bluuebunny/crossref_metadata_2025_split huggingface dataset:
The stability of the femoral component in the Oxford unicompartmental knee replacement
Authors: Reiner T. , Jaeger S. , Schwarze M. , Klotz M. C. , Beckmann N. A. , Bitsch R. G. 
Published: July 2014

Aseptic loosening of the femoral component is an important indication for revision surgery in unicompartmental knee replacement (UKR). A new design of femoral component with an additional peg was introduced for the cemented Oxford UKR to increase its stability. The purpose of this study was to compare the primary stability of the two designs of component.Medial Oxford UKR was performed in 12 pairs of human cadaver knees. In each pair, one knee received the single peg and one received the twin peg design. Three dimensional micromotion and subsidence of the component in relation to the bone was measured under cyclical loading at flexion of 40° and 70° using an optical measuring system. Wilcoxon matched pairs signed-rank test was performed to detect differences between the two groups.There was no significant difference in the relative micromotion (p = 0.791 and 0.380, respectively) and subsidence (p = 0.301 and 0.176, respectively) of the component between the two groups at both angles of flexion. Both designs of component offered good strength of fixation in this cadaver study.Cite this article: Bone Joint J 2014;96-B:896–901.
Coronal alignment in total knee replacement
Authors: Abdel M. P. , Oussedik S. , Parratte S. , Lustig S. , Haddad F. S. 
Published: July 2014

Substantial healthcare resources have been devoted to computer navigation and patient-specific instrumentation systems that improve the reproducibility with which neutral mechanical alignment can be achieved following total knee replacement (TKR). This choice of alignment is based on the long-held tenet that the alignment of the limb post-operatively should be within 3° of a neutral mechanical axis. Several recent studies have demonstrated no significant difference in survivorship when comparing well aligned versus malaligned TKRs. Our aim was to review the anatomical alignment of the knee, the historical and contemporary data on a neutral mechanical axis in TKR, and the feasibility of kinematically-aligned TKRs.Review of the literature suggests that a neutral mechanical axis remains the optimal guide to alignment.Cite this article: Bone Joint J 2014;96-B:857–62.
The importance of epidemiological fracture data
Authors: Aitken S. A. , Hutchison J. D. , McQueen M. M. , Court-Brown C. M. 
Published: July 2014

Epidemiological studies enhance clinical practice in a number of ways. However, there are many methodological difficulties that need to be addressed in designing a study aimed at the collection and analysis of data concerning fractures and other injuries. Most can be managed and errors minimised if careful attention is given to the design and implementation of the research.Cite this article: Bone Joint J 2014;96-B:863–7.
Preoperative C-reactive protein predicts the severity and likelihood of complications following appendicectomy
Authors: Shelton JA , Brown JJS , Young JA 
Published: July 2014

Introduction Diagnostic laparoscopy with appendicectomy (LA) has become the accepted method of investigation and treatment of appendicitis. However, concerns remain in cases of complicated appendicitis when many advocate conversion to an open procedure (LCOA) owing to the risk of complications. The aim of this study was to look for factors that could predict complications occurring in patients undergoing appendicectomy. Methods Data inclusive of all consecutive appendicectomies over a two-year period were retrieved from the computerised theatre database. Clinical details including admission inflammatory markers, complications, severity (final pathology) and length of stay were collected from the discharge letter. Readmissions were identified as those hospital identifiers had a second set of admission dates and/or a second discharge letter. Results During the 2-year study period, 517 appendicectomies were performed. Of these, 429 patients (83%) had LA and the remaining 88 (17%) had LCOA. The LA group had a mean age of 28 years (range: 2–86 years) and a mean C-reactive protein (CRP) level of 71mg/l (range: 0–480mg/l) while the LCOA group had a mean age of 46 years (range: 11–92 years) and a mean CRP level of 162mg/l (range: 3–404mg/l). These differences in age and CRP were significant (p<0.001). LA patients were less likely to have complications overall (22% vs 52%, p=0.015). Complications were independently more than twice as common with established inflammation with a CRP level of >150mg/l (p<0.05). Conclusions A high preoperative CRP level predicts an increased rate of postoperative complication due to established inflammation and/or infection. This raises the question of whether we should be offering primary open appendicectomies to patients with a CRP level of >150mg/l.
A Quality Improvement Study to Improve Inpatient Problem List Use
Authors: Bakel Leigh Anne , Wilson Karen , Tyler Amy , Tham Eric , Reese Jennifer , Bothner Joan , Kaplan David W. 
Published: July 2014

Background:
The problem list is a meaningful use incentivized criterion, and &gt;80% of patients should have 1 problem entered as structured data.

