604,

). Time at home was not an independent predictor for prevalence of infection per capita (beta= 0.016; 95% CI, -0.003 to 0.036;

).

Based on mobility reports from mobile phone GPS data and six characteristics of social distancing, significant associations were identified between geographic activity and prevalence of COVID-19 infections in the U.S. per capita. Mobile phone data utilizing 'location history’ may be warranted to monitor the effectiveness of social distancing parameters on reducing prevalence of COVID-19 in the U.S.

Based on mobility reports from mobile phone GPS data and six characteristics of social distancing, significant associations were identified between geographic activity and prevalence of COVID-19 infections in the U.S. per capita. Mobile phone data utilizing 'location history’ may be warranted to monitor the effectiveness of social distancing parameters on reducing prevalence of COVID-19 in the U.S.

Several procedures and types of osteotomies have been described for hallux valgus (HV) correction. Percutaneous techniques may lead to an early regain of function reducing morbidity and recovery time. In this study, we aimed to evaluate the clinical and radiographic outcomes of percutaneous hallux valgus (HV) correction.

One hundred and twenty-four feet treated with the percutaneous technique between May 2011 and December 2015 were included in our study. All patients underwent resection of the medial metatarsal exostosis, complete first metatarsal distal osteotomy, adductor hallucis tendon release and Akin osteotomy of the proximal phalanx. Pre- and postoperative X-rays were clinically assessed.

The mean hallux valgus angle (HVA) and the intermetatarsal angle (IMA) decreased significantly from the preoperative assessment to the final follow-up. The AOFAS score improved from a mean preoperative value of 70.2 to 93.8 at the final follow-up.

Percutaneous complete distal osteotomy in hallux valgus correction is a safe, reliable and effective procedure for the correction of symptomatic mild hallux valgus. Nevertheless, it requires appropriate surgical experience and patient aftercare in order to achieve the best result.

Percutaneous complete distal osteotomy in hallux valgus correction is a safe, reliable and effective procedure for the correction of symptomatic mild hallux valgus. Nevertheless, it requires appropriate surgical experience and patient aftercare in order to achieve the best result.

Whilst traumatology around elderly population becomes more and more popular nowadays, the knowledge of local bone quality prior to osteosynthesis is of paramount importance. Assessment of the local bone mechanical properties provides essential information related to implant stability and can support treatment strategies in a timely manner. In the acute setting, dual-energy X-ray absorptiometry and quantitative computer tomography cannot be used routinely, and up till now no known intraoperative methods have been established.

A novel technique was developed to determine the local bone strength. A feasibility and sensitivity analysis were performed on synthetic cancellous bone models of various densities [including osteoporotic ranges (0.12 – 0.48g/cm

)] by testing the permeability of different rod probe designs.

The Intraoperative Osseomechanical Strength Measurement (IOSM) method revealed high sensitivity for the evaluation of local density on synthetic bone material. Among the indenter designs tested, the one with 40° sharp apex and 5 mm diameter reflected accurately the density changes of the synthetic bones. It was also associated with less invasiveness posing no risk for the primary implant stability of the osteosynthesis that may follow.

The IOSM method using the indicated indenter design on synthetic cancellous models appears to be a minimal invasive technique with high accuracy in identifying different bone densities . Further studies on human bone material are now focused on the evaluation of the IOSM sensitivity compared to the gold standards (Dual-energy X-ray absorptiometry and quantitative computer tomography).

The IOSM method using the indicated indenter design on synthetic cancellous models appears to be a minimal invasive technique with high accuracy in identifying different bone densities . Further studies on human bone material are now focused on the evaluation of the IOSM sensitivity compared to the gold standards (Dual-energy X-ray absorptiometry and quantitative computer tomography).

The aim of this study was to evaluate the factors influencing patient reported outcome measures (PROM) of biceps tenodesis after the rupture of proximal long head of the biceps tendon.

Retrospective chart review was conducted to identify patients with complete proximal rupture of the long head of the biceps that underwent biceps tenodesis between 2002-2017. This yielded 42 patients, of which 23 (55%) completed the PROMIS Pain Interference, PROMIS Upper Extremity, Quick DASH, and a custom biceps tear questionnaire, at a median of 8.5 years (IQR5.2-12) post-operatively. The median age of the respondents was 57 years (IQR 43-61). The majority of patients (n=12, 52%) underwent tenodesis using suture anchor fixation, while the remaining underwent tenodesis with interference screw technique (n=6, 26%), key hole technique (n=1, 4.3%), or tunnel technique (n=1, 4.3%). A bivariate analysis was performed to evaluate factors influencing the PROMs.

Six patients (27%) reported persistent biceps cramping at a median of 8.2 years post-operatively, negatively impacting PROMs, and this was associated with older age. Six patients (27%) had post-operative complications, including infection, pain, stiffness, and re-rupture, of which four patients (17%) underwent reoperation. Patients with activity/sports-induced injury or those that underwent tenodesis using a suture anchor technique demonstrated better PROMs.

Post-operative biceps cramping persists in almost one-third of patients and significantly impacts PROMs. Patient activity level and the use of suture anchor technique for tenodesis were independent predictors of improved biceps tenodesis outcome scores.

