Where Are the Women in Orthopaedic Surgery?

Science.gov (United States)

Rohde, Rachel S; Wolf, Jennifer Moriatis; Adams, Julie E

2016-09-01

Although women account for approximately half of the medical students in the United States, they represent only 13% of orthopaedic surgery residents and 4% of members of the American Academy of Orthopaedic Surgeons (AAOS). Furthermore, a smaller relative percentage of women pursue careers in orthopaedic surgery than in any other subspecialty. Formal investigations regarding the gender discrepancy in choice of orthopaedic surgery are lacking. (1) What reasons do women orthopaedic surgeons cite for why they chose this specialty? (2) What perceptions do women orthopaedic surgeons think might deter other women from pursuing this field? (3) What role does early exposure to orthopaedics and mentorship play in this choice? (4) What professional and personal choices do women in orthopaedics make, and how might this inform students who are choosing a career path? A 21-question survey was emailed to all active, candidate, and resident members of the Ruth Jackson Orthopaedic Society (RJOS, n = 556). RJOS is the oldest surgical women's organization incorporated in the United States. An independent orthopaedic specialty society, RJOS supports leadership training, mentorship, grant opportunities, and advocacy for its members and promotes sex-related musculoskeletal research. Although not all women in orthopaedic practice or training belong to RJOS, it is estimated that 42% of women AAOS fellows are RJOS members. Questions were formulated to determine demographics, practice patterns, and lifestyle choices of women who chose orthopaedic surgery as a specialty. Specifically, we evaluated the respondents' decisions about their careers and their opinions of why more women do not choose this field. For the purpose of this analysis, the influences and dissuaders were divided into three major categories: personal attributes, experience/exposure, and work/life considerations. The most common reasons cited for having chosen orthopaedic surgery were enjoyment of manual tasks (165 of 232

The Effect of an Orthopaedic Surgical Procedure in the National Basketball Association.

Science.gov (United States)

Minhas, Shobhit V; Kester, Benjamin S; Larkin, Kevin E; Hsu, Wellington K

2016-04-01

Professional basketball players have a high incidence of injuries requiring surgical intervention. However, no studies in the current literature have compared postoperative performance outcomes among common injuries to determine high- and low-risk procedures to these athletes' careers. To compare return-to-play (RTP) rates and performance-based outcomes after different orthopaedic procedures in National Basketball Association (NBA) players and to determine which surgeries are associated with the worst postoperative change in performance. Cohort study; Level of evidence, 3. Athletes in the NBA undergoing anterior cruciate ligament reconstruction, Achilles tendon repair, lumbar discectomy, microfracture, meniscus surgery, hand/wrist or foot fracture fixation, and shoulder stabilization were identified through team injury reports and archives on public record. The RTP rate, games played per season, and player efficiency rating (PER) were determined before and after surgery. Statistical analysis was used to compare the change between pre- and postsurgical performance among the different injuries. A total of 348 players were included. The RTP rates were highest in patients with hand/wrist fractures (98.1%; mean age, 27.0 years) and lowest for those with Achilles tears (70.8%; mean age, 28.4 years) (P = .005). Age ≥30 years (odds ratio [OR], 3.85; 95% CI, 1.24-11.91) and body mass index ≥27 kg/m(2) (OR, 3.46; 95% CI, 1.05-11.40) were predictors of not returning to play. Players undergoing Achilles tendon repair and arthroscopic knee surgery had a significantly greater decline in postoperative performance outcomes at the 1- and 3-year time points and had shorter career lengths compared with the other procedures. NBA players undergoing Achilles tendon rupture repair or arthroscopic knee surgery had significantly worse performance postoperatively compared with other orthopaedic procedures. © 2016 The Author(s).

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

Science.gov (United States)

Kuo, Calvin C; Robb, William J

2013-06-01

The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

Do Orthopaedic Surgeons Acknowledge Uncertainty?

Science.gov (United States)

Teunis, Teun; Janssen, Stein; Guitton, Thierry G; Ring, David; Parisien, Robert

2016-06-01

Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decision-making. We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years

Patient compliance and effect of orthopaedic shoes

DEFF Research Database (Denmark)

Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R

1999-01-01

Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed...

Resources for your career in orthopaedic traumatology: what can the OTA do for you?

Science.gov (United States)

Mehta, Samir; Smith, Jeffrey M

2012-09-01

For those choosing a career in orthopaedic traumatology, several resources have been established by the Orthopaedic Trauma Association to facilitate progression from the years in training to the early years in practice. Young practitioners have access to educational programming, such as preparation for Part II of the Board Examination, web-based resources, such as on-line job postings, advocacy in health policy for the issues that will affect their ability to practice, and public relations efforts to increase their presence in the community. Ultimately, the resources set aside for the young practitioner by the Orthopaedic Trauma Association are intended to facilitate a sense of excellence, service, and community.

Management of Patients with Orthopaedic Implants Undergoing Dental Procedures.

Science.gov (United States)

Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

2017-07-01

The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

Orthopaedic research and education foundation and industry.

Science.gov (United States)

Wurth, Gene R; Sherr, Judy H; Coffman, Thomas M

2003-07-01

Members of orthopaedic industry commit a significant amount of funds each year to support research and education programs that are directly related to their product(s). In addition, industry supports organizations such as the Orthopaedic Research and Education Foundation. The relationship between the Orthopaedic Research and Education Foundation and industry began in the early 1980s. The support to the Orthopaedic Research and Education Foundation from industry primarily has come in the form of unrestricted grants. These grants best can be looked at as an investment rather than a contribution. This form of giving, once called corporate philanthropy is more accurately referred to as strategic philanthropy. Members of industry make these investments to enhance their reputations, build brand awareness, market their products and services, improve employee morale, increase customer loyalty, and establish strategic alliances. The specialty of orthopaedics is among the leaders in medicine in the amount of funding raised within the specialty for research and education programs. This is because of the amount of support from members of industry and the surgeons. During the past 15 years, 40% of the annual support to the Orthopaedic Research and Education Foundation has come from industry and the balance has come from surgeons and members of lay public. Future industry support of the Orthopaedic Research and Education Foundation and other organizations within the specialty of orthopaedics will be dependent on the continued demonstration of tangible returns in areas described.

Interleukin 1 beta promoter polymorphism is associated with keratoconus in a Japanese population

OpenAIRE

Mikami, Takenori; Meguro, Akira; Teshigawara, Takeshi; Takeuchi, Masaki; Uemoto, Riyo; Kawagoe, Tatsukata; Nomura, Eiichi; Asukata, Yuri; Ishioka, Misaki; Iwasaki, Miki; Fukagawa, Kazumi; Konomi, Kenji; Shimazaki, Jun; Nishida, Teruo; Mizuki, Nobuhisa

2013-01-01

Purpose Polymorphisms in the interleukin 1 alpha (IL1A) and IL1B gene regions were previously associated with keratoconus in a Korean population. In the present study, we investigated whether the IL1A and IL1B polymorphisms are associated with keratoconus in a Japanese population. Methods A total of 169 Japanese patients with keratoconus and 390 Japanese healthy controls were recruited. We genotyped one IL1A single nucleotide polymorphism (SNP; rs2071376) and two IL1B SNPs (rs1143627 and rs16...

Hand dominance in orthopaedic surgeons.

LENUS (Irish Health Repository)

Lui, Darren F

2012-08-01

Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

Origins of eponymous orthopaedic equipment.

Science.gov (United States)

Meals, Clifton; Wang, Jeffrey

2010-06-01

Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation. We explored the origins of common and eponymous orthopaedic equipment. We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants and instruments owing to the overwhelming number of these devices. The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop creative solutions of their own. The rich history of the field's eponymous instruments informs an ongoing tradition of innovation in orthopaedics.

April 2006. 32 Major Orthopaedic Procedures

African Journals Online (AJOL)

user

2006-04-01

Apr 1, 2006 ... Major Orthopaedic Procedures: 17 Year Trends. Biruk Lambisso Wamisho1 ... financial and logistic constraints with poor compliance of ... Modern orthopaedic surgery is very expensive. A highly ..... Case management. Tribury.

Development, implementation and evaluation of a patient handoff tool to improve safety in orthopaedic surgery.

Science.gov (United States)

Gagnier, Joel J; Derosier, Joseph M; Maratt, Joseph D; Hake, Mark E; Bagian, James P

2016-06-01

To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. Components of this project included a literature review, resident surveys and observations, checklist development and refinement, implementation and evaluation of impact on adverse events through a chart review of a prospective cohort compared with a historical control group. Large teaching hospital. Findings of a literature review were presented to orthopaedic residents, epidemiologists, orthopaedic surgeons and patient safety experts in face-to-face meetings, during which we developed and refined the contents of a resident handoff tool. The tool was tested in an orthopaedic trauma service and its impact on adverse events was evaluated through a chart review. The handoff tool was developed and refined during the face-to-face meetings and a pilot implementation. Adverse event data were collected on 127 patients (n = 67 baseline period; n = 60 test period). A handoff tool for use by orthopaedic residents. Adverse events in patients handed off by orthopaedic trauma residents. After controlling for age, gender and comorbidities, testing resulted in fewer events per person (25-27% reduction; P < 0.10). Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Orthopaedic Footwear Design

Science.gov (United States)

1992-01-01

Although the need for orthopaedic shoes is increasing, the number of skilled shoemakers has declined. This has led to the development of a CAD/CAM system to design and fabricate, orthopaedic footwear. The NASA-developed RIM database management system is the central repository for CUSTOMLAST's information storage. Several other modules also comprise the system. The project was initiated by Langley Research Center and Research Triangle Institute in cooperation with the Veterans Administration and the National Institute for Disability and Rehabilitation Research. Later development was done by North Carolina State University and the University of Missouri-Columbia. The software is licensed by both universities.

Improving operation notes to meet British Orthopaedic Association guidelines.

Science.gov (United States)

Morgan, David; Fisher, Noel; Ahmad, Aman; Alam, Fazle

2009-04-01

Operation notes are an important part of medical records for clinical, academic and medicolegal reasons. This study audited the quality of operative note keeping for total knee replacements against the standards set by the British Orthopaedic Association (BOA). A prospective review of all patients undergoing total knee replacement at a district general hospital over 8 months. Data recorded were compared with those required by the BOA good-practice guidelines. Change in practice was implemented and the audit cycle completed. Data were statistically analysed. A total of 129 operation notes were reviewed. There was a significant improvement in the mean number of data points recorded from 9.6 to 13.1. The least well recorded data were diagnosis, description of findings, alignment and postoperative flexion range. All had a significant improvement except description of findings. The operating surgeon writing the note improved from 56% to 67%. Detailed postoperative instructions also improved in quality. Surgeon education and the use of a checklist produce better quality total knee replacement operation notes in line with BOA guidelines. Further improvements may be made by making the data points part of the operation note itself.

Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology

DEFF Research Database (Denmark)

Rendon, J S; Swinton, M; Bernthal, N

2017-01-01

by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. METHODS: All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss......: The 13 surgeons who participated in the discussion represented orthopaedic oncology practices from seven countries (Argentina, Brazil, Italy, Spain, Denmark, United States and Canada). Four categories and associated themes emerged from the discussion: the need for collaboration in the field...... of orthopaedic oncology due to the rarity of the tumours and the need for high level evidence to guide treatment; motivational factors for participating in collaborative research including establishing proof of principle, learning opportunity, answering a relevant research question and being part...

Leadership and business education in orthopaedic residency training programs.

Science.gov (United States)

Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

2011-01-01

Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

Biases and regularities of grapheme-colour associations in Japanese nonsynaesthetic population.

Science.gov (United States)

Nagai, Jun-ichi; Yokosawa, Kazuhiko; Asano, Michiko

2016-01-01

Associations between graphemes and colours in a nonsynaesthetic Japanese population were investigated. Participants chose the most suitable colour from 11 basic colour terms for each of 40 graphemes from the four categories of graphemes used in the Japanese language (kana characters, English alphabet letters, and Arabic and kanji numerals). This test was repeated after a three-week interval. In their responses, which were not as temporally consistent as those of grapheme-colour synaesthetes, participants showed biases and regularities that were comparable to those of synaesthetes reported in past studies. Although it has been believed that only synaesthetes, and not nonsynaesthetes, tended to associate graphemes with colours based on grapheme frequency, Berlin and Kay's colour typology, and colour word frequency, participants in this study tended in part to associate graphemes with colours based on the above factors. Moreover, participants that were nonsynaesthetes tended to associate different graphemes that shared sounds and/or meanings (e.g., Arabic and kanji numerals representing the same number) with the same colours, which was analogous to the findings in Japanese synaesthetes. These results support the view that grapheme-colour synaesthesia might have its origins in cross-modal association processes that are shared with the general population.

Clinical features of anaerobic orthopaedic infections.

Science.gov (United States)

Lebowitz, Dan; Kressmann, Benjamin; Gjoni, Shpresa; Zenelaj, Besa; Grosgurin, Olivier; Marti, Christophe; Zingg, Matthieu; Uçkay, Ilker

2017-02-01

Some patient populations and types of orthopaedic surgery could be at particular risk for anaerobic infections. In this retrospective cohort study of operated adult patients with infections from 2004 to 2014, we assessed obligate anaerobes and considered first clinical infection episodes. Anaerobes, isolated from intra-operative samples, were identified in 2.4% of 2740 surgical procedures, of which half (33/65; 51%) were anaerobic monomicrobial infections. Propionibacterium acnes, a penicillin and vancomycin susceptible pathogen, was the predominantly isolated anaerobe. By multivariate analysis, the presence of fracture fixation plates was the variable most strongly associated with anaerobic infection (odds ratio: 2.1, 95% CI: 1.3-3.5). Anaerobes were also associated with spondylodesis and polymicrobial infections. In contrast, it revealed less likely in native bone or prosthetic joint infections and was not related to prior antibiotic use. In conclusion, obligate anaerobes in our case series of orthopaedic infections were rare, and mostly encountered in infections related to trauma with open-fracture fixation devices rather than clean surgical site infection. Anaerobes were often co-pathogens, and cultures most frequently recovered P. acnes. These observations thus do not support changes in current practices such as broader anaerobe coverage for perioperative prophylaxis.

Radiologic examination of orthopaedics. Methods and techniques

International Nuclear Information System (INIS)

Hafner, E.; Meuli, H.C.

1976-01-01

This volume describes in detail radiological examinations of the skeleton modern procedures in orthopaedic surgery. Special emphasis is given to functional examination techniques based upon the authors' extensive work on standardized radiological examinations best suited to the needs of orthopaedic surgeons. These techniques were developed at the Radiodiagnostic Department of the Central Radiological Clinic, Bern University, in cooperation with the University Clinic of Orthopaedics and Surgery of the Locomotor System. Exposure techniques are explained concisely, yet with extraordinary precision and attention to detail. They have proved highly successful in teaching programs for X-ray technicians and as standard examination techniques for many hospitals, X-ray departments, orthopaedic units, and private clinics. Recommended for orthopaedic surgeons, radiologists, general surgeons, and X-ray technicians, this definitive treatise, with its superb X-ray reproductions and complementary line drawings, explains how to achieve improved diagnoses and standardized control with the least possible radiation exposure to the patient

The financial impact of orthopaedic fellowship training.

