bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra-operative Analysis of Different Patellar Implant Designs in Total Knee Replacement: A Prospective Randomised Comparative Trial
Authors: MacDessi Samuel , Chen Darren , Gharaibeh Monther 
Published: May 2017

Objectives: Present scientific literature supports patellar resurfacing with regards to reduced re-operation risk and improved long term patient satisfaction in total knee arthroplasty (Schindler 2012). Two basic techniques are present for resurfacing the patella (Lachiewicz 2003); onlay and round inset (IN). Onlay designs are either symmetrical (round) (OR) or oval shaped with an asymmetric ridge (OO). When using a round patellar implant, a lateral facetectomy is often performed to avoid lateral compression syndrome and enhance patellar tracking (Zhang, Zhang et al. 2012). However, none of these implants have been found to be superior to the other. This study will compare three different types of patellar implant designs commonly used for resurfacing in TKA and report on intra-operative outcomes. We hypothesise that OO design offers improved bone coverage with less need to perform facetectomy when compared to round designs. Methods: A prospective, randomised trial was performed on patients undergoing unilateral TKA by 2 surgeons. Patients who agreed to participate were allocated to one of the three patellar design groups (IN, OR, OO). Patients were blinded to the implant assigned to them. The prostheses were implanted with the aim to restore pre-resection thickness, uniform facet thickness, with maximal bone coverage and medialisation of the median ridge to enhance tracking. Groups were compared in terms of implant size, percentage bone coverage, lateral facet underhang and requirement for facetectomy. Paired t-tests and ANOVA were used to compare continuous outcome measures with chi-squared test for categorical variables. Results: 86 patients were initially assessed for inclusion. Eight patients refused to participate and a further 18 did not meet the study inclusion criteria. A total of 60 patients were included in the final analysis. There were no differences between the 3 groups with regards to mean age, sex, pre-resection patellar thickness, patellar dimensions or pre-operative Kujala score. The asymmetrical onlay design resulted in a statistically significant larger button size (mean size 25.3 mm IN, 32.7 mm OR, 34.6 mm OO; p<0.001), reduced lateral underhang (mean 11.1mmm IN, 7.7 mm OR, 1.2 mm OO; p<0.001), and reduced need for facetectomy (85% IN, 85% OR, 0% OO). Percentage of surface bone coverage was 49%, 63.8%, 89.6% for IN, OR, OO implants respectively (p< 0.001). Conclusion: Oval onlay design demonstrates better surface bone coverage than round onlay or inlay implants. There were no cases in the oval group that required lateral facetectomy. Future analysis of this study group will aim to determine whether radiographic, patellar vascular and functional outcomes vary amongst the designs.
NZ ACL Registry 2016 Annual Report
Authors: Love Hamish 
Published: May 2017

Objectives: Presentation of the cumulative results of the first 2 years of the New Zealand ACL registry. Methods: The NZ ACL registry aims to collect relevant data for all patients undergoing ACL reconstruction in New Zealand. Injury and demographic data is collected. Marx activity and KOOS scores are recorded pre-operatively, and at 6,12 and 24 months postoperatively. Operative data is including chondral and meniscal injuries, implant choice, graft choice and diameter and concomitant procedures are recorded. Results: Demographic data. Patterns of technique and implant utilization. Outcome scores, complication and failure rates for the 2,500 patients currently enrolled in the registry will be presented. Conclusion: This report will contain the cumulative results of the NZ ACL Registry for the first full two years of it’s operation.
The hybrid anterior cruciate ligament reconstruction surgical technique does permit an accelerated early functional recovery and return to sport.
Authors: Annear Peter , Jay Ebert 
Published: May 2017

