Closure Duration Research Articles

Barbed sutures reduce arthrotomy closure duration and suture utilisation compared to interrupted conventional sutures for primary total hip arthroplasty: a randomised controlled trial.

The broad aim of this study was to compare the safety and efficacy of using barbed sutures and running closure versus interrupted placement of standard of care sutures for closure of the arthrotomy during total hip arthroplasty (THA). Specifically, we compared duration of arthrotomy closure, the number of sutures utilised for arthrotomy closure, and 90-day outcomes including wound-related readmission, reoperation, and complications. A total of 60 patients undergoing 60 THAs were enrolled in a prospective, single-blinded trial and randomised to receive either running closure of the arthrotomy with barbed sutures (n = 30) or interrupted closure with standard of care sutures (n = 30). Patients were eligible if they were undergoing primary THA for osteoarthritis and excluded if they had a BMI > 45 kg/m2 or age > 80 years or <18 years. Arthrotomy closure duration was significantly shorter in the barbed suture group (3 minutes ± 9 seconds) versus the standard of care group (8 minutes ± 26 seconds, p < 0.001). The suture utilisation for arthrotomy closure was 1 suture in the barbed sutured group 28/30 (93%) patients versus 2-4 sutures in 27/30 (90%) in the standard of care group (p < 0.001). The overall number of wound-related complications in the barbed suture group was 1/30 (3%) versus 1/30 (3%) in the standard of care group (p = 1.00). The rate of suture abscesses was 1/30 (3%) in barbed suture group versus the standard of care (p = 1.00). There was trochanter bursitis 1/30 (3%) in the standard of care group versus zero in the barbed suture group (p = 1.00). These results suggest that barbed suture utilisation may be faster and more resource efficient than use of standard of care sutures for arthrotomy closure in THA.ClinicalTrials.gov Identifier: NCT03285555.

Barbed sutures reduce arthrotomy closure duration compared to interrupted conventional sutures for total knee arthroplasty: a randomized controlled trial.

The broad aim of this study was to compare the safety and efficacy of using barbed sutures versus standard-of-care sutures for closure of arthrotomy during total knee arthroplasty. Specifically, we compared theduration of arthrotomy closure, thenumber of sutures utilized for arthrotomy closure, and 90-day outcomes, including wound-related readmission, reoperation, and complications. A total of 60 patients undergoing primarytotal knee arthroplasty were enrolled in a prospective, blinded trial and randomized to receive either running closure of the arthrotomy with barbed sutures (n = 30) or interrupted closure with standard-of-care sutures (n = 30). Arthrotomy closure time was significantly shorter in the barbed suture group (3min ± 2min) versus the standard-of-care group (13min ± 5min, p < 0.001). The average suture utilization for arthrotomy closure was 1 suture (range 1-2) versus 3 sutures (range 2-4) in the standard-of-care group (p < 0.001). The overall number of wound-related complications in the barbed suture group was 3/30 (10%) versus 3/30 (10%) in the standard-of-care group (p = 1.00). There was one dehiscence 1/30 (3%) in the standard-of-care group versus zero in the barbed suture group (p = 1.00). The rate of superficial surgical site infection was 1/30 (3%) in barbed suture versus zero inthe standard-of-care groups (p = 1.00). These results suggest barbed suture utilization may be faster and more resource-efficient than theuse of standard-of-care sutures for arthrotomy closure in primarytotal knee arthroplasty without increased complications. CLINICALTRIALS. NCT03285529.

Effect of piezocision on mandibular second molar protraction.