Science.gov (United States)

Gaskill, Trevor; Cook, Chad; Nunley, James; Mather, R Chad

2009-07-01

Previous reports have compared the expected financial return of a medical education with those expected in other professions. However, we know of no published report estimating the financial return of orthopaedic training. The purpose of this study was to estimate the financial incentives that may influence the decision to invest an additional year of training in each of the major orthopaedic fellowships. With survey data from the American Academy of Orthopaedic Surgeons and using standard financial techniques, we calculated the estimated return on investment of an additional year of orthopaedic training over a working lifetime. The net present value, internal rate of return, and the break-even point were estimated. Eight fellowships were examined and compared with general orthopaedic practice. Investment in an orthopaedic fellowship yields variable returns. Adult spine, shoulder and elbow, sports medicine, hand, and adult arthroplasty may yield positive returns. Trauma yields a neutral return, while pediatrics and foot and ankle have negative net present values. On the basis of mean reported incomes, the break-even point was two years for spine, seven years for hand, eight years for shoulder and elbow, twelve years for adult arthroplasty, thirteen years for sports medicine, and twenty-seven years for trauma. Fellowship-trained pediatric and foot and ankle surgeons did not break even following the initial investment. When working hours were controlled for, the returns for adult arthroplasty and trauma became negative. The financial return of an orthopaedic fellowship varies on the basis of the specialty chosen. While reasons to pursue fellowship training vary widely, and many are not financial, there are positive and negative financial incentives. Therefore, the decision to pursue fellowship training is best if it is not made on the basis of financial incentives. This information may assist policy makers in analyzing medical education economics to ensure the

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

Science.gov (United States)

Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

2016-04-01

More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

Orthopaedic training in Kenya | Mulimba | East African Orthopaedic ...

African Journals Online (AJOL)

Objective: To do a survey of the current orthopaedic specialists in Kenya's training since their first medical degrees. Determine the duration, facilities and methods of training. Methods: A number of doctors trained under different arrangements were identified, interviewed and where curriculum was available this was read.

II Italian intersociety consensus statement on antithrombotic prophylaxis in orthopaedics and traumatology: arthroscopy, traumatology, leg immobilization, minor orthopaedic procedures and spine surgery.

Science.gov (United States)

Randelli, F; Romanini, E; Biggi, F; Danelli, G; Della Rocca, G; Laurora, N R; Imberti, D; Palareti, G; Prisco, D

2013-03-01

Pharmacological prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures, but few data exist in other fields of orthopaedics and traumatology. Thus, no guidelines or recommendations are available in the literature except for a limited number of weak statements about knee arthroscopy and lower limb fractures. In any case, none of them are a multidisciplinary effort as the one here presented. The Italian Society for Studies on Haemostasis and Thrombosis (SISET), the Italian Society of Orthopaedics and Traumatology (SIOT), the Association of Orthopaedic Traumatology of Italian Hospitals (OTODI), together with the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) and the Italian Society of General Medicine (SIMG) have set down easy and quick suggestions for VTE prophylaxis in a number of surgical conditions for which only scarce evidence is available. This inter-society consensus statement aims at simplifying the approach to VTE prophylaxis in the single patient with the goal to improve its clinical application.

1 venous thromboembolism in orthopaedics references

African Journals Online (AJOL)

2008-05-23

2004; 126: 338-400S. 3. American Academy of Orthopaedic Surgeons. American Academy of orthopaedic Surgeons clinical guidelines on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty.www.aaos.org/Research/ guidelines/PE_guideline. Pdf (accessed May 23, 2008). 4.

Nigerian Journal of Orthopaedics and Trauma

African Journals Online (AJOL)

The Nigerian Journal of Orthopaedics and Trauma publishes original papers, review articles and case reports on pathology, anaesthesia, orthopaedics and trauma. Vol 12, No 1 (2013). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of Contents. Articles. Management of ...

Biomaterials in orthopaedics

Science.gov (United States)

Navarro, M; Michiardi, A; Castaño, O; Planell, J.A

2008-01-01

At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field. PMID:18667387

Evaluation of low back pain using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire for lumbar spinal disease in a multicenter study. Differences in scores based on age, sex, and type of disease

International Nuclear Information System (INIS)

Ohtori, Seiji; Ito, Toshinori; Yamashita, Masaomi

2010-01-01

The Japanese Orthopaedic Association (JOA) has investigated the JOA Back Pain Evaluation Questionnaire (JOABPEQ) to evaluate several aspects of low back pain in patients. The score includes five categories (25 items) selected from the Roland Morris Disability Questionnaire and Short Form 36, and a visual analogue scale. Japanese physicians have recently used these scores to evaluate back pain; however, the efficacy has not been fully explored in large-scale studies. In the current study, we used the JOABPEQ to evaluate lumbar spinal disease in 555 patients (with lumbar disc herniation, lumbar spinal stenosis, and lumbar disc degeneration/spondylosis) in multiple spine centers and compared the results based on age, sex, and type of disease. A total of 555 patients who had low back or leg pain were selected in 22 hospitals in Chiba Prefecture. Spine surgeons diagnosed their disease type based on symptoms, physical examination, radiography images, and magnetic resonance imaging. In all, 486 patients were diagnosed with spinal stenosis (239 patients), disc degeneration/spondylosis (143 patients), or disc herniation (104 patients). The other 69 patients were diagnosed with spondylolysis (16 patients) or other diseases (53 patients). The pain score in all patients was evaluated using the JOABPEQ (from 0 to 100, with 0 indicating the worst pain). The age of the patients was 56.1±13.3 years (mean±standard deviation (SD)); the age of patients in the disc herniation and disc degeneration/spondylosis group was significantly lower than that in the spinal stenosis group. The average JOABPEQ scores in all patients were, for low back pain, 47.1; lumbar function, 53.6; walking ability, 54.8; social life function, 48.7; and mental health, 48.3. The low back pain score in men was significantly worse than that in women. In contrast, the mental health score in women was significantly higher than that in men. The low back pain score in patients 65 years old were significantly lower

Quality of life during orthopaedic training and academic practice. Part 1: orthopaedic surgery residents and faculty.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2009-10-01

A pilot study of two academic training programs revealed concerning levels of resident burnout and psychological dysfunction. The purpose of the present study was to determine the quality of life of orthopaedic residents and faculty on a national scale and to identify risk factors for decompensation. Three hundred and eighty-four orthopaedic residents and 264 full-time orthopaedic faculty members completed a voluntary, anonymous survey consisting of three validated instruments (the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and question sets assessing demographic information, relationship issues, stress reactions/management, and work/life balance. High levels of burnout were seen in 56% of the residents and 28% of the faculty members. Burnout risk was greatest among second-postgraduate-year residents and residents in training programs with six or more residents per postgraduate year. Sixteen percent of residents and 19% of faculty members reported symptoms of psychological distress. Sleep deprivation was common among the residents and correlated positively with every distress measure. Faculty reported greater levels of stress but greater satisfaction with work and work/life balance. A number of factors, such as making time for hobbies and limiting alcohol use, correlated with decreased dysfunction for both residents and faculty. Despite reporting high levels of job satisfaction, orthopaedic residents and faculty are at risk for burnout and distress. Identification of protective factors and risk factors may provide guidance to improve the quality of life of academic orthopaedic surgeons in training and beyond.

Communication skills training in orthopaedics.

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Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

2008-06-01

Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

Computational radiology for orthopaedic interventions

CERN Document Server

Li, Shuo

2016-01-01

This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

Evaluation of Pediatric Questions on the Orthopaedic In-Training Examination-An Update.

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Murphy, Robert F; Nunez, Leah; Barfield, William R; Mooney, James F

2017-09-01

Pediatric orthopaedics is tested frequently on the Orthopaedic In-Training Examination (OITE). The most recent data on the pediatrics section of the OITE were generated from content 10 years old. The purpose of this study is to assess the pediatric orthopaedic questions on the 2011 to 2014 OITE, and to compare question categories and cognitive taxonomy with previous data. Four years (2011 to 2014) of OITE questions, answers, and references were reviewed. The number of pediatric questions per year was recorded, as well as presence of a clinical photo or imaging modality. Each question was categorized and assigned a cognitive taxonomy level. Categories included: knowledge; knowledge-treatment modalities; diagnosis; diagnosis/recognition of associated conditions; diagnosis/further studies; and diagnosis/treatment. Cognitive taxonomy levels included: simple recall, interpretation of data, and advanced problem-solving. The 3 most commonly covered topics were upper extremity trauma (17.4%), scoliosis (10.1%), and developmental dysplasia of the hip (5.7%). Compared with previous data, the percentage of pediatric questions was constant (13% vs. 14%). Categorically, the more recent OITE examinations contained significantly fewer questions testing simple knowledge (19% vs. 39%, P=0.0047), and significantly more questions testing knowledge of treatment modalities (17% vs. 9%, P=0.016) and diagnosis with associated conditions (19% vs. 9%, P=0.0034). Regarding cognitive taxonomy, there was a significant increase in the average number of questions that required advanced problem-solving (57% vs. 46%, P=0.048). Significantly more questions utilized clinical photographs and imaging studies (62% vs. 48%, P=0.012). The most common reference materials provided to support correct responses included Lovell and Winter's Pediatric Orthopaedics (25.7%) and the Journal of Pediatric Orthopaedics (23.4%). Although the percentage of pediatric questions on the OITE has remained essentially

Orthopaedic Timing in Polytrauma in a Second Level Emergency Hospital. An Overrated Problem?

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V, Dei Giudici; N, Giampaolini; A, Panfighi; M, Marinelli; R, Procaccini; A, Gigante

2015-01-01

The main concern for orthopaedic treatment in polytrauma has always been the same for almost forty years, which also regards “where” and “when” to proceed; correct surgical timing and correct interpretation of the DCO concept are still being debated. In the last few years, several attempts have been made to classify patients based on their clinical presentation and by trying to figure out which vital parameters are able to predict the patient’s outcome. This study evaluated all patients who presented with code red at the Emergency Department of our Hospital, a level II trauma center. For every patient, the following characteristics were noted: sex, age, day of hospitalization, orthopaedic trauma, time to surgery, presence of an associated surgical condition in the fields of general surgery, thoracic surgery, neurosurgery and vascular surgery, cardiac frequency, blood pressure, oxygen saturation, Glasgow Coma Scale and laboratory data. All patients included were divided into subgroups based on orthopaedic surgical timing. Two other subgroups were also identified and analyzed in detail: deceased and weekend traumas. A total of 208 patients were included. Our primary goal was to identify a correlation between the mortality and surgical timing of the orthopaedic procedures; our secondary goal was to recognize, if present, a statistically relevant association between historical, clinical and laboratory data, and mortality rate, defining any possible risk factor. A correlation between mortality and orthopaedic surgical timing was not found. Analyzing laboratory data revealed an interesting correlation between mortality and: blood pressure, platelet count, cardiac frequency, hematocrit, hemoglobin and age. PMID:26312113

Antibiotic-impregnated calcium phosphate cement as part of a comprehensive treatment for patients with established orthopaedic infection.

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Niikura, Takahiro; Lee, Sang Yang; Iwakura, Takashi; Sakai, Yoshitada; Kuroda, Ryosuke; Kurosaka, Masahiro

2016-07-01

The treatment of established orthopaedic infection is challenging. While the main focus of treatment is wide surgical debridement, systemic and local antibiotic administration are important adjuvant therapies. Several reports have described the clinical use of antibiotic-impregnated calcium phosphate cement (CPC) to provide local antibiotic therapy for bone infections. However, these were all individual case reports, and no case series have been reported. We report a case series treated by a single surgeon using antibiotic-impregnated CPC as part of a comprehensive treatment plan in patients with established orthopaedic infection. We enrolled 13 consecutive patients with osteomyelitis (n = 6) or infected non-union (n = 7). Implantation of antibiotic-impregnated CPC was performed to provide local antibiotic therapy as part of a comprehensive treatment plan that also included wide surgical debridement, systemic antibiotic therapy, and subsequent second-stage reconstruction surgery. We investigated the rate of successful infection eradication and systemic/local complications. The concentration of antibiotics in the surgical drainage fluids, blood, and recovered CPC (via elution into a phosphate-buffered saline bath) were measured. The mean follow-up period after surgery was 50.4 (range, 27-73) months. There were no cases of infection recurrence during follow-up. No systemic toxicity or local complications from the implantation of antibiotic-impregnated CPC were observed. The vancomycin concentration in the fluid from surgical drainage (n = 6) was 527.1 ± 363.9 μg/mL on postoperative day 1 and 224.5 ± 198.4 μg/mL on postoperative day 2. In patients who did not receive systemic vancomycin therapy (n = 3), the maximum serum vancomycin level was antibiotic-impregnated CPC is an option to provide local antibiotic therapy as part of a comprehensive treatment plan. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights

An information revolution in orthopaedics.

Science.gov (United States)

Goldberg, A J; MacGregor, A; Spencer, S A

2012-04-01

With the established success of the National Joint Registry and the emergence of a range of new national initiatives for the capture of electronic data in the National Health Service, orthopaedic surgery in the United Kingdom has found itself thrust to the forefront of an information revolution. In this review we consider the benefits and threats that this revolution poses, and how orthopaedic surgeons should marshal their resources to ensure that this is a force for good.

Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance?

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O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew

2012-11-07

Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

Genome-wide association study of schizophrenia in Japanese population.

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Kazuo Yamada

Full Text Available Schizophrenia is a devastating neuropsychiatric disorder with genetically complex traits. Genetic variants should explain a considerable portion of the risk for schizophrenia, and genome-wide association study (GWAS is a potentially powerful tool for identifying the risk variants that underlie the disease. Here, we report the results of a three-stage analysis of three independent cohorts consisting of a total of 2,535 samples from Japanese and Chinese populations for searching schizophrenia susceptibility genes using a GWAS approach. Firstly, we examined 115,770 single nucleotide polymorphisms (SNPs in 120 patient-parents trio samples from Japanese schizophrenia pedigrees. In stage II, we evaluated 1,632 SNPs (1,159 SNPs of p<0.01 and 473 SNPs of p<0.05 that located in previously reported linkage regions. The second sample consisted of 1,012 case-control samples of Japanese origin. The most significant p value was obtained for the SNP in the ELAVL2 [(embryonic lethal, abnormal vision, Drosophila-like 2] gene located on 9p21.3 (p = 0.00087. In stage III, we scrutinized the ELAVL2 gene by genotyping gene-centric tagSNPs in the third sample set of 293 family samples (1,163 individuals of Chinese descent and the SNP in the gene showed a nominal association with schizophrenia in Chinese population (p = 0.026. The current data in Asian population would be helpful for deciphering ethnic diversity of schizophrenia etiology.

