bluuebunny/crossref_metadata_2025 huggingface dataset:
Does intravenous patient-controlled analgesia or continuous block prevent rebound pain following infraclavicular brachial plexus block after distal radius fracture fixation? A prospective randomized controlled trial
Authors: Lee Jong-hyuk , Kim Ha-jung , Kim Jae Kwang , Cheon Sungjoo , Shin Young Ho
Published: April 2023

Background: The purpose of this study was to investigate the role of opioid-based intravenous patient-controlled analgesia (IV PCA) or continuous brachial plexus block (BPB) in controlling rebound pain after distal radius fracture (DRF) fixation under BPB as well as total opioid consumption. Methods: A total of 66 patients undergoing surgical treatment for a displaced DRF with volar plate fixation were randomized to receive a single infraclavicular BPB (BPB only group) (n = 22), a single infraclavicular BPB with IV PCA (IV PCA group) (n = 22), or a single infraclavicular BPB with continuous infraclavicular BPB (continuous block group) (n = 22). The visual analog scale (VAS) for pain and the amount of pain medication were recorded at 4, 6, 9, 12, 24, and 48 h and two weeks postoperatively. Results: At postoperative 9 h, the pain VAS score was significantly higher in the BPB only group (median: 2; Q1, Q3 [1, 3]) than in the IV PCA (0 [0, 1.8], P = 0.006) and continuous block groups (0 [0, 0.5], P = 0.009). At postoperative 12 h, the pain VAS score was significantly higher in the BPB only group (3 [3, 4]) than in the continuous block group (0.5 [0, 3], P = 0.004). The total opioid equivalent consumption (OEC) was significantly higher in the IV PCA group (350.3 [282.1, 461.3]) than in the BPB only group (37.5 [22.5, 75], P < 0.001) and continuous block group (30 [15, 75], P < 0.001); however, OEC was not significantly different between the BPB only group and the continuous block group (P = 0.595).Conclusions: Although continuous infraclavicular BPB did not reduce total opioid consumption compared to BPB only, this method is effective for controlling rebound pain at postoperative 9 and 12 h following DRF fixation under BPB.
The Vowel Processing Skills of ESL Learners Related to their English Spelling Difficulties: A Psycholinguistic Approach
Authors: Seeff Belinda , Jordaan Reila
Published: April 2023

The purpose of this study was to explore the input speech processing difficulties of English Second Language (ESL) learners who experience English spelling difficulties in English First Language (EFL) educational environments. Twenty two adolescent ESL learners participated in this study. A spelling task was designed to assess the subjects' spelling abilities related to words containing four vowel contrasts of native (L1) and non-native (L2) vowels. A psycholinguistic framework was adhered to when assessing the subjects' auditory discrimination and phonological representations at the input level of speech processing. The spelling abilities of the ESL learners were found to be strongly correlated with their input processing of L1 and L2 vowels. An increased length of exposure was found to have a positive effect on their spelling and input processing skills. Subjects who had been exposed to EFL environments for more than two years were able to use their semantic knowledge of English to assist their auditory discrimination of real-word minimal pairs containing L1 and L2 vowels. Implications for the management of ESL English spelling difficulties are discussed.
Cultural Narratives: Bridging the gap. Educating Speech-language Pathologists to Work in Multicultural Populations
Authors: Penn Claire
Published: April 2023

Preparation of the clinician to work in multicultural contexts involves the identification of a range of skills, knowledge and values. The field of narrative medicine as well as an increased understanding of the dynamics of interpreting are areas which can add considerably to clinical effectiveness. The paper outlines some cornerstones of narrative medicine and their potential application to the field of speech-language pathology and audiology. An analysis of the dynamics of a mediated interview yields a series of suggestions for the clinician. Some proposals are offered for future training and clinical practice in South Africa.
Effects of PM2.5 on zebrafish embryonic development
Authors: Jie Sheng , Jianlin Cui , Peng Chen
Published: April 2023

Background and Objectives: Particulate matter 2.5 (PM2.5) has been recognized as an important factor which may cause human respiratory tract related cancer and affect the growth of embryos. In this experiment, the toxicity of PM2.5 on zebrafish's embryos was explored. Methods: Zebrafish animal models were used in the experiment. The zebrafish embryos were exposed to PM2.5 solution of different concentrations, and the aggregation rate, the hatching rate and the malformation rate as the changes in the concentration of PM2.5 were observed. Result: The results showed that when the concentration of PM2.5 was 0-250 μg/L, it had no significant effect (P > 0.05) on the embryo aggregation rate, the hatching rate or the malformation rate. When the concentration of PM2.5 was 500-2500 μg/L, it had a significant effect (P < 0.05) on the embryo aggregation rate, the hatching rate and the malformation rate, and PM2.5 concentration was positively correlated with the embryo aggregation rate, but negatively correlated with the embryo hatching rate. Conclusion: The experiment shows PM2.5 has clear toxic effects on zebrafish embryos, which may provide a basis for further research on PM2.5 pathogenesis.
A questionnaire survey of stigma related to human immunodeficiency virus infection/acquired immunodeficiency syndrome among healthy population
Authors: Meha Jain , Reema Sinha , Sujita Kumar Kar , Mamta Yadav
Published: April 2023

