bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weight-bearing Allowed Following Internal Fixation of Ankle Fractures, a Systematic Literature Review and Meta-Analysis
Authors: Khojaly Ramy , Rowan Fiachra E. , Hassan Mekki , Hanna Sammy , Mac Niocail Ruairí 
Published: July 2022

Background: Postoperative management regimes vary following open reduction and internal fixation of unstable ankle fractures. Traditional postoperative nonweightbearing cast immobilization may prevent loss of fixation and protect the soft tissue envelope but may also be associated with poorer functional outcomes. This systematic review and meta-analysis aimed to compare the complication rate and functional outcomes of early weightbearing (EWB) vs late weightbearing (LWB) following open reduction and internal fixation of ankle fractures. Methods: We performed a systematic review with a meta-analysis of controlled trials and comparative cohort studies using 3 databases. We included all studies that investigated the effect of weightbearing following internal fixation of ankle fractures in adult patients by any means. Studies that investigated mobilization but not weightbearing, non–English-language publications, and tibial Plafond fractures were excluded from this systematic review. We assessed the risk of bias using ROB 2 tools for randomized controlled trials and ROBINS-1 for cohort studies. Data extraction was performed using Covidence online software and meta-analysis by using RevMan 5.3. Results: This systematic review included 10 randomized controlled trials and 4 comparative cohort studies. Most of the included studies were rated as having some concern with regard to the risk of bias. There was no significant difference in the complication rate between the protected EWB and LWB groups (the risk ratio [RR] for infection was 1.30, 95% CI 0.74, 2.30; I² = 0%; P = .36), but better functional outcome scores were detected in the EWB group only at 6 weeks postoperatively (MD =10.08, 95% CI 5.13, 15.02; I² = 0%; P ≤ .0001), with no significant difference seen at 6 or 12 months postoperatively. Conclusion: Based on the studies reviewed, it appears that early protected weightbearing following open reduction and internal fixation of ankle fractures does not affect surgical incision or fracture healing and is associated with better early functional outcomes at 6 weeks, but not 6 or 12 months, postoperatively.
Comparing Treatment Outcomes in Children and Adolescents With ADHD to Other Disorders Within an Australian and Dutch Outpatient Cohort
Authors: Payne Leanne , Roest Sanna L. , Lu Zhen Qi , Zendarski Nardia , Bisset Matthew , Sciberras Emma , Stathis Stephen , Siebelink Bart M. , Vermeiren Robert R. J. M. , Bellgrove Mark A. , Coghill David , Middeldorp Christel M. 
Published: July 2022

Objective: Previous studies at child and youth mental health services (CYMHS) suggest that children with ADHD have poorer outcomes compared to those with other diagnoses. This study investigates this in more detail. Methods: Children with ADHD were compared to those with ASD and those with emotional disorders, on routinely collected outcomes at CYMHS in Australia ( N = 2,513) and the Netherlands ( N = 844). Results: Where the emotional disorders group reached a similar level of emotional symptoms at the end-of-treatment as the ADHD and ASD groups, the latter two groups still had higher scores on ADHD and ASD symptoms (attention and peer problems). The poorer outcomes were mainly explained by higher severity at baseline. In Australia, an ADHD and/or ASD diagnosis also independently contributed to worse outcomes. Conclusion: Those with neurodevelopmental disorders within both countries had poorer outcomes than those with emotional disorders. Services should aim to optimize treatment to ensure best possible outcomes.
Malignancy Rates by Bethesda Subcategory in the Pediatric Population
Authors: Park Soyun , Osterbauer Beth , Sahyouni Grace , Paik Connie , Austin Juliana , Gomez Gabriel , Shillingford Nick , Kwon Daniel 
Published: July 2022

Introduction While the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the most widely used method for categorizing thyroid nodules, its applicability to children is often debated. We describe our institution’s experience utilizing the TBSRTC and examine the rates of malignancy in our population. Methods We conducted a retrospective chart review of eligible patients undergoing primary thyroidectomy at a high-volume tertiary care pediatric hospital. All patients had pre-operative fine needle aspiration Results Of the 112 patients in our cohort, 85 (76%) were female. The median age was 15.1 years. The patients were divided into groups based on the Bethesda categorization of the fine needle aspirations of their nodules. The percentages of patients whose resection specimens showed evidence of malignancy on the surgical pathology reports were recorded as follows: category I (n = 5): 20%, category II (n = 11): 0%, category III (n = 30): 17%, category IV (n = 13): 31%, category V (n = 17): 94% and category VI (n = 36): 100%. Conclusion Our findings indicate that the malignancy rates at our institution are comparable to those reported by other high-volume studies. When compared with the 2017 TBSRTC data, we found that our results were similar in many categories, with the exception of categories I and V.
Teachers as new speakers of a minority language: Identity, speakerness, and ideologies on variation in Irish
Authors: Ó Murchadha Noel , Flynn Colin J. 
Published: July 2022

