bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional Responses to a Sexual Assault Threat: A Qualitative Analysis Among Women With Histories of Sexual Victimization
Authors: Silver Kristin E. , Anderson RaeAnn E. , Brouwer Amanda M.
Published: February 2020

Sexual assaults against women are a leading threat to human rights and public health in the United States. Considering the high rates of sexual revictimization among women and the limited understanding of the mechanisms which fuel this phenomenon, the goal of the present study was to investigate the role of emotion in coping with a hypothetical threat of sexual assault for previously sexually victimized college women. A total of 114 college women with a history of sexual victimization listened to an audio-recording describing a sexual assault scenario and then described how they felt. A qualitative analysis paradigm was used to capture participants’ responses in an open-ended, real-time, experiential manner. Data were analyzed using Consensual Qualitative Research—Modified methodology. Four main themes emerged ( Negative Reactions, Indifferent Evaluations, Active Responses, and Cognitive Appraisal of the Situation), along with various subcategories, demonstrating the variability of women’s responses to a sexual assault threat. Many women experienced uncomfortable or distressing emotional reactions to the vignette, primarily through discomfort, but also through anger, anxiety, and being upset. Few women reported experiencing fear, and a small number reported experiencing self-blame. The low endorsement of fear and anger in our high-risk sample indicates emotional dysregulation as a potential mechanism of repeated sexual victimization and a promising target for clinical intervention. Overall, results may inform sexual assault risk reduction efforts and the empowerment of women who have experienced sexual victimization.
Wellness Program Nonparticipation and Its Association With Employee Turnover
Authors: Jenkins Kristi Rahrig , Sherman Bruce W.
Published: February 2020

Purpose:

This study examines the association between nonparticipation in wellness activities and employee turnover risk.

Design:

Retrospective, cross-sectional analysis.

Setting:

Large university in the Midwestern United States.

Participants:

Employees with continuous employment during 2016 and complete human resources and wellness program data (n = 34 405).

Methods:

Demographic, health risk assessment (HRA), and wellness program participation data were collected in 2016 and paired with administratively recorded turnover status from 2017. For the multivariate analyses, logistic regression models were used.

Results:

There were statistically significant associations between various socioeconomic and demographic characteristics (gender, age, race, wage, union and faculty status, and health score) with turnover status. Also, all 3 participation levels (participated in the HRA only, participated in the HRA and wellness programming, and participated in wellness programming only) had lower odds of experiencing turnover compared to nonparticipants (participated in the HRA only [adjusted odds ratio, AOR: 0.89; confidence interval, CI: 0.80-0.99], participated in wellness program(s) only [AOR: 0.77; CI: 0.62-0.95] and participated in both the HRA and program(s) [AOR: 0.82; CI: 0.74-0.91], respectively).

Conclusion:

Employee participation in wellness program activities appears to represent a measure of engagement with work. Nonparticipation in these programs is associated with increased risk of employment turnover in the subsequent year.
The Forms and Uses of Acquired Prostate Cancer Expertise Among Prostate Cancer Survivors
Authors: Green Richard
Published: February 2020

This article examines men’s prostate cancer experiences through the lens of patient expertise. Qualitative interviews were conducted with 29 men treated for prostate cancer, recruited from two prostate cancer support groups (PCSGs) in the South-East of England. Different forms of expertise, as classified by Collins, were found to be possessed by these men. How these different forms of expertise were acquired, used, and shared with others are explored, and a concept of communal licensing is posited to better understand these activities. The acquisition and usage of these different forms of expertise, through the employment of moral discourses that emphasise responsibility for one’s own health, are found to serve to blur the boundaries between lay person and expert.
The role of pension contributions in explaining inequalities in depressive symptoms. Results from SHARE
Authors: Hoven Hanno , Dragano Nico , Lunau Thorsten , Deindl Christian , Wahrendorf Morten
Published: February 2020

Aims: Research has established solid evidence that socioeconomic position impacts health. It is, however, still debated to what extent characteristics of entire employment histories are associated with health inequalities later on. This study investigates associations between contributing to pension schemes throughout entire employment histories and depressive symptoms in older men and women. Methods: We use retrospective life history data from the Survey of Health, Ageing and Retirement in Europe (SHARE), collected in 2008–2009 from retired men and women. Data include detailed information on previous employment histories (between age 25 and 60 years) that allows us to measure labour market involvements and pension contributions during past working lives. In addition, we measure elevated depressive symptoms using EURO-D. Results: We observe that employed work without contributing to pension schemes is associated with elevated depressive symptoms for women, even when taking the current household income into consideration. For men (but not for women), self-employed work without pension contributions is linked to elevated depressive symptoms. Conclusions: Our results indicate that studies linking previous employment participation to health after labour market exit should not only consider whether a person worked, but also whether he or she contributed to a pension scheme. In addition, our study points to interesting gender differences, where pension contributions matter most for women in employed work and for men in self-employed work.
An Exploration of Parental Support in the Retention of Rural First-Generation College Students
Authors: McCulloh Edna
Published: February 2020

