neutral position,3.6 BW; 4. maximum plantar flexion, angle of 12°,4.5 BW. At the end of repeatedly, loading, the displacement of fracture fragment (X) was measureed with space motion system. Results: At 12°of dorsiflexion and 15°of plantar flexion, there was a significant difference of X between A and B group, no matter the S and H. When ankle was dorsiflexion of 5°, X of group A was more great than that of group B except A3a /B3a and A1b/B1b. At neutral positon, there was significant differenceof X in all the groups except group A2b and B2b. Conclusion: Compared with 2 paralleled 4.0 mm calcaneus screws from posterior to anterior, plate can provide stronger fixation for osteoporosis patients with posterior malleolus fracture. But both of the two methods cannot provide stable fixation for osteoporosis patients with posterior malleolus fragment S>1/3 and H>19.3 mm.
Quality Measures in Foot and Ankle Care
Authors: Xiong Grace , Chou Loretta , Bennett Chase , Kamal Robin 
Published: September 2017

Category: Ankle, Ankle Arthritis, Arthroscopy, Bunion, Diabetes, Hindfoot, Trauma Introduction/Purpose: National healthcare delivery systems are shifting to value-based models. Understanding quality measures used to assess performance is important as they may be operationalized in alternative payment models, such as bundled payment programs, or quality reporting programs, such as the Merit-Based Incentive Payment System. Previous literature has shown that quality measures in other orthopaedic subspecialties disproportionately focus on effective clinical care or processes of care, while ignoring patient outcomes. We completed a systematic review of quality measures and candidate quality measures that address foot and ankle care to identify gaps in current measures and to inform future measure development initiatives. Methods: We conducted a systematic review of the National Quality Forum, the Agency for Healthcare Research and Quality, and the Physician Quality Reporting System for quality measures related to foot and ankle care. We also reviewed candidate quality measures from clinical practice guidelines (CPG) in the literature meeting Institute of Medicine CPG criteria. Measures were classified by clinical entity, Donabedian domain (structure, process, or outcome), and the National Quality Strategy (NQS) priority that they addressed. Results: We identified 12 quality measures and 16 candidate measures. Quality measures addressed NQS priorities of “Effective Clinical Care” (33%), “Communication and Coordination of Care” (58%), “Patient Safety” (25%), “Community and Population Health” (8%), and “Person and Caregiver Centered Experience and Outcomes” (8%). All candidate measures addressed “Effective Clinical Care”. Furthermore, 83% of quality measures and 94% of candidates were process measures, 17% of quality and 6% of candidate were outcome measures, and there were no structure measures. Diabetic foot care was the most commonly addressed clinical entity for both quality measures (58%) and candidate measures (69%). Conclusion: Foot and ankle quality measures and candidate measures disproportionately assess effective clinical care and processes of healthcare delivery. Additionally, few clinical disorders within the field are included, focusing primarily on diabetic foot care. Currently only two outcome measures exist, leaving an opportunity for outcome measure development. These patterns are reflected in candidate measures, suggesting that the narrow focus of quality measures will continue unless efforts are made to develop more comprehensive measures. Additional measures that address a broader array of clinical disorders across the spectrum of NQS priorities and Donabedian domains are needed to prepare for a quality-based healthcare system.
The Clinical Comparison of Extensile Lateral Approach and Sinus Tarsi Approach Combined with Medial Distraction Technique for Intra-Articular Calcaneal Fractures
Authors: Yang Yunfeng , Zhou Haichao , Zhang Yun 
Published: September 2017

Category: Hindfoot Introduction/Purpose: To study and compare the clinical outcomes of open reduction and internal fixation via extensile L-shape incision and limited open reduction via sinus tarsi approach using medial distraction technique for intra-articular calcaneal fractures. Methods: We performed a retrospective review of 65 intra-articular calcaneal fractures treated operatively between March 2012 and February 2015, including 32 cases of Sanders type? and 33 of Sanders type?. There were 49 men and 16 women. The mean age was 43.7 years old. They were divided into two groups: sinus tarsi approach group and extensile lateral approach group. No significant difference was found in gender, age, injury pattern, fracture classification between two groups (P>0.05). The Böhler angle, Gissane angle and calcaneal varus angle were measured before surgery, 1 week after surgery and at each follow-up visit respectively. The postoperative function was evaluated by the ankle and hind-foot score of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS). Results: All of the fractures were healed at about 10 weeks postoperatively. Böhler angle, Gissane angle and calcaneal varus angle were restored obviously, while there was no significant statistically difference between the two groups. Only the corrected value of calcaneal varus angle is statistically significant.At the last follow-up, the average AOFAS ankle and hind-foot score of minimal group was 88.4±6.6, and the VAS score was 1.9±0.7, while of extensile lateral approach group was 83.2±5.6 and 2.3±1.0 respectively. Conclusion: Limited open reduction via sinus tarsi approach for intra-articular calcaneal fractures could reduce the incidence of wound complications effectively, and the medial distraction technique is helpful to correct the calcaneus varus deformity.
Comparison of postoperative outcomes between modified Mann procedure and modified Lapidus procedure for hallux valgus
Authors: Yui Akiyama , Hirano Takaaki , Mitsui Hiroyuki , Maeda Shingo , Niki Hisateru 
Published: September 2017