To assess the effects of piezocision on the rate of mandibular second molar protraction. Thirty-one subjects (average age: 22.26 ± 5.63 years) who presented with at least one extracted mandibular first molar were selected to participate in the study. The subjects were subdivided into one of two groups, 22 molars each: group 1, where piezocision was performed immediately before molar protraction and group 2, where molar protraction was performed with no piezocision. Piezocision was performed by making two vertical incisions mesial and distal to the extraction space, and bone cuts were done with a length up to the mucogingival line at a depth of 3 mm. The rate of second molar protraction, duration of space closure, and level of interleukin-1-β (IL-1β) in gingival crevicular fluid (GCF) during the first month of space closure were recorded. During the first 2 months after surgery, the rates of second molar protraction were 1.26 ± 0.12 mm/month and 0.68 ± 0.19 mm/month in the piezocision and no piezocision groups, respectively (P < .001). Duration of lower first molar space closure was 9.61 ± 0.98 months in the piezocision group and 10.87 ± 1.52 months in the no piezocision group (P < .01). The level of IL-1β in GCF was higher in the piezocision group compared to the no piezocision group, up to 1 week after surgery (P = .02). Although piezocision doubled the rate of second molar protraction during the first 2 months after surgery, overall second molar protraction was increased by only 1 month.

Assessing the validity of eyelid parameters to detect impairment due to benzodiazepines.

Benzodiazepines impair driving ability and psychomotor function. Eyelid parameters accurately reflect drowsiness; however, the effects of benzodiazepines on these measures have not been extensively studied. The aim of this study was to investigate the effect of benzodiazepines on eyelid parameters and evaluate their accuracy for detecting psychomotor impairment. Eyelid parameters were recorded during a psychomotor vigilance task (PVT) and driving simulation over 2 days, baseline, and after 20-mg oral temazepam. The utility of eyelid parameters for detecting PVT lapses was evaluated using receiver operating characteristic curves, and cut-off levels indicating impairment (≥1 and ≥2 PVT lapses per min) were identified. The accuracy of these cut-off levels for detecting driving simulator crashes was then examined. PVT and driving simulator performance was significantly impaired following benzodiazepine administration (p < .05). Average eyelid closure duration (inter-event duration) was a reliable indicator of PVT lapses (area under the curve [AUC] of 0.87-0.90). The cut-off value of eyelid closure duration derived from PVT AUC was able to predict driving simulator crashes with moderately high sensitivity and specificity (76.23% and 75.00%). Eyelid parameters were affected by benzodiazepines and accurately detected the psychomotor impairment. In particular, eyelid closure duration is a promising real-time indicator of benzodiazepine impairment.

Confirmation of Tenotomy Healing at 3 Weeks Using the Ponseti Protocol

Percutaneous Achilles tenotomy is an integral key element of the Ponseti method in clubfoot management. The duration of posttenotomy casting has been empirical. Evidence-based duration of healing in Achilles tendon is required to objectively determine the period of posttenotomy casting. This study aims to use clinical and ultrasonographic methods to evaluate the mean duration of Achilles tendon gap (ATG) closure and the weekly percentage of feet that achieved ATG closure after tenotomy. Prospectively, 37 feet of 25 patients <5 years old with idiopathic clubfoot were managed using Ponseti methods. The Achilles tendon was assessed clinically and ultrasonographically before and after tenotomy. The tendon stump gap was created at tenotomy, and posttenotomy assessments were done on a weekly basis until tendon stump gap closure was achieved, with a minimum follow-up of 2 years. The immediate posttenotomy ultrasonographic mean tendon gap area was 5 ± 2.8 mm. The mean duration of the tendon stump gap closure as determined clinically was 1.9 ± 0.8 weeks, whereas it was 2.6 ± 0.9 weeks as assessed ultrasonographically (p < .001). The significant difference between clinical and ultrasound methods of assessing the Achilles tendon gap closure appears to establish casting removal and ambulatory walking at 3 weeks after tenotomy for <5-year-old children with idiopathic clubfoot treated with the Ponseti method. We recommend that the duration of posttenotomy cast should be 3 weeks based on the ultrasonographic findings.

