Spearman Rank-order Test Research Articles

Cross-cultural adaptation and validation of the Pittsburgh Sleep Quality Index (PSQI) in the Igbo language

BackgroundSleep disturbances are associated with decreased quality of life, increased use of healthcare resources, and poor mood. The Pittsburgh Sleep Quality Index (PSQI) is a standardised questionnaire that was created to help measure sleep quality and to alert medical professionals to the need for additional evaluation of patients exhibiting sleep-related complaints in seven domains based on the previous month. The non-availability of the Igbo version can affect its effective use among Igbo speakers in Southeast Nigeria.AimTo translate and cross-culturally adapt the PSQI scale to the Igbo Culture and Environment among Igbo language speakers in Southeast Nigeria using established guidelines.MethodThe PSQI was translated, combined, back-translated, and reviewed by an expert panel, leading to the development of the final Igbo version (I-PSQI). A sample size of 100 was calculated using G-power, and the PSQI and I-PSQI were distributed to 100 apparently healthy adults (40% males and 60% females) recruited conveniently in Otolo Nnewi, Nigeria. The data were analysed using frequency counts, percentages, means, standard deviations, Spearman rank order tests, Cronbach’s alpha, and principal component analysis (PCA). The level of significance was set at 0.05.ResultsThere was no statistically significant difference observed between the PSQI and I-PSQI scores (p < 0.001). The correlations between the corresponding domains and total scores on both versions of the PSQI were excellent (ρ = 0.86–1.0). The Cronbach’s alpha value of the I-PSQI was 0.7, indicating acceptable internal consistency between the items on the I-PSQI.ConclusionThe I-PSQI proved to be a valid and reliable instrument, making it suitable for assessing sleep quality among Igbo language speakers.

The Igbo version of the Global Physical Activity Questionnaire (GPAQ)- A cross-cultural adaptation study

BackgroundPhysical activity (PA) plays a critical role in preventing non-communicable diseases, and maintaining the overall health and well-being of adults. PA surveillance has become a global concern leading to the development of numerous surveys for its measurement. Global Physical Activity Questionnaire (GPAQ) merges the advantages of both the short and long versions of the International Physical Activity Questionnaire (IPAQ) by incorporating various domains (work, transport, and leisure time), while still maintaining a significantly shorter length. This study aimed to cross-culturally adapt the original English version of GPAQ to the Igbo culture and environment.MethodsThe original version of GPAQ (GPAQ) was translated, synthesized, back-translated, and subjected to expert panel review before producing the final Igbo version of the GPAQ (GPAQ-I). The GPAQ and GPAQ-I were administered to 155 community-dwelling adults (36.1% males and 63.9% females) living in Nnewi who were recruited consecutively. The data obtained was analyzed using frequency counts, percentages, mean, standard deviations, Spearman rank order test, and Mann-Whitney U test with p-value set at 0.05.ResultsThere was no significant difference in the scores on the English and Igbo versions of the GPAQ (p < 0.001). The correlations between the corresponding domains and total scores on both versions of the GPAQ (rho = 1.0)showed excellent concurrent agreement.ConclusionThe successfully adapted GPAQ-I demonstrated a strong agreement with the original English version. Further psychometric testing is required to fully establish its internal consistency, reliability, and validity.

Ocular residual astigmatism (ORA) does not seem to correlate with baseline refractive error among refractive surgery candidates.

