bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatrics Residents' Preparedness for Neonatal Resuscitation Assessed Using High-Fidelity Simulation
Authors: Cordero Leandro , Hart Brandon J. , Hardin Rene , Mahan John D. , Giannone Peter J. , Nankervis Craig A.
Published: July 2013

Background

Pediatrics residents are expected to demonstrate preparedness for neonatal resuscitation, yet research has shown gaps in residents' readiness to perform this skill.

Objective

To evaluate procedural skills and team performance of pediatrics residents during neonatal resuscitation (NR) using a high-fidelity mannequin, and to assess residents' confidence in their NR skills before and after training.

Methods

Two teams of residents (all had completed NR program training) participated in 2 separate, 90-minute sessions (2 to 3 weeks apart) in an off-site delivery room during their neonatal intensive care rotation. Residents' confidence in assisting and leading NR was surveyed before each session. Teams participated in a scenario (adapted from the NR program), which required 5 skills (positive pressure ventilation, chest compressions, endotracheal intubation, umbilical vein catheterization, and epinephrine administration). Video recording was used for debriefing and scoring. Skills were scored for technique and timeliness, and team behaviors were scored for communication, management, and leadership.

Results

Twenty-six residents (11 teams) completed 2 paired sessions. Self-confidence scores increased between the 2 sessions but were not correlated with performance. Gaps in procedural skill performance were observed, and timeliness for most skills did not meet expectations. Significant improvement in team communication was noted.

Conclusions

Important gaps in procedural skill performance, particularly timeliness, were detected by NR simulation training; residents' improvements in self-confidence did not reflect gains in actual performance. Their relative unpreparedness for NR (despite prior certification) highlights the need for deliberate practice and specific team training before and during neonatal intensive care delivery room rotations.
Validation of the Colorado Psychiatry Evidence-Based Medicine Test
Authors: Rothberg Brian , Feinstein Robert E. , Guiton Gretchen
Published: July 2013

Background

Evidence-based medicine (EBM) has become an important part of residency education, yet many EBM curricula lack a valid and standardized tool to identify learners' prior knowledge and assess progress.

Objective

We developed an EBM examination in psychiatry to measure our effectiveness in teaching comprehensive EBM to residents.

Methods

We developed a psychiatry EBM test using the validated EBM Fresno Test of Competence for family medicine. The test consists of case scenarios with open-ended questions. We also developed a scoring rubric and obtained reliability with multiple raters. Fifty-seven residents provided test data after completing 3, 6, 25, or 31 EBM sessions. The number of sessions for each resident was based on their length of training in our program.

Results

The examination had strong interrater reliability, internal reliability, and item discrimination. Many residents showed significant improvement on their examination scores when data were compared from tests taken before and after a sequence of teaching sessions. Also, a threshold for the level of expert on the examination was established using test data from 5 EBM teacher-experts.

Conclusions

We successfully developed a valid and reliable EBM examination for use with psychiatry residents to measure essential EBM skills as part of a larger project to encourage EBM practice for residents in routine patient care. The test provides information on residents' knowledge in EBM from entry level concepts through expert performance. It can be used to place incoming residents in appropriate levels of an EBM curriculum and to monitor the effectiveness of EBM instruction.
Morning Report: Can an Established Medical Education Tradition Be Validated?
Authors: McNeill Matthew , Ali Sayed K. , Banks Daniel E. , Mansi Ishak A.
Published: July 2013

Background

Morning report is accepted as an essential component of residency education throughout different parts of the world.

Objective

To review the evidence of the educational value, purpose, methods, and outcomes of morning report.

Methods

A literature search of PubMed, Ovid, and the Cochrane Library for English-language studies published between January 1, 1966, and October 31, 2011, was performed. We searched for keywords and Medical Subject Heading terms related to medical education, methods, attitudes, and outcomes in regard to “morning report.” Title and abstract review, followed by a full-text review by 3 authors, was performed to identify all pertinent articles.

Results

We identified 71 citations; 40 articles were original studies and 31 were commentaries, editorials, or review articles; 56 studies (79%) originated from internal medicine residency programs; 6 studies (8%) focused on ambulatory morning report; and 63 (89%) originated from the United States. Identified studies varied in objectives, methods, and outcome measures, and were not suitable for meta-analysis. Main outcome measures were resident satisfaction, faculty satisfaction, preparation for professional examinations, use of evidence-based medicine, clinical effects on patient care, adverse event detection, and utilization of a curriculum in case selection.

Conclusions

Morning report has heterogeneous purposes, methods, and settings. As an educational tool, morning report is challenging to define, its outcome is difficult to measure, and this precludes firm conclusions about its contribution to resident education or patient care. Residency programs should tailor morning report to meet their own unique educational objectives and needs.
The Relationship Between the American Board of Anesthesiology Part 1 Certification Examination and the United States Medical Licensing Examination
Authors: Dillon Gerard F. , Swanson David B. , McClintock Joseph C. , Gravlee Glenn P.
Published: July 2013

Background

The graduate medical education community uses results from the United States Medical Licensing Examination (USMLE) to inform decisions about individuals' readiness for postgraduate training.

