bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical Effects of Capsular Shift in the Treatment of Hip Microinstability
Authors: Jackson Timothy J. , Peterson Alexander B. , Akeda Masaki , Estess Allyson , McGarry Michelle H. , Adamson Gregory J. , Lee Thay Q. 
Published: December 2015

Background: A capsular shift procedure has been described for the treatment of hip instability; however, the biomechanical effects of such a shift are unknown. Purpose: To create a cadaveric model of hip capsule laxity and evaluate the biomechanical effects of a capsular shift used to treat hip instability on this model. Study Design: Controlled laboratory study. Methods: Eight cadaveric hips with an average age of 58.5 years were tested with a custom hip testing system in 6 conditions: intact, vented, instability, capsulotomy, side-to-side repair, and capsular shift. To create the hip model, the capsule was stretched in extension under 35 N·m of torque for 1 hour in neutral rotation. Measurements included internal and external rotation with 1.5 N·m of torque at 5 positions: 5° of extension and 0°, 15°, 30°, and 45° of flexion for each of the above conditions. The degree of maximum extension with 5 N·m of torque and the amount of femoral distraction with 40 N and 80 N of force were measured. Statistical analysis was performed by use of repeated-measures analysis of variance with Tukey post hoc analysis. Results: The instability state significantly increased internal rotation at all flexion angles and increased distraction compared with the intact state. The capsulotomy condition resulted in significantly increased external rotation and internal rotation at all positions, increased distraction, and maximum extension compared with the intact state. The side-to-side repair condition restored internal rotation back to the instability state but not to the intact state at 5° of extension and 0° of flexion. The capsular shift state significantly decreased internal rotation compared with the instability state at 5° of extension and 0° and 15° of flexion. The capsular shift and side-to-side repair conditions had similar effects on external rotation at all flexion-extension positions. The capsular shift state decreased distraction and maximum extension compared with the instability state, but the side-to-side repair state did not. Conclusion: The hip capsular instability model was shown to have significantly greater total range of motion, external rotation, and extension compared with the intact condition. The greatest effects of capsular shift are seen with internal rotation, maximum extension, and distraction, with minimal effect on external rotation compared with the side-to side repair state. Clinical Relevance: The biomechanical effects of the capsular shift procedure indicate that it can be used to treat hip capsular laxity by decreasing extension and distraction with minimal effect on external rotation.
Experimental subjects and partial truth telling during technological change in radiotherapy
Authors: Wood Lisa Anne 
Published: December 2015

Background: Cone Beam Computed Tomography (CBCT), the focus of a number of radiotherapy fundraising campaigns in the mid-2000s, was introduced accompanied by a fanfare of newness and discourses of ‘hope’, ‘inspiring clinical confidence’ and ‘accuracy’. The CBCT system, used in the delivery of Radiotherapy treatment, was incorporated into strategic planning priorities across the United Kingdom based on a rationale of self-evidence. During this time, the way in which the new system was discussed with patients was variable. Research objectives: The purpose of this study was to uncover how experimental practices were embedded and enacted during the use of a new technological system, specifically relating to how patients were enrolled during introductory phases of technology adoption. Research design and context: Drawing on ethnographic work and interviews with staff members in one hospital, the study examines staff discussions prior to the introduction of the Cone-Beam CT imaging system in radiotherapy. It considers how staff views were at odds with practices that occurred during the ‘experimental’ stages of use and how these were shared with patients. Ethical considerations: Approval was obtained from the Local National Health Service Research Ethics Committee and National Health Service Main Research Ethics Committee (REC 07/Q1308/16) for the interview and ethnographic stages, respectively. All names have been changed and participants signed a consent form. Findings: Staff reported a lack of evidence, absence of proof and perturbing doubts with the X-ray volumetric imaging. Both patients’ and practitioners’ partial understanding about the risks and benefits of the system created incommensurable ideas regarding its use and what the patients’ role was during these introductory stages. Conclusion: Maintaining partial truth telling renders patients’ experiences of new treatment at odds with ‘experimental’ practice. This has wide-reaching implications for practice.
Determinants of Palliative Care Utilization Among Patients Hospitalized With Metastatic Gastrointestinal Malignancies
Authors: Okafor Philip N. , Stobaugh Derrick J. , Nnadi Augustine K. , Talwalkar Jayant A. 
Published: December 2015

