bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying High-Risk Patients Undergoing Urgent and Emergency Surgery
Authors: Neary WD , Foy C , Heather BP , Earnshaw JJ 
Published: March 2006

INTRODUCTION The aim was to identify high-risk patients undergoing non-elective orthopaedic and general surgery. PATIENTS AND METHODS This was a retrospective cohort study of all non-elective general and orthopaedic surgical procedures performed in a 1-year interval in a district general hospital. A total of 1869 patients underwent urgent or emergency surgery in the calendar year 2000. Outcomes were identified from various related hospital databases. Case notes of those who died were reviewed. Risk factors for mortality were examined using univariate and multivariate analysis. RESULTS The mortality rates were 89/1869 (5%) at 30 days and 216 (12%) after 1 year. The high initial death rate continued for about 100 days after surgery. Increasing age (P < 0.0001), size of operation (P = 0.004) and American Society of Anesthesiologists (ASA) fitness grade (P < 0.0001) were associated with significantly higher risk of death at 1 year on multivariate analysis. A high risk group was identified of 273 patients aged over 50 years, of ASA Grade III or above who needed major surgery; they had a 30-day mortality rate of 18%. CONCLUSIONS A simple scoring system could be used to identify high-risk patients who require non-elective surgery that could be a target for interventions to try and reduce their risk of death.
Registry of Shoulder Arthroplasty – The Scottish Experience
Authors: Sharma S , Dreghorn CR 
Published: March 2006

INTRODUCTION Recognising that timely dissemination of information in the orthopaedic community was important and in the absence of any national guidelines for shoulder arthroplasty, the Scottish shoulder arthroplasty registry, a voluntary registry, was started in 1996. The goals of the registry were to assess contemporary practice, provide a benchmark against which surgeons could compare their practice, identify risk factors for a poor outcome, and to improve outcomes through continuous feedback to the participating surgeons. PATIENTS AND METHODS A standardised proforma was used to collect information on the diagnostic and demographic data, type of procedure performed, type of implant used, any associated procedures performed in conjunction with the arthroplasty, and peri-operative complications. Postoperative pain, activity and patient satisfaction were assessed annually using another standardised proforma. RESULTS Twenty surgeons have contributed to the register and 451 shoulder arthroplasties were registered over a 5-year period. Of patients, 23.2% were male and 76.8% female. The mean age was 65 years (range, 37–90 years). Shoulder arthroplasty was commonly performed for rheumatoid arthritis followed by trauma, osteoarthritis and avascular necrosis of the humeral head. Overall, 397 (88%) patients had a hemi-arthroplasty and 54 (12%) had a total shoulder replacement. Of the 54 cases that had a glenoid replacement, 28 were performed for inflammatory arthritis, 21 for osteoarthritis and 5 were for revisions. The humeral component was cemented in 204 (45%) cases, 160 of whom had a shoulder replacement for trauma. The glenoid component was cemented in 48 (89%) cases. Cross referencing our data with the figures of the actual number of shoulder arthroplasties performed, however, indicated that our registry at best collected only 53% of all the shoulder arthroplasties performed in Scotland annually. CONCLUSIONS The value of a joint registry is dependent on the accuracy and completeness of the data entered. Our registry, therefore, fails as an implant registry. We believe that compliance for data registration can only be ensured if dedicated data collection staff are employed to co-ordinate the data collection and collation process.
Femoral Cementing Techniques: Current Trends in the UK
Authors: Nedungayil SK , Mehendele S , Gheduzzi S , Learmonth ID 
Published: March 2006