Objective

We sought to determine the relationship between performance on the USMLE and the American Board of Anesthesiology (ABA) Part 1 Certification Examination using a national sample of examinees, and we considered the relationship in the context of undergraduate medical education location and examination content.

Methods

Approximately 7800 individuals met inclusion criteria. The relationships between USMLE scores and ABA Part 1 pass rates were examined, and predictions for the strength of the relationship between USMLE content areas and ABA performance were compared with observed relationships.

Results

Pearson correlations between ABA Part 1 scores and USMLE Steps 1, 2 (clinical knowledge), and 3 scores for first-taker US/Canadian graduates were .59, .56, and .53, respectively. A clear relationship was demonstrated between USMLE scores and pass rates on ABA Part 1, and content experts were able to successfully predict the USMLE content categories that would least or most likely relate to ABA Part 1 scores.

Conclusions

The analysis provided evidence on a national scale that results from the USMLE and the ABA Part 1 were correlated and that success on the latter examination was associated with level of USMLE performance. Both testing programs have been successful in conceptualizing many of the knowledge areas of interest and in developing test content to reflect those areas.
PEARLs of Wisdom: Impact of a New Block Conference on Pediatrics Resident Attendance, Satisfaction, and Learning
Authors: Moreno Megan A. , Kota Rajitha , McIntosh Gwen C. , Frohna John G.
Published: July 2013

Background

Resident attendance and participation at didactic conferences is often limited owing to time demands. In 2010, University of Wisconsin-Madison pediatrics residency eliminated all noon conferences and implemented a new block format, PEARL (Pediatric Education and Active Resident Learning).

Objective

The purpose of this study was to assess whether changes in a conference structure improved resident attendance, distractibility, satisfaction, perception of clinical relevance, and connection.

Methods

Pediatrics residents were surveyed to compare experiences in 2 different conference structures: a traditional noon conference and an interactive case-based PEARL conference. Pediatrics residents from the 2008–2010 classes were surveyed about noon conference experiences and 2009–2011 classes were surveyed about PEARL conference experiences.

Results

Participants included 32 residents in the 2010 presurvey and 36 in the 2011 postsurvey. All measures of attendance, distractibility, and satisfaction showed positive changes. For example, the average proportion of conferences attended was 73% with noon conferences and 98% with PEARL (P  =  .001). However, measures of perceived clinical relevance and resident participation did not change significantly. For example, on average 47% of residents reported contributing comments in a noon conference, whereas 56% of residents reported contributing in a block conference (P  =  .199).

Conclusions

PEARL conference significantly improved resident attendance, lowered distractibility, and improved resident satisfaction. However, these structural changes did not lead to changes in perceived clinical relevance of information learned or resident participation. Further content changes or faculty teaching strategies should be considered.
Using a Learning Coach to Develop Family Medicine Residents' Goal-Setting and Reflection Skills
Authors: George Paul , Reis Shmuel , Dobson Margaret , Nothnagle Melissa
Published: July 2013

Background

Self-directed learning (SDL) skills, such as self-reflection and goal setting, facilitate learning throughout a physician's career. Yet, residents do not often formally engage in these activities during residency.

Intervention

To develop resident SDL skills, we created a learning coach role for a junior faculty member to meet with second-year residents monthly to set learning goals and promote reflection.

Methods

The study was conducted from 2008–2010 at the Brown Family Medicine Residency in Pawtucket, Rhode Island. During individual monthly meetings with the learning coach, residents entered their learning goals and reflections into an electronic portfolio. A mixed-methods evaluation, including coach's ratings of goal setting and reflection, coach's meeting notes, portfolio entries, and resident interviews, was used to assess progress in residents' SDL abilities.

Results

Coach ratings of 25 residents' goal-setting ability increased from a mean of 1.9 to 4.6 (P < .001); ratings of reflective capacity increased from a mean of 2.0 to 4.7 (P < .001) during each year. Resident portfolio entries showed a range of domains for goal setting and reflection. Resident interviews demonstrated progressive independence in setting goals and appreciation of the value of reflection for personal development.

Conclusions

Introducing a learning coach, use of a portfolio, and providing protected time for self-reflected learning allowed residents to develop SDL skills at their own pace. The learning coach model may be applicable to other residency programs in developing resident lifelong learning skills.
Retention of Critical Care Skills After Simulation-Based Mastery Learning
Authors: Moazed Farzad , Cohen Elaine R. , Furiasse Nicholas , Singer Benjamin , Corbridge Thomas C. , McGaghie William C. , Wayne Diane B.
Published: July 2013

Background

Whether cognitive and patient care skills attained during simulation-based mastery learning (SBML) are retained is largely unknown.

Objective

We studied retention of intensive care unit (ICU) clinical skills after an SBML boot camp experience.