Background: Gastrointestinal tract cancers account for a significant proportion of the national cancer burden. Aim: We sought to explore patient- and hospital-level determinants of palliative care utilization among patients hospitalized with metastatic gastrointestinal tract cancers using a national database. Methods: An analysis of the 2012 National Inpatient Sample was performed. International Classification of Diseases, Ninth Revision codes were used to identify hospital discharges associated with metastatic digestive tract cancers and patient/hospital covariates for inclusion in a logistic regression model. Total charges and length of stay were analyzed in a linear regression model. Results: Compared to males, females were more likely to receive inpatient palliative care (adjusted odds ratio [OR] 1.12, P = .002). No difference was seen between white and Asian patients (adjusted OR 1.2, P = .11) or Native Americans patients (adjusted OR 1.4, P = .22). However, relative to white patients, African Americans (adjusted OR 1.13, P = .02) and Hispanics (adjusted OR 1.25, P = .001) had significantly higher odds of inpatient palliative care. Medicare patients were least likely to receive palliative care compared to those with Medicaid or commercial payers. Length of stay during these hospitalizations was longer in African Americans ( P = .0001), Asians ( P = .0001), and Native Americans ( P = .03) compared to white patients. No difference was seen when total charges were compared between white and African American patients ( P = .08). Conversely, total charges were higher in Hispanics ( P = .005) and Asians ( P = .001) relative to white patients. Conclusion: Gender and racial differences exist in utilization of inpatient palliative care among patients hospitalized with metastatic gastrointestinal tract cancers.
Internal Fixation of Unstable Osteochondritis Dissecans in the Skeletally Mature Knee with Metal Screws
Authors: Barrett Ian , King Alexander H. , Riester Scott , van Wijnen Andre , Levy Bruce A. , Stuart Michael J. , Krych Aaron J. 
Published: December 2015

Purpose Several bioabsorbable and metal options are available for internal fixation of an unstable osteochondritis dissecans (OCD) lesion, but currently there are little data on outcomes with metal headless compression screws in the adult knee. The purpose of this study was to determine (1) the radiographic healing rates, (2) midterm clinical outcomes, and (3) comparison between healed and unhealed OCD fragments after use of headless metal compression screws for the treatment of unstable OCD lesions in the knees of skeletally mature patients. Methods Retrospective chart review for all skeletally mature patients who presented with unstable femoral condyle OCD lesions of the knee was conducted. All patients underwent open or arthroscopic reduction and internal fixation using headless metal compression screws. Preoperative and postoperative radiographs were reviewed with healing defined as radiographic evidence of union of the OCD progeny fragment with the condyle. Clinical outcome data were collected retrospectively using 3 validated outcome scores: International Knee Documentation Committee (IKDC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Marx. Results Twenty-two knees in 22 patients with a mean age of 21 years (range= 14-37 years) were followed for an average of 8.7 years (range = 2-22 years). Metal, headless, cannulated compression screws were used in all 22 cases. At a mean of 31 months postoperatively (range = 2-262), fragment union was observed in 18 knees (82%). The remaining 4 knees (18%) required loose fragment excision and hardware removal at a mean of 9 months (range = 2-16 months) postoperatively. Mean postoperative Marx score was 7 (range = 0-16), the mean postoperative IKDC score was 85 (range = 62-100), and mean KOOS scores included KOOS Pain (93; range = 69-100), KOOS Symptoms (86; range = 71-100), KOOS ADL (98; range = 90-100), KOOS Sports (82; range = 50-100), and KOOS QOL (76; range = 50-100). Conclusion Headless metal compression screws provide a satisfactory union rate for treatment of unstable OCD lesions of the femoral condyles in skeletally mature patients. Patients achieving union have good knee function, maintain satisfactory activity levels, and have superior knee outcomes compared with those that failed to heal after fixation at mid to long-term follow-up.
What happens to Allium saxatile M.Bieb. (Amaryllidaceae)? An unknown story of the well‐known name
Authors: Sennikov Alexander N. , Seregin Alexey P. 
Published: December 2015