Rural first-generation college students (FGCSs) encounter complications in college that are often the result of a lack of college readiness, difficulty adjusting to new communities, and the absence of a support network. This study explored the parental support that promoted retention of rural FGCSs attending a small, private university, where withdrawal rates of this population are higher than that of continuing-generation students. A case study design facilitated the exploration of 12 rural FGCSs’ perceptions of their parental support. Data collection consisted of semistructured individual interviews. The emergent themes included in this article are (a) parental support, (b) extended family support, and (c) community support. The results revealed that parental support reflected a spectrum of types, and the social capital provided by parents, family, and community support systems made possible rural FGCS retention.
LncRNA KCNQ1OT1 attenuates sepsis-induced myocardial injury via regulating miR-192-5p/XIAP axis
Authors: Sun Fangyuan , Yuan Weifang , Wu Hao , Chen Gang , Sun Yuxia , Yuan Lin , Zhang Wei , Lei Ming
Published: February 2020

Myocardial dysfunction is a prime cause of death in sepsis. This study is to delve into the function of lncRNA KCNQ1OT1 in myocardial injury induced by sepsis. Sepsis-induced myocardial injury model in rat was initiated by intraperitoneally injecting of LPS (10 mg/kg) in vivo, and cardiomyocyte H9c2 was treated with LPS to mimic sepsis in vitro. KCNQ1OT1 and miR-192-5p expressions were detected by qRT-PCR. The cell viability was probed with CCK-8 experiment and the apoptosis of the cardiomyocytes was tested using flow cytometry analysis. Western blot was operated to determine apoptosis-related proteins expressions. ELISA was used to evaluate the levels of TNF-α, IL-6, and IL-1β. Bioinformatics analysis, RT-PCR, dual luciferase reporter assay, and RNA immunoprecipitation experiment were utilized to detect the interrelation of genes. Herein, we proved that KCNQ1OT1 was considerably down-regulated, whereas miR-192-5p was markedly increased in myocardial tissues of septic rats. KCNQ1OT1 interrelated with miR-192-5p, and negatively modulated its expression levels. Overexpression of KCNQ1OT1 or the transfection of miR-192-5p inhibitors greatly facilitated the viability and impeded the apoptosis of H9c2 cardiomyocytes. miR-192-5p paired with the 3ʹUTR of XIAP, and repressed its protein expression, and XIAP was modulated positively by KCNQ1OT1. In conclusion, our work indicates that down-regulation of KCNQ1OT1 advances cardiac injury through regulating miR-192-5p/XIAP axis during sepsis.

Impact statement

Sepsis-induced cardiomyopathy remains to be a major challenge to health care systems around the globe. There are no known therapies currently available that can cure the disease. This study provides convincing evidence that KCNQ1OT1 could attenuate sepsis-mediated myocardial injury. We further demonstrate that the beneficial function of KCNQ1OT1 was achieved by regulating the miR-192-5p/XIAP axis. We therefore found a new mechanism of cardioprotective effect of KCNQ1OT1, one which also offers a novel theoretical basis for the therapy of sepsis-induced cardiomyopathy.
5-HT7 Receptor Inhibition Transiently Improves Respiratory Function Following Daily Acute Intermittent Hypercapnic-Hypoxia in Rats With Chronic Midcervical Spinal Cord Contusion
Authors: Wu Ming-Jane , Vinit Stéphane , Chen Chun-Lin , Lee Kun-Ze
Published: February 2020

Background. Intermittent hypoxia can induce respiratory neuroplasticity to enhance respiratory motor outputs following hypoxic treatment. This type of respiratory neuroplasticity is primarily mediated by the activation of Gq-protein-coupled 5-HT2 receptors and constrained by Gs-protein-coupled 5-HT7 receptors. Objective. The present study hypothesized that the blockade of 5-HT7 receptors can potentiate the effect of intermittent hypercapnic-hypoxia on respiratory function after cervical spinal cord contusion injury. Methods. The ventilatory behaviors of unanesthetized rats with midcervical spinal cord contusions were measured before, during, and after daily acute intermittent hypercapnic-hypoxia (10 episodes of 5 minutes of hypoxia [10% O2, 4% CO2, 86% N2] with 5 minutes of normoxia intervals for 5 days) at 8 weeks postinjury. On a daily basis, 5 minutes before intermittent hypercapnic-hypoxia, rats received either a 5-HT7 receptor antagonist (SB269970, 4 mg/kg, intraperitoneal) or a vehicle (dimethyl sulfoxide). Results. Treatment with intermittent hypercapnic-hypoxia induced a similar increase in tidal volume between rats that received SB269970 and those that received dimethyl sulfoxide within 60 minutes post-hypoxia on the first day. However, after 2 to 3 days of daily acute intermittent hypercapnic-hypoxia, the baseline tidal volumes of rats treated with SB269970 increased significantly. Conclusions. These results suggest that inhibiting the 5-HT7 receptor can transiently improve daily intermittent hypercapnic-hypoxia–induced tidal volume increase in midcervical spinal contused animals. Therefore, combining pharmacological treatment with rehabilitative intermittent hypercapnic-hypoxia training may be an effective strategy for synergistically enhancing respiratory neuroplasticity to improve respiratory function following chronic cervical spinal cord injury.
An online and real-time adaptive operational modal parameter identification method based on fog computing in Internet of Things
Authors: Wang Cheng , Huang Haiyang , Chen Jianwei , Wei Wei , Wang Tian
Published: February 2020