Methods

Forty-seven postgraduate year (PGY)-1 residents completed SBML intervention designed to increase procedural, communication, and patient care skills. The intervention included ICU skills such as ventilator and hemodynamic parameter management. Residents were required to meet or exceed a minimum passing score (MPS) on a clinical skills examination before starting actual patient care. Skill retention was assessed in 42 residents who rotated in the medical ICU. Residents received a standardized 15-minute booster teaching session reviewing key concepts during the first week of the rotation. During the fourth week of their rotation, PGY-1 residents completed a clinical skills examination at the bedside of an actual ICU patient. Group mean examination scores and the proportion of subjects who met or exceeded the MPS at each testing occasion were compared.

Results

Residents scored a mean 90% (SD  =  6.5%) on the simulated skills examination immediately after training. Residents retained skills obtained through SBML as the mean score at bedside follow-up testing was 89% (SD  =  8.9%, P  =  .36). Thirty-seven of 42 (88%) PGY-1 residents met or exceeded the MPS at follow-up.

Conclusion

SBML leads to substantial retention of critical care knowledge, and patient care skills PGY-1 boot camp is a highly efficient and effective model that can be administered at the beginning of the academic year.
“Best Practice” for Patient-Centered Communication: A Narrative Review
Authors: King Ann , Hoppe Ruth B.
Published: July 2013

Background

Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians.

Objective

This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed.

Results

A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes “best practice” for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior.

Conclusions

Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills.
Polished Cobalt-Chrome vs Titanium Tibial Trays in Total Knee Replacement (a Comparison using the PFC Sigma System)
Authors: Hug Kevin T , Henderson Robert A , Hansen Benjamin J , Wellman Samuel S , Vail Thomas P
Published: July 2013

Fixed-bearing total knee arthroplasty components can cause wear debris due to fretting micromotion between the polyethylene insert and the metal tibial tray, possibly leading to osteolysis and implant failure. This study compared the effects of either a highly polished cobalt-chrome (CoCr) or titanium tibial tray in patients receiving the PFC. Sigma® posterior stabilized knee system with a moderately cross-linked polyethylene insert. One hundred five patients with titanium tibial trays and 70 patients with CoCr tibial trays were prospectively enrolled at the time of follow-up of at least 4 years from surgery. There were two revisions with implant removal in each group. On blinded radiographic review, osteolysis was observed in three of 105 knees in the titanium group and three of 70 knees in the CoCr group. Radiolucent lines were categorized in accordance with the Knee Society roentgenographic evaluation system. In the titanium group 18% showed no radiolucent lines, 65% scored four or less (nonconcerning), and 17% scored between five and nine (requires observation for progression). In the CoCr group 24% showed no radiolucencies, 61% scored four or less, and 14% scored between five and nine. None of the knees in either group scored greater than 10 (possible or impending failure). Knee society scores and radiographic alignment were statistically similar between groups. These results suggest that there may not be a difference in clinical or radiographic mid-term outcome between titanium and CoCr tibial trays in total knee arthroplasty.

Hug KT, Henderson RA, Hansen BJ, Wellman SS, Vail TP, Bolognesi MP. Polished Cobalt-ChromevsTitanium Tibial Trays in Total Knee Replacement (A Comparison using the PFC Sigma System). The Duke Orthop J 2012;2(1):5-11.
Anomalous Thenar Musculature Associated with Aberrant Median Nerve Motor Branch Take-off: An Anatomic and Clinical Study
Authors: Lourie Gary M , Gaston R Glenn , Peljovich Allan E , Marshall Jason J , Patterson Lee
Published: July 2013

Introduction

Iatrogenic laceration of the median nerve motor branch during carpal tunnel release is a devastating complication that has been reported with both open and endoscopic techniques. The purpose of this study is to highlight a previously underreported relationship between an aberrant course of the median nerve motor branch and an anomalous thenar muscle that places the motor branch at high risk.

Materials and methods

This was a two part study. The first part was a retrospective review of over 500 cases of carpal tunnel release over a 7 year period. There were 530 carpal tunnel releases performed and 20/530 cases were found to have a characteristic anomalous thenar muscle associated with a consistent aberrant course of the motor branch of the median nerve. Part two was an anatomic study in which 42 cadaveric wrists were dissected to determine median nerve branching patterns, dimensions of the transverse carpal ligament, and thenar musculature dimensions.

Results

Twenty patients (3.8%) in the clinical arm were found to have anomalous musculature. In each case, the characteristics of the muscle were similar; the muscle was triangular in shape, was distal to the FPB, and had minimal fascial covering. In 100% of the cases the motor branch was found to be more anterior/central or ulnar in its take-off. In the anatomic study, two hands (5%) had aberrant musculature extending distal to the transverse carpal ligament (TCL). Both were associated with an anterior/central or ulnar median motor branch take-off with recurrent course. Larger thenar musculature dimensions and anomalous thenar muscle were associated with more anterior and ulnar motor branch take-off.

Conclusion

There appears to be a high association between anomalous thenar musculature and an aberrant course of the motor branch of the median nerve placing it a greater potential risk for iatrogenic injury.

