bluuebunny/crossref_metadata_2025 huggingface dataset:
Suprasegmental information cues morphological anticipation during L1/L2 lexical access
Authors: Sagarra Nuria , Casillas Joseph V.
Published: January 2018

We use visual-world eye-tracking and gating methods to investigate whether Spanish monolinguals and English late learners of Spanish use prosodic cues (lexical stress) to anticipate morphological information (suffixes) during spoken word recognition, and if they do, whether L2 proficiency and working memory (WM) mediate their anticipatory abilities. Our findings show that the monolinguals used prosodic information to predict word endings in both tasks, regardless of first-syllable stress (stressed, unstressed) and structure (CV, CVC). In contrast, the beginning learners did not use prosodic information to anticipate word suffixes in any task or condition. Importantly, the advanced learners mirrored the monolinguals, except in words with first-syllable CV structure, but were slower than the monolinguals. Finally, WM was not associated with anticipatory eye movements, though results were inconclusive for offline processing. Taken together, the present study shows that suprasegmental information facilitates morphological anticipation during spoken word recognition, and that adult learners can gain anticipatory processing patterns qualitatively, but not quantitatively, similar to monolinguals.
Responding to direct complaints
Authors: Liu Ping , Liu Huiying
Published: January 2018

This article examines the role of metapragmatic expressions (MPEs) in constructing common ground (CG) in the call taker’s responses to customer direct complaints in telephone interactions in the framework of the socio-cognitive approach proposed and developed by Kecskes (2008,2010,2013,2017) and Kecskes and Zhang (2009,2013). Based on five extracts drawn from the data of about two hours of 15 recordings of telephone interactions that include successful complaint settlements made between customers and the customer service department of one Chinese airline, it reveals that the call taker mainly employs five types of MPEs as CG construction devices to explicitly manifest intentions of giving accounts and explanations, confirming and checking information, negotiating adequate compensations, establishing close interpersonal relationships, and aligning with the organization. This article enhances our understanding of the functioning process of metapragmatic indicators in complaint settlement in institutional telephone interactions.
Recovering alcoholic
Authors: Wittke Jonas B.
Published: January 2018

This paper examines the competing construals of the phrase recovering alcoholic, which, as a Membership Categorization Device (Sacks 1992), serves to fulfill a commitment to an identity category and at the same time evokes other category-bound activities, often with unintended consequences. Former problem drinkers are routinely referred to by themselves and others as recovering alcoholics, yet they are not ‘recovering’ in the canonical sense of the word, and they participate in a behavior – not drinking – which is a negation of the behavior that originally qualified them as alcoholics. This use of the relatively new identity marker recovering alcoholic may discourage a problem drinker from attempting sobriety, as it implies an unbounded, never-ending period of recovery, unlike recovery from other diseases (and, oddly, unlike the full recovery proffered by Alcoholics Anonymous).
Do the meanings of abstract nouns correlate with the meanings of their complementation patterns?
Authors: Vergaro Carla , Schmid Hans-Jörg
Published: January 2018

There is a widespread assumption in Construction Grammar (but also before and elsewhere) that the meanings of verbs correlate with or even determine their complementation forms and patterns. There is much less research on noun complementation, however, although this category is even more interesting for a number of reasons such as the potential for valency reduction, nominal topicalization constructions, and additional complementation options, e.g.of-PPs and existential constructions.

In this paper we focus on the class of nouns reporting commissive illocutionary acts (promise, offer, pledge, refusal, bet, threat, etc.), and address the question of whether there is a correlation (i) between the meaning of these nouns and their preferred complementation patterns, and (ii) between their semantic similarity and their similarity in the distribution of complementation patterns.

We report the results of a study of a set of 17 commissive nouns chosen from a wider collection of illocutionary nouns. Two types of analysis were carried out in order to compare the semantic and grammatical characteristics of these nouns. The semantic analysis was based on insights from speech act theory and the philosophy of language. We developed a framework for a systematic comparative description of the nouns in our word field. The results were tallied with a corpus-based grammatical analysis. Two hundred tokens of each noun type were randomly sampled from the Corpus of Contemporary American English. Using these data, the 17 nouns were subjected to an analysis of the relative frequencies of their complementation patterns.

Results indicate a general match between noun meanings and complementation patterns. More specifically, however, they indicate that the closeness of this match depends on the prototypicality of nouns as members of the class of commissives.

The study, then, contributes to our understanding of the relation between lexis and syntax. At the same time, it confirms the need for a close semantic analysis to account for the great extent to which item-specific information, i.e. properties of individual nouns, have to be taken into consideration at the expense of large-scale generalizations.
Gestures of the abstract
Authors: Parrill Fey , Stec Kashmiri
Published: January 2018

