bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Defect Size and Ratio to Condylar Size With Respect to Outcomes After Isolated Osteochondral Allograft Transplantation
Authors: Lee Simon , Frank Rachel M. , Christian David R. , Cole Brian J.
Published: May 2019

Background:

Osteochondral allograft transplantation (OCA) is a successful knee joint preservation technique; however, the effects of defect size and defect size:condyle ratio (DSCR) are poorly understood.

Purpose:

To quantify clinical outcomes of isolated OCA of the knee based on defect size and DSCR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data from patients who underwent OCA of the knee without major concomitant procedures by a single surgeon were analyzed at a minimum follow-up of 2 years. Osteochondral defect size was measured intraoperatively, and femoral condyle size was measured with preoperative imaging. Patient-reported outcomes, reoperations, and survival rates were analyzed per defect size and DSCR, comparing males and females and patients <40 and ≥40 years old.

Results:

Sixty-eight patients were included, of whom 57% were male (mean ± SD: age, 34.5 ± 10.3 years; follow-up, 5.2 ± 2.6 years). Mean osteochondral defect size and DSCR were 3.48 ± 1.72 cm2 and 0.2 ± 0.1, respectively. Defect size was larger among males as compared with females (3.97 ± 1.71 cm2 vs 2.81 ± 1.16 cm2, P = .005), while DSCRs were not significantly different between sexes ( P = .609). The cohort as a whole demonstrated improvements in the following scores: Lysholm, International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, and 12-Item Short Form Health Survey Physical ( P < .05). There were 27 reoperations (39.7%) at a mean of 2.5 ± 1.92 years and 8 failures (11.8%) at a mean of 2.62 ± 1.3 years. Mean DCSR was higher among patients with graft failure (0.26 ± 0.20 vs 0.19 ± 0.07, P = .049). After stratification by age, failures among patients ≥40 years old were associated with a larger defect size (mean 5.37 ± 3.50 cm2 vs 3.22 ± 1.32 cm2, P = .03) and higher DSCR (mean 0.30 ± 0.25 vs 0.19 ± 0.06, P = .05) when compared with nonfailures. Failures among patients <40 years old were not significantly associated with defect size or DSCR ( P > .05) as compared with nonfailures.

Conclusion:

Patients undergoing isolated OCA transplantation demonstrated significant clinical improvements and a graft survival of 88.2% at 5.2 years. Failures overall were associated with a larger DSCR, and failures among patients ≥40 years old with a larger DSCR and larger defect size. Increasing defect size among males was positively correlated with some improved outcomes, although this was not maintained in analysis of the DSCR, suggesting similar prognosis after OCA regardless of sex.

Clinical Relevance:

Failed osteochondral allografts are associated with larger defect sizes and defect:condyle ratios in this study, providing additional information to surgeons for appropriate patient consultation.
The Effect of Egocentric Taste Judgments on Stereotyping of Welfare Recipients and Attitudes Toward Welfare Policy
Authors: Shepherd Steven , Campbell Troy
Published: May 2019

Despite the centrality of purchasing behavior and choice to the welfare debate, research has generally understood attitudes toward welfare at a broader level and as a function of rational or deliberative processes (e.g., self-interest, ideology). This project identifies the effect of egocentrism on welfare attitudes, finding that a welfare recipient’s purchase of an item that the participant personally values less (vs. more) leads to increased stereotyping of welfare recipients (e.g., irresponsibility, impulsivity) and favorable attitudes toward policy that would restrict that purchase. This effect is illustrated for both chronic and situational preferences and across a number of products commonly debated in welfare policy. The authors find that egocentrism is robust to debiasing; therefore, tests of boundary conditions involved countering the stereotype of irresponsibility rather than the bias itself. For example, the effects do not emerge in the context of healthy foods and necessities, nor when information suggests that the target consumer is otherwise responsible (e.g., budgeting, clipping coupons). Implications for policy and welfare advocacy are discussed. In general, these findings establish how personal preferences may shape attitudes toward marginalized consumers and related policy.
Impeded Opportunities: The Content and Consequences of Structures Constraining Supervisors’ Communication With Older Workers
Authors: Kroon Anne C.
Published: May 2019

Supervisors are confronted with the challenge to support the employability of rapidly aging teams. Drawing on structuration theory, two studies construct and test a conceptual model of how structures (rules and resources) constraining supervisors’ communication with older workers impede older workers’ job performance and access to promotion. A set of constraining structures was qualitatively identified through in-depth interviews and subsequently quantified in a survey. The results reveal a set of constraining structures that obstruct supervisors’ conversations with older workers and consequently hinder employability outcomes. If older workers are to take advantage of national and organizational policies and resources aimed at improving their employability, these constraining structures should be targeted.
Organizational Dissent Dynamics in Universities: Simulations With a System Dynamics Model
Authors: Zaini Raafat Mahmoud , Elmes Michael B. , Pavlov Oleg V. , Saeed Khalid
Published: May 2019