Post-operative biceps cramping persists in almost one-third of patients and significantly impacts PROMs. Patient activity level and the use of suture anchor technique for tenodesis were independent predictors of improved biceps tenodesis outcome scores.

The association between ulnar styloid fracture and distal radius fracture is common while the necessity of ulnar styloid fixation is still controversial. We have aimed to elucidate the effect of ulnar styloid fracture fixation on final outcome of distal radius fracture treatment.

In a two-arm randomized clinical trial, patients with Fernandez type I distal radius fracture associated with ulnar styloid fracture in the base were divided into two groups of fixed (group A) and unfixed (group B) ulnar styloid fracture. They were followed up for 12 months using pain visual analogue scale (VAS), quick form of the Disabilities of the Arm, Shoulder, and Hand (DASH) score questionnaire, and Mayo performance score as well as wrist range of motion and grip strength evaluation.

Quick DASH score was 35.4±14.0 in group A and 30.5±5.82 in group B (

) at 3-month follow-up and 29.8±18.2 in group A and 18.3±8.40 in group B At 6-month follow-up (

). VAS score for pain was declined 4.46±2.17 and 3.64±0.96 after 6 months (

) and 4.00±1.73 and 2.50±0.81 after 12 months (

) in groups A and B, respectively. The mean Mayo wrist scores were measured as 59.3 and 57.8 in group A and B three months after the fracture, respectively (P= 0.504). We found no significant difference in the wrist range of motion and grip strength between two groups after three months (

).

According to our findings, ulnar styloid fixation using pin and wire have an adverse effect on distal radius fixation outcomes.

According to our findings, ulnar styloid fixation using pin and wire have an adverse effect on distal radius fixation outcomes.

Given the fact that the carpal tunnel syndrome (CTS) happens as a consequence of the median nerve entrapment, besides other known factors, the shape and anthropometric characteristics of the carpal tunnel, wrist, and hand could be considered as a predisposing risk factor for idiopathic CTS. The aim of this study was to evaluate the morphology and radiologic scales in CTS hands.

In this prospective study, patients who underwent upper extremity electrodiagnostic studies were enrolled for hand morphologic and radiographic indexes. Patients were divided into CTS suffering and CTS symptom-free groups according to nerve conduction velocity (NCV) findings. A true posteroanterior radiograph of the hands was pas performed for each participant. Metacarpal length to wrist length index (carpal ratio), metacarpal length to metacarpal width index, third to first metacarpal length, hand length index, and hand volume index were measured in both groups.

Significant differences were seen between the two groups regarding th a higher carpal ratio. In conclusion, CTS hands are bulkier with wider palms and shorter fingers compared to thumb. In this study, the thumb to the third metacarpal length was proved to be the best index for diagnosis of „CTS hand”.

The aim of this study was to assess the functional outcomes and time to improve after the modified arthroscopic technique (recession technique) by using a knife to sharply cut the extensor carpi radialis brevis (ECRB) tendon origin in patients with recalcitrant tennis elbow.

In a prospective study, we included 11 consecutive patients. Following the routine elbow arthroscopy and after exposing the ECRB tendon, we used a knife (no. 11 blade) to cut the tendon at the level of radiocapitellar articulation while avoiding the lateral collateral ligament, which is considered a tendon recession as is done in spastic muscles. Patients were followed up for 1, 3, 6, and 12 month intervals and were asked to fill the Mayo Elbow Performance Index (MEPI), Quick Disabilities of the Arm Shoulder Hand (QuickDASH), and Patient-Rated Tennis Elbow Evaluation (PRTEE).

The mean PRTEE, QuickDASH, and MEPI scores showed significant improvement over time (

). There were 5 excellent, 5 good and 1 fair results based on MEPI. The e to the routine piecemeal shaving of the pathologic tissue.

This randomized clinical trial was undertaken to document the clinical presentation of de Quervain’s disease and evaluate the outcome of management with triamcinolone acetonide (TAC) injection versus surgical decompression.

Half of the patients were assigned to the corticosteroid injection group (group A) and half to the surgery group (group B). In group A, 40 mg of TAC was injected into the affected first extensor compartment. In group B, surgical decompression of first extensor compartment was performed.

There were 56 patients with 38 (67.85 %) females and 18(32.14%) males. The age range was 23-66 years. In group A, one injection was employed among 7(25%) patients whereas two injections among 21(75%) patients. Local complications with injections were observed among 7 patients. Symptomatic relief with injection at 6-weeks was observed among 25% patients whereas recurrence at one year was observed among 9(32.14%) patients. In group B, no critical complications were encountered following surgery; all the patients had symptomatic relief at 6-weeks and there was no case with recurrence at one year.

Surgical decompression provided superior results in terms of providing symptomatic relief at 6-weeks among all patients, absence of complications and no recurrence. The corticosteroid injections (CSI) were associated with the need for repeat injections among 75% cases and a recurrence rate of 32.14% at one year, rendering it to be comparatively a poorer choice.

Surgical decompression provided superior results in terms of providing symptomatic relief at 6-weeks among all patients, absence of complications and no recurrence. The corticosteroid injections (CSI) were associated with the need for repeat injections among 75% cases and a recurrence rate of 32.14% at one year, rendering it to be comparatively a poorer choice.