Speakers perform manual gestures in the physical space nearest them, called gesture space. We used a controlled
elicitation task to explore whether speakers use gesture space in a consistent way (assign spaces to ideas and
use those spaces for those ideas) and whether they use space in a contrastive way (assign different spaces to
different ideas when using contrastive speech) when talking about abstract referents. Participants answered two questions designed
to elicit contrastive, abstract discourse. We investigated manual gesture behavior. Gesture hand, location on the horizontal axis,
and referent in corresponding speech were coded. We also coded contrast in speech. Participants’ overall tendency to use the same
hand (t(17) = 13.12, p = .001, 95% CI [.31, .43], d = 2.53) and same location
(t(17) = 7.47, p = .001, 95% CI [.27, .47], d = 1.69) when referring to an
entity was higher than expected frequency. When comparing pairs of gestures produced with contrastive speech to pairs of gestures
produced with non-contrastive speech, we found a greater tendency to produce gestures with different hands for contrastive speech:
(t(17) = 4.19, p = .001, 95% CI [.27, .82], d = 1.42). We did not find
associations between dominant side and positive concepts or between left, center, and right space and past, present, and future,
respectively, as predicted by previous studies. Taken together, our findings suggest that speakers do produce spatially consistent
and contrastive gestures for abstract as well as concrete referents. They may be using spatial resources to assist with abstract
thinking, and/or to help interlocutors with reference tracking. Our findings also highlight the complexity of predicting gesture
hand and location, which appears to be the outcome of many competing variables.
Variations in the use of metaphor at the macro-contextual level
Authors: Shie Jian-Shiung
Published: January 2018

This article investigates linguistic metaphors in four English newspapers from the perspective of Conceptual Metaphor Theory, focusing on their variations at the macro-contextual level. Analyzed in their respective macro contexts were lexicalized and non-lexicalized metaphors in 1,105 full-length news stories. The exploration reveals that: (i) the distributions of non-lexicalized metaphors are far more variable than those of lexicalized metaphors across the four newspapers, (ii) lexicalized metaphors are much more common than non-lexicalized metaphors in all the four newspapers, (iii) non-lexicalized metaphors occur more in the news stories for native speakers than in those for international or global readers, with a decreasing tendency toward those for EOL and EFL readers, and (iv) the lexicalized and non-lexicalized metaphors both have cognitive functions, while the latter serve additional stylistic purposes. The study sheds some light on the affordance between linguistic metaphors and the macro contexts of the news stories.
Leave-taking in Indonesian during short-term study abroad
Authors: Hassall Tim
Published: January 2018

This study uses multiple sources of data to examine the learning of leave-taking in Indonesian by twelve students from Australia during a sojourn of either four or seven weeks. The learners departed with very little knowledge of leave-taking routines. They rapidly learned the forms of certain routines, and used them often. However they did not learn suitable contexts for them, and also failed to learn a number of other common routines. Under influence of English, they relied excessively on statements of obligation for taking leave but also adopted one useful discourse marker. The study confirms that pragmatic routines are a site of rapid learning during study abroad, while suggesting some very common routines are hard to learn by naturalistic exposure. It confirms study abroad learners are often slow to learn to adjust forms to social context, and shows the powerful influence of L1 transfer on their pragmatic development.
Self-perceived linguistic progress, target language use and
personality development during study abroad
Authors: Arvidsson Klara , Eyckmans June , Rosiers Alexandra , Lundell Fanny Forsberg
Published: January 2018

This exploratory study investigates the development of personality dimensions
related to multicultural effectiveness and its relation to amount of target
language use and self-perceived progress in speaking during a sojourn abroad in
seven European countries. The participants were 59 Swedish and Belgian
university students. The Multicultural Personality Questionnaire – Short
Form (van der Zee, Van Oudenhoven,
Ponterotto, & Fietzer, 2013) was administered at the beginning
and the end of the semester, and data on self-reported weekly hours of target
language use and self-perceived linguistic progress were gathered at Time 2. The
main findings are the observed moderate or near moderate correlations between
self-perceived progress in speaking and change in Cultural Empathy, and between
amount of target language use and change in Cultural Empathy and Openmindedness.
This points to the relevance of further studies on the role of target language
use and progress in the development of personality characteristics.
The modernisation of HIV and AIDS’ nomenclatures in Nigeria’s major
languages
Authors: Igboanusi Herbert , Odoje Clement , Ibrahim Garba
Published: January 2018

Although the level of awareness of HIV has significantly improved over the past
decade following the coordinated activities of the National Agency for the
Control of AIDS (NACA), Nigeria still remains one of the most burdened countries
in the world with about 3 million people living with HIV. Increasing
enlightenment campaigns on HIV and AIDS have not been able to achieve remarkable
behaviour change as a result of the non-use of appropriate nomenclatures. Given
the low literacy rate of Nigerians in English (about 61% based on UNESCO
Institute for Statistics), communication strategies can only be effective when
indigenous Nigerian languages have standardised and appropriate nomenclatures
for HIV and AIDS. This study argues that the use of appropriate terms in the
local languages in referring to HIV and AIDS is capable of reducing the
stigmatisation and discrimination of people living with HIV and AIDS, and
consequently reduce the spread of HIV through behaviour change. Accordingly, the
study embarks on the lexical modernisation of HIV and AIDS nomenclatures in
Nigeria’s three major languages (i.e. Hausa, Igbo and Yoruba) in line with
current developments around the world in the management of the two health
conditions.
Expressing time through space
Authors: Nilsson Anna-Lena
Published: January 2018

