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Venkataraman, Sagar, Prabhu Ethiraj, Arun Heddur Shanthappa Naik, and Sachin Prakash Angadi. "Diaphyseal fractures of the forearm in adults, comparative study of dynamic compression plate versus intramedullary nail." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 916. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193835.
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<p class="abstract"><strong>Background:</strong> Forearm fractures are common nowadays because of road traffic accident. It is important to achieve anatomical reduction of both bone forearm fractures to regain function of upper limb. This study is undertaken to observe functional and radiological outcome using two different surgical modalities like dynamic compression plating (DCP), and intramedullary nailing in both bone forearm fractures and also to indivualize the optimal treatment method for different fracture pattern.</p><p class="abstract"><strong>Methods:</strong> Our study included 60 patients with diaphyseal forearm fractures in adults presenting to orthopaedic outpatient department. Among 60 patients, 30 patients underwent open reduction and internal fixation by dynamic compression plate and other 30 patients underwent closed reduction/open reduction by square nail after detailed pre-operative evaluation.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study average union time in DCP group is 23.39 weeks and square nail group is 28.89 weeks. Union in DCP group was 27 (90%) and square nail group 22 (73.33%). Delayed union in DCP group was 03 (10%) and in Square nail group was 6 (20%), non-union in DCP group was 0 (nil) and in square nail group was 2 (06%).</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation with DCP plates for both bone diaphyseal forearm fractures gives good results with early union rates. We also found that in open fractures and complex fracture like segmental fractures square nailing was better option compared to dynamic compression plate to reduce infection rates, retain periosteal blood supply from soft tissue. Thus we conclude that both implants are equally important and we should prioritize based on preoperative planning.</p>
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Pearson, Dave, Antoinette Angulo, Emily Bourcier, Elizabeth Freeman, and Roger Valdez. "Hospitality Workers' Attitudes and Exposure to Secondhand Smoke, Hazardous Chemicals, and Working Conditions." Public Health Reports 122, no. 5 (September 2007): 670–78. http://dx.doi.org/10.1177/003335490712200515.
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Objective. Compelling reasons exist for labor and public health to collaborate. For example, compared to white-collar workers, blue-collar and service workers are much more likely to be targeted by the tobacco industry and become smokers. The purpose of this descriptive study was to assess if there were ways public health and labor could collaborate to document the health attitudes and needs of hospitality industry workers. Methods. Eligible union members were identified through an electronic enrollment file consisting of 3,659 names maintained by the union. The mail survey instrument covered exposure to secondhand smoke, exposure to hazardous chemicals and materials, time pressure and job demands, and work-related pain/disability. Additional questions related to age, gender, race/ethnicity, level of education, employment history, English proficiency, and self-reported health status. Results. Study results demonstrated that important health information could be successfully collected on unionized workers. Survey data showed that union members were a very diverse group who were exposed to secondhand smoke and supported working in clean-air settings. Workers, especially housekeeping staff, characterized their work as being chaotic and demanding, while almost half of workers reported work-related pain. Conclusions. Key to the successful collaboration was establishing trust between the parties and emphasizing data collection that served the information needs of both organizations. Opportunities exist to improve the health and working conditions of this population. Health interventions need to be designed to take into consideration the very diverse, mostly female, and limited English proficiency of this group of workers.
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Gupta, Amit, Giovanni Risitano, Robert J. Crawford, and Frank D. Burke. "THE UNUNITED SCAPHOID: Prognostic Factors in Delayed and Nonunions of the Scaphoid." Hand Surgery 04, no. 01 (July 1999): 11–19. http://dx.doi.org/10.1142/s0218810499000101.
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This study attempts to classify scaphoid nonunions, identify the prognostic indicators of scaphoid nonunions and report the clinical, functional and radiographic results of scaphoid nonunions treated by Herbert screw and bone grafting. The patient population included 51 scaphoid nonunions in 50 patients treated by Herbert screw with or without bone graft. Group I was patients with delayed union; Group II was stable nonunions, Group IIIA consisted of unstable nonunions without DISI; Group IIIB included unstable nonunions with DISI deformity. Although the overall union rate was 84%, 87% stable nonunions (Groups I and II) united compared to only 60% unstable (Groups IIIA and B). This was statistically significant using the Chi-square test at p < 0.05. Thus, delayed unions and stable nonunions unite readily but unstable and displaced nonunions have significantly lower rates of union even after Herbert screw and bone grafting.
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Vasanicova, Petra, Sylvia Jencova, Beata Gavurova, and Radovan Bacik. "Coopetition of European Union Countries within Destination Management." Journal of Tourism and Services 13, no. 24 (June 30, 2022): 71–89. http://dx.doi.org/10.29036/jots.v13i24.368.
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Coopetition has been the issue of various studies in different fields, but there is a research gap in examining coopetition within the tourism sector and destination management. This paper aims to determine whether there are internally homogeneous and externally heterogeneous groups of European Union countries regarding indicators of natural and cultural resources of the Travel and Tourism Competitiveness Index (TTCI), and thus subsequently identify the importance and possibilities of competition among countries within the tourism sector. Multidimensional scaling and cluster analysis are used to verify the research hypothesis, along with ten indicators of the fourth sub-index (Natural and Cultural Resources) of TTCI. The results of the cluster analysis led to a six-group solution. Italy, Spain, and France have the best position in terms of tourism competitiveness. The results show space for competition in the international tourism market. Even though EU countries are competitors at a global level, their cooperation could be beneficial to tourism development. The findings of this study can be helpful in planning and strategy development for tourism policymakers and destination management organizations but can also be used to develop various marketing strategies. Furthermore, cooperation between destinations will support the need for strategic flexibility in the tourism sector, as the diversity of tourism attractions will increase.
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Wellington, Kelvin J. "A One Square Kilometer Radiotelescope: Design Challenges." International Astronomical Union Colloquium 161 (January 1997): 735–40. http://dx.doi.org/10.1017/s0252921100015323.
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AbstractSETI searches, as well as radioastronomy, require large radiotelescopes for high sensitivity. In recent years a strong scientific case has been made for the construction of a radiotelescope operating at decimeter wavelengths with an aperture of about one square kilometer. Such an instrument would have a sensitivity about two orders of magnitude greater than is currently available. However, current projections indicate that this will require about an order of magnitude reduction in cost per unit area compared to existing structures in order to make it financially feasible. This reduction will demand new and innovative approaches in design. Even with this reduction in capital cost such a facility is expected to be several hundred million dollars. Such a major facility will need to be developed as an international project. The International Radio Science Union (URSI) and the International Astronomical Union (IAU) have recognized this and set up a joint Working Group to facilitate the development. Several countries and institutes have become actively involved and are working together in an international framework. Several different design approaches are currently being studied. These vary from a small number of large spherical radiotelescopes, through a moderate number of medium-sized parabolic antennae, to a phased array of a large number of small nonmoving «tiles». Each approach has advantages, disadvantages and particular challenges.
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Ruggieri, Giovanni, Marco Platania, and Julian Zarb. "Island Development Model Specialisation: A Panel Data Analysis Comparing Evolutionary Tourism Model, Industrial to Community-Based (2010–2019)." Economies 10, no. 9 (August 30, 2022): 208. http://dx.doi.org/10.3390/economies10090208.
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Islands are frequently characterised by an economic structure centred on tourism and the service sector. This specialisation has taken different forms and characterisations concerning the chosen or spontaneously developed model. To understand the development choices and patterns, this article analyses sixteen islands and archipelagos in the European Union over ten years from 2010 to 2019. A panel data analysis was based on critical variables identifying the tourism industry model from those that could represent a proxy of the community-based tourism model. The principal component analysis was adopted to compare the evolutionary trends of these two different ways of choosing the island’s tourism model. Findings identified before the COVID-19 pandemic crisis include two island clusters. One group of islands followed a spontaneous tourism model based on the local community and small or micro hospitality systems, with auto-entrepreneurship in tourism. The second group of islands followed a planning and industry-based tourist model with an employment system and a relevant hospitality industry. Both paradigms have limitations and identify two different tourism evolutionary scenarios useful for the EU’s future island tourism policies.
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Choti, Khrisnanda. "PENGARUH LEARNING ORIENTATION TERHADAP INNOVATIVE BEHAVIOR PADA STUDENT UNION DI UNIVERSITAS CIPUTRA." PERFORMA 6, no. 6 (March 17, 2022): 474–83. http://dx.doi.org/10.37715/jp.v6i6.2149.
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The propose of this research is to find out the effect of individual innovative behavior on individual innovative behavior with work group cohesion as mediating variable in the context of virtual teams. The method that is used in this research is the analysis method in the form of Partial Least Square (PLS) with software SmartPLS. The sample in this research is the Student Union member of 2020/2021 period International Business Management major that is the number of 36 respondents. Data collection technique in this research is to distribute google form questionnaires with likert scale measurement. Based on data analysis, it is concluded that individual learning orientation (X) and individual innovative behavior (Y) are significant.
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SJOGREN, JON A. "CONNECTIVITY AND SPECTRUM IN A GRAPH WITH A REGULAR AUTOMORPHISM GROUP OF ODD ORDER." International Journal of Algebra and Computation 04, no. 04 (December 1994): 529–60. http://dx.doi.org/10.1142/s0218196794000142.
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Let a finite group G of odd order n act regularly on a connected (multi-)graph Γ. That is, no group element other than the identity fixes any vertex. Then the “quotient graph” Δ under the action is the induced graph of orbits. We give a result about the connectivity of Γ and Δ in terms of their numbers of labeled spanning trees. In words, the spanning tree count of the graph is equal to n, the order of the given regular automorphism group, times the spanning tree count of the graph of orbits, times a perfect square integer. There is a dual result on the Laplacian spectrum saying that the multiset of Laplacian eigenvalues for the main graph is the disjoint union of the multiset for the quotient graph together with a multiset all of whose elements have even multiplicity. Specializing to the case of one orbit, we observe that a Cayley graph of odd order has spanning tree count equal to n times a square, and that that the Laplacian spectrum consists of the value 0 together with other doubled eigenvalues. These results are based on a study of matrices (and determinants) that consist of blocks of group-matrices. The generic determinant for such a matrix with the additional property of symmetry will have a dominanting square factor in its (multinomial) factorization. To show this, we make use of the Feit-Thompson theorem which provides a normal tower for an odd-order group, and perform a similarity conjugation with a fixed integer, unimodal matrix. Additional related results are given for certain group-matrices “twisted” by a group of automorphisms, generalizing the “g-circulants” of P.J. Davis.
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Harjanti, Dhyah. "Burnout and Employee Performance in Hospitality Industry: The Role of Social Capital." Jurnal Teknik Industri 21, no. 1 (June 28, 2019): 15–24. http://dx.doi.org/10.9744/jti.21.1.15-24.
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The hospitality industry is known for its labor-intensive and intense interpersonal relationships characteristic. The high rate of burnout in hospitality industry has been a crucial issue. The burnout could lead to employee performance decline. The previous studies suggested that the happy and cooperative employees tend to deliver a better performance. Since cooperative is a part of social capital, this study aims to analyse the role social capital in reducing burnout and improving employee performance.The data collection was conducted by distributing questionnaires to all of non-daily worker employees at the first-line and middle-line level in three budget hotels in the similar chained hotel group in Surabaya. We processed the data using partial least square analysis technique.The result reveals that the social capital have a significant negative influence on burnout, and a significant positive influence on employee performance. We also ascertain that burnout have a significant negative influence on employee performance.