Postnatal treatment factors affecting craniofacial morphology of unilateral cleft lip and palate (UCLP) patients in a Japanese population.

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Alam, M K; Iida, J; Sato, Y; Kajii, Takashi S

2013-12-01

We have evaluated the craniofacial morphology of Japanese patients with unilateral cleft lip and palate (UCLP) and assessed the various postnatal factors that affect it. Lateral cephalograms of 140 subjects (mean (SD) aged 7 (2) years) with UCLP were taken before orthodontic treatment. Surgeons from Hokkaido University Hospital had done the primary operations. The craniofacial morphology was assessed by angular and linear cephalometric measurements. Cheiloplasty, palatoplasty, and preoperative orthopaedic treatment were chosen as postnatal factors. To compare the assessments of the postnatal factors, we made angular and linear cephalometric measurements for each subject and converted them into Z scores in relation to the mean (SD) of the two variables. Subjects treated by the modified Millard cheiloplasty had larger sella-nasion-point A (SNA) and nasion-point A-pogonion (NA-POG) measurements than subjects treated by the modified Millard with a vomer flap cheiloplasty. Two-stage palatoplasty showed consistently better craniofacial morphology than the other palatoplasty. Subjects who had preoperative orthopaedic treatment with a Hotz plate had significantly larger upper incisor/sella-nasion (U1-SN) measurements than who had no preoperative orthopaedic treatment or an active plate. We conclude that in subjects treated by a modified Millard type of cheiloplasty, a two-stage palatoplasty, and a Hotz plate there were fewer adverse effects on craniofacial morphology. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Mentorship in orthopaedic and trauma residency training ...

African Journals Online (AJOL)

Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

Evaluation of the orthopaedics and traumatology resident education in Turkey: A descriptive study.

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Huri, Gazi; Cabuk, Yusuf Sertan; Gursoy, Safa; Akkaya, Mustafa; Ozkan, Secil; Oztuna, Volkan; Aydingoz, Onder; Senkoylu, Alparslan

2016-10-01

The objective of this study is to describe the current situation regarding the training, working conditions, future plans, fields of interest and satisfaction of orthopaedics and traumatology residents in Turkey. A descriptive survey questionnaire consisting of 24 questions was designed to identify the problems and solution suggestions concerning training of orthopaedic residents. All orthopaedics and traumatology residents who took the 2013 Progress Testing for Speciality in Medicine (UEGS) held by Turkish Orthopaedics and Traumatology Education Council (TOTEK) were surveyed in the class at the end thereof as well as the young orthopaedic surgeons who were reached through the email groups of Turkish Society of Orthopaedics and Traumatology - Residents and Young Attendings Council (TOTBID-AGUH). A total of 725 residents and 132 young attendings were surveyed. The most outstanding answers are as follows: 62,7% of the respondents replied to the question "Is there a training program/Is it being applied" as "yes/yes". It was found out that 94,3% of the respondents wanted to be involved in a rotation abroad. The "patient care" was the most common answer, with a ratio of 36,9%, to the question "What's the priority of the department you are studying in?". Regarding work conditions, "many emergency on-calls" was found to be the most important parameter affecting life conditions (p traumatology residents in Turkey face as regards their training, this survey stands as a pioneering study with a high participation rate. Analysis of survey data highlights the importance of several key factors such as the development of training programs and increasing the time spent with academicians as well as spreading and promotion of log book application. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Association of TNFAIP3 Polymorphism with Susceptibility to Systemic Lupus Erythematosus in a Japanese Population

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Aya Kawasaki

2010-01-01

Full Text Available Recent genome-wide association studies demonstrated association of single nucleotide polymorphisms (SNPs in the TNFAIP3 region at 6q23 with systemic lupus erythematosus (SLE in European-American populations. In this study, we investigated whether SNPs in the TNFAIP3 region are associated with SLE also in a Japanese population. A case-control association study was performed on the SNPs rs13192841, rs2230926, and rs6922466 in 318 Japanese SLE patients and 444 healthy controls. Association of rs2230926 G allele with SLE was replicated in Japanese (allelic association P=.033, odds ratio [OR] 1.47, recessive model P=.023, OR 8.52. The association was preferentially observed in the SLE patients with nephritis. When the TNFAIP3 mRNA levels of the HapMap samples were examined using GENEVAR database, the presence of TNFAIP3 rs2230926 G allele was associated with lower mRNA expression of TNFAIP3 (P=.013. These results indicated that TNFAIP3 is a susceptibility gene to SLE both in the Caucasian and Asian populations.

Smartphone apps for orthopaedic sports medicine - a smart move?

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Wong, Seng Juong; Robertson, Greg A; Connor, Katie L; Brady, Richard R; Wood, Alexander M

2015-01-01

With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and content, along with a review of these apps. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for Orthopaedic Sports medicine themed apps, using the search terms; Orthopaedic Sports Medicine, Orthopaedics, Sports medicine, Knee Injury, Shoulder Injury, Anterior Cruciate Ligament Tear, Medial Collateral Ligament Tear, Rotator Cuff Tear, Meniscal Tear, Tennis Elbow. All English language apps related to orthopaedic sports medicine were included. A total of 76 individual Orthopaedic Sports Medicine themed apps were identified. According to app store classifications, there were 45 (59 %) medical themed apps, 28 (37 %) health and fitness themed apps, 1 (1 %) business app, 1 (1 %) reference app and 1 (1 %) sports app. Forty-nine (64 %) apps were available for download free of charge. For those that charged access, the prices ranged from £0.69 to £69.99. Only 51 % of sports medicine apps had customer satisfaction ratings and 39 % had named medical professional involvement in their development or content. We found the majority of Orthopaedic Sports Medicine apps had no named medical professional involvement, raising concerns over their content and evidence-base. We recommend increased regulation of such apps to improve the accountability of app content.

Orthopaedic podiatry triage: process outcomes of a skill mix initiative.

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Homeming, Lyndon J; Kuipers, Pim; Nihal, Aneel

2012-11-01

The Orthopaedic Podiatry Triage Clinic (OPodTC) is a 'skill mix' model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. This study highlights the potential of screening and triage functions in the skill mix debate. In this example, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service.

Understanding how orthopaedic surgery practices generate value for healthcare systems.

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Olson, Steven A; Mather, Richard C

2013-06-01

Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

Developmental orthopaedic diseases in foals

International Nuclear Information System (INIS)

Şİrİn, Özlem; Alkan, Zeki

2010-01-01

Developmental Orthopaedic Diseases (DOD) is seen frequently in horses which completed their maturity. Osteochondrosis, physitis, angular limb deformities, flexural deformities, juvenil arthritis, cervical vertebral anomalies, cuboidal bone abnormalities are problems investigated under Developmental Orthopaedic Diseases title. This diseases can develop single or some together in fast growing, heavy animals (especially Arabian and English Thoroughbreds). Multifactorial causes of this diseases etiopathogenesis can be listed as genetic predisposition, trauma, nutrition, vitamins/minerals and endocrine disorders. But the exact causes of these diseases are not known. In this review detailed information are given about the diseases mentioned above

A Clinico- Epidemiological Study Of Filarial Related Orthopaedic Manifestations

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Patond K.R

1992-01-01

Full Text Available An epidemiological study was undertaken to study the incidence and distribution of orthopaedic manifestations of filariasis in an endemic area. A total of 207 cases were clinically examined and investigated. Patients were divided into three groups , viz., Group A: Orthopaedic manifestations with no history of filariasis . Group B: Orthopaedic manifestations with history of filariasis such as microfilaraemia or filarial fevers etc., Group C: Orthopaedic manifestations with chronic manifestations such as elephantiasis, hydrocele etc. To confirm filarial etiology, all the cases were examined for the presence of filarial antibody by indirect ELISA using wuchereda bancrofti microfilarial excretory- secretary antigen (wd Mf ESAg . A total of 61 of 102 patients of Group A, 14 of 21 patients of group B, and 73 of 84 patients of Group C were positive for filarial antibody. This study showed the prevalence of filarial antibody in about 71.4% of various orthopaedic manifestations.

An interobserver reliability comparison between the Orthopaedic Trauma Association's open fracture classification and the Gustilo and Anderson classification.

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Ghoshal, A; Enninghorst, N; Sisak, K; Balogh, Z J

2018-02-01

To evaluate interobserver reliability of the Orthopaedic Trauma Association's open fracture classification system (OTA-OFC). Patients of any age with a first presentation of an open long bone fracture were included. Standard radiographs, wound photographs, and a short clinical description were given to eight orthopaedic surgeons, who independently evaluated the injury using both the Gustilo and Anderson (GA) and OTA-OFC classifications. The responses were compared for variability using Cohen's kappa. The overall interobserver agreement was ĸ = 0.44 for the GA classification and ĸ = 0.49 for OTA-OFC, which reflects moderate agreement (0.41 to 0.60) for both classifications. The agreement in the five categories of OTA-OFC was: for skin, ĸ = 0.55 (moderate); for muscle, ĸ = 0.44 (moderate); for arterial injury, ĸ = 0.74 (substantial); for contamination, ĸ = 0.35 (fair); and for bone loss, ĸ = 0.41 (moderate). Although the OTA-OFC, with similar interobserver agreement to GA, offers a more detailed description of open fractures, further development may be needed to make it a reliable and robust tool. Cite this article: Bone Joint J 2018;100-B:242-6. ©2018 The British Editorial Society of Bone & Joint Surgery.

Factors Associated with the Empowerment of Japanese Families Raising a Child with Developmental Disorders

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Wakimizu, Rie; Fujioka, Hiroshi; Yoneyama, Akira; Iejima, Atsushi; Miyamoto, Shinya

2011-01-01

We identified factors associated with the empowerment of Japanese families using the Family Empowerment Scale (FES) to contribute to the improvement of empowerment in Japanese families raising a child with developmental disorders (DDs). The study was conducted in 350 caregivers who raised children aged 4-18 years with DDs in urban and suburban…

Database and Registry Research in Orthopaedic Surgery: Part I: Claims-Based Data.

Science.gov (United States)

Pugely, Andrew J; Martin, Christopher T; Harwood, Jared; Ong, Kevin L; Bozic, Kevin J; Callaghan, John J

2015-08-05

The use of large-scale national databases for observational research in orthopaedic surgery has grown substantially in the last decade, and the data sets can be grossly categorized as either administrative claims or clinical registries. Administrative claims data comprise the billing records associated with the delivery of health-care services. Orthopaedic researchers have used both government and private claims to describe temporal trends, geographic variation, disparities, complications, outcomes, and resource utilization associated with both musculoskeletal disease and treatment. Medicare claims comprise one of the most robust data sets used to perform orthopaedic research, with >45 million beneficiaries. The U.S. government, through the Centers for Medicare & Medicaid Services, often uses these data to drive changes in health policy. Private claims data used in orthopaedic research often comprise more heterogeneous patient demographic samples, but allow longitudinal analysis similar to that offered by Medicare claims. Discharge databases, such as the U.S. National Inpatient Sample, provide a wide national sampling of inpatient hospital stays from all payers and allow analysis of associated adverse events and resource utilization. Administrative claims data benefit from the high patient numbers obtained through a majority of hospitals. Using claims, it is possible to follow patients longitudinally throughout encounters irrespective of the location of the institution delivering health care. Some disadvantages include lack of precision of ICD-9 (International Classification of Diseases, Ninth Revision) coding schemes. Much of these data are expensive to purchase, complicated to organize, and labor-intensive to manipulate--often requiring trained specialists for analysis. Given the changing health-care environment, it is likely that databases will provide valuable information that has the potential to influence clinical practice improvement and health policy for

Comparison of postmenopausal endogenous sex hormones among Japanese, Japanese Brazilians, and non-Japanese Brazilians

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Maciel Maria

2011-02-01

Full Text Available Abstract Background Differences in sex hormone levels among populations might contribute to the variation in breast cancer incidence across countries. Previous studies have shown higher breast cancer incidence and mortality among Japanese Brazilians than among Japanese. To clarify the difference in hormone levels among populations, we compared postmenopausal endogenous sex hormone levels among Japanese living in Japan, Japanese Brazilians living in the state of São Paulo, and non-Japanese Brazilians living in the state of São Paulo. Methods A cross-sectional study was conducted using a control group of case-control studies in Nagano, Japan, and São Paulo, Brazil. Participants were postmenopausal women older than 55 years of age who provided blood samples. We measured estradiol, estrone, androstenedione, dehydroepiandrosterone sulfate (DHEAS, testosterone and free testosterone by radioimmunoassay; bioavailable estradiol by the ammonium sulfate precipitation method; and sex hormone-binding globulin (SHBG by immunoradiometric assay. A total of 363 women were included for the present analyses, comprising 185 Japanese, 44 Japanese Brazilians and 134 non-Japanese Brazilians. Results Japanese Brazilians had significantly higher levels of estradiol, bioavailable estradiol, estrone, testosterone and free testosterone levels, and lower SHBG levels, than Japanese. Japanese Brazilians also had significantly higher levels of bioavailable estradiol, estrone and DHEAS and lower levels of SHBG and androstenedione than non-Japanese Brazilians. Levels of estradiol, testosterone and free testosterone, however, did not differ between Japanese Brazilians and non-Japanese Brazilians. These differences were observed even after adjustment for known breast cancer risk factors. We also found an increase in estrogen and androgen levels with increasing body mass index, but no association for most of the other known risk factors. Conclusions We found higher levels of

Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures

International Nuclear Information System (INIS)

Romanova, K.; Alyakov, M.; Vassileva, J.

2015-01-01

The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/ shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens. (authors)

Association of gene polymorphism of the fat mass and obesity associated gene with metabolic syndrome: a retrospective cohort study in Japanese workers.

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Kawajiri, Tomoka; Osaki, Yoneatsu; Kishimoto, Takuji

2012-06-01

To investigate whether gene polymorphism of the fat mass and obesity associated gene (FTO) is associated with metabolic syndrome (MS), we used two MS criteria, the National Cholesterol Education Program-Adult Treatment panel III (NCEP-ATPIII) definition in 2003 and the Japanese definition in 2005. Subjects were respectively 859 and 865 Japanese workers at a company in Shimane Prefecture, Japan. They were non-MS individuals in 1998 and had regular health checkups between 1998 and 2006. The Cox proportional hazard regression was used to predict MS. Three SNPs in the FTO, rs9939609, rs1121980 and rs1558902, were genotyped by the TaqMan PCR assay and a retrospective study was performed. The three SNPs in the FTO were significantly associated with body mass index, and rs1121980 and rs1558902 were associated with fasting plasma glucose. MS defined by the NCEP-ATPIII definition was significantly associated with additive and dominant models of rs9939609 and rs1121980, and the dominant model of rs1558902, even after adjusting for confounding factors such as age, sex and lifestyle. MS defined by the Japanese definition was significantly associated with the additive model of rs1121980 and additive and dominant models of rs1558902 in multivariate analysis. These results suggested that FTO gene polymorphisms, rs9939609, rs1121980 and rs1558902, were associated with an increased risk of MS among Japanese workers.