Category: Bunion Introduction/Purpose: Surgery for hallux valgus (HV) includes a variety of techniques based on the osteotomy site. We use the modified Mann technique in cases with deformity ranging from 30° to 40° and the modified Lapidus procedure in HV cases with deformity of over 40° or with metatarsalgia. Methods: Here we report our investigation of the appropriateness of the modified Mann technique and the modified Lapidus procedure based on a comparison of postoperative outcomes. In total, 73 feet of 58 cases who underwent surgery for HV with subsequent follow-up observation for at least 1 year were included in the study. The modified Mann technique was performed on 31 feet of 26 cases (M Group), and the modified Lapidus procedure was performed on 42 feet of 32 cases (L Group). Six cases in the M Group and 39 cases in the L Group also underwent concurrent surgery for metatarsalgia. The outcome measures were changes in the HV angle, the angle between the M1M2, the Japanese Society for Surgery of the Foot (JSSF) hallux scale, complications, and HV recurrence. These outcome measures were compared using the unpaired t-test on standing anteroposterior X-ray of the feet. Results: In the M Group, comparison of pre- and postoperative radiological changes indicated that the HV angle improved from 38.2° to 11.4°, M1M2 angle improved from 14.5° to 5.0° respectively. JSSF hallux score improved from 53.3 to 89.6. Postoperative hallux varus was confirmed in four cases, Osteoarthrosis of the MTP joint in six, and HV recurrence in two. In the L Group, comparison of pre- and postoperative radiological changes indicated that the HV angle improved from 46.0° to 16.9°, M1M2 angle improved from 15.2° to 6.6°respectivelty. JSSF hallux score improved from 47.8 to 94.7. Postoperative hallux varus was confirmed in two cases, Osteoarthrosis of the MTP in four, and HV recurrence in four. In both groups, only preoperative HV angle exhibited significant differences (p < 0.0001). Conclusion: Surgical technique was selected based on HV severity and metatarsalgia whether were present; however, both groups showed satisfactory results. In cases of severe HV or in cases accompanied by metatarsalgia, we performed the modified Lapidus procedure that reduced pronation and valgus of first metatarsal. The X-ray and clinical findings of the present study showed that the results of the L Group were not inferior when compared to those of the M Group. Surgical technique should be selected based on both HV severity and lessor toe symptoms.
Osteochondral autograft transfer combined with supramalleolar osteotomy for the treatment of osteochondral defect of the talus in varus ankle
Authors: Zhu Yuan , Xu Xiangyang 
Published: September 2017

Category: Ankle, Ankle Arthritis, Arthroscopy, Sports Introduction/Purpose: Osteochondral lesion of the talus (OLTs) is among the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (> 15 mm in diameter) involving posteromedial aspect of talar dome, osteochondral autograft transplantation is usually warranted. This article highlights the distal tibial double osteotomy for the management of patient with concomitant large OLTs and varus ankle malalignment. Methods: From January 2012 to July 2015, 15 patients (8 males, 7 females) received the surgery in our department. The average age was 55.4 (range, 34 to 69) years old. Oblique medial malleolar osteotomy was performed to expose the talar lesion, following by osteochondral autograft transplantation and distal tibial opening-wedge osteotomy. Weight bearing X-rays were obtained for the measurement of tibial articular surface (TAS) angle and tibial lateral surface (TLS) angle. The American Orthopaedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) questionnaires and Visual Analog Scale (VAS) were evaluated for ankle function. In 5 cases arthroscopy was performed 12 months postoperatively and the cartilage repair was assessed with the criteria of the International Cartilage Repair Society. Results: Thirteen patients completed the follow-up with a mean of 21.2 months. The average talar lesion was 170.0mm2, and the average depth was 11.4 mm. The mean time of bone healing was 8.5 weeks. No patient reported donor site morbidity by the last follow-up. The mean AOFAS-AH score and VAS score improved from 53 to 90 points (p < 0.05), 6.7 to 1.9 points (p < 0.05), respectively. The mean TAS angle improved from 83.1 to 90.3 degrees (p < 0.05). The radiolucent area of the cysts disappeared on the plain radiographs in all cases. The mean International Cartilage Repair Society arthroscopic score from follow-up arthroscopy was (9±1) points. Conclusion: The use of osteochondral autograft transfer combined with supramalleolar osteotomy is an effective option for the treatment of osteochondral defect of the talus in varus ankle. It provides excellent visualization of the talar defect and favorable biomechanical environment for the ankle joint.
Evaluating the “Leeds criteria” forPseudomonas aeruginosainfection in a cystic fibrosis centre
Authors: Proesmans M. , Balinska-Miskiewicz W. , Dupont L. , Bossuyt X. , Verhaegen J. , Høiby N. , de Boeck K. 
Published: September 2017