Ocular residual astigmatism (ORA) is defined as the difference between refractive astigmatism and anterior corneal astigmatism. A high ORA may be correlated with poorer results in patients undergoing corneal-based laser surgery. Is a high baseline refractive error related to a higher degree of ORA? This was a retrospective analytical study including 181 right eyes of an equal number of refractive surgery candidates. Manifest subjective refraction was measured, along with a Pentacam AXL Wave corneal tomography. Via a vector analysis with this methodology, subjective cylinder was translated into the corneal plane and a vectorial subtraction was performed in order to measure ORA. Spearman's rank order test, one-way ANOVA and Chi-square were used to determine whether different levels of baseline refractive error correlate with different levels of ORA. Mean age was 28.33 ± 4.71years with a female preponderance (65.7%). Mean ORA was 0.74 ± 0.39 D, with 33.1% of eyes having an ORA ≥ 0.90 D. There was not a correlation between ORA and level of myopia (rho = - 0.022; p = 0.764), nor between ORA and spherical equivalent (rho = 0.009; p = 0.903). Refractive astigmatism did not demonstrate to be correlated with ORA level either (rho = 0.078; p = 0.329). One-way ANOVA tests failed to demonstrate an association between different classifications of refractive error and level of ORA. In the studied population, ORA is not correlated with baseline refractive error. Every patient presenting for possible corneal-based laser refractive surgery should be evaluated for a possible high level of ORA, irrespective of their baseline ametropia level.

PNPLA3 rs738409 risk genotype decouples TyG index from HOMA2-IR and intrahepatic lipid content

BackgroundRecent reports suggested a different predictive value for TyG index compared to HOMA-IR in coronary artery calcification (CAC) and other atherosclerotic outcomes, despite that both indices are proposed as surrogate markers of insulin resistance. We hypothesized a key role for liver pathology as an explanation and therefore assessed the relationship among the two indices and the intrahepatic lipid content stratified by PNPLA3 rs738409 genotypes as a known non-alcoholic fatty liver disease (NAFLD) genetic risk.MethodsThirty-nine women from a prior GDM-genetic study were recalled with PNPLA3 rs738409 CC and GG genotypes for metabolic phenotyping and to assess hepatic triglyceride content (HTGC). 75 g OGTT was performed, fasting lipid, glucose, insulin levels and calculated insulin resistance indices (TyG and HOMA2-IR) were used. HTGC was measured by MR based methods. Mann–Whitney-U, χ2 and for the correlation analysis Spearman rank order tests were applied.ResultsThe PNPLA3 rs738409 genotype had a significant effect on the direct correlation between the HOMA2-IR and TyG index: the correlation (R = 0.52, p = 0.0054) found in the CC group was completely abolished in those with the GG (NAFLD) risk genotype. In addition, the HOMA2-IR correlated with HTGC in the entire study population (R = 0.69, p < 0.0001) and also separately in both genotypes (CC R = 0.62, p = 0.0006, GG: R = 0.74, p = 0.0058). In contrast, the correlation between TyG index and HTGC was only significant in rs738409 CC genotype group (R = 0.42, p = 0.0284) but not in GG group. A similar pattern was observed in the correlation between TG and HTGC (CC: R = 0.41, p = 0.0335), when the components of the TyG index were separately assessed.ConclusionsPNPLA3 rs738409 risk genotype completely decoupled the direct correlation between two surrogate markers of insulin resistance: TyG and HOMA2-IR confirming our hypothesis. The liver lipid content increased in parallel with the HOMA2-IR independent of genotype, in contrast to the TyG index where the risk genotype abolished the correlation. This phenomenon seems to be related to the nature of hepatic fat accumulation and to the different concepts establishing the two insulin resistance markers.

Employees' Perception of Organizational Readiness for Business Continuity During the Pandemic

Purpose of the study: The study aimed to determine employee perception of organisational readiness for Business Continuity during the Pandemic. Design/methodology/approach: A cross-sectional survey was conducted among Mr. Price's employees at the head office. A total of 1,500 online questionnaires were distributed to employees via Google Forms. A Spearman rank order test was conducted to determine the correlational relationships between the variables. Findings: The findings of this study indicate that the Mr. Price Group has made adequate preparations for ensuring business continuity throughout the pandemic. The use of remote working as a strategy for business continuity management (BCM) was enthusiastically accepted by workers. The participants expressed their appreciation for the ease of access to resources, the prominent presence of digital leadership in a remote work environment, and the effective business continuity plan that facilitated their transition to remote work. There was a favorable correlation seen between employees' assessment of organisational preparedness and their level of engagement in remote work. Recommendations/value: The study identified crucial components that can be integrated into remote working conditions. By extension of the study findings, it recommended that research is conducted to examine the effects of remote working on the overall well-being of employees. Furthermore, it is important to explore the moderating factors that influenced their overall experience. Managerial implications: The research study provides illuminating findings for the retail sector that can be useful to both HR academics and practitioners. As they endeavor towards the creation of sustainable remote working conditions as a business continuity management tool.

