Contributor to the November Issue/Notes

Notes by Charles G. Hasson, Robert J. Mahoney, Robert E. Sullivan, John Kelly, John D. O\u27Neill, John M. Anderton, Charles R. Gerard, R. A. Macdonell, William B. Ball, Robert E. Sullivan, and Leonard D. Bodkin

The biomechanical strength of olecranon fixation constructs: a systematic review and meta-regression

Olecranon fractures are often operative when displaced over 2 mm, but the most stable fixation construct is debated. The purpose of this study was to provide an overview of biomechanical properties of the most commonly used surgical fixations of olecranon fractures. This systematic review included 13 biomechanical studies comparing displacement during cyclic loading of olecranon fractures fixated with either tension band wiring (TBW), intramedullary screw, or plate fixation. In regard to overall gapping, plates displayed (and screws trended towards) increased stability versus TBW. However, there was no difference between the constructs in gapping at the articular surface. Plating displayed increased stability along the posterior surface. No construct allowed gapping over 2 mm, suggesting safe early post-operative motion with any of the techniques

Contributor to the November Issue/Notes

Notes by Charles G. Hasson, Robert J. Mahoney, Robert E. Sullivan, John Kelly, John D. O\u27Neill, John M. Anderton, Charles R. Gerard, R. A. Macdonell, William B. Ball, Robert E. Sullivan, and Leonard D. Bodkin

Esophageal Carcinoma Histology Affects Perioperative Morbidity Following Open Esophagogastrectomy

Background. Esophagectomy for esophageal cancer is being practiced routinely with favorable results at many centers. We sought to determine if tumor histology is a powerful surrogate marker for perioperative morbidity. Methods. Seventy three consecutive patients managed operatively were reviewed from our prospectively maintained database. Results. Adenocarcinoma (AC) was present in 52 (71%) and squamous cell (SCC) in 21 (29%). The use of neoadjuvant therapy was similar for the AC (34.62%) and SCC (42.86%) groups. The SCC group had a higher incidence of prior pulmonary disease than the AC group (23.8% versus 5.8%, resp.; P = .03). SCC patients were more likely to have a prolonged ICU stay than AC patients (P = .004) despite similar complication rates, EBL, and prognostic nutritional index. The SCC group did, however, experience higher grades of complications (P = .0053). Conclusions. Presence of SCC was the single best predictor of prolonged ICU stay and more severe complications as defined by this study. Only a past history of pulmonary disease was different between the two histologic subgroups

Invitation to the Table Conversation: A Few Diverse Perspectives on Integration

This article represents an invitation to the integration table to several previously underrepresented perspectives within Christian psychology. The Judeo-Christian tradition and current views on scholarship and Christian faith compel us to extend hospitality to minority voices within integration, thereby enriching and challenging existing paradigms in the field. Contributors to this article, spanning areas of cultural, disciplinary, and theological diversity, provide suggestions for how their distinct voices can enhance future integrative efforts

Benthic algae assessments in the EU and the US: Striving for consistency in the face of great ecological diversity

Freshwaters face multiple environmental problems including eutrophication, acidification, salinization, and climate-change, all of which can lead to impairment of ecosystem structure and function. Furthermore, these stressors often act in combination. Benthic algal-based assessments to quantify impairment are used in both the EU and US. In this review, we use case studies, experience, and the literature to compare concepts, approaches, and methods between the EU and US to offer an updated picture of benthic algal-based assessments. Both the US and EU are composed of numerous constituent states having considerable flexibility to adopt individual methods. The goal of this work is to synthesize the various approaches that are used across the EU and US. Specifically, we compare and contrast benthic algal assessment performed in response to core legislation – the Water Framework Directive in the EU and the Clean Water Act in the US, with a particular focus on the steps taken to ensure consistency at different stages of the process. This includes consideration of approaches to sampling design and field methods, taxonomic resolution and laboratory harmonization, metric selection and choice of algal groups, assessment of stressors and stressor/response relationships. A number of commonalities emerged during this process, particularly the focus on diatoms over other algal groups. However, there are also a number of key differences, including more widespread use of multimetric indices in the US compared with the EU. Finally, we consider emerging opportunities, including the potential for using metagenomic approaches for bioassessment in the future

Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law

This article examines the application and effectiveness of a 2006 Indiana law designed to prevent gun violence by authorizing police officers to separate firearms from persons who present imminent or future risk of injury to self or others, or display a propensity for violent or emotionally unstable conduct. A court hearing is held to determine ongoing risk in these cases; a judge decides whether to return the seized firearms or retain them for up to five years. The study examines the frequency of criminal arrest as well as suicide outcomes for 395 gun-removal actions in Indiana. Fourteen individuals (3.5%) died from suicide, seven (1.8%) using a firearm. The study population's annualized suicide rate was about 31 times higher than that of the general adult population in Indiana, demonstrating that the law is being applied to a population genuinely at high risk. By extrapolating information on the case fatality rate for different methods of suicide, we calculated that one life was saved for every 10 gun-removal actions, similar to results of a previous study in Connecticut. Perspectives from key stakeholders are also presented along with implications for gun policy reform and implementation