Background and Objectives: Human immunodeficiency virus (HIV)-related stigma is present at all levels which act as critical barriers for effectively addressing it. This also influences the treatment uptake and under or nonparticipation in treatment available. In view of this, the present study was aimed to assess the stigma of otherwise healthy individuals of the community toward HIV infection/acquired immunodeficiency syndrome (AIDS). Methods: The study was conducted on 100 healthy individuals. Their responses were taken on a self-designed semi-structured questionnaire. Results: The results showed that there is more perceived stigma as compared to enacted stigma. Nearly 46% of the individuals feel that HIV-infected persons should be blamed for their illness and 41% individuals feel that they will feel ashamed if they have HIV. It was also seen that older adults. (between 46 and 55 years) had more stigma as compared to the younger adults (between 16 and 25 years). The educated individuals still have stigma to a certain extent. Most of the individuals would like to tell their partner if they were diagnosed with HIV. Participants were divided into two groups on the basis of their level of education. (<12 years of formal education and >12 years of formal education). Stigma related to HIV/AIDS was compared among these two groups, and there was no significant difference in the level of stigma in these distinctly different educational groups. Conclusion: There is still stigma present to a certain extent in the society in the educated and urban individuals. Level of stigma may not be significantly different in people with educational difference. Stigma needs to be addressed for prevention and better management of HIV/AIDS.
Study of Socio-economic, Biochemical and Clinical Predictors of Alcohol Withdrawal and Delirium Tremens in Patients of Alcohol Dependence in Indian Population
Authors: Nagda Parth , Harshe Devavrat , Halder Ankit , Ravindran Navna Panchami
Published: April 2023

Background:

Alcohol withdrawal syndrome (AWS) is associated with morbidity and mortality. Assessment of factors affecting AWS will help in early diagnosis and initiation of appropriate treatment, hence improving the prognosis.

Aim:

The present study was conceived and planned to assess the socioeconomic, biochemical, and clinical predictors of alcohol withdrawal and delirium tremens with alcohol dependence patients in the Indian population. Study Design: Longitudinal study.

Methodology:

The study includes 100 patients admitted for alcohol withdrawal. Participants were assessed for detailed history, physical and mental state examination, CAGE scale (Cut down, Annoyed, Guilty, Eye-opener), AUDIT scale (Alcohol Use Disorders Identification Test), PAWSS scale (Prediction of Alcohol withdrawal severity Score), MINIPLUS (Mini-International Neuropsychiatric Interview) scale and CIWA scale (Clinical Institute withdrawal Assessment of Alcohol) scoring along-with biochemical and hematological investigations. Statistical analysis was done by using SPSS version 20.

Results:

Mean age of the patients observed was 33.91 years (19-70 years). A significant association between increase of mean corpuscular volume (MCV) and total bilirubin levels (P= 0.208); highly significant association between low platelet counts, low potassium levels, serum glutamic pyruvic transaminase (SGPT), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP) and the development of delirium tremens and severity of alcohol withdrawal was observed (P<0.05). CAGE (P<0.014), AUDIT (P<0.001), and CIWA scores has significant association (P<0.001) with development of delirium and PAWSS showed good prediction (P<0.007) with patients having severe alcohol withdrawal.

Conclusion:

Our study recommends that socioeconomic and biochemical factors and predictors can be considered for early diagnosis of severity of alcohol withdrawal and delirium tremens.
Verrucous disseminated discoid lupus erythematosus with oral and palmoplantar lesions treated with hydroxychloroquine
Authors: Nandwani Subhor , Kar Sumit , Patrick Safa , Gangane Nitin , Deshmukh Abhay Vilas
Published: April 2023

Lupus erythematosus (LE) is an autoimmune inflammatory disease with a wide spectrum of cutaneous and systemic manifestations. A unifying concept of this disease is difficult to develop as clinical features of patients with LE show a great variation. Our objective was to present a case of verrucous disseminated discoid lupus erythematosus (DLE) with atypical morphology, extensive involvement, and having oral and palmoplantar lesions. For confirmation of diagnosis, histopathology was done, which showed characteristic findings of DLE. Combination therapy of hydroxychloroquine with oral and topical corticosteroids resulted in resolution of skin lesions. Sometimes, DLE lesions may pose a diagnostic and therapeutic challenge, especially in a case of unusual presentation, as in the given case of hypertrophic LE. These cases require adequate therapy with clinical and histopathological follow-up considering that squamous cell carcinoma may arise in long-standing lesions.
Assessment of serum interleukin-13 level in vitiligo patients and its correlation to disease severity
Authors: Tawfik Noha Z. , Abd Elhamid Marwa A. , Omar Hanan H. , Gomaa Amal H.A.
Published: April 2023

Background

Vitiligo is a chronic depigmenting skin disease that has a prevalence of 0.5–2% of the population worldwide. Cytokines have a regulatory role in the immune response and depigmentation process in vitiligo. There is an imbalance of various types of cytokines in vitiligo patients. Interleukin-13 (IL-13) plays a role in many autoimmune diseases.

Objective

To measure the serum level of IL-13 in vitiligo patients and detect its correlation with disease severity.

Patients and methods

This is a case–control study including 20 randomly chosen patients with nonsegmental vitiligo and 20 healthy controls. Vitiligo disease activity score was assessed in all patients. Serum level of IL-13 was measured by enzyme-linked immunosorbent assay.

Results

This study revealed that the mean serum level of IL-13 was significantly higher in vitiligo patients, and there was negative correlation between serum level of IL-13 and vitiligo extent score but not statistically significant.