A new method of aponevrosis suturing after laparotomy in urgent abdominal surgery

To improve the results of treatment of patients undergoing laparotomy by using of a new method of aponeurosis suturing after laparotomy. Training process for a new method of aponeurosis suturing after laparotomy was organized on the patented medical simulator for learning the technique of laparotomy closure. The method was introduced into surgical practice later. The study involved 130 patients who underwent emergency abdominal surgery through median laparotomy. The main group consisted of 70 patients (laparotomy closure using the proposed method (RF patent No.2644846 dated 02/14/18). Interrupted sutures were applied for aponeurosis suturing in the control group. Duration of laparotomy closure was similar in both groups. Postoperative ventral hernias in 1 year after surgery occurred in 5 (8%) patients of the main group and in 11 (18%) patients of the control group. The proposed method of aponeurosis suturing after laparotomy is mastered by students and serves as effective method for prevention of postoperative ventral hernias and eventration.

The Vital Pulp Therapy of Permanent Teeth: A Dental Practitioner's Perspective from Saudi Arabia.

ABSTRACTAims and Objectives:The aim of this study was to determine the levels of knowledge and attitude of dental practitioners (DPs) toward vital pulp therapy (VPT) of young permanent teeth in Riyadh city, Saudi Arabia.Materials and Methods:A descriptive cross-sectional study was carried out by taking convenient sample of general DPs and specialist attending Saudi International Dental Conference, Riyadh, Saudi Arabia. A total of 200 DPs administered a structured, self-administered questionnaire to evaluate their knowledge and attitude toward VPT. The questionnaire comprised four parts: Part I: Characteristics of the study participants; Part II: Items related to indications and diagnosis of VPT; Part III: Questions related to the different VPTs for immature permanent teeth; and Part IV: Dental materials used in VPT and restoration. All the data were entered into the statistical analysis software Statistical Package for the Social Sciences version 21.0 (IBM, Armonk, NY) and analyzed by using descriptive statistics of frequency distribution and percentages for the categorical variables.Results:A total of 193 (men = 57% [110] and women = 43% [83]) DPs participated in this study with a response rate of 96.5%. Less than half of correct responses were observed with (Item 1) related to the duration of complete closure of root apex (43%) and (Item 14) use of sodium hypochlorite to serve as an excellent diagnostic tool to differentiate irreversible from reversible pulpitis. A high percentage of correct responses were seen with the (Item 9) indirect pulp capping––a procedure performed in a tooth with a deep carious lesion without signs or symptoms of pulp degeneration (75%). All other item responses ranged in between 52% and 72%.Conclusion:DPs showed fair-to-good knowledge and attitude toward VPT of young permanent teeth. In general, there is a need to improve knowledge and attitude of dental professionals about the VPT by attending continuing dental educational programs.

Longer vowel duration correlates with greater tongue root advancement at vowel offset: Acoustic and articulatory data from Italian and Polish.

Voiced stops tend to be preceded by longer vowels and produced with a more advanced tongue root than voiceless stops. The duration of a vowel is affected by the voicing of the stop that follows, and in many languages vowels are longer when followed by voiced stops. Tongue root advancement is known to be an articulatory mechanism, which ensures the right pressure conditions for the maintenance of voicing during closure as dictated by the aerodynamic voicing constraint. In this paper, it is argued that vowel duration and tongue root advancement have a direct statistical relationship. Drawing from acoustic and ultrasound tongue imaging data from 17 speakers of Italian and Polish in total, it is proposed that the comparatively later closure onset of voiced stops is responsible for both greater root advancement and shorter closure durations of voiced stops. It is further shown that tongue root advancement is initiated during the vowel, and vowel duration and tongue root position at vowel offset are positively correlated so that longer vowel durations correspond to greater tongue root advancement.