This article investigates how universities may evolve into high- or low-performance institutions by taking different approaches to dissent tolerance and processing. We explore different dissent management policies related to growth and productivity. We experiment with a dynamic model of dissent creation and processing in organizations presented in an earlier paper by the authors. Computer simulations with the model suggest that as universities attempt to improve their performance through growth, they may devolve into low-performance institutions with degrading management responsiveness and low organizational productivity. Only when organizations invest in their dissent processing capability will they engage their members productively for improving performance.
Psychological Momentum and Inertia: Toward a Model of Academic Motivation
Authors: Deemer Eric D. , Derosa Pedro A. , Duhon Stacey A. , Dotterer Aryn M.
Published: May 2019

Building upon psychological momentum theory, we draw an analogy between motivational constructs proposed herein and the physical principles of mass, inertia, and momentum. From these principles, we derived constructs representing academic inertia in states of both low and high momentum. The sample consisted of 105 African American college students in science, technology, engineering, and mathematics majors. Results of a confirmatory factor analysis (CFA) of a newly developed scale yielded support for two distinct factors reflecting low momentum state inertia (LMSI) and high momentum state inertia (HMSI). The conditional relationship between LMSI and HMSI was then examined with inspiration as a moderating variable. Consistent with our prediction, results indicated that the relationship between LMSI and HMSI was positive and significant at low levels of inspiration, while this slope was not significant at high levels of inspiration. Implications for cognitive-affective factors that may inhibit or facilitate psychological momentum in the context of academic functioning are discussed.
Optimization of a high-pressure microwave curing process for T800/X850 carbon fiber-reinforced plastic
Authors: Guan Chenglong , Zhan Lihua , Liu Guiming , Yang Xiaobo , Dai Guangming , Jiang Chengbiao , Chen Xiaoping
Published: May 2019

Compared with the conventional composite curing processes, high-pressure microwave curing is a promising technology. In this study, a set of devices for high-pressure microwave curing was built and equipped with real-time temperature measurement capability and a microwave input control system. The orthogonal experimental method was applied to optimize three process parameters, including the heating rate, curing temperature, and holding time, for the high-pressure microwave curing of T800/X850 composites. The effects of the three parameters on the curing quality were studied by measuring the interlaminar shear strength (ILSS) and conducting differential scanning calorimeter tests. The fracture surface of the samples was also examined by scanning electron microscopy. The results showed that the heating rate had a significant effect on the ILSS of the laminates, and the degree of cure of all samples was more than 95% in the tests. Furthermore, the optimal process parameters were determined as follows: heat up to 170°C with a heating rate of 6°C min−1 and a holding time of 90 min. The total curing time of the sample was 42.4%, and the ILSS of the sample was slightly enhanced by 0.31% compared with standard thermal curing. These results could serve to make trade-offs between reducing manufacturing time and preserving the mechanical properties of microwave-cured composites.
Assessing the relative impact of lupus nephritis on mortality in a population-based systemic lupus erythematosus cohort
Authors: Reppe Moe S E , Molberg Ø , Strøm E H , Lerang K
Published: May 2019

Objective

There is limited knowledge on the relative impact of lupus nephritis (LN) on morbidity and mortality in population-based systemic lupus erythematous (SLE) cohorts. Here, the primary aim was to compare mortality rates between patients with and without LN in a population-based SLE cohort.

Methods

The study cohort included all SLE patients resident in the city of Oslo during 1999–2008. Follow-up time was median 14 (0–15) years. Presence of LN was defined according to the 1987 American College of Rheumatology classification criteria for SLE. LN class was determined by renal biopsy. Data on kidney function, including presence of end-stage renal disease (ESRD), were obtained from patient charts. Standardized mortality ratios (SMRs) were estimated by comparing deaths in the SLE cohort with age- and gender-matched population controls.

Results

We found that 98/325 SLE patients (30%) developed LN, 92% of whom had occurrence within the first five years from disease onset. Incidence rate of ESRD was 2.3 per 1000 patient-years. A total of 56 deaths occurred during the study period, corresponding to an overall SMR in the SLE cohort of 2.1 (95% confidence interval (CI) 1.2–3.4). Estimated SMR for LN patients was 3.8 (95% CI 2.1–6.2), and for SLE patients without LN it was 1.7 (95% CI 0.9–2.7).

Conclusion

In this population-based SLE cohort, we found that LN was associated with increased morbidity and mortality, whereas SLE patients who did not develop LN had good overall prognoses regarding survival.
Design and analysis of stratified clinical trials in the presence of bias
Authors: Hilgers Ralf-Dieter , Manolov Martin , Heussen Nicole , Rosenberger William F
Published: May 2019

Background

Among various design aspects, the choice of randomization procedure have to be agreed on, when planning a clinical trial stratified by center. The aim of the paper is to present a methodological approach to evaluate whether a randomization procedure mitigates the impact of bias on the test decision in clinical trial stratified by center.