Conclusion

IL-13 might have a role in the pathogenesis of vitiligo and might play a protective role in the disease. Further large-scale studies are needed to confirm the definite role of IL-13 in vitiligo pathogenesis.
Deformity Correction with the iFIXation System
Authors: Elbatrawy Yasser , Khaled Mohamed , Hassanein Mohamed Yahya , Agovic Ehlimana , Bazdar Elvir
Published: April 2023

The technology of computer-assisted six-axis frames is rapidly evolving. In this case report, we describe two cases of pediatric lower limb deformities treated by a novel hexapod device, the iFIXation system. For our knowledge, this is the first report in literature for its usage. The first case was a 14-years-old girl with posttraumatic shortening, varus and external rotation deformities of her lower limb around the ankle. All the deformities and shortening were corrected simultaneously with the iFIXation system. The second case was an 8-years-old girl with postinfection valgus and external rotation of the knee as well as shortening of the femur. Distal femoral deformities and shortening were simultaneously corrected by the iFIXation system and growth modulation to prevent recurrence of the deformity was done. The reported cases represent our earliest experience with the iFIXation system.
Femur Deformity Correction Planning in Sagittal Plane Using Mechanical Axis
Authors: Vilenskiy Victor A. , Solomin Leonid Nikolaevich , Utekhin Alexander Igorevitch
Published: April 2023

Recently, deformity correction planning using reference lines and angles is a standard procedure. At the same time, both anatomical and mechanical axes are used for the frontal plane. However, until nowadays, there was no algorithm for planning femoral deformity correction in the sagittal plane based on the mechanical axes of the bone fragments. The aim of this study was to develop a method of femur deformity correction planning in the sagittal plane based on mechanical axes.

Materials and Methods:

On the basis of computer tomography data of 23 adults with nondeformed femurs, we measured the angular relationships between the anatomical axis of the proximal femur in sagittal plane and mechanical axis (∠maj) and the angular relationships between the femoral neck axis and mechanical axis in sagittal plane (∠laj).

Results:

It was found that ∠maj was 16.0° ±7.6°, and ∠laj was 10.2° ±2.4°. Based on the data obtained, we developed a method for planning the correction of femoral deformities in the sagittal plane. According to this method, the mechanical axis of the proximal bone fragment can be determined using any of three options: (1) “Joint line based.” In this method, the proximal joint line of the femur is drawn, then from the center of the femur head with the angle 85° (mean value of mPPFA) to this line is drawn a line that is mechanical axis; (2) “Femoral neck based.” The neck axis is drawn first, then from the center of the femur head with the angle 16° (mean value ∠maj) to this line is drawn a line that is mechanical axis; and (3) “Anatomical axis based.” First, the anatomical axis of the proximal femur is drawn, then a line parallel to the anatomical axis from the center of the femoral head is drawn, then a line at an angle of 10° (mean value ∠laj) to it is drawn, that is the mechanical axis. Determination of the mechanical axis of the distal fragment in sagittal plane is made by the following: the distal joint line is drawn and divided into five equal segments. Then, the point located on the border of the front 2/5 and the rear 3/5 of the segment is found. From that point, at an angle of 81° (mean mPDFA), a mechanical axis of the distal femur fragment is drawn. The intersection of the mechanical axes of the proximal and distal fragments defines the apex of the deformity.

Conclusion:

The proposed method for planning deformity correction based on mechanical axes for the sagittal plane complements the existing planning methods for the frontal plane and improves the quality, namely the accuracy of preoperative planning.
Risk Factors for Focal Osteolysis in a Stainless-Steel Limb-Lengthening Device
Authors: Sax Oliver Charles , Conway Janet D. , Standard Shawn C. , Assayag Michael , Herzenberg John E. , McClure Philip Kraus
Published: April 2023

Background:

Magnetic, telescoping intramedullary lengthening devices are widely used for treatment of limb length discrepancies. However, a routine radiographic review of a stainless-steel device demonstrated soft tissue and bony changes suggestive of osteolysis. Therefore, we sought to examine all patients implanted with a stainless-steel limb-lengthening nail. We specifically asked: (1) what is the incidence of periosteal reaction osteolysis? (2) Is a new biologic reaction classification system valid and reliable? and (3) Are there predictive factors for the development of osteolysis? We hypothesized that higher patient weight and femoral insertion would be risk factors for lysis, due to increased bending moments on the implants.

Materials and Methods:

A retrospective review of all patients implanted with a stainless-steel limb-lengthening nail between December 2018 and December 2020 was conducted at a single institution. A total of 57 nails in 44 patients were radiographically examined with an average follow-up of 6.2 months (range: 1–21 months). The incidence of osteolysis was calculated through review of patient radiographs. These were then classified according to a novel system by five fellowship-trained orthopedic surgeons with agreement assessed using an intraclass correlation coefficient (ICC). Logistic regression measured predictive factors for this phenomenon. A separate histologic analysis of two bone/soft-tissue biopsies at the time of routine explantation was conducted by an independent pathologist.

Results:

The incidence of periosteal reaction and osteolysis was 36.8% and 17.5%, respectively. Nails with progression to osteolysis increased to 34.6% (9/26) when examining nails with at least a 6-month follow-up. ICC testing yielded good inter-rater agreement for the novel classification system (average measure: 0.860, 95% confidence interval 0.828–0.888). Age >16 years (P = 0.024) and body weight >150 pounds (P = 0.038) were predictors of osteolysis. Histologic analysis of the biopsies demonstrated an abundance of particulate debris suggestive of chromium reaction.

