bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study of the incidence and outcomes of incidental dural tears in microendoscopic lumbar decompressive surgery
Authors: Tsutsumimoto T. , Yui M. , Uehara M. , Ohta H. , Kosaku H. , Misawa H. 
Published: May 2014

Little information is available about the incidence and outcome of incidental dural tears associated with microendoscopic lumbar decompressive surgery. We prospectively examined the incidence of dural tears and their influence on the outcome six months post-operatively in 555 consecutive patients (mean age 47.4 years (13 to 89)) who underwent this form of surgery. The incidence of dural tears was 5.05% (28/555). The risk factors were the age of the patient and the procedure of bilateral decompression via a unilateral approach. The rate of recovery of the Japanese Orthopaedic Association score in patients with dural tears was significantly lower than that in those without a tear (77.7% vs 87.6%; p < 0.02), although there were no significant differences in the improvement of the Oswestry Disability Index between the two groups. Most dural tears were small, managed by taking adequate care of symptoms of low cerebrospinal fluid pressure, and did not require direct dural repair. Routine MRI scans were undertaken six months post-operatively; four patients with a dural tear had recurrent or residual disc herniation and two had further stenosis, possibly because the dural tear prevented adequate decompression and removal of the fragments of disc during surgery; as yet, none of these patients have undergone further surgery. Cite this article: Bone Joint J 2014;96-B:641–5.
Proximal femoral resection without post-operative traction for the painful dislocated hip in young patients with cerebral palsy
Authors: Dartnell J. , Gough M. , Paterson J. M. H. , Norman-Taylor F. 
Published: May 2014

Proximal femoral resection (PFR) is a proven pain-relieving procedure for the management of patients with severe cerebral palsy and a painful displaced hip. Previous authors have recommended post-operative traction or immobilisation to prevent a recurrence of pain due to proximal migration of the femoral stump. We present a series of 79 PFRs in 63 patients, age 14.7 years (10 to 26; 35 male, 28 female), none of whom had post-operative traction or immobilisation. A total of 71 hips (89.6%) were reported to be pain free or to have mild pain following surgery. Four children underwent further resection for persistent pain; of these, three had successful resolution of pain and one had no benefit. A total of 16 hips (20.2%) showed radiographic evidence of heterotopic ossification, all of which had formed within one year of surgery. Four patients had a wound infection, one of which needed debridement; all recovered fully. A total of 59 patients (94%) reported improvements in seating and hygiene. The results are as good as or better than the historical results of using traction or immobilisation. We recommend that following PFR, children can be managed without traction or immobilisation, and can be discharged earlier and with fewer complications. However, care should be taken with severely dystonic patients, in whom more extensive femoral resection should be considered in combination with management of the increased tone. Cite this article: Bone Joint J 2014; 96-B:701–6.
The risk of surgical site infection and re-admission in obese patients undergoing total joint replacement who lose weight before surgery and keep it off post-operatively
Authors: Inacio M. C. S. , Kritz-Silverstein D. , Raman R. , Macera C. A. , Nichols J. F. , Shaffer R. A. , Fithian D. C. 
Published: May 2014

This study evaluated whether obese patients who lost weight before their total joint replacement and kept it off post-operatively were at lower risk of surgical site infection (SSI) and re-admission compared with those who remained the same weight.We reviewed 444 patients who underwent a total hip replacement and 937 with a total knee replacement who lost weight pre-operatively and sustained their weight loss after surgery. After adjustments, patients who lost weight before a total hip replacement and kept it off post-operatively had a 3.77 (95% confidence interval (CI) 1.59 to 8.95) greater likelihood of deep SSIs and those who lost weight before a total knee replacement had a 1.63 (95% CI 1.16 to 2.28) greater likelihood of re-admission compared with the reference group.These findings raise questions about the safety of weight management before total replacement of the hip and knee joints.Cite this article: Bone Joint J 2014;96-B:629–35.
A case–control study of surgical site infection following operative fixation of fractures of the ankle in a large UK trauma unit
Authors: Korim M. T. , Payne R. , Bhatia M. 
Published: May 2014