This study describes how temporal discourse content is expressed in signing space in Swedish Sign Language (SSL) and identifies and describes the differences between L1- and L2-interpreters’ signed target language output. The study found that L1-interpreters systematically use complex simultaneous combinations of lexical signs and various hand, arm and body movements on and along time lines. The L2-interpreters stand more still, and their use of body movements differs from that of the L1-interpreters. Though the L2-interpreters in the study often succeed in showing that two or more entities/events are separate, they are less successful in showing the more specific, temporal and/or other, relationship(s) between them. This crucial aspect of idiomatic signed language production, therefore, should be included in interpreter training to improve the quality of interpreted target language output.
Name pronunciation strategies of ASL-Spanish-English trilingual
interpreters during mock video relay service calls
Authors: Treviño Rafael , Quinto-Pozos David
Published: January 2018

This study investigates the ways in which trilingual (American Sign Language,
English, and Spanish) interpreters pronounce names that commonly appear with
either English or Spanish phonology. Twenty trilingual interpreters interpreted
an ASL mock videophone call into English of a Deaf caller attempting to leave a
message for the Social Security Administration. Results suggest that
self-reported strategies for pronouncing Spanish-influenced names generally do
not align with observed behavior. Instead, a relationship was noted between
reported language proficiency and pronunciation; their dominant language
influenced their pronunciations. Those interpreters who report a “balanced
proficiency,” however, patterned differently. The results are contextualized
using Gile’s Sequential Model of translation and Effort Model of simultaneous
interpreting.
Effects of Si and Cu contents on grain size of Al–Si–Cu alloys
Authors: Bazhenov V. E. , Magura M. A.
Published: January 2018

The influence of the silicon and copper contents on the grain size of high-purity Al–Si, Al–Cu, and Al–Si–Cu alloys was investigated. In the Al–Si alloys, a poisoning effect was observed and a poor correlation between the grain size and growth restriction factor was obtained. A possible cause of the poisoning effect in these alloys is the formation of a TiSi2 monolayer on the particles acting as nucleation sites or another poisoning mechanism not associated with TiSi2 phase formation. In the Al–Cu alloys, a good correlation between the grain size and growth restriction factor was found, whereas in the Al–Si–Cu alloys, the correlation between these two parameters was inferior.
Uniqueness for SQG patch solutions
Authors: Córdoba Antonio , Córdoba Diego , Gancedo Francisco
Published: January 2018

This paper is about the evolution of a temperature front governed by the surface quasi-geostrophic equation. The existence part of that program within the scale of Sobolev spaces was obtained by the third author (2008). Here we revisit that proof introducing some new tools and points of view which allow us to conclude the also needed uniqueness result.
Renal Considerations in the Treatment of Hypertension
Authors: Palmer Biff F , Clegg Deborah J
Published: January 2018

There are renal implications when employing intensive blood pressure control strategies. While this approach provides cardiovascular benefit in patients with and without chronic kidney disease, the impact on renal disease progression differs according to the pattern of underlying renal injury. In the setting of proteinuria, stringent blood pressure control has generally conferred a protective effect on renal disease progression, but in the absence of proteinuria, this benefit tends to be much less impressive. Thiazide diuretics are frequently part of the regimen to achieve intensive blood pressure control. These drugs can cause hyponatremia and present with biochemical evidence mimicking the syndrome of inappropriate antidiuretic hormone secretion. Altered prostaglandin transport may explain the unique susceptibility to this complication observed in some patients. Hyperkalemia is also a complication of intensive blood pressure lowering particularly in the setting of renin–angiotensin–aldosterone blockade. There are strategies and new drugs now available that can allow use of these blockers and at the same time ensure a normal plasma potassium concentration.
Homology-based enzymatic DNA fragment assembly-based illumina sequencing library preparation
Authors: Shinozuka Hiroshi , Sudheesh Shimna , Shinozuka Maiko , Cogan Noel O I
Published: January 2018

The current Illumina HiSeq and MiSeq platforms can generate paired-end reads of up to 2 x 250 bp and 2 x 300 bp in length, respectively. These read lengths may be substantially longer than genomic regions of interest when a DNA sequencing library is prepared through a target enrichment-based approach. A sequencing library preparation method has been developed based on the homology-based enzymatic DNA fragment assembly scheme to allow processing of multiple PCR products within a single read. Target sequences were amplified using locus-specific PCR primers with 8 bp tags, and using the tags, homology-based enzymatic DNA assembly was performed with DNA polymerase, T7 exonuclease and T4 DNA ligase. Short PCR amplicons can hence be assembled into a single molecule, along with sequencing adapters specific to the Illumina platforms. As a proof-of-concept experiment, short PCR amplicons (57–66 bp in length) derived from genomic DNA templates of field pea and containing variable nucleotide locations were assembled and sequenced on the MiSeq platform. The results were validated with other genotyping methods. When 5 PCR amplicons were assembled, 4.3 targeted sequences (single-nucleotide polymorphisms) on average were successfully identified within each read. The utility of this for sequencing of short fragments has consequently been demonstrated.
Prospective and Multicenter Evaluation of Outcomes for Quality of Life and Activities of Daily Living for Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures: The EVOLVE Trial
Authors: Beall Douglas P , Chambers M R , Thomas Sam , Amburgy John , Webb James R , Goodman Bradly S , Datta Devin K , Easton Richard W , Linville Douglas , Talati Sanjay , Tillman John B
Published: January 2018

BACKGROUND

Osteoporotic and neoplastic vertebral compression fractures (VCF) are common and painful, threatening quality of life and increasing risk of morbidity and mortality. Balloon kyphoplasty is a percutaneous option for treating painful cancer- and osteoporosis-related VCFs, supported by 2 randomized trials demonstrating efficacy benefits of BKP over nonsurgical care.