An Ecological Study Assessing the Relationship between Public Health Policies and Severity of the COVID-19 Pandemic.

Reliance on government-led policies have heightened during the COVID-19 pandemic. Further research on the policies associated with outcomes other than mortality rates remains warranted. We aimed to determine associations between government public health policies on the severity of the COVID-19 pandemic. This ecological study including countries reporting ≥25 daily COVID-related deaths until end May 2020, utilised public data on policy indicators described by the Blavatnik school of Government. Associations between policy indicators and severity of the pandemic (mean mortality rate, time to peak, peak deaths per 100,000, cumulative deaths after peak per 100,000 and ratio of mean slope of the descending curve to mean slope of the ascending curve) were measured using Spearman rank-order tests. Analyses were stratified for age, income and region. Among 22 countries, containment policies such as school closures appeared effective in younger populations (rs = −0.620, p = 0.042) and debt/contract relief in older populations (rs = −0.743, p = 0.009) when assessing peak deaths per 100,000. In European countries, containment policies were generally associated with good outcomes. In non-European countries, school closures were associated with mostly good outcomes (rs = −0.757, p = 0.049 for mean mortality rate). In high-income countries, health system policies were generally effective, contrasting to low-income countries. Containment policies may be effective in younger populations or in high-income or European countries. Health system policies have been most effective in high-income countries.

Amide proton transfer-weighted MRI in the clinical setting – correlation with dynamic susceptibility contrast perfusion in the post-treatment imaging of adult glioma patients at 3T

IntroductionWe investigated the correlation between amide proton transfer-weighted magnetic resonance imaging (APTw MRI) and dynamic susceptibility contrast (DSC) perfusion in order to assess the potential of APTw MRI as an alternative to DSC in adult brain tumor (glioma) imaging. MethodsAfter Ethical Committee approval, forty adult patients, treated for histopathologically confirmed glioma (World Health Organization (WHO) grade II-IV), were prospectively imaged at 3 Tesla (3 T) with DSC perfusion and a commercially available three-dimensional (3D) APTw sequence. Two consultant neuroradiologists independently performed region of interest (ROI) measurements on relative cerebral blood volume (rCBV) and APTw maps, co-registered with anatomical images. The correlation APTw MRI-DSC perfusion was assessed using Spearman's rank-order test. Inter-observer agreement was evaluated by the intraclass correlation coefficient (ICC) and Bland-Altman (BA) plots. ResultsA statistically significant moderately strong positive correlation was observed between maximum rCBV (rCBVmax) and maximum APTw (APTwmax) values (observer 1: r = 0.73; p < 0.01; observer 2: r = 0.62; p < 0.01). We found good inter-observer agreement for APTwmax (ICC = 0.82; 95% confidence interval (CI) 0.66–0.90), with somewhat broad outer 95% CI for the BA Limits of Agreement (LoA) (−1.6 to 1.9). ICC for APTwmax was higher than ICC for rCBVmax (ICC = 0.74; 95%; CI 0.50–0.86), but the difference was not statistically significant. ConclusionAPTwmax values correlate positively with rCBVmax in patients treated for brain glioma. APTw imaging is a reproducible technique, with some observer dependence. Results need to be confirmed by a larger population analysis. Implications for practiceAPTw MRI can be a useful addition to glioma follow-up imaging and a potential alternative to DSC perfusion, especially in patients where contrast agent is contraindicated.

Pulse Wave Imaging Coupled With Vector Flow Mapping: A Phantom, Simulation, and In Vivo Study.