Treatment recommendations for trapeziometacarpal (TMC) arthrosis are highly variable from surgeon to surgeon. This study addressed the influence of viewing radiographs on a decision to offer surgery for TMC arthrosis.

In an online survey, 92 hand surgeons viewed clinical scenarios and were asked if they would offer surgery to 30 patients with TMC arthrosis. Forty-two observers were randomly assigned to review clinical information alone and 50 to review clinical information as well as radiographs. The degree of limitation of daily activities, time since diagnosis, prior treatment, pain with grind, crepitation with grind, and metacarpal adduction with metacarpophalangeal hyperextension were randomized for each patient scenario to determine the influence of these factors on offers of surgery. A cross-classified binary logistic multilevel regression analysis identified factors associated with surgeon offer of surgery.

Surgeons were more likely to offer surgery when they viewed radiographs (42% vs. 32%,

).bias, and the potential for surgeon and patient impatience with the adaptation process, methods for increasing patient participation in the decision-making process merit additional attention and study.

Soft tissue injury associated with fractures of the distal tibia is a predictive factor for a poor prognosis. The purpose of this study was to investigate factors associated with the need for a flap coverage after distal tibial fracture, and whether there was a difference in functional outcomes between patients with flap coverage or no flap coverage for a distal tibial fracture.

All fractures of the distal tibia treated in our department between 2010 and 2017 were reviewed. The functional result was assessed using the SF-36 Quality of Life Questionnaire, the Visual Analog Scale (VAS) when walking and the AOFAS scale (American Orthopedic Foot and Ankle Society).

132 distal tibia fractures were reviewed, of which 51 required soft tissue flap reconstruction, which was associated with open fractures (

, OR 5.25), high energy trauma (

, OR 1.7)), the use of external fixation (

, OR 12.5) and the presence of vascular alterations on the Angio-CT scan (

). No significant differences were found in any of the scales that assessed the functional results between the group of patients who required soft tissue flap reconstruction and the group of patients who did not.

We found that the need for a soft tissue flap was associated with the following parameters open fracture, high energy of trauma, presence of skin necrosis, the use of external fixation and the existence of vascular injury. In relation to functional results, differences were not found between the group that needed coverage with a flap and the one that did not.

We found that the need for a soft tissue flap was associated with the following parameters open fracture, high energy of trauma, presence of skin necrosis, the use of external fixation and the existence of vascular injury. In relation to functional results, differences were not found between the group that needed coverage with a flap and the one that did not.

Disability following hand and upper extremity conditions is common. Patient-reported outcome measures (PROs) are used to capture patients’ status subjectively. This review has aimed to synthesis the literature regarding the extent and methodological quality of translation, cross-cultural adaptation, and psychometric properties of the hand and upper extremity disability PROs in the Persian language.

Seven electronic databases (MEDLINE, EMBASE, Psychinfo, Scopus, ISI, Science direct, and Google Scholar) were searched until May 2020. Studies reporting cross-cultural adaptation and psychometric properties testing of the Persian validated disability PROs of the hand and upper extremity were identified. We appraised the eligible studies using Guidelines for the Process of Cross-cultural Adaptation of Self-report Measures and COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist.

Out of 98 identified records, 22 studies on 17 PROs were reviewed. Most of tt quality to be used in clinical settings.

There have been studies indicating that the non acute rotator cuff repair can be augmented with reconstituted absorbable collagen scaffold (RACS)which results in better structural integrity and functional outcome. Hence, this review aims to systematically analyse the available evidence based on its methodological quality, technique and functional outcome.

Systematic review was carried on PubMed for articles related to non acute rotator cuff repair reconstituted absorbable collagen scaffold. Also, Colemans method of scoring was used to assess the methodological quality of the studies.

mong the studies included, the minimum follow up duration was 12 months. All the studies reported statistically significant improved outcomes following repair with reconstituted absorbable collagen scaffold for partial thickness tears, full thickness tears and in massive tears.

Repair reconstituted absorbable collagen scaffold seems to be a viable option to improve the structural integrity following non acute rotator cuff repair.