Lourie GM, Gaston RG, Peljovich AE, Marshall JJ, Patterson L. Anomalous Thenar Musculature Associated with Aberrant Median Nerve Motor Branch Take-off: An Anatomic and Clinical Study. The Duke Orthop J 2012;2(1):18-22.
Free Vascularized Fibular Grafting Preserves Athletic Activity Level in Patients with Osteonecrosis
Authors: Sabesan VJ , Pedrotty DM , Urbaniak JR , Gahreeb G , Aldridge JM
Published: July 2013

Background

Athletic patients with osteonecrosis of the femoral head have few desirable therapeutic options that preserve athletic ability. A total hip arthroplasty for this young and active patient population would be catastrophic for patients’ chances of returning to vigorous athletic endeavors. Therefore, other therapeutic alternatives must be considered prior to enlisting this patient population for a total hip arthroplasty.

Materials and methods

We retrospectively evaluated 15 patients (19 hips) who presented at an average age of 28.5 years (12-46) and stages 2 (6/19), 3 (2/19), 4 (9/19) and 5 (2/19) of osteonecrosis of the femoral head (ONFG). All patients were participating in strenuous athletic activity and were treated with free vascularized fibular autografting (FVFG) to the femoral head.

Results

Postoperative evaluation of pain symptoms and functional activity showed improvements in all patients. The average follow-up time was 8 years. Harris hip scores significantly increased from an average preoperative score of 72.5 to an average postoperative score of 94. Seventy-five percent of patients were able to return to their sport after recovery and all patients reported being satisfied with the procedure and would repeat their decision to have surgery. Three patients’ hips were converted to arthroplasty at 3, 11 and 17 years post-FVFG.

Conclusion

Our results demonstrate FVFG as a successful treatment in athletes with osteonecrosis of the femoral head. This procedure has the potential to reduce pain, increase activity and allow most to return to their sport, an achievement often not possible with other treatment options.

Sabesan VJ, Pedrotty DM, Urbaniak JR, Gahreeb G, Aldridge III JM. Free Vascularized Fibular Grafting Preserves Athletic Activity Level in Patients with Osteonecrosis. The Duke Orthop J 2012;2(1):40-43.
Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft
Authors: Morrell Nathan T , Mercer Deana M , Moneim Moheb S
Published: July 2013

Introduction

Distal biceps tendon ruptures are a rare injury and surgical reconstruction is typically recommended for chronic ruptures. There is no consensus regarding the most appropriate reconstruction technique. We present our experience with fascia lata autograft reconstructions of chronic distal biceps tendon ruptures using a modified single incision technique and distal fixation with suture anchors.

Materials and methods

We retrospectively reviewed the outcome of 12 male patients with chronic distal biceps tendon ruptures who had reconstruction using a fascia lata autograft through a single anterior approach. The age ranged from 29 to 62 years. The average delay to surgery was 26.5 weeks (range 6-68 weeks). A modified single anterior incision was utilized for all patients. Fascia lata autograft was attached distally to the bicipital tuberosity using suture anchors. Tension was set with the elbow in 50° of flexion. The average follow-up was 14.5 months (range 1.5-66 months). All patients were treated by the senior author (MSM).

Results

Eleven patients (92%) reported subjective improvement in elbow flexion and supination strength, as well as painless range of motion. The average elbow flexion/ extension arc was 126° (5° flexion to 131° flexion) and the average supination/pronation arc was 167 degrees (87° pronation to 80° supination). Five patients underwent isokinetic flexion strength testing which revealed a restoration of 86% of strength when compared to the uninvolved side. Four patients underwent supination isokinetic strength testing which revealed a restoration of 87% of strength when compared to uninvolved side. Four patients reported numbness in the superficial radial nerve distribution that recovered within 12 months. There were no cases of heterotopic ossification or graft rupture. There was one case of wound dehiscence at the elbow that required local flap coverage and went on to heal uneventfully. Aside from a small muscle bulge at the donor site, there were no donor site complications.

Conclusion

To our knowledge, this is the largest case series of patients undergoing distal biceps tendon reconstruction using fascia lata autograft. Our study has demonstrated a low complication rate with functional results similar to those reported in the literature utilizing a similar technique. We conclude that this technique offers a surgical treatment alternative that yields satisfactory functional outcomes with a low risk of complication.

Morrell NT, Mercer DM, Moneim MS. Reconstruction of Chronic Distal Biceps Tendon Rupture using Fascia Lata Autograft. The Duke Orthop J 2012;2(1):55-59.
Combined Arthroscopic and Mini-Open Treatment of CAM-Type Femoroacetabular Impingement
Authors: Watters Tyler S , Kaufman Adam M , Solic John M , Stinnett Sandra S
Published: July 2013

Purpose

Osteochondroplasty of the femoral head-neck junction can improve hip pain and function in patients with femoroacetabular impingement. We report our initial series of patients undergoing surgical treatment for symptomatic CAM type femoroacetabular impingement using a combined arthroscopic and mini-open approach.

