Evaluation Scores Research Articles

Evaluation Method of Teaching Effect of Environmental Art and Design in Universities Based on Multi-Source Data Fusion Technology

The evaluation of teaching reform satisfaction is crucial for improving teaching quality. In the evaluation of satisfaction with teaching reforms in environmental art and design, issues such as the low reliability of evaluation indicator data can lead to unsatisfactory results. To address this, this paper proposes a new method for evaluating satisfaction with teaching reforms in environmental art and design based on multi-source data integration. By establishing principles for constructing a multi-source indicator system for evaluating satisfaction with teaching reforms in environmental art and design, a four-level multi-source indicator system was determined. This system mainly includes one first-level indicator, four second-level satisfaction evaluation indicators, and several third- and fourth-level evaluation indicators. The construction of the multi-source indicator system for evaluating satisfaction with teaching reforms in environmental art and design was completed. Using a four-part graph model and entropy weight calculation, the importance of the evaluation indicators for satisfaction with teaching reforms in environmental art and design was classified. The expert scoring method was introduced to correct the multi-source indicator data for evaluating satisfaction with teaching reforms in environmental art and design. Based on standardized indicator data, a penalty rule was added to the loss function of the multiple linear regression model to remove data noise, achieving pre-processing of the multi-source indicators for evaluating satisfaction with teaching reforms in environmental art and design. After completing the above process, first collect multi-source data from questionnaire surveys, student feedback, etc., and preprocess and map it to a unified ontology class. Subsequently, data features are extracted through non-negative matrix factorization, and the similarity between object types is calculated. Finally, based on the importance, redundancy, and interaction of data sources, an integrated quality model is designed to effectively integrate multiple sources of data, construct a satisfaction evaluation model, and output the score of satisfaction evaluation. The experimental results show that the proposed method has the highest satisfaction index, reaching about 0.99, indicating a high degree of recognition for the reform; when the amount of integrated data changes, the proposed method maintains the best integratison reliability. Even with an increase in data volume, its reliability only slightly decreases and stabilizes at a high level; meanwhile, the average absolute error of the proposed method is the lowest, consistently below 2.5%, indicating a high level of stability and accuracy in its evaluation results. The above results confirm that the proposed method can effectively evaluate the satisfaction of environmental art design teaching reform and improve teaching quality.

Surgical Treatment of Periarticular Distal Radius Fracture in Elderly: A Systematic Review

Background/Objectives: The treatment of periarticular distal radius fractures remains challenging. Different surgical treatment options have been proposed as alternatives to conservative treatment. This systematic review aims to compare the functional outcomes, radiological outcomes, and complications among volar locking plates (VLPs), Kirschner-wire fixations, and external fixations (EFs) for distal radius fractures in patients aged 60 years and older. Methods: We conducted a comprehensive search of PubMed, Cochrane, and Science Direct databases assessing the effects of VLP, EF, and K-wire treatments for distal radius fractures in patients aged 60 years and over. The primary outcome was the evaluation of the range of motion (ROM) degrees after three surgical procedures, trying to assess the best treatment option. The secondary outcome included evaluation of the Disabilities of the Arm, Shoulder, and Hand (DASH) score, quick-DASH score, Patient-Rated Wrist Evaluation (PRWE) score, Visual Analog Scale (VAS) score, grip strength, radiographic assessment, and complications comparing VLPs, EFs and K-wires. Results: A total of 23 studies were included, comparing VLP, EF, and K-wire fixation. The overall population comprised 5618 patients, with 4690 females and 1015 males, of which 4468 patients were treated with VLP, 503 with EF, and 647 with K-wire. The most common complications among the VLP group were complex regional pain syndrome (7.5%) and carpal tunnel syndrome (6.8%); for the EF group, infections (9.8%) and carpal tunnel syndrome (6.8%); and for the K-wire group, carpal tunnel syndrome (7.5%) and infections (6.9%). Conclusions: VLP showed better clinical outcomes in the first few months after treatment. However, these differences decreased over time and became similar after one year. EF and K-wire fixations remain easier to manage during surgery.