Repair reconstituted absorbable collagen scaffold seems to be a viable option to improve the structural integrity following non acute rotator cuff repair.Objective To develop a conceptual model that confirms whether mobility-related activities of daily living (ADLs) abilities are strongly associated with reduced health-related quality of life (HRQOL) in older adults. Methods A total of 153 participants (63 men, 90 women) were analyzed. The mobility-related ADL survey from the Ministry of Education, Culture, Sports, Science, and Technology of Japan was used. The Japanese version (v1.2) of the Medical Outcomes Study 36-item Short-Form Health Survey was administered to evaluate HRQOL. Structural equation modeling was performed to test a hypothetical model mobility-related ADL abilities would influence HRQOL. Results The chi-square value was not significant (chi-square = 9.463, p = .305), and goodness-of-fit values were high, implying that the model was validated; goodness-of-fit index, 0.981; adjusted goodness-of-fit index, 0.949; comparative fit index, 0.996; and root mean square error of approximation, 0.035. Results showed that mobility-related ADL abilities influenced the physical health including physical function and general health in HRQOL. Conclusions This study developed the conceptual model confirming the influence of mobility-related ADL abilities especially on physical health. Further intervention studies on instructions/training for physical activity of healthy older adults should assess this causal relationship.Urinary tract infection (UTI) is a common cause of delirium in the elderly. Although diagnosis of delirium secondary to UTI is relatively straightforward, a lack of thorough investigation could result in missing underlying factors and medical conditions that may require immediate clinical/surgical intervention. Case of a 77-year-old male with delirium diagnosis and multiple psychiatric hospital admissions is reported here. This patient with multiple medical disorders and anxiety was admitted to psychiatric facilities on three different occasions with multiple psychiatric diagnoses including delirium. After a month of hospital stay and thorough medical and radiological examinations, the cause of refractory delirium was identified as multifactorial including urothelial carcinoma. Although UTI and urinary retention are common in the elderly, this case shows the importance of multifactorial diagnoses in cases of prolonged or refractory delirium to avoid delays in appropriate treatment.The challenges of implementing interventions in healthcare settings have been more apparent during the COVID-19 pandemic. This pre-implementation evaluation used a rapid qualitative approach to explore barriers and facilitators to an intervention in intensive care units in Argentina, aimed to promote the use of personal protection equipment, provide emotional support for professionals, and achieve patient flow goals. Data were collected using semi-structured interviews with health professionals of 15 public hospitals in Argentina. Normalization Process Theory was used to guide content analysis of the data. Participants identified potential barriers such as the incorporation of non-specialist staff, shortage of resources, lack of communication between groups and shifts. Potential facilitators were also identified regular feedback and communication related to implementation, adequate training for new and non-specialist staff, and incentives (e.g., scholarships). The immediacy of the pandemic demanded rapid qualitative research, sharing actionable findings in real time.Triple negative breast cancer (TNBC) is an aggressive subtype of breast cancer with limited targeted therapeutic options. A defining feature of TNBC is the propensity to metastasize and acquire resistance to cytotoxic agents. Mitogen activated protein kinase (MAPK) and extracellular regulated kinase (ERK) signaling pathways have integral roles in cancer development and progression. While MEK5/ERK5 signaling drives mesenchymal and migratory cell phenotypes in breast cancer, the specific mechanisms underlying these actions remain under-characterized. To elucidate the mechanisms through which MEK5 regulates the mesenchymal and migratory phenotype, we generated stably transfected constitutively active MEK5 (MEK5-ca) TNBC cells. Downstream signaling pathways and candidate targets of MEK5-ca cells were based on RNA sequencing and confirmed using qPCR and Western blot analyses. MEK5 activation drove a mesenchymal cell phenotype independent of cell proliferation effects. Transwell migration assays demonstrated MEK5 activation significantly increased breast cancer cell migration. In this study, we provide supporting evidence that MEK5 functions through FRA-1 to regulate the mesenchymal and migratory phenotype in TNBC.Investigating the early dynamics of chemical systems following ionization is essential for our understanding of radiation damage. However, experimental as well as theoretical investigations are very challenging due to the complex nature of these processes. Time-resolved x-ray absorption spectroscopy on a femtosecond timescale, in combination with appropriate simulations, is able to provide crucial insights into the ultrafast processes that occur upon ionization due to its element-specific probing nature. In this theoretical study, we investigate the ultrafast dynamics of valence-ionized states of urea and its dimer employing Tully’s fewest switches surface hopping approach using Koopmans’ theorem to describe the ionized system. We demonstrate that following valence ionization through a pump pulse, the time-resolved x-ray absorption spectra at the carbon, nitrogen, and oxygen K-edges reveal rich insights into the dynamics. Excited states of the ionized system give rise to time-delayed blueshifts in the x-ray absorption spectra as a result of electronic relaxation dynamics through nonadiabatic transitions. Moreover, our statistical analysis reveals specific structural dynamics in the molecule that induce time-dependent changes in the spectra. For the urea monomer, we elucidate the possibility to trace effects of specific molecular vibrations in the time-resolved x-ray absorption spectra. For the urea dimer, where ionization triggers a proton transfer reaction, we show how the x-ray absorption spectra can reveal specific details on the progress of proton transfer.Visualizing molecular transformations in real-time requires a structural retrieval method with Ångström spatial and femtosecond temporal atomic resolution. Imaging of hydrogen-containing molecules additionally requires an imaging method sensitive to the atomic positions of hydrogen nuclei, with most methods possessing relatively low sensitivity to hydrogen scattering. Laser-induced electron diffraction (LIED) is a table-top technique that can image ultrafast structural changes of gas-phase polyatomic molecules with sub-Ångström and femtosecond spatiotemporal resolution together with relatively high sensitivity to hydrogen scattering. Here, we image the umbrella motion of an isolated ammonia molecule (NH3) following its strong-field ionization. Upon ionization of a neutral ammonia molecule, the ammonia cation (NH3 +) undergoes an ultrafast geometrical transformation from a pyramidal ( Φ HNH = 107 ° ) to planar ( Φ HNH = 120 ° ) structure in approximately 8 femtoseconds. Using LIED, we retrieve a near-planar ( Φ HNH = 117   ±   5 ° ) field-dressed NH3 + molecular structure 7.8 – 9.8 femtoseconds after ionization. Our measured field-dressed NH3 + structure is in excellent agreement with our calculated equilibrium field-dressed structure using quantum chemical ab initio calculations.Purpose To validate a previously proposed algorithm that modifies a mammogram to appear as if it was acquired with different technique factors using realistic phantom-based mammograms. Approach Two digital mammography systems (an indirect- and a direct-detector-based system) were used to acquire realistic mammographic images of five 3D-printed breast phantoms with the technique factors selected by the automatic exposure control and at various other conditions (denoted by the original images). Additional images under other simulated conditions were also acquired higher or lower tube voltages, different anode/filter combinations, or lower tube current-time products (target images). The signal and noise in the original images were modified to simulate the target images (simulated images). The accuracy of the image modification algorithm was validated by comparing the target and simulated images using the local mean, local standard deviation (SD), local variance, and power spectra (PS) of the image signals. The absolute relative percent error between the target and simulated images for each parameter was calculated at each sub-region of interest (local parameters) and frequency (PS), and then averaged. Results The local mean signal, local SD, local variance, and PS of the target and simulated images were very similar, with a relative percent error of 5.5%, 3.8%, 7.8%, and 4.4% (indirect system), respectively, and of 3.7%, 3.8%, 7.7%, and 7.5% (direct system), respectively. Conclusions The algorithm is appropriate for simulating different technique factors. Therefore, it can be used in various studies, for instance to evaluate the impact of technique factors in cancer detection using clinical images.

