bluuebunny/crossref_metadata_2025_split huggingface dataset:
Financial analysis of revision knee surgery based on NHS tariffs and hospital costs
Authors: Kallala R. F. , Vanhegan I. S. , Ibrahim M. S. , Sarmah S. , Haddad F. S. 
Published: January 2015

Revision total knee arthroplasty (TKA) is a complex procedure which carries both a greater risk for patients and greater cost for the treating hospital than does a primary TKA. As well as the increased cost of peri-operative investigations, blood transfusions, surgical instrumentation, implants and operating time, there is a well-documented increased length of stay which accounts for most of the actual costs associated with surgery. We compared revision surgery for infection with revision for other causes (pain, instability, aseptic loosening and fracture). Complete clinical, demographic and economic data were obtained for 168 consecutive revision TKAs performed at a tertiary referral centre between 2005 and 2012. Revision surgery for infection was associated with a mean length of stay more than double that of aseptic cases (21.5 vs 9.5 days, p < 0.0001). The mean cost of a revision for infection was more than three times that of an aseptic revision (£30 011 (sd 4514) vs £9655 (sd 599.7), p < 0.0001). Current NHS tariffs do not fully reimburse the increased costs of providing a revision knee surgery service. Moreover, especially as greater costs are incurred for infected cases. These losses may adversely affect the provision of revision surgery in the NHS. Cite this article: Bone Joint J 2015;97-B:197–201.
Social deprivation as a risk factor for fractures in childhood
Authors: Ramaesh R. , Clement N. D. , Rennie L. , Court-Brown C. , Gaston M. S. 
Published: January 2015

Paediatric fractures are common and can cause significant morbidity. Socioeconomic deprivation is associated with an increased incidence of fractures in both adults and children, but little is known about the epidemiology of paediatric fractures. In this study we investigated the effect of social deprivation on the epidemiology of paediatric fractures. We compiled a prospective database of all fractures in children aged < 16 years presenting to the study centre. Demographics, type of fracture, mode of injury and postcode were recorded. Socioeconomic status quintiles were assigned for each child using the Scottish Index for Multiple Deprivation (SIMD). We found a correlation between increasing deprivation and the incidence of fractures (r = 1.00, p < 0.001). In the most deprived group the incidence was 2420/100 000/yr, which diminished to 1775/100 000/yr in the least deprived group. The most deprived children were more likely to suffer a fracture as a result of a fall (odds ratio (OR) = 1.5, p < 0.0001), blunt trauma (OR = 1.5, p = 0.026) or a road traffic accident (OR = 2.7, p < 0.0001) than the least deprived. These findings have important implications for public health and preventative measures. Cite this article: Bone Joint J 2015;97-B:240–5.
The effect of orientation of the acetabular component on outcome following total hip arthroplasty with small diameter hard-on-soft bearings
Authors: Grammatopoulos G. , Thomas G. E. R. , Pandit H. , Beard D. J. , Gill H. S. , Murray D. W. 
Published: January 2015

We assessed the orientation of the acetabular component in 1070 primary total hip arthroplasties with hard-on-soft, small diameter bearings, aiming to determine the size and site of the target zone that optimises outcome. Outcome measures included complications, dislocations, revisions and ΔOHS (the difference between the Oxford Hip Scores pre-operatively and five years post-operatively). A wide scatter of orientation was observed (2sd 15°). Placing the component within Lewinnek’s zone was not associated withimproved outcome. Of the different zone sizes tested (± 5°, ± 10° and ± 15°), only ± 15° was associated with a decreased rate of dislocation. The dislocation rate with acetabular components inside an inclination/anteversion zone of 40°/15° ± 15° was four times lower than those outside. The only zone size associated with statistically significant and clinically important improvement in OHS was ± 5°. The best outcomes (ΔOHS > 26) were achieved with a 45°/25° ± 5° zone. This study demonstrated that with traditional technology surgeons can only reliably achieve a target zone of ±15°. As the optimal zone to diminish the risk of dislocation is also ±15°, surgeons should be able to achieve this. This is the first study to demonstrate that optimal orientation of the acetabular component improves the functional outcome. However, the target zone is small (± 5°) and cannot, with current technology, be consistently achieved. Cite this article: Bone Joint J 2015;97-B:164–72.
Cemented versus cementless Oxford unicompartmental knee arthroplasty using radiostereometric analysis
Authors: Kendrick B. J. L. , Kaptein B. L. , Valstar E. R. , Gill H. S. , Jackson W. F. M. , Dodd C. A. F. , Price A. J. , Murray D. W. 
Published: January 2015