Objectives: A major reason for undergoing anterior cruciate ligament reconstruction (ACLR) for patients is to return to high demand activity and sport. Published literature supports a return to sport (RTS) at 6-12 months, though the recovery of lower limb strength and functional symmetry is critical and is linked with a patient’s ability to RTS, as well as reducing the incidence of secondary re-tear. This study aimed to compare clinical outcomes and RTS between patients undergoing ACLR utilizing a hamstring graft and those undergoing a hybrid technique which augments the hamstring graft with a synthetic LARS ligament. Methods: A non-randomized study design was used to compare clinical outcomes at 10-12 months post-surgery, in 82 patients undergoing conventional ACLR via a hamstring graft (HG) and 35 patients undergoing a hybrid hamstring/LARS graft (HLG). All patients were assessed using a range of patient-reported outcome (PRO) scores (IKDC, KOOS, Cinncinati, Lysholm, SF-36, Tegner, Noyes, Global Rating of Change – GRC). Limb symmetry indices (LSIs) presenting the operated limb as a percentage of the unaffected limb were calculated for several strength/functional assessments (peak isokinetic quadriceps and hamstring strength, the single, triple and triple crossover hop for distance, and the 6 m timed hop). Results: There were no group differences (p>0.05) in patient demographics and the majority of PROs. The HLG group perceived themselves to be significantly ‘more recovered’ (p=0.046) on the GRC scale (HLG = 3.2, HG = 2.2), and also reported a significantly greater (p=0.004) Tegner score (HLG = 7.2, HG = 5.9). For the HG group, 62% of patients had returned to Noyes Level 1 or 2 activities, versus 80% of the HLG group. For the Tegner score, 57% of patients reported a score >6, versus 77% of the HLG group. There were no significant differences (p>0.05) in LSIs between groups for the strength and functional hop tests. However, the HLG group demonstrated a mean LSI above 90% for all four hop tests, while all four were below 90% in the HG group. Both groups demonstrated mean hamstring strength LSIs above 90%, while the quadriceps strength LSI was 81.9% and 85.8% for the HG and HLG groups, respectively. Conclusion: Patients in the HLG group perceived themselves to be more recovered, and had returned to a higher level of activity/sport, compared with the HG group. While not significant, the HLG group did demonstrate more favorable functional hop and quadriceps strength LSIs, which has been linked with the ability to RTS and the incidence of ACL re-tear. A larger patient cohort and follow-up is required to observe long-term outcomes.
5 Year Survival of Endoscopic ACL Reconstruction with Live Donor Hamstring Tendon Allograft in Juveniles and Adolescents
Authors: Roe Justin , Fitzgibbon Emma , Salmon Lucy , Cooper Robert , Pinczewski Leo 
Published: May 2017

Introduction: ACL reconstruction with autografts in the young is associated a higher incidence of repeat injury when compared to adults. This led the authors to consider alternative graft material for the ACL deficient young population. This study was performed to assess the survival of ACL reconstruction with a living related hamstring tendon autograft in a large series of juveniles and adolescents. Aim: To determine the survival of the ACL graft and the contralateral ACL (CACL) after primary ACL reconstruction with living donor allograft in patients aged < 18 years and to identify the factors that increase the odds of subsequent ACL injuries. Methods: Patients having undergone primary ACL reconstruction with a living donor hamstring tendon allograft at age <18 years between 2005 and 2014 included in a prospective database were considered for this study. Patients completed a subjective survey involving the International Knee Documentation Committee (IKDC) questionnaire in addition to questions regarding current symptoms, further ACL injuries, family history of ACL injury, and current level of activity. Results: A total of 218 adolescents (mean age 14.7, age range, 8-17 years) met the inclusion criteria and were reviewed at a mean of 48 months after surgery. Of these, there were 51 ACL graft ruptures (23%) and 26 contralateral ACL ruptures (12%). The 1, 2 and 5 year survival of the ACL graft was 88%, 80% and 74%. The 1, 2 and 5 year survival of the contralateral ACL was 99%, 93% and 85%. Survival of the ACL graft was more favorable in those with open growth plates (93, 90, 85 at 1,2 and 5 survival) compared to closed growth plates (86, 75, 68 at 1,2 and 5 year survival), odds ratio 2.3 (95% CI 1.1 to 4.8, p=0.03). A return to preinjury level of activity was reported by 79%, and the mean IKDC score was 92 of a possible 100. A positive family history of ACL injury was present in 35%. Conclusion: Further injury after ACL reconstruction in the young presents a challenging problem. ACL reconstruction using a living related donor allograft is associated with high rates of return to sport and good subjective outcomes. This technique may be considered a viable option for ACL reconstruction in the young patient with open growth plates, but does not appear to reduce further injury in older adolescents.
One year follow-up of a case series using the iBalance medial opening wedge HTO system and an accelerated rehabilitation program
Authors: Hazratwala Kaushik 
Published: May 2017