Methods

We use the weighted t test to analyze the data from a clinical trial stratified by center with a two-arm parallel group design, an intended 1:1 allocation ratio, aiming to prove a superiority hypothesis with a continuous normal endpoint without interim analysis and no adaptation in the randomization process. The derivation is based on the weighted t test under misclassification, i.e. ignoring bias. An additive bias model combing selection bias and time-trend bias is linked to different stratified randomization procedures.

Results

Various aspects to formulate stratified versions of randomization procedures are discussed. A formula for sample size calculation of the weighted t test is derived and used to specify the tolerated imbalance allowed by some randomization procedures. The distribution of the weighted t test under misclassification is deduced, taking the sequence of patient allocation to treatment, i.e. the randomization sequence into account. An additive bias model combining selection bias and time-trend bias at strata level linked to the applied randomization sequence is proposed. With these before mentioned components, the potential impact of bias on the type one error probability depending on the selected randomization sequence and thus the randomization procedure is formally derived and exemplarily calculated within a numerical evaluation study.

Conclusion

The proposed biasing policy and test distribution are necessary to conduct an evaluation of the comparative performance of (stratified) randomization procedure in multi-center clinical trials with a two-arm parallel group design. It enables the choice of the best practice procedure. The evaluation stimulates the discussion about the level of evidence resulting in those kind of clinical trials.
A multi-treatment response adaptive design for ordinal categorical responses
Authors: Biswas Atanu , Bhattacharya Rahul , Das Soumyadeep
Published: May 2019

A multi-treatment response adaptive procedure is developed considering “comparison with the best” philosophy of multiple comparison procedures for clinical trials with ordinal categorical responses, when there is no shared control. For each response category, we arbitrarily create two outcome groups; one by combining the categories more favorable to it and the other by merging the categories at most as favorable to it and hence define the odds (i.e. cumulative odds). Pairwise ratios of such odds (i.e. cumulative odds ratios) based on pairs of treatments are combined conveniently to derive a measure of relative superiority and hence the allocation probability functions. For practical implementation, we suggest response-adaptive randomization (RAR), that is, update the allocation probabilities dynamically using the available allocation and response information to favor the treatment doing better. Empirical as well as large sample properties following the randomization are investigated in detail. Moreover, a real clinical trial with trauma patients is redesigned using the proposed RAR to envisage practical applicability.
Radotinib inhibits mitosis entry in acute myeloid leukemia cells via suppression of Aurora kinase A expression
Authors: Heo Sook-Kyoung , Noh Eui-Kyu , Jeong Yoo Kyung , Ju Lan Jeong , Sung Jun Young , Yu Ho-Min , Cheon Jaekyung , Koh SuJin , Min Young Joo , Choi Yunsuk , Jo Jae-Cheol
Published: May 2019

Aurora kinases play critical roles in regulating several processes pivotal for mitosis. Radotinib, which is approved in South Korea as a second-line treatment for chronic myeloid leukemia, inhibits the tyrosine kinase BCR-ABL and platelet-derived growth factor receptor. However, the effects of radotinib on Aurora kinase expression in acute myeloid leukemia are not well studied. Interestingly, the cytotoxicity of acute myeloid leukemia cells was increased by radotinib treatment. Radotinib significantly decreased the expression of cyclin-dependent kinase 1 and cyclin B1, the key regulators of G2/M phase, and inhibited the expression of Aurora kinase A and Aurora kinase B in acute myeloid leukemia cells. In addition, radotinib decreased the expression and binding between p-Aurora kinase A and TPX2, which are required for spindle assembly. Furthermore, it reduced Aurora kinase A and polo-like kinase 1 phosphorylation and suppressed the expression of α-, β-, and γ-tubulin in acute myeloid leukemia cells. Furthermore, radotinib significantly suppressed the key regulators of G2/M phase including cyclin B1 and Aurora kinase A in a xenograft animal model. Therefore, our results suggest that radotinib can abrogate acute myeloid leukemia cell growth both in vitro and in vivo and may serve as a candidate agent or a chemosensitizer for treating acute myeloid leukemia.
An Introduction to Islandwood Papers on Social Work and the Arts
Authors: Flynn Marilyn L. , Sela-Amit Michal
Published: May 2019

The social work profession has adopted science and empirical evidence as the means of validating discovery. As the commitment to science has intensified, interest in the use of arts in practice has grown as a counterpoise and an effort to justify other forms of knowledge and human experience. A roundtable was held in summer 2017 to examine whether the arts have a distinctive place in social work practice. It has been acknowledged that the arts have played a role in the history of the profession, however, remained neglected and marginalized in social work education. Roundtable participants argued that creativity, necessary disruption, and transformation have been lost to the field as a result. It is possible that social work education might be reimagined with new underpinnings of science, social innovation, and the arts. It should not be assumed that outcome measurement is not possible; however, measures would have to be rethought.
Soft-assembled human–machine perceptual systems
Authors: Favela Luis H
Published: May 2019