The most common reasons for revision of unicompartmental knee arthroplasty (UKA) are loosening and pain. Cementless components may reduce the revision rate. The aim of this study was to compare the fixation and clinical outcome of cementless and cemented Oxford UKAs. A total of 43 patients were randomised to receive either a cemented or a cementless Oxford UKA and were followed for two years with radiostereometric analysis (RSA), radiographs aligned with the bone–implant interfaces and clinical scores. The femoral components migrated significantly during the first year (mean 0.2 mm) but not during the second. There was no significant difference in the extent of migration between cemented and cementless femoral components in either the first or the second year. In the first year the cementless tibial components subsided significantly more than the cemented components (mean 0.28 mm (sd 0.17) vs. 0.09 mm (sd 0.19 mm)). In the second year, although there was a small amount of subsidence (mean 0.05 mm) there was no significant difference (p = 0.92) between cemented and cementless tibial components. There were no femoral radiolucencies. Tibial radiolucencies were narrow (< 1 mm) and were significantly (p = 0.02) less common with cementless (6 of 21) than cemented (13 of 21) components at two years. There were no complete radiolucencies with cementless components, whereas five of 21 (24%) cemented components had complete radiolucencies. The clinical scores at two years were not significantly different (p = 0.20). As second-year migration is predictive of subsequent loosening, and as radiolucency is suggestive of reduced implant–bone contact, these data suggest that fixation of the cementless components is at least as good as, if not better than, that of cemented devices. Cite this article: Bone Joint J 2015; 97-B:185–91.
Carpal tunnel release with subneural reconstruction of the transverse carpal ligament compared with isolated open and endoscopic release
Authors: Zhang X. , Li Y. , Wen S. , Zhu H. , Shao X. , Yu Y. 
Published: January 2015

We report a new surgical technique of open carpal tunnel release with subneural reconstruction of the transverse carpal ligament and compare this with isolated open and endoscopic carpal tunnel release. Between December 2007 and October 2011, 213 patients with carpal tunnel syndrome (70 male, 143 female; mean age 45.6 years; 29 to 67) were recruited from three different centres and were randomly allocated to three groups: group A, open carpal tunnel release with subneural reconstruction of the transverse carpal ligament (n = 68); group B, isolated open carpal tunnel release (n = 92); and group C, endoscopic carpal tunnel release (n = 53). At a mean final follow-up of 24 months (22 to 26), we found no significant difference between the groups in terms of severity of symptoms or lateral grip strength. Compared with groups B and C, group A had significantly better functional status, cylindrical grip strength and pinch grip strength. There were significant differences in Michigan Hand Outcome scores between groups A and B, A and C, and B and C. Group A had the best functional status, cylindrical grip strength, pinch grip strength and Michigan Hand Outcome score. Subneural reconstruction of the transverse carpal ligament during carpal tunnel decompression maximises hand strength by stabilising the transverse carpal arch. Cite this article: Bone Joint J 2015;97-B:221–8
The evolving role of computer-assisted navigation in musculoskeletal oncology
Authors: Young P. S. , Bell S. W. , Mahendra A. 
Published: January 2015

We report our experience of using a computer navigation system to aid resection of malignant musculoskeletal tumours of the pelvis and limbs and, where appropriate, their subsequent reconstruction. We also highlight circumstances in which navigation should be used with caution. We resected a musculoskeletal tumour from 18 patients (15 male, three female, mean age of 30 years (13 to 75) using commercially available computer navigation software (Orthomap 3D) and assessed its impact on the accuracy of our surgery. Of nine pelvic tumours, three had a biological reconstruction with extracorporeal irradiation, four underwent endoprosthetic replacement (EPR) and two required no bony reconstruction. There were eight tumours of the bones of the limbs. Four diaphyseal tumours underwent biological reconstruction. Two patients with a sarcoma of the proximal femur and two with a sarcoma of the proximal humerus underwent extra-articular resection and, where appropriate, EPR. One soft-tissue sarcoma of the adductor compartment which involved the femur was resected and reconstructed using an EPR. Computer navigation was used to aid reconstruction in eight patients. Histological examination of the resected specimens revealed tumour-free margins in all patients. Post-operative radiographs and CT showed that the resection and reconstruction had been carried out as planned in all patients where navigation was used. In two patients, computer navigation had to be abandoned and the operation was completed under CT and radiological control. The use of computer navigation in musculoskeletal oncology allows accurate identification of the local anatomy and can define the extent of the tumour and proposed resection margins. Furthermore, it helps in reconstruction of limb length, rotation and overall alignment after resection of an appendicular tumour. Cite this article: Bone Joint J 2015;97-B:258–64.
Retrospective evaluation of the incidence of early periprosthetic infection with silver-treated endoprostheses in high-risk patients
Authors: Wafa H. , Grimer R. J. , Reddy K. , Jeys L. , Abudu A. , Carter S. R. , Tillman R. M. 
Published: January 2015