Acoustic analysis of Korean stop sounds in patients with dysarthrias

Purpose Korean ‘stops’ are considered an especially good acoustic variable since they are sensitive to speech intelligibility and reflect physiological coordination between laryngeal and supra-laryngeal mechanisms. The purpose of the study was to evaluate the acoustic characteristics of both the dysarthria and control groups in the production of nine Korean stops, /p, p′, ph, t, t′, th, k, k′, kh/, in VCV contexts. Methods The participants comprised eight patients with dysarthria and eight age- and gender-matched normal adults. After the acoustic analysis of the closure duration, aspiration duration, and the ratio of closure duration to closure-aspiration combined duration, the results were compared among three types of phonation and places of articulation for Korean stops. Results The dysarthria group (DG) had longer closure durations, suggesting slower articulatory movements of the DG than the normal control group (NC). Although statistically not significant except for /ap′a/ and /at′a/, the absolute aspiration durations of the DG were still longer than those of the NC. This resulted in the normal levels of ratios in the DG between closure duration and closure-aspiration combined durations. Furthermore, the DG could change the durational aspects of stop production distinctively according to types of phonation more than they could according to the places of articulation. This trend was more prominent during the closure duration than during the aspiration duration. Conclusions This finding suggested that while the DG has centralized tongue positions, they control the tenseness and the timing coordination between laryngeal and supra-laryngeal articulators to distinctively produce different types of phonation of stops. Keywords: Dysarthria; Acoustic analysis; Korean stops; Closure duration; Aspiration duration

What Makes Spanish-Accented English Sound Spanish-Accented? Acoustic Measures and Listener Cues

This study aimed to understand which acoustic parameters of Spanish-accented English are correlated with listeners’ perception of Spanish-accentedness. Temporal differences were analyzed in multisyllabic target words spoken in sentences by 22 Spanish speakers of English and five native speakers of American English (AE). Recordings were presented to AE listeners who judged the degree of accentedness on a 9-point scale. Spearman rank order correlation showed that the listeners’ ratings of degree of accentedness in sentences correlated strongly (r= +0.82) with those in words. Listeners’ ratings of accentedness correlated in varying degrees with various temporal measures, namely Overall word durations (+0.04 to +0.56), Stressed/unstressed vowel duration ratios (–0.01 to +0.35), Voice Onset Time of stops (+0.26 to +0.36), and, closure duration (+0.29 to +0.59). Results suggest that Spanish-accented English is characterized by systematic temporal differences from native AE, and that these temporal differences contribute to the perception of accentedness. Implications of findings in improving theoretical understanding and applied practices are discussed.

Improving the Efficiency of Robot-Mediated Rehabilitation by Using a New Organizational Model: An Observational Feasibility Study in an Italian Rehabilitation Center

Robotic rehabilitation is a promising way to restore upper limb function, but new organizational models are crucial in order to improve its sustainability. We aimed to analyze the feasibility of a robot-Assisted REhabilitation Area (robotAREA) equipped with four devices, using a new organizational model in which one physiotherapist supervises up to four patients. In 33 days, 60 patients were treated in the robotAREA. Two hundred fifty-five rehabilitation sessions were analyzed, each including two, three, or four patients supervised by one physiotherapist (the R2, R3, and R4 group, respectively). For each session, the duration of (a) setup, (b) training, (c) supervision, (d) session closure, and participant satisfaction were measured. For each patient, upper limb impairment, disability, mobility, and comorbidity were recorded. The time of training in the R4 group was lower by only 2 and 3 min compared to the R2 and R3 groups, respectively, while the supervision significantly changed between the R2, R3, and R4 groups. No differences were observed in satisfaction. Moreover, according to the logistic regression analysis, when the mean disability of the group is moderate, four patients can be supervised by one physiotherapist. These results suggest that the proposed model is feasible, and the mean disability of the group could influence the proper physiotherapist/patient ratio.

An exploratory study of voicing-related differences in vowel duration as compensatory temporal adjustment in Italian and Polish

Over a century of phonetic research has established the cross-linguistic existence of the so called “voicing effect”, by which vowels tend to be shorter when followed by voiceless stops and longer when the following stop is voiced. However, no agreement is found among scholars regarding the source of this effect, and several causal accounts have been advanced. A notable one is the compensatory temporal adjustment account, according to which the duration of the vowel is inversely correlated with the stop closure duration (voiceless stops having longer closure durations than voiced stops). The compensatory account has been criticised due to lack of empirical support and its vagueness regarding the temporal interval within which compensation is implemented. The results from an exploratory study of Italian and Polish suggest that the duration of the interval between two consecutive stop releases in CVCV words in these languages is not affected by the voicing of the second stop. The durational difference of the first vowel and the stop closure would then follow from differences in timing of the VC boundary within this interval. While other aspects, like production mechanisms related to laryngeal features effects and perceptual biases cannot be ruled out, the data discussed here are compatible with a production account based on compensatory mechanisms.