Employing machine learning techniques for prediction of micronutrient supplementation status during pregnancy in East African Countries

Micronutrient deficiencies, known as “hidden hunger” or “hidden malnutrition,” pose a significant health risk to pregnant women, particularly in low-income countries like the East Africa region. This study employed eight advanced machine learning algorithms to predict the status of micronutrient supplementation among pregnant women in 12 East African countries, using recent demographic health survey (DHS) data. The analysis involved 138,426 study samples, and algorithm performance was evaluated using accuracy, area under the ROC curve (AUC), specificity, precision, recall, and F1-score. Among the algorithms tested, the random forest classifier emerged as the top performer in predicting micronutrient supplementation status, exhibiting excellent evaluation scores (AUC = 0.892 and accuracy = 94.0%). By analyzing mean SHAP values and performing association rule mining, we gained valuable insights into the importance of different variables and their combined impact, revealing hidden patterns within the data. Key predictors of micronutrient supplementation were the mother’s education level, employment status, number of antenatal care (ANC) visits, access to media, number of children, and religion. By harnessing the power of machine learning algorithms, policymakers and healthcare providers can develop targeted strategies to improve the uptake of micronutrient supplementation. Key intervention components involve enhancing education, strengthening ANC services, and implementing comprehensive media campaigns that emphasize the importance of micronutrient supplementation. It is also crucial to consider cultural and religious sensitivities when designing interventions to ensure their effectiveness and acceptance within the specific population. Furthermore, researchers are encouraged to explore and experiment with various techniques to optimize algorithm performance, leading to the identification of the most effective predictors and enhanced accuracy in predicting micronutrient supplementation status.

Outcomes after Functional Nasal Surgery in Patients with Versus without Rhinitis Medicamentosa.

Topical nasal decongestants (TNDs) are used to reduce nasal soft tissue edema and obstruction. However, after frequent TND use, patients can develop rhinitis medicamentosa (RM) with rebound nasal edema and obstruction. Management of RM has centered largely on TND cessation ± intranasal corticosteroids. The purpose of this study was to compare nasal obstruction outcomes following nasal obstruction surgery in patients with versus without RM. A retrospective case-control study was conducted with adult patients who underwent bilateral inferior turbinate reduction (ITR) with or without septoplasty and nasal valve repair. Patients with versus without RM were assessed. RM was defined as at least daily TND use for ≥4 weeks. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores, and long-term TND cessation rates were collected. NOSE score changes were compared between patients with versus without RM. Of the 36 RM patients, mean age was 52.0 years, and 63.9% were male. Of 116 non-RM patients, mean age was 41.6 years, and 46.6% were male. Postoperative NOSE scores were collected at a mean 972.1 days postoperatively for RM patients, and 565.0 days for non-RM patients. Mean NOSE score reductions were - 9.8 for RM and - 8.6 for non-RM patients, both of which were significant (p < 0.0001). NOSE score reductions were not significantlybetween the two groups (p = 0.2438). Long-term TND cessation was maintained in 86.1% of RM patients. Patients with and without RM achieved similar long-term significant NOSE score reductions following nasal obstruction surgery, and 86.1% of RM patients maintained long-term TND cessation. Level 3 evidence Laryngoscope, 2024.