We conducted a case-control study to examine the merit of silver-coated tumour prostheses. We reviewed 85 patients with Agluna-treated (silver-coated) tumour implants treated between 2006 and 2011 and matched them with 85 control patients treated between 2001 and 2011 with identical, but uncoated, tumour prostheses. In all, 106 men and 64 women with a mean age of 42.2 years (18.4 to 90.4) were included in the study. There were 50 primary reconstructions (29.4%); 79 one-stage revisions (46.5%) and 41 two-stage revisions for infection (24.1%). The overall post-operative infection rate of the silver-coated group was 11.8% compared with 22.4% for the control group (p = 0.033, chi-square test). A total of seven of the ten infected prostheses in the silver-coated group were treated successfully with debridement, antibiotics, and implant retention compared with only six of the 19 patients (31.6%) in the control group (p = 0.048, chi-square test). Three patients in the silver-coated group (3.5%) and 13 controls (15.3%) had chronic periprosthetic infection (p = 0.009, chi-square test). The overall success rates in controlling infection by two-stage revision in the silver-coated group was 85% (17/20) compared with 57.1% (12/21) in the control group (p = 0.05, chi-square test). The Agluna-treated endoprostheses were associated with a lower rate of early periprosthetic infection. These silver-treated implants were particularly useful in two-stage revisions for infection and in those patients with incidental positive cultures at the time of implantation of the prosthesis. Debridement with antibiotic treatment and retention of the implant appeared to be more successful with silver-coated implants. Cite this article: Bone Joint J 2015;97-B:252–7.
Does osteoporosis have a negative effect on the functional outcome of an osteoporotic distal radial fracture treated with a volar locking plate?
Authors: Choi W-S. , Lee H. J. , Kim D-Y. , Lee C-H. , Lee B. G. , Kim J-H. , Lee K-H. 
Published: January 2015

We performed a retrospective study to determine the effect of osteoporosis on the functional outcome of osteoporotic distal radial fractures treated with a volar locking plate. Between 2009 and 2012 a total of 90 postmenopausal women with an unstable fracture of the distal radius treated with a volar locking plate were studied. Changes in the radiological parameters of 51 patients with osteoporosis (group 1, mean age 66.9, mean T-score –3.16 (sd 0.56)) were not significantly different from those in 39 patients without osteoporosis (group 2, mean age 61.1, mean T-score –1.72 (sd 0.57)). The mean Disabilities of the Arm, Shoulder and Hand (DASH) score at final follow-up was 11.5 (sd 12.2) in group 1 and 10.5 (sd 13.25) in group 2. The mean modified Mayo wrist score at final follow-up was 79.0 (sd 14.04) in group 1 and 82.6 (sd 13.1) in group 2. However, this difference was not statistically significant (p = 0.35 for DASH score, p = 0.2 for modified Mayo wrist score). Univariable and multivariable logistic regression analysis showed that only the step-off of the radiocarpal joint was related to both a poor DASH and modified Mayo wrist score. Pearson’s correlation coefficient showed a weak negative relationship only between the T-score and the change in volar tilt (intraclass coefficient –0.26, p = 0.02).We found that osteoporosis does not have a negative effect on the functional outcome and additional analysis did not show a correlation between T-score and outcome.Cite this article: Bone Joint J 2015;97-B:229–34.
Verkehrsflussmessungen – Vergleich zwischen Laserscanner und Trackingradar
Authors: Kupper Johannes 
Published: January 2015