Inpatient consultations to an orthopaedic service: the hidden workload.

LENUS (Irish Health Repository)

O'Malley, N T

2011-12-01

While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses.

Science.gov (United States)

Greer, Andrew I M; Lim, Teoh S; Brydone, Alistair S; Gadegaard, Nikolaj

2016-01-01

Sol-gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol-gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol-gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol-gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol-gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C.

Smartphones in orthopaedics.

Science.gov (United States)

Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

2012-08-01

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

The detection of patients with 'fragility fractures' in fracture clinic - an audit of practice with reference to recent British Orthopaedic Association guidelines.

Science.gov (United States)

Gidwani, S; Davidson, N; Trigkilidas, D; Blick, C; Harborne, R; Maurice, H D

2007-03-01

The British Orthopaedic Association published guidelines on the care of fragility fracture patients in 2003. A section of these guidelines relates to the secondary prevention of osteoporotic fractures. The objective of this audit was to compare practice in our fracture clinic to these guidelines, and take steps to improve our practice if required. We retrospectively audited the treatment of all 462 new patients seen in January and February 2004. Using case note analysis, 38 patients who had sustained probable fragility fractures were selected. Six months' post-injury, a telephone questionnaire was administered to confirm the nature of the injury and to find out whether the patient had been assessed, investigated or treated for osteoporosis. A second similar audit was conducted a year later after steps had been taken to improve awareness amongst the orthopaedic staff and prompt referral. During the first audit period, only 5 of 38 patients who should have been assessed and investigated for osteoporosis were either referred or offered referral. This improved to 23 out of 43 patients during the second audit period. Improvements in referral and assessment rates of patients at risk of further fragility fractures can be achieved relatively easily by taking steps to increase awareness amongst orthopaedic surgeons, although additional strategies and perhaps the use of automated referral systems may be required to achieve referral rates nearer 100%.

What Provisions Do Orthopaedic Programs Make for Maternity, Paternity, and Adoption Leave?

Science.gov (United States)

Weiss, Jennifer; Teuscher, David

2016-09-01

The process of choosing medical specialty and residency programs is multifaceted. Today's generation of medical students may have an increased interest in work-life balance and time with their families. In considering this factor, medical students may be influenced by policy regarding maternity, paternity, and adoption leave during residency and fellowship training. Current policy among orthopaedic programs regarding maternity, paternity, and adoption leave is not well described. To understand the influence these policies may have on the choices that medical students make in choosing their specialty, the policies must first be better understood. (1) What proportion of orthopaedic programs have formal or unwritten policies regarding maternity, paternity, and adoptive leave? (2) What are the provisions for time away, allotment of time, and makeup options for trainees who take leave? (3) What proportion of orthopaedic programs report utilization of leave, and what proportions of leave are for maternity, paternity, or adoptive reasons? Accredited programs in orthopaedic surgery were identified through the Council of Orthopedic Residency Directors within the American Orthopaedic Association. Current program directors of these accredited programs were surveyed. The survey was emailed to 144 program directors, of which 141 emails were delivered. Responses were received from 45 program directors, representing 31% of programs. The survey focused on maternity, paternity, and adoptive leave, and it consisted of questions designed to explore program policies (formal, unwritten, no policy, or in development), time considerations (amount allowed, allocation of time away, and makeup requirements), and utilization (trainees who took leave and type of leave used). Most respondents have maternity leave policy (formal: 36 of 45 [80%]; unwritten: 17 of 45 [38%]). Sixteen programs (16 of 45 [36%]) reported having both a formal and an unwritten maternity leave policy. Less than half of

Association of household income and education with eating behaviors in Japanese adults: a cross-sectional study.

Science.gov (United States)

Nakamura, Saki; Inayama, Takayo; Hata, Kikuko; Matsushita, Munehiro; Takahashi, Masaki; Harada, Kazuhiro; Arao, Takashi

2016-01-22

Socioeconomic inequalities as social determinants of health are important issues in public health and health promotion. However, the association between socioeconomic status and eating behaviors has been investigated poorly in Japanese adults. To fill this gap, the present study examines the association of eating behaviors with household income and education. The sample comprised 3,137 Japanese adults (1,580 men and 1,557 women) aged 30 to 59 years who responded to an Internet-based cross-sectional survey in 2014. Data on the following eating behaviors were collected via self-report: "taking care of one's diet for health," "eating vegetables," "frequency of eating breakfast," "frequency of family breakfasts," "frequency of family dinners," "using the information on nutrition labels," and "conversations with family or friends during meals." Self-reported data on socioeconomic status (household income and education) and demographic variables (gender, age, district of residence, marital status, residence status, and employment status) were also collected. The associations between eating behaviors and household income or education were tested using binomial logistic regression analysis with eating behaviors as dependent variables and household income and education as independent variables. A trend P -value was calculated for three categories of household income (less than 3,000,000 JPY, 3,000,000-7,000,000 JPY, and over 7,000,000 JPY) and education (junior high/high school, 2-year college, and 4-year college/graduate school). Higher household income and education were significantly associated with higher rates of eating vegetables, using the information on nutrition labels, and conversation with family or friends during meals in Japanese men and women. Higher household incomes were significantly associated with lower rates of frequency of family breakfasts in Japanese men and lower rates of frequency of family dinners in Japanese men and women. Higher socioeconomic

Social Media in Pediatric Orthopaedics.

Science.gov (United States)

Lander, Sarah T; Sanders, James O; Cook, Peter C; O'Malley, Natasha T

Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences. Using the Pediatric Orthopaedic Society of North America Member Directory, each active member's social media presence was reviewed through an Internet search. Members were stratified on the basis of practice model and geographic location. Individual Internet searches, social media sites, and number of publications were reviewed for social media presence. Of 987 Pediatric Orthopaedic Society of North America members, 95% had a professional webpage, 14.8% a professional Facebook page, 2.2% a professional Twitter page, 36.8% a LinkedIn profile, 25.8% a ResearchGate profile, 33% at least 1 YouTube. Hospital-based physicians had a lower mean level of utilization of social media compared with their private practice peers, and a higher incidence of Pubmed publications. Private practice physicians had double the social media utilization. Regional differences reveal that practicing Pediatric Orthopaedists in the Northeast had increased utilization of ResearchGate and LinkedIn and the West had the lowest mean social media utilization levels. The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health

Novel genetic markers associate with atrial fibrillation risk in Europeans and Japanese.

Science.gov (United States)

Lubitz, Steven A; Lunetta, Kathryn L; Lin, Honghuang; Arking, Dan E; Trompet, Stella; Li, Guo; Krijthe, Bouwe P; Chasman, Daniel I; Barnard, John; Kleber, Marcus E; Dörr, Marcus; Ozaki, Kouichi; Smith, Albert V; Müller-Nurasyid, Martina; Walter, Stefan; Agarwal, Sunil K; Bis, Joshua C; Brody, Jennifer A; Chen, Lin Y; Everett, Brendan M; Ford, Ian; Franco, Oscar H; Harris, Tamara B; Hofman, Albert; Kääb, Stefan; Mahida, Saagar; Kathiresan, Sekar; Kubo, Michiaki; Launer, Lenore J; MacFarlane, Peter W; Magnani, Jared W; McKnight, Barbara; McManus, David D; Peters, Annette; Psaty, Bruce M; Rose, Lynda M; Rotter, Jerome I; Silbernagel, Guenther; Smith, Jonathan D; Sotoodehnia, Nona; Stott, David J; Taylor, Kent D; Tomaschitz, Andreas; Tsunoda, Tatsuhiko; Uitterlinden, Andre G; Van Wagoner, David R; Völker, Uwe; Völzke, Henry; Murabito, Joanne M; Sinner, Moritz F; Gudnason, Vilmundur; Felix, Stephan B; März, Winfried; Chung, Mina; Albert, Christine M; Stricker, Bruno H; Tanaka, Toshihiro; Heckbert, Susan R; Jukema, J Wouter; Alonso, Alvaro; Benjamin, Emelia J; Ellinor, Patrick T

2014-04-01

This study sought to identify nonredundant atrial fibrillation (AF) genetic susceptibility signals and examine their cumulative relations with AF risk. AF-associated loci span broad genomic regions that may contain multiple susceptibility signals. Whether multiple signals exist at AF loci has not been systematically explored. We performed association testing conditioned on the most significant, independently associated genetic markers at 9 established AF loci using 2 complementary techniques in 64,683 individuals of European ancestry (3,869 incident and 3,302 prevalent AF cases). Genetic risk scores were created and tested for association with AF in Europeans and an independent sample of 11,309 individuals of Japanese ancestry (7,916 prevalent AF cases). We observed at least 4 distinct AF susceptibility signals on chromosome 4q25 upstream of PITX2, but not at the remaining 8 AF loci. A multilocus score comprised 12 genetic markers demonstrated an estimated 5-fold gradient in AF risk. We observed a similar spectrum of risk associated with these markers in Japanese. Regions containing AF signals on chromosome 4q25 displayed a greater degree of evolutionary conservation than the remainder of the locus, suggesting that they may tag regulatory elements. The chromosome 4q25 AF locus is architecturally complex and harbors at least 4 AF susceptibility signals in individuals of European ancestry. Similar polygenic AF susceptibility exists between Europeans and Japanese. Future work is necessary to identify causal variants, determine mechanisms by which associated loci predispose to AF, and explore whether AF susceptibility signals classify individuals at risk for AF and related morbidity. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The influence of alcohol and tobacco use in orthopaedic inpatients on complications of surgery.

Science.gov (United States)

Williams, Gerard; Daly, Michelle; Proude, Elizabeth M; Kermode, Steven; Davis, Michelle; Barling, Jan; Haber, Paul S

2008-01-01

Tobacco use and heavy alcohol consumption are associated with increased morbidity and mortality. There is limited research on the correlation between tobacco and risky levels of alcohol use and the possible complications associated with a hospital admission. The underestimation of problem drinking, in particular, has obvious repercussions for the management of patients in hospital. If alcohol-related problems go undetected or unrecorded, treatment may be inadequate or inappropriate. The aims of the project were to assess the prevalence of high-risk alcohol and tobacco use in orthopaedic in-patients and to examine any relationship between alcohol and tobacco use and the number and type of complications, management and length of stay. One hundred and fifty-three consecutive orthopaedic admissions to the Orthopaedic Ward at Lismore Base Hospital were screened using the Drinkcheck questionnaire, which is based on the Alcohol Use Disorders Identification Test (AUDIT), but which also screens for tobacco use. Nursing staff on the ward completed a Complications Evaluation Questionnaire (CEQ). The risk status of the subjects was compared to the number and type of complications, to assess any effects of alcohol and tobacco on post-surgical complications. Significant correlations were found between tobacco use, hazardous and harmful alcohol use and numerous medical complications and behavioural problems. Behavioural problems associated with risky alcohol use included verbal abuse, agitation and sleep disturbances, particularly in men; problems associated with tobacco use included agitation and non-compliance. Orthopaedic patients who smoke and/or drink heavily prior to surgery may have more non-medical complications than non-smokers and light or non-drinkers. All surgery patients should thus be screened for alcohol and tobacco use and alcohol withdrawal, which may cause other symptoms such as behavioural problems, non-compliance and verbal abuse post-surgery.

Using financial incentives to improve value in orthopaedics.

Science.gov (United States)

Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J

2012-04-01

A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

Rapid Prototyping in Orthopaedic Surgery: A User's Guide

OpenAIRE

Frame, Mark; Huntley, James S.

2012-01-01

Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce pr...

Eosinophilic pustular folliculitis associated with hematological disorders: A report of two cases and review of Japanese literature.

Science.gov (United States)

Takamura, Saori; Teraki, Yuichi

2016-04-01

Eosinophilic pustular folliculitis (EPF) occurs in patients with hematological disorders. However, clinical information about hematological disorder-associated EPF is scarce. We report two cases of EPF associated with mantle cell lymphoma and reviewed the available published work on Japanese cases. We identified a total of 23 Japanese cases, including the two cases reported here, who had hematological disorder-associated EPF. Fourteen cases were associated with treatment for hematological malignancies (transplantation-related EPF) and nine cases were associated with hematological malignancies themselves (hematological malignancy-related EPF). Although the skin eruption was clinically indistinguishable between the two subtypes, transplantation-related EPF occurred on the face and trunk of young and middle-aged men and women, whereas hematological malignancy-related EPF occurred mostly on the face of older men. Peripheral blood eosinophilia was more frequently observed in transplantation-related EPF. These observations suggest variations among patients with EPF associated with hematological disorders. © 2015 Japanese Dermatological Association.

Comparison of health literacy in privately insured and public hospital orthopaedic patients.

Science.gov (United States)

Cosic, Filip; Porter, Tabitha; Norsworthy, Cameron; Price, Rohan; Bedi, Harvinder

2018-05-14

Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. Results In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including

Orthopaedic admissions due to sports and recreation injuries.

LENUS (Irish Health Repository)

Delaney, R A

2009-02-01

The health benefits of exercise may be attenuated by sports and recreation related injury (SRI). Though the majority of SRI are mild and self-limiting, a significant number are serious and require orthopaedic intervention. The aims of this study were to assess the burden of these serious injuries on the orthopaedic inpatient service, and to investigate potential target areas for injury prevention. All 1,590 SRI seen in the ED over a 3-month period were analysed using the Patient Information Management System to determine which patients received inpatient orthopaedic care. The medical records of those 63 patients who required inpatient care under orthopaedics were reviewed and data collected on demographic features, history, operative procedure and theatre resources, and length of hospital stay. Data were analyzed using SPSS. SRI accounted for 12.3% of all ED presentations. The principal activities resulting in injury requiring orthopaedic care were soccer, hurling and informal play e.g. trampoline. Falls made up 37% of the overall mechanism of injury but 68% of the injuries severe enough to require operative management. Most operative procedures were performed as part of a routine day trauma list but 20% were performed out of hours. This group of injuries places a significant burden on a busy trauma service. Injury prevention measures such as public education regarding falls in sport may have a role in reducing this burden.

Predicting the post-operative length of stay for the orthopaedic trauma patient.

