Long Head of Biceps Tendon Management: a Survey of the American Shoulder and Elbow Surgeons

© 2017, Hospital for Special Surgery. Background:: Management of symptomatic long head of biceps tendon (LHBT) pathology remains a source of debate. Questions/Purposes:: The purpose of this study was to identify consensus trends for the treatment of LHBT pathology among specialists. Methods:: A survey was distributed to members of the American Shoulder and Elbow Society (ASES), consisting of three sections—demographics, case scenarios, and general LHBT pathology management. Cases presented common clinical scenarios, and surgeons reported their management preferences. Consensus responses were defined as \u3e 50% of participants giving a single response. Results:: One hundred and forty-two of 417 (34%) surgeons completed surveys. Forty-seven percent of questions reached a consensus answer. Biceps tenodesis was the overwhelmingly preferred technique in cases demonstrating LHBT pathology, as compared to tenotomy. No consensus, however, was reached regarding a specific surgical technique for biceps tenodesis. The two most popular techniques were arthroscopic tenodesis to bone and open subpectoral biceps tenodesis. Fellowship-trained arthroscopic surgeons and surgeons with a largely arthroscopic practice were more likely to perform tenodesis arthroscopically. Conclusion:: ASES members favored biceps tenodesis over tenotomy for surgical management of LHBT pathology, without consensus regarding a specific surgical technique

How changes in human activities during the lockdown impacted air quality parameters: A review

The health emergency linked to the spread of COVID-19 has led to important reduction in industrial and logistics activities, as well as to a drastic changes in citizens' behaviors and habits. The restrictions on working activities, journeys and relationships imposed by the lockdown have had important consequences, including for environmental quality. This review aims to provide a structured and critical evaluation of the recent scientific bibliography that analyzed and described the impact of lockdown on human activities and on air quality. The results indicate an important effect of the lockdown during the first few months of 2020 on air pollution levels, compared to previous periods. The concentrations of particulate matter, nitrogen dioxide, sulfur dioxide and carbon monoxide have decreased. Tropospheric ozone, on the other hand, has significantly increased. These results are important indicators that can become decision drivers for future policies and strategies in industrial and logistics activities (including the mobility sector) aimed at their environmental sustainability. The scenario imposed by COVID-19 has supported the understanding of the link between the reduction of polluting emissions and the state of air quality and will be able to support strategic choices for the future sustainable growth of the industrial and logistics sector

Health service changes to address diabetes in pregnancy in a complex setting: perspectives of health professionals

Background: Australian Aboriginal and Torres Strait Islander women have high rates of gestational and pre-existing type 2 diabetes in pregnancy. The Northern Territory (NT) Diabetes in Pregnancy Partnership was established to enhance systems and services to improve health outcomes. It has three arms: a clinical register, developing models of care and a longitudinal birth cohort. This study used a process evaluation to report on health professional's perceptions of models of care and related quality improvement activities since the implementation of the Partnership. Methods: Changes to models of care were documented according to goals and aims of the Partnership and reviewed annually by the Partnership Steering group. A 'systems assessment tool' was used to guide six focus groups (49 healthcare professionals). Transcripts were coded and analysed according to pre-identified themes of orientation and guidelines, education, communication, logistics and access, and information technology. Results: Key improvements since implementation of the Partnership include: health professional relationships, communication and education; and integration of quality improvement activities. Focus groups with 49 health professionals provided in depth information about how these activities have impacted their practice and models of care for diabetes in pregnancy. Co-ordination of care was reported to have improved, however it was also identified as an opportunity for further development. Recommendations included a central care coordinator, better integration of information technology systems and ongoing comprehensive quality improvement processes. Conclusions: The Partnership has facilitated quality improvement through supporting the development of improved systems that enhance models of care. Persisting challenges exist for delivering care to a high risk population however improvements in formal processes and structures, as demonstrated in this work thus far, play an important role in work towards improving health outcomes.R. Kirkham, J.A. Boyle, C. Whitbread, M. Dowden, C. Connors, S. Corpus, L. McCarthy, J. Oats, H.D. McIntyre, E. Moore, K. O’Dea, A. Brown, L. Maple-Brown (On behalf of the NT Diabetes in Pregnancy Partnership

The meaning of “life” and other abstract words: Insights from neuropsychology

There are a number of long‐standing theories on how the cognitive processing of abstract words, like ‘life’, differs from that of concrete words, like ‘knife’. This review considers current perspectives on this debate, focusing particularly on insights obtained from patients with language disorders and integrating these with evidence from functional neuroimaging studies. The evidence supports three distinct and mutually compatible hypotheses. (1) Concrete and abstract words differ in their representational substrates, with concrete words depending particularly on sensory experiences and abstract words on linguistic, emotional, and magnitude‐based information. Differential dependence on visual versus verbal experience is supported by the evidence for graded specialization in the anterior temporal lobes for concrete versus abstract words. In addition, concrete words have richer representations, in line with better processing of these words in most aphasic patients and, in particular, patients with semantic dementia. (2) Abstract words place greater demands on executive regulation processes because they have variable meanings that change with context. This theory explains abstract word impairments in patients with semantic‐executive deficits and is supported by neuroimaging studies showing greater response to abstract words in inferior prefrontal cortex. (3) The relationships between concrete words are governed primarily by conceptual similarity, while those of abstract words depend on association to a greater degree. This theory, based primarily on interference and priming effects in aphasic patients, is the most recent to emerge and the least well understood. I present analyses indicating that patterns of lexical co‐occurrence may be important in understanding these effects