Impact of teardrop angle correction on functional outcomes in die punch fractures of the distal radius: retrospective study

Background: Anatomic reduction of die punch fractures of the distal radius is crucial to optimize functional outcomes. The teardrop angle, formed by the volar cortex and articular surface, reflects distal radius alignment and articular congruity. This study evaluated the relationship between teardrop angle correction and clinical/functional results following surgical fixation of these injuries. Methods: This retrospective study included patients undergoing open reduction and internal fixation for die punch distal radius fractures between 2015-2020. Patients were divided into two groups based on teardrop angle correction: group 1 (≤10°) and group 2 (&gt;10°). Disabilities of the arm, shoulder and hand (DASH) scores, patient-rated wrist evaluation (PRWE) scores, range of motion, and grip strength were assessed at final follow-up (minimum 12 months). Multivariate analysis identified predictors of functional outcomes. Results: 60 patients were included (32 in group 1, 28 in group 2). Groups were similar in baseline demographics and injury characteristics. Group 2 (&gt;10° correction) had significantly better outcomes including lower DASH scores (14.5 versus 24.6, p=0.003), lower PRWE scores (21.6 versus 36.8, p=0.002), greater grip strength (84.6% versus 71.2%, p=0.005), increased flexion (62.5° versus 52.7°, p=0.004), and extension range of motion (55.8° versus 43.5°, p&lt;0.001). On multivariate analysis, greater teardrop angle correction was an independent predictor of improved DASH and PRWE scores. Conclusions: Obtaining &gt;10° of teardrop angle correction during surgical fixation of die punch distal radius fractures correlated with superior functional outcome scores, grip strength, and mobility compared to ≤10° of correction. These findings emphasize the importance of restoring distal radius anatomy and articular congruity in this injury pattern. Precise intraoperative correction of the teardrop angle deformity should be a key goal.

Effect of osmotic dehydration and gamma irradiation on quality characteristics of dried vegetable slices

AbstractOsmotic drying is commonly utilized to create innovative products, as it can improve the sensory and nutritional qualities of the final products. The present study aims to investigate the effect of different osmotic solutions, including soaking in 1% citric acid, 10% NaCl, and a combination of 1% citric acid and 10% NaCl, as well as different doses of gamma irradiation (1 and 3 kGy), on the quality properties of dehydrated vegetable slices. The chemical composition, mineral content, Color measurement, texture profile, vitamin C levels, and sensory attributes were evaluated for dried vegetable slices. The findings showed that treating vegetable slices with a combination of 1% citric acid and 10% NaCl increased ash (3.43–4.34%), hardness, and total phenolic content (38.37–117.04 mg GAE/100 g). It was the most preferred by the panelists in sensory evaluation scores in comparison to the other treatments. Moreover, there were no significant differences in terms of chemical composition, mineral content, and texture profile analysis between irradiation doses of 1 and 3 kGy. Furthermore, samples irradiated at 1 kGy had significantly higher scores in sensory evaluation compared to both irradiated and unirradiated samples. The current study recommends treating vegetable slices with a combination of 1% citric acid and 10% NaCl before drying to enhance most of the quality attributes of the dried vegetable slices.

C anton MT: Investigating Back-Translation and Model-Switch Mechanisms for Cantonese-English Neural Machine Translation

This paper investigates the development and evaluation of machine translation models from Cantonese to English (and backward), where we propose a novel approach to tackle low-resource language translations. Despite recent improvements in Neural Machine Translation (NMT) models with Transformer-based architectures, Cantonese, a language with over 80 million native speakers, has below-par State-of-the-art commercial translation models due to a lack of resources. The main objectives of the study are to develop a model that can effectively translate Cantonese to English and evaluate it against state-of-the-art commercial models. To achieve this, a new parallel corpus has been created by combining different available corpora online with preprocessing and cleaning. In addition, a monolingual Cantonese dataset has been created through web scraping to aid the synthetic parallel corpus generation. Following the data collection process, several approaches, including fine-tuning models, back-translation , and model switch , have been used. The translation quality of models has been evaluated with multiple quality metrics, including lexicon-based metrics (SacreBLEU and hLEPOR) and embedding-space metrics (COMET and BERTscore). Based on the automatic metrics, the best model is selected and compared against the 2 best commercial translators using a new human evaluation framework HOPES . The best model proposed in this investigation (NLLB-mBART) with model switch mechanisms has reached comparable and even better automatic evaluation scores against State-of-the-art commercial models (Bing and Baidu Translators), with a SacreBLEU score of 16.8 on our test set. Furthermore, an open-source web application has been developed to allow users to translate between Cantonese and English, with the different trained models available for effective comparisons between models from this investigation and users. CantonMT is available at https://github.com/kenrickkung/CantoneseTranslation