Sexual and gender minorities (SGM) experience higher rates of depression and anxiety, which are linked to higher rates of discrimination and victimization. SGM individuals may conceal their SGM identities to decrease discrimination and victimization exposure; however, these experiences still occur, and concealment itself is often associated with greater anxiety and depression. However, it remains unclear whether lifetime victimization and identity concealment moderate the effect of day-to-day discrimination, which we evaluated in the current study using ecological momentary assessment (EMA).

Fifty SGM participants (

21.82,

=4.70; 84% White) completed baseline assessment (e.g., concealment and lifetime victimization) followed by EMA of daily discrimination and anxious and depressed mood for 14 days.

As hypothesized, daily discrimination predicted momentary increases in anxious and depressed mood,

.34,

.001. Notably, these effects were more pronounced among individuals who reported higher levels ate real-time effects of minority stress exposure, and to develop interventions that may mitigate risk among SGM individuals with prior victimization exposure and higher levels of identity concealment in particular.

Although clavicle fractures are a common sports injury, there are limited studies on the incidence and causes of clavicle fractures among winter sports athletes.

To evaluate the characteristics and injury mechanisms associated with clavicle fractures among patients evaluated at a Colorado ski resort.

Descriptive epidemiology study.

This was a retrospective descriptive analysis of patients with clavicle fractures at the Denver Health Winter Park Medical Center during the 2012-2013 to 2016-2017 ski seasons. Chart review was performed on the patient cohort to confirm clavicle fracture diagnosis and to evaluate factors associated with clavicle fracture.

A total of 393 clavicle fractures (6.2% of total clinic visits) occurred during the study period, corresponding to an overall clavicle fracture incidence of 8.4 per 100,000 participant-visits. The mean patient age was 26.4 years (range, 5-73 years). The majority were middle-third fractures (85.5%), occurring mainly in men (87.3%). More than half of the fic fracture location was the midclavicle. A greater proportion of clavicle fractures among men were sustained during snowboarding and among women during skiing.

Patients are commonly evaluated at the emergency department (ED) with acute anterior cruciate ligament (ACL) tears, but providers without orthopaedics training may struggle to correctly diagnose these injuries.

It was hypothesized that few patients would be diagnosed with an ACL tear while in the ED and that these patients would be of lower socioeconomic status and more likely to have public insurance.

Cohort study; Level of evidence, 3.

The 2017 State Ambulatory Surgery and Services Database (SASD) and State Emergency Department Database (SEDD) from the state of Florida were utilized in this study. Cases with Current Procedural Terminology code 29888 (arthroscopically aided ACL reconstruction [ACLR]) were selected from the SASD, and data from the SEDD were matched to patients who had an ED visit for a knee injury within 120 days before ACLR. Chi-square analysis was used to test for differences in patient and surgical variables between the ED visit and nonvisit patient groups. A generalized linear modtely on patients of low socioeconomic status and patients with Medicaid.

Utilizing the ED for care after an ACL injury was expensive, averaging a $4587 increase in total cost associated with ACLR. However, patients rarely left with a definitive diagnosis, with only 4.5% of patients who underwent ACLR being correctly diagnosed with an ACL tear in the ED. This additional cost was levied disproportionately on patients of low socioeconomic status and patients with Medicaid.

The all-inside anterior cruciate ligament reconstruction (ACLR) procedure uses a single hamstring tendon folded twice and secured to itself to form a 4-stranded graft. There are several possible configurations for preparing the graft.

To investigate the biomechanical properties of a new graft preparation technique in comparison with 2 commonly used configurations.

Controlled laboratory study.