A large number of smart devices make the Internet of Things world smarter. However, currently cloud computing cannot satisfy real-time requirements and fog computing is a promising technique for real-time processing. Operational modal analysis obtains modal parameters that reflect the dynamic properties of the structure from the vibration response signals. In Internet of Things, the operational modal analysis method can be embedded in the smart devices to achieve structural health monitoring and fault detection. In this article, a four-layer framework for combining fog computing and operational modal analysis in Internet of Things is designed. This four-layer framework introduces fog computing to solve tasks that cloud computing cannot handle in real time. Moreover, to reduce the time and space complexity of the operational modal analysis algorithm and support the real-time performance of fog computing, a limited memory eigenvector recursive principal component analysis–based operational modal analysis approach is proposed. In addition, by examining the cumulative percent variance of principal component analysis, this article explains the reasons behind the identified modal order exchange. Finally, the time-varying operational modal identification results from non-stationary random response signals of a cantilever beam whose density changes slowly indicate that the limited memory eigenvector recursive principal component analysis–based operational modal analysis method requires less memory and runtime and has higher stability and identification effect.
A home is more than a roof over your head: Post-prison reintegration challenges in Austria
Authors: Schartmueller Doris
Published: February 2020

Life after prison can pose challenges for the formerly incarcerated, their families, and wider communities. This research studies Austria where probation services are either mandated by the court or sought voluntarily after prison. Through semi-structured interviews with formerly incarcerated individuals, reintegration experiences from their perspectives are examined. The narratives emphasized social factors that either assuage or complicate life after prison. The main factors addressed were stable housing, the maintaining and (re)building of relationships, and employment. Overall, a lack of stable housing appeared to complicate life after prison the most and also negatively affected relationships and employment. For some, life after prison was further exacerbated by immigration status and a perceived stigma related to the nature of one’s convictions. This study shows the importance of working towards a better understanding of the social context individuals are released into after prison to better meet their individual needs and to counteract recidivism.
Radiation Exposure in Posterior Lumbar Fusion: A Comparison of CT Image-Guided Navigation, Robotic Assistance, and Intraoperative Fluoroscopy
Authors: Wang Erik , Manning Jordan , Varlotta Christopher G. , Woo Dainn , Ayres Ethan , Abotsi Edem , Vasquez-Montes Dennis , Protopsaltis Themistocles S. , Goldstein Jeffrey A. , Frempong-Boadu Anthony K. , Passias Peter G. , Buckland Aaron J.
Published: February 2020

Study Design:

Retrospective clinical review.

Objective:

To assess the use of intraoperative computed tomography (CT) image-guided navigation (IGN) and robotic assistance in posterior lumbar surgery and their relationship with patient radiation exposure and perioperative outcomes.

Methods:

Patients ≥18 years old undergoing 1- to 2-level transforaminal lateral interbody fusion in 12-month period were included. Chart review was performed for pre- and intraoperative data on radiation dose and perioperative outcomes. All radiation doses are quantified in milliGrays (mGy). Univariate analysis and multivariate logistic regression analysis were utilized for categorical variables. One-way analysis of variance with post hoc Tukey test was used for continuous variables.

Results:

A total of 165 patients were assessed: 12 IGN, 62 robotic, 56 open, 35 fluoroscopically guided minimally invasive surgery (MIS). There was a lower proportion of women in open and MIS groups ( P = .010). There were more younger patients in the MIS group ( P < .001). MIS group had the lowest mean posterior levels fused ( P = .015). Total-procedure radiation, total-procedure radiation/level fused, and intraoperative radiation was the lowest in the open group and highest in the MIS group compared with IGN and robotic groups (all P < .001). Higher proportion of robotic and lower proportion of MIS patients had preoperative CT ( P < .001). Estimated blood loss ( P = .002) and hospital length of stay ( P = .039) were lowest in the MIS group. Highest operative time was observed for IGN patients ( P < .001). No differences were observed in body mass index, Charlson Comorbidity Index, and postoperative complications ( P = .313, .051, and .644, respectively).

Conclusion:

IGN and robotic assistance in posterior lumbar fusion were associated with higher intraoperative and total-procedure radiation exposure than open cases without IGN/robotics, but significantly less than MIS without IGN/robotics, without differences in perioperative outcomes. Fluoro-MIS procedures reported highest radiation exposure to patient, and of equal concern is that the proportion of total radiation dose also applied to the surgeon and operating room staff in fluoro-MIS group is higher than in IGN/robotics and open groups.
Assessment of Disability Related to Hip Dysplasia Using Objective Measures of Physical Performance
Authors: Scott Elizabeth J. , Willey Michael C. , Mercado Arthur , Davison John , Wilken Jason M.
Published: February 2020

Background:

Lower extremity physical performance measures (PPMs), which can objectively quantify functional ability, are an attractive adjuvant to patient-reported outcome (PRO) instruments. However, few tests have been validated for use in hip instability.