Cognitive systems are highly adaptable and flexible, such that action and perception capabilities can be achieved with the body in various ways, and incorporate features of the environment and nonbiological tools. Perceptual learning refers to enduring changes to a system’s ability to perceive and respond to environmental stimuli. Here I present an integrative framework for understanding how such capabilities occur in human–machine systems comprising brain–body–tool–environment interactions. Central to this work is the claim that the capacity for high degrees of adaptation, flexibility, and learning are possible because human–machine systems are soft-assembled systems, that is, systems whose material constitution is not rigidly constrained so as to achieve goals via a variety of configurations. I begin by presenting the foundations of the framework on offer: the concepts, methods, and theories of ecological psychology; embodied cognition; dynamical systems theory; and machine intelligence. Next, I apply the framework to the case of visually-guided action. I conclude by explaining how this framework provides the explanatory and investigative tools to understand human–machine perceptual systems as soft-assembled systems that span brains-bodies-tools-environments.
Jesus, Trinity, and Creation: Divine Simplicity, the “Real” Relation, and Trinitarian Economy in Dialogue with Robert Jenson
Authors: Platter Jonathan M.
Published: May 2019

In this essay, I engage Robert Jenson ecumenically by offering a reading of his theology that gives appropriate weight to his radical identification of God’s eternal being (immanent life) with God’s historical acts (economy), while also arguing that his arguments have a striking point of contact with the classical denial of a real relation of God to creation. I argue that both positions share a desire to express a radical intimacy between God and creation as well as God’s boundlessness and simplicity. The benefit of this comparative study is that it illuminates potential commonalities between Jenson’s revisionary metaphysics and one aspect of “classical” metaphysics. The recognition of such metaphysical common ground provides opportunity for mutual enrichment.
The “Elliptical” Femoral Prosthesis
Authors: Pipino F. , Molfetta L.
Published: May 2019

The elliptical femoral prosthesis was designed for solving the problem of the relationship between the prosthetic head and the anatomical acetabulum and to minimize the incidence of cotyloiditis, i.e. acetabular wear-protrusion and pain. Long -term clinical tests have been performed using the Cathcart prosthesis, which is the most advanced technological design. Its basic feature lies in the ellipticity of the head and its development was based on the anatomy and biomechanics of the hip: the femoral head is, in fact, naturally elliptical. The acetabulum is a “deformable” structure, the fades lunata being a stress contact and bearing area, whereas the trabecular system of a “gothic arch”, the “sourcil” and the ileum cortical laminae serve as a load distribution and carrying structure. Clinical results have shown a very low percentage of “cotyloiditis” (1-3%), thanks to the optimal relationship between the prosthetic head and the antomical acetabulum, which guarantees improved distribution of the lubrication stresses and nourishment of the articular cartilage.
Magnetic Resonance Imaging in the Treatment of Congenital Dislocation of the Hip in Infants
Authors: Exner G.U. , Haldemann R. , Hodler J. , Schreiber A.
Published: May 2019

In 11 children (aged 4 weeks to 8 months) with congenital dysplasia of the hip and complete dislocations of the femoral head, magnetic resonance imaging was performed after closed reduction. Gradient echo sequences allowing for a short examination time are well suited for imaging of the articular cartilage and documentation of the position of the femoral head. The use of magnetic resonance imaging decreases the risk that incompletely reduced or redislocated hips after closed or open reduction are retained in this position. Magnetic resonance imaging can be recommended for postreduction assessment of congenital dislocation of the hip in infants and may significantly reduce the need for arthrography.
Multiple Revision of Total Hip Arthroplasty
Authors: Surace A. , Mineo G. , Micale C. , Privitera A.M. , Pietrogrande L.
Published: May 2019

The Authors present 85 cases of multiple reimplantation of total hip arthroplasty (THA), analyzing the complex problems connected to this type of intervention, and putting in evidence primary objectives related technical procedures.
Joint Replacement Failure: Error of Inevitable Event
Authors: Mineo G. , Pietrogrande L. , Surace M.
Published: May 2019

It has been a matter of debate as to when a hip prosthesis can be said to have failed. Pain, limp and functional impairment are considered clinical signs of failure while radiolucent lines, subside, bone reabsorption and gross mobilitation are considered radiological sing. But many times, the patients without signs, free of pain and well functioning, show radiological signs of failure and the patients without radiological signs show clinical signs of failure. In the revision of 613 hip arthroplasties performed since 1983, the authors have pointed out 19 failures of their patients and 36 failures of the implants done in other hospitals. Moreover, they have observed on 15 cases radiological signs of failure without clinical sings.
The Continuing Development of Vibration Arthrometry as a Screening Method in Developmental Dysplasia of the Hip
Authors: Kernohan W. G. , Trainor B. , Haugh P. , Johnston A. , Turner I. , Mollan R.A.B.
Published: May 2019