Four separate categories of chronicPseudomonas aeruginosa(Pa) infection in children with cystic fibrosis (CF) have been previously defined, based on airway cultures taken over the previous year.The aim of the present study was to evaluate this definition in the current authors' paediatric and adult CF clinic using clinical, immunological and lung function parameters.During follow-up, out of 193 patients, 55 (34%) CF patients had never been infected withPa, 27 (17%) were free ofPa, 29 (18%) were intermittently infected and 51 (31%) were chronically infected. Disease severity markers, such as lung function, were significantly worse in the chronic group, especially in the paediatric population. Differences in adult patients were smaller and no longer significant.Paantibodies differed strongly between the groups, and were very high (mean±sd55.4±5.5) and highly statistically significant from all other groups in the chronic group. They were low and different from all other groups in the never group (1.8±0.6).Paantibodies did not differ between the free ofPaand the intermittent group.In conclusion, the current authors confirmed an agreement betweenPseudomonas aeruginosastatus according to the new definition and clinical status, as well as with the level ofPseudomonas aeruginosaantibodies.
Neuropsychiatric adverse drug reactions in children initiated on montelukast in real-life practice
Authors: Benard Brigitte , Bastien Valérie , Vinet Benjamin , Yang Roger , Krajinovic Maja , Ducharme Francine M. 
Published: September 2017

Although montelukast is generally well tolerated, postmarketing studies have reported serious neuropsychiatric adverse drug reactions (ADRs) leading to a United States Food and Drug Administration warning. The objective of this study was to determine the incidence of neuropsychiatric ADRs leading to discontinuation of montelukast in asthmatic children.We conducted a retrospective cohort study in children aged 1–17 years initiated on montelukast. In a nested cohort study, children initiated on montelukast as monotherapy or adjunct therapy to inhaled corticosteroids (ICS) were matched to those initiated on ICS monotherapy. A non-leading parental interview served to ascertain the occurrence of any ADRs with any asthma medication, and circumstances related to, and evolution of, the event.Out of the 106 participants who initiated montelukast, most were male (58%), Caucasian (62%) with a median (interquartile range) age of 5 (3–8) years. The incidence (95% CI) of drug cessation due to neuropsychiatric ADRs was 16 (10–26)%, mostly occurring within 2 weeks. Most frequent ADRs were irritability, aggressiveness and sleep disturbances. The relative risk of neuropsychiatric ADRs associated with montelukastversusICS was 12 (2–90).In the real-life setting, asthmatic children initiated on montelukast experienced a notable risk of neuropsychiatric ADRs leading to drug cessation, that is significantly higher than that associated with ICS.
Contributions of a hand-held fan to self-management of chronic breathlessness
Authors: Luckett Tim , Phillips Jane , Johnson Miriam J. , Farquhar Morag , Swan Flavia , Assen Teresa , Bhattarai Priyanka , Booth Sara 
Published: September 2017

This study explored the benefits of a hand-held fan as perceived by patients with chronic breathlessness and their carers.A secondary multimethod analysis was conducted of interview data collected in three clinical trials. Two researchers independently coded level of benefit qualitatively reported by each patient. Univariate and multivariate statistics were used to explore perceived benefit as a factor of sex, age and diagnosis. Qualitative analysis used an integrative method.133 patients commented on the fan, of whom 72 had a carer. Diagnoses included nonmalignant (n=91, 68.4%) and malignant (n=21, 15.8%) conditions. Of 111 patients who provided codable data, four (3.6%) perceived no benefit, 16 (14.4%) were uncertain, 80 (72.0%) perceived some benefit and 11 (10.0%) perceived very substantial benefit. Multivariate analysis was inconclusive. Benefit was described in terms of shorter recovery time, especially after activity. 10 (7.5%) patients said the fan reduced their need for home oxygen or inhaled β-agonist medications. Negative perceptions of a few included dislike of the cooling sensation and embarrassment in public.Findings suggest that a hand-held fan is a portable intervention with few disadvantages from which most patients with chronic breathlessness will derive benefit alongside other nonpharmacological and pharmacological strategies. Research is needed to optimise guidance on fan administration.
Mesoporous Alumina as an Effective Adsorbent for Molybdenum (Mo) toward Instant Production of Radioisotope for Medical Use
Authors: Saptiama Indra , Kaneti Yusuf Valentino , Suzuki Yumi , Suzuki Yoshitaka , Tsuchiya Kunihiko , Sakae Takeji , Takai Kimiko , Fukumitsu Nobuyoshi , Alothman Zeid Abdullah , Hossain Md Shahriar A , Ariga Katsuhiko , Yamauchi Yusuke 
Published: September 2017