Most of the literature on surgical site infections following the surgical treatment of fractures of the ankle is based on small series of patients, focusing on diabetics or the elderly. None have described post-operative functional scores in those patients who develop an infection. We performed an age- and gender-matched case–control study to identify patient- and surgery-related risk factors for surgical site infection following open reduction and internal fixation of a fracture of the ankle. Logistic regression analysis was used to identify significant risk factors for infection and to calculate odds ratios (OR). Function was assessed using the Olerud and Molander Ankle Score. The incidence of infection was 4% (29/717) and 1.1% (8/717) were deep infections. The median ankle score was significantly lower in the infection group compared with the control group (60 vs 90, Mann–Whitney test p < 0.0001). Multivariate regression analysis showed that diabetes (OR = 15, p = 0.031), nursing home residence (OR = 12, p = 0.018) and Weber C fractures (OR = 4, p = 0.048) were significant risk factors for infection. A low incidence of infection following open reduction and internal fixation of fractures of the ankle was observed. Both superficial and deep infections result in lower functional scores. Cite this article: Bone Joint J 2014;96-B:636–40.
Continuous distal migration and internal rotation of the C-stem prosthesis without any adverse clinical effects
Authors: von Schewelov T. , Carlsson Å. , Sanzén L. , Besjakov J. 
Published: May 2014

In 2005, we demonstrated that the polished triple-tapered C-stem at two years had migrated distally and rotated internally. From that series, 33 patients have now been followed radiologically, clinically and by radiostereometric analysis (RSA) for up to ten years. The distal migration within the cement mantle had continued and reached a mean of 2 mm (0.5 to 4.0) at ten years. Internal rotation, also within the cement mantle, was a mean 3.8° (external 1.6° to internal 6.6°) The cement mantle did not show any sign of migration or loosening in relation to the femoral bone. There were no clinical or radiological signs indicating that the migration or rotation within the cement mantle had had any adverse effects for the patients. Cite this article: Bone Joint J 2014;96-B:604–8.
Nanotechnology
Authors: Sullivan M. P. , McHale K. J. , Parvizi J. , Mehta S. 
Published: May 2014

Nanotechnology is the study, production and controlled manipulation of materials with a grain size < 100 nm. At this level, the laws of classical mechanics fall away and those of quantum mechanics take over, resulting in unique behaviour of matter in terms of melting point, conductivity and reactivity. Additionally, and likely more significant, as grain size decreases, the ratio of surface area to volume drastically increases, allowing for greater interaction between implants and the surrounding cellular environment. This favourable increase in surface area plays an important role in mesenchymal cell differentiation and ultimately bone–implant interactions.Basic science and translational research have revealed important potential applications for nanotechnology in orthopaedic surgery, particularly with regard to improving the interaction between implants and host bone. Nanophase materials more closely match the architecture of native trabecular bone, thereby greatly improving the osseo-integration of orthopaedic implants. Nanophase-coated prostheses can also reduce bacterial adhesion more than conventionally surfaced prostheses. Nanophase selenium has shown great promise when used for tumour reconstructions, as has nanophase silver in the management of traumatic wounds. Nanophase silver may significantly improve healing of peripheral nerve injuries, and nanophase gold has powerful anti-inflammatory effects on tendon inflammation.Considerable advances must be made in our understanding of the potential health risks of production, implantation and wear patterns of nanophase devices before they are approved for clinical use. Their potential, however, is considerable, and is likely to benefit us all in the future.Cite this article: Bone Joint J 2014; 96-B: 569–73.
A Rights‐Based Approach to Sexuality Education: Conceptualization, Clarification and Challenges
Authors: Berglas Nancy F. , Constantine Norman A. , Ozer Emily J. 
Published: May 2014

ContextAlthough a rights‐based approach to sexuality education has been increasingly discussed in the past decade, documented consensus regarding the goals, concepts and underlying assumptions of this approach is lacking. Differences in the assumed meaning of a rights‐based approach can limit discussions of its implementation and evaluation, and impede opportunities to explore and critique a new model for sexuality education.MethodsIn‐depth interviews were conducted in 2012 with 21 U.S. and international sexuality education experts. Data were thematically coded and analyzed using an iterative approach. Responses were compared according to respondents’ professional discipline and geographic focus.ResultsA rights‐based approach can be defined as the intersection of four elements: an underlying principle that youth have sexual rights; an expansion of programmatic goals beyond reducing unintended pregnancy and STDs; a broadening of curricula content to include such issues as gender norms, sexual orientation, sexual expression and pleasure, violence, and individual rights and responsibilities in relationships; and a participatory teaching strategy that engages youth in critical thinking about their sexuality and sexual choices. These elements were consistently identified by respondents across professional disciplines and geographic foci. In addition, all respondents raised questions about the feasibility of implementing a rights‐based approach, particularly in the United States.ConclusionsWhile questions remain to be answered regarding the implementation and impact of rights‐based sexuality education, the proposed conceptual definition suggests multiple avenues for advocates, researchers, program developers and funders to enhance adolescent sexual health.
Uncertainty supply chain model and transport in its deployments
Authors: Oliveira Fabiana Lucena 
Published: May 2014

