bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of a dedicated Ponseti service on the outcome of idiopathic clubfoot treatment
Authors: Mayne A. I. W. , Bidwai A. S. , Beirne P. , Garg N. K. , Bruce C. E. 
Published: October 2014

We report the effect of introducing a dedicated Ponseti service on the five-year treatment outcomes of children with idiopathic clubfoot. Between 2002 and 2004, 100 feet (66 children; 50 boys and 16 girls) were treated in a general paediatric orthopaedic clinic. Of these, 96 feet (96%) responded to initial casting, 85 requiring a tenotomy of the tendo-Achillis. Recurrent deformity occurred in 38 feet and was successfully treated in 22 by repeat casting and/or tenotomy and/or transfer of the tendon of tibialis anterior, The remaining 16 required an extensive surgical release. Between 2005 and 2006, 72 feet (53 children; 33 boys and 20 girls) were treated in a dedicated multidisciplinary Ponseti clinic. All responded to initial casting: 60 feet (83.3%) required a tenotomy of the tendo-Achillis. Recurrent deformity developed in 14, 11 of which were successfully treated by repeat casting and/or tenotomy and/or transfer of the tendon of tibialis anterior. The other three required an extensive surgical release. Statistical analysis showed that children treated in the dedicated Ponseti clinic had a lower rate of recurrence (p = 0.068) and a lower rate of surgical release (p = 0.01) than those treated in the general clinic. This study shows that a dedicated Ponseti clinic, run by a well-trained multidisciplinary team, can improve the outcome of idiopathic clubfoot deformity. Cite this article: Bone Joint J 2014;96-B:1424–6
The anatomical footprint of the Achilles tendon
Authors: Ballal M. S. , Walker C. R. , Molloy A. P. 
Published: October 2014

We dissected 12 fresh-frozen leg specimens to identify the insertional footprint of each fascicle of the Achilles tendon on the calcaneum in relation to their corresponding muscles. A further ten embalmed specimens were examined to confirm an observation on the retrocalcaneal bursa. The superficial part of the insertion of the Achilles tendon is represented by fascicles from the medial head of the gastrocnemius muscle, which is inserted over the entire width of the inferior facet of the calcaneal tuberosity. In three specimens this insertion was in continuity with the plantar fascia in the form of periosteum. The deep part of the insertion of the Achilles tendon is made of fascicles from the soleus tendon, which insert on the medial aspect of the middle facet of the calcaneal tuberosity, while the fascicles of the lateral head of the gastrocnemius tendon insert on the lateral aspect of the middle facet of the calcaneal tuberosity. A bicameral retrocalcaneal bursa was present in 15 of the 22 examined specimens. This new observation and description of the insertional footprint of the Achilles tendon and the retrocalcaneal bursa may allow a better understanding of the function of each muscular part of the gastrosoleus complex. This may have clinical relevance in the treatment of Achilles tendinopathies. Cite this article: Bone Joint J 2014; 96-B:1344–8
The expression of vascular endothelial growth factor and Syndecan-4 in cartilage from osteoarthritic knees
Authors: Oh J. S. , Youm Y. S. , Cho S. D. , Choi S. W. , Cho Y. J. 
Published: October 2014

Previous studies support the important role of vascular endothelial growth factor (VEGF) and syndecan-4 in the pathogenesis of osteoarthritis (OA). Both VEGF and syndecan-4 are expressed by chondrocytes and both are involved in the regulation of matrix metalloproteinase-3, resulting in the activation of aggrecanase II (ADAMTS-5), which is essential in the pathogenesis of OA. However, the relationship between VEGF and syndecan-4 has not been established. As a pilot study, we assayed the expression of VEGF and syndecan-4 in cartilage samples and cultured chondrocytes from osteoarthritic knee joints and analysed the relationship between these two factors. Specimens were collected from 21 female patients (29 knees) who underwent total knee replacement due to severe medial OA of the knee (Kellgren–Lawrence grade 4). Articular cartilage samples, obtained from bone and cartilage excised during surgery, were analysed and used for chondrocyte culture. We found that the levels of expression of VEGF and syndecan-4 mRNA did not differ significantly between medial femoral cartilage with severe degenerative changes and lateral femoral cartilage that appeared grossly normal (p = 0.443 and 0.622, respectively). Likewise, the levels of expression of VEGF and syndecan-4 mRNA were similar in cultured chondrocytes from medial and lateral femoral cartilage. The levels of expression of VEGF and syndecan-4 mRNAs were significantly and positively correlated in cartilage explant (r = 0.601, p = 0.003) but not in cultured chondrocytes. These results suggest that there is a close relationship between VEGF and syndecan-4 in the cartilage of patients with OA. Further studies are needed to determine the exact pathway by which these two factors interact in the pathogenesis of OA. Cite this article: Bone Joint J 2014;96-B:1319–24.
Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation
Authors: Nakamae A. , Ochi M. , Deie M. , Adachi N. , Shibuya H. , Ohkawa S. , Hirata K. 
Published: October 2014

