bluuebunny/crossref_metadata_2025 huggingface dataset:
Large, loyal, lingering? An analysis of online overseas audiences for UK news brands
Authors: Thurman Neil , Hensmann Thiemo , Fletcher Richard
Published: January 2020

Amidst the financial crisis affecting UK newspapers, one area of optimism is their online overseas audiences. These foreign visitors often outnumber their domestic equivalents, and some newspapers have made the ‘long-distance’ market a key component of their commercial strategies. Overseas news audiences are, however, under-researched, an omission this study aims to help remedy via an investigation into the audiences for 7 UK newspaper brands (and a public-service broadcaster) across 10 countries using data from a leading source of Internet audience measurement, Comscore. The study uses an innovative, multidimensional model (derived from work by Zheng et al.) to analyse audience engagement across the dimensions of visibility, popularity, depth, loyalty and stickiness. The results reveal that there are significant differences in how audiences behave from country to country, dependent on language and culture. The study has implications for how news organizations serve their overseas audiences and suggests new directions for research into audiences for globalized online journalism.
To Tweet for Solidarity or Just Report the News? Comparing Social Media Strategies of Spanish- and English-language TV Networks
Authors: Cárdenas Lourdes , González de Bustamante Celeste , Retis Jessica
Published: January 2020

This article examines Twitter use among the top U.S. Spanish- and English-language television news networks during a significant breaking news event: the Orlando, Florida, shooting at Pulse Night Club on June 12, 2016. The study used a qualitative methodology and used the conceptual framework of ambient journalism to compare how Spanish- and English-language networks used social media to cover both the Latinx and LGBTQ communities, and to what extent these networks attempted to engage with audiences. The study found that Spanish-language media engaged with the Latinx and LGBTQ communities to a greater extent than English-language media. Findings also suggest that despite the advent of new digital that news networks have at their disposal, such as Twitter, their production and dissemination behaviors have not changed in a significant way.
Collagenase Use and a Trap for the Unwary in Patients With Upper Limb Spasticity
Authors: Beecher Suzanne M. , Lane O’Neill Billy , O’Shaughnessy Michael
Published: January 2020

Collagenase has revolutionized the treatment of Dupuytren’s disease. It acts by lysing collagen in Dupuytren’s cords. It can also act on collagen in tendons, leading to tendon rupture. In this letter, we highlight caution where bowstringed flexor tendons were masquerading as Dupuytren’s cords in a patient with upper limb spasticity. The initial plan was to inject the cords with collagenase; however, we proceeded with an open approach. If we had proceeded with our initial plan to inject the palpable cords with collagenase, tendon rupture would have been the likely outcome. We advise that administrators of collagenase proceed with caution in patients with upper limb neurological disorders, bearing in mind that bow-stringed flexor tendons can mimic Dupuytren’s cords.
Treatment of Distal Radius Fracture: Does Early Activity Postinjury Lead to a Lower Incidence of Complex Regional Pain Syndrome?
Authors: Boersma Emily Z. , Meent Henk vd , Klomp Frank P. , Frölke JanPaul M. , Nijhuis-van der Sanden Maria W. G. , Edwards Michael J. R.
Published: January 2020

Background: The optimal treatment for a distal radius fracture (DRF) remains an ongoing discussion. This study observed whether early activity postinjury can lead to the prevention of type 1 complex regional pain syndrome (CRPS-1). Method: Patients who underwent nonoperative treatment for a DRF were invited to participate in this study. Patients followed an exercise program with progressive loading exercises at home immediately after cast removal. After a minimum of 3 months, patients were interviewed by telephone to determine the presence of disproportionate pain. If present, the patients were seen during a clinical consultation to determine whether they had CRPS-1, using the Budapest Diagnostic Criteria. Results: Of the 129 patients included in this study, 12 reported disproportionate pain, and none were diagnosed with CRPS-1. The incidence of CRPS-1 was zero in this study. Conclusion: A more active treatment approach seems to lower the incidence of CRPS-1. A larger randomized study is necessary to strengthen the evidence.
Fruit recognition based on pulse coupled neural network and genetic Elman algorithm application in apple harvesting robot
Authors: Jia Weikuan , Mou Shanhao , Wang Jing , Liu Xiaoyang , Zheng Yuanjie , Lian Jian , Zhao Dean
Published: January 2020