AbstractThe present lectotypification of the Caucasian endemic Allium saxatile M.Bieb. is found ineffective and falling outside the current concept of the species. The original collections of A. saxatile were destroyed during the Russian Civil War, and conservation of this name is suggested to avoid its lectotypification from remaining illustrations which belong to the Siberian species A. stellerianum and A. rubens. This conservation would also remove the illegitimacy of A. saxatile M.Bieb. caused by homonymy with the overlooked earlier name A. saxatile Pall. The original material of A. caucasicum is identified and discussed, and the name is typified with an illustration referable to A. globosum. Two near‐homonyms of A. caucasicum, the originally heterotypic A. caucaseum and A. caucasium are uncovered, and their identity with A. globosum is ascertained.
An updated molecular phylogeny of Polygonoideae (Polygonaceae): Relationships of Oxygonum, Pteroxygonum, and Rumex, and a new circumscription of Koenigia
Authors: Schuster Tanja M. , Reveal James L. , Bayly Michael J. , Kron Kathleen A. 
Published: December 2015

AbstractMany Polygonaceae are primary successors or “weedy” and Aconogonon polystachyum and species and hybrids of both Emex and Reynoutria are pernicious invasives outside their native ranges. Polygonaceae have a particularly muddled taxonomic history and despite ongoing systematic studies, there are still large ‐scale questions about evolutionary relationships within the group. In this study, we address the relationships of Aconogonon, Emex, Fallopia, Koenigia, Oxygonum, Polygonum, and Rumex. We clarify the evolutionary history of Polygonoideae by building on an existing molecular dataset (nrITS, matK, trnL‐trnF) analysed with maximum likelihood and Bayesian methods. Results indicate that the African Oxygonum is an isolated lineage likely sister to all other members of Polygonoideae, the two species of Emex are nested in the Rumex clade, Fallopia and Koenigia are polyphyletic with Aconogonon and Koenigia forming a clade, and Fallopia denticulata and F. cilinodis are separate from the Fallopia s.str. clade. Relationships within the Polygonum clade reflect geographic distribution with a North America clade sister to a clade containing cosmopolitan and Central Asian species. Based on these findings, we recognize Oxygoneae and Pteroxygoneae as tribes, include Aconogonon within Koenigia, and merge Emex with Rumex. Formal descriptions and nomenclatural changes are provided.
The utility of repeat ultrasound imaging in the follow-up of metal-on-metal hip arthroplasty patients
Authors: Matharu GS , Janardhan S , Brash L , Pynsent PB , Dunlop DJ , James SLJ 
Published: January 2016

Introduction We assessed changes in metal-on-metal hip arthroplasties (MoMHAs) after repeat ultrasound examination. Methods This retrospective, single-centre cohort study involved all patients undergoing two ultrasound examinations of the same MoMHA. Between 2010 and 2014, 96 ultrasound examinations were performed in 48 MoMHAs (mean time between scans = 1.1 years). A radiologist assigned each scan to one of four grades and measured volumes of any solid/cystic masses. Changes in grade and lesion volume between scans were analysed. Results Change in grade between scans was significant (p=0.012); 27% (n=13) of MoMHAs increased in grade, 67% (n=32) had no grade change, and 6% (n=3) decreased in grade. The mean increase in lesion volume was 24.2cm3 by the second scan, and was significant (p=0.023). Evidence of progression in findings was observed in 54% (26/48) of MoMHAs. Of patients with normal scans initially, 44% (8/18) developed abnormalities. No factors (including blood metal ion concentrations and cup position) were associated significantly with progression of ultrasound findings. Conclusions Repeat ultrasound in MoMHA patients demonstrated that findings frequently progress in the short-term. Therefore, regular surveillance of MoMHA patients is important, with ultrasound representing an effective investigation for identifying the development and progression of lesions.
Sildenafil Treatment of Infants With Bronchopulmonary Dysplasia–Associated Pulmonary Hypertension
Authors: Backes Carl H. , Reagan Patricia B. , Smith Charles V. , Jadcherla Sudarshan R. , Slaughter Jonathan L. 
Published: January 2016

OBJECTIVE:
This study had 2 goals: (1) to identify clinical and demographic characteristics associated with sildenafil exposure for infants with bronchopulmonary dysplasia (BPD)-associated pulmonary hypertension (PH); and (2) to characterize hospital-specific treatment frequency, age at first administration, and length of sildenafil treatment.

METHODS:
This retrospective cohort study used data from the Pediatric Health Information System to determine variables associated with sildenafil exposure and between-hospital variations in sildenafil utilization patterns. The study included infants with BPD-PH who were discharged between January 1, 2006, and December 31, 2013.