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Sonaike, Kola. "Labor Union Leadership And Career Advancement In Major Nigerian Oil Companies." International Business & Economics Research Journal (IBER) 11, no. 12 (November 29, 2012): 1397. http://dx.doi.org/10.19030/iber.v11i12.7418.
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Labor related issues in the upstream sector of the Nigerian oil industry started to emerge soon after the discovery of petroleum in commercial quantities within the Niger Delta area mid- 1950s (Shell, 2000). Different groups within and outside the oil industry formed opinions about union leaders in the most strategic industry in the country. This was in part the case because the work force became better educated than their predecessors. One group among the industrys stakeholders believe labor union leaders have been ill treated, penalized, and stagnated, over the years by their managements. Supervisors and managers, it is alleged, act repulsively and harassingly towards union leaders in order to suppress their activities. Others believe the union leaders have been pampered and favorably treated by the managements of these companies in order to maintain peace. This study sets out to discover whether or not these notions about labor union leaders in the major oil companies in Nigeria are true. In this regard, ten null hypotheses were tested to accept or reject the notion that union leaders are not favored, are not educationally qualified, are not productive, are not militant, are not loyal, are not penalized for holding labor union leadership positions, cannot progress beyond executive status and cannot score more than 70 percentile on the researchers charismatic and superior leadership scale. One of the hypotheses was tested using ANOVA, two were tested using Kruskal-Wallis, and seven were tested using Chi-Square. The research findings highlighted some areas that the management of major oil companies and the federal government of Nigeria need to look into. Management of these companies need to look into the issue of the small group of managers and supervisors in the companies who still view labor unionism in negative light and consider labor union leaders as mere loafers and trouble makers. Training programs in labor unionism need to be carried out on regular basis for union leaders, managers, and supervisors in these companies. Further, the federal government of Nigeria needs to look into the perennial labor-related conflicts between the major oil companies and their host communities.
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Ullah, Hidayat, Shandana Khan, Saif Ullah, Sartaj ,. Khan, and Maheen Mir. "Outcome of Transbuccal and Transoral Technique in Open Reduction and Internal Fixation of Mandibular Angle Fractures." Pakistan Journal of Medical and Health Sciences 16, no. 7 (July 30, 2022): 85–87. http://dx.doi.org/10.53350/pjmhs2216785.
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Background: Angle fractures have the highest percentage among mandibular fractures. It has many reasons like thinner cross section area, presence of third molar, muscle forces acting at the angle area and abrupt change of shape from horizontal to vertical rami. Aim: To determine the outcomes of trans-buccal and trans-oral technique in open reduction and internal fixation of mandibular angle fractures. Study Design: Randomized control trial. Methodology: Total of 194 patients were recruited and divided in two groups. All patients underwent general anesthesia. In trans-oral group incision line was on external oblique ridge, exposing the ridge, the 5 holes mono-cortical plate were twisted and adapted to the ridge contour and fixed with 4 mono-cortical 2mm diameter screws. While in transbuccal approach, the angle region was exposed trans-orally. Statistical analysis: The collected data was analyzed by using SPSS version 25. Chi square was applied with p-value of less than 0.05 as significant. Results: The result showed infection in trans-buccal group was 5.4% and in transoral group was 17.4%. Wound dehiscence in trans-buccal group was 2.2% while in transoral group was 10.9%. Plate or screw loosening in trans-buccal group was 1.1% and transoral group was 7.6%. Mal-union in trans-buccal group was 1.1% and in trans-oral group, it was 7.6%. Conclusion: It was concluded that the trans-buccal is an effective procedure in terms of infection, wound dehiscence, mal-union and plate/screw loosening in comparison to trans-oral approach. Keywords: Trans-buccal, Trans-oral, Infection and Wound Dehiscence.
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Hall, C. Michael. "Study group on the geography of sustainable tourism of the International Geographical Union — tourism and migration conferences and research." Tourism Geographies 1, no. 1 (February 1999): 132–34. http://dx.doi.org/10.1080/14616689908721301.
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FENDOĞLU, Eda. "POPULATION FORECAST WITH THE DATA PROCESSING GROUP METHOD (GMDH) type NEURAL NETWORK FOR EUROPEAN UNION COUNTRIES." IEDSR Association 6, no. 15 (September 20, 2021): 563–98. http://dx.doi.org/10.46872/pj.323.
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Population is a critically important factor in a country's planning, policy making, and setting its social and economic goals. Population estimation and planning in advance are of great importance for policy makers, since the natural resources, which are the production areas where people can meet their basic needs, are limited and they need to protect the areas they live in in order to continue their lives. In this study, the Group Method of Data Handling (GMDH) type Neural Network (NN) approach was used for the annual population estimation of 27 European Union (EU) countries (Germany, Austria, Belgium, Bulgaria, Czech Republic, Denmark, Estonia, Finland, France, Cyprus, Croatia, Netherlands, Ireland, Spain, Sweden, Italy, Latvia, Lithuania, Luxembourg, Hungary, Malta, Poland, Portugal, Romania, Slovenia, Slovak Republic, Greece). The data set was obtained from the World Data Bank and analyzed using data from the years 1960 - 2020. The test performances obtained are generally below 10% of the Root Mean Square Percentage Error (RMSPE). The coefficient of determination (R^2) is above 0.90 and generally around 0.99. In addition, the mean absolute percentage error (MAPE) value is below 10%. According to these values, it is concluded that the model predicts extremely accurately. In addition, the analysis was compared with the 2021 - 2032 forecast values in the World Bank Database. According to the findings and comparison results, it has been concluded that the GMDH type Neural Network is a very good approach for the annual population estimation of 27 EU countries, it has almost exactly the same results with the real values in the past years, therefore it is consistent and successful in its predictions for the future years.
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Al-Sadek, Tabet A., Desislav Niklev, and Ahmed Al-Sadek. "Diaphyseal Fractures of the Forearm in Adults, Plating Or Intramedullary Nailing Is a Better Option for the Treatment?" Open Access Macedonian Journal of Medical Sciences 4, no. 4 (November 24, 2016): 670–73. http://dx.doi.org/10.3889/oamjms.2016.138.
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BACKGROUND: Fractures of the radius and ulna occupy a large field of the modern traumatology. Therefore, these fractures are a major subject in modern orthopaedics and traumatology. The study of the mechanisms of the trauma, and the pathophysiological changes that occur are of great importance for the development of ever more efficient and varied ways of the treatment and prophylactics of this type of fracture.AIM: The aim of this paper was to study the pattern of the diaphyseal fractures of the forearm in adults, to decide the modalities of surgical management, to observe the period of fracture healing clinically and radiologically, as well to study the rehabilitation of the patients.MATERIAL AND METHODS: The present study included 45 cases of diaphyseal fractures of both bones forearm in adults presenting to the orthopaedic outpatient department. For all the patients a detailed history was taken. A thorough clinical examination was carried out, required X-rays were taken, and initial treatment was given and admitted as in all patients. After careful pre-operative planning and evaluation for anaesthetic fitness, patients were operated for the fractures of both bone forearms. Twenty-three cases with 46 fractures were treated by open reduction and rigid fixation with DCP & Semi-tubular plates and 22 cases with 44 fractures were treated by closed reduction and fixation with “Talwarkar” intramedullary square nails.RESULTS: United results were found in 100% of plating group vs. 86% in the nailing group. Delayed and non-union results were found in 9% of the nailing group only. Average time to union in weeks was 9.4 weeks in the plating group vs. 10.2 weeks in the nailing group.CONCLUSION: Open reduction and internal fixation with compression plates with strict adherence to surgical technique is the gold standard method of treatment in both bones forearm fractures with excellent results than closed reduction, internal fixation with “Talwarkar” square nails which is also again a simple method with better results than conservative methods.
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Mulligan, Ryan, Samuel Adams, James DeOrio, Mark Easley, and James Nunley. "Posterior Achilles Tendon-Splitting Approach and Intramedullary Nailing versus Lateral Trans-Fibular Approach with Fixed-Angle Plating for Tibiotalocalcaneal Arthrodesis." Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0003. http://dx.doi.org/10.1177/2473011417s000302.
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Category: Ankle, Ankle Arthritis, Hindfoot Introduction/Purpose: A variety of operative approaches and fixation techniques have been described for tibiotalocalcaneal (TTC) arthrodesis. As a durable, load-sharing device with favorable biomechanical properties, the intramedullary (IM) nail is commonly used. Lateral, fixed-angle plating continues to be popular as well, due to ease of use and lack of significant clinical inferiority. A lateral approach with distal fibula resection allows for direct access to the tibiotalar and subtalar joints, but the posterior, Achilles tendon-splitting (PAS) approach offers a robust soft tissue envelope. The purpose of this study was to compare the results of TTC arthrodesis with either PAS approach and IM nailing or lateral, trans-fibular (LTF) approach with lateral, fixed- angle plating. Methods: Following institutional review board approval, all patients who underwent simultaneous tibiotalar and subtalar arthrodesis were identified with minimum one year clinical and radiographic follow up. A retrospective review of all clinic notes, operative details, and radiographs was performed by a fellowship-trained orthopaedic foot and ankle surgeon not associated with the procedures. Patients were excluded if they underwent TTC arthrodesis through an approach other than PAS or LTF, and received fixation without an IM nail or lateral, fixed-angle plate. Primary outcomes examined were union rate and complications. Statistical analysis was performed with student’s t-test for continuous data and Chi-square test for categorical variables. P-values less than 0.05 were considered significant. Results: 38 patients underwent TTC arthrodesis with a PAS approach and IM nailing, and 28 with a LTF approach and lateral plating. The overall union rate for the PAS/IM nail group was 76.3% (29 of 38), and 64.3% (18 of 28) for LTF/lateral plating group (p=0.41). 15.8% (6 of 38) in the PAS/IM nail group underwent revision arthrodesis versus 7.1% (2 of 28) in the LTF/lateral plating group (p=0.45). Nonunion at the subtalar joint occurred in 25.0% (7 of 28) in the LTF/lateral plating group and 5.3% (2 of 38) in the PAS/IM nail group (p=0.03), but there was not a significant difference in tibiotalar union. Patients were allowed to bear weight 3 weeks earlier in the PAS/IM nail group (11.2 vs 14.4 weeks, p=0.01). Conclusion: Despite similar overall union rates, nonunion of the subtalar joint was significantly increased in the LTF/lateral plating group. This could be due to disruption of blood supply during exposure, insufficient stability, or inadequate compression of the arthrodesis site. However, revision arthrodesis rates were similar between groups because some nonunions were not symptomatic enough to warrant correction. Patients were allowed to fully weight bear significantly earlier in the PAS/IM nail group. PAS approach and IM nailing for TTC arthrodesis may allow for quicker recovery and increased likelihood of radiographic union at the subtalar joint.
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Luka, Ineta. "DEVELOPING LANGUAGE COMPETENCE FOR TOURISM STUDENTS AND EMPLOYEES IN A BLENDED LEARNING LANGUAGE COURSE." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 1 (May 26, 2016): 137. http://dx.doi.org/10.17770/sie2016vol1.1493.
