Plate-Assisted Intramedullary Nailing of Distal Tibia Fractures

The combination of plate and intramedullary nailing has been established as the treatment of proximal tibial fractures.  Nevertheless, at the distal end of the tibia, the application of the plate-assisted intramedullary nailing is rarely applied as a therapeutic technique. The authors provide a technical note on the use of the reduction plating technique for nail insertion as the management of distal tibia fractures. Keywords: Distal tibia fracture; open reduction internal fixation; percutaneous plating; plate-assisted reduction; intramedullary nail; nail plate combination

Cryptozoology Meets Ecology: A Look into the Megalodon

The megalodon was the largest shark that ever lived with the oldest fossil specimens being around 20 million years old. The creature is estimated to have gone extinct around 3.6 million years ago, but some skeptics maintain that the creature still exists deep in modern oceans. By examining false information surrounding the megalodon and developing an understanding of the paleontological and ecological mechanisms that scientists use to study it, we can paint a picture of the megalodon and determine how it survived in its ancient habitat and if it could thrive in oceans as we know them today

Open-Circuit Mouthpiece Ventilation: Indications, Evidence and Practicalities

Open-circuit mouthpiece ventilation (MPV) is a method of noninvasive ventilation, which can be used to provide full-time support, induce lung volume recruitment, increase cough efficacy, defer tracheostomy and possibly improve survival and quality of life in advanced-stage neuromuscular patients. MPV might also be applicable to other chronic respiratory diseases as well as in acute exacerbations of chronic obstructive pulmonary disease and can also be employed for the extubation of unweanable neuromuscular patients. A candidate for MPV should be able to rotate his neck adequately, grab the mouthpiece with his lips and maintain sufficient control of the upper airway muscles. MPV is usually provided in the volume assisted-controlled mode with a tidal volume between 0.7 and 1.5 L, zero PEEP and backup rate set to the lower allowed value, allowing the patient to define his own ventilatory pattern. The “low pressure” and “apnea” alarm should be switched off, if possible, or special setting adjustments should be used to prevent their activation. Comprehensive patient training and dedicated nursing time are important for the application of MPV. MPV is considered a safe method for the majority of the patients, but accidental mouthpiece loss is an important concern

Language attitudes and use in a transplanted setting: Greek Cypriots in London

In this paper we explore language attitudes and use in the Greek Cypriot community in London, England. Our study is based on an earlier survey carried out in Nicosia, Cyprus and we compare attitudes to language and reported language use in the two communities. We thereby highlight the significance of sociolinguistic variables on similar groups of speakers. We further extend our investigation to include codeswitching practices in the London community. \ud Analysis of language attitudes and use within the Greek-Cypriot population of London, and comparisons with findings in Nicosia, reflect symbolic forces operating in the two contexts. Despite obvious differences between the two communities, (most obviously the official languages and distinct cultural backgrounds of the two nations), the Greek Cypriot Dialect continues to play an active role in both. English is however the ‘default choice‘ for young Cypriots in the UK and Standard Modern Greek occupies a much more limited role than in Cyprus. It is argued that differences in language attitudes and use can be interpreted in light of different market forces operating in the nation (i.e. Cyprus) and the Diaspora (i.e. UK)

Andrée TABOURET-KELLER (26/8/1929-20/09/2020)

Originally published in International Journal of Bilingual Education and Bilingualism, DOI: 10.1080/13670050.2020.1834663, 2020. Andrée Tabouret-Keller, who passed away on Sunday 20 September 2020, was a unique figure in Sociolinguistics in France, though not only in the Sociolinguistics of French. She was thoroughly French, but at the same time deeply attached to her native Alsace and a fluent Alsatian speaker. She came from a modest background; her father was an engineer and her mother had ..