We report the clinical outcome and findings at second-look arthroscopy of 216 patients (mean age 25 years (11 to 58)) who underwent anterior cruciate ligament (ACL) reconstruction or augmentation. There were 73 single-bundle ACL augmentations (44 female, 29 male), 82 double-bundle ACL reconstructions (35 female, 47 male), and 61 single-bundle ACL reconstructions (34 female, 27 male).In 94 of the 216 patients, proprioceptive function of the knee was evaluated before and 12 months after surgery using the threshold to detect passive motion test.Second-look arthroscopy showed significantly better synovial coverage of the graft in the augmentation group (good: 60 (82%), fair: 10 (14%), poor: 3 (4%)) than in the other groups (p = 0.039). The mean side-to-side difference measured with a KT-2000 arthrometer was 0.4 mm (-3.3 to 2.9) in the augmentation group, 0.9 mm (-3.2 to 3.5) in the double-bundle group, and 1.3 mm (-2.7 to 3.9) in the single-bundle group: the result differed significantly between the augmentation and single-bundle groups (p = 0 .013). No significant difference in the Lysholm score or pivot-shift test was seen between the three groups (p = 0.09 and 0.65, respectively). In patients with good synovial coverage, three of the four measurements used revealed significant improvement in proprioceptive function (p = 0.177, 0.020, 0.034, and 0.026).We conclude that ACL augmentation is a reasonable treatment option for patients with favourable ACL remnants.Cite this article: Bone Joint J 2014;96-B:1325–32
Does a pathological fracture affect the prognosis in patients with osteosarcoma of the extremities?
Authors: Salunke A. A. , Chen Y. , Tan J. H. , Chen X. , Khin L. W. , Puhaindran M. E. 
Published: October 2014

Opinion remains divided as to whether the development of pathological fracture affects the prognosis of patients with an osteosarcoma of the extremities. We conducted a comprehensive systematic review and meta-analysis of papers which reported the outcomes of osteosarcoma patients with and without a pathological fracture. There were eight eligible papers for final analysis which reported on 1713 patients, of whom 303 (17.7%) had a pathological fracture. The mean age for 1464 patients in six studies was 23.2 years old (2 to 82). The mean follow-up for 1481 patients in seven studies was 90.1 months (6 to 240). The pooled estimates of local recurrence rates in osteosarcoma patients with and without pathological fractures were 14.4% (8.7 to 20.0) versus 11.4% (8.0 to 14.8). The pooled estimate of relative risk was 1.39 (0.89 to 2.20). The pooled estimates of five-year event-free survival rates in osteosarcoma patients with and without a pathological fracture were 49.3% (95% CI 43.6 to 54.9) versus 66.8% (95% CI 60.7 to 72.8). The pooled estimate of relative risk was 1.33 (1.12 to 1.59). There was no significant difference in the rate of local recurrence between patients who were treated by amputation or limb salvage. The development of a pathological fracture is a negative prognostic indicator in osteosarcoma and is associated with a reduced five-year event-free survival and a possibly higher rate of local recurrence. Our findings suggest that there is no absolute indication for amputation, as similar rates of local recurrence can be achieved in patients who are carefully selected for limb salvage. Cite this article: Bone Joint J 2014; 96-B:1396–1403
Comparative outcome of arthroscopic release for frozen shoulder in patients with and without diabetes
Authors: Mehta S. S. , Singh H. P. , Pandey R. 
Published: October 2014