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The paper presents the main findings of the second stage of Erasmus+ project „Key Skills for European Union Hotel Staff” (2014-2016) – the online course designed for A2/B1 level of language competence in 12 European languages and B2/C1 English language course to promote tourism students’ and employees’ language competence and raise their intercultural awareness. It analyses pedagogical, linguistic and field professional literature on course creation and presents the conducted evaluation research containing formative evaluation from three perspectives – provider (document review), recipient (a focus group interview with 14 learners) and wider community (a focus group interview with 7 hospitality industry managers and a survey of 21 language teachers from six countries) to identify the initiative’s consequences and opportunities for modification and improvement. The strengths and weaknesses of the course have been identified and suggestions on how the process could be made more efficient/effective for the organisation, the end users and the community have been provided.
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Xu, Xiaofeng, Fangxing Zhu, Chengshuai Yang, Bing Xu, Zhaoqi Yuan, Wenbin Zhang, and Jun Shi. "OCCS Classification and Treatment Algorithm for Comminuted Mandibular Fractures Based on 109 Patients and 11 Years Experiences: A Retrospective Study." Journal of Clinical Medicine 11, no. 21 (October 26, 2022): 6301. http://dx.doi.org/10.3390/jcm11216301.
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Comminuted mandibular fractures (CMFs) pose significant challenges to surgeons for their serious complications and poor outcomes. We aimed at proposing a classification with treatment algorithm of each category for CMFs. Patients with CMFs were retrospectively reviewed and classified into five categories: Type I: relatively good occlusion, no or slightly displaced fragments, no continuity destruction or bone defect; Type II: relatively good occlusion, damaged morphology, low comminution degree but intact continuity without bone defect; Type III: damaged morphology and higher comminution degree with intact continuity and relatively good occlusion; Type IV: high comminution, impaired continuity and poor occlusion without segmental bone defect; Type V: segmental bone defect. Conservative treatment, open reduction and internal fixation or microvascular osteocutaneous free flap transplantation was performed, accordingly. Demographics, perioperative data, complications and reasons for reoperations were recorded. The chi-square test was used for statistical analysis. In total, 109 patients were included in the study. After surgery, in the following group, 5 manifested infections, 1 manifested bone non-union, and 2 experienced reoperations, while in the unfollowing group, 10 manifested infections, 5 manifested bone non-union and 8 experienced reoperations. The OCCS classification and algorithm for CMFs achieve better outcomes and with lower complication rate.
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White, Neil J., Johnny T. Lau, Kevin Ong, Steven M. Kurtz, and Sheldon S. Lin. "Union of Foot/Ankle Arthrodesis: A Registry Study of Low-Intensity Pulsed Ultrasound (LIPUS)." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0048. http://dx.doi.org/10.1177/2473011420s00488.
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Category: Ankle; Hindfoot; Midfoot/Forefoot; Trauma. Introduction/Purpose: To aid in healing and avoid costly revision surgery, bone grafts, growth factors, and bone stimulation devices are used as adjuncts to foot/ankle arthrodesis. This study evaluated the union rates of LIPUS as an adjunct to foot/ankle arthrodesis and the corresponding factors associated with improved healing. Methods: Foot/ankle arthrodesis patients were identified retrospectively from a prospective post-market arthrodesis/fracture registry for EXOGEN (Bioventus LLC, Durham, NC). Inclusion criteria were males or non-pregnant females 18 years of age or older at time of enrollment, known date of fracture, known start and end dates of LIPUS treatment, and known treatment success outcome. Treatment success was defined by both clinical (solid and pain-free on manual stress) and radiological (at least 3 of 4 cortices bridged on x-rays) criteria. Association between union rates and surgical treatments, comorbidities, and medications was tested with Chi-square tests. Results: A total of 235 primary and 16 revision foot/ankle arthrodesis patients used EXOGEN. 41.4% used EXOGEN within 90 days of the fracture/arthrodesis. Overall union rate was 86.9% (primary: 86.4%; revision: 93.8%). Having the comorbidity of diabetes, obesity, or current smoker was not associated with a higher non-union rate (p=0.779). Other comorbidities were also not associated with increased non-union rates (e.g., Charcot disease p=0.614, NSAID p=0.862, steroids p=0.647). EXOGEN use within 90 days of the fracture/procedure date was associated with improved union rates for the overall (p=0.004, odds ratio (OR) 3.7 (95% CI: 1.5-9.3)) and primary (p=0.007, OR 3.4 (95% CI: 1.3-8.6)) groups. For the overall group, union rates were 94.2% (EXOGEN use <=90 days post-fracture/procedure), 80.6% (91 to 365 days), and 84.6% (>365 days). Conclusion: Union rates for foot/ankle arthrodesis with adjunctive LIPUS were comparable to other therapies with and without other adjuncts (Table 1). Known risk factors for non-union, such as smoking and Charcot disease, were not found to be associated with healing for the LIPUS patients. This suggests the possibility that LIPUS was able to mitigate potential patient risk factors and may offer a low risk post-operative adjunct in difficult healing scenarios. [Table: see text]
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Wang, Hongbin, Zhen Zhou, and Zhongquan Hu. "Distributed Tracking Control for Discrete-Time Multiagent Systems with Novel Markovian Switching Topologies." Discrete Dynamics in Nature and Society 2017 (2017): 1–10. http://dx.doi.org/10.1155/2017/1626452.
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Distributed discrete-time coordinated tracking control problem is investigated for multiagent systems in the ideal case, where agents with a fixed graph combine with a leader-following group, aiming to expand the function of the traditional one in some scenes. The modified union switching topology is derived from a set of Markov chains to the edges by introducing a novel mapping. The issue on how to guarantee all the agents tracking the leader is solved through a PD-like consensus algorithm. The available sampling period and the feasible control gain are calculated in terms of the trigonometric function theory, and the mean-square bound of tracking errors is provided finally. Simulation example is presented to demonstrate the validity of the theoretical results.
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Shah, Ashish, Parke Hudson, Ibukunoluwa Araoye, Zachariah Pinter, Girish Motwani, Bahman Sahranavard, Brent Cone, and Cesar de Cesar Netto. "Outcomes of First Metatarsophalangeal Joint Fusion in Patients with Greater Than Fifteen Percent Intermetatarsal Angle. Is Lag Screw Essential?" Foot & Ankle Orthopaedics 2, no. 3 (September 1, 2017): 2473011417S0003. http://dx.doi.org/10.1177/2473011417s000361.
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Category: Midfoot/Forefoot Introduction/Purpose: Metatarsophalangeal arthrodesis has usually been performed using a dorsal plate to immobilize the MTP joint with or without lag screw fixation. Data in the literature is sparse on outcomes of dorsal plate plus lag screw fixation, especially in patients with IMA greater than 15 percent. Our objective was to compare IMA correction outcomes and union rates between dorsal plate only fusions and dorsal plate plus lag screw fixation in patients with IMA greater than 15 percent. Methods: We retrospectively reviewed the charts of 36 patients (39 feet) who underwent first MTP joint arthrodesis for moderate to severe HV deformity between 2011 and 2015. Average age was 61 (range, 39 to 84) years. There were 24 females and 12 males. A single surgeon performed all operations. Joints were immobilized postoperatively using either dorsal locking plate alone or dorsal locking plate with a lag screw. Union (at least 3 bridging cortices) was determined radiographically at 6 weeks, 3 months, 6 months and yearly. All suspect nonunions were examined with CT. Other radiographic parameters examined included preoperative and postoperative hallux valgus, intermetatarsal, and dorsiflexion angles (HVA, IMA, and DFA respectively). Student’s t test was used to compare group means while Pearson’s Chi square test was used to compare group rates. Results: Overall union rate was 82.1% (32/39). There was no significant difference in union rates between the two groups (dorsal plate only = 81.5% (22/27), dorsal plate plus lag screw group = 83.3% (10/12)) (P > 0.05). Average follow-up was 9 (range 7 to 35) months. Overall, the average IMA correction was 4.7 (preoperative = 17.8, postoperative = 13.1) degrees. Average IMA corrections were 4.7 and 4.54 degrees in the dorsal plate only group and dorsal plate plus lag screw groups respectively. Overall, average HVA correction was 21 (preoperative = 39.5, postoperative = 18.5) degrees. Conclusion: Our findings indicate that there is no difference in the fusion rates between both patient groups with IMA greater than fifteen percent. Because other published studies have a wide range of IMAs preoperatively, our study represents more attainable goals in patients with severe (IMA greater than 15%) deformities. In addition, our findings suggest that in such patients, MTP arthrodesis may not be sufficient as a standalone procedure for correction of IMA. Additional proximal osteotomy may be required for correction of the IMA.
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Watson, Alastair W., Babak Taheri, Steven Glasgow, and Kevin D. O’Gorman. "Branded restaurants employees’ personal motivation, flow and commitment." International Journal of Contemporary Hospitality Management 30, no. 3 (March 19, 2018): 1845–62. http://dx.doi.org/10.1108/ijchm-02-2017-0075.
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Purpose Augmenting employees’ commitment is of important interest to hospitality managers, particularly in the branded restaurant industry where the workforce is often transient. This paper aims to identify and analyse if levels of personal motivation and flow are drivers of commitment, and if the relationship between the variables is moderated by length of service, age and gender. Design/methodology/approach The study is a large-scale empirical investigation of hospitality staff in the UK branded restaurants through 1,133 survey responses, measuring levels of personal motivation, flow and commitment, as well as the moderating effects of multi-group differences among age, gender and length of service. Partial least square structural equation modelling (PLS-SEM) is used for analysis of data. Findings Using PLS-SEM found personal motivation to be important in determining employees’ level of flow and, in turn, employees’ commitment. Using multi group analysis, results revealed that relationship among personal motivation, flow and commitment played superior role for older employees and working for a long time in a hospitality organisation than those younger and working less than five years. No significant differences between male and female staff are found. Research limitations/implications Through finding flow and personal motivations to be drivers of commitment, branded restaurant practitioners can focus on emphasising these elements in their employees to increase commitment. Further, part-time roles are often taken by people likely to be non-committal in their job needs, e.g. students funding their studies. By focussing on extending lengths of service to meet the optimum years identified, managers can fortify their businesses. Originality/value The paper is one of few large-scale quantitative studies to examine personal motivation, flow and commitment in the context of UK branded restaurants. It identifies that employees exhibit higher levels of commitment through intrinsic values over time, and establishes relationships between the constructs of flow, personal motivation and commitment.
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Ruta, David, Robert Ellis, Benjamin Grear, Susan Ishikawa, David Richardson, and Garnett Murphy. "Headless Compression Screw Fixation of Jones Fractures." Foot & Ankle Orthopaedics 2, no. 2 (June 1, 2017): 2473011416S0001. http://dx.doi.org/10.1177/2473011417s000015.