Trilingual conversations: a window into multicompetence

A recurrent theme in the literature on trilingual language use is the question of whether there is a specific “trilingual competence.” In this paper we consider this question in the light of codeswitching patterns in two dyadic trilingual conversations between a mother and daughter conducted in (Lebanese) Arabic, French, and English. Quantitative and qualitative analysis of codeswitching in both conversants shows that, despite the fact that both subjects are fluent in all three languages, uses of switching are significantly different for mother and daughter across a number of features, including relative frequency of different switch types, and the incidence of hybrid constructions involving items from two or more languages. The subjects appear to display qualitatively distinct profiles of competence in the trilingual mode. This in turn leads to the conclusion that the facts of trilingual language use are best characterized in terms of “multicompetence” (Cook, 1991). The paper concludes with some further reflections on the uniqueness of trilingual language use (an “old chestnut” in trilingualism research, cf. Klein, 1995)

"Il parle normal, il parle comme nous”: self-reported usage and attitudes in a banlieue

We report on a survey of language attitudes carried out as part of a project comparing youth language in Paris and London. As in similar studies carried out in London (Cheshire et al. 2008), Berlin (Wiese 2009) and elsewhere (Boyd et al. 2015), the focus was on features considered typical of ‘contemporary urban vernaculars’ (Rampton 2015). The respondents were pupils aged 15-18 in two secondary schools in a working-class northern suburb of Paris. The survey included (1) a written questionnaire containing examples of features potentially undergoing change in contemporary French; (2) an analysis of reactions to extracts from the project data: participants were asked to comment on the speakers and the features identified. Quantitative analysis had shown that some of these features are more widespread than others and are used by certain categories of speaker more than others (Gardner-Chloros and Secova, 2018). This study provides a qualitative dimension, showing that different features have different degrees of perceptual salience and acceptability. It demonstrates that youth varieties do not involve characteristic features being used as a ‘package’, and that such changes interact in a complex manner with attitudinal factors. The study also provides material for reflection on the role of attitude studies within sociolinguistic surveys

Assumptions behind grammatical approaches to code-switching: when the blueprint is a red herring

Many of the so-called ‘grammars’ of code-switching are based on various underlying assumptions, e.g. that informal speech can be adequately or appropriately described in terms of ‘‘grammar’’; that deep, rather than surface, structures are involved in code-switching; that one ‘language’ is the ‘base’ or ‘matrix’; and that constraints derived from existing data are universal and predictive. We question these assumptions on several grounds. First, ‘grammar’ is arguably distinct from the processes driving speech production. Second, the role of grammar is mediated by the variable, poly-idiolectal repertoires of bilingual speakers. Third, in many instances of CS the notion of a ‘base’ system is either irrelevant, or fails to explain the facts. Fourth, sociolinguistic factors frequently override ‘grammatical’ factors, as evidence from the same language pairs in different settings has shown. No principles proposed to date account for all the facts, and it seems unlikely that ‘grammar’, as conventionally conceived, can provide definitive answers. We conclude that rather than seeking universal, predictive grammatical rules, research on CS should focus on the variability of bilingual grammars

Ultrasound in the diagnosis of a median neuropathy in the forearm: case report

<p>Abstract</p> <p>Background</p> <p>Electrodiagnostic studies are traditionally used in the diagnosis of focal neuropathies, however they lack anatomical information regarding the nerve and its surrounding structures. The purpose of this case is to show that high-resolution ultrasound used as an adjunct to electrodiagnostic studies may complement this lack of information and give insight to the cause.</p> <p>Case presentation</p> <p>A 60-year-old male patient sustained a forearm traction injury resulting in progressive weakness and functional loss in the first three digits of the right hand. High-resolution ultrasound showed the presence of an enlarged nerve and a homogenous soft-tissue structure appearing to engulf the nerve. The contralateral side was normal. Surgery revealed fibrotic bands emanating from the flexor digitorum profundus muscle compressing the median nerve thus confirming the ultrasound findings.</p> <p>Conclusion</p> <p>A diagnostically challenging case of median neuropathy in the forearm is presented in which high-resolution ultrasound was valuable in establishing an anatomic etiology and directing appropriate management.</p