OBJECTIVE

To investigate 12-mo disability, quality of life, and safety outcomes specifically in a Medicare-eligible population, representing characteristic patients seen in routine clinical practice.

METHODS

A total of 354 patients with painful VCFs were enrolled at 24 US sites with 350 undergoing kyphoplasty. Four coprimary endpoints—Numerical Rating Scale (NRS) back pain, Oswestry Disability Index (ODI), Short Form-36 Questionnaire Physical Component Summary (SF-36v2 PCS), EuroQol-5-Domain (EQ-5D)—were evaluated for statistically significant improvement 3 mo after kyphoplasty. Data were collected at baseline, 7 d, and 1, 3, 6, and 12 mo (www.clinicaltrials.gov registration NCT01871519).

RESULTS

At the 3-mo primary endpoint, NRS improved from 8.7 to 2.7 and ODI improved from 63.4 to 27.1; SF-36 PCS was 24.2 at baseline improving to 36.6, and EQ-5D improved from 0.383 to 0.746 (P < .001 for each). These outcomes were statistically significant at every follow-up time point. Five device-/procedure-related adverse events, intraoperative asymptomatic balloon rupture, rib pain, and aspiration pneumonia, and a new VCF 25 d postprocedure, and myocardial infarction 105 d postprocedure were reported and each resolved with proper treatment.

CONCLUSION

This large, prospective, clinical study demonstrates that kyphoplasty is a safe, effective, and durable procedure for treating patients with painful VCF due to osteoporosis or cancer.
Unexpected corporate outcomes from hedge fund activism in Japan
Authors: Buchanan John , Chai Dominic H , Deakin Simon
Published: January 2018

Hedge fund activism has been identified in the USA as a driver of enduring corporate governance change and market perception. We investigate this claim in an empirical study to see whether activism produced similar results in Japan in four representative areas: management effectiveness, managerial decisions, labour management and market perception. Experience from the USA would predict positive changes at Japanese target companies in these four areas. However, analysis of financial data shows that no enduring changes were apparent in the first three areas, and that market perception was consistently unfavourable. Our findings demonstrate that the same pressures need not produce the same results in different markets. Moreover, while the effects of the global financial crisis should not be ignored, we conclude that the country-level differences in corporate governance identified in the varieties of capitalism literature are robust, at least in the short term.
Exploring bariatric surgery
Authors: Lockhart Lisa , Davis Charlotte
Published: January 2018

Learn the basics of four common surgical options for adult obesity treatment when diet and exercise have failed to produce significant weight loss.
A Pilot Randomized Controlled Trial of a Phone-based Intervention for Smoking Cessation and Relapse Prevention in the Postpartum Period
Authors: Coleman-Cowger Victoria H. , Mark Katrina S. , Rosenberry Zachary R. , Koszowski Bartosz , Terplan Mishka
Published: January 2018

Objectives:

To pilot-test a Phone-based Postpartum Continuing Care (PPCC) protocol developed from existing evidence-based approaches to address both postpartum smoking relapse among low-income women who quit smoking during pregnancy and postpartum smoking increase among those who had cut down.

Methods:

One hundred thirty low-income pregnant women who were current or recently quit tobacco smokers were recruited at their first prenatal appointment and randomized to either a Control (standard care) or Experimental (standard care + PPCC) group. An intent-to-treat analysis was conducted on biochemically verified data from 6 in-person interviews during pregnancy and postpartum. Feasibility with regard to recruitment, randomization, assessment, and implementation of PPCC were assessed, along with acceptability among the target population.

Results:

PPCC was found to be feasible and acceptable to some participants, but not all. There were no significant differences in tobacco products per day at 6 months postpartum between groups; however, effect sizes differed at 6 weeks compared with 6 months postpartum. Similarly, there were no significant differences between groups in cessation rate (24% in each group) and past 90-day tobacco use (59 vs 55 days, for Control and Experimental groups, respectively).

Conclusions:

The PPCC intervention did not differentially reduce tobacco use postpartum compared with a controlled comparison group, though it was found to be acceptable among a subpopulation of low-income pregnant women and feasible with regard to recruitment, randomization, assessment procedures, and implementation. Further research is needed to identify an intervention that significantly improves smoking relapse rates postpartum.
The Effect of Melatonin Upon Postacute Withdrawal Among Males in a Residential Treatment Program (M-PAWS): A Randomized, Double-blind, Placebo-controlled Trial
Authors: Bondi Corry D. , Kamal Khalid M. , Johnson David A. , Witt-Enderby Paula A. , Giannetti Vincent J.
Published: January 2018

Objective:

Assess the effect of melatonin (5 mg) compared with placebo as an adjuvant treatment along with current behavioral and pharmacotherapy for 28 days on weekly self-reported severity of anxiety, depression, stress, and sleep complaints, and also how sleep is affecting daily life in males 18 years of age and older in recovery from substance use at a residential program in south-western Pennsylvania.