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Category: Sports Introduction/Purpose: There remains controversy over the ideal implant for intramedullary screw fixation of fifth metatarsal Jones fractures. Promising results have separately been reported for both indication-specific partially threaded screws and headless compression screws. The purpose of this study was to compare clinical and radiographic results between Jones fracture patients treated with indication-specific partially threaded screws to variable-pitched headless compression screws. We also evaluated the association of various patient and fracture characteristics with surgical failure. Methods: We performed a retrospective review and comparative analyses of all Jones fractures treated with primary intramedullary screw fixation by 4 foot and ankle fellowship-trained orthopaedic surgeons at a single institution from 1995 through 2015. Exclusion criteria included concomitant foot or ankle procedures and revision surgery. Charts were reviewed for patient and injury characteristics, implant, and postoperative course. Serial radiographs were examined for fracture classification (Torg and anatomic zone) and radiographic union. Primary endpoint was number of surgical failures, defined as delayed union, nonunion, or refracture. Secondary endpoints included time to each of radiographic union, weight bearing, and pain resolution. Data were analyzed using independent T test, one-way ANOVA, chi-square, and correlation analyses with significance defined as p < 0.05. Results: Fifty-nine feet were reviewed with mean age 30 years and follow-up 9.6 months. Forty-seven received a partially threaded screw (PT) and 12 feet a headless compression screw (HC). The PT group had more failures (10/47, 21.3% vs. 1/12, 8.3%; p=0.31) and more weeks to full weight (4.2 vs. 3.3, p=0.06), without significant differences in time to radiographic union or pain resolution. Most failures were delayed unions. Pooled union rate was 96.6%. Correlated with failure were age (r=0.469, p < 0.001), diabetes (r=0.390, p=0.002), and BMI (r=0.281, p=0.03), without significant correlation for tobacco, gender, or weight. Compared to Torg 1 and 2, Torg 3 fractures had greater time to pain resolution and radiographic union, age, weight, and BMI. No differences were found between zone II and III fractures. Conclusion: To our knowledge, this is the first reported clinical comparison between indication-specific partially threaded screws (PT) and headless compression screws (HC) for treating Jones fractures. This is also one of the largest clinical series on the subject. The two groups had similar clinical and radiographic results, both with high union rates. While most failures were delayed unions that ultimately healed, the 21% failure rate in the PT group is concerning and may warrant further investigation. Increasing patient age, diabetes, and BMI were associated with worse outcomes. These data support headless compression screw fixation as a viable treatment for Jones fractures.
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Benkő, Melinda, and Tibor Germán. "Crime prevention aspects of public space renewal in Budapest." Journal of Place Management and Development 9, no. 2 (July 11, 2016): 191–209. http://dx.doi.org/10.1108/jpmd-09-2015-0034.
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Purpose Security is one of the most important challenges for contemporary integrated urban developments. In Hungary, every strategic document highlights this goal, seeking social and smart city solutions to the problem. Yet, what about crime prevention through environmental design (CPTED)? The purpose of the paper is to introduce a Central-European perspective into the international discussion of the topic. Design/methodology/approach Focusing on European Union-funded renewal of public space in the historic city centre of Budapest, the research investigates how urban security can be facilitated through urban planning and design. The analysis of two projects based on design documents and interviews with actors highlights the importance of CPTED, although it is not recognised officially either in the development or in the management phase. Findings March 15th Square is an attractive contemporary public space in the tourist-historic city centre. The project was centrally planned, executed with typical EU indicators, but without any special requirements for security. The process resulted in a safescape. By contrast, the main principal for the renewal of Teleki László Square, the first Hungarian example of community-based planning, was to instil a feeling of security. The public square became a fenced defensible space. Practical implications The analysis method can be used for other projects evaluating changes in urban security due to public space renewal: history, requirements for security, design solutions for space division, materials and urban furniture, as well as use of space and management after the regeneration. Originality/value The paper uncovers Hungarian cases where environmental crime prevention criteria are not explicitly but implicitly present in contemporary urban planning and design. In relation to urban security, it highlights the gap that exists among disciplines, indicative of a lack of dialogue among policymakers, researchers, designers and management.
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Wilmer, S. E. "Cultural Encounters in Modern Productions of Greek Tragedy." Nordic Theatre Studies 28, no. 1 (June 22, 2016): 15. http://dx.doi.org/10.7146/nts.v28i1.23969.
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The exiled character in need of asylum is a recurrent theme in ancient Greek tragedy. In many of these plays, we see uprooted and homeless persons seeking sanctuary, and for the ancient Greeks, hospitality was an important issue. Many of these plays have been updated to comment on the current social and political conditions of refugees and often reflect on the notion of hospitality, something which both Emmanuel Levinas and Jacques Derrida considered to be fundamental to ethics.
Recently there has been a series of demonstrations and occupations of public spaces by asylum seekers that has gained considerable news coverage. In Austria a group of about sixty refugees (from the Afghanistan-Pakistan border area) occupied the famous Votiv church in the middle of Vienna in 2012 and went on hunger strike. In Germany a large group of asylum seekers marched from various parts of the country to Berlin where they occupied the square at the Brandenburg Gate before being allowed to establish a tent community in Kreuzberg. In Hamburg a group of 80 asylum seekers who came to Germany via Lampedusa found refuge in St Pauli church, and it was there that Nicholas Stemann presented a first reading of Elfriede Jelinkek’s play Die Schutzbefohlenen in September 2013. More recently right-wing groups have mounted weekly marches through Dresden to call for a halt to immigration, and these have been contested by simultaneous counter-demonstrations in favour of immigrants and refugees. In this paper I will consider several adaptations of Greek tragedy that highlight cultural encounters between the local population and those arriving from abroad who are looking for asylum. In particular I will examine Stemann’s production that has been running at the Thalia Theater in Hamburg since September 2014, and features asylum seekers from Lampedusa on stage who beg the audience for the right to remain in Germany.
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Krešić, Greta, and Jelka Pleadin. "Gender - specific differences in perception of menu labelling, witnessed among Hospitality Management students." Hrvatski časopis za prehrambenu tehnologiju, biotehnologiju i nutricionizam 13, no. 1-2 (September 3, 2018): 4–11. http://dx.doi.org/10.31895/hcptbn.13.1-2.7.
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Since nutrition labelling is obligatory for all packed food circulating across the European Union (EU), out-eating people demand, ever more often, to be provided with proper nutrition information on food they are eating through the restaurant menu. Given that, at present, no EU laws and regulations mandate nutritional menu labelling, this study aimed to explore a possible relationship between the perception of the need for menu and packed food labelling in a group of Hospitality Management students (n=324; out of which 84 men and 240 women). To that end, a comprehensive three-section questionnaire comprising demographic data, the perception of the need for menu labelling and questions about packed food labelling was developed. The perception of the need for menu labelling was assessed using a five-point Likert scale, the answers thereby scoring from 1 (strongly disagree) to 5 (fully agree). The students of both genders consider menu-delivered nutritional information important (3.59±0.95) for making healthier food choices (3.96±0.98) and achieving better caloric intake control (3.81±1.07). Health impact of menu labelling is more appreciated by female as compared to male students. Students did not perceive menu labelling as a significant cost for the restaurant management (2.67±1.17). The results confirmed that in students of both genders there exists a significant correlation between their habit of reading nutrition labels and a positive perception of menu labelling (p=0.001), the perception of menu labelling health impact (p<0.001) and the perception of menu labelling as a means to an end of better energy intake control (p<0.001). However, when it comes to energy value labelling, a significant correlation was seen solely among female students. The results of multiple regression analysis confirmed that, unlike male students, female students perceive food labelling as a strong predictor of menu labelling intention (nutrition label reading habit, β=0.17; p=0.008; energy value label reading habit, β =0.23; p<0.001. These findings suggest that hospitality managers could act as valuable promoters of this innovative foodservice approach.
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Habib, Yasir, Ali Shami, Muhammad Hanif, Obaid Ur Rahman, Muhammad Shehryar Zia, Wazir Ahmed, and Ali Akhtar. "The Functional Outcomes in Treatment of Displaced Extra Articular Distal Radius Fracture by Pop Alone or K-Wire Augmentation." Pakistan Journal of Medical and Health Sciences 16, no. 9 (September 30, 2022): 781–83. http://dx.doi.org/10.53350/pjmhs22169781.
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Background & Objective: A distal radius fracture is responsible for one-sixth visit to the orthopedic emergency room. Although these fractures are common, the best treatment for these fractures is still controversial. The objective of the study was to compare the functional outcomes in terms of union in displaced extra articular distal radius fracture by POP alone or k-wire augmentation. Methods: A comparative study was conducted in the department of orthopedic surgery, Pakistan Institute of Medical Science, Islamabad from June to December 2021. A total of sixty (n=60) adult patients irrespective of gender with distal radial fracture were included in the study. Patients allocated in two groups, Group A included patients who were treated with above elbow POP casting after reducing the fracture, under sedation or blockage of hematoma and Group B included the patients in whom surgery was performed with k-wire by closed reduction and internal fixation. The main outcome measure of the study was functional outcomes in terms of excellent, good and fair. The chi square test was used between study groups for comparison of acceptable outcomes (excellent to good). A p value ≤ 0.05 was considered significant. Results: The average age of the patients of both groups was 38.6±15.8 years. Among 60 patients, 70% (n=42) were male and 30% (n=18) were females. In group A (POP) 30% (n=9) patients showed excellent, 23.3% (n=7) showed good and 46.7% (n=14) showed fair outcome as per our study outcomes. In group B (k-wire) 56.7% (n=17) patients showed excellent, 36.7% (n=11) showed good and 6.6% (n=2) showed fair outcome with p value 0.002. Conclusions: The study concluded that the functional outcomes in terms of union of displaced extra articular distal radius fractures, K-wire fixation showed better results than POP cast alone. Keywords: Bone wires; Casts, Surgical; Internal fixators; Radius fractures.
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Ceccarini, Paolo, Rosario Petruccelli, Michele Bisaccia, Giuseppe Rinonapoli, and Auro Caraffa. "Profile vs Tubular Plate in Unimalleolar or Bimalleolar Fractures: is There a Real Difference in Wound complications?" Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0015. http://dx.doi.org/10.1177/2473011420s00158.
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Category: Ankle; Trauma Introduction/Purpose: The aim of our study is to compare two types of plates, one third tubular plate and LCP distal fibula plate, evaluating the clinical outcome and the skin complications associated with their use. Methods: We collected the data of 122 consecutive unimalleolar or bimalleolar fractures treated by internal fixation for a closed, displaced distal closed fibular fracture. Exclusion criteria were: 1) open ankle fractures,2) trimalleolar fractures, 3) previous ankle fractures 4) severe venous insufficiency, 5) ankleosteoarthritis previous to surgery, 6) associated ankle dislocation. After this selection, 93 patients were included in our study and assigned in two groups, based on using of different implant: in group A48 patients were treated with one-third tubular and in group B 45 patients were treated with LCP distalfibula plate. There were no significant differences in the baseline characteristics. Patients received the same surgical procedure and the same post-operative care, then they were radiologically evaluated at1-3-12 months and clinical examination was made at 24 (range 15-36) months using AOFAS clinical rating system. All data were evaluated using chi-square test. Results: At the final 24-month follow-up a comparison between the two groups showed no statistical significant differences in reduction accuracy and bone union ratio at radiological examination. The wound complications rate of the overall study group was 7.6%. There were no statistical differences in the rate of wound complications between the two groups. There were no differences between both group in percentage of hardware removal at follow-up (overall 5.4%). In the group A occurred 1 deep infection, 2 superficial infection, no wound dehiscence; in group B occured 1 deep infection, 1 superficial infection and 2 wound dehiscence. There were no statistical differences in the rate of wound complications between the two groups (p=0.70; Fisher exact test). Conclusion: Our study has shown no difference in radiographic bone union rate, no significant differences in terms of clinical outcomes, in time of bone reduction and wound complication rate between the LCP distalfibula plate and conventional one-third tubular plate. RCT or metanalasys are in this case useful to improve scientific evidence and give more information for the correct surgical treatment of ankle fractures.