Pulse wave imaging (PWI) is an ultrasound imaging modality that estimates the wall stiffness of an imaged arterial segment by tracking the pulse wave propagation. The aim of the present study is to integrate PWI with vector flow imaging, enabling simultaneous and co-localized mapping of vessel wall mechanical properties and 2-D flow patterns. Two vector flow imaging techniques were implemented using the PWI acquisition sequence: 1) multiangle vector Doppler and 2) a cross-correlation-based vector flow imaging (CC VFI) method. The two vector flow imaging techniques were evaluated in vitro using a vessel phantom with an embedded plaque, along with spatially registered fluid structure interaction (FSI) simulations with the same geometry and inlet flow as the phantom setup. The flow magnitude and vector direction obtained through simulations and phantom experiments were compared in a prestenotic and stenotic segment of the phantom and at five different time frames. In most comparisons, CC VFI provided significantly lower bias or precision than the vector Doppler method ( ) indicating better performance. In addition, the proposed technique was applied to the carotid arteries of nonatherosclerotic subjects of different ages to investigate the relationship between PWI-derived compliance of the arterial wall and flow velocity in vivo. Spearman's rank-order test revealed positive correlation between compliance and peak flow velocity magnitude ( rs = 0.90 and ), while significantly lower compliance ( ) and lower peak flow velocity magnitude ( ) were determined in older (54-73 y.o.) compared with young (24-32 y.o.) subjects. Finally, initial feasibility was shown in an atherosclerotic common carotid artery in vivo. The proposed imaging modality successfully provided information on blood flow patterns and arterial wall stiffness and is expected to provide additional insight in studying carotid artery biomechanics, as well as aid in carotid artery disease diagnosis and monitoring.

Dosimetric assessment of the impact of low-cost materials used in stereolithography in high-dose-rate brachytherapy.

Purpose3D printing has become a popular and widely available technique of rapid prototyping. The impact of used materials on the dose distribution has been studied for high energy sources. However, brachytherapy sources emit lower energy photons, and materials used in 3D printing may differ. This study was conducted to analyze the influence of common materials (polylactic acid – PLA and acrylonitrile butadiene styrene – ABS) used in stereolithography.Material and methodsA 3D-printed phantom was designed, printed, and used to calibrate Gafchromic films. In the next step, a range of 1 mm thick plates of PLA and ABS (from zero to thirty) were inserted between source and detector to measure the impact of studied materials on delivered dose. Measurements were performed using a calibrated radiochromic film and Farmer ionization chamber in water.ResultsNo statistically significant correlation (p = 0.4854) between the thickness of inserted PLA and the dose delivered to the film was obtained. With ionization chamber, Spearman’s rank order test showed a significant correlation (p = 0.00004); however, the correlation was found weak. In case of ABS measurement, a statistically significant (p = 0.0159), yet weak negative correlation was found between the thickness of used material and the dose delivered to the film. On the other hand, a weak statistically significant (p = 0.0212) but positive correlation was found when the dose was measured with Farmer ionization chamber. We find these correlations false, as all measured doses were within the measurement uncertainty range (film ±8.0%, Farmer ±8.8%) from 100% of the prescribed dose.ConclusionsAccording to obtained results, with the accuracy of measurement under clinical conditions, the impact of highly filled PLA and ABS printed objects on the dose distribution from an 192Ir source in water can be omitted.

Photographic sagittal plane analysis and its clinical correlation after surgery for adult spinal deformity: a preliminary study.

The aim of this study is to determine the correlation between photographic sagittal parameters and patient-reported outcome measures (PROM) results in adult patients operated on spinal deformity. Non-concurrent prospective study. age at surgery older than 25, minimum 2-year follow-up after a 5 or more level fusion for adult spinal deformity (ASD). Full body lateral standing photographs were taken with adhesive markers placed on ten bony landmarks. SRS-22 and SF-36 questionnaires were completed for every patient. The following photographic parameters were measured: lumbar angle, lumbar curve, thoracic inclination (TI), trunk angle, pelvic tilt, head angle, neck angle, cervicothoracic angle, lumbar vector angle (LVA), dorsal vector angle (DVA), cervical vector angle (CVA), cranial pelvic angle (CrPA), cranial sacral angle (CrSA), fibular inclination angle (FIA) and cranial sagittal vertical axis measured to sacrum (Cr-S), greater trochanter (Cr-GT), knee (Cr-K) and ankle (Cr-A). 65 patients (58 female) operated on ASD in a single institution were included. Age at surgery was 61years (26-67). Postoperative follow-up was 53months (24-120). Spearman rank order test showed several significant (p ≤ 0.01) correlations. After multivariate linear regression analysis age, LVA and TI remained as predictors for SRS image scores (corrected r2 0.41), LVA for SRS satisfaction (corrected r2 0.27), CrPA and age for SRS total scores (corrected r2 0.33), FIA and age for SF36 physical functioning (corrected r2 0.36) and CrSA for SF36 role physical (corrected r2 0.14). Some sagittal photographic parameters may predict mid-term clinical results after ASD surgery.