Aims and objectives: This article reports the ideologies on linguistic variation among a cohort of new speaker teachers (NSTs) of Irish. It investigates responses to the three main traditional dialects of Irish and a post-traditional variety common among new speakers. Design and methodology: An experimental design was employed. Participants responded to 15-second samples of four speakers, first on adjective items referring to speakers’ characteristics (speaker phase) and second on statements referring specifically to the type of Irish in the samples (speech phase). Background information was also gathered, for example, school type, place of origin, and type of Irish spoken. Data and analysis: We present the responses of a subset of 88 NSTs of Irish, focusing specifically on participants’ responses in the speech phase where they evaluated the type of Irish in the samples. Data were analysed to determine whether there were significant differences in the ratings of samples within different respondent subgroups. Findings and conclusions: Some significant differences were found among subgroups. Teachers working in Irish-medium schools align more closely with established native speaker language ideologies than those in English-medium institutions. Participants did not distinguish significantly between their local Gaeltacht variety and other Gaeltacht areas, but did rate all three Gaeltacht samples more positively than the new speaker variety. Finally, participants who self-identify as speakers of ‘standard’ Irish and those who describe themselves as practising a Gaeltacht variety rated the Gaeltacht samples more positively. Originality: While experimental investigations of linguistic ideologies are central to sociolinguistics, this article is original in its focus on the ideologies of NSTs of Irish. Significance and implications: This research illustrates the robustness of established ideologies in the responses of some participants but shows that others challenge these ideologies. Results speak to the complexities and contradictions of identity and speakerness among NSTs of a minority language.
Pad cultures: An ethnography of continence care and its consequences for people living with dementia during a hospital admission
Authors: Northcott Andy , Boddington Paula , Featherstone Katie 
Published: July 2022

Background There is little research examining how continence care is organised and delivered to people living with dementia across an acute hospital admission, despite the prevalence of this patient population and their vulnerability within these settings. Objective To explore how continence care is delivered to people living with dementia during an acute hospital admission. Design Ethnographic. Setting(s) Acute medical units and wards within three hospitals across England and Wales. Participants People living with dementia and ward staff (registered nurses and care assistants) on participating wards. Methods Ethnographic fieldwork collected over a period of 12 months (180 days of non-participant observation) focussing on the organisation and delivery of continence care to people living with dementia. Observations were supported with in situ ethnographic interviews ( n = 562) with patients, visitors and staff within the six observed wards. Data collection and analysis drew on the theoretical sampling and constant comparison techniques of grounded theory. Results The findings comprised of five overall themes: (1) visibility of continence; (2) rationales of continence care; (3) containment and contagion; (4) consequences of continence care and (5) supporting continence. Conclusions We introduce the term ‘pad cultures’ to refer to the established routine use of continence pads in the care of a wider group of people living with dementia (regardless of continence status and independence), with the rationale to provide safeguards, ensure containment and prevent ‘accidents’ or incontinent episodes. There was an expectation within acute wards that people living with dementia not only wear continence pads but that they also use them.
Endovascular Rescue Aortic Fenestration After Accidental False Lumen TEVAR in Type B Dissection
Authors: Massmann Alexander , Giebels Christian , Buecker Arno , Schäfers Hans-Joachim , Fries Peter 
Published: July 2022

Purpose: Unintended false-lumen thoracic endovascular aortic repair (TEVAR) is under-reported and often fatal. We present percutaneous endovascular rescue techniques for true-lumen reperfusion with strategies to address the peripheral artery perfusion needs unique to each case. Case Report: Two patients deteriorated 24 hours after uncomplicated and complicated acute aortic type-B dissection TEVAR treatment at a tertiary community hospital. Reevaluation of index and repeated imaging studies revealed inadvertent false-lumen TEVAR with severe visceral and peripheral ischemia. Stepwise subtraction angiography was used to confirm continuous true-lumen catheterization from femoral puncture into the thoracic aorta. Retrograde fenestration distal to the misplaced TEVAR from the true- into the false-lumen allowed for snorkeling by distal stent-extension across the dissection membrane. In one case, TEVAR stent graft extension resulted in true-lumen re-expansion and in the other case, bare-metal stent-extension for stabilization of the dissection membrane resulted in true-lumen re-expansion in addition to preservation of visceral and peripheral perfusion via the false-lumen. Despite excellent acute hemodynamic results and initial signs of recovery, both patients eventually died (multiorgan failure; cerebral hemorrhagic infarction). Conclusion: Correct indication and prompt recognition of potential inadvertent false-lumen stenting is critical to avoid disastrous sequelae, for example, malperfusion. Endovascular salvage is feasible for restoration of correct perfusion and must be performed in a timely manner. Clinical Impact Clinically apparent, complicated type-B dissection necessitates instantaneous treatment. Prerequisite for an endovascular approach is a true-lumen guidewire continuously from access to the ascending aorta. DSA after TEVAR and prompt clinical re-evaluation are to verify effective visceral and peripheral restoration of blood flow. Despite these measures, inadvertent false-lumen TEVAR may occur rarely. Immediate recognition may allow for timely true-lumen re-expansion using percutaneous endovascular salvage techniques e.g. retrograde fenestration from the true- into the false-lumen for distal snorkeling of the misplaced TEVAR across the dissection membrane. However, morbidity and mortality are very high, if erroneous stent graft placement is not identified early.
‘We may have bad days . . . that doesn’t make us killers’: How military veterans perceive contemporary British media representations of military and post-military life
Authors: Parry Katy , Pitchford-Hyde Jenna 
Published: July 2022