Conclusions:

The modular junction of a stainless-steel lengthening device is susceptible to osteolytic changes, and this appears to be associated with increased age and weight. This phenomenon has an apparent time dependence: osteolysis increases with greater follow-up.
Limb Lengthening of a Rare Case of Congenital Femoral Deficiency with an Unstable Knee
Authors: Marta Ricardo , Campos Armando , Oliveira António , Carvalho João
Published: April 2023

Congenital femoral deficiency (CFD) is a rare birth defect that is characterized by a short femur, associated with hip and knee deformity, deficiency, or instability. Children with severe CFD may need multiple deformity correction or lengthening procedures to reduce axial malalignment and limb length discrepancy (LLD). During limb lengthening, it can occur knee subluxation or dislocation, a severe treatment-related complication. We report a 15-year-old girl with a CFD with a previous episode of posterior subluxation of the knee during a femoral lengthening using a monolateral external fixator. She had a 13 cm LLD and coxa vara; therefore, it was applied a knee spanning Ilizarov fixator with a double osteotomy of the femur for gradual correction. At 11 months following Ilizarov application, a complete correction was achieved, and the circular fixator was removed. Knee joints of patients with CFD show highly variable grades of instability. Adequate surgical techniques, preventive measures, and early detection of signs of subluxation can lead to good functional results. Femur lengthening with a preventive bridging of the knee with an Ilizarov frame is a safe and effective way of treating patients with CFD.
Multicentre Review of Intramedullary Lengthening Nails
Authors: Harrison William D. , Laubscher Maritz , Saifi Saleh Al , Abdelaziz Ahmed , Barnard Annette-Christi , Birkholtz Franz , Ferreira Nando
Published: April 2023

Background:

Lengthening nails (ILN) are an established method of limb reconstruction for leg length discrepancy (LLD). Literature on these nails is predominantly from developed countries, with more accessible resources for the procurement of devices and post-operative therapies. This paper aims to present the results and lessons learned from four tertiary level limb reconstruction units working within two middle-income countries (MIC).

Methods:

Ethical approval was obtained from all four units. All ILN (PRECICE II, NuVasive, USA) undertaken between 2013 and 2020 were included. Demographics, etiology, surgical approach, and information about the planned versus achieved correction were compared. Data on time to consolidation and complications were recorded with a 12-month minimum follow-up. Complications were classified according to the Black et al. criteria.

Results:

Sixty limb segments lengthened in 56 patients, of which 46 were femora, 12 tibiae and two humeri. Etiology of LLD was predominately posttraumatic (33%), congenital (26%), and growth plate injuries (22%). Mean distraction length was 46 mm (20–90 mm). Fifty-four segments (90%) had <5 mm discrepancy of planned distraction lengths. Mean healing index was 34.6 days/cm (range: 18–180 days/cm). Thirteen patients experienced complications, of which ten required further surgery.

Conclusion:

The findings of our work support the use of intramedullary ILN in MIC with equivalent complication rates and healing indices compared to the literature. Patient compliance and remote geography were not an issue during treatment. The lack of access to weekly rehabilitation therapy did not seem to impact the majority of patients. Reusing nails for extensive LLD cases were safe but should be used with caution.
Acquired Long Bone Defect Classifications of the Diaphysis
Authors: Komarov Artem V. , Semenistyy Anton A. , Sheridan Gerard A. , Rozbruch S. Robert , Solomin Leonid N.
Published: April 2023

Introduction:

The management of acquired long bone defects (LBDs) is a persistent problem in modern orthopedics with few effective solutions. The goal of this review is to conduct a thorough analysis of existing diaphyseal LBD classifications and to identify if any of these may be adopted for universal application in future.

Materials and Methods:

A literature review was performed analyzing articles between 1970 and 2019 on PubMed (English) and CyberLeninka (Russian) databases. All studies developing or utilizing a classification tool were eligible for inclusion. The search retrieved a total of 1032 articles from PubMed, 477 from CyberLennika, and 28 articles from reference lists. Any disagreement regarding the inclusion of articles was resolved by consensus between all authors.

Results:

A total of 18 classifications in the literature underwent analysis. Among the classifications we analyzed, 12 described posttraumatic defects, 6 described osteomyelitis defects or infected nonunions, and 5 described, among other defects, iatrogenic bone. Of the 18 classifications, 12 have a focus on a specific treatment method. We found that consensus exists between most authors regarding the criteria necessary to measure to determine the most appropriate treatment method. These key factors include the size and location of the bone defect.

Conclusion:

This analysis showed that despite the large number of publications devoted to the classification and treatment of LBD, there is still no consensus among authors regarding not only a universal clinical classification but also a general definition of the term “bone defect.” The classification proposed by Solomin et al. is very useful but in its present form, has significant drawbacks and requires further improvement before it can be adopted as a universal classification system for LBDs.
Orthopedic Implant Design from Concept to Final Tested Product
Authors: Pretorius Henry Sean , Ferreira Nando
Published: April 2023

Background:

Orthopedic surgeons are invariably faced with situations where contemporary surgical techniques and implants are not satisfactory for a specific clinical scenario. One such scenario frequently arises around the lack of implant choice for intramedullary fixation of radius and ulna fractures. We will describe our experience designing and testing a new radius and ulna nail, inclusive of protecting the underlying intellectual property.