Background:

Individuals in recovery experience a variety of symptoms including, but are not limited to, anxiety, depression, sleep difficulties, and stress. In the U.S., melatonin is a readily available nutraceutical that is used to alleviate sleep difficulties. Studies also suggest that melatonin may also have anxiolytic and antidepressive actions alone, as well as in those with co-morbid insomnia. Observation of clinicians treating individuals during and/or post drug cessation indicated that melatonin is commonly provided specifically to alleviate sleep difficulties with little evidence regarding efficacy in this population. The paucity of evidence as well as observation of clinical practices provided the rationale for this randomized clinical trial.

Methods:

A single-center, randomized, double-blind, placebo-controlled, parallel-group trial was conducted. Seventy individuals were enrolled, block-randomized with an allocation ratio of 1:1. Intention-to-treat analysis was performed for all primary outcome measures. Primary outcome measures were assessed with the Generalized Anxiety Disorder Scale (GAD-7), Personal Health Questionnaire Depression Scale (PHQ-8), Perceived Stress Scale (PSS-14), and Pittsburgh Sleep Symptom Questionnaire—Insomnia (PSSQ-1). Secondary outcome measures were to acquire participant characteristics, determine adherence, and document adverse events.

Results:

No statistically significant between-group differences were detected for baseline characteristics. Even though the proportion of individuals reporting an adverse event between groups was not significantly different, the frequency of reported adverse events was greater in the melatonin group. Intention-to-treat analysis for all the measured outcomes revealed no statistically significant between-group differences for same day comparisons.

Conclusions:

The diversity of medication regimens, and also the services provided by the residential treatment site add to the complexity of assessing the efficacy of melatonin on the measured outcomes. Given these limitations, there exists insufficient evidence to suggest that the effect of melatonin and placebo on the outcomes were significantly different.
Preferential peroneal nerve injury after acetabular fracture and reconstruction
Authors: Goyal Kanu S. , Hill Michael , O’Malley Michael , Mehta Manish , Moossy John , Tarkin Ivan
Published: January 2018

Background:

Sciatic nerve dysfunction typically involving the peroneal division infamously plagues acetabular reconstruction through a posterior exposure. Competing explanations include mechanical compression from retractor placement at the hip versus overstretch. In an effort to improve the current care paradigm, we asked what underlying mechanisms of injury lead to preferential injury to the peroneal division of the sciatic nerve.

Methods:

A cadaver model was established to measure both sciatic nerve strain and intraneural pressure generated during simulated retraction performed during acetabular reconstruction. The tibial and peroneal divisions were studied independently using a micro differential variable reluctance transducer (DVRT) to quantify strain and an angiocatheter to measure intraneural pressure. Measurements were recorded at both the hip and knee.

Results:

Both divisions of the sciatic nerve experienced significantly more pressure at the hip than at the knee. Knee flexion reduced intraneural pressure of the peroneal division at the hip by approximately 30%. Intraneural pressure at the knee was significantly greater in the peroneal versus tibial nerve during knee extension, yet was reduced with knee flexion.

Conclusions:

Our results suggest that direct compression of the peroneal nerve during hip retraction has the most potential to cause iatrogenic sciatic nerve injury. Knee flexion was beneficial for decreasing nerve stretch and pressure. The peroneal division, however, is vulnerable to dysfunction because of the higher intraneural pressures experienced by the tethering effect of the fibular tunnel at the knee.
MRI Is Better Than CT Scan for Detection of Structural Pathologies After Traumatic Posterior Hip Dislocations in Children and Adolescents
Authors: Thanacharoenpanich Songkiat , Bixby Sarah , Breen Michael A. , Kim Young-Jo
Published: January 2018

Background:

Traumatic posterior hip dislocations in children and adolescents requires emergent closed reduction. Postreduction imaging is necessary to assess the concentricity of reduction and structural injuries to the hip. There is no a consensus for which imaging is a modality of choice in such condition. The purposes of this study are to describe magnetic resonance imaging (MRI) findings of traumatic posterior hip dislocations and to compare the effectiveness of MRI with computerized tomography (CT) in detecting structural abnormalities of the hip that impact patient management.

Methods:

This study is a retrospective review of imaging in traumatically dislocated hips in patients who were treated at our institution. All CT and MRI imaging were reviewed and specific osseous and soft tissue injuries documented by consensus among 2 musculoskeletal pediatric radiologists who interpreted the MRI and CT scans of each patient in a blinded manner.

Results:

In total, 27 patients (23 males, 4 females) with mean age of 12.5 years (range, 2 to 19 y) with postreduction MRI were evaluated. MRI findings revealed femoral head injuries in 17 (62.9%), posterior labral entrapments in 6 (22.2%), posterior labral tears in 17 (62.9%), posterior wall fractures in 15 (55.5%), fracture of the posterior unossified part of acetabulum in 4 (14.8%), and ligamentum teres injuries in 8 (29.6%). Of 16 patients who had postreduction CT scans, 6 (37.5%) had femoral head fractures, 9 (56.3%) had posterior wall fractures, and 8 (50%) had intra-articular osseous entrapments. All bony fractures and intra-articular entrapment could be seen on MRI imaging. In 16 patients with both CT and MRI, posterior acetabular injury was detected in 10/16 (62.5%) on MRI and 9/16 (56.3%) on CT. Three patients with entrapment of labrums identified on MRI could not be seen on CT scan. One patient with persistently unstable hip after reduction had an entrapped unossified portion of acetabular fracture which was seen on MRI but not on CT.