Objectives: To investigate the clinical outcome and postoperative alignment changes changes to following computer navigated medial opening wedge HTO using the iBalance HTO system Methods: We performed a prospective observational series at a single centre of 20 consecutive patients undergoing computer navigated high tibial osteotomy by a single surgeon. The surgical device used to maintain the osteotomy was the Arthrex iBalance® HTO system. We compared preoperative and postoperative ROM, WOMAC, Lysholm, IKDC, alignment and the inferred tibial slope. We also measured the tibiofemoral angle on long leg weight bearing plain radiographs at 2 weeks, 6 weeks, 3 months and 1 year and calculated any change from the initial correction measured at 2 weeks to asses any loss of correction over 1-year time frame. We also correlated clinical outcome with loss of correction. Results: Regarding intraoperative results, the mean navigated correction to HKA was 5.4°±1.3°. No significant change was found to the knee sagittal angle posteroperatively (pre op mean 0.1°±4.4°, post op mean 0.81°±5.1°; p> 0.05). No significant change was found to the post operative ROM (pre op mean 125.4°±41.5°, post op mean 123.9°±34.4°; p> 0.05). The IKDC, Lysholm and WOMAC scores showed a significant difference, between 6 week to 3 months and 3 months to 6 months follow-up. After this time point scores did not show and statistical significant difference. The IKDC, Lysholm and WOMAC scores all demonstrate a general improvement over 12 months. One patient had to be removed from the study, as he had a lateral cortex breach at three months, and was converted to a TKR. There was a significant loss of correction between 2 weeks and 6 weeks, and again a significant loss of correction between 6 weeks and 3 months. However, the average loss of correction was measured radiographically to be 1.6°±1.7°, between 2 week and 12 month postoperative follow-up. Though this may be statistically significant, it is not clinically significant when compared to PROMs. We divided the loss of correction into greater than 1.5° and less than 1.5° and compared them to measured PROMs at all time points. We found no significant correlation between increased loss of correction and poorer PROM scores. Conclusion: Computer assisted iBalance medial opening wedge HTO with accelerated rehabilitation program does radiographically show loss of correction over 12 months. However it is not clinically significant when compared to PROMs. ROM and inferred tibial slope is preserved.
Medial meniscal root repair with the lasso technique
Authors: Lawrie Steven , Hopkins Nathan 
Published: May 2017

Objectives: To describe a new technique for repair of root tears of the medial meniscus. To determine that this technique is not inferior to other pull out repair techniques as described in the current literature. Methods: This paper reports on an observational series of an operative technique for repair of root tears of the medial meniscus. Twenty-five sequential patients presenting with root tears of the medial meniscus are described. The technique describes a simple method for repairing the root of the medial meniscus using a trans-tibial tunnel, suture loop, Fast-Fix meniscal sutures and a modified ACL jig as a prototype device. Results: Two objective failures have occurred in 25 sequential patients. 13 patients presented with significant medial femoral condyle oedema on MRI scan, all resolved on 6 months post operative MRI. Patients showed marked improvement in outcome measures with an average increase in the following scores;Tegner Lysholm of 50.8, KOOS of 46.9, IKDC 43, Oxford Knee Score 22.6, WOMAC 49.3.Time from injury to surgery appears to be a predictor of failure. Conclusion: The described technique compares reasonably to similar case series in the current literature. A successful outcome results in significant improvement in patient reported outcomes. Delay to surgery is a risk factor for failure.
Right ventricular dyssynchrony and exercise capacity in idiopathic pulmonary arterial hypertension
Authors: Badagliacca Roberto , Papa Silvia , Valli Gabriele , Pezzuto Beatrice , Poscia Roberto , Reali Manuela , Manzi Giovanna , Giannetta Elisa , Berardi Daniele , Sciomer Susanna , Palange Paolo , Fedele Francesco , Naeije Robert , Vizza Carmine Dario 
Published: June 2017