Abstract
Mesoporous materials with high surface area and pore volume have attracted significant attention as adsorbents as they can provide extensive reaction sites for molybdenum (Mo) adsorption. In this study, we have prepared mesoporous alumina (MA) materials using a soft-templated approach. By changing the applied calcination temperatures, the mesostructural ordering, surface areas, and crystallinity of the MA materials can be varied. Furthermore, the effects of these parameters on their molybdenum (Mo) adsorption properties have been carefully investigated. The findings in this study will provide guidance for designing effective Mo adsorbents using mesoporous materials toward the next 99Mo/99mTc generator preparation.
1912 Parliamentary elections Armenians and Armenian deputies<p>1912 Meclis-i Mebusan seçimlerinde Ermeniler ve Ermeni milletvekilleri
Authors: Olgun Kenan 
Published: September 2017

As soon as 1908 Parliament was extingwished in the result of struggle for power the preparations for the new parliamentary elections began. The elections of 1912 between the Party of Union and Progress and their political opponent Party of Liberty and Mutual Agreement have been known as “elections of clubs”. Before the elections the majority of Armenians and Tashnaktsutyun supported Party of Union and Progress while Hinchak stood for Party of Liberty and Mutual Agreement. Armenian patriarchate informed the Ottoman Government that according to the low number of Armenians according to the total population of the Empire they had little chance to become deputies and asked for separation. İn the result of the elections 10 Armenians took place in the list of Party of Union and Progress were chosen deputies in 1912 Parliament.Extended English abstract is in the end of PDF (TURKISH) file.Özet1908 Meclis-i Mebusan’ı, iktidar mücadelesi yüzünden feshedilmiş, yeni meclis için seçimlere hemen başlanmıştır. İttihat ve Terakki Fırkası ile ittihatçılar karşısındaki muhalefetin tamamını bünyesinde toplamış olan Hürriyet ve İtilaf Fırkası arasında geçen 1912 seçimleri, tarihte “sopalı seçim” olarak da anılmaktadır. Seçimler öncesi Ermenilerin çoğunluğu ve Taşnak, İttihat ve Terakki’yi desteklerken, Hınçak, Hürriyet ve İtilaf Fırkası ile anlaşmıştır. Ermeni Patrikhanesi, nüfuslarına göre Ermeni milletvekili sayısının az olacağını ifade ile Başbakanlıktan ayrıcalık istemiştir. Seçimler sonucunda İttihat ve Terakki listesinde yer alan 10 Ermeni, milletvekili olarak 1912 Meclis-i Mebusan’ına seçilmiştir.
Revolting Sympathies in Mary Shelley’s The Last Man
Authors: Deren Jennifer 
Published: September 2017

Jennifer Deren, “Revolting Sympathies in Mary Shelley’s The Last Man” (pp. 135–160)
Building on recent scholarship that explores Mary Shelley’s advocacy for sympathy in The Last Man (1826), this essay traces the complexity of interpersonal and reader-text relations as they play out in the novel and in the experience of reading it. I argue that moments of intimacy explicitly called “sympathy” in the novel are often idealizations that turn “revolting” as sympathy becomes something other than the beneficial exchange that participants expect of it. These scenes delineate a politics of sympathy that challenges the dominant model with a portrayal of human intimacy as uncontrollable, amoral, and infectious. Shelley encodes in the novel’s infamous plague her concern that the experience of sympathy that underlies nineteenth-century politics of community- and nation-formation can and sometimes does generate violence, discord, and inequality alongside mutually beneficial relationships. Exploring readers’ uncertain responses to the novel alongside the novel’s representation of sympathy as revolting, I suggest that the novel’s framing “Introduction” reveals an aesthetics of sympathy in which reader-text relations are constitutively unstable. Readers’ resistance to Lionel’s effusive narration is a revolting response written into the novel’s sympathetic design. By making sympathetic reading a revolting experience, Shelley advances a revision of sympathy that forces us to rethink the possibilities and the consequences of human relationships and invites us to reimagine a communal future that makes room for those realities.