Do Emergency Certified Teachers Require Differentiated Administrative Support? A Comparison of Teacher Evaluation Scores by Certification Status

ABSTRACT To address growing K-12 teacher shortages, many districts are hiring emergency certified teachers at higher rates than in the past. Yet, little empirical research evaluates the performance of emergency certified teachers. In this study, we estimate the relationship between certification status and teacher evaluation scores (n = 1,312) in a large urban district with a high percentage of emergency certified teachers. Results indicate lower overall evaluation scores (β = -0.41, p < .001) for emergency certified teachers. The largest gaps were found for measures relating to learning strategies and classroom management. Findings suggest that targeted support in these two areas could be beneficial when leaders integrate emergency certified teachers.

Personalised High Tibial Osteotomy Surgery Is Accurate: An Assessment Using 3D Distance Mapping

Early-stage knee osteoarthritis is often suitable for treatment with high tibial osteotomy (HTO). This is an effective joint-preserving treatment, resulting in good postoperative outcomes. To overcome the limitations of traditional HTO, the surgical technique and correction accuracy can be enhanced by personalised procedures using three-dimensional digital planning and metal additive manufacturing, The purpose of this clinical trial study was to evaluate the three-dimensional accuracy of a new personalised HTO procedure, using modern imaging techniques, 3D modelling, and distance map analysis (DMA). Twenty-five patients were treated with the personalised HTO procedure. Before surgery and after 6 months, they underwent clinical evaluation scoring, radiographic imaging, and computed-tomography scanning to generate morphological models. Specifically, preoperative tibia models were used to plan the tibia correction and the design and position of the fixation plate. Preoperative, planned, and postoperative models were imported in computer-aided and designing software (Geomagic ControlTM 2014, 3D Systems, Rock Hill, SC, USA) for DMA implementation to assess geometrical differences between model surfaces. A very good reproduction of the planned tibia morphology was achieved postoperatively (average differences between −0.9 mm and 1.4 mm). DMA values associated with fixation-plate deformation were less than 1 mm, similar to those for plate-to-tibia surface-contour matching. Overall, personalised digitally planned HTO utilising three-dimensional printed surgical guides and plates enables accurate planned correction and plate placement.

The Effect of Patient-Reported Allergies on Patient-Reported Outcomes in Carpal Tunnel Release.

Patient-reported allergies have been shown to be a risk factor for poor surgical outcomes in a variety of orthopedic procedures. The relationship between patient-reported allergies and outcomes in carpal tunnel surgery remains unclear. A retrospective electronic medical chart review was conducted on 390 patients who underwent primary carpal tunnel releases, without concomitant procedures, who completed preoperative and postoperative Quick Disabilities of Arm, Shoulder, and Hand or Patient-Rated Wrist Evaluation scores, with a minimum of 1-year follow-up. Patient demographic data and patient-reported outcome measures were collected. Patients were grouped based on the number of allergies reported (≤3 allergies or ≥4 allergies), and statistical analysis was performed. Three hundred and ninety patients were included in the analysis (347 patients [89.0%] with ≤3 allergies; 43 patients [11.0%] with ≥4 allergies). Patients were predominantly female (n = 243, 62.3%), and the median age at surgery was 61 years. Patients with ≥4 allergies were more likely to be female (88.4% vs 59.1%), older (64.3 years vs 60.3 years), and more likely to be taking psychotropic medication (51.2% vs 28.2%). No differences were seen in patient-reported outcomes at any time point preoperatively or postoperatively, with both groups showing similar postoperative improvement. Patients with a high number of reported allergies have similar improvement in patient-reported outcomes following carpal tunnel release as low-allergy cohorts.