The role of vowel length and glottalization in German learners’ perception of the English coda stop voicing contrast

In German, the voicing contrast in word-final stops is neutralized towards the voiceless sound. We tested how German learners of English use in perception two phonetic cues to this contrast in English: the duration of the vowel preceding the stop and the partial glottalization of this vowel. While a longer vowel cues the voiced sound of the contrast, glottalization enhances the voiceless sound, which should be ‘easy’ for learners as word-finally it is the default in German. We asked whether cueing the ‘easy’ sound would nevertheless affect learners’ word identification. Learners categorized two English minimal pairs along vowel duration continua with either a fully modal vowel or the last 25% of the vowel glottalized. Learners gave more voiced-stop responses as vowel duration increased. They also used glottalization by giving fewer voiced-stop responses for the glottalized continua. A second experiment demonstrated that the glottalization was not merely perceived as a change in the vowel+closure duration ratio. When the glottalized portion of the vowels was set to silence learners gave even fewer voiced-stop responses than in the glottalized condition. Results suggest that learners can use a phonetic cue to a second language sound contrast even if it enhances the familiar ‘easy’ sound.

Effects of L1 on the voicing of intervocalic voiceless stops and its relation with L2 proficiency

This study investigates the correlation between the proficiency of L2 learners of English and the degree of L1 Korean intervocalic voicing rule transfer on the English intervocalic voiceless stop production by Korean English learners. Korean has a phonological rule that voiceless stops become voiced between vowels (Korean intervocalic voicing rule) but this rule does not apply in English. The aforementioned difference between the phonological rule of the two languages makes it possible to predict that Korean learners with lower L2 proficiency might produce English intervocalic voiceless stops with higher degree of voicing than the learners with higher L2 proficiency. The speech data of Korean L2 learners of English is extracted from GenieSpeeCor, rated and categorized English speech corpus of Korean L2 learners of English production, and the value of intensity drop and closure duration were used as acoustic cues for voicing difference. Alveolar stop is excluded from the data analysis because the flapped /t/ sound is difficult to distinguish from the voiced sound. As a result of the current study, when it comes to the closure duration as an acoustic cue, there was no meaningful statistical relation between learners' L2 proficiency and the degree of intervocalic stops voicing. However, in terms of the intensity drop learners with the highest L2 proficiency showed a lower degree of voicing than the learners with middle and lowest proficiency.This study investigates the correlation between the proficiency of L2 learners of English and the degree of L1 Korean intervocalic voicing rule transfer on the English intervocalic voiceless stop production by Korean English learners. Korean has a phonological rule that voiceless stops become voiced between vowels (Korean intervocalic voicing rule) but this rule does not apply in English. The aforementioned difference between the phonological rule of the two languages makes it possible to predict that Korean learners with lower L2 proficiency might produce English intervocalic voiceless stops with higher degree of voicing than the learners with higher L2 proficiency. The speech data of Korean L2 learners of English is extracted from GenieSpeeCor, rated and categorized English speech corpus of Korean L2 learners of English production, and the value of intensity drop and closure duration were used as acoustic cues for voicing difference. Alveolar stop is excluded from the data analysis because the flapped /...