Five porcine flexor tendons were prepared into the test graft configuration side-to-side fixation with a backup fixation at the button loop (graft M). The test configuration was compared with the results of a previous study that included grafts with simple interrupted sutures (graft A; n = 5) and end-to-end fixation (graft C; n = 5). All grafts were subjected to the same mechanical testing protocol to determine the mean failure load, stiffness, rate of elongation, and total elongation during both cyclic loading and pull to failure. Differences between groups were evaluated.

Graft A had a significantly lower faies surgeons with a new method of preparing grafts and evaluates the method with respect to currently used configurations.

Knee joint-line orientation is altered after open-wedge high tibial osteotomy (OWHTO), and excessive joint-line obliquity (JLO) can adversely affect outcomes. Little is known regarding preoperative prediction of postoperative knee JLO.

The purpose of this study was to assess the correlation between the amount of lower limb adduction and changes in knee JLO after OWHTO. The hypothesis was that postoperative knee JLO could be predicted using the amount of lower limb adduction after OWHTO.

Case series; Level of evidence, 4.

The records of 67 patients (77 knees) who underwent OWHTO for medial compartment osteoarthritis were retrospectively reviewed. The mechanical hip-knee-ankle (HKA) axis, lateral distal femoral angle, medial proximal tibial angle (MPTA), knee JLO, ankle JLO, and joint-line convergence angle were measured on standing whole-leg plain radiographs preoperatively and at 1 year postoperatively. The limb adduction angle was defined as the angle between the native weightbearing line (WBL) and tassociated with postoperative knee JLO (

< .001;

= 0.83).

Changes in knee JLO after OWHTO were associated with adduction of the lower limb after OWHTO. During preoperative planning, postoperative knee JLO can be predicted as the sum of the preoperative knee JLO and the limb adduction angle between the preoperative WBL and planned WBL.

Changes in knee JLO after OWHTO were associated with adduction of the lower limb after OWHTO. During preoperative planning, postoperative knee JLO can be predicted as the sum of the preoperative knee JLO and the limb adduction angle between the preoperative WBL and planned WBL.

Studies have reported that opening wedge high tibial osteotomy (OWHTO) without bone grafting has outcomes that are similar to or even better than those of OWHTO with bone grafting, especially after use of a locking plate. However, a consensus on managing the gap after OWHTO has not been established.

To determine the degree of gap healing achieved without bone grafting, the factors associated with gap healing, and whether additional gap healing would be obtained after plate removal.

Cohort study; Level of evidence, 3.

This retrospective study included 73 patients who underwent OWHTO without bone grafting between 2015 and 2018.Patients in the study were divided into 2 groups based on the correction angle small correction group (<10°; SC group) and large correction group (≥10°; LC group). The locking plate used in OWHTO was removed at a mean of 13.5 months after surgery in 65 patients. Radiographic indexes were measured gap filling height, gap vacancy ratio (GVR), and osteotomy filling index. The accemoval. Considering the results of this study, a bone graft is not necessary in routine OWHTO in terms of gap healing.

All patients achieved acceptable gap healing without bone graft. The degree of gap healing was higher in the SC group and increased over time. Gap healing was promoted after plate removal. Considering the results of this study, a bone graft is not necessary in routine OWHTO in terms of gap healing.

There is increasing concern of iatrogenic hip instability after capsulotomy during surgery. Greater emphasis is now being placed on capsular closure during surgery. There are no prospective studies that address whether capsular closure has any effect on outcomes.

The purpose of this study was to evaluate patient outcomes after interportal capsulotomy repair compared with no repair. We hypothesized that restoration of normal capsular anatomy with interportal repair will achieve clinical outcomes similar to those for no repair.

Randomized controlled trial; Level of evidence, 1.

Adult patients with femoral acetabular impingement indicated for hip arthroscopy were randomized into either the capsular repair (CR) or the no repair (NR) groups. All patients underwent standard hip arthroscopy with labral repair with or without CAM/pincer lesion resection. Clinical outcomes were measured via the Hip Outcome Score-Activities of Daily Living (HOS-ADL) subscale, Hip Outcome Score-Sport Specific (HOS-SS) subscale, ere was significant improvement in the VR-12 Physical subscale at 2 years postoperatively in the capsular CR group compared with the NR group. Capsular closure appears to have no detrimental effect on functional outcome scores after hip arthroscopy. We recommend restoration of native anatomy if possible when performing hip arthroscopy.

There was significant improvement in the VR-12 Physical subscale at 2 years postoperatively in the capsular CR group compared with the NR group. Capsular closure appears to have no detrimental effect on functional outcome scores after hip arthroscopy. We recommend restoration of native anatomy if possible when performing hip arthroscopy.

Given the importance of the education system in the health sector and the necessity to calculate the cost in this sector, this study aimed to calculate the cost of education for health students in Shiraz Medical School, using activity-based costing (ABC).

This study was conducted in Shiraz University of Medical Sciences in 2015-2016, considering the cost structure of the education department. The data required for the present research study was gathered from accrual accounting system, payroll system, educational deputy system called SAMA, list of paid salaries, information received from medical school such as exact position of individuals and course credits assigned to teachers, interviews conducted at the university headquarter in order to determine the appropriate indicators for allocating the costs, and interviewing clinical and non-clinical teachers to calculate the cost of training in these fields.