Science.gov (United States)

Chona, Deepak; Lakomkin, Nikita; Bulka, Catherine; Mousavi, Idine; Kothari, Parth; Dodd, Ashley C; Shen, Michelle S; Obremskey, William T; Sethi, Manish K

2017-05-01

Length of stay (LOS) is a major driver of cost and quality of care. A bundled payment system makes it essential for orthopaedic surgeons to understand factors that increase a patient's LOS. Yet, minimal data regarding predictors of LOS currently exist. Using the ACS-NSQIP database, this is the first study to identify risk factors for increased LOS for orthopaedic trauma patients and create a personalized LOS calculator. All orthopaedic trauma surgery between 2006 and 2013 were identified from the ACS-NSQIP database using CPT codes. Patient demographics, pre-operative comorbidities, anatomic location of injury, and post-operative in-hospital complications were collected. To control for individual patient comorbidities, a negative binomial regression model evaluated hospital LOS after surgery. Betas (β), were determined for each pre-operative patient characteristic. We selected significant predictors of LOS (p < 0.05) using backwards stepwise elimination. 49,778 orthopaedic trauma patients were included in the analysis. Deep incisional surgical site infections and superficial surgical site infections were associated with the greatest percent change in predicted LOS (β = 1.2760 and 1.2473, respectively; p < 0.0001 for both). A post-operative LOS risk calculator was developed based on the formula: [Formula: see text]. Utilizing a large prospective cohort of orthopaedic trauma patients, we created the first personalized LOS calculator based on pre-operative comorbidities, post-operative complications and location of surgery. Future work may assess the use of this calculator and attempt to validate its utility as an accurate model. To improve the quality measures of hospitals, orthopaedists must employ such predictive tools to optimize care and better manage resources.

Safety syringes and anti-needlestick devices in orthopaedic surgery.

Science.gov (United States)

Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

2011-09-07

The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting

Association of unipedal standing time and bone mineral density in community-dwelling Japanese women.

Science.gov (United States)

Sakai, A; Toba, N; Takeda, M; Suzuki, M; Abe, Y; Aoyagi, K; Nakamura, T

2009-05-01

Bone mineral density (BMD) and physical performance of the lower extremities decrease with age. In community-dwelling Japanese women, unipedal standing time, timed up and go test, and age are associated with BMD while in women aged 70 years and over, unipedal standing time is associated with BMD. The aim of this study was to clarify whether unipedal standing time is significantly associated with BMD in community-dwelling women. The subjects were 90 community-dwelling Japanese women aged 54.7 years. BMD of the second metacarpal bone was measured by computed X-ray densitometry. We measured unipedal standing time as well as timed up and go test to assess physical performance of the lower extremities. Unipedal standing time decreased with increased age. Timed up and go test significantly correlated with age. Low BMD was significantly associated with old age, short unipedal standing time, and long timed up and go test. Stepwise regression analysis revealed that age, unipedal standing time, and timed up and go test were significant factors associated with BMD. In 21 participants aged 70 years and over, body weight and unipedal standing time, but not age, were significantly associated with BMD. BMD and physical performance of the lower extremities decrease with older age. Unipedal standing time, timed up and go test, and age are associated with BMD in community-dwelling Japanese women. In women aged 70 years and over, unipedal standing time is significantly associated with BMD.

Orthopaedic training in Kenya

African Journals Online (AJOL)

Background: Orthopaedic training in Kenya, like in other East, central and .... quite a number of good facilities that would train an ... provide a forum for exchange of ideas and training. (2,3) ... administrators purely interested in service provision,.

Radiation safety knowledge and practices among Irish orthopaedic trainees.

LENUS (Irish Health Repository)

Nugent, M

2014-04-23

Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees.

The (CTGn polymorphism in the NOTCH4 gene is not associated with schizophrenia in Japanese individuals

Directory of Open Access Journals (Sweden)

Okubo Takehito

2001-06-01

Full Text Available Abstract Background The human NOTCH4 gene is a candidate gene for schizophrenia due to its chromosomal location and neurobiological roles. In a British linkage study, NOTCH4 gene polymorphisms were highly associated with schizophrenia. In a Japanese case-control association study, however, these polymorphisms did not show significant associations with schizophrenia. We conducted a case-control study with Japanese subjects to explore an association between the triplet repeat polymorphism in the NOTCH4 gene and schizophrenia, including subtypes of schizophrenia, longitudinal disease course characteristics, and a positive family history for psychoses. Methods We examined the (CTGn repeat polymorphism in the NOTCH4 gene among 100 healthy Japanese individuals and 102 patients with schizophrenia (22 paranoid, 38 disorganized, 29 residual, 64 episodic, 31 continuous, 42 with prominent negative symptoms, and 46 with positive family histories using a polymerase chain reaction-based, single-strand conformational polymorphism analysis. Results Five different alleles consisting of 6, 9, 10, 11, and 13 repeats of CTG (Leu in patients with schizophrenia, and 4 alleles consisting of 6, 9, 10, and 11 repeats in controls were found. No significant differences in genotype or allele frequencies of repeat numbers were found between controls and patients. In addition, there were no associations between the polymorphism and schizophrenia subtypes, longitudinal disease course characteristics, or positive family history of the patients. Conclusions Our data suggest a lack of association between the NOTCH4 gene triplet repeat polymorphism and schizophrenia in Japanese individuals.

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.

Planning for life after orthopaedics.

Science.gov (United States)

Barr, Joseph S; McCaslin, Michael J; Hinds, Cynthia K

2014-01-01

The word retirement is going out of fashion. Many orthopaedic surgeons want to work in some capacity when they stop performing surgery. Making a smooth transition from a busy orthopaedic practice to alternative work demands advanced planning. The surgeon must consider personal issues that involve how to use human capital (his or her accumulated knowledge and experience). New ventures, hobbies, travel, and spending time with family and friends are some possibilities. Plans for slowing down or leaving the practice should be discussed and agreed on well ahead of time. Agreements for buyouts may be difficult to work out and will require creative thinking. The solo practitioner can close the practice or hire a successor. Financial planning is perhaps the most important consideration and should be started by approximately age 40. It is recommended that the surgeon develop a portfolio of secure investments and annuities to provide adequate income for as long as is needed and then to turn the residual income to one's family, favorite charities, or other desired cause. A team of competent advisors is needed to help develop and achieve one's goals, create financial security, and provide the discipline to carry out the needed planning for life after orthopaedics.

Supply and Demand Analysis of the Orthopaedic Trauma Surgeon Workforce in the United States.

Science.gov (United States)

Sielatycki, John A; Sawyer, Jeffrey R; Mir, Hassan R

2016-05-01

To investigate recent trends in the orthopaedic trauma workforce and to assess whether supply of orthopaedic trauma surgeons (OTS) matches the demand for their skills. Supply estimated using Orthopaedic Trauma Association (OTA) membership and American Academy of Orthopaedic Surgeons census data. The annual number of operative pelvic and acetabular fractures reported by American College of Surgeons verified trauma centers in the National Trauma Data Bank (NTDB) was used as a surrogate of demand. Because surrogates were used, the annual rate of change in OTA membership versus rate of change in operative injuries per NTDB center was compared. From 2002 to 2012, reported operative pelvic and acetabular injuries increased by an average of 21.0% per year. The number of reporting trauma centers increased by 27.2% per year. The number of OTA members increased each year except in 2009, with mean annual increase of 9.8%. The mean number of orthopaedic surgeons per NTDB center increased from 7.98 to 8.58, an average of 1.5% per year. The annual number of operative pelvic and acetabular fractures per NTDB center decreased from 27.1 in 2002 to 19.03 in 2012, down 2.0% per year. In the United States, from 2002 to 2012, the number of OTS trended upward, whereas operative pelvic and acetabular cases per reporting NTDB center declined. These trends suggest a net loss of such cases per OTS over this period.

The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.

LENUS (Irish Health Repository)

O Mir, Marie

2016-04-01

The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady\\'s Children\\'s Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.

Adverse Effects of Smoking on Outcomes of Orthopaedic Surgery

OpenAIRE

Sheung-tung Ho

2017-01-01

Smoking has many adverse effects on the musculoskeletal system, particularly on the outcomes after orthopaedic surgery. Smoking is associated with surgical site infection and postoperative wound complications after spine surgery, total joint arthroplasty, and fracture fixation; nonunion after spinal fusion, ankle fusion, osteotomy, and internal fixation and bone grafting for scaphoid nonunion; worse outcomes after lumbar disc prolapse, spinal stenosis, and cervical myelopathy surgery; peripro...

Bone graft materials in fixation of orthopaedic implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan

2013-01-01

Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...

Association of interleukin 1 receptor-like 1 gene polymorphisms with eosinophilic phenotype in Japanese adults with asthma.

Science.gov (United States)

Inoue, Hideki; Ito, Isao; Niimi, Akio; Matsumoto, Hisako; Oguma, Tsuyoshi; Tajiri, Tomoko; Iwata, Toshiyuki; Nagasaki, Tadao; Kanemitsu, Yoshihiro; Morishima, Toshitaka; Hirota, Tomomitsu; Tamari, Mayumi; Wenzel, Sally E; Mishima, Michiaki

2017-11-01

IL1RL1 (ST2) is involved in Th2 inflammation including eosinophil activation. Single nucleotide polymorphisms (SNPs) of the IL1RL1 gene are associated with asthma development and increased peripheral blood eosinophil counts. However, the association between IL1RL1 SNPs and eosinophilic phenotype among adults with asthma remains unexplored. In a primary cohort of 110 adult Japanese patients with stable asthma, we examined the associations between IL1RL1 SNPs and clinical measurements including forced expiratory volume (FEV 1 ), airway reversibility of FEV 1 , exhaled nitric oxide (FeNO), serum soluble-ST2 (sST2) levels, peripheral blood eosinophil differentials and serum total IgE level. The findings in the primary cohort were confirmed in a validation cohort of 126 adult Japanese patients with stable asthma. Patients with minor alleles in 3 SNPs (rs17026974, rs1420101, and rs1921622) had high FeNO, blood eosinophil differentials, and reversibility of FEV 1 , but low levels of serum sST2 and FEV 1 . Minor alleles of rs1041973 were associated with low serum sST2 levels alone. In the validation cohort, minor alleles of rs1420101 were associated with high FeNO and blood eosinophil differentials, whereas minor alleles of rs17026974 and rs1921622 were associated with high blood eosinophil differentials and FeNO, respectively. Multivariate analyses revealed that the minor allele of rs1420101 additively contributed to the FeNO, blood eosinophil differentials, and reversibility of FEV 1 . The minor alleles of IL1RL1 SNPs were associated with high FeNO and peripheral blood eosinophilia among adult Japanese patients with stable asthma. IL1RL1 SNPs may characterize the eosinophilic phenotype with greater eosinophilic inflammation in the Japanese asthma cohort. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

The Placenta: Applications in Orthopaedic Sports Medicine.

Science.gov (United States)

McIntyre, James Alexander; Jones, Ian A; Danilkovich, Alla; Vangsness, C Thomas

2018-01-01

Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Systematic review. Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes

Bouba/Kiki in Touch: Associations Between Tactile Perceptual Qualities and Japanese Phonemes

Directory of Open Access Journals (Sweden)

Maki Sakamoto

2018-03-01

Full Text Available Several studies have shown cross-modal associations between sounds and vision or gustation by asking participants to match pre-defined sound-symbolic words (SSWs, such as “bouba” or “kiki,” with visual or gustatory materials. Here, we conducted an explorative study on cross-modal associations of tactile sensations using spontaneous production of Japanese SSWs and semantic ratings. The Japanese language was selected, because it has a large number of SSWs that can represent a wide range of tactile perceptual spaces with fine resolution, and it shows strong associations between sound and touch. In the experiment, we used 120 everyday materials to cover basic material categories that could be associated with fundamental dimensions of tactile perception. Upon contact with these materials, participants expressed their tactile sensations by using Japanese SSWs, and at the same time, evaluated the tactile sensations by semantic differential scales using adjective pairs. Thanks to the variety of testing materials, we were able to demonstrate the existence of systematic associations between sounds and tactile fundamental perceptual dimensions in a more detailed and comprehensive way than ever done so before. In particular, we found that for vowels, positive tactile ratings were associated with the back vowel (/u/, while negative ratings were associated with the front vowels (/i/ and /e/. The central vowels (/o/ and /a/ were mainly associated with rough, hard, and dry feelings. Consonants were categorized based on vocal features and articulation. The category of the voiced consonants (e.g., /dz/ and /g/ corresponded to feelings of roughness, while that of voiceless consonants (e.g., /ʦ/, and /s/ corresponded to feelings of smoothness. The categories of the bilabial plosive (/p/ and /b/ and voiced alveolar nasal (/n/ consonants were mainly related to soft, sticky and wet feelings, while that of voiceless alveolar affricate (/ʦ/ and voiceless velar

A Confirmatory Model for Substance Use Among Japanese American and Part-Japanese American Adolescents

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Williams, John Kino Yamaguchi; Else, 'Iwalani R. N.; Goebert, Deborah A.; Nishimura, Stephanie T.; Hishinuma, Earl S.; Andrade, Naleen N.

2013-01-01

Few studies have examined the effect of ethnicity and cultural identity on substance use among Asian and Pacific Islander adolescents. A cross-sequential study conducted in Hawai'i with 144 Japanese American and part-Japanese American adolescents assessed a model integrating Japanese ethnicity, cultural identity, substance use, major life events, and social support. Japanese American adolescents scored higher on the Japanese Culture Scale and on the Peers’ Social Support than the part-Japanese American adolescents. Significant associations for substance use and impairment included culturally intensified events and Japanese cultural identity- behavior subset. Models had good overall fits and suggested that conflict surrounding cultural identity may contribute to substance use. PMID:23480213

Bone Adaptation Around Orthopaedic Implants of Varying Materials

DEFF Research Database (Denmark)

Bagge, Mette

1998-01-01

The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading......The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading...

Prevalence and pattern of small animal orthopaedic conditions at ...

African Journals Online (AJOL)

Small animal orthopaedic case records of a 20-year period were surveyed to obtain the prevalence and pattern of orthopaedic conditions presented to the Veterinary Teaching Hospital (VTH), University of Ibadan, Nigeria, with the objective of providing data for planning on small animal healthcare facilities, policy ...