Our aim was to compare the outcome of arthroscopic release for frozen shoulder in patients with and without diabetes. We prospectively compared the outcome in 21 patients with and 21 patients without diabetes, two years post-operatively. The modified Constant score was used as the outcome measure. The mean age of the patients was 54.5 years (48 to 65; male:female ratio: 18:24), the mean pre-operative duration of symptoms was 8.3 months (6 to 13) and the mean pre-operative modified Constant scores were 36.6 (standard deviation (sd) 4.6) and 38.4 (sd 5.7) in the diabetic and non-diabetic groups, respectively. The mean modified Constant scores at six weeks, six months and two years post-operatively in the diabetics were 55. 6 (sd 4.7), 67. 4 (sd 5.6) and 84. 4 (sd 6.8), respectively; and in the non-diabetics 66.8 (sd 4.5), 79.6 (sd 3.8) and 88.6 (sd 4.2), respectively. A total of 15 (71%) of diabetic patients recovered a full range of movement as opposed to 19 (90%) in the non-diabetics. There was significant improvement (p < 0.01) in the modified Constant scores following arthroscopic release for frozen shoulder in both groups. The results in diabetics were significantly worse than those in non-diabetics six months post-operatively (p < 0.01) with a tendency towards persistent limitation of movement two years after operation. These results may be used when counselling diabetic patients for the outcome after arthroscopic treatment of frozen shoulder.Cite this article: Bone Joint J 2014;96-B:1355–8.
The surgical treatment of rheumatoid arthritis
Authors: Nikiphorou E. , Konan S. , MacGregor A. J. , Haddad F. S. , Young A. 
Published: October 2014

There has been an in increase in the availability of effective biological agents for the treatment of rheumatoid arthritis as well as a shift towards early diagnosis and management of the inflammatory process. This article explores the impact this may have on the place of orthopaedic surgery in the management of patients with rheumatoid arthritis. Cite this article: Bone Joint J 2014;96-B:1287–9
Improving the accuracy of predicted basal-area diameter distribution in advanced stands by determining stem number
Authors: Siipilehto Jouni 
Published: October 2014

The objective of this paper was to study to what extent the accuracy of predicted basal-area diameter distributions (DDG) could be improved by means of stem number observations in advanced (HÂ >Â 10 m) stands. In the Finnish forest management planning (FMP) inventory practice, stem number is determined only in young stands; in older stands stand basal area is used. The study material consisted of sixty stands of Norway spruce (Picea abies Karst.) and ninety-one stands of Scots pine (Pinus sylvestris L.) with birch (Betula pendula Roth and B. pubescens Ehrh.) admixtures in southern and eastern Finland. For test data, 167â292 independent, National Forest Inventory-based, permanent sample plots were used. DDGs were estimated with the maximum likelihood method. Species-specific models for predicting the distribution parameters were derived using regression analysis. The two-parameter Weibull distribution was compared to the three-parameter Johnsonâs SB distributions in predicting DDGs. The models were based on either predictors that are consistent with current FMP (model G), or assuming an additional stem number observation (model G+N). The predicted distributions were compared in terms of the derived stand variables: stem number, total and timber volumes. The results were similar in modelling and test data sets. Methods, based on the SB distribution obtained with model (G+N), proved to give the most accurate description of the stand structure. Differences were marginal in stand total volumes. However, the error variation in stem number was 20% to 80% lower than when applying model (G). SB and Weibull distributions gave very much the same results if model (G) was applied.
Tree mortality after prescribed burning in an old-growth Scots pine forest in northern Sweden
Authors: Linder Per , Jonsson Peter , Niklasson Mats 
Published: October 2014