An Ecological Study Assessing the Relationship between Public Health Policies and Severity of the COVID-19 Pandemic

Background: The COVID-19 pandemic has claimed almost half a million deaths worldwide. Reliance on government-led policies have been heightened during the pandemic to mitigate the spread of disease. Which of these policies are associated with important outcomes other than mortality rates remains unknown. Hence, we aimed to determine the associations between government public health policies on the severity of the COVID-19 pandemic. Methods: This ecological study utilised publicly accessible data on seventeen policy indicators of Containment, Economic and Health systems and their respective Stringency Index described by the Blavatnik school of Government. Countries reporting >25 daily COVID-related deaths until end May 2020 were included. We assessed the association of individual SI with the profile of severity of COVID-19 by using several outcomes; mean mortality rate, time to peak, peak deaths per 100,000 population, cumulative deaths after peak per 100,000 population and ratio of the mean slope of the descending curve to the mean slope of the ascending curve. Analyses were stratified according to age, income and region. Spearman rank-order tests were employed to measure associations. Results were presented descriptively and direct comparisons were made. Findings: Twenty-two countries were included. Containment policies appeared more effective in younger populations and debt/contract relief in older populations. In European countries, containment policies were generally associated with good outcomes. In non-European countries, school closures alone had the strongest association with most of the outcomes examined. In high-income countries, health system policies such as public information campaigns and testing were generally effective, in contrast to low-income countries. Interpretation: Containment policies may be effective when targeted towards younger populations and occur in high-income or European countries. Health system policies have not been as effective in low-income and non-European countries.Funding Statement: None.Declaration of Interests: None.Ethics Approval Statement: Due to the ecological study design and the use of publicly accessible data, ethical approval was not required.

Gender Gap in Industry Relationships and Scholarly Impact Among Academic Urologists in the United States

ObjectivesTo examine the distribution of industry payments to male and female academic urologists and the relationship between industry funding, academic rank, and scholarly impact. Material and MethodsAcademic urologists from 131 programs with publicly available websites were compiled. Gender, rank, fellowship training, and scholarly impact metrics were recorded. Data from the 2016 Centers for Medicare and Medicaid Services Open Payments database were paired with faculty names. Comparisons were made using Fisher's Exact, Wilcoxon Rank Sum, and Spearman's Rank-Order tests. Multivariable logistic regression modeling identified predictors of receiving payments in the top quintile. ResultsAmong 1,657 academic urologists, males comprised 84%. While there were no gender differences in the number of urologists listed in the Open Payments Database, males received more total funding (P < .001) and higher median general payments per capita (P < .03). Males also received higher proportions of research funding (P = .002), speaker fees (P = .03), education fees (P = .03) and higher median consulting fees (P = .003). Overall, males had higher scholarly impact (P < .001), which correlated with total industry payments (rho = 0.27, P < .001). Predictors of accepting the top quintile payments include male gender, associate professorship and H-index score ≥10. ConclusionMost academic urologists accepted at least one industry payment in 2016, but males received more funding than females. There is a positive correlation between total industry payments, H-index, and total publications. More research is needed to understand why gender and scholarly productivity are associated with higher payouts. This is another important area that may influence career advancement and compensation for female urologists.