Purpose:

To evaluate 4 different PPMs for their ability to differentiate between young adults with hip dysplasia indicated for treatment with periacetabular osteotomy (PAO) and asymptomatic controls and to test inter- and intratest reliability and relationship with popular hip PRO instruments.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

A total of 24 symptomatic patients aged 15 to 39 years (100% female) with hip dysplasia (lateral center-edge angle <25°) indicated for treatment with PAO completed the visual analog scale (VAS) for pain, Hip disability and Osteoarthritis Outcome (HOOS) Pain subscale, HOOS Short Version (HOOS PS), International Hip Outcome Tool Short Version (iHOT-12), modified Harris Hip Score (mHHS), Patient Reported Outcome Measurement Information System (PROMIS) physical function (PF) and pain interference (PI), and 4 physical function tests: (1) self-selected walking speed (SSWS), sit-to-stand 5 times (STS5), (3) 4-square step test (FSST), and (4) timed stair ascent (TSA). A further 21 young, asymptomatic adults aged 18 to 39 years (91% female) also underwent testing. Between-group comparisons were made with unpaired t test with Bonferroni-Holm correction. Inter- and intrarater reliability was assessed in 38 participants by repeating PPMs at a second visit and using 2 raters. Spearman rank correlation coefficients were used to determine associations between PPMs and PRO instruments.

Results:

Significant differences between patients with hip dysplasia and controls were observed for all PRO instruments (HOOS Pain, 47.8 vs 99.2; HOOS PS, 61.9 vs 99.2; iHOT-12, 32.2 vs 99.2; mHHS, 54.5 vs 90.6; PROMIS PF, 41.4 vs 65.6; and PROMIS PI, 62.0 vs 39.1 [all P < .001]), and all PPMs (SSWS, 1.21 vs 1.53 m/s; STS5, 10.85 vs 5.95 s; FSST, 6.59 vs 4.03 s [all P < .001]; and TSA, 4.58 vs 3.29 s [ P = .002]). All 4 PPMs demonstrated excellent intra- and intertest reliability (intraclass correlation coefficient, 0.83-0.99). STS5, FSST, and TSA were correlated highly ( r > 0.5) with physical function PRO instruments, including PROMIS PF, mHHS, and iHOT-12.

Conclusion:

Patients with symptomatic hip dysplasia demonstrated significant impairment on functional testing compared with asymptomatic controls, and performance measure testing demonstrated excellent test-retest reliability. Timed stair ascent and sit-to-stand testing in particular were correlated strongly with physical function PRO instruments. PPMs may be a viable and well-received adjuvant to PRO instrument administration for patients with nonarthritic hip conditions, and investigation of the ability of PPMs to assess surgical outcomes for hip dysplasia is warranted.
Meniscal Injury Does Not Significantly Affect the Dimensions of the Intact Meniscus in the Opposite Compartment of the Knee
Authors: Yoon Kyoung Ho , Song Sang Jun , Lee Hee Sung , Park Cheol Hee
Published: February 2020

Background:

Meniscal allograft transplant requires precise matching of the size of the allograft with the dimensions of the recipient knee. Estimation of contralateral meniscal size on magnetic resonance imaging (MRI) has been considered the ideal method to measure menisci before transplant. We questioned whether a contralateral intact meniscus with meniscal injury in the opposite compartment could be used as a reference to determine allograft size. Our question was derived from knowledge of meniscal injury influencing structures of the opposite compartment of the knee, including the meniscus.

Purpose:

To compare meniscal dimensions between intact meniscus with meniscal injury in the opposite compartment and normal meniscus with a normal opposite compartment.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This observational, cross-sectional study was performed between 2016 and 2017. The control group consisted of 200 knees with normal medial and lateral menisci. The medial intact group consisted of 150 cases of medial intact meniscus with injured lateral meniscus, and the lateral intact group consisted of 150 cases of lateral intact meniscus with injured medial meniscus. All patients were male. Mean age, height, and weight did not differ among groups. We investigated meniscal dimensions on MRI, including anteroposterior and mediolateral lengths, distance between the anterior and posterior horns (AHPH distance), and widths and heights of the anterior and posterior horns and midbody.

Results:

Most medial meniscal dimensions were similar between the control and medial intact groups, but the AHPH distance was smaller in the medial intact group ( P < .001). Likewise, most lateral meniscal dimensions were similar between the control and lateral intact groups, but the AHPH distance was smaller in the lateral intact group ( P < .001).

Conclusion:

Most dimensions of the intact meniscus with meniscal injury in the opposite compartment were similar to those of the normal meniscus with normal opposite compartment. Measuring the dimensions of the contralateral intact meniscus with meniscal injury in the opposite compartment on MRI can be an appropriate method to determine meniscal allograft size.
Can the distal tibial insertion of the anterolateral ligament be palpated to identify lesions in anterior cruciate ligament tears?
Authors: Cavaignac Etienne , Murgier Jérôme , Thomas Pierre , Courtot Louis , Marot Vincent
Published: February 2020

Background:

It has been established that the anterolateral ligament (ALL) plays a role in controlling the rotational stability of the knee. We have demonstrated that ALL injuries can be identified by ultrasound. In most instances, the injury is tibial. The objective of this study was to evaluate the correlation between acutely painful palpation of the distal insertion of the ALL and the lesion as observed on ultrasound.