The findings indicated that the cost of training in general accounted for 70% of the total cost of ststs of education. Hence, in order to allocate the budget more equitably, costs of education for each field calculated by ABC should be based on allocating the funds to the university.

Instruction in teacher-centered formats may lead to early learning fatigue, which in turn, decelerates students’ knowledge retrieval. Presently, teachers try to increase students’ participation and their active attention to course content by incorporating effective, applicable, low-cost, and enjoyable teaching apparatuses.

The participants of this quasi-experimental study were the students of speech therapy in 4th semester (n=83) at Ahvaz Jundishapur University of Medical Sciences. They were simple-randomly divided into two groups of experimental (who received the crossword puzzle accompanied by lecture or the hybrid method as Group A) and control (who received the traditional method as Group B). The students’ knowledge level and students’ satisfaction with their received instruction methods were assessed as outcome measures throughout the experiment for both groups. The test score of students’ initial knowledge of the concepts in Speech Therapy, the score from the semester final exam of the courses in fo the crossword puzzle as an enjoyable and participatory teaching tool accompanied by lecture could improve management quality in Speech Therapy sessions.

Utilizing the crossword puzzle as an enjoyable and participatory teaching tool accompanied by lecture could improve management quality in Speech Therapy sessions.

Based on the needs of the health system, continuous revising and monitoring are essential for General Practice (GP) Curriculum. The present study was conducted to investigate the diseases of GP Curriculum based on the students’ and professors’ viewpoints.

This cross-sectional study was carried out at Mashhad University of Medical Sciences in 2018. A total of 80 GP students of internship and 71 professors of the faculty of medicine in clinical and basic science disciplines were enrolled in the study using quota and convenience sampling methods, respectively. Two self-made, reliable, and validated 4-point scale questionnaires (ranging from totally agree to totally disagree) were used to collect the data on the viewpoints of students and professors on the diseases of GP curriculum. The mean score and percentage of agreement between professors and students on the incidence of each disease were calculated.

The highest and lowest rates of agreement between the professors and students in terms of the presence d the necessity of curriculum revision, as one of the priorities of the educational system.

Today’s human health care needs are so complex and dealing with them requires interprofessional collaboration and teamwork, which must be learned by the appropriate educational methods. In this regard, the Crisis Management Interprofessional Education program (CMIPE) in the form of desktop maneuver with the presence of the military nurses and other professional groups involved in the crisis was designed and implemented in Military Nursing School in Tehran, Iran. The aim of this study was to explore the experiences of the military nurses of participating in an interprofessional education program in crisis management domain.

This was an exploratory case study using conventional content analysis of the experiences of 28 military nurses participating in this program. The qualitative data were collected with three methods including observation in the field (note-taking and filming) and an open-ended questionnaire and two focus group discussions with military nurses.

Qualitative analysis of the experiences ofon, and therefore, enhancing their ability to cope with different crises.

Emergency medical services (EMS) are provided in the difficult and unpredictable conditions of prehospital settings. Therefore, EMS students need to receive quality education to acquire considerable knowledge and skills. This qualitative study aimed to explore the educational challenges in medical emergency students.

This qualitative study was carried out in 2019 using qualitative content analysis. Participants were fourteen undergraduate EMS students purposively recruited from Hamadan University of Medical Sciences, Hamadan, Iran. Data collection was done through semi-structured interviews and continued up to data saturation. Data were analyzed using the conventional content analysis approach explained by Graneheim and Lundman.

The four main categories of the challenges of EMS education were shortcomings of the clinical education environment, lack of qualified EMS instructors, deficit of the curriculum, and theory-practice gap.

During their university education, EMS students face different challenges. For effective training, more coordination is needed among the emergency medical board, faculty members and EMS managers. It is also recommended that the curriculum should be revised.

During their university education, EMS students face different challenges. For effective training, more coordination is needed among the emergency medical board, faculty members and EMS managers. It is also recommended that the curriculum should be revised.

Storytelling is one of the earliest ways to share scientific advancements and discoveries. The advent of technology has updated this ancient art into a digitalized form. The boundaries between the digital storytelling (DST), and other types of videos are unclear. Therefore, in this review, the process, aim, producers, and uses of DST in health profession education have been reviewed.

This study is a systematized review, which is in nature like a systematic review with only a few differences in the comprehensive search and quality assessment procedure. All studies, whose duplicates were removed, were retrieved from Science Direct, PubMed, and Scopus databases or through google scholar search engine screened in 3 stages title, abstract and full study. All journal articles including experimental, case study and case report, mixed method, and qualitative studies in English language in the field of health profession education were chosen for this review after being evaluated based on QUESTS dimensions.

In tonce between DST and producing a digital story. Therefore, researchers should consider the correct use of this term in their studies. Although few interventional and high-quality studies have been conducted in this area, further quantitative and qualitative research is suggested.

This systematized review indicated that DST has some applications in different subjects in different fields of health professions and with a potential to be used by different stakeholders of health system. According to the definition of DST, digital storytelling involves the process of writing a script to produce a digital story by one individual or a group. Consequently, there is a difference between DST and producing a digital story. Therefore, researchers should consider the correct use of this term in their studies. Although few interventional and high-quality studies have been conducted in this area, further quantitative and qualitative research is suggested.