Vessel Shrinkage as a Sign of Atherosclerosis Progression in Type 2 Diabetes : A Serial Intravascular Ultrasound Analysis

OBJECTIVE—The aim of this study was to determine the natural history of vascular remodeling of atherosclerotic plaques in patients with type 2 diabetes and the predictors of vessel shrinkage

Evaluation of in-stent restenosis in the APPROACH trial (assessment on the prevention of progression by Rosiglitazone on atherosclerosis in diabetes patients with cardiovascular history)

To determine (1) the medium-term effect of rosiglitazone and glipizide on intra-stent neointima hyperplasia, (2) restenosis pattern as assessed by intra-vascular ultrasound (IVUS) and quantitative coronary angiography (QCA) in patients with T2DM and coronary artery disease. A total of 462 patients with T2DM were randomized to rosiglitazone or glipizide for up to 18 months in the APPROACH trial, and had evaluable baseline and follow-up IVUS examinations. There was no significant difference in the size of plaque behind stent between the rosiglitazone and glipizide groups at 18 months among those treated with a bare metal stent (−5.6 mm3 vs. 1.9 mm3; P = 0.61) or with a drug-eluting stent (12.1 mm3 vs. 5.5 mm3; P = 0.09). Similarly, there was no significant difference in percentage intimal hyperplasia volume between the rosiglitazone and glipizide groups at 18 months among those treated with a bare metal stent (24.1% vs. 19.8%; P = 0.38) or with a drug-eluting stent (9.8% vs. 8.3%; P = 0.57). QCA data (intra-stent late loss, intra-stent diameter stenosis or binary restenosis) were not different between the rosiglitazone and glipizide groups. This study suggests that both rosiglitazone and glipizide have a similar effect on neointimal growth at medium term follow-up, a finding that warrants investigation in dedicated randomized trials

HelexKids:a word frequency database for Greek and Cypriot primary school children

In this article, we introduce HelexKids, an online written-word database for Greek-speaking children in primary education (Grades 1 to 6). The database is organized on a grade-by-grade basis, and on a cumulative basis by combining Grade 1 with Grades 2 to 6. It provides values for Zipf, frequency per million, dispersion, estimated word frequency per million, standard word frequency, contextual diversity, orthographic Levenshtein distance, and lemma frequency. These values are derived from 116 textbooks used in primary education in Greece and Cyprus, producing a total of 68,692 different word types. HelexKids was developed to assist researchers in studying language development, educators in selecting age-appropriate items for teaching, as well as writers and authors of educational books for Greek/Cypriot children. The database is open access and can be searched online at www.helexkids.org

Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction

<p>Abstract</p> <p>Background</p> <p>In the setting of primary percutaneous coronary intervention, patients with a chronic total occlusion in a non-infarct related artery were recently identified as a high-risk subgroup. It is unclear whether ST-elevation myocardial infarction patients with a chronic total occlusion in a non-infarct related artery should undergo additional percutaneous coronary intervention of the chronic total occlusion on top of optimal medical therapy shortly after primary percutaneous coronary intervention. Possible beneficial effects include reduction in adverse left ventricular remodeling and preservation of global left ventricular function and improved clinical outcome during future coronary events.</p> <p>Methods/Design</p> <p>The Evaluating Xience V and left ventricular function in Percutaneous coronary intervention on occLusiOns afteR ST-Elevation myocardial infarction (EXPLORE) trial is a randomized, prospective, multicenter, two-arm trial with blinded evaluation of endpoints. Three hundred patients after primary percutaneous coronary intervention for ST-elevation myocardial infarction with a chronic total occlusion in a non-infarct related artery are randomized to either elective percutaneous coronary intervention of the chronic total occlusion within seven days or standard medical treatment. When assigned to the invasive arm, an everolimus-eluting coronary stent is used. Primary endpoints are left ventricular ejection fraction and left ventricular end-diastolic volume assessed by cardiac Magnetic Resonance Imaging at four months. Clinical follow-up will continue until five years.</p> <p>Discussion</p> <p>The ongoing EXPLORE trial is the first randomized clinical trial powered to investigate whether recanalization of a chronic total occlusion in a non-infarct related artery after primary percutaneous coronary intervention for ST-elevation myocardial infarction results in a better preserved residual left ventricular ejection fraction, reduced end-diastolic volume and enhanced clinical outcome.</p> <p>Trial registration</p> <p>trialregister.nl NTR1108.</p