As part of the continuing development of a non-invasive, objective screening method to achieve efficient early detection of developmental dysplasia of the hip (DDH), we determined the diagnostic sensitivity of an experienced nurse examiner and vibration arthrometry in the range of pathological anatomy of the disease. A cohort of 25 children were studied prior to commencement of their treatment. The hips were classified into four categories by an experienced paediatric orthopaedic surgeon with all diagnostic modalities available (“normal”, “stable but dysplastic”, “unstable and reducible” or “irreducible”). Of the 28 hips identified as abnormal, two hips were classified as stabledysplastic, 11 were unstable/reducible and 15 were irreducible hips. The experienced nurse examiner identified eight out of 11 unstable-reducible hips and reported clinical signs of abnormality in another 18 cases. Vibration arthrometry identified nine out of 11 unstable-reducible dislocations and detected abnormal signals from three irreducible hips. Vibration arthrometry may be of value in detecting abnormality in unstable-reducible and clicking hips. The low detection rate in the irreducible and dysplastic hips by vibration arthrometry was due to the absence of detectable vibration from mechanical events as the hips were manoeuvred. Examination by an experienced clinical examiner continues to be necessary if all degrees of mechanical abnormality in DDH are to be detected. Further development is required to achieve an objective non-invasive system of detecting all stages in the pathology of DDH.
Acetabular Growth Potential in the Dysplastic and Normal Hip. A Long-Term Follow-Up
Authors: Specchiulli F. , Scialpi L. , Solafino G. , Battelli L. , Nitti L.
Published: May 2019

In CHD (Congenital Hip Dislocation), the elements which determine the degree and quality of acetabular growth are not clear. This has caused a great deal of controversy on the capability of development of the cotyloid cavity, hence on the indications to reconstructive surgical treatment.

In order to study the behavior of che cotyloid cavity, two groups of patients were taken into consideration: normal subjects and subjects with CHD.

In normal subjects the median value of the Hingelreiner angle was 19°–4'± 1° (normal limit), at 1 year old. The acetabular index decreases rapidly until becoming stable at adult values at the age of 8-10 years of age.

The distinctive characteristics of the hip with spontaneous recovery from cotyloid dysplasia could be defined as follows:

a) the higher critical value on average is reached after 24 months of treatment;

b) once the borderline is reached, the dislocated hip evolves in the same way as the healthy hip;

c) the earlier treatment is started, the sooner correction of the H angle is obtained;

d) the cotyloid cavity continues to develop even after 5 years from reduction.

In CHD with terminal residual dysplasia, an initial correction of the H angle is followed by a sudden interruption in acetabular development, which remains inadequate and will never reach normal values.

These data allow not only the definition of the acetabular growth potential, but also the establishment of more precise indications for reconstructive surgical treatment.
Factors Affecting the Design of the Head and Neck Segment of a Contemporary Total Hip Prosthesis
Authors: Zicat B. , Kukita Y. , Grandia S. , Engh C.
Published: May 2019

Anthropometric investigation of femoral sizes and femoral pelvic relationships was performed in a group of unilateral total hip arthroplasty patients. Standardized radiographs were used to perform the measurements. The non-operated, contralateral side was used as a standard for endosteal anatomy and the normal femoral pelvic relationship. Analysis of endosteal shape reveals a spectrum ranging from the stovepipe shape of the aged bone that has undergone diaphyseal expansion, to the trumpet shaped proximal femur found in younger patients. There is also a relationship between this shape and the relative varus or valgus position of the head and neck of the femur. Implants can be designed with head and neck geometry corresponding to these relationships. These implants would reconstruct normal anatomy more accurately. Cementless, acetabula placed in a more medial and proximal position should be matched to femoral components with longer neck-length options than cemented acetabular components.
Clinical Results and Radiologic Findings Four to Eight Years after Total Hip Replacement with the Link RS Endoprosthesis System
Authors: Savilahti S. , Myllyneva I. , Pajamäki K.J.J. , Nevalainen J. , Lindholm T.S.
Published: May 2019

A total of 102 uncemented Link Rippen System (RS) total hip prostheses were implanted in 100 patients whose mean age was 57 years. The Merle d'Aubigné hip score was 9.3 preoperatively and 15.3 at the latest follow-up. The thigh was painful in 56 per cent; 5 per cent had moderate or severe pain. Forty-five per cent of patients had a slight limp and 9 per cent a severe limp at the most recent follow-up. Fifteen per cent still needed a cane.

A Kaplan-Meier survivorship analysis revealed a 74 per cent probability of survival at 6 years.

Serial radiographic evaluations revealed that 16 per cent of patients (non-revised hips) had acetabular component migration, 10 per cent had continuous femoral radiolucen-cies, 14 per cent had subsidence and 31 per cent progressive varus migration.
Does Acute Urinary Retention after Total Joint Replacement Predispose to Deep Vein Thrombosis?
Authors: Murray D.W. , Gibbons C.L.M.H. , Gregg-Smith S.J.
Published: May 2019

Deep vein thrombosis (DVT) and acute urinary retention are both common complications of total hip replacement. Previous experimental studies have demonstrated that bladder distension obstructs the iliac veins causing a decrease in venous outflow from the legs, and that after hip replacement a decrease in venous outflow is associated with the development of DVT. This suggests that acute urinary retention after joint replacement predisposes to DVT and that routine catheterisation would reduce the risk of DVT.