This article discusses the Model Uncertainty of Supply Chain, and proposes a matrix with their transportation modes best suited to their chains. From the detailed analysis of the matrix of uncertainty, it is suggested transportation modes best suited to the management of these chains, so that transport is the most appropriate optimization of the gains previously proposed by the original model, particularly when supply chains are distant from suppliers of raw materials and / or supplies.Here we analyze in detail Agile Supply Chains, which is a result of Uncertainty Supply Chain Model, with special attention to Manaus Industrial Center. This research was done at Manaus Industrial Pole, which is a model of industrial agglomerations, based in Manaus, State of Amazonas (Brazil), which contemplates different supply chains and strategies sharing same infrastructure of transport, handling and storage and clearance process and uses inbound for suppliers of raw material. The state of art contemplates supply chain management, uncertainty supply chain model, agile supply chains, Manaus Industrial Center (MIC) and Brazilian legislation, as a business case, and presents concepts and features, of each one. The main goal is to present and discuss how transport is able to support Uncertainty Supply Chain Model, in order to complete management model. The results obtained confirms the hypothesis of integrated logistics processes are able to guarantee attractivity for industrial agglomerations, and open discussions when the suppliers are far from the manufacturer center, in a logistics management.
Pediatric Subspecialty Fellowship Clinical Training Project: Recent Graduates and Midcareer Survey Comparison
Authors: Freed Gary L. , Dunham Kelly M. , Moran Lauren M. , Spera Laura , McGuinness Gail A. , Stevenson David K. 
Published: May 2014

BACKGROUND:The American Board of Pediatrics charged a task force to examine fellowship training. As part of that process, a study was conducted to assess the perceptions of fellowship training by those who had recently completed training and those who were in the middle of their careers.METHODS:The American Board of Pediatrics provided a random sample of subspecialists stratified across all 14 subspecialties (N = 5072). Subspecialists were identified either as recent graduates (N = 2702), those who had completed fellowship within the last 5 years or as midcareer subspecialists (N = 2370), and those who completed fellowship 15 to 20 years ago. Two distinct 20-item structured questionnaires were administered by mail, 1 for each group, in January through March 2012. χ2 Statistics were used to assess differences between groups.RESULTS:Response rates were 77.8% for recent graduates and 73.8% for midcareer subspecialists. Overall, most subspecialists described their work primarily as a clinician (36%) or as a clinician-educator (48%). Fewer (12%) reported primarily research. The majority of subspecialists (55%) have full-time academic appointments, but recent graduates are more likely to do so than midcareer subspecialists (62% vs 48%; P &lt; .0001). The majority (60%) believe that the overall length of training in their subspecialty should remain at 3 years. However, almost one-third (29%) believe there should be 2 different tracks in their subspecialty, shorter for clinicians and/or clinician-educators and longer for those pursuing an academic career.CONCLUSIONS:We found a significant range of opinion regarding subspecialty training. Some of this variation is undoubtedly due to differences between the individual subspecialties.
Portrayal of Alcohol Consumption in Movies and Drinking Initiation in Low-Risk Adolescents
Authors: Hanewinkel Reiner , Sargent James D. , Hunt Kate , Sweeting Helen , Engels Rutger C.M.E. , Scholte Ron H.J. , Mathis Federica , Florek Ewa , Morgenstern Matthis 
Published: May 2014

OBJECTIVES:
To investigate the hypothesis that exposure to alcohol consumption in movies affects the likelihood that low-risk adolescents will start to drink alcohol.