INTRODUCTION The results of a survey conducted amongst hip surgeons in Great Britain on the use of bone cement and femoral cementing techniques are reported. MATERIALS AND METHODS A postal questionnaire was sent out to the members of the British Orthopaedic Association for their opinion on cement usage and femoral cementing techniques in primary hip arthroplasty. RESULTS A majority of surgeons use high viscosity cement (82%) and cement containing antibiotics (77%). Almost a fifth of the respondents were unaware of the place of storage of the cement and of the ambient theatre temperature. Over two-thirds experienced inconsistencies in the handling of cement and attributed this to inconsistent theatre temperature (40%) and storage temperature (14%). A majority of the surgeons followed the ‘modern’ femoral cementing technique of vacuum mixing (94%), plugging the femoral canal (98%), pulsed lavage (87%), retrograde cement introduction (95%), use of stem centralisers (62%) and cement pressurisation. Four-fifths of the surgeons used time as a guide for cement and stem insertion rather than consistency of the cement. CONCLUSIONS Though most of the surgeons follow contemporary cementing techniques, it appears that inconsistency of the working properties of the cement is a major impediment. Many surgeons are also unaware of the variables that can influence polymerisation and working time of the cement.
Perceptions of the Application of Fast-Track Surgical Principles by General Surgeons
Authors: Walter Catherine Jane , Smith Adrian , Guillou Pierre 
Published: March 2006

INTRODUCTION Fast-track surgery is a novel approach which uses a multimodal package of changes to traditional surgical care to reduce the stress response evoked by surgery allowing for enhanced recovery times. The depth of understanding and application of fast-track principles to general surgical practice by consultant surgeons is unknown. MATERIALS AND METHODS ‘Core management features’ central to published fast-track general surgical studies were identified following a comprehensive Medline literature search. The knowledge and application of these features were examined in a postal questionnaire sent to 116 general surgeons in a single region. RESULTS Of respondents, 31% indicated they were currently using fast-track surgery (the ‘fast-trackers'). The number of fast-track compliant responses was calculated for each consultant (range, 1–12 of 14). Mean scores for ‘fast-trackers’ of 8.45 (± 2.188) and ‘non-fast-trackers’ of 6.16 (± 2.352) showed no significant differences (P > 0.6). The ‘fast-trackers’ median estimated length of stay (LOS) was 5 days (inter-quartile range [IQR], 4–7) which was significantly lower than the 7 day (IQR 6–8) LOS estimates given by the ‘non-fast-trackers’ (P < 0.01). CONCLUSIONS Despite estimating reduced LOS, no significant difference in total fast-track compliant responses was found between the ‘fast-tracker’ and ‘non-fast-tracker’ groups. The ‘fast-trackers’ estimated LOS of 5 days is 2.5 times the 2 day LOS reported in the published fast-track studies. A significant gap exists between the perception and realisation of fast-track methodology amongst general surgeons.
Proton Pump Inhibition is a Feasible Primary Alternative to Surgery and Balloon Dilatation in Adult Peptic Pyloric Stenosis (APS): Report of Six Consecutive Cases
Authors: Shabbir J , Durrani S , Ridgway PF , Mealy K 
Published: March 2006

INTRODUCTION Surgery has been the gold standard in the treatment of adult pyloric stenosis (APS). The introduction of proton pump inhibitors (PPIs) in 1989 revolutionised the treatment of peptic ulcer disease and its complications. PATIENTS AND METHODS We carried out a prospective study to evaluate the effectiveness of PPIs as an alternative to surgery for treatment of APS. Six consecutive patients admitted with a diagnosis of adult peptic pyloric stenosis between November 1999 and August 2002 were studied. The diagnosis was confirmed with endoscopy. All patients were commenced on a twice-daily dose of intravenous PPI. This was changed to oral treatment after 2 days. Main outcome measures evaluated were resolution of symptoms on PPIs and failure of medical therapy. RESULTS There were five females and one male. Median age at diagnosis was 72 years (range, 30–90 years). Median duration of symptoms was 2 weeks (range, 1–5 weeks). Of the patients, five had a history of peptic ulcer disease. Complete resolution was achieved in 5 patients (83%). Median duration for resolution of symptoms was 9 days (range, 5–14 days). All patients were changed to oral PPIs after 2 days. One patient did not respond to oral therapy and required surgical intervention (pyloroplasty). Median follow-up was 26 months (range, 6–48 months). There was no recurrence of symptoms. All patients were discharged on low-dose PPI. CONCLUSIONS This study supports the view that proton pump inhibitors are a safe and feasible alternative to surgery in adult pyloric stenosis secondary to peptic ulcer disease.
Dead Men and Radiologists Don't Lie: A Review of Cadaveric and Radiological Studies of Rotator Cuff Tear Prevalence
Authors: Reilly P , Macleod I , Macfarlane R , Windley J , Emery RJH 
Published: March 2006