The application effect of the segmented teaching method in training medical students on clinical practice skills

BackgroundThe surgical clinical practice skill training is an important part of medical undergraduate education. Surgical skills are complex and difficult to master. However, the traditional teaching method has some disadvantages, for example, low student participation, weak learning atmosphere, inadequate mastery of the subject matter. We innovatively put forward the segmented teaching method in the field of clinical practice skills training. The segmented teaching method refers to dividing a specific teaching content into several relatively independent parts and providing segmented practice for each part. This approach enhances students’ learning outcomes.The aim of this controlled study is to investigate the effects of the segmented teaching methods on clinical practice skills training in medical students.Methods31 medical students participating in clinical practice skill training at The First Affiliated Hospital of University of South China from March to April 2024 were randomly assigned to either the experimental group (n = 16) receiving segmented teaching method or the control group (n = 15) receiving traditional teaching method. After completion of practical exercises, both groups underwent operational assessments, theoretical assessments, Mini-Clinical Evaluation Exercise (Mini-CEX), and Student Evaluation of Educational Quality (SEEQ) for teaching quality evaluation. A comparative analysis of the results between the two groups was conducted.ResultsAfter implementing the program, there were no statistically significant differences (P > 0.05) between the experimental and control groups in theoretical assessment scores, Mini-CEX clinical judgment scores, and SEEQ teaching quality evaluation scores. However, compared to the control group, the experimental group demonstrated better operational assessment scores, higher Mini-CEX scores in history taking, physical examination, professionalism, doctor-patient communication, organizational efficiency, and comprehensive abilities, with statistically significant differences (P < 0.05).ConclusionThe application of segmented teaching method in clinical practice skill training for medical students yields favorable training outcomes.

Comparison of Flavor Differences between the Juices and Wines of Four Strawberry Cultivars Using Two-Dimensional Gas Chromatography-Time-of-Flight Mass Spectrometry and Sensory Evaluation

Fruit wine production is a practical approach for extending the shelf life and enhancing the value of strawberries (Fragaria × ananassa). Fruit cultivars and juices are important sources of volatile organic compounds (VOCs) that determine fruit wine sensory quality. In this study, VOCs in the juices and wines of four strawberry cultivars were identified using two-dimensional gas chromatography-time-of-flight mass spectrometry, and a sensory analysis of the wines was performed. A total of 1028 VOCs were detected. PCA and OPLS-DA distinguished the four cultivars from which the juices and wines were made. Six VOCs with variable importance in projection values greater than one were the main aroma and flavor components of strawberry wines. ZJ wine had the highest sensory scores for coordination (9.0) and overall evaluation (8.9) among the 18 descriptors of strawberry wine evaluated. Overall, the ZJ wine had the highest alcohol content (13.25 ± 0.59%, v/v) and sensory evaluation score, indicating that the ZJ cultivar is more suitable for fermentation. This study reflects the differences between wines made from four strawberry cultivars and provides a reference for brewing fruit wines.

Screening of Sensorial and Inflammatory Changes in Patients Submitted to Orthognathic Surgery.

