bluuebunny/crossref_metadata_2025_split huggingface dataset:
USE OF CEMENTED FEMORAL COMPONENT FOR REVISION IN PERIPROSTHETIC FEMORAL FRACTURES (PFF) IN THE ELDERLY
Authors: Gibbons J.P. , Bodian C. , Powell A.J. , Sharr J.P. , Lash N.J. 
Published: February 2023

PFFs are an increasing burden presenting to the acute trauma services. The purpose of this study is to show that cemented revision for Vancouver B2/B3 PFFs is a safe option in the geriatric population, allows early pain-free weight bearing and comparable to a control-group of uncemented stems with regard to return to theatre and revision surgery.A retrospective review was conducted of all PFFs treated in a Level 1 trauma centre from 2015-2020. Follow up x-rays and clinical course through electronic chart was reviewed for 78 cemented revisions and 49 uncemented revisions for PFF. Primary endpoints were all cause revision and return to theatre for any reason. Secondary endpoints recorded mobility status and all-cause mortality.In the cemented group there were 73 Vancouver B2, 5 Vancouver B3 PFF; the mean age was 79.7 years and mean radiological follow-up of 11.9 months. In the cementless group there were 32 Vancouver B2 and 17 Vancouver B3 PFFs; with all 49 patients undergoing distally bearing uncemented revision, the mean age was 72.7 years and mean radiological follow-up of 21.3 months.Patients treated with a cemented prosthesis had significantly higher ASA score (2.94 -v- 2.43, p<0.001). The primary endpoints showed that there was no significant difference in all cause revision 3/78 and 5/49 p=0.077, or return to theatre 13/78 -v- 12/49 p=0.142.Secondary endpoints revealed no significant difference in in-hospital mortality. The cementless group were more likely to be mobilising without any aid at latest follow-up 35/49 -v- 24/78 p<0.001.The use of cemented revision femoral component in the setting of PFFs is one option in the algorithm for management of unstable PFFs according to the Vancouver classification. Evidence from this case-control study, shows that the all-cause revision and return to theatre for any cause was comparable in both groups.
OUTCOMES OF PATIENTS WITH SOFT-TISSUE SARCOMA AT MIDDLEMORE HOSPITAL BEFORE AND AFTER INTRODUCTION OF THE NZ SARCOMA STANDARDS
Authors: Rosser K. , Ryu J. , Deo S. , Flint M. 
Published: February 2023

The NZ Standards of Service Provision for Sarcoma patients were developed by the NZ Sarcoma working group and published by the Ministry of Health (MOH) in 2013. Although not formally enacted by the MOH we aimed to determine the impact of these published standards and referral pathways on disease-specific survival of patients with soft-tissue sarcoma in NZ.The Middlemore Musculoskeletal Tumour Unit database was searched. Patients referred for treatment in our centre with a diagnosis of soft tissue sarcoma in the five-year period before (n=115) and after (n=155) were included. We excluded patients with bone sarcomas and retroperitoneal soft tissue sarcomas.The rate of referral after inappropriate treatment reduced after implementation of the Standards (24% vs 12%, p=0.010). The number of patients referred with tumours larger than 50mm decreased (74.8% vs 72.3%, p=0.021) and fewer had metastases at diagnosis (11.3% vs 3.2%, p=0.017). Mortality was lower in the group after introduction of the Standards (45% vs 30%, p=0.017). The estimated disease-specific survival curve between the two groups shows a trend towards increased survival in the post-standards group, although not reaching statistical significance. Local recurrence rate and metastasis rate after definitive treatment were similar between the two groups. Patients had a shorter duration of symptoms before referral in the post-Standards group although this was not statistically significant.Since implementation of the Standards, patients have been referred more promptly, with fewer inappropriate treatments. The time to mortality curve indicates a trend towards improved disease-specific survival. We conclude that the pathway for investigation and referral for this condition has become clearer, supporting the ongoing use of the Sarcoma Standards, and that these should be formally implemented by the MOH.
THE DEGREE OF GLUTEAL TENDINOPATHY CORRELATES WITH WORSENING PROMS IN TOTAL HIP ARTHROPLASTY: A PROSPECTIVE STUDY OF 797 PATIENTS
Authors: Lin D , Gooden B , Lyons M , Salmon L , Martina K , Sundaraj K , Yong Yau Tai J , O'Sullivan M 
Published: February 2023