Methods:

We conducted a prospective single center study with 130 patients (89 men and 41 women). The mean age was 27.2 ± 8.3 years and the subjects had unilateral ACL injury for less than one month. On average, the distal insertion was palpated 8.8 ± 3.2 days after the trauma to determine the pain status of the ALL. An ultrasound was performed preoperatively by a surgeon trained in ultrasound diagnosis. All assessments were conducted in a double blind method (the surgeon did not know the clinical status of the ALL). We measured the correlation between the ALL ultrasound injury assessment and pain on palpation of the distal insertion using the intra-class correlation coefficient with a 95% confidence interval. The correlation between the preoperative pivot shift grade in the operating room and the ultrasound injury assessment was also examined. This study was approved by the ethics committee. Considering that the objective could not be quantified, the number of subjects required was determined by recruitment for 1 year.

Results:

The consistency between painful palpation of the distal insertion of the ALL and the ultrasound injury assessment was good with a 95% confidence interval of the ICC at 0.801 (95% CI: 0.730, 0.855) The sensitivity of this clinical test was 92% (95% CI: 88-97), specificity, 88 (95% CI: 82-93), the positive predictive value, 88% (95% CI: 82-94) and the negative predictive value, 92% (95% CI: 87 -97). The consistency between the pivot shift grade in the operating room and the injury on ultrasound was good, ICC = 0.850 (95% CI: 0.794, 0.891)

Conclusion:

The diagnostic value of painful palpation of the distal insertion of the ALL in identifying ALL injury was excellent. This structure is involved in the rotational stability of the knee. Therefore, assessment by palpation is adapted to the specific management of knee trauma.
Chronic anterior instability with hyperlaxity treated by arthroscopy using the Trillat technique with endobutton fixation: results for 14 cases
Authors: Valenti Philippe , Cartaya Marco , Werthel Jean-David
Published: February 2020

Background:

Recurrent anterior instability associated with hyperlaxity remains a difficult challenge. In 1954, Trillat proposed osteoclasis of the coracoid process in order to make it more distal and more medial to place the conjoint tendon just in front of the humeral head. The conjoint tendon lowers and reinforce the stabilizing action of the subscapularis muscle in abduction. This open surgery technique has provided satisfactory results in patients with chronic anterior glenohumoral instability associated with massive irreparable rotator cuff tears. We hypothesized that this procedure could be arthroscopy-assisted with the use of an endobutton to treat anterior glenohumoral instability with hyperlaxity without engaging bone defects.

Methods:

This is a prospective study on 14 patients (9 females, 5 males; average age 25 years) who underwent surgery between 05/2014 and 12/2016. These were patients with anterior instability with hyperlaxity (external rotation > 85° / positive sulcus sign and no associated bone lesions). Arthroscopic surgery consisted of an antero-inferior capsuloplasty with Bankart repair combined with coracoid osteoclasis and fixation with an endobutton with a self-locking mechanism. The results were evaluated using SSV, Walch-Duplay, Rowe and Constant scores. Standard X-rays and a CT scan with 3D reconstructions were also performed at follow-up.

Results:

With an average follow-up of 26 months (24 to 32 months), no recurrent instability was reported, but persistent apprehension was found in 2 cases. The average Walch-Duplay score was 85 points, Rowe 89 points, the SSV 91% and adjusted Constant score 95.8%. The average VAS score was 0.8 points. The mean preoperative active anterior elevation of 178° decreased to 165° postoperatively and similarly, external rotation with the elbow at side decreased from 90° to 57°. At the last follow-up, all osteotomies healed. No complications were reported.

Conclusion:

Arthroscopy-assisted Trillat technique with the use of an endobutton appears to be a reliable technique for the treatment of hyperlaxity associated with chronic anterior glenohumoral instability without bone defect. Stabilization and adjustment of coracoid osteoclasis are provided by the endobutton; lowering and medial placement of the coracoid causes lowering of the subscapularis muscle by the conjoint tendon in abduction and thereby reinforces anterior capsuloplasty. Longer follow-up is required to confirm the reliability of this technique.
Pediatric septic arthritis of the hip: the benefit of hip arthroscopy by extracapsular (outside-in) approach
Authors: Jan Nicolas , Pietrzak Julien , Baudoux Matthieu , Kaba Arnaud
Published: February 2020

Background:

Pediatric septic arthritis of the hip is a surgical emergency. Facing a hip flexum and fever, surgeons can use comparative ultrasound to confirm the diagnosis and to establish the surgical indication. While needle aspiration-irrigation is a simple and quick method, it gives rise to a high rate of recurrence. The purpose of our study was to demonstrate that hip arthroscopy by extracapsular approach is an effective and accessible alternative applicable in emergency situations.

Methods:

This is a report of 2 cases (7 years-135 cm; 13 years-143 cm) of needle aspiration-irrigation failure subsequently treated by hip arthroscopy. The X-ray and arthroscopy-assisted extracapsular technique was performed on a conventional orthopedic table, using a 30 degree arthroscope and a 3.5mm diameter motorized knife. Minimally invasive anterior longitudinal capsulotomy was performed by 2 anterolateral approaches via the proximal and distal tensor Fasciae Latae muscle, without dedicated instrumentation, followed by sampling, irrigation, removal of false membranes, synovial biopsies, partial synovectomy, cartilage assessment of the central then peripheral compartment and placement of a drainage.