Materials and methods

A retrospective chart review of 20 consecutive patients was performed. Seventeen patients had adequate follow-up for inclusion. Preoperative clinical and radiographic characteristics as well as intraoperative findings were obtained from patient records. Postoperative Harris Hip scores and VAS pain scores were recorded at final follow-up.

Results

At an average of 27.8 months (range 12-48 months), the mean Harris Hip score improved from 64.7 preoperatively to 86.8 (p < 0.001). The mean VAS pain score improved from 4.80 to 1.53 (p = 0.001). Two patients (11.7%) underwent total hip arthroplasty at an average of 15 months postoperatively. Fourteen patients (82%) stated they would have the procedure again. There were no significant complications.

Conclusion

Surgical treatment of CAM type femoroacetabular impingement using a combined arthroscopic and mini-open anterior hip approach has a low complication rate and improves functional and pain scores at short-term follow-up.

Watters TS, Kaufman AM, Solic JM, Stinnett SS, Olson SA. Combined Arthroscopic and Mini-Open Treatment of CAM-Type Femoroacetabular Impingement. The Duke Orthop J 2012;2(1):60-65.
Stress Fractures about the Foot and Ankle in Athletes
Authors: Mayer Stephanie W , Joyner Patrick W , Almekinders Louis C , Parekh Selene G
Published: July 2013

Stress fractures of the foot and ankle are a common problem encountered by athletes of all levels and ages. This review summarizes the history and physical exam findings, radiographic imaging, diagnosis and treatment of stress fractures of the foot and ankle in those participating in athletic activities.

These injuries can be divided into low- and high-risk based upon their propensity to heal without complication. A wide variety of nonoperative strategies are employed based on the duration of symptoms, type of fracture, and patient factors such as activity type, desire to return to sport and compliance. Operative management has proven superior in several high risk types of stress fractures. Evidence on pharmacotherapy and physiologic therapy such as bone stimulators is evolving.

A high index of suspicion for stress fractures is appropriate in many high-risk groups of athletes with lower extremity pain. Proper and timely workup and treatment is successful in returning these athletes to sport in many cases. Education of athletes as well as their families, training and coaching staff is important. Attention to training regimens, technique, equipment and proper nutrition is paramount in the prevention of these injuries.

Mayer SW, Joyner PW, Almekinders LC, Parekh SG. Stress Fractures about the Foot and Ankle in Athletes. The Duke Orthop J 2013;3(1):8-19.
Novel Rabbit Model for the Evaluation of Open Tibia Fractures: Effect of Delayed Surgery on Infection Rate
Authors: Kokko Kyle P , Kang Qian K , Wen Xuejun , An Yueheui H , Barfield William R , Hartsock Langdon A
Published: July 2013

Introduction

The objective of this investigation was to evaluate the effects of delayed surgery on infection rates of open tibia fractures in a rabbit model. Our hypothesis was that delaying irrigation and debridement (I&D) would increase the risk of bony and soft tissue infection when antibiotics were withheld.

Materials and methods

A drill hole was created in the rabbit tibia and inoculated withStaphylococcus aureus. Animals underwent I&D at controlled delayed times of 6 hours (n = 11), 12 hours (n = 9) and 24 hours (n = 10). A stainless steel pin was inserted to mimic definitive fracture fixation with a metal prosthesis. No antibiotics were administered. Animals were sacrificed at 4 weeks and evaluated for infection.

Results

The percent of soft tissue infections with I&D delays of 6, 12 and 24 hours were 18, 22 and 40%, respectively [p = 0.59; odds ratio (OR) = 3]. The percentage of animals with osteomyelitis with I&D delays of 6, 12 and 24 hours were 9, 22 and 50%, respectively (p = 0.12; OR = 10).

Discussion

In the current model, delaying I&D from 6 to 24 hours may increase the rate of postoperative osteomyelitis and further investigation is warranted.

Kokko KP, Kang QK, Wen X, An YH, Barfield WR, Hartsock LA. Novel Rabbit Model for the Evaluation of Open Tibia Fractures: Effect of Delayed Surgery on Infection Rate. The Duke Orthop J 2013;3(1):48-53. I
Simultaneous Unicompartmental Knee Arthroplasty and Lateral Patellar Facetectomy for Bicompartmental Degenerative Disease
Authors: Magnussen Robert A , Gancel Evrard , Servien Elvire , Jacobi Matthias , Demey Guillaume , Neyret Philippe , Lustig Sébastien
Published: July 2013

Introduction

Unicompartmental knee arthroplasty (UKA) is a treatment option in patients with unicompartmental degenerative disease. Compared to total knee arthroplasty (TKA), the advantages of UKA include accelerated recovery and cruciate ligament retention. These advantages, along with emerging evidence that mild patellofemoral joint osteoarthritis does not compromise results of UKA have encouraged expansion of the indications for UKA. Symptomatic lateral patellofemoral joint degenerative disease is a common cause of UKA revision. Partial lateral patellar facetectomy can provide relief from symptoms of lateral patellofemoral degenerative disease. We hypothesize that simultaneous UKA and lateral patellar facetectomy provides durable pain relief and functional improvement in a patient population with degenerative disease of one tibiofemoral compartment and the lateral patellofemoral joint.