Conclusions:

MRI is superior to CT scan for detection of structural injuries in children and adolescents with traumatic hip dislocation. The unique structural injuries included entrapment of posterior labrum and posterior unossified acetabular fractures could be seen only at MRI. These findings will impact surgical decision making of these injuries.

Level of evidence:

Level IV.
Fracture Patterns Differ Between Osteogenesis Imperfecta and Routine Pediatric Fractures
Authors: Peddada Kranti V. , Sullivan Brian T. , Margalit Adam , Sponseller Paul D.
Published: January 2018

Background:

It is important to estimate the likelihood that a pediatric fracture is caused by osteogenesis imperfecta (OI), especially the least severe type of OI (type 1).

Methods:

We reviewed records of 29,101 pediatric patients with fractures from 2003 through 2015. We included patients with closed fractures not resulting from motor vehicle accidents, gunshot wounds, nonaccidental trauma, or bone lesions. Patients with OI of any type were identified through International Classification of Diseases-9 code. We randomly sampled 500 pediatric patients in whom OI was not diagnosed to obtain a control (non-OI) group. We reviewed age at time of fracture, sex, fracture type, laterality, and bone and bone region fractured. Bisphosphonate use and OI type were documented for OI patients. Subanalysis of patients with type-1 OI was performed. The Fisher exact and χ2 tests were used to compare fracture rates between groups. P<0.05 was considered significant. Positive likelihood ratios for OI were calculated by fracture pattern.

Results:

The non-OI group consisted of 500 patients with 652 fractures. The OI group consisted of 52 patients with 209 fractures. Non-OI patients were older at the time of fracture (mean, 9.0±5.0 y) than OI patients (mean, 5.5±4.4 y) (P<0.001). OI patients had more oblique, transverse, diaphyseal, and bilateral long-bone fractures than non-OI patients (all P<0.001). Non-OI patients had more buckle (P=0.013), metaphyseal (P<0.001), and physeal (P<0.001) fractures than OI patients. For patients with type-1 OI and long-bone fractures (n=18), rates of transverse and buckle fractures were similar compared with controls. Transverse humerus (15.2), olecranon (13.8), and diaphyseal humerus (13.0) fractures had the highest positive likelihood ratios for OI, and physeal (0.09) and supracondylar humerus (0.1) fractures had the lowest.

Conclusions:

Transverse and diaphyseal humerus and olecranon fractures were most likely to indicate OI. Physeal and supracondylar humerus fractures were least likely to indicate OI. Radiographic fracture pattern is useful for estimating likelihood of OI.

Level of Evidence:

Level III.
Reconstruction of Chronic Ankle Instability With Hamstring Autograft
Authors: Karnovsky Sydney C. , Cabe Taylor N. , Drakos Mark C.
Published: January 2018

There are varied techniques in the literature for operative treatment of chronic ankle instability. Historically, ankle instability has been treated through direct repair, using imbrication of attenuated tissues. However, direct repair often is not a suitable option for patients with chronic instability that has developed as a result of generalized ligamentous laxity, failed previous stabilization, or paucity of competent local tissue. For these patients, reconstruction of the lateral ligaments is indicated and has been performed using various types of grafts, including semitendinosus grafts, gracilis grafts, peroneal grafts, plantaris grafts, and extensor digitorum longus grafts. We advocate using a hamstring autograft, either gracilis or semitendinosus, depending on the size of the patient’s tendons, to operatively reconstruct the lateral ligaments in patients with chronic ankle instability.
The Posterior Approaches to the Posterior Pilon Fracture
Authors: Greisberg Justin , Sonnenfeld Julian J.
Published: January 2018

Between simple malleolar fractures and more complex pilon injuries, is the posterior pilon fracture. Involving a variable amount of posterior tibial articular surface, these injuries may benefit from a posterior approach to reduce and stabilize the fragments. The posterolateral approach can be considered the “workhorse,” and allows good access to the tibia and fibula. The posteromedial approach may be helpful for more complex patterns, but is closer to the tibial neurovascular bundle. These approaches can be performed safely, with low complication rates and generally favorable outcomes.