The prevalence of gluteal tendinopathy (GT) associated with osteoarthritis of the hip is difficult to determine as it is frequently undiagnosed or misdiagnosed as trochanteric bursitis. Its relationship to total hip arthroplasty (THA) outcomes is currently unknown. The aim of this study was to determine the incidence of GT at the time of hip arthroplasty and examine the relationship between GT and patient reported outcomes (PROMS) before and after THA.Patients undergoing THA for primary osteoarthritis between August 2017 and August 2020 were recruited. Tendinopathy was assessed and graded at time of surgery. PROMS included the Oxford Hip Score (OHS), HOOS JR, EQ-5D, and were collected preoperatively and at one year after THA. Satisfaction with surgery was also assessed at 1 year.797 patients met eligibility criteria and were graded as Grade 1: normal tendons (n =496, 62%), Grade 2: gluteal tendinopathy but no tear (n=222, 28%), Grade 3: partial/full thickness tears or bare trochanter (n=79, 10%). Patients with abnormal gluteal tendons were older (p=0.001), had a higher mean BMI (p=0.01), and were predominately female (p=0.001). Patients with higher grade tendinopathy had statistically significant inferior PROMS at one year, OHS score (44.1 v 42.9 v 41.3, p 0.001) HOOS JR (89.3 V 86.3 V 85.6 p 0.005). Increasing gluteal tendon grade was associated with a greater incidence of problems with mobility (p=0.001), usual activities (p=0.001) and pain (p=0.021) on EQ5D. There was a 3 times relative risk of overall dissatisfaction with THA in the presence of gluteal tears.This study demonstrated that gluteal tendinopathy was commonly observed and associated with inferior 1-year PROMS in patients undergoing THA for OA. Increasing degree of tendinopathy was a negative prognostic factor for worse functional outcomes and patient satisfaction.
TWENTY-YEAR SURVIVAL OF HIGH TIBIAL OSTEOTOMY
Authors: Sundaraj K , Russsell V , Salmon L , Pinczewski L 
Published: February 2023

The aim of this study was to determine the long term 20 year survival and outcomes of high tibial osteotomy (HTO).100 consecutive subjects underwent HTO under the care of a single surgeon between 2000 and 2002, consented to participation in a prospective study and completed preoperative WOMAC scores. Subjects were reviewed at 10 years, and again at a minimum of 20 years after surgery. PROMS included further surgery, WOMAC scores, Oxford Knee Score (OHS), KOOS, and EQ-5D, and satisfaction with surgery. 20 year survival was assessed with Kaplan-Meir analysis, and failure defined as proceeding to subsequent knee arthroplasty.The mean age at HTO was 50 years (range 26-66), and 72% were males. The 5, 10, and 20 year survival of the HTO was 88%, 76%, 43% respectively. On multiple regression analysis HTO failure was associated with poor preoperative WOMAC score of 45 or less (HR 3.2, 95% CI 1.7-6.0, p=0.001), age at surgery of 55 or more (HR 2.3, 95% CI 1.3-4.0, p=0.004), and obesity (HR 1.9, 95% CI 1.1-3.4, p=0.023). In patients who met all criteria of preoperative WOMAC score of 45 or less, age <55 years and body mass index of <30 HTO survival was 100%, 94%, and 59% at 5, 10 and 20 years respectively. Of those who had not proceeded to TKA the mean Oxford Score was 40, KOOS Pain score was 91 and KOOS function score was 97. 97% reported they were satisfied with the surgery and 88% would have the same surgery again under the same circumstances.At 20 years after HTO 43% had not proceeded to knee arthroplasty, and were continuing to demonstrate high subjective scores and satisfaction with surgery. HTO survival was higher in those under 55 years, with BMI <30 and baseline WOMAC score of >45 at 59% HTO survival over 20 years. HTO may be considered a viable procedure to delay premature knee arthroplasty in carefully selected subjects.
WEIGHT CHANGES AFTER HIP AND KNEE ARTHROPLASTY, AND THE EFFECT OF OBESITY ON OUTCOMES
Authors: Sundaraj K , Gooden B , Lyons M , Roe J , Carmody D , Pinczewski L , Huang P , Salmon L , Martina K , Smith E , O'Sullivan M 
Published: February 2023