Zusammenfassung
Fahrzeuggeschwindigkeiten und Verkehrsstärken sind häufig Gegenstand von
wissenschaftlichen Untersuchungen im Straßenverkehr. Diese Messgrößen werden
zudem für intelligente Verkehrsanwendungen verwendet, um den Verkehrsfluss
insgesamt zu verbessern. Im Rahmen der hier vorgestellten Arbeit soll gezeigt
werden, dass neben den Sensoren, die bisher für die Bestimmung der genannten
Messgrößen verwendet werden, ein Trackingradar verwendet werden kann. Es
sollen hier die messtechnischen Eigenschaften dieses Trackingradars untersucht
werden und die Vorteile gegenüber den bisher eingesetzten Sensoren aufgezeigt
werden.
Numerical Modeling of Unsteady Oil Film Motion Characteristics in Bearing Chambers
Authors: Zhao Jingyu , Liu Zhenxia , Lu Yaguo , Hu Jianping 
Published: January 2015

AbstractTo obtain motion characteristics of the lubricating oil film on the aero-engine bearing chamber wall, a complete mathematical model based on theoretical study to solve three-dimensional unsteady oil film motion was established. On the basis of verifying the rationality of the computational model, the variations of the oil film thickness, velocity and temperature with the rotation speed and lubricating oil flow were analyzed and studied. The numerical results show that the following: In the stable oil film flow state, the oil film thickness shows a decreasing trend with increase in rotation speed and an increasing trend with increase in the lubricating oil flow. Particularly, comparison with the experimental work shows that the proposed numerical model based on theoretical study to solve unsteady oil film motion is a valuable technical means for the study of oil film movement mechanism and the design of actual bearing chamber.
Genetic screening of patients with medullary thyroid cancer in a referral center in Greece during the past two decades
Authors: Sarika H-L , Papathoma A , Garofalaki M , Saltiki K , Pappa T , Pazaitou-Panayiotou K , Anastasiou E , Alevizaki M 
Published: January 2015

ObjectiveMutations in theRETgene are responsible for hereditary medullary thyroid cancer (MTC) and may vary between ethnic groups. We report the spectrum of mutations detected in patients with MTC in a referral center in Greece.Patients and methodsScreening forRETmutations was performed in 313 subjects from 188 unrelated families: 51 patients had clinical suspicion for familial disease, 133 were apparently sporadic, four patients had only C cell hyperplasia, and 125 were family members. Exons 8, 10, 11, and 13–16 were screened.ResultsA total of 58 individuals (30.85%) wereRETmutations carriers, 120 (63.8%) were finally classified as sporadic, 13 apparently sporadic cases (9.8%) were identified withRETmutation: ten carried the exon 8 at codon 533 mutation (previously reported), two the exon 14 at codon 804 mutation, and one the exon 13 at codon 768 mutation. Six patients (3.19%) with clinical features of multiple endocrine neoplasia type 2A and negative forRETmutations were classified as ‘unknown cause’. The mutations of hereditary cases were as follows: 21 cases (36.2%) in exon 8 codon 533, 19 (32.8%) in exon 11 codon 634, nine (15.5%) in exon 10, five (8.6%) in exon 16, three (5.2%) in exon 14 codon 804, and one in exon 13 codon 768 (1.7%).ConclusionThe spectrum ofRETmutations in Greece differs from that in other populations and the prevalence of familial cases is higher. The exon 8 (Gly533Cys) mutation was the most prevalent in familial cases unlike other series, followed by exon 11 (codon 634) mutations which are the most frequent elsewhere. The wide application of genetic screening in MTC reveals new molecular defects and helps to characterize the spectrum of mutations in each ethnic group.
Morphine Versus Clonidine for Neonatal Abstinence Syndrome
Authors: Bada Henrietta S. , Sithisarn Thitinart , Gibson Julia , Garlitz Karen , Caldwell Rhonda , Capilouto Gilson , Li Yinglei , Leggas Markos , Breheny Patrick 
Published: January 2015