Survival in patients with pulmonary arterial hypertension (PAH) is determined by right ventricular (RV) function adaptation to afterload. How altered RV function impacts on exercise capacity in PAH is not exactly known.104 idiopathic PAH (IPAH) patients aged 52±14 years underwent a diagnostic right heart catheterisation, a comprehensive echocardiography including two-dimensional speckle tracking for RV dyssynchrony evaluation and a cardiopulmonary exercise test. Multivariate analyses were performed to identify independent predictors of peak oxygen uptake (peakV′O2).A first multivariate analysis of only resting haemodynamic variables identified cardiac index, right atrial (RA) pressure and pulmonary arterial compliance as independent predictors, with low predictive capacity (r2=0.31; p<0.001). A second multivariate analysis model which considered only echocardiographic parameters but without RV dyssynchrony, identified RV fractional area change (FAC) and RA area as independent predictors with still low predictivity (r2=0.35; p<0.001). Adding RV dyssynchrony to the second model increased its predictivity (r2=0.48; p<0.001). Repetition of the three multivariate analyses in patients with preserved RVFAC confirmed that inclusion of RV dyssynchrony results in the highest predictive capability of peakV′O2(r2=0.53; p=0.001).A comprehensive echocardiography with speckle tracking-derived assessment of the heterogeneity of RV contraction improves the prediction of aerobic exercise capacity in IPAH.
Fast and robust single PCR for Plasmodium sporozoite detection in mosquitoes using the cytochrome oxidase I gene
Authors: Echeverry Diego F. , Deason Nicholas A. , Makuru Victoria , Davidson Jenna , Xiao Honglin , Niedbalski Julie , Yu Xiaoyu , Stevenson Jennifer C. , Bugoro Hugo , Aparaimo Allan , Reuben Hedrick , Cooper Robert , Burkot Thomas R. , Russell Tanya L. , Collins Frank H. , Lobo Neil F. 
Published: May 2017

Abstract
Background
Molecular tools for detecting malaria-infected mosquitoes with improved practicality, sensitivity and specificity, and high-throughput are required. A common PCR technique used to detect mosquitoes infected with Plasmodium spp. is a nested PCR assay based on the 18s-rRNA gene. However, this technique has several technical limitations, is laborious and time consuming.

Methods
In this study, a PCR-based on the Plasmodium cytochrome oxidase I (COX-I) gene was compared with the 18s-rRNA nested PCR using serial dilutions (330–0.0012 pg) of DNA from Plasmodium vivax, Plasmodium falciparum and Plasmodium knowlesi and with DNA from 48 positive and negative Kenyan mosquitoes (previously detected by using both ELISA and PCR). This assay for Plasmodium spp. DNA detection using the fast COX-I PCR assay was then performed individually on 2122 field collected mosquitoes (from the Solomon Islands) in which DNA was extracted from head and thorax.

Results
The fast COX-I PCR assay took 1 h to run and consistently detected as low as to 0.043 pg of parasite DNA (equivalent to two parasites) in a single PCR, while analyses with the 18s-rRNA nested PCR required 4 h to complete with a consistent detection threshold of 1.5 pg of DNA. Both assays produced concordant results when applied to the 48 Kenyan control samples with known Plasmodium spp. infection status. The fast COX-I PCR identified 23/2122 Plasmodium-infected mosquitoes from the Solomon Islands.

Conclusions
This new COX-I PCR adapted for a single PCR reaction is a faster, simpler, cheaper, more sensitive technique amenable to high-throughput analyses for Plasmodium DNA detection in mosquitoes and is comparable to the 18s-rRNA nested PCR. The improved sensitivity seen with the fast COX-I PCR will improve the accuracy of mosquito infection rate determination.
A promising tool for surgical lipotransfer: a constant pressure and quantity injection device in facial fat grafting
Authors: Song Mei , Liu Yi , Liu Ping , Zhang Xianying 
Published: May 2017

Abstract

Background
The purpose of this study was to preliminarily assess a constant pressure and quantity fat granule injection device for minimal invasive properties in clinic.