Design Process:

Phase 1: Identifying a need: Current intramedullary forearm devices have abandoned the ability to place interlocking screws at the nondriving end and are therefore not length stable. As current nails only come in 20 mm length increments, this may pose challenges in attaining accurate anatomical length restoration. Phase 2: Concept: (1) Anatomically designed in terms of length, diameter, and radius of curvature. (2) Nail inventory that has the optimal choice of implants to manage the majority of forearm injuries. (3) Locking system at the nondriving end that is easily targeted and has an acceptable radiation exposure for freehand locking. Phase 3: Anatomical study: Multiplanar reconstruction of upper limb computer tomography angiography scans were used to analyze the forearm osteology of 98 individuals. Primary measurements included the lengths of both radius and ulna shafts, the minimum canal diameter size, the proximal shaft angle of the ulna, and the radius of curvature of the radius. The size of the proximal ulna and distal radius were also measured for design parameters of the nondriving end of the nail. Phase 4A: Prototype design: To improve the usability of these nails, the design priorities were set as: (1) Locking hole design. (2) Jig and instrument design for insertion and removal. (3) Pressure release during insertion. Phase 4B: Prototype testing: Prototype testing consisted of nail insertion into human cadaver forearm bones using the initial prototype and instruments. The design aspects of the implant such as the locking holes with X-ray-assisted screw insertion or the radius of curvature were also evaluated. Mechanical testing will also be done.
Circular External Fixation as an Alternative Method of Stabilization for Extra-articular Tibia Fractures in the Elderly
Authors: Lovisetti Giovanni , Vulcano Ettore , Bettella Lorenzo , Cook Ralph , Sala Francesco , Muelle John D. , Talamonti Tazio
Published: April 2023

Background:

Recent epidemiologic reports from national fracture registries demonstrate an increase in the incidence of tibia fractures in the elderlies. Objectives: the objective of this retrospective study is to evaluate Circular External Fixation (CEF) for primary and definitive fixation of tibia extra-articular fractures (TEF) in the elderly treated at a level I trauma center.

Materials and Methods:

we evaluated a subset of 31 elderly patients (over 70 years) with 31 TEF (mean age 76 years, range 70-89) of which six (19.4%) were open treated with CEF between 2010 and 2017. 29 (93.5%) fractures underwent definitive fixation with traditional Ilizarov, 2 were treated with Sheffield and Taylor Spatial frames and evaluated clinically and radiologically accordingly to ASAMI bone and functional scores.

Results:

All fractures consolidated without additional procedures at an average of 21.3 weeks (range 9-42). No deep infections were observed. Four malunions within 8° occurred. ASAMI bone results were excellent in 93.6% of patients and revealed an excellent result in 21 (67.7%) of patients, eight patients (25.8%) had a good result, and 2 (6.5%) a fair result.

Conclusions:

CEF gave excellent results in the treatment of a variety of tibial shaft fractures in an elderly population, in terms of early return to ambulation, with average time to union, rate of delayed union, and misalignment rate comparable or superior to intramedullary nail and plate osteosynthesis, that represent the options more frequently proposed in clinical practice and literature. Advantages of circular external fixation in osteosynthesis of extra-articular tibia fractures in these patients are the minimal impact on soft tissues and the stability of the construct, that allows immediate weight bearing and early return to ambulation.
Masquelet's Induced Membrane Technique for Reconstruction of Large Extra-Articular Intercalary Bone Defect
Authors: Soliman Mouhammed Elsayed , Elzohairy Mohamed Mansour , AbdelWahab Ahmed Mohamed , Khaira Yousuf Mohamed , Elbatrawy Yasser , Abdalla Usama Gaber , Mansour Saher Mohamed , Dabash Sherif , Abuomira Ibrahim Elsayed Abdellatif , Thabet Ahmed M.
Published: April 2023

Background:

Intercalary bone defects are challenging for both surgeon and patient. The Masquelet's induced membrane technique saves bone consolidation time is less technically demanding than other techniques and achieves good results in the reconstruction of large extra-articular intercalary bone defects.

Patients and Methods:

This prospective study reviewed 60 patients treated with the induced membrane technique. Patients with femoral or tibial extra-articular intercalary bone defects ≥5 cm long, occurring either posttraumatically or after debridement of infected bone, were included in the study. Patients with bone defects <5 cm long were excluded from the study. The male-to-female ratio was 17:3. Patient age ranged from 10 to 50 years. Recorded outcomes included union, infection, residual deformity, soft-tissue healing, persistent pain, return to previous occupation, permanent joint contracture, and patient satisfaction.

Results:

Mean follow-up was 3.1 years (range, 2.2–4 years). Mean intercalary bone defect measured 7.5 cm (range, 5–13 cm) in length. Forty-five of 60 patients had open fractures. Thirty-nine underwent Ilizarov fixation, 12 with locked plates, and nine with a limb reconstruction system. The mean interval between the first and second stages was 56 days (range, 42–84 days). Bony union was achieved in 51 patients (85%). Twelve patients experienced relapsed infection during treatment, three because of flap failure, and nine because of inadequate debridement. Three were treated with repeat debridement and free vascularized flap after gastrocnemius flap, six underwent bone transport, and three required amputation.