Trends in Weight among Undergraduate Students in a Northeast Public University

Objective: Increasing BMI, overweight, and obesity are urgent and grave problems in the US. The goal of this study is to begin to understand trends in overweight and obesity among undergraduate students in the U.S. to assist in informing public health education and health promotion practices. Methods: Data on self-reported weight and height were collected in 2012, 2014, and 2016 from randomly selected college students who were enrolled in a public university in Northeast US. Spearman's Rank Order Test was used to evaluate trends within specific demographic categories. Results: BMI increased for almost all students from 2012-2016. Groups with significant increases in BMI included: males, females, sophomores, and seniors. Conclusions: Results suggest the need for interventions to reduce increases in overweight and obesity that are experienced during college years. College is a critical transitional time when students adopt health behaviors that they continue into adulthood. Increasing BMI in college students indicates a need for additional research to understand the factors that contribute to the increasing trend of overweight and obesity in this population. College is an optimal setting for implementation of effective interventions that can help prevent BMI increases in this population and establish healthy behaviors for the future.

Root canal isthmi and interorifice distance in human permanent teeth of an Indian subpopulation using cone-beam computed tomography: A retrospective cross-sectional study.

Objective:The aim of the study was to evaluate the prevalence of root canal isthmus (RCI) and measure the interorifice distance (IOD) between the root canals. Additionally to correlate IOD with the RCI in human permanent teeth using conebeam computed tomography (CBCT) in an Indian sub-population (Chennai).Materials and Methods:A total of 5881 teeth from 280 CBCT full mouth scans were analyzed. The presence or absence of complete and incomplete RCI of each tooth was identified using the map-reading strategy. IOD was calculated by measuring the distance between the center of each root canal orifice to that of the center of the adjacent orifice at the level of the cementoenamel junction using the axial and sagittal sections. Chi-square analysis and correlation statistics using Spearman's rank-order test was done (P < 0.05).Results:High prevalence of RCI was found in maxillary first premolars, mesial root of mandibular molars, and mesiobuccal root of maxillary first molars, while its prevalence was low in maxillary canines and mandibular premolars and absent in maxillary incisors. RCI was predominantly seen in the cervical and middle third of the root canal in all the teeth evaluated. A weak negative correlation was established between the IOD and RCI for maxillary premolars, whereas a weak positive correlation was seen in maxillary first molars and mandibular second molars.Conclusion:The prevalence of RCI was high in the posterior teeth in comparison to the anterior teeth in the present study. There was no strong correlation between IOD and RCI in all the teeth evaluated.

The relationship between trained ratings and untrained listeners’ judgments of global coherence in extended monologues

ABSTRACTBackground: Global coherence rating scales have been used by a number of researchers to examine spoken discourse in populations with and without acquired neurogenic communication disorders. The 4-point global coherence (GC) scale in the current study has demonstrated reliability and convergent validity. However, we have not yet established how a global coherence rating corresponds to functional communication.Aims: The current study explores the clinical meaningfulness of the 4-point GC rating scale. Survey questions and ratings were developed to examine discourse quality and functional coherence as perceived by untrained listeners. Ratings by untrained listeners were compared to trained discourse ratings using the established 4-point GC scale.Methods and Procedures: Twelve discourse samples, scored by a trained rater, were selected for the current study from a previously collected set of discourse transcripts. Transcripts were extended monologues in response to one of four possible open-ended questions that were re-recorded by the trained rater to remove any distracting features of the original recordings, such as articulatory errors. Twenty-four untrained listeners rated the discourse samples using a short questionnaire that included questions for each sample about: topic maintenance, inclusion of unnecessary information, and the listener level of interest and attention. Questions for untrained listeners were based on operational definitions of global coherence and discourse quality respectively. These untrained ratings were compared to trained ratings of global coherence. Outcome measures were compared using non-parametric tests and a Spearman Rank Order test was also used to examine relationships among variables.Main Contribution: Untrained listeners’ ratings for topic maintenance and inclusion of unnecessary information were significantly different between trained low, medium, and high global coherence ratings. Topic maintenance and inclusion of unnecessary information were also both significantly correlated with global coherence. Untrained listeners’ ratings of their level of interest and attention for a sample were significantly different between trained medium-high and low-high global coherence ratings. Interest and attention ratings were also significantly correlated with ratings of global coherence.Conclusions: Untrained raters did differentiate between levels of global coherence using ratings of topic maintenance, inclusion of unnecessary information, and their level of attention and interest. Global coherence was also significantly correlated with the untrained ratings. These findings provide preliminary external validity for the global coherence scale and support its clinical utility.