A simplification analysis of Andalusian aspirated stop clusters

Weakening or “aspiration” of syllable-final /s/ is a widespread phenomenon in Spanish. When /s/ precedes a voiceless stop in varieties with /s/-aspiration, the result is normally a pre-aspirated stop [ht]. Some speakers in southern Spain now realize /s/ + stop (sC) clusters as post-aspirated stops, particularly in Western Andalusian Spanish (WAS) [Ruch and Harrington, J. Phonics 45(1), 12 (2014)]. Previous studies have analyzed this change as a timing realignment [Parrell, J. Phonics 40(1), 37 (2012)] or articulatory overlap [Torreira, JIPA 42(1), 49 (2012)]. The current study is the first to investigate sC clusters in naturalistic data. The data consist of 34 sociolinguistic interviews with WAS speakers. Preliminary results based on 10 speakers indicate a negative correlation between closure duration and VOT, and lower overall duration of post-aspirated clusters. Affrication of /ht/ to [ts] occurred at a rate of 7%, and deletion of the vowel in 4% of /ht/ tokens in vowel-initial words (e.g., [tha] for está), a phenomenon not reported in laboratory speech. We argue that low-level gestural realignment cannot account for the naturalistic variability in sC clusters, and argue for an account involving simplification to a single post-aspirated stop.

Infant perception of VOT and closure duration contrasts

Previous research suggests that infant perception of phonetic contrasts undergoes a reorganisation during the first year of life with universal sound discrimination from birth that adapts to the native phoneme contrasts around 12 months of age. This paper focuses on two closely related languages that crucially differ in the realisation of stop contrasts: (Standard High) German and Swiss German. The first employs a VOT contrast for tense/lax stops, the latter uses a length contrast to distinguish singletons and geminates.In a habituation paradigm, German and Swiss infants aged 7, 11 and 15 months were tested on their ability to discriminate (a) VOT contrasts and (b) closure duration contrasts for labial stops. Results show that German infants discriminated the VOT contrast at all ages. Swiss German infants discriminated the VOT contrast at 11 months only. At 7 months, neither German nor Swiss German children discriminated the closure duration contrast, whereas both groups were able to perceive the contrast at 11 and 15 months of age. Our findings contribute to clarifying the so far inconsistent picture of infant perception of length contrasts. We discuss the findings critically with regard to the different dimensions of VOT and closure duration.

Pharyngeal Area Changes in Parkinson's Disease and Its Effect on Swallowing Safety, Efficiency, and Kinematics.

Pharyngeal area can increase as a function of normal healthy aging and muscle atrophy. These increases in pharyngeal area can negatively affect swallowing function in healthy older adults (HOA). However, the presence of pharyngeal area changes and their effects on swallowing function in Parkinson's disease (PD) remain unknown. Therefore, we compared the pharyngeal area of people with PD to HOA to determine if pharyngeal area changes were present in PD above and beyond what is seen in HOA. Within PD, we also evaluated if and how an increase in pharyngeal area affects swallowing kinematics, swallowing safety, and swallowing efficiency. A secondary analysis of videofluoroscopic swallow studies was completed comparing 41 HOA and 40 people with PD. Measures of pharyngeal area, swallowing kinematics, swallowing safety (penetration/aspiration), and swallowing efficiency (residue) were analyzed. An analysis of covariance (ANCOVA) was used to determine if pharyngeal area was significantly different between the HOA and PD groups while controlling for age, sex, and height. Regression analyses were used to examine if and how pharyngeal area influenced swallowing kinematics, swallowing safety, and swallowing efficiency in PD. Pharyngeal areas were significantly larger for people with PD when compared to HOA (p = .008). An increase in pharyngeal area was associated with less pharyngeal constriction (p = .022), shorter duration of airway closure (p = .017), worse swallowing safety (p < .0005), and worse swallowing efficiency (p = .037). This study revealed that pharyngeal areas are larger in people with PD when compared to HOA, and that this increase in pharyngeal area is associated with maladaptive changes to swallowing kinematics, residue, and penetration/aspiration. These findings support the notion that pharyngeal muscle atrophy may be exacerbated in PD above and beyond what is seen in normal, healthy aging group. Results from this study highlight the need to consider pharyngeal muscle atrophy as a source for swallowing dysfunction in PD, and as a potential treatment target for swallowing rehabilitation.

Spidroin in carbopol-based gel promotes wound healing in earthworm's skin model.