Obesity is a common in individuals undergoing arthroplasty, and the potential for weight loss with improved mobility may be expected by some. The aim of this study was 1. determine the proportion that achieved weight loss after hip or knee arthroplasty, and 2. examine the effect of obesity on patient reported outcomes (PROMS) and satisfaction with surgery.Participants underwent primary TKA or THA between July 2015 and December 2020 and consented to participation in a research database with baseline PROMS, including weight, BMI, Oxford Knee, or Hip Score, and EQ5D. Participants repeated PROMS at 12 months after surgery with additional questions regarding satisfaction with surgery.3449 patients completed PROMS 1 year after arthroplasty with weight and BMI. There were 1810 THA and 1639 TKA procedures. The mean baseline BMI was higher in TKA (29.8, SD 5.2) compared to THA (27.7, SD 5.0), p=0.001. A higher proportion of TKA were classified as obese class 1 (29% TKA, 19% THA), obese class 2 (11% TKA and 6% THA), and obese class 3 (5% TKA and 2% THA), p=0.001. The mean weight loss after 1 year was 0.4kg and 0.9kg in obese THA subjects and TKA subjects respectively. In the obese >5kg weight loss was achieved in 13% of TKA and 7% of THA (p=0.001). Obese experienced equivalent improvement in Oxford scores, compared to non-obese subjects. Satisfaction with surgery was reported by 95% of THA and 91% of TKA subjects with no significant differences between BMI group grades (p=0.491 THA and p=0.473 TKA).Preoperative obesity was observed in 44% of TKA and 27% of THA subjects. In the obese only 1 in 10 subjects lost 5kg or more over 12 months. Obese patients experienced equivalent improvements in outcome after arthroplasty and rates of satisfaction with surgery to the non-obese.
The possible onset of fibromyalgia following acute COVID-19 infection
Authors: Savin Einat , Rosenn Gali , Tsur Avishai M. , Hen Or , Ehrenberg Scott , Gendelman Omer , Buskila Dan , Halpert Gilad , Amital Daniela , Amital Howard 
Published: February 2023

Introduction
The exact pathogenesis of fibromyalgia (FM) syndrome is unclear. However, various infectious have been implicated with the development of FM after their acute phase. We aimed to investigate the incidence of FM syndrome among convalesced individuals following hospitalization for Acute Coronavirus Disease-2019 (COVID-19).

Methods
We performed a cross-sectional study on patients who were discharged after COVID-19 hospitalization from the Sheba Medical Center, Israel, between July 2020 to November 2020. A phone interview was performed consisting of the following questionnaires: the Fibromyalgia Survey Diagnostic Criteria Questionnaire, Sense of Coherence Questionnaire to evaluate resilience, and the Subjective Traumatic Outlook Questionnaire to assess the associated psychological aspects of the trauma. The incidence of post-COVID FM was calculated and regression models were performed to identify predictors.