Relationship of Glove Arm Kinematics With Established Pitching Kinematic and Kinetic Variables Among Youth Baseball Pitchers.

Background:While the kinematics of the pitching arm, trunk, and pelvis have been described and studied, glove arm kinematics remain an understudied portion of the pitching motion. Baseball pitchers seek to achieve maximum ball velocity in a fashion that does not place the arm at risk of injury.Purpose:To assess the relationship between glove arm shoulder horizontal abduction and elbow flexion and pitching arm kinematics and kinetics among youth pitchers to determine whether recommendations can be made toward a safer pitching motion.Study Design:Descriptive laboratory study.Methods:Thirty-three right-handed youth male baseball pitchers (mean ± SD: age, 13.6 ± 2.0 years; height, 169.4 ± 14.3 cm; weight, 63.5 ± 13.0 kg; experience, 7.3 ± 3.0 years) threw 3 fastballs to a catcher while kinematic data were collected with an electromagnetic tracking system. The Spearman rank-order test was used to identify relationships between glove arm horizontal abduction and glove arm elbow flexion and various kinematics and kinetics found at maximum shoulder external rotation (MER) and ball release for the fastest fastball delivered by each participant.Results:At MER, there were significant relationships found between a more flexed glove arm elbow and increased pitching arm elbow valgus force (rs[31] = –0.52, P = .002), increased pitching arm shoulder anterior force (rs = –0.39, P = .024), and decreased hip velocity (rs[31] = –0.45, P = .009). Additionally, there were significant relationships between greater glove arm horizontal abduction at MER and increased pitching arm humeral velocity (rs[31] = 0.52, P = .002) and increased trunk rotational velocity (rs[31] = 0.40, P = .022) at MER.Conclusion:A more extended glove arm elbow and more horizontally abducted glove arm shoulder at MER could prove to be more advantageous for performance and possibly be a safer motion for the baseball thrower.Clinical Relevance:The orthopaedic community can dictate safer biomechanics when communicating with pitchers, trainers, and pitching coaches.

Social media presence of otolaryngology journals: The past, present, and future.

Evaluate the use of Twitter by otolaryngology journals and determine the relationship between social media altmetrics and measures of academic impact. Cross-sectional analysis. Twitter profiles from the top 50 otolaryngology journals per 2016 SCImago Journal & Country Rank (SJR) were included. Twitter activity for each profile was calculated using Twitonomy analytics and Riffle software. Social media influence was measured using Klout scores. Annual SJR rank and H-Index scores between 2008 and 2016 were recorded for each journal. Associations between social media influence and academic indices were assessed using Wilcoxon rank sum test, Spearman's rank order test, and Pearson correlation coefficients (α = .05). Average SJR was 0.86 ± 0.3 and H-Index was 50.9 ± 24. Eighteen journals had Twitter profiles. Journals with social media accounts had significantly higher SJR (P = .03) and H-Index (P = .01) scores compared to those without. The average Klout score of Twitter profiles was 32.5 ± 13. There was a significant association between a journal's Klout score and SJR rank (P = .004). Older Twitter profiles had higher Klout scores (P = .04). There was a direct relationship between a journal's total Twitter followers and H-Index score (P = .009), and a direct relationship between tweets and academic influence (P = .03 and .01 for SJR and H-Index, respectively). Social media is often underutilized and remains an untapped resource by many journals to increase readership and disseminate research. Journals with social media profiles had significantly higher academic metrics, and among journals with profiles, increased online activity was a predictor for academic influence. Future studies are warranted to elucidate causal relationships. NA. Laryngoscope, 128:363-368, 2018.