Over the last two decades of long wars in Afghanistan and Iraq, the media’s attention on military veterans in the UK has been characterized by a series of shifts: from a focus on combat operations; to initiatives to support transition to civilian life; and finally to a largely invisible presence of veteran issues in the mediated public sphere. This article presents findings from an online qualitative survey conducted with British veterans in 2020. The authors’ primary focus is on how veterans express their concerns when asked about varied televised representations of military and post-military experience. How did the respondents perceive differences across television genres (drama, news, reality TV), and how did this affect their engagement? How do they see their veteran identity reflected back at them through popular media culture? There is a growing research interest in ‘veteran studies’ from a range of disciplines, but the relationship between veteran identity and perceptions of (post)-military representations remains largely under-researched, at least in the UK context. One concern is that negative or misleading stereotypes of veterans among publics could hinder their successful reintegration into society, but the authors are interested in how veterans make sense of such representations across popular media culture, how they imagine the ‘general public’ audience in their reflections, and the nature of veteran identity they project within the survey responses. This study finds that anxieties about ‘mad, bad or sad’ stereotypical representations of veterans continue, but the diversity within its findings also reaffirms the importance of not treating veterans as a homogeneous group in research.
The effect of pre-operative shoulder injections on post-operative opioid use, infection and revision following shoulder arthroplasty
Authors: Lemme Nicholas J , Yang Daniel , Lama Christopher , Testa Edward J , Dworkin Myles , Modest Jacob M , Owens Brett D , Daniels Alan H , DeFroda Steven F 
Published: July 2022

Background Treatment of glenohumeral osteoarthritis (GHOA) may include conservative management with use of intraarticular injections, prior to considering total shoulder arthroplasty (TSA). The purpose of this study was to assess trends in the use of preoperative cortisone (CO) and hyaluronic acid (HA) injections, as well as investigate the relationship between injection use and infection or revision arthroplasty following TSA. Methods Pearl Driver was used to identify all patients undergoing TSA for GHOA between 2010 and 2018. Patients were categorized based on the type and number of injections they received. Outcomes of interest included post-operative opioid use, post-operative infection, and risk of revision surgery within 1 year of the index procedure. Results The incidence of patients receiving a CO or HA injections within 1 year of their TSA decreased by 83% and 54%, respectively. Patients who had received 1 or more steroid injections had higher odds of prolonged opiate use following surgery. Patients that received 1 or 2 CO injection prior to TSA had an increased risk of needing revision surgery. Discussion Use of intraarticular injections for the management of GHOA has declined. Patients receiving preoperative injections had increased odds of prolonged opiate use and the need for revision surgery.
Subscapularis management in anatomic total shoulder arthroplasty: A systematic review and network meta-analysis
Authors: Ahmed Abdulaziz F , T Kreulen Randall , Mikula Jacob , Nayar Suresh K , Miller Andrew S , McFarland Edward G , Srikumaran Uma 
Published: July 2022