Despite the high levels of success after orthognathic surgery, the immediate postoperative pain and edema, besides the neurosensorial deficits, are common complications. This study aimed to evaluate the pattern of sensory and inflammatory responses in patients undergoing orthognathic surgery. This prospective observational study included 20 patients undergoing bimaxillary orthognathic surgery, who were evaluated in the preoperative period and on Days 1, 2, 3, 4, 5, 6, 7, and 30 after surgery, using a battery of tests to assess sensorial and inflammatory changes. Subjective and objective evaluations of edema indicated a trend toward edema resolution within 30 days, with a significant decrease in mouth opening on days 1, 7, and 30 after surgery. Regarding nasal obstruction, a significant increase in Nasal Obstruction Symptom Evaluation (NOSE) scores was demonstrated on the first, second, and third days, returning to preoperative levels after 30 days. There was a significant increase in visual analogic scale (VAS) scores from the first to the seventh day after surgery, with a reduction within 30 days. For mechanical and thermal sensitivity tests, the lower lip and chin regions had poorer results, without recovery after 30 days. Positive correlations were observed between painful and inflammatory parameters, as well as between subjective and objective evaluations. Analysis of saliva biomarkers did not show significant differences for pre- and postoperative CCL3 or CCL4 levels. Data provide new evidence about the early inflammatory and sensorial complications after orthognathic surgery.

Service priority classification using machine learning

This article details a procedure for classifying service cases with various priority levels based on machine learning (ML). It accurately defines the priority level of each service case. The presence of imbalanced datasets in service cases poses a challenge for achieving reliable classification accuracy. To address this, the use of the synthetic minority over-sampling technique (SMOTE) was proposed as the method for balancing the datasets prior to applying the ML method. From these experimental results, an improvement in the precision of the learning process was observed, which led to better outcomes in the test sets. This improvement was measured using the efficiency metrics from the confusion matrix. The experiment involved 6,182 service cases, categorized into four levels: critical, serious, moderate, and low. These were based on test comparisons with other ML methods. The accuracy achieved in the test data was 94.37%. By employing a hybrid technique to address the imbalance in SMOTE and the support vector machine model, it was found to be more effective than the comparative term frequency-inverse document frequency model that was used in conjunction with cosine similarity, which achieved an evaluation score of 70.14%.

PST-Diff: Achieving High-Consistency Stain Transfer by Diffusion Models With Pathological and Structural Constraints.

Histopathological examinations heavily rely on hematoxylin and eosin (HE) and immunohistochemistry (IHC) staining. IHC staining can offer more accurate diagnostic details but it brings significant financial and time costs. Furthermore, either re-staining HE-stained slides or using adjacent slides for IHC may compromise the accuracy of pathological diagnosis due to information loss. To address these challenges, we develop PST-Diff, a method for generating virtual IHC images from HE images based on diffusion models, which allows pathologists to simultaneously view multiple staining results from the same tissue slide. To maintain the pathological consistency of the stain transfer, we propose the asymmetric attention mechanism (AAM) and latent transfer (LT) module in PST-Diff. Specifically, the AAM can retain more local pathological information of the source domain images, while ensuring the model's flexibility in generating virtual stained images that highly confirm to the target domain. Subsequently, the LT module transfers the implicit representations across different domains, effectively alleviating the bias introduced by direct connection and further enhancing the pathological consistency of PST-Diff. Furthermore, to maintain the structural consistency of the stain transfer, the conditional frequency guidance (CFG) module is proposed to precisely control image generation and preserve structural details according to the frequency recovery process. To conclude, the pathological and structural consistency constraints provide PST-Diff with effectiveness and superior generalization in generating stable and functionally pathological IHC images with the best evaluation score. In general, PST-Diff offers prospective application in clinical virtual staining and pathological image analysis.

Increased Postoperative Deltoid Signal seen after Suprapectoral Biceps Tenodesis: Potential Risk to the Anterior Branch of the Axillary Nerve