INTRODUCTION Rotator cuff tears are a common pathology, with a varied prevalence reported. PATIENTS AND METHODS A literature review was undertaken to determine the cadaveric and radiological (ultrasonography and magnetic resonance imaging [MRI]) prevalence of rotator cuff tear. The radiological studies were subdivided into symptomatic and asymptomatic subjects. RESULTS Cadaveric rotator cuff tears were found in 4629 shoulders of which only 2553 met the inclusion criteria. The prevalence of full-thickness tears was 11.75% and partial thickness 18.49% (total tears 30.24%). The total tear rate in ultrasound asymptomatic was 38.9% and ultrasound symptomatic 41.4%. The total rate in MRI asymptomatic was 26.2% whilst MRI symptomatic was 49.4%. DISCUSSION The unselected cadaveric population should contain both symptomatic and asymptomatic subjects. A prevalence of tears between the symptomatic and asymptomatic radiological groups would be expected. However, apart from the MRI asymptomatic group, the radiological prevalence of rotator cuff tears exceeds the cadaveric. CONCLUSIONS Rotator cuff tears are frequently asymptomatic. Tears demonstrated during radiological investigation of the shoulder may be asymptomatic. It is important to correlate radiological and clinical findings in the shoulder.
How Well Equipped are ENT Wards for Airway Emergencies?
Authors: Banga Rupan , Thirlwall Andrea , Corbridge Rogan 
Published: March 2006

INTRODUCTION With increased cross cover of specialities at night and more direct triaging of casualty patients to ENT wards, there is an increased need to ensure that there is adequate provision of emergency airway management. There are currently no national guidelines on what equipment should be available on ENT wards, and the authors have devised a portable airway box with all equipment deemed necessary to manage an acute airway. We believe that all junior doctors covering ENT should have airway training and access to an airway box. The aim of this study was to determine the provision of on-ward airway equipment and training on ENT wards in England. MATERIALS AND METHODS A telephone survey of all English hospitals with in-patient ENT services. RESULTS A total of 103 departments were contacted with 98% response rate. Most wards were covered by a combination of ENT and other specialties. Results indicated that only 18% of departments had an airway box and 28% had some training in airway management. CONCLUSIONS Results suggest poor provision of emergency airway equipment and training on wards. We recommend the use of an airway box, and list of minimal equipment required.
The Surgical Risk of Suprapubic Catheter Insertion and Long-Term Sequelae
Authors: Ahluwalia RS , Johal N , Kouriefs C , Kooiman G , Montgomery Bruce SI , Plail RO 
Published: March 2006

INTRODUCTIONSuprapubic catheter (SPC) insertion is a common urological procedure, which is often referred to as safe and simple even in inexperienced hands. There is, however, very little published evidence on the safety of this procedure. Our study aimed to provide evidence on the associated morbidity and mortality and provide guidance for practising clinicians.PATIENTS AND METHODSA total of 219 patients who underwent SPC insertion under cystoscopic guidance at two urology institutions between 1994 and 2002 were identified and their case notes reviewed.RESULTSThe intra-operative complication rate was 10% and the 30-day complications rate was 19%. Mortality rate was 1.8%. Long-term complications included recurrent UTIs (21%), catheter blockage (25%) resulting in multiple accident and emergency attendance (43%). Despite this, the satisfaction rate was high (72%) and most patients (89%) prefer the SPC over the urethral catheter.CONCLUSIONSSPC bladder drainage results in a high patient satisfaction rate. Patients and clinicians should be aware of the potential complications associated with SPC insertion.
The Effect of Total Hip Replacement on the Employment Status of Patients Under the Age of 60 Years
Authors: Mobasheri R , Gidwani S , Rosson JW 
Published: March 2006