RESULTS:
Within 36 US pediatric hospitals, 3720 infants were diagnosed with BPD, of whom 598 (16%) also had a diagnosis of PH (BPD-PH). Among infants with BPD-PH, 104 infants (17%) received sildenafil. The odds for sildenafil treatment among infants born between 25 and 26 weeks’ gestational age (GA) and &lt;24 weeks’ GA, respectively, were 2.26 (95% confidence interval [CI]: 1.20–4.24) and 3.21 (95% CI: 1.66–6.21) times those of infants born at 27 to 28 weeks’ GA. Severity of BPD correlated with sildenafil exposure, with adjusted odds ratios (ORs) for moderate BPD (OR: 3.03 [95% CI: 1.03–8.93]) and severe BPD (OR: 7.56 [95% CI: 2.50–22.88]), compared with mild BPD. Greater rates of sildenafil exposure were observed among small for GA neonates (OR: 2.32 [95% CI: 1.21–4.46]). The proportion of infants with BPD-PH exposed to sildenafil varied according to hospital (median: 15%; 25th–75th percentile: 0%–25%), as did the median duration of therapy (52 days; 25th–75th percentile: 28–109 days).

CONCLUSIONS:
The odds of sildenafil treatment were greatest among the most premature infants with severe forms of BPD. The frequency and duration of sildenafil exposure varied markedly according to institution. Patient-centered trials for infants with BPD-PH are needed to develop evidence-based practices.
Incidence of Amblyopia and Its Risk Factors in Children with Isolated Metopic Craniosynostosis
Authors: Nguyen Thuan B. , Shock Leslie A. , Missoi Tara G. , Muzaffar Arshad R. 
Published: December 2015

Objective Ophthalmic abnormalities in children with syndromic craniosynostosis have been reported previously, and referral of these children to a pediatric ophthalmologist is recommended. However, it is not as clear whether a child with nonsyndromic synostosis needs to be referred to a pediatric ophthalmologist. The aim of this study is to report the incidence of amblyopia and its risk factors in children with isolated metopic craniosynostosis. Design An institutional review board–approved, retrospective review was performed on 91 children diagnosed with isolated metopic craniosynostosis. Ophthalmologic records were reviewed for diagnoses of amblyopia, strabismus, and refractive error. Results Of the 91 children, 19 (20.9%) had astigmatism, eight (8.8%) had amblyopia, eight (8.8%) had strabismus, five had myopia (5.5%), five had hyperopia (5.5%), and five had anisometropia (5.5%). The incidence of amblyopia and its risk factors found in our study are higher than the rate found in the clinically normal pediatric population. Conclusions In our patient population, children with isolated metopic craniosynostosis demonstrate an increased rate of amblyopia and its risk factors. Amblyopia is best treated early in life to achieve a successful outcome. A referral to a pediatric ophthalmologist for a formal eye exam and potential treatment is therefore recommended for children with isolated metopic craniosynostosis.
GEOTOURISM IN THE NIŠAVA RIVER MIDSTREAM VALLEY, SOUTHEASTERN SERBIA – CURRENT STATE AND ISSUES OF FUTURE DEVELOPMENT
Authors: Began Milica , Višnić Tamara 
Published: December 2015

<pre>The region of East and Southeast Serbia, has the biggest collection of geoheritage sites in the Republic of Serbia. In the southeastern part of Serbia, following various mineralogical compositions of the rocks, the Nišava river has carved a composite valley. This is an area of extraordinary nature capacity because of large number of natural rarities and phenomena that have great possibilities for geotourism development. Despite exceptional predispositions in terms of the value of geological heritage, geosites of this area are still unknown to a wider audience. Aim of this paper is to analyze current state of geotourism and to highlight the values of geosites in Srednje Ponišavlje using the evaluating model as well to evaluate its quality and give the assessment of geotourism development success. Using GAM model, 7 geosites have been analyzed, the ones with extraordinary geological/geomorphological and hydrological features for geotourism development. </pre>
O ARRANJO DA PECUÁRIA NA RESERVA DE DESENVOLVIMENTO SUSTENTÁVEL DO UATUMÃ-AM
Authors: Gomes Fábio Alves , Lacerda Elisângela Gonçalves 
Published: December 2015