Results:

In both cases, effusion completely disappeared and the inflammatory process gradually normalized with antibiotic therapy without any repeat procedure or complications related to the approach. Weight bearing was resumed in 3 weeks. Postoperatively, in 6 months and 15 months respectively, after resumption of sports activities hip examination was painless and no damage was noted on x-rays in either case.

Conclusion:

In our experience, hip arthroscopy by extracapsular approach can effectively address cases of failed needle aspiration-irrigation in pediatric septic arthritis of the hip. It could be provided as first-line emergency treatment in the event of purulent septic arthritis or late management, as a replacement for arthrotomy.
External snapping hip: a new technique for ultrasound-assisted sectioning of the iliotibial band
Authors: Coulomb Rémy , Cascales Valentin , Mares Olivier , Bertrand Martin , Marchand Philippe , Kouyoumdjian Pascal
Published: February 2020

Background:

External snapping hip (ESH) is the most typical form of coxa saltans and is caused by the iliotibial band (ITB) slipping over the greater trochanter (GT) during a hip movement. In combination with a typical interview and specific clinical tests, dynamic ultrasound imaging appears to be an important tool to confirm the diagnosis and precisely identify the cause of slipping. Surgical treatment is indicated in some cases of symptomatic ESH that are refractory to well-managed conservative treatment, in selected patients. Many procedures have been described, from open surgery to endoscopy. The purpose of this study was to (1) describe and (2) compare a new technique for ultrasound-assisted sectioning of the iliotibial band with a similar endoscopic technique, in terms of sectioning rates, iatrogenic injuries, learning curve and material cost.

Methods:

An anatomic study was conducted. After a feasibility study to describe the technique, 6 specimens were available, i.e. 12 hips. Both procedures were carried out on each specimen followed by an open control procedure to take measurements. A junior surgeon carried out all the procedures.

Results:

The average sectioning rate of the ITB was 92% in the ultrasound group, compared to 90% in the endoscopy group. No iatrogenic injuries were noted, including nerve damage. The average duration of the ultrasound procedure was 15 minutes compared to 24.7 minutes for endoscopy, with a decrease by a factor of 2 to 3 between the first and last procedure, regardless of the technique. Incomplete sectioning rates were noted at the beginning of the study and all reached 100% by the 4th procedure, regardless of the technique. The ultrasound procedure was 1.8 times less expensive in terms of equipment than the endoscopic procedure, and up to 3 times less expensive in terms of consumables alone (119.56 euros vs 353.48 euros).

Conclusion:

This technique of ultrasound-assisted sectioning of the ITB seems to be as effective and safe as a similar endoscopic technique, with an attainable learning curve for surgeons in training, for an average period and with lower material costs.
Intra-articular echo-endoscopy during shoulder arthroscopy: an anatomical feasibility study
Authors: Lateur Gabriel , Bentejac Antonin , Pailhé Regis , Bacry Maureen Cohen , Chanrion Marie Anne , Custillon Guillaume , Vettier Benoit , Voros Sandrine , Moreau-Gaudry Alexandre
Published: February 2020

Background:

The development of an ultrasound probe that can be used through an arthroscopic portal would provide direct access to the deep tissues of the shoulder. These structures are sometimes barely seen with an external ultrasound system and are also difficult to analyze under arthroscopy. Therefore, this intraoperative imaging technique could refine the diagnosis and surgical procedure and as a result provide more adequate therapy. The main objective of the study was to evaluate the feasibility of using an echo-endoscope to produce images during shoulder arthroscopy without causing secondary lesions. The secondary objective was to detect rotator cuff tears, calcific tendonitis, chondropathies, acromioclavicular arthropathy and labral tears.

Methods:

We used 6 shoulders of 3 anatomic subjects. The endo-ultrasound system used was the M15 probe developed by the society Cartimage Medical SAS® . The eleven structure of interest included in the principal objective of the study were: the tendon of the long head of the biceps, the glenoid and humeral cartilage surface, the gleno humeral ligament, the labrum, the rotator cuff tendon on their acromial and articular surfaces and the acromioclavicular joint. We noticed all lesions induced by the probe and we measured the acquisition time for the ultrasound images. The validation of the principles and secondary objectives were assessed by independent observer during the manipulations which were realized by one unique shoulder surgeon specialized in arthroscopic surgery.

Results:

We were able to produce ultrasound images of 68% of all the structures of interest. The inability to acquire certain images was partially due to the fact that the subjects were elderly (average age 90 years) and therefore, the structures of interest were no longer present. The secondary objective was partially fulfilled with the detection of complete tears of the supraspinatus tendon in 3 shoulders. We were also able to produce images of partial tears in the intra-tendinous cleavage. Intra-tendinous calcifications were explored in 1 shoulder. Humeral or glenoid chondropathy was identified in all the shoulders examined. Finally, no ultrasound-induced injuries were noted in any of the 6 shoulders in the study. The image acquisition time with the echo-endoscope was no more than 20 minutes for each shoulder, with an average time of 10 min 15 sec for shoulders with complete tissue evaluation.