OBJECTIVE:The study goal was to determine whether clonidine treatment of neonatal abstinence syndrome (NAS) would result in a better neurobehavioral performance compared with morphine.METHODS:This pilot study prospectively enrolled infants ≥35 weeks’ gestational age admitted for treatment of NAS. After informed consent was obtained, infants were randomized to receive morphine (0.4 mg/kg per day) or clonidine (5 μg/kg per day) divided into 8 doses. A 25% dose escalation every 24 hours was possible per protocol (maximum of 1 mg/kg per day for morphine and 12 μg/kg per day for clonidine). After control of symptoms, the dose was tapered by 10% every other day. Clinical staff monitored infants by using Finnegan scoring. Masked research staff administered the NICU Network Neurobehavioral Scale (NNNS) at 1 week and at 2 to 4 weeks after initiation of treatment and the Bayley Scales III, and Preschool Language Scale IV, at 1-year adjusted age. Analyses included descriptive statistics, repeated measures analysis of variance, and Wilcoxon tests.RESULTS:Infants treated with morphine (n = 15) versus clonidine (n = 16) did not differ in birth weight or age at treatment. Treatment duration was significantly longer for morphine (median 39 days) than for clonidine (median 28 days; P = .02). NNNS summary scores improved significantly with clonidine but not with morphine. On subsequent assessment, those receiving clonidine had lower height of arousal and excitability (P &lt; .05). One-year motor, cognitive, and language scores did not differ between groups.CONCLUSIONS:Clonidine may be a favorable alternative to morphine as a single-drug therapy for NAS. A multicenter randomized trial is warranted.
The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update
Authors: Ammerman Seth , Ryan Sheryl , Adelman William P. ,   THE COMMITTEE ON SUBSTANCE ABUSE, THE COMMITTEE ON ADOLESCENCE, Levy Sharon , Ammerman Seth D. , Gonzalez Pamela K. , Ryan Sheryl A. , Siqueira Lorena M. , Smith Vincent C. , Braverman Paula K. , Adelman William P. , Alderman Elizabeth Meller , Breuner Cora C. , Levine David A. , Marcell Arik V. , O’Brien Rebecca Flynn 
Published: January 2015

This Technical Report was reaffirmed January 2024.
This technical report updates the 2004 American Academy of Pediatrics technical report on the legalization of marijuana. Current epidemiology of marijuana use is presented, as are definitions and biology of marijuana compounds, side effects of marijuana use, and effects of use on adolescent brain development. Issues concerning medical marijuana specifically are also addressed. Concerning legalization of marijuana, 4 different approaches in the United States are discussed: legalization of marijuana solely for medical purposes, decriminalization of recreational use of marijuana, legalization of recreational use of marijuana, and criminal prosecution of recreational (and medical) use of marijuana. These approaches are compared, and the latest available data are presented to aid in forming public policy. The effects on youth of criminal penalties for marijuana use and possession are also addressed, as are the effects or potential effects of the other 3 policy approaches on adolescent marijuana use. Recommendations are included in the accompanying policy statement.
Effect of carbetocin, oxytocin and prostaglandin E2 and F2α on intrauterine pressure in cows in dioestrus and oestrus
Authors: Adler M. , Bleul U. 
Published: January 2015

SummaryObjective: To describe the physiological activity of the myometrium in oestrus and dioestrus and the induced activity after medication in cows with particular reference to segmental differences. Material and methods: Six cows were given the pharmaceuticals carbetocin, oxytocin and prostaglandin (PG) F2α (dinoprost) intramuscularly and PGE2 intravenously. The physiological myometrial activity was recorded for 15 minutes and the induced activity for 105 minutes by using a transcervically attached pressure probe containing six pressure micro-transducers. Results: Lower pressures were measured in dioestrus com pared to oestrus before (dioestrus 3.2 ± 8.88 mmHg, oestrus 12.4 ± 13.23 mmHg, p < 0.0001) and after the drug administration. Carbetocin provoked the longest lasting effect (60 minutes in dioestrus, 75 minutes in oestrus) followed by PGE2 (45 minutes in dioestrus, 60 minutes in oestrus), PGF2α (30 minutes each) and oxytocin (15 minutes in oestrus only). In contrast to the other drugs carbetocin did not cause any pressure decrease beneath the base level after the primary pressure increase in dioestrus. In dioestrus the pressure before drug administration was significantly higher in the cervix (3.6 ± 19.40 mmHg) and the uterine body (7.1 ± 36.10 mmHg) than in the uterine horn (1.1 ± 7.21 mmHg). Conversely, in oestrus the pressure in the uterine horn (16.6 ± 17.73 mmHg) was significantly higher than in the uterine body (6.2 ± 16.59 mmHg) and the cervix (10.4 ± 17.91 mmHg). Drug administration in dioestrus caused a cornual pressure increase and the pressure in the uterine body decreased, whereas in oestrus the pressure increased in all uterine segments. The physiological frequency of the pressure waves in dioestrus was 5.2 ± 3.02 in 15 minutes compared to 7.5 ± 2.89 in 15 minutes in oestrus. No traceable changes of the contraction frequency were found after medication. Conclusion and clinical relevance: Carbetocin caused the most enduring increase in intrauterine pressure in dioestrus and oestrus and may therefore be indicated best for therapeutic use. The tested drugs had the same effects on the various uterine segments and no effect on the contraction frequency.