Assessment of Corrosion, Fretting, and Material Loss of Retrieved Modular Total Knee Arthroplasties

BackgroundModular junctions in total hip arthroplasties have been associated with fretting, corrosion, and debris release. The purpose of this study is to analyze damage severity in total knee arthroplasties of a single design by qualitative visual assessment and quantitative material loss measurements to evaluate implant performance and patient impact via material loss. MethodsTwenty-two modular knee retrievals of the same manufacturer were identified from an institutional review board–approved database. Junction designs included tapers with an axial screw and tapers with a radial screw. Constructs consisted of 2 metal alloys: CoCr and Ti6Al4V. Components were qualitatively scored and quantitatively measured for corrosion and fretting. Negative values represent adhered material. Statistical differences were analyzed using sign tests. Correlations were tested with a Spearman rank order test (P < .05). ResultsThe median volumetric material loss and the maximum linear depth for the total population were −0.23 mm3 and 5.84 μm, respectively. CoCr components in mixed metal junctions had higher maximum linear depth (P = .007) than corresponding Ti components. Fretting scores of Ti6Al4V alloy components in mixed metal junctions were statistically higher than the remaining groups. Taper angle did not correlate with material loss. ConclusionResults suggest that CoCr components in mixed metal junctions are more vulnerable to corrosion than other components, suggesting preferential corrosion when interfacing with Ti6Al4V. Overall, although corrosion was noted in this series, material loss was low, and none were revised for clinical metal-related reaction. This suggests the clinical impact from corrosion in total knee arthroplasty is low.

Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score

The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this study was to identify possible factors that may explain the variance of pre-operative FJS levels and evaluate the relationship between pre-operative FJS and pre-operative Oxford Knee Score (OKS). Four-hundred and six individual knees undergoing primary TKA between 2014 and 2016 were included in the study. Age, gender, body mass index (BMI), pre-operative FJS and pre-operative OKS were obtained maximum 2 weeks prior to surgery. Kellgren-Lawrence (K-L) grade, alignment and joint space width (JSW) were evaluated on pre-operative radiographs. Mean FJS was 21.1 ± 15.6. Females, younger patients and patients with high BMI had significantly the worst pre-operative FJS (p < 0.005). Females scored 6.5 FJS points lower than males. A 0.2-point increase in FJS for every added year indicated improvement in knee awareness with age. A 0.4-point decrease in FJS points for every added BMI point indicated worse knee awareness with higher BMI. There was a strong positive correlation between pre-operative FJS and pre-operative OKS according to the Spearman's rank order test (p < 0.005). Females, younger patients and patients with high BMI had significantly the worst pre-operative joint awareness. FJS had a strong positive correlation to OKS in pre-operative patients for primary TKA. This information can be used for improved patient selection; clinically continuous low FJS despite weight loss and/or the passing of time may be indication for TKA. Prospective cohort study, Level II.

On the importance of albumin binding for the flux of 7α-hydroxy-3-oxo-4-cholestenoic acid in the brain

We confirmed previous findings by a Japanese group that there is an accumulation of 7α-hydroxy-3-oxo-4-cholestenoic acid (7-Hoca) in human subdural hematomas. The accumulation correlated with the time from the bleeding to the sample collection. We present evidence that these accumulations are likely to be caused by the strong affinity of 7-Hoca to albumin and the marked difference between plasma and brain with respect to levels of albumin. In the circulation, 80-90% of 7-Hoca is bound to albumin with a ratio between the steroid acid and albumin of ∼1.4 ng/mg. In cerebrospinal fluid (CSF), the ratio between 7-Hoca and albumin is ∼30 ng/mg. When albumin or hemolyzed blood in a dialysis bag was exposed to CSF, there was a flux of 7-Hoca from CSF to the albumin. We suggest that the major explanation for accumulation of 7-Hoca in subdural hematoma is a flux from the brain into the hematoma due to the high affinity to albumin and the high capacity of 7-Hoca to pass biomembranes. We discuss the possibility that the markedly different ratios between 7-Hoca and albumin in circulation and brain can explain the flux of 7-Hoca from the brain into circulation against a concentration gradient.