BackgroundArthroscopic suprapectoral biceps tenodesis is a common procedure for lesions of the long head of the biceps in the setting of anterior shoulder pain. However, the distal portal poses a theoretical risk to the terminal branches of the axillary nerve as the nerve travels from posterior to anterior to innervate the anterior deltoid. The purpose of this retrospective cohort study was to assess for axillary nerve branch injury, identified by deltoid signal change in postoperative magnetic resonance imaging (MRI) in patients who underwent an arthroscopic suprapectoral biceps tenodesis. MethodsPatients who underwent rotator cuff repair with a concomitant arthroscopic suprapectoral biceps tenodesis, had a postoperative MRI, and at least 1 year of follow-up were included. The incidence of increased deltoid signal consistent with injury to an anterior branch of the axillary nerve on proton density fat saturated sequences was collected. Age, sex, body mass index (BMI), and patient reported outcome measures (PROMs) including the American Shoulder and Elbow Surgeons Shoulder Score (ASES) score, Patient-Reported Outcomes Measurement Information System (PROMIS) pain, physical function (PF), and upper extremity (UE) scores, and Single Assessment Numeric Evaluation (SANE) score were compared in patients with and without increased deltoid signal on postoperative MRI. P<0.05 was used for significance. ResultsTwenty-four patients were eligible for inclusion (9 female, average age 59.0±10.1, BMI 27.6±6.7). Edema-like signal within the anterior deltoid musculature was observed in 9 patients on postoperative MRI. Two patients had a second follow-up MRI performed which demonstrated resolution of signal, and one patient required a second surgery for release of adhesions. Patients with increased deltoid signal had higher BMI (p=0.03). There was no difference in any other demographic or postoperative PROM between patients with increased signal and those without at any follow-up time point. No patient demonstrated persistent weakness or numbness in the axillary nerve distribution at final follow-up. DiscussionOver one third of patients in our cohort had MRI evidence of axillary nerve branch injury as seen on proton density fat saturated MRI sequences postoperatively. The distal arthroscopic portal for a suprapectoral biceps tenodesis may place anterior terminal branches of the axillary nerve at risk for injury. Additional investigation and strategies for avoidance of nerve injury in this area should be pursued.

Practice variation in induction of labor: A critical document analysis on the contribution of regional protocols.

Despite national guidelines with recommendations on induction of labor (IOL), large variation in the use of this intervention exists between regions in the Netherlands. Guidelines are translated into protocols, which give a contextual description of medical practice provided in a given region. Possibly, protocols developed by regional multidisciplinary maternity care networks (MCNs) contribute to the regional variation in IOL. The aim of this study was to assess the variation between regional protocols and national guidelines regarding recommendations on IOL and the extent to which this contributes to practice variation. We performed a systematic document analysis using the Ready materials, Extract data, Analyze, Distil (READ) approach. National guidelines (n = 4) and regional protocols (n = 18) from six MCNs on topics linked to IOL were assessed between October 2021 and April 2022. An analytical framework was used to extract data for the comparison of regional protocols. Some MCNs followed all the recommendations of national guidelines in their regional protocols, others developed their own recommendations, and for some this varied per topic. When developing their own recommendations, MCNs with a high percentage of IOL added additional risk factors and stricter cut-off values. In contrast, MCNs with a low percentage of IOL added more care options for continuing midwife-led care. No clear relationship was observed between the Appraisal of Guidelines for Research & Evaluation (AGREE) scores of the national guidelines and the extent to which regional protocols complied with the recommendations. The translation of national guidelines to regional protocols seemed arbitrary and not very systematic. To reduce unwarranted practice variation in the use of IOL, guidance is needed to better align regional protocols with national guidelines, while including appropriate contextual factors and allowing women's preferences. Additionally, healthcare providers should be trained in practicing evidence-based medicine instead of using evidence.

A Comparison Between Volar Locking Plates and Percutaneous Pinning in the Treatment of Distal Radius Fractures: A Systematic Review

