Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

News values or forward referencing?: Explaining click through rates from news value expression

News values are often studied as the reflection of journalists’ activities (Harcup & O’Neill, 2017). Whether or not news values attract news users to select and read news items is difficult to assess using journalist-centered definitions. Instead, discursively defined news values make it possible to assess news user effects (Bednarek & Caple, 2014). News users' selection of news has become more and more important since news is presented online (Lagerwerf, Timmerman, & Bosschaert, 2016). Counting clicks on hyperlinked headlines (resulting in a ‘click through rate’) makes it possible to assess readers’ preferences directly (Kuiken, Schuth, Spitters, & Marx, 2017). For instance, it appeared that headlines containing forward referencing generate more click through rate. Forward referencing comprises a set of formulations such as deictic phrases (This woman escaped a disaster), or interrogative words (How the accident took place), expressing an unidentified referent or event that can only be found by reading the news item after the click (Blom & Hansen, 2015). The phenomenon of click bait (headlines luring news users into uninteresting or even fake news for commercial or propagandistic reasons) may be recognized by overly use of forward referencing. So, abundant use of forward referencing would not be appropriate for quality news. The effect of news values expressed in headlines on click through rates has not been investigated before, so our research question is: Can news values in headlines generate more click through rate? To answer this question we used data provided by the Dutch quality newspaper website NRC.nl. They tested alternative formulations of headlines simultaneously on their website (A/B tests), which resulted in a dataset of 7790 headlines and their click through rates. By conducting detailed content analysis on a sample of 4000 headlines we compared click through rate effects between forward referencing and discursive expression of news values

Deceptive news: Characteristics of untrustworthy news items

Trustworthiness is key in journalism, yet some journalists intentionally deceive their audiences by fabricating sources or inventing news stories altogether. Earlier research suggests that deceitful news articles have characteristics that are different from trustworthy news articles. We aimed to confirm and expand on the existing literature by examining the case of Perdiep Ramesar, an esteemed Dutch journalist until it was discovered in 2014 that sources were non-existing in 126 of his articles for national newspaper Trouw (‘Fidelity’). Using content analysis, we searched for systematic differences in source use and presentation comparing Ramesar’s deceptive news articles with two same-sized sets of reliable articles, 1) articles on similar topics from other journalists, and 2) articles with verifiable sources from Ramesar himself. Results indicate that compared to real news sources, fictitious sources are more often secondary definers, who are presented in more stereotypical ways and through more and longer direct quotations. Furthermore, negations and self-references occur more often in deceptive news articles

Zelf retrograad spoelen: behandeling van fecale incontinentie na lage anterieure resectie

Two patients, a woman aged 75 and a man aged 63 years, developed faecal incontinence after low anterior resection. Their external sphincter function was intact. They were advised to irrigate their bowel with normal tap water and reached complete pseudocontinence. Faecal incontinence is not always due to sphincter dysfunction. One of the other causes of incontinence is the lack of compliance of the rectum, as seen in patients with a low anterior resection. The part of the colon that has replaced the original rectum is not able to distend in the same manner as the rectum. Irrigation of the colon is a simple means of allowing the patient to achieve pseudocontinence. When the colon is cleaned it will take one or two days before new faeces arrive and a risk for incontinence occurs. It is important to irrigate with safe tap water at a temperature of around 37 degrees C. Most patients treated in this way feel safe to go out again. The irrigation can be performed in patients without the need for extensive diagnostics. This method of irrigation can be used in other forms of faecal incontinence as well

Neuromodulation for functional bowel disorders

In patients with functional bowel disorders not responding to maximal medical treatment, bowel lavage or biofeedback therapy, can nowadays be treated by sacral nerve neuromodulation (SNM). SNM therapy has evolved as a treatment for faecal incontinence and constipation. The exact working mechanism remains unknown. It is known that SNM therapy causes direct stimulation of the anal sphincter and causes changes in rectal sensation and several central nervous system areas. The advantage of SNM therapy is the ability to do a minimally invasive temporary screening phase to assess permanent stimulation outcome. Ideal candidates for SNM therapy are not known. Several studies have described positive and negative predictive factors, but the temporary screening remains the instrument of choice. Clinical results are good and as the technique is developing, fewer complications occur. New indications for SNM include constipation and anorectal or pelvic pain