Level of Evidence: Diagnostic Level 4. See instructions for authors for a complete description of levels of evidence.
Suture Fixation Using Polyblend Polyethylene Sutures With Hydroxyapatite Block for an Intra-articular Depression Fracture of the Pisiform Bone
Authors: Kataoka Toshiyuki , Kuriyama Kohji , Yasui Yukihiko
Published: January 2018

Few cases in which open reduction and internal fixation was performed for displaced pisiform fractures have been reported. We present a new surgical technique for the treatment of depressed intra-articular pisiform fractures. First, the depressed fragment was reduced by pushing the bone tamp. Then, the fracture void resulting from the reduction of the depressed fragment was filled with a shaped hydroxyapatite block. Finally, the fragments were sutured using braided polyblend polyethylene sutures. The postoperative radiography could achieve a well-reduced articular facet, and this procedure had a good clinical outcome.
Structural and Mechanical Comparison of Human Ear, Alar, and Septal Cartilage
Authors: Bos Ernst Jan , Pluemeekers Mieke , Helder Marco , Kuzmin Nikolay , van der Laan Koen , Groot Marie-Louise , van Osch Gerjo , van Zuijlen Paul
Published: January 2018

Background:

In the human ear and nose, cartilage plays a key role in establishing its form and function. Interestingly, there is a noticeable paucity on biochemical, structural, and mechanical studies focused on facial cartilage. Such studies are needed to provide elementary knowledge that is fundamental to tissue engineering of cartilage. Therefore, in this study, a comparison is made of the biochemical, structural, and mechanical differences between ear, ala nasi, and septum on the extracellular matrix (ECM) level.

Methods:

Cartilage samples were harvested from 10 cadaveric donors. Each sample was indented 10 times with a nanoindenter to determine the effective Young’s modulus. Structural information of the cartilage was obtained by multiple-photon laser scanning microscopy capable of revealing matrix components at subcellular resolution. Biochemistry was performed to measure glycosaminoglycan (GAG), DNA, elastin, and collagen content.

Results:

Significant differences were seen in stiffness between ear and septal cartilage (P = 0.011) and between ala nasi and septal cartilage (P = 0.005). Elastin content was significantly higher in ear cartilage. Per cartilage subtype, effective Young’s modulus was not significantly correlated with cell density, GAG, or collagen content. However, in septal cartilage, low elastin content was associated with higher stiffness. Laser microscopy showed a distinct difference between ear cartilage and cartilage of nasal origin.

Conclusion:

Proposed methods to investigate cartilage on the ECM level provided good results. Significant differences were seen not only between ear and nasal cartilage but also between the ala nasi and septal cartilage. Albeit its structural similarity to septal cartilage, the ala nasi has a matrix stiffness comparable to ear cartilage.
Impact of Pulmonary Rehabilitation on Exercise Tolerance and Quality of Life in Patients With Idiopathic Pulmonary Fibrosis
Authors: Gomes-Neto Mansueto , Silva Cassio Magalhães , Ezequiel Diego , Conceição Cristiano Sena , Saquetto Micheli , Machado Adelmir Souza
Published: January 2018

Background:

Patients with pulmonary fibrosis are living longer and present with an increasing number of comorbidities over time. Pulmonary rehabilitation, as a nonpharmacological approach, may be promising in these patients, although there is limited information on the impact of pulmonary rehabilitation on exercise tolerance and quality of life. Thus, conducting a systematic review and meta-analysis, the purpose of this study was to determine the effects of pulmonary rehabilitation on exercise tolerance and quality of life in patients with idiopathic pulmonary fibrosis.

Methods:

We searched MEDLINE, Cochrane Library, Embase, Scielo, PEDro, and CINAHL (from the earliest date available to June 2016) for trials. Study selection included randomized controlled trials (RCTs) that examined the effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis. Two reviewers selected studies independently. Data were extracted from published RCTs. Study quality was evaluated using the PEDro scale. Weighted mean differences, standard mean differences, and 95% CIs were calculated.

Results:

We analyzed data from 5 RCTs comparing a pulmonary rehabilitation group with a control group. Pulmonary rehabilitation improved exercise tolerance weighted mean differences (44 m; 95% CI, 5.3-82.8) compared with no exercise. The meta-analyses also showed significant improvement in symptoms, impact, and total score from the St George's Respiratory Questionnaire for participants in pulmonary rehabilitation compared with control. No serious adverse events were reported.

Conclusion:

Pulmonary rehabilitation is effective in increasing exercise tolerance and improving quality of life in patients with idiopathic pulmonary fibrosis.
Multiple Eyelid Cysts (Apocrine and Eccrine Hidrocystomas, Trichilemmal Cyst, and Hybrid Cyst) in a Patient With a Prolactinoma
Authors: Ma Lina , Jakobiec Frederick A. , Wolkow Natalie , Dryja Thaddeus P. , Borodic Gary E.
Published: January 2018

A 53-year-old man presented with smooth-domed, variegated cysts (polycystic disease) of all 4 eyelids, worse on the left side. Some of the cysts were clear, while others were creamy-white colored. In addition, multiple, very fine vesicopapules were noted along the eyelid margins. Histopathologic examination revealed a trichilemmal cyst, several pure apocrine hidrocystomas displaying multiple chambers, a hybrid cyst, and many small eccrine cysts of the deep dermis. The apocrine lesions, including the small ones at the eyelid margins, predominated. Smooth muscle actin sometimes positively stained outer myoepithelial cells in some of the apocrine cysts, which helped to distinguish them from eccrine cysts. Most noteworthy was the fact that the patient had been diagnosed with a prolactinoma 20 years earlier. There is only 1 previous report of multiple apocrine cysts and an antecedent prolactinoma in the dermatologic literature. This syndrome should be separated from that of Schöpf–Schulz–Passarge, which manifests multiple small eyelid apocrine cysts and other ectodermal dysplasias without any association with neoplasia, and from that of focal dermal hypoplasia (Goltz–Gorlin) syndrome with apocrine cysts but again without neoplasia.
Coregulation of endoplasmic reticulum stress and oxidative stress in neuropathic pain and disinhibition of the spinal nociceptive circuitry
Authors: Ge Yanhu , Jiao Yingfu , Li Peiying , Xiang Zhenghua , li Zhi , Wang Long , Li Wenqian , Gao Hao , Shao Jiayun , Wen Daxiang , Yu Weifeng
Published: January 2018