INTRODUCTION A retrospective study was undertaken of a consecutive cohort of 86 patients (101 hips) under the age of 60 years operated on by a single orthopaedic team between 1993 and 2003 at a district general hospital. PATIENTS AND METHODS Demographic and diagnostic data were collected from patients’ hospital records, and a detailed questionnaire regarding occupational status was used at follow-up. RESULTS Nearly all of the patients working prior to surgery returned to employment following surgery. Nearly half of those not working pre-operatively regained employment postoperatively; among those that did not return to work, this was for reasons unrelated to their hip. Those patients who had been out of work prior to their surgery took significantly longer to return to work. CONCLUSIONS Our study demonstrates that total hip replacement is effective in keeping patients under the age of 60 years employed. It is also effective in allowing those already off work due to hip pain to return to work, although there is a much greater delay.
Simulative Performance Test for Hot Mix Asphalt Using Asphalt Pavement Analyzer
Authors: Kandhal PS , Cooley LA 
Published: February 2006

Abstract
Permanent deformation, or rutting, has been and continues to be a problem in the performance of hot mix asphalt (HMA) pavements. This paper presents a summary of work conducted under National Cooperative Highway Research Program (NCHRP) Project 9-17. This research project was undertaken to evaluate the Asphalt Pavement Analyzer (APA) to determine its suitability as a general method of predicting rut potential. There was a need to identify test conditions within the APA that produced results most related to field rutting performance. Ten HMA mixes of known field rutting performance were tested within a full factorial experiment designed to determine the combination of testing conditions for the APA that best predicts field rutting. The experimental plan consisted of different specimen types (beam and cylinder), air void contents in compacted test specimen (4 and 7 %), hose diameters (25 and 38 mm), and test temperatures (high temperature of standard PG grade based upon climate and 6°C higher temperature). Based upon the test results and analysis, a tentative standard method of test was developed and recommended. A standard practice for establishing maximum specified rut depth for APA by highway agencies has also been recommended.
Fatigue Strength in Presence of Inhomogeneities: Influence of Constraint
Authors: Beretta S , Carboni M , Madia M 
Published: February 2006

AbstractThe effect of defects on the entity of the fatigue limit is nowadays well known and is demonstrated to be equivalent to the nonpropagating condition of short cracks. The influence of constraint at the defect tip has been addressed in the present paper considering a mild steel whose mechanical behavior has been experimentally determined together with the propagation threshold values for long cracks. The activity has first dealt with the determination of the Kitagawa diagram by means of fatigue limit tests using specimens containing micro-notches with different shapes (drilled holes and narrow slits). Experimental results showed a significant influence of the defect shape on the fatigue limit and thresholds. In order to understand the reasons, defects have then been analyzed by elasto-plastic FEM analyses. Computational results have confirmed a significant difference in the global constraint factor at the crack tip between round and narrow defects.
Creep Crack Growth Analysis of Welded Joints for High Cr Heat Resisting Steel
Authors: Tabuchi M , Hongo H , Watanabe T , Yokobori AT 
Published: February 2006

AbstractThe creep strength of weldment for high Cr ferritic steels decreases due to Type IV damages in the heat affected zone during long-term services at high temperatures. It is important to predict initiation and growth of creep voids and cracks in weldment. This paper clarified the Type IV crack initiation and growth properties in fine-grained HAZ of weldments for tungsten strengthened high Cr steels. On the basis of experimental results, the computational simulation for Type IV crack growth behavior was conducted. The effect of multiaxial stress condition on vacancy diffusion and crack initiation was discussed.
An Investigation of Regression Rate of the Melting Interface for Iron Burning in Normal Gravity and Reduced Gravity
Authors: Ward NR , Suvorovs T , Steinberg TA 
Published: February 2006