Results
The study population consisted of 198 eligible patients who completed the phone interview. The median age was 64 (52–72) and 37% were women. The median follow-up was 5.2 months (IQR 4.4–5.8). The incidence of FM was 15% (30 patients) and 87% (172 patients) had at least one FM-related symptom. Female gender was significantly associated with post-COVID FM (OR 3.65, p = 0.002). In addition, high median Subjective Traumatic Outlook scores and low median Sense of Coherence scores were both significantly associated with post-COVID FM (OR 1.19, p<0.001 and OR 0.92, p<0.001, respectively).

Conclusions
FM is highly prevalent among COVID-19 convalescent patients. Our finding suggests that a significant subjective traumatic experience and a low resilience are highly associated with post-COVID FM.
Abordaje transmandibular para resección de aneurisma carótideo
Authors: Álvarez-Álvarez Ignacio , Ballesteros-Pomar Marta , Martín-Villares Cristina , Fernández-Cascón Sara , Rodríguez-García Ana , Cid-Martínez Marina , Martín-Sigüenza Gerardo 
Published: February 2023

Introducción y objetivo: Los abordajes transmandibulares forman parte del arsenal quirúrgico de nuestra Especialidad y, aunque su principal indicación la constituyen los tumores malignos de la cavidad oral y la orofaringe, también se utilizan ocasionalmente para tumores del espacio parafaríngeo.
Presentamos el caso de un paciente con un aneurisma carotídeo de localización muy alta, que planteaba diagnóstico diferencial con un paraganglioma vagal, no accesible a una cervicotomía convencional y que fue resecado mediante una abordaje transmandibular.

Método: Se realizó una manibulotomía lateral en escalón para acceder al espacio carotídeo y una vez comprobado el diagnóstico, una doble sección en el segmento craneal de la arteria carótida interna izquierda, excluyendo el tramo donde estaba el aneurisma, y a continuación un By-pass vascular con vena safena interna. Una vez comprobada la viabilidad del injerto se reconstruyó la mandíbulotomía con miniplacas de titanio y se dejó una sonda nasogástrica para alimentación durante 3 semanas.
Posteriormente se comprobó con una ortopantomografía la correcta alineación de las osteotomías.

Resultados: La deglución hubo de ser progresiva por manifestarse tras los primeros días un dolor al primer bocado que desapareció a las pocas semanas.
El paciente no presentó ninguna otra complicación.
Los estudios funcionales realizados hasta la fecha confirman la permeabilidad del injerto y la deglución es completamente normal sin limitación ni dolor a la apertura bucal.
Discusión: Se expone este caso a la consideración del creciente protagonismo del cirujano ORL en la cirugía cervicofacial y de la base del cráneo, y de la idoneidad de la actuación conjunta de diferente Especialidades en la resolución de problemas complejos de estas localizaciones.
Conclusiones: La actuación sinérgica con otros especialistas que también realizan cirugía en el área de cabeza y cuello ofrece óptimos resultados en el tratamiento quirúrgico de problemas complejos de esta localización.
Neumoencéfalo espontáneo. A propósito de un caso.
Authors: Rodríguez-García Ana , Fernández-Cascón Sara , Pérez-González Rafael , Martín-Sigüenza Gerardo , Ramírez-Salas Jesús Eduardo , Álvarez-Álvarez Ignacio 
Published: February 2023