In order to improve the harvesting efficiency of apple harvesting robot, this article presents an apple recognition method based on pulse coupled neural network and genetic Elman neural network (GA-Elman). Firstly, we use pulse coupled neural network to segment the captured 150 images, respectively, and extract six color features of R, G, B, H, S, and I and 10 shape features of circular variance, density, the ratio of perimeter square to area, and Hu invariant moments of segmented images, and these 16 features are considered as the inputs of Elman neural network. In order to overcome some defects of Elman neural network, such as, trapping local minimum easily and determining the number of hidden neurons difficultly; in this article, genetic algorithm is introduced to optimize it, and new optimization way is designed, that is, the connection weights and number of hidden neurons separate encoding and evolving simultaneously, in the process of structural evolution at the same time the learning of connection weights is completed, and then the operating efficiency and recognition precision of Elman model are improved. In order to get more precision neural network, and avoid the influence of fruit recognition caused by branches or leaves shadow, apple along with branches and leaves is allowed to train. The results of experiments show that compared with the traditional back-propagation, Elman neural network, and other two recognition algorithms of obscured fruit. the genetic Elman neural network algorithm is the optimal method which successful training rate can reach to 100%, recognition rate of overlapping fruit and obscured fruit can reach to 88.67% and 93.64%, respectively, and the total recognition rate reaches to 94.88%.
Hybrid-based drug design of 1,2,3-triazole-pyrimidine-hybrid derivatives: Efficient inhibiting agents of mesenchymal–epithelial transition factor reducing gastric cancer cell growth
Authors: Oyebamiji Abel Kolawole , Fadare Olatomide A , Semire Banjo
Published: January 2020

Anti-gastric cancer activity of 18 synthesized compounds was studied using theoretical and computational method. The studied compounds were docked against mesenchymal–epithelial transition factor (PDB ID: 2wgj) and the obtained scoring was compared with the standard used. Thus, all the studied compounds were efficient than the standard (5-florouracil); also, A9 proved to be more effective than other studied compounds.
A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair
Authors: Beletsky Alexander , Cancienne Jourdan M. , Manderle Brandon J. , Mehta Nabil , Wilk Kevin E. , Verma Nikhil N.
Published: January 2020

Context:

Recent studies examining return to sport after traumatic shoulder instability suggest faster return-to-sport time lines after bony stabilization when compared with soft tissue stabilization. The purpose of the current study was to define variability across online Latarjet rehabilitation protocols and to compare Latarjet with Bankart repair rehabilitation time lines.

Evidence Acquisition:

Online searches were utilized to identify publicly available rehabilitation protocols from Accreditation Council for Graduate Medical Education (ACGME)–accredited academic orthopaedic surgery programs.

Study Design:

Descriptive epidemiology study.

Level of Evidence:

Level 3.

Results:

Of the 183 ACGME-accredited orthopaedic programs reviewed, 14 institutions (7.65%) had publicly available rehabilitation protocols. A web-based search yielded 17 additional protocols from private sports medicine practices. Of the 31 protocols included, 31 (100%) recommended postoperative sling use and 26 (84%) recommended elbow, wrist, and hand range of motion exercises. Full passive forward flexion goals averaged 3.22 ± 2.38 weeks postoperatively, active range of motion began on average at 5.22 ± 1.28 weeks, and normal scapulothoracic motion by 9.26 ± 4.8 weeks postoperatively. Twenty (65%) protocols provided specific recommendations for return to nonoverhead sport–specific activities, beginning at an average of 17 ± 2.8 weeks postoperatively. This was compared with overhead sports or throwing activities, for which 18 (58%) of protocols recommended beginning at a similar average of 17.1 ± 3.3 weeks.

Conclusion:

Similar to Bankart repair protocols, Latarjet rehabilitation protocols contain a high degree of variability with regard to exercises and motion goal recommendations. However, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols. Consequently, variability in the timing of rehabilitation goals may contribute to earlier return to play metrics identified in the broader literature for the Latarjet procedure when compared with arthroscopic Bankart repair.

Strength of Recommendation Taxonomy (SORT):

Level C.
Transpalpebral Frontal Sinus Septectomy: Feasibility and Results
Authors: Graziani Jade , Penicaud Martin , Hazbri Djamel , Dessi Patrick , Michel Justin , Radulesco Thomas
Published: January 2020

Background

Transpalpebral frontal septectomy (TFS) can be performed for unilateral frontal sinusitis drainage (into the contralateral healthy frontal sinus) or to provide access to the lateral extent of the contralateral frontal sinus. This procedure has demonstrated its usefulness in several problematic situations for the endoscopic surgeon.

Objective

The main objective of our study was to evaluate the feasibility of TFS. Secondary objectives were to define outcomes, early and late complications, contraindications, and failure rates of the TFS.

Methods

We reviewed patient demographics including age and gender, indication for frontal septectomy, prior surgeries, failure rates and necessity of revision surgery, early and late complications, and the side of the approach (ipsi- or contralateral to the frontal sinus pathology). Twenty patients who had undergone TFS were included. Patients were classified into 2 groups according to the surgical indication: group 1—TFS performed for unilateral frontal sinusitis to drain a frontal sinus in the contralateral frontal sinus; and group 2—TFS performed to provide access to the lateral extent of the contralateral frontal sinus. Scarring was assessed using the SCAR-Q questionnaire.

Results

TFS was performed on all patients in Groups 1 and 2 (success rate = 100%). No patients had recurrence of the pathology 6 months after surgery (0%). No patient needed revision surgery (0%). One complication (frontal hypoesthesia) was reported 6 months after surgery. Mean SCAR-Q score was 99.3 ± 2.5 (min = 91/100, max = 100/100).