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Chen, Chun-Chu, Jiyoon (Jennifer) Han, and Yao-Chin Wang. "A hotel stay for a respite from work? Examining recovery experience, rumination and well-being among hotel and bed-and-breakfast guests." International Journal of Contemporary Hospitality Management 34, no. 4 (January 11, 2022): 1270–89. http://dx.doi.org/10.1108/ijchm-08-2021-0975.
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Purpose This paper aims to examine the relationship among guests’ lodging recovery experience, work-related rumination, guest satisfaction and well-being, within the context of hotels and bed and breakfasts (B&Bs). Design/methodology/approach The sample included 823 Taiwanese full-time workers. The proposed relationships were tested using partial least square structural equation modeling, and the moderating effects of accommodation types were tested using multi-group analysis. Findings The research findings indicate that staying at a hotel or B&B provides a respite from work and reduces negative, repetitive thoughts about work issues (work-related rumination). These recovery effects then contribute to customer satisfaction and hedonic and eudaimonic well-being. Practical implications The findings indicate that practitioners need to develop products that could reduce customers’ negative emotional attachments to work and enhance the well-being of customers in a stressful society, which could ultimately contribute to promoting the public health of full-time workers. Originality/value To the best of the authors’ knowledge, this study is the first to examine the stress-recovery aspect of lodging experiences and their impacts on customer satisfaction and well-being. Further insights are demonstrated with the inclusion of work-related rumination.
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M. Adam, Anokye, and Imran Sharif Chaudhry. "The currency union effect on intra-regional trade in Economic Community of West African States (ECOWAS)." Journal of International Trade Law and Policy 13, no. 2 (June 10, 2014): 102–22. http://dx.doi.org/10.1108/jitlp-04-2013-0008.
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Purpose – The purpose of this paper is to investigate the currency union (CU) effect on aggregate intra-trade in the Economic Community of West African States (ECOWAS) and on bilateral trade among individual countries using the gravity model. Design/methodology/approach – Using panel dynamic ordinary least square, we examined the short- and long-run CU effect on aggregate intra-ECOWAS trade and bilateral trade among ECOWAS countries from 1995 to 2010. Chow poolability test was conducted for the appropriateness of pooling the cross-section parameters as against individual model. The augmented Dickey–Fuller (ADF) test; the Phillips–Perron (PP) test; and the Kwiatkowski, Phillips, Schmidt and Shin (KPSS) test were conducted on the individual data series, and the Levin, Lin and Chu test; the Im, Pesaran and Shin test; the Breitung test; and the Hadri test were used for testing cross-sectional independent panel unit root tests. Kao panel cointegration test was conducted to identify long-run relationships. Findings – We found evidence of significant positive CU effect on aggregate intra-ECOWAS trade. The estimates also show that Benin, Burkina Faso, Niger, Senegal and Togo trade more with countries they share common currency with than what they would have been in both short and long run. We again observed that CU is insignificant in explaining Cote d’Ivoire, Mali and Senegal intra-trade with ECOWAS countries, though their observed intra-trade with ECOWAS is relatively high which is found to be explained by export diversification. Practical implications – The findings reveal that CU is good for aggregate intra-regional trade though some individual members respond negative to CU. The finding of diversification as a necessary tool to increase intra-regional trade imply that as effort of introducing single currency is being pursued rigorously, effort to diversify export or trade complement should not be overlooked. Originality/value – There exist panel studies on CU on aggregate intra-regional trade in ECOWAS. However, there is a need to have country level study to identify CU effect on each country, as it is sensitive to country-specific factors which are unobservable in time series analysis of group of countries. Also, our group estimate differs in methodology in the sense that the dynamic generalised least takes care of endogeneity in trade gravity literature.
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Kowal, Anna, and Grzegorz Przekota. "VAT Efficiency—A Discussion on the VAT System in the European Union." Sustainability 13, no. 9 (April 23, 2021): 4768. http://dx.doi.org/10.3390/su13094768.
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The effectiveness of the tax system can be analysed in various ways. According to the authors one of manifestations of such effectiveness is resistance to tax evasion. This phenomenon is influenced by multiple factors, with few being the level of VAT rates and the number of rates in force in the country concerned. The aim of the considerations is therefore to analyse how the standard VAT rate as well as the number of rates affect the effectiveness of this tax. The research was based on a literature query in the field of value added tax in the European Union. In addition, the problem of tax evasion was indicated and the aggregated data on the size of the tax gap in the Member States were presented. Then, there are the results of the research for 27 European Union countries for 2011–2019. The efficiency of VAT collection was modelled using square function, determining the significance of the parameters of this function, as well as the value of abscissa, which made it possible to group the countries based on how they maintained the efficiency of VAT collection over the analysed period of time. The final part of the study concentrates on the relationship between the efficiency of tax collection and the amount of both the basic rate and the number of rates. The conclusions of the research are as follows: a tax system with a small number of reduced rates, and preferably with one relatively low standard rate, is the system least susceptible to tax fraud. The research also shows a positive correlation between the value of the basic VAT rate along with the number of preferential rates and the scale of the tax gap, i.e., in countries with a higher standard VAT rate and a greater number of preferential rates, the tax gap is greater. The study will enable further investigation into the strategy of determining the optimal VAT rate and the process of its unification. Proposed changes may contribute to increasing the efficiency of VAT administration in EU countries, reducing the shadow economy, tax fraud and positively influencing economic growth.
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Chaudhary, Pashupati, AR Bajracharya, A. Joshi, B. Sharma, R. Bose, BP Shrestha, and G. P. Khanal. "Randomized control trial comparing primary hip spica versus initial traction and hip spica of fracture at or below the junction of the upper and middle third of femur in children." Health Renaissance 13, no. 2 (June 20, 2017): 80–91. http://dx.doi.org/10.3126/hren.v13i2.17557.
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Background: The debate regarding optimal management of femoral shaft fractures in the pediatric population is still far from resolved. While some consensus exists in the treatment of this injury in children younger than the age of six, opinion still widely divided in children six to 11 years.Objective: The aim of study was to compare the outcome of primary hip spica versus initial traction and hip spica of fracture of shaft of femur at or below the junction of the upper and middle third in children in terms of deformity and fracture healing.Method: A RCT study was carried out in the departments of Orthopedics, B.P.Koirala Institute of Health Sciences, Dharan, Nepal from March 2004 to January 2006. Forty five patients were included in the study in which 22 patients included in early spica casting (group I) and 23 patients in traction with spica casting (group II). The functional outcomes were assessed with Pearson’ Chi-square test, Independent samples test and union was assessed radiologically.Result: There was no statistically significant difference in time of union; all of them united in 8-10 weeks follow up. No significant overall difference in terms of deformity was noted in the two groups(p value-0.306).There was significant difference in terms of hospital stay in both the groups(p value<0.05).Conclusion: The study showed that there is significant advantage in primary hip spica cast for the treatment of isolated , closed femur fractures in children ages less than 10 years and weight less than 80 pounds(45kg) which allowed us to treat these fractures without any worry of wound dehiscence, pin site infections, avascular necrosis of the femoral head.Health Renaissance 2015;13(2): 80-91
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Nwobashi, Humphrey Nwefuru, and Anthony Itumo. "Democracy and Contributions of Town Union to Educational Development in Ebonyi State: A Focus on Some Selected Rural Communities." Mediterranean Journal of Social Sciences 8, no. 4 (July 27, 2017): 47–61. http://dx.doi.org/10.1515/mjss-2017-0005.
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AbstractThis study interrogates the nexus between democratic governance and the contributions of town unions to provision basic education in rural communities in Ebonyi State. The study was carried out in twelve selected rural communities chosen across the three senatorial zones of the state. The study was provoked by need to empirically test the contentious debate among development scholars over the correlation between democracy and development. The data for the study were gathered through the use of questionnaire, Focus Group Discussion (FGD), observation and documentary methods. The study adopted community action theory as its framework of analysis. The data were analyzed using simple percent, contingency tables, and histogram while chi square was used for the test of hypotheses. The findings revealed that democratic governance has increased contributions of town unions in the provision of basic education in rural communities in Ebonyi State. The study equally revealed that lack of enlightenment, illiteracy, and poverty among the rural dwellers poses challenge to the contributions of town unions in the provision of basic education. The study recommended that government should provide periodic subventions to town unions to enable them mobilize adequate funds for the provision of basic educational projects. Besides, leadership trainings should be organized on regular basis to educate and enlighten town union executives on the best global practices on rural development.
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Wheaton, Felicia V., and Desmond Brown. "AGE DIFFERENCES IN THE CHARACTERISTICS AND HABITS OF 2019 BIKE WEEK ATTENDEES IN DAYTONA BEACH, FLORIDA." Innovation in Aging 3, Supplement_1 (November 2019): S974—S975. http://dx.doi.org/10.1093/geroni/igz038.3532.
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Abstract Older adults are an important demographic group in the tourism sector, particularly in Florida. This study assessed age-group differences in the characteristics and habits of 2019 Daytona Bike Week attendees, as evidence indicates the average age of bike week visitors is rising. Aging Studies and Hospitality undergraduate students at Bethune-Cookman University interviewed 335 participants using Google Forms on their mobile phones. Results from chi-square tests indicate that there were significant differences between younger (20-39 years), middle-aged (40-59 years) and older adults (60+ years) in terms of gender and income, expenditures on accommodations, type of accommodations, nights spent, and first-time attendance. A greater percentage of older bike week attendees were male and higher income, and were less likely to be first-time attendees. Older adults also tended to spend more on accommodation and stayed longer, and were more likely to stay in Air BnBs, rental homes or a second home/condo compared with younger and middle-aged adults, but were less likely to stay in a hotel/motel or with friends/family. No significant differences were found in expenditures on food, alcohol, gas, entertainment or shopping. Findings suggest that older bike week attendees are important contributors to bike week tourism, particularly with respect to accommodations.
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Adamčák, Štefan, Gabriel Bujdoš, Michal Marko, and Karol Görner. "Physical Activity Analysis and Comparison of Secondary School Students in Terms of Selected Regions of Slovakia: A Cross-Sectional Study." Sport i Turystyka. Środkowoeuropejskie Czasopismo Naukowe 5, no. 2 (2022): 47–64. http://dx.doi.org/10.16926/sit.2022.02.03.