Coronavirus-19 (SARS-CoV-2) is constantly changed through mutation, and new stains of this virus are detected throughout the world such as B.1.1.7 (UK), B.1.351 (South Africa), and P.1 (Brazil). These strains seem to be more easily transmissible than other variants, which may lead to more cases and more deaths. Currently, there are many vaccines for SARS-CoV-2 available in the market but without full clinical data beside. Despite the existence of these vaccines, the numbers of outpatients are still increasing in many countries around the world, and the reliability of these vaccines still remains elusive. It is well known that trace element deficiencies increase the individual susceptibility to immune dysfunction and lead to global health problem. In this context, improving the immune defense system to combats this pandemic is absolutely necessary. The purpose of this review is to establish the probable relation between trace elements supplementation and COVID-19.

Several clinical studies confirmed that Cu, Se, and Zn insufficiencies alter the immune system and increase the vulnerability to viral infections. Based on antiviral and anti-inflammatory effects of these micronutrients, it seems logical that dietary supplementations of these components might enhance human immune system and lower the graveness of COVID-19 infection.

Based on available data, we hypothesize that the clinical use of some essential trace element supplementations such as copper, selenium, and zinc might be a preventive and promising option to enhance human immunity against the new pandemic COVID-19 and its new strains.

The aim of this paper is to study the derivation of appropriate meso- and macroscopic models for interactions as appearing in social processes. There are two main characteristics the models take into account, namely a network structure of interactions, which we treat by an appropriate mesoscopic description, and a different role of interacting agents. The latter differs from interactions treated in classical statistical mechanics in the sense that the agents do not have symmetric roles, but there is rather an active and a passive agent. We will demonstrate how a certain form of kinetic equations can be obtained to describe such interactions at a mesoscopic level and moreover obtain macroscopic models from monokinetics solutions of those. The derivation naturally leads to systems of nonlocal reaction-diffusion equations (or in a suitable limit local versions thereof), which can explain spatial phase separation phenomena found to emerge from the microscopic interactions. We will highlight the approach in three examples, namely the evolution and coarsening of dialects in human language, the construction of social norms, and the spread of an epidemic.The aim of this research study is to contribute to the sustainability of e-working initiatives, specifically by exploring three employee-financial impacts. The study adopted a two-step methodological approach firstly, a comprehensive review of the existing literature was done and, secondly, secondary data analysis was carried out. The study analyses how three potential financial benefits for e-workers differ in various countries and whether these can increase e-workers’ earnings. It was found that there are significant benefits. Regarding the affordability of a home, e-working presents a useful tool to move to less costly regions. This reduces the struggle with housing. Aside from housing, commuting is one of the largest time and cost consuming expenses. Based on our calculations, all employees can save commuting time and money by using public transport or their own vehicles. Important considerations here are the costs, such as fuel, insurance, tolls, time, health and environment. Making cappuccino or coffee at home is a useful way to decrease expenses compared to buying them at a café. Generally, the results indicate that an increase of e-working tends to decrease selected expenses of employees. This paper point outs that, on the basis of average costings, e-working decreases selected expenses of employees. The findings also indicate that more long-term and comprehensive studies are needed, especially in relation to other benefits, such as lunch, childcare and clothing. This study has contributed to highlighting the e-working financial benefits for e-workers by not commuting to work.This article draws from a broader research project Transnational childhoods, illuminating the agency and experiences of children and young people migrating from Poland and Romania to Sweden under the age of 18. Focusing on young people born in Poland and having social relationships post-migration as central theoretical component, the article explores the role that the Polish Catholic community in Sweden plays in the lives of young Polish migrants. It does so by grounding the analysis on 23 qualitative interviews, combined with network maps and life-lines, produced by the young Polish participants. The study identifies three important dimensions in the role of the Polish Catholic community. These are comprised of the community’s role for young Poles’ spiritual development and religious identity, for building new friendships and making sense of common migration and religious experiences, and guidance by specifically Polish Catholic priests in the young migrants’ family relationships and in future life projects. The article concludes that while practicing religion and building significant social relationships within the Polish congregations the young migrants shape feelings of belonging and inclusion, however primarily within the limits of their own ethnic community. Further research is needed on the wider implications of primarily mono-ethnic relational practices for the young Poles’ lives within the increasingly ethnically heterogeneous Swedish society.For many young black South African women, the competitive arena of social media offers access to significant social and cultural capital, which can be invaluable in the unequal context in which they live. In order to succeed in this high stakes environment young women carefully construct the identities and idealised selves that they present on platforms like Instagram. They display a lifestyle of glamorous consumption, showcasing exclusive brands and fashionable items and modifying and modelling themselves to fit a beauty ideal that emphasises youth, light skin, slender bodies and straight hair. As well as these physical features, young women on Instagram are also hyper-aware of the need to appear „authentic” to have their online lives and selves appear natural, easy and free of artifice in order to further enhance their status as role models to other women. This article draws from in-depth interviews with 10 black South African „micro-celebrities.” It reveals the central role of authenticity in these young women’s online performances of self, and considers the contradictory impulses that require them to both „feel” and „appear” real.