Conclusion

TFS was feasible for all patients in this study. This procedure permits drainage of the frontal sinus and gives access to the lateral extent of the contralateral frontal sinus, without visible scarring, and with few lasting complications. Authorization to conduct this study was obtained from the Ethical Committee of our institution (APHM, n°2019_65).
Sulcal artery syndrome presenting as an incomplete Brown–Sequard syndrome – Report of an unusual case and review of the literature
Authors: Win May Myat , Saini Monica , Pande Shrikant Digambarrao , Prasanna Kappaganthu Venkatesh
Published: January 2020

Sulcal arteries perfuse the anterior two-thirds of the spinal cord, and spinal cord infarction as a result of sulcal artery occlusion is rare. Most reported cases are associated with vertebral artery dissection, and commonly involve the cervical spinal cord. A 74-year-old man presented with sudden onset weakness and numbness after a brief bout of abdominal pain. Further investigations concluded that this was sulcal artery syndrome. We report a case of sulcal artery syndrome affecting the thoracic spinal cord presenting as Brown–Sequard syndrome. Sulcal artery syndrome usually has good prognoses, unlike anterior spinal artery infarction.
Creating G-Class: A gamified learning environment for freshman students
Authors: Malahito John Aries I , Quimbo Maria Ana T
Published: January 2020

In this era of digital media, teachers are competing against technological advancements in gaining students’ engagement and attention. Incorporating game elements in the learning environment known as gamification is a new field of study that re-engages students in learning. This study was done primarily to create a gamified learning environment that will serve as another teaching strategy to engage students in learning. The learning environment was aligned with the principles of gamification and was called Gamified-Class or simply G-Class. Using data gathered from 27 freshman college students, G-Class was developed following the Analysis–Design–Development–Implementation–Evaluation model of instructional design and using the Mechanics–Dynamics–Aesthetics framework of game design. The material was implemented in a General Physics class through a quasi-experimental research design. A G-Class mobile and desktop application together with a user guide was created. G-Class was evaluated both as instructional design material and as instructional task. As an instructional design, it was assessed in terms of content and learning objectives; design, interactivity, and usability; and assessment aligned with learning outcomes. As an instructional task, G-Class was assessed using the Intrinsic Motivation Inventory which consisted of four subscales in a 7-point Likert scale, namely, interest/enjoyment, perceived competence, choice, and pressure/tension. Overall, G-Class was given positive rating both as instructional material and as instructional task. With an overall rating of 5.60, students were found to be more engaged with their subject. Applying gamification in the learning environment pointed to its beneficial effects in enhancing students’ engagement in learning.
Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: The China-PAR project
Authors: Wang Xinyan , Liu Fangchao , Li Jianxin , Yang Xueli , Chen Jichun , Cao Jie , Wu Xigui , Lu Xiangfeng , Huang Jianfeng , Li Ying , Zhao Liancheng , Shen Chong , Hu Dongsheng , Yu Ling , Liu Xiaoqing , Wu Xianping , Wu Shouling , Gu Dongfeng
Published: January 2020

Aims

The role of tea consumption in the primary prevention of atherosclerotic cardiovascular disease remains unclear in cohort studies. This prospective cohort study aimed to investigate the associations of tea consumption with the risk of atherosclerotic cardiovascular disease and all-cause mortality.

Methods

We included 100,902 general Chinese adults from the project of Prediction for ASCVD Risk in China (China-PAR) in 15 provinces across China since 1998. Information on tea consumption was collected through standardized questionnaires. Outcomes were identified by interviewing study participants or their proxies, and checking hospital records and/or death certificates. Cox proportional hazard regression models were used to calculate hazard ratios and their corresponding 95% confidence intervals related to tea consumption.

Results

During a median follow-up of 7.3 years, 3683 atherosclerotic cardiovascular disease events, 1477 atherosclerotic cardiovascular disease deaths, and 5479 all-cause deaths were recorded. Compared with never or non-habitual tea drinkers, the hazard ratio and 95% confidence interval among habitual tea drinkers was 0.80 (0.75–0.87), 0.78 (0.69–0.88), and 0.85 (0.79–0.90) for atherosclerotic cardiovascular disease incidence, atherosclerotic cardiovascular disease mortality, and all-cause mortality, respectively. Habitual tea drinkers had 1.41 years longer of atherosclerotic cardiovascular disease-free years and 1.26 years longer of life expectancy at the index age of 50 years. The observed inverse associations were strengthened among participants who kept the habit during the follow-up period.

Conclusion

Tea consumption was associated with reduced risks of atherosclerotic cardiovascular disease and all-cause mortality, especially among those consistent habitual tea drinkers.
WHO guidance for digital health: What it means for researchers
Authors: Jandoo Tarveen
Published: January 2020

In healthcare, digital solutions have been adopted with zeal, but there is paucity of evidence for benefits and harms of these solutions. The impact, immediate or long term, of digital applications on healthcare has not been assessed. With the overwhelming numbers and types of digital solutions, it is becoming increasingly important to develop evidence-based insights for the integration of these solutions in routine medical care. Digitalization can certainly empower and enable patients and physicians to achieve health objectives. The World Health Organisation has released guidance for digital health after a critical review of available evidence for the benefits, harms, acceptability, feasibility, resource use and equity considerations of digital health interventions. This guidance can potentially inspire and impact future research endeavors for digital applications. In this paper, the guidance has been reviewed in context of the current research situation and insights are shared for researchers engaged in the design and assessment of digital interventions.
Self-Assessment Variables as a Source of Information in the Evaluation of Intervention Programs: A Theoretical and Methodological Framework
Authors: Eyal Yonatan
Published: January 2020