Introducción y objetivo: El neumoencéfalo es la presencia de aire en cualquiera de los compartimentos intracraneales (intraventricular, intraparenquimatoso, subaracnoideo, subdural y epidural), generalmente se asocia con una pérdida de la continuidad ósea tras procedimientos quirúrgicos o traumatismos, siendo infrecuente su presentación sin factor desencadenante (2%). Mediante la presentación de un caso clínico, explicaremos las características fundamentales de dicha entidad y exposición de la bibliografía.
Método: Varón de 48 años que acude al Servicio de Urgencias tras cuadro de cefalea intensa de reciente aparición en hemicráneo derecho de cinco días de evolución que controló inicialmente con paracetamol, mostrando empeoramiento progresivo sin respuesta a analgesia; en este momento, presenta visión borrosa y cervicalgia. Se solicita TC craneal y ante hallazgos, se deriva el paciente al servicio de Otorrinolaringología y Neurocirugía.
Resultados: Neumoencéfalo localizado en región frontal izquierda y hoz cerebral, así como pequeñas burbujas en región occipital izquierda y en seno cavernoso derecho. Dehiscencia a nivel de la lámina cribosa del etmoides en fosa nasal izquierda. Ante estos hallazgos se realiza observación intrahospitalaria y tratamiento analgésico intravenoso durante dos semanas con evolución satisfactoria y se realiza nueva TC donde no se observa neumoencéfalo en parénquima cerebral, persistiendo la dehiscencia previamente descrita.
Discusión: La aparición del neumoencéfalo espontáneo suele ser secundario a un defecto en la continuidad ósea craneal, siendo una entidad muy rara (2%); la presencia de neumoencéfalo suele ocurrir tras una intervención quirúrgica, traumatismo craneofacial o tumores en base de cráneo. Como complicación podemos encontrar el neumoencéfalo a tensión, que se debe a la entrada de gas intracraneal que eleva la presión, produciendo un efecto válvula con la entrada de aire, pero no su salida, precisando tratamiento quirúrgico. Esta entidad se manifiesta clínicamente con cefalea, náuseas, vómitos e incluso convulsiones y alteraciones del estado neurológico. En su diagnóstico la técnica de elección sigue siendo la TC craneal. Cuando es un hallazgo casual se opta por un manejo conservador, resolviéndose de forma espontánea en unas dos semanas. Si presenta síntomas, fracturas de base del cráneo, o un defecto aéreo >15 mm se considera el tratamiento quirúrgico.
Conclusiones: Ante la clínica de cefalea con otros síntomas neurológicos asociados con mala respuesta a tratamiento analgésico, debemos incluir en el cuadro de diagnóstico diferencial el neumoencéfalo, sobre todo, ante la presencia de cirugías craneales o traumatismos previos. La resolución suele ser espontánea, pero debemos considerar la posibilidad de aparición de neumoencéfalo a tensión, por lo que es necesaria la vigilancia estrecha intrahospitalaria.
Síndrome de Ramsay Hunt con páralisis de X par craneal asociada. A propósito de un caso
Authors: Martín-García Sandra , García-Núñez Gianni Mercy , Villaoslada-Fuentes Rosana , Chaves-Araújo Rosalyn , Velasco-García María Jesús 
Published: February 2023

Introducción y objetivo: El síndrome de Ramsay-Hunt es una complicación poco frecuente de la afectación del ganglio geniculado por el VVZ causando parálisis facial periférica con afectación del conducto auditivo externo y membrana timpánica. En ocasiones puede afectar a pares craneales bajos al ser una neuritis periférica múltiple que puede afectar a los pares craneales VII, VIII, IX y X debido a sus relaciones de vecindad, a su origen embrionario común en el mismo arco branquial o por una afectación sanguínea a través de los vasos que los nutren.
Método: Mujer 93 años, que presenta lesiones ampollosas en pabellón auricular derecho de 4 días de evolución, con otorrea asociada. Disfagia para sólidos con odinofagia. Habiendo iniciado tratamiento antibiótico y antiviral sin mejoría clínica. Aparición súbita de parálisis facial derecha grado III (House Brackmann). A la exploración se objetivan lesiones costrosas con edema de pabellón auricular derecho, doloroso a la palpación, abundante secreción de CAE y membrana timpánica íntegra. Lesiones costrosas a nivel de párpado superior derecho y parálisis facial grado III derecha. En la nasofibroscopia se objetiva parálisis laríngea derecha con lesiones compatibles con Herpes Zóster. Se decide ingreso para tratamiento intravenoso y observación, con buena evolución.
Resultados: Herpes Zoster con parálisis de VII y X par craneal.
Discusión: La peculiaridad del caso presentado reside en la asociación de un Síndrome de Ramsay-Hunt con una parálisis del nervio laríngeo recurrente.
Conclusiones: El síndrome de Ramsay-Hunt es una complicación poco frecuente de la afectación del ganglio geniculado por el VVZ. Puede presentarse bajo diversas formas clínicas que guardan en común la neuritis de pares craneales de forma muy diversa. Debemos tener en cuenta la posible asociación de parálisis de otros nervios craneales de cara a un correcto diagnóstico diferencial.
Argumentative Exchange in Science: How Social Epistemology Brings Longino back down to Earth
Authors: Ajdari Emma Nyhof 
Published: February 2023