Azathioprine Intolerance in Japanese Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

Science.gov (United States)

Morishita, Michiko; Watanabe, Haruki; Yan, Minglu; Zeggar, Sonia; Hiramatsu, Sumie; Ohashi, Keiji; Miyawaki, Yoshia; Katsuyama, Eri; Katsuyama, Takayuki; Takano Narazaki, Mariko; Toyota Tatebe, Noriko; Sunahori Watanabe, Katsue; Kawabata, Tomoko; Sada, Ken-Ei; Wada, Jun

2017-01-01

Objective To assess the safety of azathioprine (AZA) in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods We retrospectively enrolled 67 consecutive AAV patients who had initiated AZA treatment from January 2006 to August 2014 at Okayama University Hospital. We evaluated the development of severe adverse events (AEs), AZA discontinuation due to total AEs (severe AEs included) within 1 year, and AZA-associated risk factors. Results The patients' median age was 70 years old. Forty-nine women and 18 men participated at the initiation of the study. Fifty-eight (87%) patients experienced AEs, and 36 experienced severe AEs (21 hepatic and 11 cytopenic severe AEs). Thirty-one (46%) patients discontinued treatment because of AEs. Abnormal hepatic laboratory test results at the treatment initiation were more frequent in patients with hepatic severe AEs and were associated with treatment discontinuation. The leukocyte and neutrophil counts at the treatment initiation were lower in the patients who discontinued treatment because of cytopenic AEs than in those who continued treatment. Only two patients experienced flare-ups during treatment. Conclusion The AE-associated AZA discontinuation rate in Japanese AAV patients was relatively high. AZA use warrants caution in patients with abnormal hepatic laboratory test results or low leukocyte or neutrophil counts. PMID:28674351

Associations of urinary cadmium with circulating sex hormone levels in pre- and postmenopausal Japanese women

International Nuclear Information System (INIS)

Nagata, Chisato; Konishi, Kie; Goto, Yuko; Tamura, Takashi; Wada, Keiko; Hayashi, Makoto; Takeda, Noriyuki; Yasuda, Keigo

2016-01-01

Background: Exposure to cadmium has been suspected as a risk factor for breast cancer. The present study examined the associations between urinary cadmium levels and circulating sex hormone levels that are linked to breast cancer risk in healthy women. Methods: The study subjects were 396 premenopausal Japanese women who had regular menstrual cycles less than 40 days long and 207 postmenopausal Japanese women. Urinary cadmium was measured using spot urine samples. Plasma estradiol, testosterone, and dehydroepiandrosterone sulfate were measured. Additionally, the follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin were measured for premenopausal women. Results: In premenopausal women, the urinary cadmium level either expressed in μg per liter or per g of urine creatinine was significantly inversely associated with total and free testosterone levels after controlling for age, body mass index, smoking status, alcohol intake, and the phase of the menstrual cycle. Total and free testosterone levels were 14.6% and 15.0% lower, respectively, in women in the highest quartile of urinary cadmium per g creatinine in those in the lowest quartile. In postmenopausal women, the urinary cadmium in μg per liter as well as per g creatinine was significantly inversely associated with the estradiol level after controlling for covariates. The estradiol level was 25.8% lower in women in the highest tertile of urinary cadmium per g creatinine than in those in the lowest tertile. Conclusions: The data suggest inverse associations between urinary cadmium and the plasma estradiol or testosterone level in Japanese women. - Highlights: • Exposure to cadmium has been suspected as a risk factor for breast cancer. • Urinary cadmium and plasma sex-hormone levels were measured in Japanese women. • Urinary cadmium was inversely associated with testosterone in premenopausal women. • Urinary cadmium was inversely associated with estradiol in postmenopausal

Associations of urinary cadmium with circulating sex hormone levels in pre- and postmenopausal Japanese women

Energy Technology Data Exchange (ETDEWEB)

Nagata, Chisato, E-mail: chisato@gifu-u.ac.jp [Department of Epidemiology & Preventive Medicine, Gifu University Graduate School of Medicine, Gifu (Japan); Konishi, Kie; Goto, Yuko; Tamura, Takashi; Wada, Keiko [Department of Epidemiology & Preventive Medicine, Gifu University Graduate School of Medicine, Gifu (Japan); Hayashi, Makoto [Department of Internal Medicine, Matsunami General Hospital, Gifu (Japan); Takeda, Noriyuki [Department of Endocrinology and Metabolism, Murakami Memorial Hospital, Asahi University, Gifu (Japan); Yasuda, Keigo [Department of Internal Medicine, Matsunami General Hospital, Gifu (Japan)

2016-10-15

Background: Exposure to cadmium has been suspected as a risk factor for breast cancer. The present study examined the associations between urinary cadmium levels and circulating sex hormone levels that are linked to breast cancer risk in healthy women. Methods: The study subjects were 396 premenopausal Japanese women who had regular menstrual cycles less than 40 days long and 207 postmenopausal Japanese women. Urinary cadmium was measured using spot urine samples. Plasma estradiol, testosterone, and dehydroepiandrosterone sulfate were measured. Additionally, the follicle-stimulating hormone, luteinizing hormone, and sex hormone-binding globulin were measured for premenopausal women. Results: In premenopausal women, the urinary cadmium level either expressed in μg per liter or per g of urine creatinine was significantly inversely associated with total and free testosterone levels after controlling for age, body mass index, smoking status, alcohol intake, and the phase of the menstrual cycle. Total and free testosterone levels were 14.6% and 15.0% lower, respectively, in women in the highest quartile of urinary cadmium per g creatinine in those in the lowest quartile. In postmenopausal women, the urinary cadmium in μg per liter as well as per g creatinine was significantly inversely associated with the estradiol level after controlling for covariates. The estradiol level was 25.8% lower in women in the highest tertile of urinary cadmium per g creatinine than in those in the lowest tertile. Conclusions: The data suggest inverse associations between urinary cadmium and the plasma estradiol or testosterone level in Japanese women. - Highlights: • Exposure to cadmium has been suspected as a risk factor for breast cancer. • Urinary cadmium and plasma sex-hormone levels were measured in Japanese women. • Urinary cadmium was inversely associated with testosterone in premenopausal women. • Urinary cadmium was inversely associated with estradiol in postmenopausal

Orthopaedic surgeries - assessment of ionising radiations exposure in health care workers

International Nuclear Information System (INIS)

Leite, E.S.; Uva, A.S.

2006-01-01

Full text of publication follows: 1. Objectives: The health care workers are exposed to ionizing radiations during their activities. In the operating rooms, the ionizing radiations are used in orthopaedic surgery and the dose depends on some factors, like the characteristics of the equipment. This study aims to: Estimate the occupational dose of ionizing radiations exposure of the orthopaedic doctors and nurses during the orthopaedic surgeries, in a Portuguese operating room; Sensitize the health care workers to use the individual dosimeter and to adopt radiation preventive measures. 2. Population and methods The study was conducted on nine Orthopaedic doctors and two nurses of an operating room of a hospital in Lisbon neighborhoods. We made a risk evaluating concerning: the radiations dose in different points, corresponding to gonads, hands and crystalline lens levels of all the professionals, during the surgeries; the average period of radiation in the orthopaedic surgeries; the number of annual orthopaedic surgeries, looking for that in the surgeries registers, to estimate the annual ionizing radiations dose of each orthopaedic doctor and nurse. 3. Results The annual doses estimated at different levels for orthopaedic doctors were the following: gonads: between 20,63 and 68,75 mGy; hands: 4,95 16,50 mGy; crystalline lens: 8,25 27,50 mGy). For the orthopaedic nurses: gonads: 130,63 151,25 mGy; hands: 31,35 36,30 mGy; crystalline lens 52,25 60,25 mGy. 4. Conclusions Although the location and positions of health care workers are not the same during the different surgeries and the equipment has an automatic control of the X ray emission, the annual ionizing radiations dose exposure for health care workers is an important one. The risk rating justifies the use of individual dosimeters for better individual dose assessment as part of an ionizing radiations prevention program. As a matter of fact preventive measures begin with a good quantitative risk assessment of

Interleukin 1 beta promoter polymorphism is associated with keratoconus in a Japanese population.

Science.gov (United States)

Mikami, Takenori; Meguro, Akira; Teshigawara, Takeshi; Takeuchi, Masaki; Uemoto, Riyo; Kawagoe, Tatsukata; Nomura, Eiichi; Asukata, Yuri; Ishioka, Misaki; Iwasaki, Miki; Fukagawa, Kazumi; Konomi, Kenji; Shimazaki, Jun; Nishida, Teruo; Mizuki, Nobuhisa

2013-01-01

Polymorphisms in the interleukin 1 alpha (IL1A) and IL1B gene regions were previously associated with keratoconus in a Korean population. In the present study, we investigated whether the IL1A and IL1B polymorphisms are associated with keratoconus in a Japanese population. A total of 169 Japanese patients with keratoconus and 390 Japanese healthy controls were recruited. We genotyped one IL1A single nucleotide polymorphism (SNP; rs2071376) and two IL1B SNPs (rs1143627 and rs16944) to compare the frequencies of alleles, genotypes, and haplotypes between cases and controls. Statistically significant association was observed for rs1143627 (-31 T>C) in the IL1B promoter region; the T allele of rs1143627 was associated with an increased risk of keratoconus (p=0.014, corrected p value [pc]=0.043, odds ratio=1.38). The C allele of rs16944 (-511 C>T) in the IL1B promoter region had a 1.33-fold increased risk of keratoconus, although this increase did not reach statistical significance (p=0.033, pc=0.098). The TT genotype of rs1143627 was weakly associated with an increased risk of keratoconus (p=0.033, pc=0.099, odds ratio=1.52). However, no significant differences were found in the allele and genotype frequencies between the cases and controls for rs2071376 in IL1A. Regarding haplotypic diversity, the haplotype created by the T allele of rs1143627 and C allele of rs16944 was associated with a 1.72-fold increased risk of keratoconus (p=4.0×10(-5), pc=1.6×10(-4)). Our results replicate associations reported recently in a Korean population. Thus, IL1B may play an important role in the development of keratoconus through genetic polymorphisms.

Cross-cultural adaptation and validation of the Japanese version of the Toronto Extremity Salvage Score (TESS) for patients with malignant musculoskeletal tumors in the upper extremities.

Science.gov (United States)

Akiyama, Toru; Uehara, Kosuke; Ogura, Koichi; Shinoda, Yusuke; Iwata, Shintaro; Saita, Kazuo; Tanzawa, Yoshikazu; Nakatani, Fumihiko; Yonemoto, Tsukasa; Kawano, Hirotaka; Davis, Aileen M; Kawai, Akira

2017-01-01

The Toronto Extremity Salvage Score (TESS) is a widely used disease-specific patient-completed questionnaire for the assessment of physical function in patients with musculoskeletal tumors; however, there had not been the validated Japanese version of the TESS. The aim of this study was to validate the Japanese version of the TESS in patients with musculoskeletal tumors in the upper extremity. After developing a Japanese version of the TESS, the questionnaire was administered to 53 patients to examine its reliability and validity in comparison with the Musculoskeletal Tumor Society (MSTS) scoring system and Short Form-36 (SF-36). Test-retest reliability with intraclass correlation coefficient (0.93) and internal consistency with Cronbach's alpha (0.90) were excellent. Factor analysis showed that the construct structure consisted of 3-item clusters, and the Akaike Information Criterion network also demonstrated that the items could be divided into 3 domains according to their content. The TESS strongly correlated with the MSTS rating scale (r = 0.750; P TESS had low correlations with the SF-36 mental health and role-emotional subscales and the MSTS scoring system manual dexterity domain. Our study suggests that the TESS is a reliable and valid instrument to measure patient-reported physical functioning in patients with upper extremity sarcoma. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Ireland's contribution to orthopaedic literature: a bibliometric analysis.

Science.gov (United States)

Kennedy, C; O Sullivan, P; Bilal, M; Walsh, A

2013-10-01

Bibliometric analysis of scientific performance within a country or speciality, facilitate the recognition of factors that may further enhance research activity and performance. Our aim was to illicit the current state of Irelands orthopaedic research output in terms of quantity and quality. We performed a retrospective bibliometric analysis of all Irish orthopaedic publications over the past 5 years, in the top 20 peer-reviewed orthopaedic journals. Utilising the MEDLINE database, each journal was evaluated for articles that were published over the study period. Reviews, editorials, reports and letters were excluded. Each article abstract was analysed for research content, and country of origin. A nation's mean IF was defined by multiplying each journal's IF by the number of articles. Publications per million (PmP) was calculated by dividing the total number of publications by the population of each country. We analysed a total of 25,595 article abstracts. Ireland contributed 109 articles in total (0.42% of all articles), however ranking according to population per million was 10th worldwide. Ireland ranked 18th worldwide in relation to mean impact factor, which was 2.91 over the study period. Ireland published in 16 of the top 20 journals, 9 of these were of European origin, and 1 of the top 5 was of American origin. In total, 61 Irish articles were assignable to clinical orthopaedic units. Clinical based studies (randomised controlled trials, observational, and epidemiology/bibliometric articles) and research based studies (In vivo, In vitro, and biomechanical) numbered 76 (69.7%) and 33 (30.2%) articles, respectively. This study provides a novel overview of current Irish orthopaedic related research, and how our standards translate to the worldwide orthopaedic community. In order to maintain our publication productivity, academic research should continue to be encouraged at post graduate level. Copyright © 2013 Royal College of Surgeons of Edinburgh

Are the claims made in orthopaedic print advertisements valid?

Science.gov (United States)

Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P

2014-05-01

Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p advertisements. High-quality evidence is required by orthopaedic surgeons to influence clinical practice and this evidence should be sought by manufacturers wishing to market a successful product.

[The alteration of Japanese anatomical terminology in the early Showa period and the Japanese language reform campaign].

Science.gov (United States)

Sawai, Tadashi; Sakai, Tatsuo

2010-03-01

In the second decade of the Showa period, great changes were made in the Japanese anatomical terms. It has been proposed that the presentation of JNA (Jenaer nomina anatomica) was one of the factors leading to the change. The Japanese language reform campaign, however, played an important role. The party kokugoaigo doumei and its successor kokugo kyokai required concise and unified technical terms. The anatomical nomenclature committee of the Japanese Association of Anatomists worked to satisfy this requirement. The committee consulted with nomenclature committees of other medical associations and took account of their opinions. The anatomical nomenclature committee abandoned the literal translation from Latin to Japanese and shaped a succinct Japanese terminology. Modern Japanese anatomical terms are based on this terminology.

Haemodilution study in major orthopaedic surgery experience as a technique of blood conservation.

Science.gov (United States)

Liaw, Y; Boon, P; Deshpande, S

1994-08-01

Haemodilution and auto-transfusion were carried out in 103 consecutive patients having major orthopaedic surgery. The records of 99 patients were available for retrospective assessment of this technique. Fifty-six per cent of the patients did not require any homologous blood transfusion. Homologous blood transfusion was given to 44% of the patients, who used up 99 units of blood in their entire hospital stay. There was no morbidity such as transfusion reaction, infection, decrease in platelets or re-operation for bleeding associated with the procedure, although there was one death secondary to myocardial infarction. This technique offered an alternative method to reduce the use of homologous blood transfusion in major orthopaedic operations.

Postinjury anxiety and social support among collegiate athletes: a comparison between orthopaedic injuries and concussions.

Science.gov (United States)

Covassin, Tracey; Crutcher, Bryan; Bleecker, Alisha; Heiden, Erin O; Dailey, Alexander; Yang, Jingzhen

2014-01-01

When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. Cross-sectional study. Athletic training room. A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = -1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = -4.21, P = .0001). Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play.

Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine.

Science.gov (United States)

Manning, Blaine T; Bohl, Daniel D; Hannon, Charles P; Redondo, Michael L; Christian, David R; Forsythe, Brian; Nho, Shane J; Bach, Bernard R

2018-04-01

Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician. Cross-sectional study; Level of evidence, 3. A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician's midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient

The 25 most cited articles in arthroscopic orthopaedic surgery.