Materials and methods: Between 2004 and 2008, 11 lateral UKA's were performed in association with partial lateral patellar facetectomy in 11 female patients (mean age: 66.7 years) with degenerative changes in one tibiofemoral compartment and the lateral patellofemoral joint. Patients were followed clinically and radiographically for a mean of 5 years.

Results

No patient underwent revision surgery in the followup period. The mean international Knee Society (IKS) knee score improved from 64.9 ± 11.2 points preoperatively to 87.5 ± 12.6 points at final follow-up (p = 0.01). The mean IKS functional score improved from 65.9 ± 23.5 points preoperatively to 83.2 ± 23.3 points at final follow-up (p = 0.012). The mean Kujala score was 84.3 ± 13.5 points postoperatively. Progression of patellofemoral OA was observed in one patient.

Conclusion

Simultaneous UKA and partial lateral patellar facetectomy is a viable treatment option for symptomatic degenerative disease involving one tibiofemoral compartment and the lateral patellofemoral joint. This treatment approach may be a useful alternative to TKA or bicompartmental arthroplasty in a carefully selected patient population.

Level of evidence

Case series—Level IV.

Magnussen RA, Gancel E, Servien E, Jacobi M, Demey G, Neyret P, Lustig S. Simultaneous Unicompartmental Knee Arthroplasty and Lateral Patellar Facetectomy for Bicompartmental Degenerative Disease. The Duke Orthop J 2013;3(1):61-66.
Management of Massive Rotator Cuff Tears in Active Patients with Minimal Glenohumeral Arthritis: A Prospective Observational Study with Clinical and Radiographic Analyses of Reconstruction using Dermal Tissue Matrix Xenograft
Authors: Toth Alison P , Gupta Anil K
Published: July 2013

Objectives

To evaluate the clinical and radiographic outcomes of patients undergoing interposition reconstruction of massive, otherwise irreparable rotator cuff tears through a mini-open approach with the use of a porcine dermal tissue matrix.

Materials and methods

We performed a prospective observational study of 26 patients (27 shoulders) who underwent reconstruction of massive rotator cuff tears using dermal tissue matrix xenograft. Pain level (scale 0-10, 10 = severe pain), active range of motion, and supraspinatus and external rotation strength were assessed. Additional outcome measures included modified American shoulder and elbow score (MASES) and short form-12 (SF-12) score. Clinical and radiographic analyses were performed at an average 32 months follow-up period (minimum 2-year follow-up). Ultrasound imaging (static and dynamic) of the operative shoulder was performed at final followup to assess the integrity of the reconstruction.

Results

Mean patient age was 60. Mean pain level decreased from 5.1 to 0.4 (p = 0.002). Mean active forward flexion, abduction, and external rotation motion improved from 138.8 to 167.3 (p = 0.024), 117.9 to 149.3 (p = 0.001) and 57.7 to 64.7° (p = 0.31), respectively. Supraspinatus and external rotation strength improved from 7.2 to 9.4 (p = 0.001) and 7.4 to 9.5 (p = 0.001), respectively. Mean MASES improved from 62.7 to 91.8 (p = 0.0007) and mean SF-12 scores improved from 48.4 to 56.6 (p = 0.044). Twenty-one patients (twenty-two shoulders) returned for a dynamic and static ultrasound of the operative shoulder at a minimum 2-year follow-up. Sixteen (73%) demonstrated a fully intact tendon/graft reconstruction. Five (22%) patients had partially intact reconstructions, and one (5%) had a complete tear at the graft-bone interface due to suture anchor pullout as a result of a fall. There were no cases of infection or tissue rejection.

Conclusion

We present a reproducible surgical technique for the management of massive irreparable rotator cuff tears. In our series, patients demonstrated a significant improvement in both subjective and objective clinical outcomes. Radiographic analysis demonstrated that the majority of patients had a fully intact reconstruction at a minimum 2-year follow-up.

Gupta AK, Toth AP. Management of Massive Rotator Cuff Tears in Active Patients with Minimal Glenohumeral Arthritis: A Prospective Observational Study with Clinical and Radiographic Analyses of Reconstruction using Dermal Tissue Matrix Xenograft. The Duke Orthop J 2013;3(1):80-87.
Ilizarov: The Man, The Myth, The Method: An Orthopaedic Inspiration
Authors: Garrigues Grant E , Ledford Cameron , Fitch Robert D
Published: July 2013

There are many orthopaedic pioneers whose impact continues to live on today, teaching us valuable lessons, inspiring us to greatness, and touching the lives of generations of future patients. Professor Ilizarov, a nonsurgically trained general practitioner, represents such an important orthopaedic forefather for his instruction on how to grow bones and soft tissues that would otherwise face catastrophic deformity and dysfunction. A simple look at his life, his innovation, and astonishing legacy serves as an inspiration to all involved in the amazing field of orthopaedics.