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Accumulating evidence indicates that regular physical activity plays an important role in strengthening health, however, its absence causes a loss of physical fitness and organism endurance. Our study was aimed at analysing and comparing physical activity of secondary school students in terms of selected regions of Slovakia. A cross-sectional survey measuring (January – December, 2021) physical activity was conducted through intentional sampling with the survey size of 1829 secondary school students (aged 17.35 ± .82) who attended the last year (4th) of grammar and vocational secondary schools. Each answer of the survey group was analysed, compared and evaluated by using the chi-square test (χ2) with the significance level (α) of .01 and .05. After analysing the survey answers, on average, 54.24 % (n = 902) of the survey group indicated the recreational form of physical activity (p < .01). In terms of the main place of performing physical activity, the survey answer of “Indoor (Gym, hall...)” covered 43.95 % (n = 804) of the survey group (p < .01). Physical activity of secondary school students varies depending on the region, while it is necessary to apply effective out-of-school physical activity programmes to increase the volume of physical activity of secondary school students.
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Adnan, Muhammad, Muhammad Jahangir Khan, Attique ur Rehman, Hassaan Zahid, Rakhshanda Jabbar, and Shahzad Shams. "Comparison of posterior open screw fixation with percutaneous fixation among traumatic thoracolumbar fracture patients." Professional Medical Journal 27, no. 07 (July 10, 2020): 1482–87. http://dx.doi.org/10.29309/tpmj/2020.27.07.4466.
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Objectives: To compare outcome and adverse events of open posterior pedicle screw fixation with percutaneous posterior pedicle screw fixation among patients suffering traumatic thoracolumbar fractures in our population. Study Design: Retrospectively Analyzed. Setting: Department of Neurosurgery, DHQ Teaching hospital, Gujranwala. Period: June 2015 to May 2019. Material & Methods: The patients who underwent open pedicle screw fixation (group 1) and percutaneous fixation (group 2) for traumatic thoracolumbar fractures information’s collected included patient’s age, gender, operation time, intra-operative blood loss, duration of radiation exposure during surgery, hospital stay duration, non-union at 6months and post-operative screw malpositioning and infection. Statistical analysis was done using SPSS version 25. Independent sample T test and Chi-square test for independence were used for quantitative and qualitative variables respectively to determine their significant association with type of surgery. The p values were statistically significant if < 0.05. Results: Out of 82 patients, 60.9 (n=50) underwent open pedicle screw surgery and 39.1% (n=32) underwent percutaneous fixation. Both cohorts had similar preoperative data including age (p=0.54) and gender (p=0.505). In comparison to open surgery group, the patients who underwent percutaneous fixation had significantly lesser operation time (46.63 + 6.25 minutes vs 89.88 + 9.05 minutes, p<0.01), lesser intraoperative blood loss (78.75 + 23.93 ml vs 330.40 + 101.87ml, p<0.01), greater intraoperative fluoroscopic exposure time (400.19 + 31.22 seconds vs 190.06 + 30.28 seconds, p<0.01), and lesser hospital stay time (3.13 + 0.871 days vs 5.08 + 1.209days, p<0.01). The incidence of post-surgery complications like screw malpositioning (p=0.621) and infection (p=0.733) was similar in both cohorts. The fracture union rates were also comparable in both cohorts (p=0.664). Conclusion: Minimally inavsive percutaneous posterior pedicle screw fixation had lesser operation time, blood loss, and hospital stay duration and greater fluoroscopic exposure than conventional open posterior pedicle screw fixation among patients with traumatic thoracolumbar fractures in our studied population. It also had a similar radilogic outcome and post-operative adverse events like screw malpositioning and local infection, showing the non-inferiority as compared to conventional open instrumentation. Prospective trials with large sample size are required to find superiority if any of one modality over other exists in our people.
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Shin, Hyejo Hailey, and Miyoung Jeong. "Travelers’ motivations to adopt augmented reality (AR) applications in a tourism destination." Journal of Hospitality and Tourism Technology 12, no. 2 (May 28, 2021): 389–405. http://dx.doi.org/10.1108/jhtt-08-2018-0082.
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Purpose This study aims to identify travelers’ motivational factors to adopt augmented reality (AR) applications at tourism destinations. Furthermore, this study seeks to investigate the role of personal innovativeness as a moderator in the relationships between motivations and travelers’ behavioral outcomes. Design/methodology/approach Building upon two theories, cognitive evaluation theory and self-presentation theory, this study developed a conceptual framework to identify travelers’ inclination to use AR applications at tourism destinations. A sample size of 473 was collected through an online self-administered survey. Using partial least square (PLS) analysis, the proposed model was examined. To examine the moderating effect of personal innovativeness, a multi-group analysis was conducted with two groups: high-innovative and low-innovative. PLS method is used to test the study’s theoretical model. Findings Findings of this study indicate that both hedonic and utilitarian motivations significantly influenced travelers’ attitudes toward AR applications at tourism destinations. Self-presentation motivation appears to have a significantly positive impact on travelers’ attitudes toward AR applications only for the highly innovative group. Originality/value This study helps a better understanding of what motivates travelers to adopt AR applications at tourism destinations by integrating preeminent theories and applying them to the tourism context.
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Garon, Mark T., Patrick Massey, Andreas Chen, Trevor Carroll, Bradley G. Nelson, and Anne M. Hollister. "Cost and Complications of Percutaneous Fixation of Hand Fractures in a Procedure Room Versus the Operating Room." HAND 13, no. 4 (June 29, 2017): 428–34. http://dx.doi.org/10.1177/1558944717715105.
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Background: The purpose of this study was to compare closed reduction and percutaneous pinning of metacarpal and phalanx fractures performed in the operating room (OR) versus the procedure room of the emergency department with primary outcomes being infection rate, radiographic union, and monetary cost. Methods: From January 2006 to December 2010, all closed reduction and percutaneous pinnings of metacarpal and phalanx fractures (CPT codes: 26608; 26727) by a single board-certified hand surgeon (A.M.H.) were retrospectively reviewed. Patients were placed into 2 groups: Group 1 was patients treated in the OR, and group 2 was patients in an emergency department procedure room. Infection, malunion, and nonunion rates were compared using a chi-square test. Charges were compared using a t-test, and cost of supplies and labor was evaluated. Results: A total of 189 patients met final inclusion criteria for this study: 130 in group 1 and 59 in group 2. There was no statistically significant difference in infection rates ( P = .13), nonunion ( P = .40), malunion rates ( P = .89), and hardware failure with revision ( P = .94) between the 2 groups. The procedure room patients had an average hospital charge of $1358.55 compared with $3691.85 for OR-treated patients (P = .001). The total cost of supplies and nonphysician labor was $432.31 per OR case and $179.59 per procedure room case. Conclusions: Metacarpal and phalanx fractures of the hand amendable to closed reduction and percutaneous pinning can be treated in the procedure room with no increase in risk of infection, malunion, or nonunion rates. In addition, these surgeries can be performed in a procedure room with lower cost and less charges to patients than in the operating room.
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Zadrazil, Markus, Peter Marhofer, Werner Schmid, Daniela Marhofer, and Philipp Opfermann. "ADV6209 for Premedication in Pediatric Anesthesia: A Double-Blinded, Randomized Controlled Trial." Pharmaceutics 14, no. 10 (September 27, 2022): 2062. http://dx.doi.org/10.3390/pharmaceutics14102062.
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ADV6209, a new formulation of midazolam with the addition of γ-cyclodextrin for oral use, has recently been licensed as the first pediatric sedative in the European Union. We compared the clinical efficacy of ADV6209 to the standard formulation of midazolam in premedication to reduce anxiety in children before anesthesia induction in a randomized, double-blinded controlled trial. Eighty children (ASA I/II; age: 2–8 years) scheduled for elective surgery were randomized to receive 0.25 mg kg−1 of either conventional midazolam or ADV6209. Assessment tools included the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) as well as scores for oral acceptance of the premedication and facemask acceptance during inhalational anesthesia induction. Mann–Whitney U and Pearson’s chi-square tests were used for comparisons of outcome parameters. The primary outcome parameter of the study (mYPAS-SF anxiety score 30 min after the drug administration) did not reveal any significant intergroup difference between the ADV6209 group and the conventional midazolam group. Both drugs revealed their efficacy in reducing anxiety and in providing adequate sedation. The premedication dose was accepted by all children in the ADV6209 but rejected by 15% in the conventional midazolam group (p = 0.037). Acceptance of facemask placement was not found to differ significantly. No adverse events related to the study medications were noted. ADV6209 was better orally accepted than the conventional midazolam preparation and proved its efficacy in reducing preoperative anxiety. This clinically interesting preparation may alleviate the premedication process of 2−8 year-old children and obviates off-label drug use.
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Hamzah, Hanafi, Muhammad Shahrim Ab. Karim, Yuhanis Abdul Aziz, and Azilah Kasim. "Environmental management practices in the SME hospitality industry: Mediating impact of managers' commitment to institutional pressures and EMS implementation." Journal of Emerging Economies and Islamic Research 9, no. 3 (September 17, 2021): 1. http://dx.doi.org/10.24191/jeeir.v9i3.11557.
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Despite the growing concern for Environmental Management Systems (EMS) in the hospitality industry, the relationship between institutional pressures and environmental management implementation is rarely examined in the small- and medium-scale enterprise hotels (SMEHs) context. Concerning the impact of tourism activities on the environment has been increasing; unfortunately, many hotels are unwilling to develop an EMS, probably due to a lack of resources and knowledge. Little attention has been devoted, especially among the SMEHs in Malaysia. The primary purpose of this study was to investigate the effects of institutional pressures on the SMEH environmental management implementation in addition to determining the manager’s commitment as mediating factor. Quantitative research was conducted in this study to establish how managers deal with specific situations using the environmental management system. A total of 313 managers were randomly selected from a total of 1695 registered SMEHs in Malaysia. The results were analyzed using Partial Lease Square-Structural Equation Modeling (PLS-SEM) software version 3.2.8 to validate the proposed model and Bootstrapping test to determine the mediation effects of the manager’s perceived benefits and commitment. The initial observation suggested that the majority of the managers implemented the environmental management system were due to regulatory pressures and customer’s pressures. Meanwhile, a smaller group of managers were also keen on the EMS implementation due to their attributes in which they are well aware of the benefits of the system. However, the business owners were found to have relatively low engagement with the environmental agenda. This research aims to contribute to the management and operation advancement towards developing thinking, practice and research within the SMEH industry in Malaysia. Therefore, the findings of this study could provide a framework for assessing existing SMEH industry perceptions and willingness to implement the EMS for a better and sustainable hospitality practice, especially from the decision makers’ point of view.
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Crooms, Rita, Jennie Taylor, Nathalie Jette, Rachelle Morgenstern, Parul Agarwal, Nathan Goldstein, and Barbara Vickrey. "EOLP-01. PALLIATIVE CARE REFERRAL ACROSS THE DISEASE TRAJECTORY IN HIGH-GRADE GLIOMA." Neuro-Oncology 24, Supplement_7 (November 1, 2022): vii108. http://dx.doi.org/10.1093/neuonc/noac209.406.