Percutaneous fixation with Kirschner wires and open reduction and internal fixation with volar locking plates are the most common surgical techniques for managing distal radius fractures (DRFs). As the superiority of either technique is yet to be established, we aimed to conduct an updated systematic review to compare these techniques for the optimal management of unstable DRFs. We conducted a comprehensive literature search to identify studies comparing fixation outcomes for DRFs between groups treated with Kirschner wires and those treated with volar locking plates. Only randomized controlled trials (RCTs) were included. The revised Cochrane risk-of-bias tool was used to assess the methodological quality of RCTs. Meta-analyses were performed only on outcome measures that were reported at the same time points using the same metrics across three or more RCTs. Evaluated outcomes included the Disabilities of the Arm, Shoulder, and Hand (DASH) score, grip strength, wrist range of motion, and radiological outcomes. We also assessed the Patient-Rated Wrist Evaluation (PRWE) score and incidence of complications. Fourteen RCTs with 2,226 patients were included in the meta-analysis. DASH scores were significantly lower in the plating group at all time points. PRWE outcomes favored the plating group at follow-ups greater than 1 year. There were no significant differences in radiological outcomes or incidence of complications between the two groups. Although the plating group provided marginally better functional outcomes at 1 year after surgery, the K-wire group remained a viable alternative. The reported differences should be interpreted cautiously because of the inherent variability of the included RCTs. High-quality RCTs with strict inclusion criteria and standard postoperative protocols are essential to generalize our results across all age groups and fracture types to overcome our study's limitations. Therapy/Prevention, Etiology/Harm II.

Functional evaluation after cortical button fixation for distal biceps ruptures - Is there any difference between manual or non-manual workers?

Background: This study aims to compare clinical and functional results after distal biceps tendon repair in manual workers vs. non-manual workers.Methods: This is a retrospective comparative study which refers to 57 cases with distal biceps tendon rupture, divided in manual workers (24 elbows) and non-manual workers (33), that were treated by a single incision with cortical button and interference screw fixation. Included cases have a minimum of 3 months follow-up, post-operative x-ray and signed informed consent for the investigation.Results: Supination and flexion strength was higher in manual workers vs. non-manual workers (p-value 0,192 and 0,878, respectively). Nine patients showed loss of range of motion, concerning supination and pronation, and this was correlated to worse functional scores. Functional scores tend to be superior in non-manual workers. Ten patients had heterotopic ossification and 20 patients reported lateral antebrachial cutaneous nerve neuropraxia; one had both. Most of them had a full recovery.Conclusion: According to clinical evaluation and postoperative scores, the performed surgical procedure provides good to excellent mid-term functional results. Nevertheless, there were not any differences between manual or non-manual workers.

Comparison of surgical and conservative therapy in older patients with distal radius fracture: a prospective randomized clinic al trial

IntroductionThe distal radius fracture is considered the most common fracture in humans. For fractures classified as Arbeitsgemeinschaft für Osteosynthese (AO) 23-C1 + C2, there is no consensus on treatment in older patients due to inconsistent study results. The aim of this study was to compare conservative and surgical treatment in relation to wrist function and satisfaction in patients older than 65 years.MethodsIn this prospective randomized clinical trial, patients aged older than 65 years who suffered an isolated AO-classified C1 or C2 distal radius fracture were randomized to surgical treatment using palmar plate osteosynthesis or conservative treatment. Patient-rated wrist evaluation (PRWE) score and disabilities of arm, shoulder, and hand (DASH) was assessed 3, 6 and 12 months post-interventionally. Satisfaction, range of motion (ROM) and pain scores were evaluated at 6 weeks and 3, 6 and 12 months post-interventionally.ResultsA total of 80 patients with a mean age of 77.3 years (± 6.1 years) in the conservative group and 72.5 years (± 5.3 years) in the surgery group were included. Both the PRWE score, and the DASH score showed a statistically significant difference between the two groups after 3 months, 6 months and 12 months (p < 0.001). Patients in the surgical cohort showed a statistically significant higher satisfaction at the 6-week, 6-month and 12-month follow-up (p < 0.001 6 weeks + 12 months; p = 0.004 6 months).ConclusionIn this prospective randomized study, surgical treatment proved to be superior to conservative treatment in terms of the primary outcome variable PRWE score. Satisfaction was significantly better in the surgical group.