The article discusses the incorporation of individuals’ assessments regarding the effect of intervention program on themselves as a source of information in commonly used quantitative program evaluation methods. The incorporation of Self-Assessment Variables ( SAV) into the evaluation process enables the researcher to utilize the information contained in SAV while utilizing other available sources of information as well (such as administrative data). The analysis is based on the assumption that individuals possess valuable and unique information which they employ before self-selection into a program. The theory of planned behavior is used as a framework for examining different aspects of integrating SAV into program evaluation. The article elaborates on the integration of SAV into the matching method and on the possible advantages of that approach. In addition, the article discusses different aspects of the process of eliciting SAV from individuals. Finally, the article outlines possible directions for future research.
Informing iQOS Regulations in the United States: A Synthesis of What We Know
Authors: Berg Carla J. , Bar-Zeev Yael , Levine Hagai
Published: January 2020

The tobacco industry offers various products, including heated tobacco products (HTPs). Philip Morris International’s (PMI) “iQOS” has the greatest HTP market share, as well as research on its use and impact. iQOS was released in 2014 and is now in more than 40 countries. The U.S. Food and Drug Administration announced permission for PMI to sell iQOS in the United States in April 2019, and iQOS was launched in October 2019. Decisions pending its modified risk tobacco product (MRTP) application will occur subsequently. The U.S. regulatory efforts regarding iQOS could be informed by examining (a) Philip Morris USA other product marketing efforts and (b) the iQOS market in countries where it is available. This article briefly addresses these two points with extant literature and suggests that future research should address important gaps in what is currently known, including strategic international collaborations and research, which historically has been critical for advancing tobacco control globally.
An Exploratory Study on Police Oversight in British Columbia: The Dynamics of Accountability for Royal Canadian Mounted Police and Municipal Police
Authors: Stelkia Krista
Published: January 2020

Independent oversight of Canadian police has increased over the past decade in response to a number of high-profile cases of police misconduct and public dissatisfaction with internal police investigations. To date, however, the dynamics of the oversight process have not been subjected to critical analysis. This study examines the benefits and challenges of the oversight systems for the Royal Canadian Mounted Police (RCMP) and municipal police in British Columbia, Canada, as well as the role of oversight in increasing police accountability, improving public confidence, and modifying police behavior. Drawing on semi-structured interviews with persons ( n = 13) from oversight agencies, police unions, special interest groups, and professional standards units, the study found that despite having one of the most progressive oversight models in Canada, the system faces major challenges. These include slow processing of complaints, the administrative burden of minor complaints, the difficulty in determining return on investment, and the two-tier complaint model.
Administrative Work and Job Role Beliefs in Primary Care Physicians: An Analysis of Semi-Structured Interviews
Authors: Apaydin Eric
Published: January 2020

Primary care physicians face increasing amounts of administrative work (e.g., entering notes into electronic health records, managing insurance issues, delivering test results, etc.) outside of face-to-face patient visits. The objective of this study is to qualitatively describe the experience that primary care physicians have with administrative work, with an emphasis on their beliefs about their job role. I conducted semi-structured interviews with 28 family physicians and internists in Chicago, Los Angeles, and Miami and qualitatively analyzed themes from interview transcripts using the grounded theory approach. Two major themes concerning the relationship between primary care physicians and administrative work were discovered: (a) Administrative work was not central to primary care physicians’ job role beliefs, and (b) “below license” work should be delegated to nonphysicians. Job roles should be considered in future efforts to reduce physician administrative work in primary care.
Comparative Analysis of the Science Teaching Curricula in Turkey
Authors: Yaz Ömer Volkan , Kurnaz Mehmet Altan
Published: January 2020

The purpose of this study is to comparatively investigate the science teaching curricula in Turkey, which have undergone changes four times since the millennium. For this purpose, we carried out a technical and taxonomic examination of the learning outcomes listed in the science curricula that were introduced in 2000, 2005, 2013, and 2017 concerning Revised Bloom Taxonomy (RBT). In this study, the document analysis method was used. We classified a total of 2,613 learning outcomes in our analyses, which were limited to those related to the cognitive domain. The reliability score of the classifications was .89 according to the equation proposed by Miles and Huberman. The analyses showed that the teaching curricula decreased the intensity of the focus on knowledge and cognitive skills rather than making fundamental changes. Moreover, there was significant parallelism among the examined curricula in terms of the dimensions of the taxonomy. Using national-level results in international exams such as PISA (Programme for International Student Assessment) and TIMSS (Trends in International Mathematics and Science Study), we concluded that Turkey had not been successful enough in developing the examined curricula.
How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda
Authors: Bukenya Dominic , Seeley Janet , Tumwekwase Grace , Kabunga Elizabeth , Ruzagira Eugene
Published: January 2020