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Abstract BACKGROUND Patients with high-grade glioma (HGG), WHO grade 3 or 4, have substantial palliative care needs. As evidence suggests early palliative care consultation (PCC) yields improved quality of life in advanced cancer, our aim was to determine the occurrence, timing, and factors associated with PCC in HGG. METHODS Adults with HGG diagnosed between 8/3/2011 and 1/23/2020 were identified retrospectively from a large, academic, multi-center health system cancer registry. Patients were stratified by any prior PCC (yes/no), and timing of PCC by disease phase: (1) diagnosis (before radiation), (2) initial treatment (first-line chemotherapy/radiation), (3) second-line treatment (second-line to last chemotherapy), and (4) end-of-life (after last chemotherapy). Univariate analyses (e.g., Chi-square test) were conducted to compare PCC to non-PCC groups, based on data distribution. RESULTS Of 621 HGG patients, 134 (21.58%) received PCC, with 14 (10.45%) referred during phase 1; 35 (26.12%) in phase 2; 20 (14.93%) in phase 3; and 65 (48.51%) in phase 4 with a median of 74 days (IQR 15, 277) from initial PCC to death. The majority of referrals were inpatient (111 (82.84%)). The PCC group did not differ significantly from non-PCC in age, sex, language, race, or ethnicity, but did differ by marital status: single (263 (42.35%) vs 187 (38.4%)), divorced/separated (37 (27.61%) vs 107 (21.97%)), married/civil union (17 (12.69%) vs 154 (31.62%)); (Chi-square p < .01). Compared to non-PCC, more patients in the PCC group had glioblastoma histopathology (89.55% vs. 82.14%, p = .04). CONCLUSION A minority of HGG patients ever received PCC, which primarily occurred in the inpatient setting, and half of those referred for PCC received it during the end-of-life phase. Thus, only about one in 10 patients in the entire cohort potentially received the benefits of early PCC. Further studies should elucidate barriers and facilitators to early palliative care in HGG.
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Barnds, Brandon, G. Matthew Heenan, Armin Tarakemeh, J. Paul Schroeppel, Scott Mullen, and Bryan G. Vopat. "Comparison of the Rate of Nonunion or Delayed Union in Fifth Metatarsal Fractures Receiving Anti- Inflammatory Medications." Foot & Ankle Orthopaedics 4, no. 4 (October 1, 2019): 2473011419S0010. http://dx.doi.org/10.1177/2473011419s00100.
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Category: Midfoot/Forefoot, Trauma Introduction/Purpose: Controversy exists regarding the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on fracture healing. Our retrospective study uses a private payer database to isolate patients diagnosed with 5th metatarsal (MT) fractures and compare the rate of delayed open reduction and internal fixation (ORIF) or non/malunion repair as a surrogate for nonunion or delayed union, in those prescribed anti-inflammatories and those not prescribed anti-inflammatories. Methods: Data was collected from the PearlDiver Technologies Humana dataset using CPT and ICD-10 codes. All patients included had a diagnosis of 5th MT fracture and did not receive ORIF or repair of non/malunion within 60 days of diagnosis. Two groups were then created based on the presence or absence of insurance claim records for anti-inflammatory medications within 60 days of diagnosis. The number of patients in each group who underwent ORIF or non/malunion repair after 60 days post- diagnosis was determined, and the rates were compared using a chi-square analysis. Results: 10,626 patients had a diagnosis of 5th MT fracture and did not undergo early repair/ORIF (within 60 days). 1,615 had records of insurance claims for anti-inflammatories within 60 days of diagnosis, leaving 9,011 who did not receive these medications. 18 (1.11%) patients who received an anti-inflammatory medication underwent ORIF or repair of non/malunion after 60 days post-diagnosis. 44 (0.49%; p=0.0055) subjects who did not receive an anti-inflammatory prescription underwent ORIF or repair of non/malunion after 60 days post-diagnosis. Conclusion: The rate of delayed ORIF or non/malunion repair of 5th MT fractures, a surrogate for delayed union or nonunion in an insurance database study, was significantly higher in subjects receiving anti-inflammatories within 60 days of diagnosis. This study isolates a specific fracture and finds a negative correlation between NSAIDs and fracture healing. Further, this provides valuable information to help guide future higher level studies.
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Barnds, Brandon, G. Matthew Heenan, Armin Tarakemeh, Scott M. Mullen, John Paul Schroeppel, and Bryan George Vopat. "Comparison of the Rate of Nonunion or Delayed Union in Fifth Metatarsal Fractures Receiving Anti-Inflammatory Medications." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0032. http://dx.doi.org/10.1177/2325967119s00326.
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Objectives: Controversy exists regarding the effect of non-steroidal anti-inflammatory drugs (NSAIDs) on fracture healing. Our retrospective study uses a private payer database to isolate patients diagnosed with 5th metatarsal (MT) fractures and compare the rate of delayed open reduction and internal fixation (ORIF) or non/malunion repair as a surrogate for nonunion or delayed union, in those prescribed anti-inflammatories and those not prescribed anti-inflammatories. Methods: Data was collected from the PearlDiver Technologies Humana dataset using CPT and ICD-10 codes. All patients included had a diagnosis of 5th MT fracture and did not receive ORIF or repair of non/malunion within 60 days of diagnosis. Two groups were then created based on the presence or absence of insurance claim records for anti-inflammatory medications within 60 days of diagnosis. The number of patients in each group who underwent ORIF or non/malunion repair after 60 days post-diagnosis was determined, and the rates were compared using a chi-square analysis. Results: 10,626 patients had a diagnosis of 5th MT fracture and did not undergo early repair/ORIF (within 60 days). 1,615 had records of insurance claims for anti-inflammatories within 60 days of diagnosis, leaving 9,011 who did not receive these medications. 18 (1.11%) patients who received an anti-inflammatory medication underwent ORIF or repair of non/malunion after 60 days post-diagnosis. 44 (0.49%; p=0.0055) subjects who did not receive an anti-inflammatory prescription underwent ORIF or repair of non/malunion at after 60 days post-diagnosis. Conclusion: The rate of delayed ORIF or non/malunion repair of 5th MT fractures, a surrogate for delayed union or nonunion in an insurance database study, was significantly higher in subjects receiving anti-inflammatories within 60 days of diagnosis. This study isolates a specific fracture and finds a negative correlation between NSAIDs and fracture healing. Further, this provides valuable information to help guide future higher level studies.
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de Ruijter, Marinus Alexander, Jian Zhang Yuan, and Robert Jan Derksen. "The Clinical Outcomes of Operative Treatment Versus Conservative Treatment for Dancer’s Fractures: Protocol for a Retrospective Cohort Study." JMIR Research Protocols 11, no. 4 (April 5, 2022): e37171. http://dx.doi.org/10.2196/37171.
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Background Fifth metatarsal fractures are one of the most common foot fractures, and 11% to 25% of such fractures are Dancer’s fractures (distal spiral fractures). Conservative therapy while wearing a cast and operative treatment have been used as preferred modes of treatment in the limited literature available. However, we often see healing problems, such as delayed union and nonunion, when Dancer’s fractures are treated nonoperatively, resulting in a need for secondary intervention. In our institution, treatment has changed over the years from predominantly conservative treatment to mostly operative treatment. To investigate whether our hypothesis holds true that primary surgical treatment is beneficial, a retrospective study was designed. Objective The objective of the study is to compare differences between outcomes (delayed union and nonunion) of conservative and operative treatments for Dancer’s fractures. Methods A retrospective comparative cohort study will be conducted in a level II trauma center (Zaandam Medical Center). Patients who experienced a Dancer’s fracture in the period of 2012 to 2021 will be included and divided into 2 cohorts—the conservative (2012-2015) and operative (2016-2021) treatment cohorts. The primary outcome will be the differences in percentages of delayed union and nonunion between the two groups. The secondary outcomes will be the percentage of primary conservative treatment failure, the need for secondary operative treatment, complications (infection and hardware failure), and functional outcomes. If 118 patients are included in each group, sufficient power is expected to be reached, depending on the age distribution of patients. The percentages of delayed union and nonunion among the two groups will be calculated and statistically compared via chi-square statistics. A logistic regression analysis will be used to investigate possible associations between patient characteristics and failed conservative treatment. A Mann-Whitney U test will be used to compare functional outcomes between groups. An independent, 2-tailed t test will be used to compare mean 12-Item Short Form Survey scores if they are normally distributed, and a Wilcoxon rank sum test will be used if they are nonnormally distributed. Results In total, 2134 potentially relevant health insurance codes have been extracted from the hospital’s register. We expect to find a total of 236 Dancer’s fractures in this data set. Conclusions Our study has limitations due to it being a single-center study and data collection being performed retrospectively. However, it covers a large time period and may provide the possibility to show treatment outcome differences (delayed union and nonunion, complications, and functional outcomes) in 2 reasonably large cohorts (conservative and operative treatment cohorts), which has not been done before in literature on Dancer’s fractures. If our hypothesis that surgery is beneficial for Dancer’s fractures is proven true by our study, we plan to further corroborate it by conducting a prospective randomized controlled trial. International Registered Report Identifier (IRRID) PRR1-10.2196/37171
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Toba, Hapnes, Hendra Bunyamin, Juan Elisha Widyaya, Christian Wibisono, and Lucky Surya Haryadi. "Masking preprocessing in transfer learning for damage building detection." IAES International Journal of Artificial Intelligence (IJ-AI) 12, no. 2 (June 1, 2023): 552. http://dx.doi.org/10.11591/ijai.v12.i2.pp552-559.
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The sudden climate change occurring in different places in the world has made disasters more unpredictable than before. In addition, responses are often late due to manual processes that have to be performed by experts. Consequently, major advances in computer vision (CV) have prompted researchers to develop smart models to help these experts. We need a strong image representation model, but at the same time, we also need to prepare for a deep learning environment at a low cost. This research attempts to develop transfer learning models using low-cost masking pre-processing in the experimental building damage (xBD) dataset, a large-scale dataset for advancing building damage assessment. The dataset includes eight types of disasters located in fifteen different countries and spans thousands of square kilometers of satellite images. The models are based on U-Net, i.e., AlexNet, visual geometry group (VGG)-16, and ResNet-34. Our experiments show that ResNet-34 is the best with an F1 score of 71.93%, and an intersection over union (IoU) of 66.72%. The models are built on a resolution of 1,024 pixels and use only first-tier images compared to the state-of-the-art baseline. For future orientations, we believe that the approach we propose could be beneficial to improve the efficiency of deep learning training.
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Lyapina, Maya, Todor Kundurjiev, and Karolina Lyubomirova. "CONTACT SENSITIZATION TO METALS AMONG A GROUP OF BULGARIAN DENTAL TECHNICIAN STUDENTS IN RELATION TO THE DURATION OF THEIR EDUCATIONAL EXPOSURE." Journal of IMAB - Annual Proceeding (Scientific Papers) 27, no. 3 (July 7, 2021): 3835–41. http://dx.doi.org/10.5272/jimab.2021273.3835.