Conclusion:

The echo-endoscope was easy and safe to use to acquire ultrasound images of the different glenohumeral or subacromial structures during shoulder arthroscopy. These results open the way for further explorations with the echo-endoscope.
Validity of the construction of the ArthroSTM FAST and SHOULDER virtual reality simulator: validation in the NOVICE, CONFIRMED and EXPERTS cohorts
Authors: Bernard Elise , Walbron Paul , Sirveaux François , Common Harold , Thomazeau Hervé , Guyen Tran N
Published: February 2020

Background:

Recently, training in arthroscopy was improved with the integration of virtual reality (VR) simulators which enable semi-autonomous learning for novices. The NOVICE cohort confirmed that residents had better basic triangulation skills when they followed a regular 6-month VR simulator program, instead of occasional workshop-type training. We attempted to discover whether the skills of novices recorded for the NOVICE cohort were different from those of residents at the end of the degree course (CONFIRMED) or those of expert practitioners (EXPERTS), according to the type of training.

Methods:

2 new cohorts were formed: French residents at the end of training (CONFIRMED), and international shoulder experts (EXPERTS). They all performed “Periscoping” and “Catch the stars Glenohumeral” exercises in a single session with 3 trials, and completed the same questionnaire. Their results were compared to those of the NOVICE cohort with 6 trials after 6 months without specific training (NOVICE A), with occasional training (NOVICE B) or with regular training on a VR simulator for 6 months (NOVICE C). The variables of Time, Camera Alignment, Camera Movement and Clamp Movement were analyzed.

Results:

For the Periscoping exercise, there was a significant difference in Time (EXPERTS: 138s, CONFIRMED: 110s, NOVICE A: 149s (p > 0.0001) and NOVICE C: 129s (p=0.00976)), Camera Alignment (EXPERTS: 81%, CONFIRMED: 87%, NOVICE A: 92% (p > 0.00141)), and Camera Movement (EXPERTS: 123cm, CONFIRMED: 101cm, NOVICE A: 126cm, NOVICE B: 114cm, NOVICE C: 115cm (p > 0.0001)). For the Catch the stars exercise, there was a significant difference in Time, (EXPERTS: 81s, CONFIRMED: 143s, NOVICE A: 121s, NOVICE B: 105s, NOVICE C: 112s (p > 0.0001)), Camera Movement (EXPERTS 41cm, CONFIRMED 63cm, NOVICE A 52cm, NOVICE B 45cm, NOVICE C 51cm (p > 0.0001)) and Clamp Movement (EXPERTS 116cm, CONFIRMED 204cm, NOVICE A 155cm, NOVICE B 146cm, NOVICE C 157cm (p > 0.0001)).

Conclusion:

The ‘Catch the stars’ exercise seemed to be an exercise that distinguishes the different levels of expertise, and was closer to the daily practice of arthroscopy. The Periscoping exercise was designed to teach the basics of triangulation, and novices who had many trials were likely to perform better than experts after three trials.
Suprascapular nerve block - do it yourself
Authors: Laumonerie Pierre , Blasco Laurent , Tibbo Meagan E , Kerezoudis Panagiotis , Bonnevialle Nicolas , Mansat Pierre
Published: February 2020

Background:

Suprascapular nerve (SSN) block using bone reference points (BARO) is a technique that in principle is accessible to practitioners without experience in locoregional anesthesia or ultrasound guidance. The primary objective was to validate the feasibility of SSN BARO by an orthopedic surgeon. The secondary objective was to provide a description of the path of the sensory branches from the SSN to the shoulder.

Methods:

A BARO was performed on 15 cadaveric shoulders by an intern in orthopedic surgery. Ten ml of methylene blue and 0.75% ropivocaine were injected around the SSN. 2.5ml of a red latex solution were also injected to identify the injection site. The distribution of the sensory branches of the NSS was also described.

Results:

The average distance between the SSN and the injection site was 1.5cm (0-4.5cm). The most frequent injection site was the proximal third of the scapular neck. Fifteen SSNs were marked upstream of the origin of the sensory branches. The 15 SSN produced 3 sensory branches that innervate the posterior glenohumeral capsule, the subacromial bursa, and the coracoclavicular and acromioclavicular ligaments.

Conclusion:

SSN BARO by an orthopedic surgeon is a simple, reliable, and accurate technique. Injection near the suprascapular notch is recommended to mark the SSN upstream of its three sensory branches.
Indigenous Feminisms: Disturbing Colonialism in Environmental Science Partnerships
Authors: Dhillon Carla M.
Published: February 2020

Efforts have been under way by Indigenous peoples to reanimate governance that includes people of all ages and genders. Simultaneous initiatives to decolonize science within environmental fields must confront how settler colonial systems can continue to operate under the guise of partnership. Indigenous feminist theories aid understanding of ongoing colonialism alongside heteropatriarchy and racism with attempts to dismantle oppression in everyday practice. The author examines governance in a North American environmental science partnership consisting of Indigenous and non-Indigenous climate scientists. Using a mixed-methods social network approach, the author evaluates central actors in the national-scale climate science organization on the basis of intersectional identities, relational ties, and structural leadership roles. Findings indicate that Indigenous women and youth were not among core governance dominated by elder Indigenous men and White women. However, Indigenous women consistently bridged distant members back into the group and provided less visible labor to support the organization. These did not translate to decision-making roles. The author argues that Indigenous values of relational reciprocity and self-determination need to supersede the rhetoric of diversity in environmental fields. The case demonstrates the importance of inclusive Indigenous governance to decolonize environmental partnerships and the potential lack of legitimacy should unexamined notions of tradition be used to obscure settler colonial dominance.
The Foreign Policy of the Baltic States and the Ukrainian Crisis: A Case of Europeanization?
Authors: Vilson Maili
Published: February 2020