We investigated how follow-up counselling had increased linkage to HIV care in a trial of referral to care and follow-up counseling, compared to referral to care only, for participants diagnosed as HIV-positive through home-based HIV counseling and testing. We carried out a cross-sectional qualitative study. Using random stratified sampling, we selected 43 trial participants (26 [60%] in the intervention arm). Sample stratification was by sex, distance to an ART facility, linkage, and nonlinkage to HIV care. Twenty-six in-depth interviews were conducted with participants in the intervention arm: 17 people who had linked to HIV care and 9 who had not linked after 6 months of follow-up. Home-based follow-up counseling helped to overcome worries resulting from an HIV-positive test result. In addition, the counseling offered an opportunity to address questions on HIV treatment side effects, share experiences of intimate partner violence or threats, and general problems linking to care. The counselling encouraged early linkage to HIV care and use of biomedical medicines, discouraging alternative medicine usage. Home-based follow-up counseling also helped to promote HIV sero-status disclosure, facilitating linkage to, retention in and adherence to HIV care and treatment. This study successfully demonstrated that home-based follow-up counselling increased linkage to care through encouragement to seek care, provision of accurate information about HIV care services and supporting the person living with HIV to disclose and manage stigma.
How a Teacher Education Program Through Action Research Can Support English as a Foreign Language Teachers in Implementing Communicative Approaches: A Case From Taiwan
Authors: Chen Yi-Mei
Published: January 2020

Communicative approaches have been a dominant paradigm in foreign/second language teaching since the 1980s. However, they are not widely accepted by teachers in many English as a Foreign Language (EFL) contexts. The current study adopted an action research approach to study classroom practice in a Taiwanese EFL secondary school, to identify and solve any problems arising. Three volunteer teachers and their 90 students were involved. The results suggest that the teachers’ limited understanding of the approaches seemed to be a dominant factor and further suggest that some commonly cited obstacles in the implementation of communicative approaches result from the teachers’ lack of understanding. This investigation gained insights into how teachers can learn and can be supported from the five cycles of action research. These experiences may provide a useful reference for practitioners and teacher education/development programmers in a variety of contexts.
Utilizing Participatory Action Research to Change Perception About Organizational Culture From Knowledge Consumption to Knowledge Creation
Authors: Sparre Mogens
Published: January 2020

This study explains how participatory action research has been used to create a new intersubjective awareness of the phenomenon of organizational culture. The question of creating voluntary democratic participation has been crucial for all stakeholders in this case. Through this two-and-a-half-year study including more than 30 workshops, in a marine industry, we have managed to create new beliefs about being part of and responsible for creating the organizational culture. With these new understandings of the culture, which has been dramatically changed, the participants have created new personal knowledge about themselves and working in an organization like this. The management group have discovered that they are responsible for their own knowledge creation.
When Servant Leaders Inspire Followers to Become Organizational Citizens? Empirical Evidence From Vietnam
Authors: Thao Nguyen Phan Hanh , Kang Seung-Wan
Published: January 2020

The purpose of this article is to contribute to the existing servant leadership literature, especially at the individual level of analysis in new settings, by examining the potential joint effects of servant leadership, dyadic duration, and job self-efficacy, with organizational citizenship behaviors (OCBs) as the dependent variable. We, after analyzing survey data from 148 leader–follower dyads collected from an engineering venture, find that dyadic duration is a significant moderator of the relationship between servant leadership and OCB. Furthermore, the moderating effect of dyadic duration on the relationship between servant leadership and OCB depends on job self-efficacy, such that the interaction effect is neutralized when job self-efficacy is high rather than low. The findings about interactive effects can provide useful information that will help to better deploy servant leadership in organizations to create positive follower outcomes.
Discussing the determinants of online budget transparency based on a spatial regression analysis of Croatian cities and municipalities: Do good neighbours make you better?
Authors: Mourao Paulo Reis , Bronić Mihaela , Stanić Branko
Published: January 2020

Taxpayers want to pay as little in taxes as possible to fund an adequate level of public goods and services in their local government, and so they need to keep their local incumbents accountable. Online local budget transparency (OLBT) facilitates this accountability, as it enables citizens to find information online about their local budgets that is timely, accurate, comprehensive and understandable. The aim of this article is to identify the most important determinants of OLBT for all 556 Croatian cities and municipalities from 2014 to 2017. Using a dynamic spatial lag Durbin model, the analysis explores the direct and indirect effects of potential determinants on OLBT. The main contribution is the pioneering use of a dynamic spatial lag Durbin model for researching local budget transparency determinants in a Central and Eastern European democracy. The results show that neighbours have an influence on OLBT but that direct effects dominate; that is, the major OLBT determinants come from within each city/municipality. Particularly important determinants are residents’ income, the local government’s wealth, the number of public employees in the city/municipality and the population size.
The effect of pulsed lavage irrigation on suture knot security
Authors: Golz Andrew , Yun Jonathan , Garbis Nickolas , Salazar Dane
Published: January 2020

Purpose:

The purpose of this study was to determine the effect of low-pressure and pulsed lavage irrigation on suture knot security.