Abstract
This paper investigates the causes of increased regression rates of the melting interface for metals burning in reduced gravity. Promoted ignition tests have been conducted for 3.2-mm diameter iron rods during a transition from normal gravity to reduced gravity. Immediately upon transition to a reduced-gravity environment, a change in regression rate of the melting interface was evident. The rate was consistently 1.75 times higher in reduced gravity than in normal gravity. The sudden increase in regression rate of the melting interface indicates that it is due to a change in the geometry of the molten ball, rather than higher temperatures. A one-dimensional, steady state heat transfer model was developed, correlating regression rate of the melting interface to surface area of the solid/liquid interface. Evidence is presented suggesting that (a) the solid/liquid interface adopts a “dome” shape in reduced gravity, and (b) that this causes an increase in regression rate of the melting interface directly proportional to the increase in surface area of the solid/liquid interface.
The Adiabatic Compression Test for Type Approval of Components — History and Final Test Protocol
Authors: Barthélémy H 
Published: February 2006

Abstract
This paper explains why this test was proposed for the qualification of oxygen compatible equipment such as valves, regulators, and flexible hoses. This was done to avoid the repetition of accidents or incidents reported by the industry in high pressure equipment. In addition, this paper explains how this test method was developed and improved over the years and how harmonization was reached in the various Standards. Finally, a proposal for future work is outlined.
Functional Characterization of the Putative Aspergillus nidulans Poly(ADP-Ribose) Polymerase Homolog PrpA
Authors: Semighini Camile P , Savoldi Marcela , Goldman Gustavo H , Harris Steven D 
Published: March 2006

Abstract
POLY(ADP-RIBOSE) polymerase (PARP) is a highly conserved enzyme involved in multiple aspects of animal and plant cell physiology. For example, PARP is thought to be intimately involved in the early signaling events that trigger the DNA damage response. However, the genetic dissection of PARP function has been hindered by the presence of multiple homologs in most animal and plant species. Here, we present the first functional characterization of a putative PARP homolog (PrpA) in a microbial system (Aspergillus nidulans). PrpA belongs to a group of PARP homologs that includes representatives from filamentous fungi and protists. The genetic analysis of prpA demonstrates that it is an essential gene whose role in the DNA damage response is sensitive to gene dosage. Notably, temporal patterns of prpA expression and PrpA–GFP nuclear localization suggest that PrpA acts early in the A. nidulans DNA damage response. Additional studies implicate PrpA in farnesol-induced cell death and in the initiation of asexual development. Collectively, our results provide a gateway for probing the diverse functions of PARP in a sophisticated microbial genetic system.
Oxygen Uptake and Involvement of Superoxide Radicals upon Photolysis of Ketones in Air‐saturated Aqueous Alcohol, Formate, Amine or Ascorbic Acid Solutions
Authors: Görner Helmut 
Published: February 2006

ABSTRACTThe photolysis of acetophenone, benzophenone, 4‐carboxy‐benzophenone and benzil was studied in air‐saturated aqueous solution in the presence of alcohols. The overall reaction is an oxidation of 2‐propanol to acetone. The quantum yield of oxygen uptake (φ‐O2) increases with increasing 2‐propanol concentration up to 0.9. The photoreaction can also be initiated by quenching of the ketone triplet state by ascorbic acid, formate or an amine e.g. triethylamine. Subsequent reactions of the involved radicals with oxygen yield the super‐oxide radical and eventually hydrogen peroxide. For the ketones in the presence of 3–30 mM ascorbic acid or triethylamine φ‐O2= 0.3–0.9. The specific properties of ketones, including 4‐methoxyacetophenone and 2‐acetonaphthone, the radicals involved and the pH and concentration dependences of φ‐O2 are discussed.
Bolbophorus Infections in Cultured Fathead Minnow
Authors: Mitchell Andrew J. , Goodwin Andrew E. , Levy Michael G. 
Published: February 2006

Abstract
Bolbophorus trematodes in fish recently gained national attention because B. damnificus infections have caused major losses of commercially raised channel catfish Ictalurus punctatus. We report the presence of a mixed infection (B. damnificus and Bolbophorus sp.) in fathead minnow Pimephales promelas. Of the 10 trematodes identified by Bolbophorus spp.−specific polymerase chain reaction assays, 9 were Bolbophorus sp. and 1 was B. damnificus. This is the first report of a natural infection of B. damnificus in a nonictalurid host. In fathead minnow, the prodiplostomula examined histologically were surrounded by thin-walled cysts; rarely, the cysts were accompanied by an inflammatory reaction that consisted primarily of macrophages.