Objective:
The aim of the present study was to use a series of interventions to increase the use of the problem list for inpatients to &gt;80% as measured by at least 1 hospital problem at discharge.

Methods:
This study was a quasi-experimental time series quality improvement trial. The primary outcome was 80% of medical and psychiatric inpatients with a problem added to the problem list before discharge. Control charts of percentage (p charts) of medical and psychiatric patients with an inpatient problem list at discharge were constructed with three-σ control limits. Control limits were revised after evidence of improvement. The charts were annotated with interventions, including increasing awareness, focused education, and timely feedback in the form of performance graphs e-mailed to providers.

Results:
For medical inpatients, use rose from 31% to 97% at its peak in April 2011 and continues to maintain above the goal of 80%. In psychiatry, problem list use rose from 2% initially to an average of 72% after the interventions.

Conclusions:
Significant gains were made with inpatient problem list usage by the medical and psychiatric teams. Our goal ascribed by meaningful use for &gt;80% of inpatients to have a problem at discharge was met after initiation of our series of interventions.
Family-Centered Rounding: Can It Impact the Time of Discharge and Time of Completion of Studies at an Academic Children’s Hospital?
Authors: Oshimura Jennifer M. , Downs Stephen M. , Saysana Michele 
Published: July 2014

Background and Objective:
Family-centered rounds (FCR) involve multidisciplinary rounds at the patient bedside with an emphasis on physicians partnering with patients and families in the clinical decision-making for the patient. Although the purpose of FCR is to provide patient-centered care, an unanticipated benefit of FCR may be to improve time to discharge. The objective of this study was to determine the impact of FCR on time to discharge for pediatric patients in an academic medical center.

Methods:
We retrospectively compared the timing of patient discharges from July 2007 to June 2008 (before FCR) versus those from July 2008 to May 2009 (after FCR) on the pediatric hospital medicine service. We further compared time from order entry to study completion on a subset of patients receiving head MRIs and EEGs, studies that typically occurred on the day of discharge.

Results:
In our center, before FCR, 40% of patients were discharged before 3:00 pm (n = 912). After FCR, 47% of children were discharged before 3:00 pm (n = 911) (P = .0036). Time from order entry to study completion for MRIs and EEGs decreased from 2.15 hours before FCR (n = 225) to 1.73 hours after FCR (n = 206) (P = .001).

Conclusions:
FCR provided a modest improvement in the timeliness of the discharge process at our institution.
Five-Year Follow-up of Community Pediatrics Training Initiative
Authors: Minkovitz Cynthia S. , Goldshore Matt , Solomon Barry S. , Guyer Bernard , Grason Holly 
Published: July 2014

OBJECTIVE:To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians.METHODS:A cross-sectional analyses compared 2008–2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ≥1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). χ2 statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement.Results:Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P &lt; .01) and being moderately/very skilled in 4 of 6 community activities (P &lt; .05). Comparable percentages used ≥1 strategies (52.2% vs 47.3%, P &gt; .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5–3.7).Conclusions:Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce.
A Parent Questionnaire for Developmental Screening in Infants Born Late and Moderately Preterm
Authors: Blaggan Samarita , Guy Alexa , Boyle Elaine M. , Spata Enti , Manktelow Bradley N. , Wolke Dieter , Johnson Samantha 
Published: July 2014

BACKGROUND:
The Parent Report of Children’s Abilities-Revised (PARCA-R) is a questionnaire for assessing cognitive and language development in very preterm infants. Given the increased risk of developmental delay in infants born late and moderately preterm (LMPT; 32–36 weeks), this study aimed to validate this questionnaire as a screening tool in this population.