Methods:

Ninety-tied suture loops were measured for baseline circumference and then subjected to no irrigation, bulb syringe irrigation, or pulsed lavage irrigation. The sutures were placed under a load and then measured for final circumference. A larger circumference difference indicated poorer knot security.

Results:

There was a statistically significant difference in the knot security between all three groups ( p < 0.001). Pulsed lavage resulted in the greatest circumference increase (0.52 ± 0.19 mm), followed by bulb syringe (0.24 ± 0.18 mm), and lastly no irrigation (0.08 ± 0.00 mm). None of the groups had any catastrophic failures. No knots met the predetermined criteria for knot failure.

Conclusion:

Pulsed lavage irrigation resulted in a statistically significant decrease in suture knot security as compared to bulb syringe irrigation and no irrigation. None of the groups met the currently accepted criteria for clinical suture failure, which has a relatively arbitrary value. While the available literature does not discuss increases in loop circumference for specific orthopedic applications, this small difference suggests that pulse lavage is unlikely to have a clinically significant impact on the suture integrity for most orthopedic procedures.
Evaluation of an expectation and outcome measurement questionnaire in ankle fracture patients: The Trauma Expectation Factor Trauma Outcomes Measure (TEFTOM) Eurasia study
Authors: Fang Christian , Platz Andreas , Müller Lars , Chandy Thomas , Luo Cong-Feng , Vives Josep María Muñoz , Leung Frankie , Babst Reto
Published: January 2020

Background:

The Trauma Expectation Factor Trauma Outcomes Measure (TEFTOM) questionnaire is a self-administered, patient-rated outcome measurement questionnaire designed to measure both ‘expectation’ and ‘outcome’ in orthopaedic trauma patients using two subsets of 10 items. We aimed to validate this instrument in a culturally diverse cohort of patients recruited from Asian and European regions.

Methods:

A total of 193 adult patients with surgically treated AO Foundation/Orthopaedic Trauma Association types 43 and 44 ankle malleolar and distal tibia fractures were recruited with 158 followed up till 1 year. Expectations were assessed prior to surgery, at 2 weeks and after 6 months using the trauma expectation factor (TEF) score. Outcomes were evaluated at 2 weeks, 6 and 12 months using the trauma outcome measure (TOM), American Academy of Orthopaedic Surgeons (AAOS), foot and ankle outcome score (FAOS) and short form-36 (SF-36) questionnaires. Psychometric properties of TEFTOM were assessed.

Results:

TEF and TOM demonstrated good internal consistency (Cronbach’s α > 0.87) and reliability at all time points (intra-class correlation coefficients > 0.90). TOM showed strong correlations ( R 2 ≥ 0.60) with the AAOS foot and ankle score, all FAOS subscales, except ‘symptoms’ and SF-36 physical functioning, role physical, bodily pain, social functioning and the physical component summary at 6 and 12 months. Effect sizes for TOM were 2.30 and 0.74 from 2 weeks to 6 months and from 6 months to 12 months, respectively. The baseline patient TEF was predictive for the 1-year TOM score.

Conclusions:

TEFTOM demonstrated good psychometric properties in this cohort of patients with ankle fractures. The TEF ‘expectation’ score was predictive of the TOM ‘outcome’ score. We recommend researchers and clinicians to utilize TEFTOM when patient expectation measurement is concerned for orthopaedic trauma patients.
Ventral scapular osteochondroma excision through ‘triangle of auscultation’: A case series
Authors: Prakash Saket , Kalra Pulkit , Khan Yasim , Dhal Anil
Published: January 2020

Introduction:

Surgical intervention through the ‘triangle of auscultation’ is less morbid to patients, as it is devoid of muscles and provides an easy access to tumours arising on the ventral aspect of scapula especially near inferior angle.

Method:

Three patients presented to us with pseudo-winging of scapula and an audible thud on abduction of the arm. A bony mass, painful in two and painless in one patient, was palpable along the anterior aspect of the inferior angle of scapula. A clinical diagnosis of osteochondroma was made which was corroborated by X-rays and computed tomography (CT) imaging. Ventral scapular osteochondroma excision is challenging due to multiple muscle attachments, requiring extensive soft tissue dissection and muscular release. Numerous blood vessels and nerves in the vicinity may also add to the degree of difficulty. This necessitates the need of a minimally invasive and muscle-sparing procedure. We hereby describe a novel surgical approach to the ventral aspect of scapula through the triangle of auscultation for excision of scapular osteochondroma.

Results:

Pseudo-winging disappeared following surgery. Snapping of the scapula resolved with early, full shoulder range of motion. Quick disabilities of arm, shoulder and hand (DASH) score improved from mean 20.2 preoperatively to 0 postoperatively at 3 months in all the patients.

Conclusion:

The approach is simple with minimal blood loss as it does not involve splitting or cutting of trapezius, rhomboid major or subscapularis muscles.
The effects of partial meniscectomy and meniscal repair on the knee proprioception and function
Authors: Başar Betül , Başar Gökhan , Aybar Ahmet , Kurtan Akif , Başar Hakan
Published: January 2020

Purpose:

Aim of our study was to compare the effects of partial meniscectomy and meniscus repair on knee proprioception and function.