Ledford C, Garrigues GE, Fitch RD. Ilizarov: The Man, The Myth, The Method: An Orthopaedic Inspiration. The Duke Orthop J 2013;3(1):104-107.
Surface response to rain events throughout the West African monsoon
Authors: Lohou F. , Kergoat L. , Guichard F. , Boone A. , Cappelaere B. , Cohard J.-M. , Demarty J. , Galle S. , Grippa M. , Peugeot C. , Ramier D. , Taylor C. M. , Timouk F.
Published: July 2013

Abstract. This study analyses the response of the continental surface to a rain event, taking advantage of the long-term near-surface measurements over different vegetation covers at different latitudes, acquired during the African Monsoon Multidisciplinary Analysis (AMMA) experiment. The simulated surface response by nine land surface models involved in AMMA Land Model Intercomparison Project (ALMIP), is compared to the observations. The surface response, described via the evaporative fraction, evolves in two steps: the immediate surface response and the surface recovery. The immediate surface response corresponds to an increase in the evaporative fraction occurring immediately after the rain. For all the experimental sites, the immediate surface response is strongest when the surface is relatively dry. From the simulation point of view, this relationship is highly model and latitude dependent. The recovery period, characterized by a decrease of the evaporative fraction during several days after the rain, follows an exponential relationship whose rate is vegetation dependent: from 1 day over bare soil to 70 days over the forest. Land surface models correctly simulate the decrease of EF over vegetation covers whereas a slower and more variable EF decrease is simulated over bare soil.
Opportunistic feeding on various organic food sources by the cold-water coral Lophelia pertusa
Authors: Mueller C. E. , Larsson A. I. , Veuger B. , Middelburg J. J. , van Oevelen D.
Published: July 2013

Abstract. The ability of the cold-water coral Lophelia pertusa to exploit different food sources was investigated under standardized conditions in a flume. All tested food sources, dissolved organic matter (DOM, added as dissolved free amino acids), bacteria, algae, and zooplankton (Artemia) were deliberately enriched in 13C and 15N. The incorporation of 13C and 15N was traced into bulk tissue, fatty acids, hydrolysable amino acids, and the skeleton (13C only) of L. pertusa. Incorporation rates of carbon (ranging from 0.8–2.4 µg C g–1 DW d–1) and nitrogen (0.2–0.8 µg N g–1 DW d–1) into coral tissue did not differ significantly among food sources indicating an opportunistic feeding strategy. Although total food assimilation was comparable among sources, subsequent food processing was dependent on the type of food source ingested and recovery of assimilated C in tissue compounds ranged from 17% (algae) to 35% (Artemia). De novo synthesis of individual fatty acids by L. pertusa occurred in all treatments as indicated by the 13C enrichment of individual phospholipid-derived fatty acids (PLFAs) in the coral that were absent in the added food sources. This indicates that the coral might be less dependent on its diet as a source of specific fatty acids than expected, with direct consequences for the interpretation of in situ observations on coral nutrition based on lipid profiles.
Kulturlandschaft gemeinsam verstehen – Praktische Beispiele der Landschaftssozialisation aus dem Schweizer Alpenraum
Authors: Stotten R.
Published: July 2013

Abstract. Within the research field of landscape perception new approaches have been developed and applied on different scales in Switzerland. Agriculture still has a huge impact on the appearance of cultural landscape. The project Kulturlandschaft gemeinsam verstehen investigates the perception among farmers and is focusing on regional differences. Therefore problem-centred interviews have been conducted in two case study areas during an on-site walk with farmers. Regarding the theory of landscape socialisation participative and mediation processes in the realm of landscape values have been considered. The results point out a differentiated perception of cultural landscape within the two case study areas and show that an active inclusion of farmers has a positive impact on the landscape perception.
Leibniz and geography: geologist, paleontologist, biologist, historian, political theorist and geopolitician
Authors: Elden S.
Published: July 2013

Abstract. This article discusses the way that the German philosopher and mathematician Gottfried Leibniz (1646–1716) made a number of significant contributions to geography. In outlining his contributions as a geologist, palaeontologist, biologist, historian, political theorist and geopolitician, it challenges the straightforward way he is read in geography. Particular focus is on his Protogaea, the Annales Imperii and the Consilium Aegyptiacum, respectively a pre-history of the earth, a chronology of German nobility in the Middle Ages, and a military-strategic proposal to King Louis XIV. Making use of contemporary debates about ways of reading Leibniz, and drawing on a wide range of his writings, the article indicates just how much remains to be discovered about his work.
Effective rainfall: a significant parameter to improve understanding of deep-seated rainfall triggering landslide – a simple computation temperature based method applied to Séchilienne unstable slope (French Alps)
Authors: Vallet A. , Bertrand C. , Mudry J.
Published: July 2013