Spider silk's regenerative, biocompatible, and antimicrobial properties render it a promising biomaterial for wound healing promotion. Spidroin as the main protein component of spider silks was used in this study to evaluate the potential effects on wound healing via topical application of novel spidroin-containing carbopol 934 (CP934) gel. Spidroin was extracted, formulated into CP934 gel, and characterized both in vitro and in vivo. Spidroin gel was translucent and brownish-yellow in color. An optimum viscosity was obtained at 0.6% CP934 at neutral pH. Optimized spidroin gel (0.6% CP934) effectively inhibited the growth of clinical bacterial isolates of methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA) and Escherichia coli at 440 μg/mL with MIC values of 0.98, 4.6, and 8.2 μg/mL, respectively. Optimized spidroin gel was evaluated for wound healing via topical application on wounds surgically induced in Allolobophora caliginosa earthworms used as a robust human skin model. After application for three consecutive days, dramatic reductions in wound closure and reepithelialization duration were observed macroscopically and via histological studies (light and electron microscopy) when compared with control. In conclusion, these results show that spidroin gel is a promising promoter for wound healing, and further studies would be directed toward investigating mechanisms underlying this effect.

The Significance of Visceral Protection in Preventing Enteroatmospheric Fistulae During Open Abdomen Treatment in Patients With Secondary Peritonitis: A Propensity Score-matched Case-control Analysis.

To evaluate the influence of a visceral protective layer (VPL) on the formation of enteroatmospheric fistulae (EAF) in open abdomen treatment (OAT) for peritonitis. EAF formation is a severe complication of OAT. Despite the widespread use of OAT, there are no robust evidence-based recommendations for preventing EAF. A total of 120 peritonitis patients with secondary peritonitis as a result of a perforation of a hollow viscus or anastomotic insufficiency who had undergone OAT were included, and 14 clinical parameters were recorded in prospective OAT databases at 2 tertiary referral centers. For this analysis, patients with a VPL were assigned to the treatment group and those without a VPL to the control group. Propensity Score (PS) matching was performed. Known risk factors in OAT such as malignant disease, mortality, emergency operation, OAT duration, and fascial closure were matching variables. The influence of VPL on EAF formation was statistically evaluated using logistic regression analysis. With 34 patients in each group, no notable differences were identified with regard to age, sex, underlying disease, mortality, emergency operation, fascial closure, and OAT duration. Overall, a mortality rate of 22.1% for OAT due to peritonitis was observed. Mean OAT duration was approximately 9 days, and secondary fascial closure was achieved in more than two-thirds of all patients. Fascial traction was used in more than 75% of cases. EAF formation was significantly more frequent in the control group (EAF formation: VPL group 2.9% vs control 26.5%; P = 0.00). In the final regression analysis, the use of VPL resulted in a significant reduction in the risk of EAF formation (odds ratio 0.08; 95% confidence interval 0.01-0.71, P = 0.02), which translates to a relative risk reduction of 89.1%. VPL effectively prevents EAF formation during OAT in patients with peritonitis. We recommend the consistent use of VPL as part of a standardized OAT treatment algorithm.

Evidence against interactive effects on articulation in Javanese verb paradigms.

In interactive models of speech production, wordforms that are related to a target form are co-activated during lexical planning, and co-activated wordforms can leave phonetic traces on the target. This mechanism has been proposed to account for phonetic similarities among morphologically related wordforms. We test this hypothesis in a Javanese verb paradigm. In Javanese, one class of verbs is inflected by nasalizing an initial voiceless obstruent: one form of each word begins with a nasal, while its otherwise identical relative begins with a voiceless obstruent. We predict that if morphologically related forms are co-activated during production, the nasal-initial forms of these words should show phonetic traces of their obstruent-initial forms, as compared to nasal-initial wordforms that do not alternate. Twenty-seven native Javanese speakers produced matched pairs of alternating and non-alternating wordforms. Based on an acoustic analysis of nasal resonance and closure duration, we present good evidence against the original hypothesis: We find that the alternating nasals are phonetically identical to the non-alternating ones on both measures. We argue that interactive effects during lexical planning do not offer the best account for morphologically conditioned phonetic similarities. We discuss an alternative involving competition between phonotactic constraints and word-specific phonological structures.