Methods:

The study included 46 patients with clinical and radiological diagnosis of meniscal tear and accompanying anterior cruciate ligament (ACL) rupture. The patients were evaluated under two groups: group 1: partial meniscectomy and ACL reconstruction, and group 2: meniscal repair and ACL reconstruction. Proprioceptive and functional evaluation of all patients was performed prior to surgery and on postoperative 12th month.

Results:

Group 1 consists of 18 male and 1 female patients with an average age of 28.78 ± 3.50. Group 2 consists of 23 male and 4 female patients with an average age of 27.14 ± 3.65. Preoperative evaluation revealed significant differences in knee joint position sense values on wide range of knee motion (15°, 30°, 45°, 60°, and 75°) in both groups. The statistically significant difference was observed in only the range of knee motion of 60° in patients underwent meniscal repair (group 2), whereas in the range of knee motion of 45°, 60°, and 75° in patients underwent partial meniscectomy (group 1) at 12th-month control. According to Lysholm knee scoring system, significantly better results were achieved with meniscal repair compared to the partial meniscectomy at 12th-month control.

Conclusion:

In case of ACL rupture accompanied by meniscal tear, the meniscal repair should be sutured, if possible, in order to obtain better results in terms of knee function and proprioception.
The impact of plating level on the postoperative loss of cervical lordosis in alternative skipped-level plating laminoplasty
Authors: Wu Jinyan , Lin Junyu , Huang Zucheng , Wu Xiaoliang
Published: January 2020

Purpose:

The aim of this study is to evaluate the impact of plating level on the loss of cervical lordosis (LCL) after laminoplasty with skipped-level plating.

Methods:

This retrospective study included patients who underwent alternative skipped-level plating laminoplasty from C3 to C6. Patients were divided into two groups according to the plating level. Group 1 had miniplate fixed at C3 and C5 (C3/C5 group), while patients in group 2 were fixed at C4 and C6 (C4/C6 group). The outcome of interest was the difference of LCL between the two groups; meanwhile, kyphosis development after laminoplasty was also compared.

Results:

A total of 70 patients were included in our study with a mean age of 60.44 ± 9.97 years. The median follow-up was 15 (12, 16) months. Median lordosis was 15.43° (9.35°, 22.23°) before surgery and 9.88° (4.15°, 18.94°) after, with a median LCL of 4.48° (−0.66°, 8.11°). There were 17 patients in the C3/C5 group, whereas 53 patients in the C4/C6 group. While preoperative C2–C7 Cobb’s angle was comparable between the two groups (15.32° (9.73°, 23.84°) vs. 15.51° (9.03°, 21.70°), p = 0.864), there were statistical differences regarding postoperative C2–C7 Cobb’s angle (6.54° (2.49°, 16.42°) vs. 10.62° (5.89°, 18.85°), p = 0.006) and LCL (4.74° (4.17°, 12.03°) vs. 4.07° (−1.89°, 6.69°), p = 0.034) between the C3/C5 group and the C4/C6 group. In all, 94.1% (16 of 17) of patients showed some degree of LCL after laminoplasty in the C3/C5 group, which was significantly higher when compared with 64.2% (34 of 52) of C4/C6 group ( p = 0.038). Before surgery, there were no kyphosis patients in either the C3/C5 group or the C4/C6 group. Postoperatively, four patients (23.5%) developed kyphotic alignment in the C3/C5 group, but only one (1.9%) in the C4/C6 group ( p = 0.013).

Conclusions:

Cervical alignment was compromised after laminoplasty. When alternative skipped-level plating is adopted in laminoplasty from C3 to C6, plating at C4/C6 may better preserve cervical lordosis than plating at C3/C5 after surgery.
Visualizing Change in Ordinal Measures: Religious Attendance in the United States (1972–2018)
Authors: Wood Michael Lee
Published: January 2020

The figure plots self-reports of religious attendance using data from the General Social Survey (1972–2018), contributing to current debates about how religiosity is changing in the United States by clearly showing the relative increase or decrease of each level of religious attendance over time. The main new insight is that the observed decline in religious attendance in the United States has been driven primarily by a large increase in people reporting never attending religious services and a corresponding decrease in people reporting weekly attendance, rather than uniform changes across different levels. Some categories, such as attendance once a month, have seen virtually no change. More generally, the figure may be used as a template for plotting other ordinal measures over time, such as political attitudes or ideology.
The word learning profile of adults with developmental language disorder
Authors: McGregor Karla K , Arbisi-Kelm Timothy , Eden Nichole , Oleson Jacob
Published: January 2020

Background and aims

Previous investigations of word learning problems among people with developmental language disorder suggest that encoding, not retention, is the primary deficit. We aimed to replicate this finding; test the prediction that word form, not the linking of form to referent, is particularly problematic; and determine whether women with developmental language disorder are better word learners than men with developmental language disorder.

Methods

Twenty adults with developmental language disorder and 19 age-, sex-, and education-matched peers with typical language development attempted to learn 15 words by retrieval practice. Their retention was measured one day-, one week-, and one month after training.