Science.gov (United States)

Cassar Gheiti, Adrian J; Downey, Richard E; Byrne, Damien P; Molony, Diarmuid C; Mulhall, Kevin J

2012-04-01

The purpose of this study was to use Web of Knowledge to determine which published arthroscopic surgery-related articles have been cited most frequently by other authors by ranking the 25 most cited articles. We furthermore wished to determine whether there is any difference between a categorical "journal-by-journal" analysis and an "all-database" analysis in arthroscopic surgery and whether such a search methodology would alter the results of previously published lists of "citation classics" in the field. We analyzed the characteristics of these articles to determine what qualities make an article important to this subspecialty of orthopaedic surgery. Web of Knowledge was searched on March 7, 2011, using the term "arthroscopy" for citations to articles related to arthroscopy in 61 orthopaedic journals and using the all-database function. Each of the 61 orthopaedic journals was searched separately for arthroscopy-related articles to determine the 25 most cited articles. An all-database search for arthroscopy-related articles was carried out and compared with a journal-by-journal search. Each article was reviewed for basic information including the type of article, authorship, institution, country, publishing journal, and year published. The number of citations ranged from 189 to 567 in a journal-by-journal search and from 214 to 1,869 in an all-database search. The 25 most cited articles on arthroscopic surgery were published in 11 journals: 8 orthopaedic journals and 3 journals from other specialties. The most cited article in arthroscopic orthopaedic surgery was published in The New England Journal of Medicine, which was not previously identified by a journal-by-journal search. An all-database search in Web of Knowledge gives a more in-depth methodology of determining the true citation ranking of articles. Among the top 25 most cited articles, autologous chondrocyte implantation/transplantation is currently the most cited and most popular topic in arthroscopic

Association of serum carotenoids and tocopherols with atopic diseases in Japanese children and adolescents.

Science.gov (United States)

Okuda, Masayuki; Bando, Noriko; Terao, Junji; Sasaki, Satoshi; Sugiyama, Shinichi; Kunitsugu, Ichiro; Hobara, Tatsuya

2010-06-01

The present study assessed whether serum carotenoids and tocopherols are associated with atopic diseases (eczema and asthma) in 10- and 13-yr-olds in a Japanese community. Of 2796 students attending schools in Shunan, Japan, in 2006, 396 students were randomly selected for this study using nested case-control design. Atopic diseases and dietary food intake were assessed using self-administered questionnaires, and serum antioxidants were analyzed using high-performance liquid chromatography. We found no associations between serum carotenoids and atopic diseases. However, odds ratios (OR)s for the third and fourth quartiles of serum alpha-tocopherol with atopic eczema were 0.33 (95% confidence interval: 0.15-0.73) and 0.36 (0.14-0.89), respectively, and the trend was negatively significant (P(trend) = 0.048). We did not find a significant association for asthma. In conclusion, serum alpha-tocopherol was negatively associated with the prevalence of eczema. Serum carotenoids did not show definitive protective effects in Japanese youth.

The use of three-dimensional printing technology in orthopaedic surgery.

Science.gov (United States)

Wong, Tak Man; Jin, Jimmy; Lau, Tak Wing; Fang, Christian; Yan, Chun Hoi; Yeung, Kelvin; To, Michael; Leung, Frankie

2017-01-01

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

Relative risks of radiation-associated cancer: comparison of second cancer in therapeutically irradiated populations with the Japanese atomic bomb survivors

International Nuclear Information System (INIS)

Little, M.P.; Muirhead, C.R.; Haylock, R.G.E.; Thomas, J.M.

1999-01-01

In this paper the radiation-associated relative risks of second primary cancer incidence in groups treated for first primary cancer by radiotherapy are compared with radiation-associated relative risk estimates in the Japanese atomic bomb survivor cancer incidence data. For four cancer sites, namely lung cancer, bone cancer, ovarian cancer and leukaemia, the relative risks in the comparable (age at exposure, time since exposure, sex matched) subsets of the Japanese data are significantly greater than those in the majority of second cancer studies. Even when the differences between the relative risks in the Japanese atomic bomb survivors and the medical series do not approach conventional levels of statistical significance, relative risks tend to be higher in the Japanese data than in the second cancer studies. At least for leukaemia, the discrepancy between the Japanese and second cancer risks can be largely explained by cell- sterilisation effects. There are few indications of modification of radiation-associated second cancer relative risk among those treated with adjuvant chemotherapy, nor are there strong indications of modification of radiation- associated relative risk by heritable genetic factors. If anything, there is evidence that second cancer relative excess risks are lower among those patients with cancer-prone disorders than among non-susceptible patients. However, the higher underlying cancer risk in some of these medically exposed populations should also be considered, in particular for those with cancer-prone conditions, so that the absolute excess risk is sometimes higher than in the Japanese data. (orig.)

Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

Directory of Open Access Journals (Sweden)

Ioana Petre

2014-07-01

Full Text Available Year after year recovery clinics worldwide report significant numbers of lower limb bearing joint disabilities. An effective method for the speedy rehabilitation of patients with such afflictions is Continuous Passive Motion (CPM, drawing upon a range of specific equipment. This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

Open access publishing: a study of current practices in orthopaedic research.

Science.gov (United States)

Sabharwal, Sanjeeve; Patel, Nirav; Johal, Karanjeev

2014-06-01

Open access (OA) publications have changed the paradigm of dissemination of scientific research. Their benefits to low-income countries underline their value; however, critics question exorbitant publication fees as well as their effect on the peer review process and research quality. This study reports on the prevalence of OA publishing in orthopaedic research and compares benchmark citation indices as well as evidence quality derived from OA journals with conventional subscription based orthopaedic journals. All 63 orthopaedic journals listed in ISI's Web of Knowledge Journal Citation Report (JCR) were examined. Bibliometric data attributed to each journal for the year 2012 was acquired from the JCR. Studies that fulfilled the criteria of level I evidence were identified for each journal within PubMed. Individual journal websites were reviewed to identify their open access policy. A total of 38 (60.3 %) journals did not offer any form of OA publishing; however, 20 (31.7 %) hybrid journals were identified which offered authors the choice to publish their work as OA if a publication fee was paid. Only five (8 %) journals published all their articles as OA. There was variability amongst the different publication fees for OA articles. Journals that published OA articles did not differ from subscription based journals on the basis of 2012 impact factor, citation number, self citation proportion or the volume of level I evidence published (p > 0.05). OA journals are present in orthopaedic research, though in small numbers. Over a third of orthopaedic journals catalogued in the ISI Web of Knowledge JCR® are hybrid journals that provide authors with the opportunity to publish their articles as OA after a publication fee is paid. This study suggests equivalent importance and quality of articles between OA and subscription based orthopaedic journals based on bibliometric data and the volume of level I evidence produced. Orthopaedic researchers must recognize the

Does Orthopaedic Outpatient Care Reduce Emergency Department Utilization After Total Joint Arthroplasty?

Science.gov (United States)

Chaudhary, Muhammad Ali; Lange, Jeffrey K; Pak, Linda M; Blucher, Justin A; Barton, Lauren B; Sturgeon, Daniel J; Koehlmoos, Tracey; Haider, Adil H; Schoenfeld, Andrew J

2018-05-22

Emergency department (ED) visits after elective surgical procedures are a potential target for interventions to reduce healthcare costs. More than 1 million total joint arthroplasties (TJAs) are performed each year with postsurgical ED utilization estimated in the range of 10%. We asked whether (1) outpatient orthopaedic care was associated with reduced ED utilization and (2) whether there were identifiable factors associated with ED utilization within the first 30 and 90 days after TJA. An analysis of adult TRICARE beneficiaries who underwent TJA (2006-2014) was performed. TRICARE is the insurance program of the Department of Defense, covering > 9 million beneficiaries. ED use within 90 days of surgery was the primary outcome and postoperative outpatient orthopaedic care the primary explanatory variable. Patient demographics (age, sex, race, beneficiary category), clinical characteristics (length of hospital stay, prior comorbidities, complications), and environment of care were used as covariates. Logistic regression adjusted for all covariates was performed to determine factors associated with ED use. We found that orthopaedic outpatient care (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.68-0.77) was associated with lower odds of ED use within 90 days. We also found that index hospital length of stay (OR, 1.07; 95% CI, 1.04-1.10), medical comorbidities (OR, 1.16; 95% CI, 1.08-1.24), and complications (OR, 2.47; 95% CI, 2.24-2.72) were associated with higher odds of ED use. When considering that at 90 days, only 3928 patients sustained a complication, a substantial number of ED visits (11,486 of 15,414 [75%]) after TJA may be avoidable. Enhancing access to appropriate outpatient care with improved discharge planning may reduce ED use after TJA. Further research should be directed toward unpacking the situations, outside of complications, that drive patients to access the ED and devise interventions that could mitigate such behavior. Level III

Orthopaedic Trauma Care Capacity Assessment and Strategic Planning in Ghana: Mapping a Way Forward.

Science.gov (United States)

Stewart, Barclay T; Gyedu, Adam; Tansley, Gavin; Yeboah, Dominic; Amponsah-Manu, Forster; Mock, Charles; Labi-Addo, Wilfred; Quansah, Robert

2016-12-07

Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with hospital staff were used to assess resource availability and factors contributing to deficiencies at 40 purposively sampled facilities. Cost-distance analyses described population-level spatial access to orthopaedic trauma care. Facilities for targeted capability improvement were identified through location-allocation modeling. Orthopaedic trauma care assessment demonstrated marked deficiencies. Some deficient resources were low cost (e.g., spinal immobilization, closed reduction capabilities, and prosthetics for amputees). Resource nonavailability resulted from several contributing factors (e.g., absence of equipment, technology breakage, lack of training). Implants were commonly prohibitively expensive. Building basic orthopaedic care capacity at 15 hospitals without such capacity would improve spatial access to basic care from 74.9% to 83.0% of the population (uncertainty interval [UI] of 81.2% to 83.6%), providing access for an additional 2,169,714 Ghanaians. The availability of several low-cost resources could be better supplied by improvements in organization and training for orthopaedic trauma care. There is a critical need to advocate and provide funding for orthopaedic resources. These initiatives might be particularly effective if aimed at hospitals that could provide care to a large proportion of the population.

Smartphones in orthopaedics

OpenAIRE

Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

2012-01-01

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to ...

[Famous figures of the Poznań orthopaedics of the period of the occupation and post-war years. Coryphees of Polish orthopaedics].

Science.gov (United States)

Barcikowski, Władysław

2008-01-01

In this article author presents, from a perspective of own memories is portraying persons which he met in his professional activity. They participated in forming the orthopaedics in Poznań and different nooks of Poland. He resembles their, often very dramatic, fates and the influence they had on Polish medicine reviving after the II world war. With the special attention he is reminding one of most well-known and valued celebrities of the Polish orthopaedics professor Wiktor Dega.

Social Competence and Temperament in Children with Chronic Orthopaedic Disability

Science.gov (United States)

Yagmurlu, Bilge; Yavuz, H. Melis

2015-01-01

The aim of the study was to investigate social competence in children with orthopaedic disability and its concurrent relations to child's temperament, health condition, and maternal warmth. Participants were 68 Turkish children (mean = 5.94 years) with chronic orthopaedic disability and their mothers coming from disadvantaged backgrounds. Mother…

Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome

Science.gov (United States)

2015-10-01

Award Number: W81XWH-10-2-0138 TITLE: Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome PRINCIPAL INVESTIGATOR...Immunogenicity to Metals Affects Orthopaedic pla t Outcome 5b. GRANT NUMBER W91ZSQ0135N646 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Nadim James...DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEM ENTARY NOTES 14. ABSTRACT The effects of battlefield

Rapid Prototyping in Orthopaedic Surgery: A User's Guide

Science.gov (United States)

Frame, Mark; Huntley, James S.

2012-01-01

Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce precise models for preoperative planning and procedure rehearsal. We describe the method with an illustrative case. PMID:22666160

Orthopaedic Patient Information on the World Wide Web: An Essential Review.

Science.gov (United States)

Cassidy, John Tristan; Baker, Joseph F

2016-02-17

Patients increasingly use the Internet to research health-related issues. Internet content, unlike other forms of media, is not regulated. Although information accessed online can impact patients' opinions and expectations, there is limited information about the quality or readability of online orthopaedic information. PubMed, MEDLINE, and Google Scholar were searched using anatomic descriptors and three title keywords ("Internet," "web," and "online"). Articles examining online orthopaedic information from January 1, 2000, until April 1, 2015, were recorded. Articles were assessed for the number of reviewers evaluating the online material, whether the article examined for a link between authorship and quality, and the use of recognized quality and readability assessment tools. To facilitate a contemporary discussion, only publications since January 1, 2010, were considered for analysis. A total of thirty-eight peer-reviewed articles published since 2010 examining the quality and/or readability of online orthopaedic information were reviewed. For information quality, there was marked variation in the quality assessment methods utilized, the number of reviewers, and the manner of reporting. To date, the majority of examined information is of poor quality. Studies examining readability have focused on pages produced by professional orthopaedic societies. The quality and readability of online orthopaedic information are generally poor. For modern practices to adapt to the Internet and to prevent misinformation, the orthopaedic community should develop high-quality, readable online patient information. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Nationwide surveillance of bacterial respiratory pathogens conducted by the surveillance committee of Japanese Society of Chemotherapy, the Japanese Association for Infectious Diseases, and the Japanese Society for Clinical Microbiology in 2012: General view of the pathogens' antibacterial susceptibility.