METHODS:
Longitudinal study of 2346 adolescent never drinkers who also reported at baseline intent to not to do so in the next 12 months (mean age 12.9 years, SD = 1.08). Recruitment was carried out in 2009 and 2010 in 112 state-funded schools in Germany, Iceland, Italy, Netherlands, Poland, and Scotland. Exposure to movie alcohol consumption was estimated from 250 top-grossing movies in each country in the years 2004 to 2009. Multilevel mixed-effects Poisson regressions assessed the relationship between baseline exposure to movie alcohol consumption and initiation of trying alcohol, and binge drinking (≥ 5 consecutive drinks) at follow-up.

RESULTS:
Overall, 40% of the sample initiated alcohol use and 6% initiated binge drinking by follow-up. Estimated mean exposure to movie alcohol consumption was 3653 (SD = 2448) occurrences. After age, gender, family affluence, school performance, TV screen time, personality characteristics, and drinking behavior of peers, parents, and siblings were controlled for, exposure to each additional 1000 movie alcohol occurrences was significantly associated with increased relative risk for trying alcohol, incidence rate ratio = 1.05 (95% confidence interval, 1.02–1.08; P = .003), and for binge drinking, incidence rate ratio = 1.13 (95% confidence interval, 1.06–1.20; P &lt; .001).

CONCLUSIONS:
Seeing alcohol depictions in movies is an independent predictor of drinking initiation, particularly for more risky patterns of drinking. This result was shown in a heterogeneous sample of European youths who had a low affinity for drinking alcohol at the time of exposure.
Pleural Cholesterol to the Diagnosis of Exudative Effusion
Authors: Rufino Rogério , Marques Bruna L. , Azambuja Renato de Lima , Mafort Thiago , Pugliese José G. , Costa Cláudia Henrique da 
Published: May 2014

Introduction:
Diagnostic approaches to patients with a pleural effusion must be precise because many
procedures depend on the nature of the fluid in the effusion. To date, no biochemical test is considered an appropriate
alternative to Light’s criteria. This study compared the absolute pleural cholesterol (PC) level and the pleural
cholesterol/serum cholesterol (PC/SC) ratio with Light’s criteria to determine exudative pleural effusions.

Materials and Methodology:
This study was a case series of 100 consecutive patients with pleural effusions. The clinical
parameters that were used to diagnosis an exudative effusion included the cholesterol level, a pleural cholesterol level ≥
50 mg/dL, a pleural/serum ratio ≥ 0.4, and Light’s criteria. The sensitivity, specificity, and positive and negative
predictive values of each test for the diagnosis of an exudative effusion were assessed.

Results:
A total of 79 patients were definitively diagnosed with an exudative effusion and were included in the trial and
analyzed. The mean PC level in the exudates was 90.39 mg/dL. The PC levels demonstrated a sensitivity of 97.22%, a
specificity of 85.71%, a positive predictive value of 98.59% and a negative predictive value of 75%. The PC/SC ratio
demonstrated a sensitivity of 81.48%, a specificity of 57.14%, a positive predictive value of 93.61% and a negative
predictive value of 28.57%.

Conclusion:
The pleural cholesterol dosage level and the pleural/serum cholesterol ratio can be utilized as unique
biomarkers to identify an exudative effusion and replace Light’s criteria.
Is Acute Exacerbation of COPD (AECOPD) Related to Viral Infection Associated with Subsequent Mortality or Exacerbation Rate?
Authors: Kherad Omar , Bridevaux Pierre-Olivier , Kaiser Laurent , Janssens Jean-Paul , Rutschmann Olivier T. 
Published: May 2014

Background:
There is a growing interest in better defining risk factors associated with increased susceptibility
to exacerbation in patients with COPD.

Introduction:
The aim of the study was to determine whether identification of a respiratory virus during a severe acute
exacerbation of COPD (AECOPD) increases the risk of subsequent exacerbations and mortality during a one-year followup.

Methods:
Secondary analysis of 86 COPD patients admitted for AECOPD between June 2007 and December 2008 at
Geneva’s University Hospital who were followed up for 1 year. Fifty-one percent of index AECOPD were related to viral
infection. Rate of AECOPD, time to next AECOPD, and all-cause mortality were compared between patients with vs
without viral index AECOPD.