Estonia, Latvia and Lithuania have established themselves as ardent supporters of the EU's Eastern Partnership, and have also combined this with robust national policies. The crisis in Ukraine, with the annexation of Crimea and Russian military aggression precipitating confrontation in EU-Russia relations, presented the Baltic countries with the most formidable political challenge since restoring independence. Combining Europeanization literature with Larsen's (2005) approach to the foreign policy of small states, the article focuses on the relationship between national foreign policies of EU member states and the European Union as a foreign policy platform. The analysis synthesizes the results of a content analysis of official press releases with interviews with the Baltic states’ diplomats. The empirical results show that in responding to the Ukraine crisis, the Baltic states have regularly pursued their policy aims through the EU, contesting the conventional notion that Europeanization rarely extends to foreign and security affairs. More specifically, the Baltic states’ handling of the Ukraine crisis suggests that Europeanization can affect even dossiers with heavy bearing on member states’ security and national sovereignty where – according to the extant consensus in the literature – it should be least likely.
Deterring Things with Words: Deterrence as a Speech Act1
Authors: Vuori Juha A.
Published: February 2020

As Cold War historians and fans of the film Doctor Strangelove know, deterrence can be a tricky business. The complexity of deterrence and the lack of attention that has been paid to its social effects have too often left one of its forms – nuclear deterrence – depoliticized, uncontested, and thus a danger to us all. I argue in this article that speech act theory can provide insights into deterrence and its concomitant political effects. It can be used to philosophically explain the communicative difficulties involved in deterrent relationships, and to form a basis for a critical stance on deterrence as politics. This entails a shift of focus from deterrence as a state of mind to the politics of deterrence and the deontic powers it wields – a shift from the causative aspects of deterrence to the deontology of deterrents. The analysis of such political functions is aided by the neologism of deterrentification, which refers to assertive and declarative acts that alter the status functions of things so that they are thought to act as deterrents and bring about determent in someone or something. It also aids in conceptualizing how the status of deterrents can be cancelled, and how nuclear weapons can be drawn away from the exceptional sphere of deterrence and back into the sphere of politics. Such a status transformation is required to achieve a sustained nuclear disarmament.
History, Nationalism and Democracy: Myth and Narrative in Viktor Orbán's ‘Illiberal Hungary’
Authors: Toomey Michael
Published: February 2020

This article studies the relationship between nationalistic discourse and Hungary's ‘illiberal turn’ from the election of Viktor Orbán's Fidesz party in the 2010 Hungarian elections up until 2015. It begins by examining the arguments of authors such as Jeffrey Alexander, Quentin Skinner, and Tapio Juntunen in order to establish a theoretical framework for how political actors construct and manipulate historical myths for their own political purposes. It then goes on to examine how Orbán specifically uses and constructs narratives surrounding the Treaty of Trianon and Miklós Horthy, the interwar leader of Hungary. This article argues that in addition to allowing Orbán to build a defensive shield against criticism from international and domestic actors, these interpretations of Hungarian history restore to prominence the interwar-era ‘populist-urbanist’ cleavage, and allow Orbán to create an exclusionary image of Hungarian nationalism. Thus, this serves to legitimize Orbán and Fidesz, while denying opposition parties from both the right and the left the opportunity to stake claims to being true representatives of the Hungarian people.
Careless Speech: Conceptualizing Post-Truth Politics1
Authors: Hyvönen Ari-Elmeri
Published: February 2020

The notion of post-truth politics has been insufficiently conceptualized, leaving its empirical viability questionable. As a response to this uncertainty, I seek to elaborate a concept of post-truth politics by comparing facts to public infrastructure, which I understand in an Arendtian fashion: as a condition that both limits and enables opinionated debate. I put forward an understanding of post-truth as a two-sided process brought about by mutually dependent structural factors contributing to the irrelevance of factual truths and a particular political style labelled careless speech. I place post-truth in a historical context and seek to distinguish it, particularly, from Harry Frankfurt's ‘bullshit’. Bullshit works within the mindset of carefully crafted advertisement-speak. Careless speech seeks to create confusion and bring democratic debate to a halt. I also explicate some key economic, cultural, and media-related factors that contribute to the emergence of post-truth politics. The third section discusses effective practices of conveying truth in the public sphere. I critically analyze fact-checking, (Foucauldian) fearless speech ( parrhesia) and storytelling, contrasting them to ‘careless speech’, and emphasize the need to address political structures in addition to more epistemologically-oriented solutions. I conclude with reflections on the economic-cultural background to factual infrastructure's disrepair, and highlight some future lines of inquiry in IR and Political Science.