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Purpose: Sensitization to metals is a significant problem in dental, occupational exposures. The purpose of this study was to evaluate the prevalence of contact sensitization to selected metals during the course of study among students from dental technician school and the prevalence of co- sensitization. Material and Methods: Skin patch testing with potassium dichromate, cobalt, gold, nickel, copper, palladium, aluminium, tin and sodium tetrachloropalladate(II)hydrate was performed among 150 dental technician students (38 – 1st year of study,40 – 2nd year of study and 38 – 3rd year of study); the control group included 34 students without educational exposure to metals. Chi-square test, Fisher Exact Test and multiple binary logistic regression were used in data analysis. Results: During the educational course of dental technician students, a clear tendency of increase in the prevalence of sensitization to nickel (1st year of study - 10.5%, 3rd year of study - 36.8% cobalt (13.2% vs 39.5%) and palladium(II)chloride (10.5% vs 26.3%) was established. For the whole studied population, the prevalence of positive reactions to sodium tetrachloropalladate (II) hydrate was the highest – 30%; the highest recorded value was among the 2nd year students – 57.5%. The prevalence of sensitization to more than one metal allergen among the studied population was high (66.7%), the highest value was reported among 3rd-year dental technician students (78.9%). Conclusions: Our data indicate a high risk of contact sensitization to metals relevant for the dental technician students, which increases in the course of educational exposure for some of the metal haptens. Sodium tetrachloropalladate(II) hydrate could be outlined as a sensitizer of prominent importance, probably due to the increased sensitivity of this test salt. Additional and studies, including more respondents from the othe Colleges in Bulgaria are recommended. Adequate prevention programs and information should be provided, and the European Union regulations should be properly applied.
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Jain, Rajesh Kumar, and Nitin Kiradiya. "Use of intramedullary implants in adult diaphyseal fracture both bone forearm." International Journal of Research in Orthopaedics 4, no. 2 (February 23, 2018): 243. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20180522.
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<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Fractures of the forearm bones are very common. The most common form of stabilization is plate and screw fixation. The role of Intramedullary nailing of fractures of the shafts of the adult radius and ulna is still to be defined. This study was perform to analyze anatomical and function outcome of the patients treated by Talwarkar square nail.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We evaluated 46 patients (29 males and 17 females) had fracture both bone forearm treated by intramedullary nail. We analyzed patients in two broad group one with close fracture or grade I, II open fracture (34 patients) and other have open fracture grade IIIA or IIIB (12 patients). First group patients further analyzed weather close (22 patients) or open reduction (8 patients) required. Functional outcome was calculated by Grace and Eversman system</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 32 patients of close fracture or open grade 1 or 2 fracture, 29 (90.62%) have excellent or acceptable result. All the patients (100%) in whom close reduction succeeds achieved excellent result. 22 (64.70%) patients close nailing possible.12 patients in whom open reduction required 9 (75%) goes into union. Close nailing have overall success rate is 90.62% where it fail and open nailing require success rate bring down to 75%.. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">IM nailing gives satisfactory results. Advantages of close nailing are- early union, low incidence of infection, small scars, less blood loss, short operating time with minimal surgical trauma, easier implant removal. Even though plate and screw fixation is the gold standard for stabilization of both bone forearm fracture but intramedullay implant can be used in selected cases with good result. To achieve acceptable result – early surgery, proper selection of the case, pre-operative planning, proper assessment of diameter, length and radial bowing of the nail, is required.</span></p>
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Rachmat Primana, Hendy, Andri Primadhi, Ahmad Ramdan, and Ghuna A. Utoyo. "Knee bracing vs Taping as an Adjunct to Rehabilitative Exercise in Patellofemoral Pain Syndrome Management among Basketball Players: A Prospective Study." Sport Mont 19, no. 3 (October 1, 2021): 3–7. http://dx.doi.org/10.26773/smj.211001.
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Patellofemoral pain syndrome (PFPS) is a common source of knee problems found mostly in physically active young adults. Causative factors are multifactorial, including lower extremity weakness, especially quadriceps muscles. Conservative treatment of PFPS consists mainly of knee bracing and knee taping combined with physical therapy. This study was aimed to analyse the outcome comparison between knee bracing and knee taping in combination with rehabilitative exercise for PFPS management. A prospective study was performed involving twenty-five bas- ketball players suffering from PFPS, aged 19–30 years old with regular practice sessions. The subjects were each grouped randomly into a taping or a bracing group. Follow-up evaluations in term of Kujala patellofemoral score were done in the 1 st , 2 nd , and 4 th weeks after treatment. Unpaired t-test and chi-square were used to analyse the difference between both groups in pre- and post-intervention. Baseline characteristics of each group did not dif- fer significantly (p>0.05). Both groups had significantly higher functional scores after the 1 st , 2 nd , and 4 th weeks of intervention (p<0.05). Significantly higher functional scores were found in the bracing group on the 2 nd (p=0.013) and 4 th weeks (p=0.002). No significant differences were found in functional scores between both groups in the 1 st week (p=0.142). While both methods were efficacious, knee bracing is more effective compared to knee taping in improving functional outcomes as an adjunct to rehabilitative exercise in PFPS management.
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Lindeman, Robert W., Brandon S. Lanier, Douglas E. Parsell, and James R. Ramsey. "Clinical Outcomes For Open Reduction Internal Fixation Of Midshaft Clavicle Fractures In Adolescent/post-adolescent Athletes Utilizing A Two Month Return To Play Protocol." Orthopaedic Journal of Sports Medicine 7, no. 7_suppl5 (July 2019): 2325967119S0038. http://dx.doi.org/10.1177/2325967119s00381.
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Objectives: The success rate and the return to sport after midshaft clavicle fracture has been shown to improve with open reduction internal fixation (ORIF) treatment versus non-operative management. The period of time for return to sport, post-ORIF, has been reported in the literature with considerable range. Return to sport times for NFL athletes are reported to typically require three to seven months, while professional cyclists have resumed training in only one week. As the percentage of clavicle fractures in athletes is likely dominated by the high school and college populations, it is clinically relevant to evaluate the success of specific return to sport protocols after clavicle ORIF with respect to age. To evaluate this aspect of care, a retrospective study utilizing an adolescent/immediate post-adolescent and an adult control patient was performed. Methods: A single surgeon performed locking plate ORIF of clavicle fractures with patient population of athletes, ages 13 to 22 years old (mean 16.7 yrs.), and an adult control group (mean 50.8 yrs.). A uniform period for return to sport of two months was utilized for the athlete group, unless complications were present. The athlete group contained 90 patients, and the adult control group contained 64 patients. The athlete group had 48% of fractures resulting from football. High energy mechanisms (auto accident, ATV accident, etc.) accounted for 23.3% of the athlete group fractures, while these mechanisms accounted for 46.9% of the adult group fractures. Post-operative complications and adverse outcomes were monitored for a minimum period of one year. Results: Clavicle fractures within both patient groups were dominantly midshaft fractures with 97.7% of the athlete fractures and 88.5% of the adult fractures being located midshaft. The athlete group exhibited minimal post-operative complication/adverse outcomes with one patient reporting pain with weightlifting and two patients requiring minor scar revisions, for a total complication/adverse outcome rate of 3.3%. The adult group included ten patients with significant residual pain and one patient requiring revision for non-union, yielding a total complication/adverse outcome rate of 15.6% in this group. Applying a Chi-square analysis, a statistically significant difference in complication/adverse outcome rates exist between the patient groups (p=0.003). Additionally, all patients in the athlete group, desiring to return to their sport, did so within the two-month post-operative period. Conclusion: Locking plate ORIF of midshaft clavicle fractures allowed for a successful two month return to sport, with a low occurrence of complications, for a young athlete patient group. High energy fracture events and an adult aged patient group were associated with higher rates of adverse clinical outcome.
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Holleran, Amanda H., Judith F. Baumhauer, Jeff Houck, Daniel Homeier, Adolph S. Flemister, John P. Ketz, Benedict F. DiGiovanni, and Irvin Oh. "Is there a Difference in Outcomes between Patients who Received a Double or Triple Arthrodesis for Hindfoot Arthritis?" Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0025. http://dx.doi.org/10.1177/2473011420s00251.
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Category: Hindfoot Introduction/Purpose: Triple arthrodesis has historically been considered the standard of treatment for arthritis of the hindfoot with or without deformity. The complications of this surgery including non-union, malunion, nerve injury, infection and wound healing problems can occur at any of the three joints. Double arthrodesis is capable of producing a similar reduction in degrees of motion and correction of foot deformity but may also cause less patient morbidity in regard to these complications due to one less joint being incorporated into the fusion procedure. What is unknown is the patient reported outcomes, specifically physical function (PF) and pain interference (PI) between these two procedures. The purpose of this study is to evaluate the clinical outcomes for hindfoot deformity using a triple compared to a double arthrodesis. Methods: A retrospective medical record review was performed (February 2015-December 2019), of 96 identified cases, 54 had complete data over 4 months post operation for either a double (Age = 58 (11); Body Mass Index (BMI) = 34.4 (6.0); n=24) or triple arthrodesis (Age= 55 (13); BMI = 33.0 (10.0); n = 30). Patient Reported Outcome Measurement Information System (PROMIS) physical function and pain interference were assessed at last available pre-operation and last follow up time points. Medical records were reviewed for complications (yes/no). ANOVA models were used to assess differences pre to post surgery (covariates included age, BMI, and length of follow up). Chi Square analysis was used to assess proportions of patients achieving a minimal clinically important difference (34.5) and complications by group. Results: There were no differences between groups in terms of age (p = 0.51), BMI (p = 0.44), or length of follow up (triple = 540 (334) days versus double = 390 (336) days; p=0.12). There were no significant differences in PROMIS PF (pre-post change 95% CI: triple= 1.2 (-4.1 to 1.6) versus double = 0.2 (-2.5 to 2.0)). The for PROMIS PI both groups experienced lower pain (average 5.1 (1.0) with the greater decrease in pain in the triple group (Figure 1; pre-post change 95% CI: triple= 7.1 (-10.2 to -4.0) versus double = 3 (-5.5 to -0.6)). Chi square analysis showed that a greater proportion of patients undergoing a triple (triple 61.9 % versus double 33.3 %) experienced MCID improvement in PROMIS PI (X2=4.4, p=0.04). There were 4 complications in the double group, and 6 in the triple group. Conclusion: Double arthrodesis can allow for similar correction of foot deformities without the increased risk of wound complication, infection or nonunion/malunion. However, we found that patients who underwent a triple arthrodesis were more likely to have an improvement in minimally important clinical difference (MCID) in the PROMIS pain interference scores than those who underwent a double arthrodesis.
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Nagy, Nikoletta, Csaba Ökrös, and Csaba Sós. "Research on Relative Age in Hungarian Swimming." Physical Culture and Sport. Studies and Research 68, no. 1 (December 1, 2015): 5–13. http://dx.doi.org/10.1515/pcssr-2015-0023.
Full textAbstract:
AbstractIn 2017, the 19th World Swimming Championship will be organized in Hungary. Up to now, many people have already been working with swimmers to achieve good results. However, in the next period they must work even harder to ensure that the national swimmers of a country as small as Hungary can achieve the outstanding results of their predecessors. Since high-level competitions in swimming have become more intense, innovations including scientific studies are needed during preparation for the event. The purpose of this paper is to present the major results of an independent study carried out by the authors about the relative age of the best Hungarian swimmers with the aim of contributing to their preparation. The research population consisted of selected age groups of swimmers registered by the Hungarian Swimming Association (N=400). The method for data collection was an analysis of documents. To evaluate the data, the Chi-square and Kruskal-Wallis tests were used. The results are presented according to the period of the competitor’s date of birth, gender, and age group. The results confirm only partly the hypothesis that people born in the first quarters of the year play a dominant role in Hungarian national swimming teams. In the conclusion, the authors recommend further research on relative age in swimming and in other sports.