<p>O estado do Amazonas enfrenta atualmente um aumento do seu rebanho bovino. Por conter em seu território muitas áreas destinadas a fins conservacionistas surge a necessidade de se pensar acerca do uso da terra. Para entender os efeitos da pecuária sobre as áreas protegidas é necessária a compreensão de sua dinâmica quando desenvolvida dentro ou próxima destas áreas. Este estudo visou contribuir com o esclarecimento desta problemática analisando o tipo de criação desenvolvido na Reserva de Desenvolvimento Sustentável (RDS) do Uatumã (AM). Na RDS, a pecuária é marcada pelos baixos índices zootécnicos. Técnicas de manejo não são desenvolvidas devido à falta de financiamentos e de apoio na extensão rural. Excetuando-se a vacinação contra a febre aftosa, nenhum tipo de apoio ou incentivo lhes é concedido. O arranjo espacial da atividade é definido em grande medida pelas áreas de pastagem. A atividade depende essencialmente da estrutura familiar e do nível de capitalização do produtor. Após a criação da RDS os custos das relações de trabalho foram profundamente alterados. A relação que o poder público mantém com os moradores da RDS tem dado mais ênfase à repressão, proibição e normatização e oferece poucas alternativas substitutivas às atividades proibidas em virtude da criação da área protegida. </p>
ANÁLISE DOS CICLOS DE PRECIPITAÇÃO NA REGIÃO DE BOA VISTA - RR NOS ANOS DE 1910 A 2014
Authors: Silva Danielle Alves , Sander Carlos , Araújo Júnior Antônio Carlos Ribeiro , Wankler Fábio Luiz 
Published: December 2015

<p>Este estudo buscou relacionar e identificar a influência dos fenômenos ENOS nos índices de precipitação da série histórica (1910 a 2014) da estação pluviométrica de Boa Vista, Capital do Estado de Roraima, Brasil. Os procedimentos metodológicos compreenderam: a) análises estatísticas dos dados diários, mensais e anuais para definição da série pluviométrica identificação de diferentes ciclos pluviométricos; b) identificação e confrontação dos dados pluviométricos com os períodos de vigência dos fenômenos ENOS <em>(El Niño</em> e <em>La Niña</em>) a fim de identificar relações destes com anomalias observadas na série histórica. A análise da série histórica permitiu a identificação de quatro ciclos pluviométricos, representados por dois ciclos secos e outros dois úmidos. Os eventos ENOS (El Niño e La Niña) apresentaram grande compatibilidade com as variações pluviométricas da série. Os resultados apontam para a necessidade do estado e da sociedade civil se organizar aos efeitos dos ciclos de <em>El Niño</em>, em especial a retração do volume superficial de água disponível, estações secas mais fortes e ampliação de eventos de queimadas e, no caso dos ciclos de <em>La Niña,</em> recorrência de cheias e eventos associados.</p>
An evaluation of gestational diabetes mellitus screening practices in American Samoa
Authors: Freeman Joshua R , Thompson Katherine , Muasau-Howard Bethel T , Ah Ching John , McGarvey Stephen T , Hawley Nicola L 
Published: December 2015

<p><strong>Introduction: </strong>Gestational Diabetes (GDM) is associated with myriad maternal and fetal complications. Pacific Islanders are known to be at increased risk for GDM and this is compounded by high levels of pregnancy obesity. Adequate screening for GDM is key to identify cases and act preventatively to ameliorate the associated risks. In a clinical audit, we aimed to evaluate the adequacy of GDM screening among pregnant women in American Samoa.</p><p><strong>Method: </strong>Data were extracted in a medical record review undertaken in American Samoa June-August 2009. Clinical records of 622 women were reviewed to determine: (a) whether or not the patient was screened for GDM, (b) in which week of gestation this screening occurred, and (c) what type of GDM screening the patient received. Chi-square and independent samples t-tests were used to identify differences in socio-demographic characteristics between those who were screened adequately and those who were not.</p><p><strong>Findings: </strong>Few women (16.2%) received adequate GDM screening. Many women received a first prenatal visit GDM screen in accordance with local guidelines, but very few women received a follow-up oral glucose tolerance test (OGTT) in the recommended 24-28 week testing period. There were no socio-demographic differences between those who were adequately screened and those who were not.</p><strong>Conclusion: </strong>Despite the presence of clear guidelines for GDM screening in American Samoa, this study highlights the critical need for improved screening in this high risk population. The causes of inadequate screening, which are currently unknown, must be identified and interventions should be targeted at both the clinician and patient to improve the adequacy of GDM screening in this setting.