Abstract. Pore water pressure, build up by recharge of hydrosystems, is one of the main triggering factors of deep seated landslides. Effective rainfall, which is the part of the rainfall which recharges the aquifer, is a significant parameter. Soil-water balance is an accurate way to estimate effective rainfall. Nevertheless this approach requires evapotranspiration, soil water storage and runoff characterization. Available soil storage and runoff were deduced from field observations whereas evapotranspiration computation is a highly demanding method requiring significant input of meteorological data. Most of the landslide sites used weather stations with limited datasets. A workflow method was developed to compute effective rainfall requiring only temperature and rainfall as inputs. Two solar radiation and five commonly used evapotranspiration equations were tested at Séchilienne. The method was developed to be as general as possible in order to be able to be applied to other landslides. This study demonstrated that, for the Séchilienne unstable slope, the displacement data correlation performance (coefficient of determination) is significantly enhanced with effective rainfall (0.633) compared to results obtained with raw rainfall (0.436) data. The proposed method for estimation of effective rainfall was developed to be sufficiently simple to be used by any non-hydro specialist who intends to characterize the relationship of rainfall to landslide displacements.
The Art of Thinking: Using Collage to Stimulate Scholarly Work
Authors: Simmons Nicola , Daley Shauna
Published: July 2013

Integrating the arts into higher education pedagogy provides an opportunity for cultivating rich ideas and high-level thinking, capitalizing on the creativity that every person already possesses and uses (Livingston, 2010). As Newton and Plummer (2009) note “the use of the creative arts as pedagogical strategy enables individuals to better understand themselves, [and] to stimulate thinking” (p. 75).
We extend that premise to examine the impact of an arts activity on scholarly thinking. Our exploratory study examines academics’ (graduate students and educators) identity and role constructs (Kelly, 1955) to understand to what extent engaging in arts-based activities supports meaning-making and conceptualizing research questions. We asked participants to reflect on collages they created, how the collage process supported their research conceptualization, challenges they encountered, and their overall reflections on the process as an adjunct to written scholarly work. We show that the process of creating collages supported participants in making their tacit knowledge explicit, in reflecting at meta-cognitive levels, and in transforming their thinking, often in ways they anticipated would affect their future practice.
L’intégration des arts dans la pédagogie de l’enseignement supérieur offre l’occasion de cultiver de riches idées et rend possible une réflexion d’ordre supérieur qui permet de capitaliser sur la créativité que chaque personne possède déjà et utilise (Livingston, 2010). Comme le font remarquer Newton et Plummer (2009), « l’usage des arts créatifs en tant que stratégies pédagogiques permet aux gens de mieux se comprendre et de stimuler la réflexion. » (p. 75)
Nous élargissons cette prémisse pour examiner l’impact d’une activité artistique sur la pensée savante. Notre étude exploratoire examine l’identité d’universitaires (étudiants de cycles supérieurs et éducateurs) et les constructions de rôles (Kelly, 1955) pour comprendre la mesure dans laquelle le fait de s’engager dans des activités artistiques appuie la conceptualisation de questions qui portent sur la recherche de la signification. Nous avons demandé aux participants de réfléchir aux collages qu’ils avaient créés, à la manière dont le processus de création de ces collages avait appuyé leur conceptualisation de la recherche, aux défis auxquels ils avaient été confrontés et à leur réflexion générale sur le processus en tant qu’activité d’appoint à leurs travaux académiques écrits. Nous montrons que le processus de création de collages a aidé les participants à rendre explicites leurs connaissances tacites, à réfléchir à des niveaux méta-cognitifs et à transformer leur pensée d’une manière qui allait souvent, comme ils l’avaient anticipé, affecter leur pratique future.
The Scholarship of Teaching and Learning in Canadian Post-Secondary Mathematics: 2000-2010
Authors: Chan Bernard S , Wahl Lindi M
Published: July 2013

Published accounts of pedagogical experience and pedagogical research are critical resources to post-secondary mathematics instructors, and yet the quantity and scope of this literature is rarely summarized or reviewed. In this contribution, we analyze recent peer-reviewed journal publications regarding post-secondary mathematics, published by Canadian scholars. We classified this scholarship by institution, publication year, type of pedagogical scholarship, and by topic. We highlight topics of continual interest, changing trends in time and newly emerging themes. This review therefore provides a benchmark of current scholarship in this important area, as well as a point of comparison for similar data from other countries, and other disciplines.
Les comptes rendus publiés sur les expériences pédagogiques et la recherche sur la pédagogie sont des ressources essentielles pour les enseignants de mathématiques au niveau postsecondaire. Pourtant, la quantité et la portée de cette documentation font rarement l’objet de résumés ou d’analyses. Dans cet article, nous analysons les publications récentes de chercheurs canadiens sur les mathématiques au niveau postsecondaire, qui ont paru dans des revues révisées par les pairs. Nous avons classé ces publications par établissement, année de publication, type de recherche et sujet. Nous mettons en lumière les sujets d’intérêt constant, les tendances en évolution au fil du temps et les thèmes émergents. Cette recension constitue donc une référence sur les recherches universitaires actuelles dans ce domaine important ainsi qu’un point de comparaison pour des données similaires provenant d’autres pays et d’autres disciplines.