Background This systematic review and network meta-analysis compare clinical outcomes of three different subscapularis management techniques in anatomic total shoulder arthroplasty: lesser tuberosity osteotomy, subscapularis peel, and subscapularis tenotomy. Methods PubMed, Web of Science, Embase, and Cochrane's trial registry were searched in July 2021. Comparative studies and case series evaluating the outcomes of these three techniques were included. The network meta-analysis was performed only on comparative studies. Results Twenty-three studies were included. Both lesser tuberosity osteotomy and subscapularis peel had significantly higher Western Ontario Osteoarthritis Scores compared to subscapularis tenotomy, but no difference in American Shoulder and Elbow Society Scores. Subscapularis peel had superior external rotation compared to lesser tuberosity osteotomy. However, no difference was found in external rotation between subscapularis peel and subscapularis tenotomy or between subscapularis tenotomy and lesser tuberosity osteotomy. The overall weighted average for lesser tuberosity osteotomy bony union was 93.6%, whereas the overall weighted average for subscapularis tendon healing was 79.4% and 87% for subscapularis tenotomy and subscapularis peel, respectively. Discussion This network meta-analysis demonstrated that lesser tuberosity osteotomy and subscapularis peel were associated with the high union and subscapularis healing rates and may be associated with improved shoulder function and quality of life, compared to subscapularis tenotomy. Lesser tuberosity osteotomy and subscapularis peel demonstrate a trend of superior outcomes compared to subscapularis tenotomy during anatomic total shoulder arthroplasty.
Unstable Rotational Ankle Fractures Treated With Anatomic Mortise Repair and Direct Posterior Malleolus Fixation
Authors: Littlefield Connor P. , Drake Jack H. , Egol Kenneth A. 
Published: July 2022

Introduction: The purpose of this study was to evaluate patient outcomes following a standardized algorithmic approach to ankle mortise stabilization, following rotational fracture, utilizing direct repair of the posterior malleolus in the prone position. Methods: Eighty consecutive patients with unstable rotational ankle fractures that involved the posterior malleolus were analyzed. All underwent direct repair of the posterior malleolus regardless of size through a posterolateral approach. Electronic records were retrospectively reviewed for demographic information, initial injury and operation details, healing status, and complications. Preoperative and postoperative radiographs were obtained to assess the initial injury and healing was determined both by radiographic and clinical progress at follow-up visits. Results: Average posterior malleolus fragment width was 8.1 ± 3.7 mm (range = 2.1-19.9 mm) and percentage of the articular surface was 23.6% (range = 7.1%-56.7%) on the lateral radiograph. Overall, 80/80 (100%) patients healed their ankle fractures by a mean 2.9 ± 1.1 months. Only 1 (1.3%) patient required transsyndesmotic fixation following posterior malleolus repair. Mean range of ankle motion was as follows: dorsiflexion 20° ± 10°, plantarflexion 34° ± 10°, inversion 8° ± 4°, and eversion 7° ± 4°. Seventy-nine patients (98.8%) had an anatomic mortise reduction. Nine patients (11.3%) had a superficial wound complication, 3 patients (3.8%) had dysesthesia in the sural nerve distribution, and 1 patient (1.3%) lost reduction of the medial malleolus. Conclusion: Patients who undergo direct repair of the posterior malleolus in the prone position can expect a high rate of healing with superficial wound breakdown being the biggest problem, which was associated with an ankle fracture dislocation. Posterior malleolus fixation may obviate the need of transsyndesmotic stabilization. Levels of Evidence: Retrospective Level IV
Medical students’ intention to integrate digital health into their medical practice: A pre-peri COVID-19 survey study in Canada
Authors: Paré Guy , Raymond Louis , Pomey Marie-Pascale , Grégoire Geneviève , Castonguay Alexandre , Ouimet Antoine Grenier 
Published: July 2022

Objective We aimed to explore the factors that influence medical students’ intention to integrate dHealth technologies in their practice and analyze the influence of the COVID-19 pandemic on their perceptions and intention. Methods We conducted a two-phased survey study at the University of Montreal's medical school in Canada. The study population consisted of 1367 medical students. The survey questionnaire was administered in two phases, that is, an initial survey (t0) in February 2020, before the Covid-19 pandemic, and a replication survey (t1) in January 2021, during the pandemic. Component-based structural equation modeling (SEM) was used to test seven research hypotheses. Results A total of 184 students responded to the survey at t0 (13%), whereas 138 responded to the survey at t1 (10%). Findings reveal that students, especially those who are in their preclinical years, had little occasion to experiment with dHealth technologies during their degree. This lack of exposure may explain why a vast majority felt that dHealth should be integrated into medical education. Most respondents declared an intention to integrate dHealth, including AI-based tools, into their future medical practice. One of the most salient differences observed between t0 and t1 brings telemedicine to the forefront of medical education. SEM results confirm the explanatory power of the proposed research model. Conclusions The present study unveils the specific dHealth technologies that could be integrated into existing medical curricula. Formal training would increase students’ competencies with these technologies which, in turn, could ease their adoption and effective use in their practice.
From Paragon to Peer: China's Shifting Perspective on German Education
Authors: Chen (陈洪捷) Hongjie 
Published: July 2022

Highlights Around 2000, China's view of German education began to change. The seemingly insurmountable education gap between the two countries began to close. China began viewing its education system as being equal to that of Germany. China still regards Germany as a role model and will continue using it as a reference.