Abstract
In her account of scientific objectivity, feminist philosopher of science Helen Longino shows how scientific objectivity is not so much of individual practice, but rather a social commitment practiced by a scientific community, provided by the necessary accommodations for critical discourse. However, is this conception of scientific objectivity truly capable of living up to the social realities of critical discourse and deliberation within a scientific community? Drawing from Dutilh Novaes’ social epistemological account of argumentation, this paper highlights the challenges Longino’s scientific objectivity faces on a prescriptive and descriptive level, specifically in overcoming the various epistemic injustices Longino’s proposed structural accommodations for objectivity are still sensitive to. Dutilh Novaes’ social epistemological model of argumentation illustrates how the realities of critical debate too often don’t consist of true epistemic or knowledge exchange, even though such exchanges are essential to achieve Longino’s primary goal when redefining scientific objectivity: to wield out and address idiosyncratic background assumptions and individual bigotry that possibly influence a researcher’s scientific conduct.
Story Telling and Rhetorical You Concern in 2 Corinthians 8–9
Authors: Engberg-Pedersen Troels 
Published: February 2023

Abstract
The essay aims to show the structure and inner coherence of 2 Corinthians 8–9 by analyzing two features of the text that hold it intimately together: 1) Paul’s use of chronological narration in 8,1–7, 8,16–24, and 9,1–5 and 2) his focus on rhetorical ‘you concern’ (in a manner that is explained) in 8,9–15 and 9,6–15. In the latter context, it is argued against previous scholarship that Paul’s rhetorical concern differs quite strongly in 8,9–15 and 9,6–15. Throughout, it is argued that chapters 8–9 play an important role as part of Paul’s overall aim in the letter as a whole: to prepare for his own forthcoming visit to Corinth.
The effects on radial distribution networks caused by replacing incandescent lamps with compact fluorescent lamps and LEDs
Authors: Blanco Castañeda Ana María , Parra Estrella Esperanza 
Published: February 2023

Compact fluorescent lamps and high-power light-emitting diodes use an electronic device that injects harmonics into distribution networks, thereby altering power quality levels. This paper shows these lamps' electrical characterisation and the results of a computer simulation of a radial distribution feeder supplying electricity to customers who use this type of harmonic load. The objective was to analyse the effect on distribution systems due to CFLs and LEDs' high penetration.
Developing a PQ monitoring system for assessing power quality and critical areas detection
Authors: Romero Miguel , Pardo Ricardo , Gallego Luis 
Published: February 2023

This paper outlines the development of a power quality monitoring system. The system is aimed at assessing power quality and detecting critical areas throughout at distribution system. Such system integrates a hardware system and a software processing tool developed in four main stages. Power quality disturbances are registered by PQ meters and the data is transmitted through a 3G wireless network. This data is processed and filtered in an open source database. Some interesting statistical indices related to voltage sags, swells, flicker and voltage unbalance are obtained. The last stage displays the indices geo-referenced on power quality maps, allowing the identification of critical areas according to different criteria. The results can be analyzed using clustering tools to identify differentiated quality groups in a city. The proposed system is an open source tool useful to electricity utilities to analyze and manage large amount of data.