The aim of the study was to determine, using strain gauge venous plethysmography, whether acute urinary retention after joint replacement causes a decrease in venous outflow from the legs. It was found that acute retention did not significantly alter the venous outflow. We therefore conclude that acute urinary retention after joint replacement does not predispose to DVT.
Peritrochanteric Fractures of the Femur: A Comparison between the Ender Nail, Gamma Nail and Dynamic Hip Screw
Authors: De Pedro J.A. , Rey J. , Lopez-Casero R. , Perez-Cab Aller A.J. , Dominguez I , Duran L. , Hurtado J. , Lopez-Duran L.
Published: May 2019

Surgical fixation, early weight-bearing, and bony union remain a challenge in the treatment of peritrochanteric femur fractures, especially if the fractures are comminuted or unstable. A randomized prospective study of 154 fractures treated by either the Gamma nail (43), Dynamic Hip Screw (DHS) (30) or Ender's nail (81) is reported. The average follow-up for Ender's nails was 36.7 months; for DHS 39.4 months and for Gamma nails 37.3 months. The Ender's nails required a significantly (p<0.001) shorter operation time of 42±13.4 min. The Gamma nail group required a higher mean duration of screening, 193±92 sec. Few screws in either group were in a bad position, but 12 (32%), in the Gamma nail group, and 2 (10%) in the DHS were placed superiorly in the head. From this experience, the Gamma nail appears to allow for early patient ambulation regardless of the fracture configuration with good clinical results, but the potential advantages of the Gamma nail are still unclear in these already compromised patients.
Cup Deformation during total Hip Replacement: A Brief Report
Authors: Wise D.I. , Calder S.J. , Derbyshire B.
Published: May 2019

Cup deformation is demonstrated to be significantly greater using an 8 mm than a 22 mm pusher. Deformation may lead to increased polyethylene wear and late prosthetic failure. Use of a 22 mm pusher is recommended in Charnley total hip replacement.
Extrapelvic Compression of the Femoral Nerve: An Uncommon Cause of Hip Pain
Authors: Stalder H. , Romero J. , Dietz V.
Published: May 2019

The case of a patient with short history of unilateral hip pain due to compression of the lumbar plexus by a cyst arising from the hip joint is reported. Radiologically there were only mild signs of osteoarthritis of the affected hip but severe degenerative changes were found in the lumbar spine. There was atrophy of the quadriceps muscle of the affected limb with subsequent giving-way during gait and sensory loss on the lateral aspect of the thigh. The neurological and electromyographical examination suggested compression of the lumbar plexus. By sonography, computerized tomography and contrast radiographs, a finger shaped cyst was identified going from the ventromedial aspect of the hip joint between the iliopsoas, the pectineus, and the iliacus muscles respectively. After excision of the cyst, hip pain ceased and the signs of neural compression disappeared almost completely within 12 weeks. Histologically the specimen showed synovial tissue with cartilaginous debris. In cases of hip pain without sufficient radiological and clinical signs of osteoarthritis, femoral nerve compression should be excluded by neurological examination. To our knowledge, this is the first report about compression of the femoral nerve by an isolated extrapelvic cyst arising from the hip joint.
The Charnley-Hastings Hemiarthroplasty for Fractures of the Femoral Neck with Special Reference to Complications
Authors: Bengtson S. , Olsson C.
Published: May 2019

We report a retrospective study of the incidence of major complications following Charnley-Hastings bipolar hemiarthroplasty in 117 patients with 120 fractures of the femoral neck. Primary hemiarthroplasty (n=40) was used for irreducible or old fractures and secondary hemiarthroplasty (n=80) for fractures with disturbed healing. The mean age was 80 (54-95) years. The mean follow-up was 34 (0-149) months. There was no major complication in 87.2 percent. Mortality was 10.3 percent after 6 months and 13.7 percent after one year. Dislocation occurred in 7.5 percent, prosthetic loosening in 4.2 percent, acetabular fracture and deep infection in 0.8 percent respectively. Reoperation was required in 7.5 percent: open reduction after dislocation (2.5 percent), conversion to a Charnley total hip arthroplasty (3.3 percent), Girdlestone arthroplasty (0.8 percent) and exchange of a loose femoral component (0.8 percent). We conclude that the selective use of bipolar hemiarthroplasty for fractures of the femoral neck carries few major complications. Patient selection must be strict in order to reduce the risk of dislocation.
Blood Loss and Visibility with Esmolol vs Labetalol in Endoscopic Sinus Surgery: A Randomized Clinical Trial
Authors: Lavere Philip F , Rana Nikunj A , Kinsky Michael P , Funston J Sean , Mohamed Sharif S , Chaaban Mohamad R
Published: May 2019

Objectives:

Improved intraoperative visibility during functional endoscopic sinus surgery (FESS) decreases the risk of serious orbital or skull base injuries. Esmolol and labetalol have been used to reduce bleeding and achieve better visibility, but it remains unclear which drug is more effective. This study aims to measure visibility scores and mucosal bleeding rates for esmolol and labetalol in FESS.