Conclusion:

The Masquelet's induced membrane technique was highly effective in achieving the union of large femoral intercalary bone defects, with mixed results in the tibia.
New Measurements to Determine Changes after Intra-Articular High Tibial Osteotomy
Authors: Chaudhary Milind , Apte Aditya P. , Manna Jitsen , Bhadiyadra Ravi , Herode Prafulla
Published: April 2023

Background:

Most high tibial osteotomies (HTO), performed for medial compartment osteoarthritis of the knee (MCOA) are extra-articular osteotomies of the upper tibia. Recently, attention has turned to detecting and treating intra-articular deformities of the upper tibia causing MCOA. Chiba introduced the tibial condylar valgus osteotomy (TCVO) in Japan and few English language articles have described indications, surgical techniques of results of these osteotomies. Two angles commonly measure and detect the intra-articular deformity and measure the difference between preoperative and postoperative parameters: Joint line convergence angle (JLCA) and condylar plateau angle (CPA).

Aims and Objectives:

JLCA is relatively easy to measure as it uses clearly visible landmarks to draw tangents to femoral and tibial condyles to subtend the angle. CPA is a little difficult to measure and we found it to be less reliable in intra-observer as well as interobserver readings.

Materials and Methods:

We decided to measure the intra-articular deformity by using spine edge angle (SEA) and spine vertical distance (SVD) as two new measurements. These have proved to be reliable in intra as well as interobserver measurements. We compared readings of SEA and SVD in 57 patients each who had an intra-articular TCVO and also an extraarticular medial open wedge HTO (OWHTO).

Results:

We found a significant change between preoperative and postoperative measurements of SEA and SVD in patients who underwent TCVO, but no change in patients who underwent OWHTO.

Conclusions:

The two new measurements of SEA and SVD accurately measure the change in intra-articular deformity parameters in patients who undergo TCVO and are more reliable than CPA.
Evaluating the Accuracy of the SMART Taylor Spatial Frame Software - Comparison with Manual Radiographic Analysis Methods
Authors: Ferreira Nando , Arkell Christopher , Fortuin Franklin , Saini Aaron Kumar
Published: April 2023

Background:

The accuracy of hexapod circular external fixator deformity correction is contingent on the precision of radiographic analysis during the planning stage. The aim of this study was to compare the SMART Taylor spatial frame (TSF) in suite radiographic analysis methods with the traditional manual deformity analysis methods in terms of accuracy of correction.

Methods:

Sawbones models were used to simulate two commonly encountered clinical scenarios. Traditional manual radiographic analysis and digital SMART TSF analysis methods were used to correct the simulated deformities.

Results:

The final outcomes of all six analysis methods across both simulated scenarios were satisfactory. Any differences in residual deformity between the analysis methods are unlikely to be clinically relevant. All three SMART TSF digital analyses were faster to complete than manual radiographic analyses.

Conclusion:

With experience and a good understanding of the software, manual radiographic analysis can be extremely accurate and remains the gold standard for deformity analysis. In suite SMART TSF radiographic analysis is fast and precise to within clinically relevant parameters. Surgeons can with confidence trust the SMART TSF software to provide analysis and corrections that are clinically acceptable.
Early Marriage Causes Decreased Growth and Development in Children under the Age of Three
Authors: Rifai Achmad , Juliandi Juliandi , Saputri Ika Nur , Satria Beni , Wulan Sri , Simarmata Dewinita
Published: April 2023

Introduction:

The purpose of this study is to investigate the relationship between early marriage and child development.

Materials and Methods:

A cross-sectional study was conducted on a population of mothers with children <3 years old. The subjects of this study are mothers with children aged 3–36 months, who know their age at first marriage, are not currently divorced, and are willing to engage in the study.

Results:

There is a relationship between early marriage and impaired child growth and development.

Conclusions:

It was concluded that early marriage affects the growth and development of children <3 years old. Thus, the government or society needs to make efforts to prevent early marriage through the right approach in Indonesia.
Gastrointestinal transit time of radiopaque ingested foreign bodies in children: experience of two paediatric tertiary centres
Authors: Ang Chen Xiang , Mun Win Kai , Aw Marion Margaret , Lin Diana , Chong Shu-Ling , Ong Lin Yin , Nah Shireen Anne
Published: April 2023

Introduction:

Foreign body (FB) ingestion is a common paediatric emergency. While guidelines exist for urgent intervention, less is known of the natural progress of FBs passing through the gastrointestinal tract (GIT). We reviewed these FB transit times in an outpatient cohort.

Methods:

A retrospective review was performed on all children (≤18 years) treated for radiopaque FB ingestion at two major tertiary paediatric centres from 2015 to 2016. Demographic data, FB types, outcomes and hospital visits (emergency department [ED] and outpatient) were recorded. All cases discharged from the ED with outpatient follow-up were included. We excluded those who were not given follow-up appointments and those admitted to inpatient wards. We categorised the outcomes into confirmed passage (ascertained via abdominal X-ray or reported direct stool visualisation by patients/caregivers) and assumed passage (if patients did not attend follow-up appointments).

Results:

Of the 2,122 ED visits for FB ingestion, 350 patients who were given outpatient follow-up appointments were reviewed (median age 4.35 years [range: 0.5–14.7], 196 [56%] male). The largest proportion (16%) was aged 1–2 years. Coins were the most common ingested FB, followed by toys. High-risk FB (magnets or batteries) formed 9% of cases (n=33). The 50th centile for FB retention was 8, 4 and 7 days for coins, batteries and other radiopaque FBs, respectively; all confirmed passages occurred at 37, 7 and 23 days, respectively. Overall, 197 (68%) patients defaulted on their last given follow-up.