The accumulation of unfolded or misfolded proteins in the endoplasmic reticulum (ER) lumen leads to ER stress, which is related to cellular reactive oxygen species production. Neuropathic pain may result from spinal dorsal horn (SDH) ER stress. In this study, we examined the cause–effect relationship between ER stress and neuropathic pain using the spinal nerve ligation (SNL) rat model. We showed that ER stress was mutually promotive with oxidative stress during the process. We also tested the hypothesis that spinal sensitization arose from reduced activities of GABA-ergic interneurons and that spinal sensitization was mediated by SDH ER stress. Other important findings in this study including the following: (1) nociceptive behavior was alleviated in SNL rat as long as tauroursodeoxycholic acid injections were repeated to inhibit ER stress; (2) inducing SDH ER stress in healthy rat resulted in mechanical hyperalgesia; (3) blocking protein disulfide isomerase pharmacologically reduced ER stress and nociceptive behavior in SNL rat; (4) cells in the dorsal horn with elevated ER stress were mainly neurons; and (5) whole-cell recordings made in slide preparations revealed significant inhibition of GABA-ergic interneuron activity in the dorsal horn with ER stress vs in the healthy dorsal horn. Taken together, results of the current study demonstrate that coregulation of ER stress and oxidative stress played an important role in neuropathic pain process. Inhibiting SDH ER stress could be a potential novel strategy to manage neuropathic pain.
Professionals underestimate patients' pain: a comprehensive review
Authors: Seers Tim , Derry Sheena , Seers Kate , Moore R. Andrew
Published: January 2018

Pain assessment by patients is the rule in clinical trials but may not be in clinical practice. We examined studies comparing assessment of pain by patients and professionals in clinical practice using published studies (1990-2016; ≥20 patients), in English, in an institutional setting, comparing pain assessment within 24 hours by patients and health care professionals. A difference of at least 10% of the maximum score was considered significant. We judged quality on sampling method, blinding, and study size. Eighty studies (20,496 patients) provided data from a range of settings and locations; most (51%) used unbiased sampling, and most (68%) were blind or probably blind. Nine studies with ≥500 patients involved 58% of patients; 60 with <200 patients involved 25%. Large studies were more likely to use comprehensive or random sampling and blinding of patients and professionals. Underestimation of pain by professionals compared with patients was reported by 62/80 studies (78%); there was no difference in 17 (21%) and overestimation in 1 (1%). Underestimation was reported in 75% of large studies (>500 patients), 91% of mid-sized studies (200-400), and 78% of small studies (<200). High-quality studies (blind, comprehensive, or random sampling, >200 patients) consistently reported underestimation (10/11; 91%). The extent of underestimation tended to increase with pain severity. Professionals consistently tend to underestimate pain compared with assessment by patients. This tendency is more pronounced with more severe pain, and the extent of underestimation can be large. It is likely that this contributes to undertreatment of pain.
Functional Outcomes with Externally Powered Partial Hand Prostheses
Authors: Whelan Lynsay R. , Farley Jeremy
Published: January 2018

Introduction

Despite the large number of individuals experiencing partial hand limb loss or deficiency, and the impact of this level of loss on hand function, there is minimal research available regarding the benefit of partial hand externally powered prostheses. The purpose of this research was to explore how using an externally powered partial hand prosthesis contributes to the completion of functional tasks.

Materials and Methods

Fifteen individuals being fit with i-digits partial hand prostheses were evaluated using the Southampton Hand Assessment Procedure (SHAP) and Patient-Specific Functional Scale (PSFS). The individuals were each fit during a 1-week condensed fitting and training process and received 10 to 15 hours of therapy between the prefitting and postfitting testing.

Results

Twelve male and three female clients with four- (with thumb remaining) or five-digit partial hand limb loss or deficiency participated. Average age was 42 years, and 87% had acquired amputations an average of 2.44 years before the fitting. All subjects demonstrated clinically significant change scores on both the PSFS and the SHAP. The individuals with five-digit absence demonstrated marked improvement in comparison with those with four-digit absence; however, both were far superior to the minimal detectable change score for the SHAP, with 42.33 and 19.16 average improvement scores, respectively.

Conclusions

Subjects fit with four- or five-digit externally powered partial hand prostheses demonstrated significant functional improvements in objective hand function and individualized goals. The remnant thumbs of users fit with four-digit systems sometimes exhibited limitations on range of motion or strength. Despite this, their evaluation scores still showed significant improvement; in fact, almost 10 times the minimal detectable change score. For those with five-digit absence, the change was 20 times the minimal threshold. These results suggest the benefit of the i-digits partial hand prosthesis as contributing to the function of individuals with partial hand limb loss or deficiency, particularly with the individuals' priority functional goals.