METHODS:
Parents of 219 children born LMPT completed the PARCA-R questionnaire and the Brief Infant Toddler Social and Emotional Assessment when children were 24 months corrected age (range, 24 months–27 months). The children were subsequently assessed by using the cognitive and language scales of the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).

RESULTS:
An average Bayley-III, cognitive and language (CB-III) score and a total PARCA-R Parent Report Composite (PRC) score were computed. There was a large association between PRC and CB-III scores (r = 0.66, P &lt; .001) indicating good concurrent validity. Using Youden index, the optimum PARCA-R cutoff for identifying children with moderate/severe developmental delay (CB-III scores &lt; 80) was PRC scores &lt; 73. This gave sensitivity 0.90 (95% confidence interval: 0.75–1.00) and specificity 0.76 (95% confidence interval: 0.70–0.82), indicating good diagnostic utility. Approximately two-thirds of the children who had a PRC score &lt; 73 had false-positive screens. However, these children had significantly poorer cognitive and behavioral outcomes than children with true negative screens.

CONCLUSIONS:
The PARCA-R has good concurrent validity with a gold standard developmental test and can be used to identify LMPT infants who may benefit from a clinical assessment. The PARCA-R has potential for clinical use as a first-line cognitive screening tool for this sizeable population of infants in whom follow-up may be beneficial.
Opening the Door: How the Regional Autonomy Has Made the Implementation of Perda Sharia Possible?
Authors: Rif'ah Erwin Nur 
Published: July 2014

Sharia-influenced regional regulations (perda sharia) are regulations or laws that are created by district governments and use Islamic moral teachings as a reference point. This article based on a qualitative research in two districts: Cianjur, West Java and Bulukumba South Sulawesi. In general, perda sharia seeks to manage three aspects of public life: firstly, to eradicate moral and social problems such as prostitution, drinking alcohol and gambling; secondly, to enforce ritual observances among Muslims such as reading the Qur’an, attendance at Friday prayers and fasting during Ramadan, and thirdly, to govern the way people dress in the public sphere, especially in relation to head-veiling for the women.
The Current Perception Threshold Test Differentiates Categories of Mechanical Neck Disorder
Authors: Uddin Zakir , MacDermid Joy C. , Galea Victoria , Gross Anita R. , Pierrynowski Michael R. 
Published: July 2014

Study Design Cross-sectional discriminative analysis. Objective To determine whether current perception threshold (CPT) can differentiate between categories of patients with mechanical neck disorders (MNDs). Background Neck pain is the third most common musculoskeletal disorder and affects a third of all adults each year. It can present as neck pain without musculoskeletal signs, neck pain with musculoskeletal signs but no neurological signs, or neck pain with neurological signs. CPT testing can assess altered sensory perception that may reflect neurological changes. Methods Patients with MNDs (n = 106) were classified into 3 groups, based on a standardized musculoskeletal examination process performed by an experienced physiotherapist who was blinded to CPT scores. The 3 groups were defined as neck pain without musculoskeletal signs (MND I) (n = 60), neck pain with musculoskeletal signs (MND II) (n = 29), and neck pain with neurological signs (MND III) (n = 17). A rapid protocol of CPT testing was performed at 3 frequencies (5, 250, and 2000 Hz), using 3 dermatomal locations on the hand. A 1-way analysis of variance with post hoc comparison and effect sizes was calculated to compare the mean CPT scores between the groups. A binary logistic-regression model was used to predict probability of higher CPT in MND III and to create a receiver-operating-characteristic curve. Results Mean CPT differed significantly across the 3 MND groups (MND I, 9.7; MND II, 10.6; and MND III, 11.8; P<.001; η2 = 0.6). Post hoc comparisons indicated differences between MND I and MND II (P = .05) and between MND II and MND III (P = .01) that had large effect sizes (MND I versus II, d = 1 and MND II versus III, d = 2.2). CPT testing was able to distinguish between MND II and III when a threshold value of greater than 11 was used to indicate MND III. The predicted probability of abnormal CPT in MND III had an estimated 73% sensitivity and 81% specificity; the odds ratio was 11.5 (P = .001) for the differentiation capacity of CPT between MND II and III, with a cutoff of 11. The area under the receiver-operating-characteristic curve was 0.84 (95% confidence interval: 0.72, 0.96; P<.001). Conclusion CPT testing has moderate discriminatory accuracy, specificity, and sensitivity for classification of MND categories into neck pain with or without neurological signs. J Orthop Sports Phys Ther 2014;44(7):532–540. Epub 10 May 2014. doi:10.2519/jospt.2014.4691
Evidence-based management of traumatic thoracolumbar burst fractures: a systematic review of nonoperative management
Authors: Bakhsheshian Joshua , Dahdaleh Nader S. , Fakurnejad Shayan , Scheer Justin K. , Smith Zachary A. 
Published: July 2014