Methods:

This is a 1-year randomized double-blind trial of adults undergoing FESS at a tertiary academic center. The inclusion criteria were as follows: age 18 or older; history of chronic rhinosinusitis (CRS) with or without nasal polyps; undergoing FESS for CRS; and American Society of Anesthesiologists (ASA) physical status 1 (healthy) or 2 (patient with mild systemic disease). The exclusion criteria were as follows: pregnancy; asthma, chronic obstructive pulmonary disease (COPD), bradycardia, heart failure, end-stage renal disease, cerebrovascular accident, diabetes mellitus; preoperative use of nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or beta-blockers; and body mass index (BMI) greater than 40 kg/m2. Patients received either dose-infused esmolol or intravenous push labetalol. The primary outcome was intraoperative visibility determined by surgeon using validated scoring systems (Boezaart, Wormald). The secondary outcome was hemodynamic control (rate of blood loss, average mean arterial pressure [MAP], average heart rate [HR]). Hypothesis of no difference between drugs formed before data collection.

Results:

Of the 32 adults given drug (mean age = 50), 28 patients (13 esmolol and 15 labetalol) with complete data were included in the final analysis. There were no statistically significant differences between esmolol and labetalol in rate of blood loss (0.59 [0.28] vs 0.66 [0.37] mL/min, P = 0.62), average MAP (79.7 [7.5] vs 79.4 [7.7] mm Hg, P = .93), HR (72 [8.7] vs 68 [11.7] bpm, P = .26), or mean visibility scores for the Boezaart (3.1 [0.69] vs 3.1 [0.89], P = .85) and Wormald (6.1 [1.7] vs 5.9 [1.9], P = .72) grading scales.

Conclusions:

There were no significant differences between esmolol and labetalol in rate of blood loss, MAP control, HR, or surgical visibility in FESS. Either drug may be used, and other considerations (availability, cost) can dictate choice.
Assessment of the scientific rigour of randomized controlled trials on the effectiveness of cognitive behavioural therapy and graded exercise therapy for patients with myalgic encephalomyelitis/chronic fatigue syndrome: A systematic review
Authors: Ahmed SA , Mewes JC , Vrijhoef HJM
Published: May 2019

Cognitive behavioural therapy and graded exercise therapy have been promoted as effective treatments for patients with myalgic encephalomyelitis/chronic fatigue syndrome. However, criticism on the scientific rigour of these studies has been raised. This review assessed the methodological quality of studies on the effectiveness of cognitive behavioural therapy and graded exercise therapy. The methodological quality of the 18 included studies was found to be relatively low, as bias was prominently found, affecting the main outcome measures of the studies (fatigue, physical functioning and functional impairment/status). Future research should focus on including more objective outcome measures in a well-defined patient population.
The Internet and political (in)equality in the Arab world: A multi-country study of the relationship between Internet news use, press freedom, and protest participation
Authors: Ahmed Saifuddin , Cho Jaeho
Published: May 2019

This study investigates the role of the Internet in protest participation in the Arab world. More specifically, we aim to address three important questions: (1) Does Internet news use increase the chances of protest participation? (2) Does Internet news use amplify or reduce participation gaps that exist among individuals at various socioeconomic strata? (3) How does a country’s press freedom act as a contextual factor to shape the role of the Internet in affecting protest participation gaps? The results based on an analysis of the third wave of Arab Democracy Barometer survey suggest that Internet news use for political purposes increases the likelihood of protest participation in the Arab world while it also deepens socioeconomic stratification in participation. Furthermore, national press freedom shapes the intervening role of the Internet. We discuss the theoretical implications of these findings for political inequality literature and the practical consequences for the Arab world.
Revisiting leadership in information and communication technology (ICT)-enabled activism: A study of Egypt’s grassroots human rights groups
Authors: Azer Evronia , Harindranath G , Zheng Yingqin
Published: May 2019

Scholars argue that contemporary movements in the age of social media are leaderless and self-organised. However, the concept of connective leadership has been put forward to highlight the need for movements to have figures who connect entities together. This study conducts a qualitative research of 30 interviews of human rights groups in the 2011 Egyptian revolution to address the question of how leadership is performed in information and communication technology–enabled activism. The article reconceptualises connective leadership as decentred, emergent and collectively performed, and provides a broader and richer account of leaders’ roles, characteristics and challenges.
#EndMaleGuardianship: Women’s rights, social media and the Arab public sphere
Authors: Thorsen Einar , Sreedharan Chindu
Published: May 2019

This study examines the online communicative dynamics between women and men during the Saudi women’s rights campaign to end male guardianship, which unfolded on Twitter. We analysed 2.7 million tweets with the #EndMaleGuardianship hashtag over a 7-month period quantitatively and 150,245 of these qualitatively to examine the extent to which Twitter shapes and facilitates cross-gender communication, and how this helped engender new spaces for expression of dissent. Our study shows that Twitter provided shared online communicative spaces that had several characteristics commonly associated with public sphere(s). There is also evidence that using these alternatives spaces, women transcended to an extent the gender segregation that exists in traditional public discourses and spaces of Saudi society. The anonymity of Twitter offered women a safe place to deliberate their concerns about male guardianship. We suggest that these deliberations created a counterpublic sphere of sorts, which helped Saudi women legitimise the #EndMaleGuardianship campaign.
The demographic impact of consumer green purchase intention toward Green Hotel Selection in China
Authors: Wang Lei , Wong Philip PW , Narayanan Elangkovan A
Published: May 2019