Results

The participants with developmental language disorder required more exposures to the word-referent pairs than the participants with typical language development to reach mastery. While training to mastery, they made more errors in word form production, alone or in combination with errors in linking forms to the correct referents, but the number of no attempts and pure link errors did not differ by group. Women demonstrated stronger retention of the words than men at all intervals. The developmental language disorder and typical language development groups did not differ at the one-day- and one-month retention intervals but the developmental language disorder group was weaker at the one-week interval. Review via retrieval practice at the one-day and one-week interval enhanced retention at the one-month interval; the review at one week was more beneficial than the review at one day. Women benefitted more from the review opportunities than men but the developmental language disorder and typical language development groups did not differ.

Conclusions

Adults with developmental language disorder present with weaknesses in the encoding of new words but retention is a relative strength. Encoding word forms is especially challenging but encoding word-to-referent links is not. We interpret this profile, and the evidence of a female advantage, as consistent with the Procedural Circuit Deficit Hypothesis. Implications: When treating a client with developmental language disorder whose goal is to increase vocabulary knowledge, the interventionist should anticipate the need for multiple exposures to new words within activities that highlight the forms of the words and support their memory and production. Periodic review should serve to support long-term retention.
Subsidiary country managers and subsidiary development: Upper echelons and resource-based perspectives
Authors: Raziq Muhammad Mustafa , Benito Gabriel RG , Igoe Josephine
Published: January 2020

This article examines the relationship between subsidiary country manager-level factors and subsidiary development. As existing research on subsidiaries in multinational enterprises has focused on the organizational level, thus overlooking the individual level, it offers little insight regarding the role and importance of country managers for subsidiaries. Drawing upon upper echelons theory, resource-dependence theory, and the resource-based view, we argue that subsidiary development is contingent on country manager characteristics, and that country manager assignments are less likely when the host country is perceived as being of limited strategic importance to the multinational enterprise. Survey data from 429 foreign-owned subsidiaries in New Zealand provide support for our hypotheses. We derive some theoretical and managerial implications based on the findings.
Regeneration of Functional, Full-Thickness Skin With Minimal Donor Site Contribution Using Autologous Homologous Skin Construct
Authors: Isbester Kelsey , Wee Corinne , Boas Samual , Sopko Nikolai , Kumar Anand
Published: January 2020

Autologous skin grafts (autografts) remain the gold standard in the treatment of skin loss. For extensive wounds or burns, however, identifying adequate donor sites can be the limiting factor. Additionally, donor sites are associated with pain, risk of infection, and poor cosmetic outcomes. Many skin substitutes have been engineered as alternatives to traditional autografts. These substitutes, however, all leave something to be desired either functionally or cosmetically. This report describes the use of a new technology, autologous homologous skin constructs, to regenerate full-thickness skin grafts that maintain functional polarity, allowing important components of skin such as glands and hair follicles to regenerate. These grafts only require small samples of full-thickness skin from the patient, decreasing issues of donor site availability.
Managing thromboembolic risk in patients with hereditary and acquired thrombophilias
Authors: Moran Jason , Bauer Kenneth A.
Published: January 2020

While we are now able to diagnose inherited thrombophilias in a substantial number of patients with venous thromboembolism (VTE), the initial hope that their presence would inform recurrence risk and thus decisions on anticoagulation duration has largely been disappointing. Indeed, the presence or absence of transient provoking risk factors has proven to be the most important determinant of VTE recurrence risk. Thus, particular attention to transient acquired risk factors for VTE remains paramount, as they have generally been shown to carry more prognostic weight than inherited thrombophilias. The presence of other acquired risk factors may require additional management considerations, whether pertaining to anticoagulant choice, as in antiphospholipid antibody syndrome, or to addressing a new predisposing medical condition, as in malignancy. Antithrombin deficiency or the presence of ≥1 thrombophilic defect may be exceptions that can have a role in prognostication; however, as illustrated in this review through several case vignettes, interpretation and clinical application of the results of inherited thrombophilia testing is nuanced. We have chosen to focus on cases in which patients have been identified as having thrombophilic defects rather than the indications for undertaking testing in the first place or the extent of investigation. Management decisions in such cases ultimately hinge on individualized consideration of the benefits and risks of anticoagulation along with patient preference rather than on an algorithmic pathway based on thrombophilia status.
Treatment of unusual thrombotic manifestations
Authors: Abbattista Maria , Capecchi Marco , Martinelli Ida
Published: January 2020

Venous thrombosis rarely occurs at unusual sites such as cerebral, splanchnic, upper-extremity, renal, ovarian, or retinal veins. Clinical features, symptoms, and risk factors of rare thrombotic manifestations are heterogeneous and in large part differ from those typical of the commonest manifestations of venous thrombosis at the lower extremities. The therapeutic approach also varies widely according to the affected site, whether cerebral, abdominal, or extraabdominal. To date, anticoagulant therapy for thrombosis at unusual sites is generally accepted, but the optimal therapeutic approach remains challenging. This review is focused on the treatment of unusual thrombotic manifestations as reported in the most recent guidelines and according to the updated scientific literature.