Tree mortality and input of dead trees were studied after a prescribed burning in a forest reserve in northern Sweden. The stand was a multi-layered old-growth forest. The overstorey was dominated by Scots pine (Pinus sylvestris L.) and the understorey consisted of mixed Scots pine and Norway spruce (Picea abies L. Karst.). Ground vegetation was dominated by ericaceous dwarf-shrubs and feathermosses. The stand has been affected by six forest fires during the last 500 years. The prescribed burning was a low intensity surface fire that scorched almost 90% of the ground. Tree mortality for smaller pines and spruces (DBHÂ <Â 10 cm) was over 80% in the burned parts of the reserve. For larger pines, 10â50 cm DBH, mortality showed a decreasing trend with increasing diameter, from 14% in class 10â20 cm DBH to 1.4% in class 40â50 cm DBH. However, pines with DBH â¥ 50 cm had a significantly higher mortality, 20%, since a high proportion of them had open fire scars containing cavities, caused by fungi and insects, which enabled the fire to burn inside the trunks and hollow them out. The fire-induced mortality resulted in a 21 m3 haâ1 input of dead trees, of which 12 m3 haâ1 consisted of trees with DBH â¥ 30 cm. An increased mortality among larger trees after low-intensity fires has not previously been described in Fennoscandian boreal forests, probably owing to a lack of recent fires in old-growth stands. However, since large pines with open fire scars were once a common feature in the natural boreal forest, we suggest that this type of tree mortality should be mimicked in forestry practices aiming to maintain and restore natural forest biodiversity.
Selective versus Exclusive Use of Drug-Eluting Stents in Treating Multivessel Coronary Artery Disease: A Real-World Cohort Study
Authors: Karbassi Arsha , Kassaian Seyed Ebrahim , Poorhosseini Hamidreza , Salarifar Mojtaba , Jalali Arash , Nematipour Ebrahim , Kazazi Elham Hakki , Alidoosti Mohammad , Hajizeinali Ali Mohammad , Tokaldani Masoumeh Lotfi 
Published: October 2014

There have been attempts to find new approaches to the treatment of multivessel coronary artery disease without increasing adverse events. Deployment of drug-eluting stents (DES) for complex lesions and bare-metal stents (BMS) for simpler lesions, although already in wide use, has not been well supported by clinical study.
A cohort of 1,658 patients who underwent multivessel percutaneous coronary intervention from March 2003 through June 2011 was studied for 1 year. These patients were divided into 3 groups: BMS only (599 patients); DES only (481 patients); and hybrid stenting (578 patients). Baseline characteristics were similar except for hyperlipidemia and moderate-to-severe mitral regurgitation, which were more frequent in the DES and hybrid groups, respectively. Lesion characteristics were more complex in the DES group, compared with the other groups: more B2/C type lesions, longer stents, and smaller reference-vessel diameters (P <0.001). The rates of major adverse cardiac events (MACE) at 1 year were similar between the groups (BMS=5.2%, hybrid=3.9%, and DES=3.4%; P=0.248). Subgroup analysis yielded no differences in death, nonfatal myocardial infarction, target-vessel revascularization, or target-lesion revascularization. On multivariable analysis, the strongest predictors of 1-year MACE were percutaneous intervention complicated by dissection, renal failure, left ventricular ejection fraction below 0.40, mean lesion length, reference vessel diameter, and percutaneous intervention on the left circumflex coronary artery. The latter two had inverse relationships with MACE.
In conclusion, implanting the DES for more complex lesions and the BMS for simpler lesions seems more sensible than the exclusive use of the DES or the BMS.
Changing Profile of Infective Endocarditis: A Clinicopathologic Study of 220 Patients in a Single Medical Center from 1998 through 2009
Authors: Li Li , Wang Hongyue , Wang Linlin , Pu Jielin , Zhao Hong 
Published: October 2014

The epidemiologic profile of infective endocarditis has changed substantially over the past few years, especially in industrialized countries. Our study evaluates the clinical and pathologic characteristics of infective endocarditis patients treated by cardiac surgery in China during a 12-year period.
We retrospectively evaluated 220 surgically treated infective endocarditis patients and analyzed their changes from the beginning of 1998 through 2009. The mean age of the patients increased from 36.9 to 42.7 years during those 12 years (P=0.036). The chief predisposing disease was congenital heart disease (32.8%), rather than rheumatic heart disease (13.2%); this rate did not change significantly during the 12 years. The prevalent congenital lesion was bicuspid aortic valve, the rate of which (55.6%) increased significantly over the 3 time intervals studied (P=0.016). The frequency of infective endocarditis after non-dental surgical and nonsurgical intervention was significantly greater (23.3%) during 1998 through 2001, compared with the 2 intervals that followed (9%; P=0.019). Streptococcus viridans was the most frequent causative agent overall (25.6%). Forty-seven of the 220 patients (21.4%) carried the clinical diagnosis of some other form of heart disease before surgery, but at surgery they were found to have infective endocarditis as the fundamental disease process. Of 47 patients, 33 (70.2%) had either very small or no vegetations but had focal necrosis and inflammation of valve tissue that supported the diagnosis of infective endocarditis.
Pulmonary Artery Sarcoma Mimicking Pulmonary Embolism
Authors: El-Sayed Ahmed Magdy M. , Aftab Muhammad , Al-Najjar Raed M. , de la Cruz Kim I. , Benjamin Robert S. , Hallman Charles H. 
Published: October 2014