While there have been many prior studies examining the impact of the demographic characteristics of consumers’ green purchase attitudes and behavioral intention, results have, by no means, been conclusive. Furthermore, little attention has been paid to the green hotel industry in such studies. The purpose of this study is, therefore, to examine the relationship between age, gender, education, income, green purchase attitudes, and green behavioral intention toward green hotel selection. This study proposes a theoretical research model based on the theory of reasoned action and theory of planned behavior model. About 659 valid questionnaires were employed to empirically test the hypotheses using SPSS. The results imply that there is a significant positive relationship between green purchase attitudes and green behavioral intention. Age and income are shown to both significantly influence green purchase attitudes, while education and income both significantly influence green behavioral intention. Notably, results show that there is also a significant difference between male and female influenced green purchase attitudes and green behavioral intention. This paper concludes with a thorough discussion of the practical and academic implications as well as limitations of these results.
International tax competition and justice: The case for global minimum tax rates
Authors: Cassee Andreas
Published: May 2019

International tax competition undermines states’ capacity for redistributive taxation. It is thus problematic from the point of view of both cosmopolitan and internationalist theories of justice. This article examines the proposal of a fiscal policy constraint that prohibits tax policies if they are strategically motivated and harmful to effective fiscal self-determination internationally. I argue that we should opt for a more robust, preference-independent mechanism to prevent harmful tax competition instead. States should, as a matter of justice, accept global minimum tax rates on mobile tax bases.
Cultural factors and the circadian rhythm of ST elevation myocardial infarction in patients in a Mediterranean island
Authors: Protopapas Andreas , Lambrinou Ekaterini
Published: May 2019

Introduction:

The circadian rhythm of onset of myocardial infarction shows an increased risk during the morning hours. However, it is not clear whether habits, culture and sunshine hours differentiate circadian rhythm. The aim of this study was to investigate the influence of cultural factors on the circadian rhythm of acute myocardial infarction with ST segment elevation in a Mediterranean island.

Method:

The study was a retrospective correlational survey. It included 123 patients with ST elevation myocardial infarction (mean age 60.7±12.6; 82% men). The 24 h of a day were divided into four six-hour periods of time for study purposes (00:01–06:00; 06:01–12:00; 12:01–18:00; and 18:01–24:00) and the chi-square test was used for the analysis.

Results:

A morning peak of symptoms onset of ST-elevation myocardial infarction was detected during the period 06:01–12:00 ( p=0.044). In patients who were smokers, a bimodal pattern involving a morning (06:01 –12:00) and an afternoon-to-night peak (18:01–24:00) ( p=0.005) was detected. For patients with a history of hypertension, a morning peak of their symptoms was also detected ( p=0.028). Different circadian variations were found between patients over the age of 60 years old and patients under the age of 60 years old ( p=0.025).

Conclusions:

Patients with ST elevation myocardial infarction seem to follow a circadian rhythm with a peak of onset of symptoms in the morning. In the smokers’ subgroup, a different circadian pattern was found. The habit of smoking is likely to affect the circadian rhythm of the onset of ST elevation myocardial infarction in the Mediterranean area and culture.
Transfer Student Resources: Keeping Students Once They Enroll
Authors: Daddona Mark F. , Mondie-Milner Celena , Goodson Jonathon
Published: May 2019

This descriptive study explored campus resources used by transfer students to understand ways institutions can better help them persist to graduation. Completed surveys from 257 transfer students indicated a number of programs and services that met this aim. The top three programs and services used at the current institution were the Computer Support Center, Career Services, and University Health Services. Recommended services included transfer programs, child care on campus, help with the transfer process, and advising. Themes students indicated that could help them graduate related to scheduling classes, personal life situations, enrolling in more credit hours, acceptance of more transfer credits, financial resources, advising, and offering transfer programs or workshops or support or activities. Implications and recommendation for institutions are also discussed.
Enhancing Transformation: The Value of Applying Narrative Therapy Techniques When Engaging in Critical Reflection
Authors: Edwards Thomas Mark , Walker Michael
Published: May 2019

Transformative learning (TL) is a powerful approach to education. Instead of promoting the efficient encoding and recall of information, TL has students identify, and consider, the assumptions they hold about their discipline and the wider world. Although disorientating dilemmas are the hallmark of TL, personal change cannot happen without subsequent critical reflection. For this reason, critical reflection represents the central mechanism of transformation. The current article identifies synergies between TL and narrative therapy (NT) valuable for the enhancement of critical reflection. In particular, the advantages of NT techniques such as externalisation, outsider witness, and identifying the absent but implicit within a story are discussed. By integrating NT practices within critical reflection it is hoped that a greater degree of transformation will result for students.