Conclusion:

This study provides insight into the transit times of FB ingested by children, which helps medical professionals to decide on the optimal time for follow-up visits and provide appropriate counsel to caregivers.
Logan’s problem for Jacobi transforms
Authors: Gorbachev Dmitry , Ivanov Valerii , Tikhonov Sergey
Published: April 2023

We consider direct and inverse Jacobi transforms with measures
$$\begin{align*}d\mu(t)=2^{2\rho}(\operatorname{sinh} t)^{2\alpha+1}(\operatorname{cosh} t)^{2\beta+1}\,dt\end{align*}$$
and
$$\begin{align*}d\sigma(\lambda)=(2\pi)^{-1}\Bigl|\frac{2^{\rho-i\lambda}\Gamma(\alpha+1)\Gamma(i\lambda)} {\Gamma((\rho+i\lambda)/2)\Gamma((\rho+i\lambda)/2-\beta)}\Bigr|^{-2}\,d\lambda,\end{align*}$$
respectively. We solve the following generalized Logan problem: to find the infimum
$$\begin{align*}\inf\Lambda((-1)^{m-1}f), \quad m\in \mathbb{N}, \end{align*}$$
where
$\Lambda (f)=\sup \,\{\lambda>0\colon f(\lambda )>0\}$
and the infimum is taken over all nontrivial even entire functions f of exponential type that are Jacobi transforms of positive measures with supports on an interval. Here, if
$m\ge 2$
, then we additionally assume that
$\int _{0}^{\infty }\lambda ^{2k}f(\lambda )\,d\sigma (\lambda )=0$
for
$k=0,\dots ,m-2$
.

We prove that admissible functions for this problem are positive-definite with respect to the inverse Jacobi transform. The solution of Logan’s problem was known only when
$\alpha =\beta =-1/2$
. We find a unique (up to multiplication by a positive constant) extremizer
$f_m$
. The corresponding Logan problem for the Fourier transform on the hyperboloid
$\mathbb {H}^{d}$
is also solved. Using the properties of the extremizer
$f_m$
allows us to give an upper estimate of the length of a minimal interval containing not less than n zeros of positive definite functions. Finally, we show that the Jacobi functions form the Chebyshev systems.
¿El principio del fin o el fin del principio?: apuntes para una revolución
Authors: Acosta Romero Ángel
Published: April 2023

Al final del segundo milenio nos encontramos, sin duda, en una encrucijada histórica. Y no creemos que se trate sólo, aunque también, de un tópico repetido, y, casi siempre, adornado con tintes apocalípticos. Una encrucijada es un cruce de caminos, es decir, la duda y la apertura a distintas posibilidades. La duda, es cierto, nos obliga elegir. La libertad, en este caso, se nos impone. Debemos elegir y debemos hacerlo siendo conscientes de nuestros límites y de nuestras potencialidades. La crisis de la sociedad -de un modelo de sociedad- refleja y es reflejada por la crisis del conocimiento. Ya sabemos que el sujeto y el objeto se configuran mutuamente y no pueden ser aislados artificialmente. Afrontar la revolución en el conocimiento es afrontar, al mismo tiempo, una revolución política, es decir, una revolución integral, en la que el hombre (la humanidad) se reconozca en su devenir complejo (homo sapiens/demens le llama Morin).
Validation of a three-dimensionally printed simulator for training in endoscopic sinonasal surgery
Authors: Leong S C , Strzembosz A , Tan N C
Published: April 2023

Background: The ability to incorporate different materials in the construction of 3-D printed models has resulted in the ability to mimic a variety of anatomical structures such as cartilage, mucosa and bone. The aim of this study was to evaluate the face and content validities of a model as a training tool for endoscopic sinus surgery. Methods: Twenty-six delegates and ten teaching faculty members were invited to complete a post-hoc questionnaire survey. The survey consisted of a 22-question 5-point Likert scale to assess the model's realism (face validity) and its effectiveness as a training tool (content validity). Results: Over 80% of the delegates agreed or strongly agreed that the appearance of anatomical structures within the model was realistic and mimicked actual sinus anatomy. In addition, a similar proportion agreed or strongly agreed that the application of instruments on the composite materials of the model realistically mimicked bone. All faculty agreed that the model was useful to develop hand-eye coordination and was a useful training tool for endoscopic sinus surgery. Overall, the sinus model received high scores regarding its use for training surgeons, especially to develop camera and instrument handling skills. Conclusion: The results of this study suggest that otolaryngology doctors in their early or intermediate stage of training would benefit most from a clinical-based modular programme. The model requires further development in areas such as the realism of mucosa, incorporation of sinonasal pathology and having more complex anatomy to be useful for the training of more advanced surgeons.
Assessment Competence of Teaching Staff – a Factor in the Implementation of National Policy in the Field of School Competence Assessment
Authors: Stratan Victoria
Published: April 2023

The article addresses the issue of assessment competences of teachers in the context of the reform undertaken in the Republic of Moldova at the level of educational policies related to the school competence assessment. The article examines the national normative framework; the educational policy documents underlying the assessment process in primary education are mentioned and analysed. The descriptors to be demonstrated by the teachers in the classroom assessment process, as well as the principles of andragogy, are listed here. The objective of this article is to analyse the main achievements of the national educational system at the level of educational documents and highlight the importance of training the assessment competences of teachers as an essential factor in increasing students’ performance.

