16 research outputs found
Impact of Supine Radiographs to Assess Curve Flexibility in the Treatment of Adolescent Idiopathic Scoliosis
Study Design: Retrospective cohort study. Objectives: The purpose of the study is to evaluate the role of supine radiographs in determining flexibility of thoracic and thoracolumbar curves. Methods: Ninety operative AIS patients with 2-year follow-up from a single institution were queried and classified into MT structural and TL structural groups. Equations were derived using linear regression to compute cut-off values for MT and TL curves. Thresholds were externally validated in a separate database of 60 AIS patients, and positive and negative predictive values were determined for each curve. Results: MT supine values were highly predictive of MT side-bending values (TL group: 0.63, P \u3c 0.001; MT group: 0.66, P = 0.006). Similarly, TL supine values were highly predictive of TL side-bending values (TL group: 0.56, P = 0.001 MT group: 0.68, P = 0.001). From our derived equations, MT and TL curves were considered structural on supine films if they were ℠30° and 35°, respectively. Contingency table analysis of external validity sample showed that supine films were highly predictive of structurality of MT curve (Sensitivity = 0.91, PPV = 0.95, NPV = 0.81) and TL curve (Sensitivity = 0.77, PPV = 0.81, NPV = 0.94). ROC analysis revealed that the area under curve for MT structurality from supine films was 0.931 (SEM: 0.03, CI: 0.86-0.99, P \u3c 0.001) and TL structurality from supine films was 0.922 (SEM: 0.03, CI- 0.84-0.98, P \u3c 0.001). Conclusions: A single preoperative supine radiograph is highly predictive of side-bending radiographs to assess curve flexibility in AIS. A cut-off of ℠30° for MT and ℠35° for TL curves in supine radiographs can determine curve structurality
Kommunernas markanvisningar för bostÀder : Ett byggherreperspektiv
En betydande del av dagens bostadsbyggnadsprojekt i Sverige sker pĂ„ mark som vid projektinitieringen Ă€gs av en kommun. Den kommunala marken utgör dĂ€rmed nĂ„got av en grundbult för mĂ„nga av de bostĂ€der som produceras. Detta Ă€r inget nytt fenomen. Det kommunala markinnehavet har i över hundra Ă„r fungerat som ett plan- och bostadspolitiskt instrument och i olika omfattningar styrt sĂ„vĂ€l bostĂ€dernas geografiska spridning som produktionsvolym. Förfarandet dĂ„ en kommun fördelar sin mark â sĂ€ljer eller upplĂ„ter med tomtrĂ€tt â till privata eller allmĂ€nnyttiga byggherrar brukar vanligen benĂ€mnas âmarkanvisningâ. Syftet med detta examensarbete Ă€r att utföra en kvalitativ analys av kommunernas markanvisningssystem utifrĂ„n ett byggherreperspektiv och försöka besvara följande frĂ„gestĂ€llningar: Upplever byggherrarna skillnader mellan olika kommuners markanvisningssystem? Hur uppfattar byggherrarna att markanvisningssystemet fungerar överlag? Ăr uppfattningarna olika beroende av antalet markanvisningar som en byggherre tilldelats? Dessa grundlĂ€ggande frĂ„gestĂ€llningar har belysts med hjĂ€lp av en enkĂ€t till 237 byggherrar som varit aktiva â dvs. ansökt om och/eller tilldelats markanvisning â i Stockholm, Göteborg, Uppsala och Helsingborg. EnkĂ€ten bestod av 16 stycken frĂ„gor dĂ€r vissa var ja- eller nej frĂ„gor, medan större delen besvarades genom gradering av olika pĂ„stĂ„enden. Totalt besvarade 88 stycken byggherrar enkĂ€ten, dvs. en svarsfrekvens pĂ„ 37 procent. Av svaren framkommer att det finns en delad bild av hur kommunernas markanvisningar fungerar, frĂ€mst mellan de byggherrar som tilldelats fyra eller fĂ€rre markanvisningar och de som tilldelats fem eller fler. Den senare gruppen Ă€r, kanske inte helt ovĂ€ntat, mer positivt instĂ€lld. BĂ„da grupperna anser dock att de olika kommunerna tillĂ€mpar det kommunala markanvisningssystemet olika, sett utifrĂ„n tilldelningsmetoder och bedömningskriterier, Ă€ven om skillnaderna i sig inte tycks utgöra nĂ„got problem hos en stor del av byggherrarna
Tele-Simulated Instruction and Learner Perceptions of Fiberoptic Intubation and Nasopharyngoscopy: A Pilot Study
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Ethnic Disparities and Incidence of Postoperative Complications in Obese Patients Undergoing Total Knee Arthroplasty: Analysis of the American College of Surgeons National Surgical Quality Improvement Program Data Set
INTRODUCTION: Total knee arthroplasty (TKA) is common but complex operation. A paucity of literature exists on differences between Hispanics and non-Hispanics with TKA. Our study aims to investigate the association between Hispanic ethnicity and complications in obese patients undergoing TKA. METHODS: This is a retrospective cohort study using the National Surgical Quality Improvement Program database for patients with body mass index â„30 kg/m2 who underwent TKA. Exposure in this study was ethnicity (Hispanic versus non-Hispanic), and the primary outcome was postoperative complications. Associations between ethnicity and baseline characteristics and between covariates and the outcome were assessed via bivariate analysis. Multiple logistic regression was done to determine associations between Hispanic ethnicity and complications while controlling for confounders. RESULTS: Thirty five thousand twenty-seven patients were included in our study, of which 6.3% were Hispanic. Among obese adults, Hispanics had a 1.24 (95% CI 1.11 to 1.39) times greater odds of having a postoperative complication after TKA than non-Hispanics. This increased to 1.36 (95% CI 1.20 to 1.54) after adjusting for confounders. Hispanics were notably more likely to receive transfusion (2.62% vs. 1.59%, P \u3c 0.001) and have prolonged length of stay (13.29% vs. 11.12%, P = 0.002) but were less likely to have wound disruption (0.05% vs. 0.27%, P = 0.042). CONCLUSION: In a national database, Hispanic ethnicity was associated with greater odds of postoperative complication in obese patients undergoing TKA compared with non-Hispanics. Future studies focusing on a wide range metrics of social determinants of health are needed to further investigate barriers and intervention to eliminate racial/ethnic disparities in surgical patients