Object
The overall evidence for nonoperative management of patients with traumatic thoracolumbar burst fractures is unknown. There is no agreement on the optimal method of conservative treatment. Recent randomized controlled trials that have compared nonoperative to operative treatment of thoracolumbar burst fractures without neurological deficits yielded conflicting results. By assessing the level of evidence on conservative management through validated methodologies, clinicians can assess the availability of critically appraised literature. The purpose of this study was to examine the level of evidence for the use of conservative management in traumatic thoracolumbar burst fractures.

Methods
A comprehensive search of the English literature over the past 20 years was conducted using PubMed (MEDLINE). The inclusion criteria consisted of burst fractures resulting from a traumatic mechanism, and fractures of the thoracic or lumbar spine. The exclusion criteria consisted of osteoporotic burst fractures, pathological burst fractures, and fractures located in the cervical spine. Of the studies meeting the inclusion/exclusion criteria, any study in which nonoperative treatment was used was included in this review.

Results
One thousand ninety-eight abstracts were reviewed and 447 papers met inclusion/exclusion criteria, of which 45 were included in this review. In total, there were 2 Level-I, 7 Level-II, 9 Level-III, 25 Level-IV, and 2 Level-V studies. Of the 45 studies, 16 investigated conservative management techniques, 20 studies compared operative to nonoperative treatments, and 9 papers investigated the prognosis of conservative management.

Conclusions
There are 9 high-level studies (Levels I–II) that have investigated the conservative management of traumatic thoracolumbar burst fractures. In neurologically intact patients, there is no superior conservative management technique over another as supported by a high level of evidence. The conservative technique can be based on patient and surgeon preference, comfort, and access to resources. A high level of evidence demonstrated similar functional outcomes with conservative management when compared with open surgical operative management in patients who were neurologically intact. The presence of a neurological deficit is not an absolute contraindication for conservative treatment as supported by a high level of evidence. However, the majority of the literature excluded patients with neurological deficits. More evidence is needed to further classify the appropriate burst fractures for conservative management to decrease variables that may impact the prognosis.
Circumferential management of unstable thoracolumbar fractures using an anterior expandable cage, as an alternative to an iliac crest graft, combined with a posterior screw fixation: results of a series of 85 patients
Authors: Graillon Thomas , Rakotozanany Patrick , Blondel Benjamin , Adetchessi Tarek , Dufour Henry , Fuentes Stéphane 
Published: July 2014

Object
The optimal management of unstable thoracolumbar fractures remains unclear. The objective of the present study was to evaluate the results of using an expandable prosthetic vertebral body cage (EPVBC) in the management of unstable thoracolumbar fractures.

Methods
Eighty-five patients with unstable T7–L4 thoracolumbar fractures underwent implantation of an EPVBC via an anterior approach combined with posterior fixation. Long-term functional outcomes, including visual analog scale and Oswestry disability index scores, were evaluated.