Methods
A retrospective controlled study was carried out, from October 2013 to January 2015, on 76 female healthy patients aged between 26 and 53 years at the General Hospital of Lanzhou Military Command, China. To achieve small volume, high thrust, and precision requirements of facial fat grafting, an integrated handheld controller and motor design was adopted, reducing the volume and weight of the fat transplantation injection device. The 76 patients underwent 90 procedures each side of the face; each patient was treated with the aforementioned device on the face’s left side, while a conventional hand-push injection device was used on the right side as control. The outcome was assessed on pre- and postoperative images, with 6-24 months follow-up.

Results
The current device consistently allowed deposition of fat threads at about 55 μL/cm after cannula withdrawal; the volume of fat injected could be precisely adjusted to 0.04 mL/s. This device had the advantages of small-volume injection and convenient operation. The patients exhibited a good, stable shape and a smooth contour line in both sides. The long term satisfaction was higher for the left side than for the right one. Nodules and unevenness occurred only on the right side. Ecchymosis occurred significantly less frequent on the left side than the right one. Intraoperative pain was significantly lower for the left side than the right one.

Conclusions
This device offered superior control compared with the conventional one and constitutes a promising tool for surgeons practicing lipotransfer.
Neurologic Complications of Transplantation
Authors: Pruitt Amy A. 
Published: June 2017

ABSTRACT

Purpose of Review: This article describes the diagnosis and management of neurologic problems during hematopoietic cell and solid organ transplantation using time elapsed since transplantation as a guide to expected complications, including drug toxicities, infections, strokes, autoimmune phenomena, disease recurrence, and secondary neoplasms.

Recent Findings: Growing clinical experience in the neurology of transplantation has led to appreciation of the diverse clinical and radiographic spectrum of calcineurin inhibitor–related posterior reversible encephalopathy syndrome (PRES) and progressive multifocal leukoencephalopathy. Novel autoimmune phenomena illustrate the delicate balance between adequate immunosuppression and necessary host inflammatory defenses that can lead to organ rejection. The spectrum of infectious complications has changed with the evolution of new conditioning regimens.

Summary: Neurologic problems remain an important source of morbidity and mortality, both in the immediate transplantation period and for years after the procedure. As perioperative management has reduced the incidence of acute infections, graft versus host disease, and organ rejection, problems of long-term survivors require neurologic input into multidisciplinary management of chronic neurologic conditions impacting quality of life.
Spiders have rich pigmentary and structural colour palettes
Authors: Hsiung Bor-Kai , Justyn Nicholas M. , Blackledge Todd A. , Shawkey Matthew D. 
Published: May 2017

ABSTRACT
Elucidating the mechanisms of colour production in organisms is important for understanding how selection acts upon a variety of behaviours. Spiders provide many spectacular examples of colours used in courtship, predation, defence and thermoregulation, but are thought to lack many types of pigments common in other animals. Ommochromes, bilins and eumelanin have been identified in spiders, but not carotenoids or melanosomes. Here, we combined optical microscopy, refractive index matching, confocal Raman microspectroscopy and electron microscopy to investigate the basis of several types of colourful patches in spiders. We obtained four major results. First, we show that spiders use carotenoids to produce yellow, suggesting that such colours may be used for condition-dependent courtship signalling. Second, we established the Raman signature spectrum for ommochromes, facilitating the identification of ommochromes in a variety of organisms in the future. Third, we describe a potential new pigmentary–structural colour interaction that is unusual because of the use of long wavelength structural colour in combination with a slightly shorter wavelength pigment in the production of red. Finally, we present the first evidence for the presence of melanosomes in arthropods, using both scanning and transmission electron microscopy, overturning the assumption that melanosomes are a synapomorphy of vertebrates. Our research shows that spiders have a much richer colour production palette than previously thought, and this has implications for colour diversification and function in spiders and other arthropods.
On the primacy and irreducible nature of first-person versus third-person information
Authors: Tressoldi Patrizio E. , Facco Enrico , Lucangeli Daniela 
Published: May 2017

In this essay, we will support the claim that at the current level of scientific advancement a) some first-person accounts cannot be reduced to their third-person neural and psychophysiological correlates and b) that these first-person accounts are the only information to reckon when it is necessary to analyse qualia contents. Consequently, for many phenomena, first-person accounts are the only reliable source of information available and the knowledge of their neural and psychophysical correlates don’t offer any additional information about them.