Results:
Eighty-one cases were included in this secondary follow-up analysis. Mean exacerbation rate was 1.9 AECOPD
per person-year for patients with viral index AECOPD vs 4.0 AECOPD per person year for those with non-viral index
AECOPD. Incidence rate ratio (IRR) for subsequent AECOPD during one year follow up was lower for patients with viral
index AECOPD (IRR 0.57; [CI 95% 0.39-0.84]), after controlling for previous exacerbations, and was strongly associated
with the number of exacerbations in the year preceding the index AECOPD. During the one-year follow-up period, 16
patients (19%) died. In a Cox regression model, patients with a proven viral infection did not have a higher mortality (HR
0.56 [CI 95% 0.20 -1.58]).

Conclusion:
Viral AECOPD was not associated with a higher rate of subsequent exacerbations or mortality during the
following year.
Synthesis and characterization of poly [N-acryloyl-(D/L), (+/−)-phenylalanine-co-(D/L), (−/+)N-methacryloyloxyethyl-N′-2-hydroxybutyl(urea)] copolymers
Authors: Buruiana Emil , Murariu Mioara , Buruiana Tinca 
Published: May 2014

Abstract
Two monomers of (D/L), (+/−)-N-methacryloyloxyethyl-N′-2-hydroxybutyl(urea) methacrylate (D/L-MABU) type were prepared and further polymerized through free radical polymerization with optically active monomers containing phenylalanine sequences such as N-acryloyl-(D/L), (−/+)-phenylalanine (A-D/L-Phe). The resulting copolymers, i.e., poly[N-acryloyl-(D/L), (−/+)-phenylalanine-co-(D/L), (+/−)-N-methacryloyloxyethyl-N′-2-hydroxybutyl(urea)], A-D/L-Phe-co-D/L-MABU, were characterized by FT-IR, 1D/2D NMR (1H and 13C), UV-vis, and circular dichroism (CD) spectroscopies, differential scanning calorimetry (DSC), and gel permeation chromatography (GPC). The copolymers obtained with a molar fraction of 0.76: 0.24 / 0.64: 0.36 monomer units had optical rotation values of −25° and +15°, respectively. Upon chemical modification of the phenylalanine-based copolymers with fluorescein-isothiocyanate, new fluorescent copolyacrylates (A-D/L-Phe-co-D/L-MABU-F) were synthesized and further studied for pH measurements in DMF solutions using HCl and NaOH 10−1M. It was found that sterioselectivity of the A-L-Phe-co-L-MABU-F copolymer is higher than of its dextro-form, especially at basic pH.
Afterglow and thermoluminescence of ZrO2 nanopowders
Authors: Puust Laurits , Kiisk Valter , Utt Kathriin , Mändar Hugo , Sildos Ilmo 
Published: May 2014

Abstract
A careful study of the phosphorescence afterglow and the thermoluminescence (TL) of sol-gel-prepared m-ZrO2 nanocrystalline powders in an extended temperature range −100 to 300 °C was carried out. Wavelength-resolved TL proved the existence of a single active luminescence centre in this temperature range. A TL method based on various heating rates was used to derive more reliable trap depths of 0.75, 0.95, 1.25, 1.46 and 1.66 eV whereas deconvolution methods provided somewhat lower values. The most intense room-temperature afterglows (that were easily observable beyond 1000 s) were obtained from samples annealed at 1250 and 1500 °C, and were attributed mainly to depopulation of the 1.25 eV traps.
Key Enablers to Facilitate Healthy Behavior Change: Workshop Summary
Authors: Teyhen Deydre S. , Aldag Matt , Centola Damon , Edinborough Elton , Ghannadian Jason D. , Haught Andrea , Jackson Theresa , Kinn Julie , Kunkler Kevin J. , Levine Betty , Martindale Valerie E. , Neal David , Snyder Leslie B. , Styn Mindi A. , Thorndike Frances , Trabosh Valerie , Parramore David J. 
Published: May 2014

Synopsis The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled “Incentives to Create and Sustain Change for Health.” Members of government and academia participated to identify key health enablers that could ultimately be leveraged by technology. The key health enablers discussed included (1) public health messaging, (2) changing health habits and the environmental influence on health, (3) goal setting and tracking, (4) the role of incentives in behavior-change intervention, and (5) the role of peer and social networks on change. This report summarizes leading evidence and the group consensus on evidence-based practices with respect to the key enablers in creating healthy behavior change. J Orthop Sports Phys Ther 2014;44(5):378–387. doi:10.2519/jospt.2014.0301