Primary sarcomas that arise from major blood vessels are exceedingly rare, and some of the published cases have been autopsy reports. Most patients are adults. We report a case of pulmonary artery sarcoma in a 77-year-old man who presented with acute onset of dyspnea. Magnetic resonance imaging of the chest revealed a large mass within the pulmonary trunk and its main branches. Because massive pulmonary embolism was suspected, both anticoagulant and thrombolytic therapies were initiated. The patient responded poorly to these therapies, which then necessitated resection of both the mass and the pulmonary valve. A bioprosthetic porcine valve replaced the native valve, and we reconstructed the right ventricular outflow tract with a Dacron patch. Histopathologic examination revealed a high-grade sarcoma with focal myogenic and chondrogenic differentiation. The patient tolerated the procedure well and was discharged from the hospital on postoperative day 7. He was subsequently treated with chemotherapy and radiation and continued to show no evidence of disease.
The diagnosis of pulmonary artery sarcoma should be suspected in patients who present with manifestations of pulmonary embolism, especially when there is no evidence of deep venous thrombosis and poor response to anticoagulant therapy. Multimodal therapy can provide prolonged survival.
Contemporary Use of Balloon Aortic Valvuloplasty in the Era of Transcatheter Aortic Valve Implantation
Authors: Hui Dawn S. , Shavelle David M. , Cunningham Mark J. , Matthews Ray V. , Starnes Vaughn A. 
Published: October 2014

The development of transcatheter aortic valve implantation (TAVI) has increased the use of balloon aortic valvuloplasty (BAV) in treating aortic stenosis. We evaluated our use of BAV in an academic tertiary referral center with a developing TAVI program.
We reviewed 69 consecutive stand-alone BAV procedures that were performed in 62 patients (mean age, 77 ± 10 yr; 62% men; baseline mean New York Heart Association functional class, 3 ± 1) from January 2009 through December 2012. Enrollment for the CoreValve® clinical trial began in January 2011. We divided the study cohort into 2 distinct periods, defined as pre-TAVI (2009–2010) and TAVI (2011–2012). We reviewed clinical, hemodynamic, and follow-up data, calculating each BAV procedure as a separate case.
Stand-alone BAV use increased 145% from the pre-TAVI period to the TAVI period. The mean aortic gradient reduction was 13 ± 10 mmHg. Patients were successfully bridged as intended to cardiac or noncardiac surgery in 100% of instances and to TAVI in 60%. Five patients stabilized with BAV subsequently underwent surgical aortic valve replacement with no operative deaths. The overall in-hospital mortality rate (17.4%) was highest in emergent patients (61%).
The implementation of a TAVI program was associated with a significant change in BAV volumes and indications. Balloon aortic valvuloplasty can successfully bridge patients to surgery or TAVI, although least successfully in patients nearer death. As TAVI expands to more centers and higher-risk patient groups, BAV might become integral to collaborative treatment decisions by surgeons and interventional cardiologists.
Alternative Banking and Theory
Authors: Butzbach Olivier , von Mettenheim Kurt E. 
Published: October 2014

Abstract
Unlike business models of private banks based on profit maximization and shareholder-oriented governance, alternative banks (such as cooperative banks, government savings banks, and special purpose banks) share business models based on sustainable returns with longer time horizons, corporate missions that include social and public policy goals, and stakeholder-oriented governance. Strong evidence from recent research suggests that alternative banks often equal or outperform joint-stock banks in terms of efficiency, profitability, and risk management. This counters core ideas in contemporary banking theory and expectations of regulators about the superiority of private ownership and market-based banking. Concepts and theories from banking studies help explain how alternative banks outperform private banks in core functions such as creating and managing liquidity, pooling deposits, and reducing information asymmetries and agency costs. However, heterodox theories of the firm and institutional approaches to competitive advantage broaden the scope of analysis to explain further historical, social, and organizational advantages (and risks) in alternative banking. Alternative banks therefore require, and may inspire, alternative theories of banking and new approaches to bank regulation.