Results
In a mean follow-up period of 16 months, anterior fixation led to a significant increase in vertebral body height, with an average gain of 19%. However, the vertebral regional kyphosis angle was not significantly increased by anterior fixation alone. No significant difference was found between early postoperative, 3-month, and 1-year postoperative regional kyphosis angle and vertebral body height. Postoperative impaction of the prosthetic cage in adjacent endplates was observed in 35% of the cases, without worsening at last follow-up. Complete fusion was observed at 1 year postoperatively and no cases of infections or revisions were observed in relation to the anterior approach.

Conclusions
The use of EPVBCs for unstable thoracolumbar fractures is safe and effective in providing long-term vertebral body height restoration and kyphosis correction, with a moderate surgical and sepsis risk. Anterior cage implantation is an alternative to iliac bone graft fusion and is a viable option in association with a posterior approach, in a single operation without additional risks.
Endovascular reconstruction of enlarging traumatic internal carotid artery pseudoaneurysm
Authors: Choudhri Omar , Heit Jeremy , Do Huy M. 
Published: July 2014

Traumatic dissecting pseudoaneurysms of the cervical and petrous internal carotid artery are often a result of blunt or penetrating trauma. These patients are at high risk for thromboembolic complications and are managed with antiplatelet agents. Patients who develop neurologic symptoms while on antiplatelet agents, or have interval enlargement of their pseudoaneurysms, may require repair of the vessel. We describe a case in which we performed an endovascular repair of an enlarging distal cervical internal carotid artery pseudoaneurysm, with placement of a covered stent.The video can be found here: http://youtu.be/uCypcsBvOZ4.
Endovascular treatment of a complex bilobed left superior hypophyseal internal carotid artery aneurysm: a case illustration
Authors: Hamade Youssef J. , El Tecle Najib E. , Zammar Samer G. , El Ahmadieh Tarek Y. , Yip Byron K. , Bendok Bernard R. 
Published: July 2014

We report the case of a 62-year-old female who presented for stent-assistant coiling of an incidental 11-mm complex bilobed left superior hypophyseal internal carotid artery aneurysm. A microcatheter was navigated into the aneurysm and trapped by a 37-mm stent. Using three-dimensional and two-dimensional coils, the elongated aneurysm was coiled. The bigger lobe was coiled first followed by the smaller lobe. Minimal residual filling of the smaller lobe will be re-evaluated at 6-month follow up. The patient tolerated the procedure well and no complications were encountered.The video can be found here: http://youtu.be/TrXfsaICQVo.
Paysages numériques par Spot et Landsat : de Xingtaï (Hebeï) à Yan'an (Shaanxi) (Numerized landscapes from Spot and Landsat : from Xingtai (Hebei) to Yan'an (Shaanxi))
Authors: Bardinet Claude 
Published: July 2014

A partir des méthodes de traitement d'image appliquées aux données de télédétection, on produit des paysages numériques dont la signification thématique est mise en évidence par combinaison avec les documents géographiques contrôlés sur le terrain.
L'analyse numérique des paysages de Xingtaï au Hebeï à partir de Landsat MSS et la reconstruction du relief de la région de Yan'an dans le Plateau des Loess au Shaanxi à partir de données stéréoradiométriques de Spot, ont été réalisées dans le cadre de la coopération entre CO DATA (ICSU) et l'IRSA (Beijing). Lors des transects sur le terrain, on a pu utiliser les cartes topographiques (1/10000) et prendre des photographies au sol et par avion.
Restructuration et devenir des exploitations agricoles dans une commune périurbaine : Plomelin (Finistère) (Restructuring and futur of farms in a suburban settlement : Plomelin (Finistère region))
Authors: Bernard Nicolas 
Published: July 2014

Le phénomène de périurbanisation, observé ces vingt dernières années autour de Quimper, ville moyenne de 63000 habitants, a influencé l'évolution foncière du domaine agricole de Plomelin, commune limitrophe de 4000 habitants.
Dans un contexte de déprise agricole et de forte demande en terrains constructibles, l'emprise de l'urbanisme à Plomelin explique la disparition ou la restructuration de nombreuses exploitations. Elle conduit également à l'orientation de certaines d'entre elles vers de nouvelles productions, des activités touristiques ou des fonctions «environnementales».