Kompetencje kadry nauczycielskiej w zakresie oceniania – czynnik warunkujący realizację polityki krajowej w zakresie oceniania kompetencji szkolnych
Artykuł omawia kwestię kompetencji nauczycieli w zakresie oceniania w kontekście reformy przyjętej w Republice Mołdawii na poziomie polityki oświatowej związanej z oceną kompetencji szkolnych. W artykule zbadano krajowe ramy normatywne oraz wymieniono i przeanalizowano dokumenty polityki oświatowej leżące u podstaw procesu oceniania w szkolnictwie podstawowym. Wymieniono w nim deskryptory, którymi powinni wykazać się nauczyciele w procesie oceny klasy, a także zasady andragogiki. Celem artykułu jest analiza głównych osiągnięć krajowego systemu edukacji na poziomie dokumentów oświatowych oraz podkreślenie znaczenia prowadzenia szkoleń dotyczących kompetencji nauczycieli w zakresie oceniania jako istotnego czynnika sprzyjającego poprawie wyników uczniów.
On the need for media education for seniors – selected issues
Authors: Białożyt-Wielonek Katarzyna
Published: April 2023

The article addresses the issue of media education of the elderly in Poland. It aims at presenting the problem of media education of senior, representing a specific issue in various areas of the social life. E-participation, e-services, and e-inclusion are new challenges, but also dimensions of social functioning that permanently shape the life of modern man. According to available data, Polish seniors present a low level of digital competence. The article analyzes the available data associated with the task faced by the media education in the most senior age groups. With the progressing aging of the population, there is a growing need to undertake media education activities among the elderly. This will enable their fuller social participation and also reduce the risk of their exclusion and marginalization.

O potrzebie edukacji medialnej wśród seniorów – wybrane zagadnienia
Artykuł porusza problematykę edukacji medialnej osób starszych w Polsce. Artykuł ma na celu zaprezentowanie zagadnienie związanych z edukacją medialną osób starszych, która stanowi pewnego rodzaju wyzwanie dla różnych obszarów dziedzin życia społecznego. E-uczestnictwo, e-usługi, e-integracja to nowe wyzwania, ale także wymiary funkcjonowania społecznego, które na stałe kształtują życie człowieka współczesnego. Jak wynika z dostępnych danych Polscy seniorzy prezentują niski poziom kompetencji cyfrowych. W artykule dokonano analizy dostępnych danych odnoszących się zadanie jakie stoją przed edukacją medialną najstarszych grup wiekowych. Wraz z postępującym procesem starzenia się społeczeństw, wzrasta zapotrzebowanie na podejmowanie działań z zakresu edukacji medialnej, wśród osób starszych. Pozwoli to na pełniejsza partycypację społeczną seniorów a także zmniejszy ryzyko wykluczenia i marginalizacji.
Life and professional plans of academic youth graduating in a pandemic
Authors: Nowosad Katarzyna
Published: April 2023

The aim of the article is to present the life and professional plans of university students graduating in the conditions of a pandemic and virtualization of the education process. Social and economic conditions, the demand for various professions and specializations on the labor market are becoming an important determinant of creating their own future by university graduates preparing for transition to the labor market. The presented data are the result of empirical research conducted in numerous and diverse academic environments and in various fields of study. The formulated conclusions may serve not only the process of academic education, but also to build individual professional development paths for people graduating from higher education. Keywords: academic youth, life and professional plans, conditions of the pandemic Plany życiowe i zawodowe młodzieży akademickiej kończącej studia w warunkach pandemii Celem artykułu jest przedstawienie planów życiowych i zawodowych młodzieży akademickiej kończącej studia w warunkach pandemii i wirtualizacji procesu kształcenia. Warunki społeczne i ekonomiczne, zapotrzebowanie na różne zawody i specjalności na rynku pracy stają się istotnym wyznacznikiem kreowania własnej przyszłości przez absolwentów studiów wyższych przygotowujących się do tranzycji na rynek pracy. Przedstawione dane stanowią rezultat przeprowadzonych badań empirycznych w licznych i zróżnicowanych środowiskach akademickich oraz na różnych kierunkach studiów. Sformułowane konkluzje służyć mogą nie tylko procesowi kształcenia akademickiego ale także budowania indywidualnych ścieżek rozwoju zawodowego osób kończących studia wyższe.
A Comparative Performance Evaluation of GRP and MDORA Protocols for VANET
Authors:   Department of Electrical and Electronics Engineering, Universiti Tenaga Nasional, Selangor Malaysia, Mohammed Dania , Mansor Muhamad Bin , Hock Goh Chin
Published: April 2023

The vehicular ad hoc network (VANET) is a kind of mobile ad hoc network (MANET). VANET is a wireless communication network that offers vehicle-to-vehicle (V2V) or vehicle-to-infrastructure (V2I) dialogue. They have a dynamic topology and are often ad hoc networks, meaning they lack communication management and control infrastructure. Vehicle communication must be used for comfort and safety. The effectiveness of a communication link is determined by how successfully routing protocols are implemented in the network. This work aims to compare the performance of the geographical routing protocol (GRP) with that of the maximum distance on-demand routing algorithm (MDORA). Packet delivery ratio, communication overhead, and end-to-end delay are the performance parameters evaluated in this study.