Science.gov (United States)

Yanagihara, Katsunori; Watanabe, Akira; Aoki, Nobuki; Matsumoto, Tetsuya; Yoshida, Masaki; Sato, Junko; Wakamura, Tomotaro; Sunakawa, Keisuke; Kadota, Junichi; Kiyota, Hiroshi; Iwata, Satoshi; Kaku, Mitsuo; Hanaki, Hideaki; Ohsaki, Yoshinobu; Fujiuchi, Satoru; Takahashi, Manabu; Takeuchi, Kenichi; Takeda, Hiroaki; Ikeda, Hideki; Miki, Makoto; Nakanowatari, Susumu; Takahashi, Hiroshi; Utagawa, Mutsuko; Nishiya, Hajime; Kawakami, Sayoko; Morino, Eriko; Takasaki, Jin; Mezaki, Kazuhisa; Chonabayashi, Naohiko; Tanaka, Chie; Sugiura, Hideko; Goto, Hajime; Saraya, Takeshi; Kurai, Daisuke; Katono, Yasuhiro; Inose, Rika; Niki, Yoshihito; Takuma, Takahiro; Kudo, Makoto; Ehara, Shigeru; Sato, Yoshimi; Tsukada, Hiroki; Watabe, Nobuei; Honma, Yasuo; Mikamo, Hiroshige; Yamagishi, Yuka; Nakamura, Atsushi; Ohashi, Minoru; Seki, Masafumi; Hamaguchi, Shigeto; Toyokawa, Masahiro; Fujikawa, Yasunori; Mitsuno, Noriko; Ukimura, Akira; Miyara, Takayuki; Nakamura, Takahito; Mikasa, Keiichi; Kasahara, Kei; Ui, Koji; Fukuda, Saori; Nakamura, Akihiro; Morimura, Mika; Yamashita, Mikio; Takesue, Yoshio; Wada, Yasunao; Sugimoto, Keisuke; Kusano, Nobuchika; Nose, Motoko; Mihara, Eiichirou; Kuwabara, Masao; Doi, Masao; Watanabe, Yaeko; Tokuyasu, Hirokazu; Hino, Satoshi; Negayama, Kiyoshi; Mukae, Hiroshi; Kawanami, Toshinori; Ota, Toshiyuki; Fujita, Masaki; Honda, Junichi; Hiramatsu, Kazufumi; Aoki, Yosuke; Fukuoka, Mami; Magarifuchi, Hiroki; Nagasawa, Zenzo; Kaku, Norihito; Fujita, Jiro; Higa, Futoshi; Tateyama, Masao

2017-09-01

The nationwide surveillance on antimicrobial susceptibility of bacterial respiratory pathogens from the patients in Japan was conducted by Japanese Society of Chemotherapy, Japanese association for infectious diseases and Japanese society for Clinical Microbiology in 2012. The isolates were collected from clinical specimens obtained from well-diagnosed adult patients with respiratory tract infections during the period between January and December in 2012 by three societies. Antimicrobial susceptibility testing was conducted at the central reference laboratory according to the method recommended by Clinical Laboratory Standard Institutes. Susceptibility testing was evaluated in 1236 strains (232 Staphylococcus aureus, 225 Streptococcus pneumoniae, 16 Streptococcus pyogenes, 231 Haemophilus influenzae, 147 Moraxella catarrhalis, 167 Klebsiella pneumoniae and 218 Pseudomonas aeruginosa). Ratio of methicillin-resistant S. aureus was 51.3%, and those of penicillin-intermediate S. pneumoniae was 0.4%. Among H. influenzae, 5.6% of them were found to be β-lactamase-producing ampicillin-resistant strains, and 37.2% to be β-lactamase-non-producing ampicillin-resistant strains. Extended spectrum β-lactamase-producing K. pneumoniae and multi-drug resistant P. aeruginosa with metallo β-lactamase were 4.2% and 3.2%, respectively. Continuous national surveillance is important to determine the actual situation of the resistance shown by bacterial respiratory pathogens to antimicrobial agents. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

The Relationship of Obesity to Increasing Health-Care Burden in the Setting of Orthopaedic Polytrauma.

Science.gov (United States)

Licht, Heather; Murray, Mark; Vassaur, John; Jupiter, Daniel C; Regner, Justin L; Chaput, Christopher D

2015-11-18

With the rise of obesity in the American population, there has been a proportionate increase of obesity in the trauma population. The purpose of this study was to use a computed tomography-based measurement of adiposity to determine if obesity is associated with an increased burden to the health-care system in patients with orthopaedic polytrauma. A prospective comprehensive trauma database at a level-I trauma center was utilized to identify 301 patients with polytrauma who had orthopaedic injuries and intensive care unit admission from 2006 to 2011. Routine thoracoabdominal computed tomographic scans allowed for measurement of the truncal adiposity volume. The truncal three-dimensional reconstruction body mass index was calculated from the computed tomography-based volumes based on a previously validated algorithm. A truncal three-dimensional reconstruction body mass index of obese patients and ≥ 30 kg/m(2) denoted obese patients. The need for orthopaedic surgical procedure, in-hospital mortality, length of stay, hospital charges, and discharge disposition were compared between the two groups. Of the 301 patients, 21.6% were classified as obese (truncal three-dimensional reconstruction body mass index of ≥ 30 kg/m(2)). Higher truncal three-dimensional reconstruction body mass index was associated with longer hospital length of stay (p = 0.02), more days spent in the intensive care unit (p = 0.03), more frequent discharge to a long-term care facility (p obesity on patients with polytrauma. Obese patients were found to have higher total hospital charges, longer hospital stays, discharge to a continuing-care facility, and a higher rate of orthopaedic surgical intervention. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery.

Science.gov (United States)

Ó Mír, M; O'Sullivan, C

2018-02-01

One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.

Japanese language and Japanese science

Science.gov (United States)

Tanikawa, Kiyotaka

2003-08-01

Japanese mathematical scientists including astronomers, physicists, and mathematicians obtain ideas in Japanese, discuss their problems in Japanese, and arrive at conclusions in Japanese, and yet they write their results in foreign languages such as English. This uncomfortable situation has continued for nearly one hundred years and has had serious effects on Japanese science. In this short report, the author discusses and analyses these effects. In order to put Japanese science on a sound basis, the author proposes to increase the number of articles, reviews and textbooks in Japanese, first by translation and second by the voluntary efforts of scientists themselves. As centers devoted to this activity, the author proposes to construct "Airborne Libraries" which are maintained and accumulate in an electronic form the scientific documents written in Japanese.

Distribution of autistic traits and their association with sociodemographic characteristics in Japanese workers.

Science.gov (United States)

Suzuki, Tomoko; Miyaki, Koichi; Eguchi, Hisashi; Tsutsumi, Akizumi

2017-09-01

This study aimed to confirm whether autistic traits are normally distributed across a population and to describe their association with the sociodemographic characteristics of Japanese workers. The participants were 2075 workers aged 23-65 years from various parts of Japan. Autistic traits were measured using an abridged Japanese version of the Autism-Spectrum Quotient (AQ-Short). The AQ-Short comprises five subcomponents assessing a fascination for numbers and patterns (numbers/patterns), difficulties with imagination, a preference for routine, difficulties with social skills, and difficulties with switching attention. The five subcomponents of the autistic phenotype as well as the overall autistic phenotype itself were continuously distributed across the sample population of Japanese workers. Men had significantly higher AQ-Short scores than women. AQ-Short scores were not associated with age. Except for the numbers/patterns scores, workers of a lower socioeconomic status had significantly higher AQ-Short scores than their respective counterparts. For the numbers/patterns trait, workers of a higher socioeconomic status scored higher. Workers with low general physical activity had or tended to have higher scores for total and all subcomponent traits, except for the numbers/patterns trait. Generally, the autistic phenotype was more prevalent in workers of a low socioeconomic status, while a particular trait was prevalent among workers of a high socioeconomic status.

Study of Risk Factors Associated with Peripheral Arteriopathy in Japanese-Brazilians from Bauru (SP)

Energy Technology Data Exchange (ETDEWEB)

Garofolo, Luciana, E-mail: lgarofolo@ig.com.br [Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil); Ferreira, Sandra Roberta G. [Faculdade de Saúde Pública - Universidade de São Paulo (USP), São Paulo, SP (Brazil); Miranda, Fausto Junior [Departamento de Cirurgia - Universidade Federal de São Paulo (Unifesp), São Paulo, SP (Brazil)

2014-02-15

Cardiovascular diseases are the major cause of morbidity and mortality in developed and emerging countries. Their main etiology, atherosclerosis, is a disseminated disease that affects the coronary, cerebral and peripheral territories. The peripheral arterial disease (PAD), as well as its consequences, indicates the involvement of the coronary territory. Therefore, its better understanding enables proper treatment, delaying local and long-term complications, reducing the cost to the health system. This study estimates the percentage of PAD in Japanese-Brazilians from Bauru (SP), recognized by the high prevalence of metabolic disorders such as hypertension (43%), diabetes mellitus (33%) and hypercholesterolemia (60%), and examines the association with risk biomarkers. This cross-sectional population study evaluated 1,330 Japanese-Brazilians of both genders aged ≥ 30 who underwent a complete physical examination, anthropometric measurements, laboratory tests and ankle-brachial index (ABI). Participants with ABI ≤ 0.90 were diagnosed as having PAD. After applying the exclusion criteria, 1,038 individuals were part of the analysis. We used Poisson regression to analyze associations with PAD. The mean age was 56.8 years and the percentage of PAD was 21.1%, equal among the genders. PAD was associated with smoking (PR 2.16 [1.33 to 3.48]) and hypertension (PR 1.56 [1.12-2.22]). The percentage of PAD in Japanese-Brazilians was similar to other populations of adverse cardiometabolic profile (US PARTNERS and POPADAD). The independent association of PAD with smoking and hypertension, but not with other classical risk factors, may depend on the very high frequencies of metabolic disorders in this population.

Study of Risk Factors Associated with Peripheral Arteriopathy in Japanese-Brazilians from Bauru (SP)

International Nuclear Information System (INIS)

Garofolo, Luciana; Ferreira, Sandra Roberta G.; Miranda, Fausto Junior

2014-01-01

Cardiovascular diseases are the major cause of morbidity and mortality in developed and emerging countries. Their main etiology, atherosclerosis, is a disseminated disease that affects the coronary, cerebral and peripheral territories. The peripheral arterial disease (PAD), as well as its consequences, indicates the involvement of the coronary territory. Therefore, its better understanding enables proper treatment, delaying local and long-term complications, reducing the cost to the health system. This study estimates the percentage of PAD in Japanese-Brazilians from Bauru (SP), recognized by the high prevalence of metabolic disorders such as hypertension (43%), diabetes mellitus (33%) and hypercholesterolemia (60%), and examines the association with risk biomarkers. This cross-sectional population study evaluated 1,330 Japanese-Brazilians of both genders aged ≥ 30 who underwent a complete physical examination, anthropometric measurements, laboratory tests and ankle-brachial index (ABI). Participants with ABI ≤ 0.90 were diagnosed as having PAD. After applying the exclusion criteria, 1,038 individuals were part of the analysis. We used Poisson regression to analyze associations with PAD. The mean age was 56.8 years and the percentage of PAD was 21.1%, equal among the genders. PAD was associated with smoking (PR 2.16 [1.33 to 3.48]) and hypertension (PR 1.56 [1.12-2.22]). The percentage of PAD in Japanese-Brazilians was similar to other populations of adverse cardiometabolic profile (US PARTNERS and POPADAD). The independent association of PAD with smoking and hypertension, but not with other classical risk factors, may depend on the very high frequencies of metabolic disorders in this population

Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

Science.gov (United States)

Bertani, A; Launay, F; Candoni, P; Mathieu, L; Rongieras, F; Chauvin, F

2012-11-01

Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious

42 Editorial ADVOCACY IN ORTHOPAEDICS

African Journals Online (AJOL)

2017-09-11

Sep 11, 2017 ... East African Orthopaedic Journal. Advocacy may be ... taxation of medical equipment and implants in Kenya. In 2013 a change ... Asia countries especially India were doing the opposite. They reduced ... Most developing countries have been dealing with communicable ... The role of advocacy is huge here.

Do Orthopaedic Surgeons Acknowledge Uncertainty?

NARCIS (Netherlands)

Teunis, Teun; Janssen, Stein; Guitton, Thierry G.; Ring, David; Parisien, Robert

2016-01-01

Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if

Reading the small print - labelling recommendations for orthopaedic implants.

Science.gov (United States)

Haene, Roger A; Sandhu, Ranbir S; Baxandall, Richard

2009-11-01

There exist, currently, no clear guidelines regarding standards for surgical implant labelling. Dimensions of the laminar flow canopies in orthopaedic use fixes the distance at which implant labels can be read. Mistakes when reading the label on an implant box can pose health risks for patients, and financial consequences for medical institutions. Using scientifically validated tools such as the Snellen Chart Formula, a theoretical minimum standard for text on implant labels was reached. This theoretical standard was then tested under real operating conditions. After discovering a minimum practical standard for implant labels, the authors then audited current labels in use on a wide range of orthopaedic implant packages. Furthermore, other non-text-related labelling problems were also noted. There is a definite minimum standard which should be observed when implant labels are manufactured. Implants in current use bear labels on the packaging that are of an insufficient standard to ensure patient safety in theatre. The authors have established text parameters that will increase the legibility of implant labels. In the interests of improving risk management in theatre, therefore, the authors propose a standard for orthopaedic implant labelling, and believe this will provide a useful foundation for further discussion between the orthopaedic community and implant manufacturers.

[Association of processed meat intake and obesity in a population-based study of Japanese-Brazilians].

Science.gov (United States)

Cristofoletti, Maria F; Gimeno, Suely G A; Ferreira, Sandra R G; Cardoso, Marly A

2013-08-01

The aim of this study was to investigate the association between the consumption of processed meat with overall, abdominal, and overall with abdominal obesity in a Japanese-Brazilian population, which is known to be at cardiometabolic risk. A total of 329 men and 443 women aged ≥ 30 years were evaluated in a cross-sectional population-based survey. Diagnosis of overall obesity and abdominal obesity were based on the World Health Organization (WHO) criteria for Asians. Food intake was assessed by a validated food frequency questionaire. In men, processed meat intake was positively associated with overall with abdominal obesity (OR 2.97; 95%CI 1.13-7.78) after adjustment. In women, only the red meat group was associated with overall with abdominal obesity after adjustment (OR 0.47, 95%CI 0.23-0.96). Our results showed that high intakes of processed meats were associated with overall with abdominal obesity in male Japanese-Brazilians, but not in females.

American Orthopaedic Society for Sports Medicine

Science.gov (United States)

... Upcoming Meetings Online Education Archived Meetings Faculty Resources Sports Medicine Fellowships Traveling Fellowship Submit an Abstract Submit ... Support AOSSM Research Publications Toggle American Journal of Sports Medicine Sports Health: A Multidisciplinary Approach Orthopaedic Journal ...

Investigation on Alteration of Compression of Knitted Orthopaedic Supports during Exploitation

Directory of Open Access Journals (Sweden)

Diana ALIŠAUSKIENĖ

2012-12-01

Full Text Available One of the areas of medical textile is the spacer knitted orthopaedic products. The concept of compression therapy of orthopaedic supports lies on a simple and efficient mechanical principle – it consists of applying elastic garment around the limb. Spacer orthopaedic supports are knitted on flat knitting machines equipped with especial elastomeric thread feeder. Compression made by the support depends on the support area, shape and characteristics of knitting. Because of orthopaedic supports are intended for durable wearing and need to vouchsafe compression of fixed value, it is very important to known how processes acting during exploitation influence alteration of compression values. The aim of this study was to establish the alteration of compression of knitted support during exploitation, i. e. after multifold extension, washing and drying. The samples were knitted on a flat double needle bed knitting machine in combined jacquard-laid-in pattern with elastomeric weft threads. It was established that compressive properties of knits after cyclic tensile load changed slightly, i. e. range between margins of error. It was measured that knitted orthopaedic supports dimensions and density after washing and drying cycles changes significant, i. e. knitted supports shrinks and thickens and their compression decreases.DOI: http://dx.doi.org/10.5755/j01.ms.18.4.3097

A basic introduction to statistics for the orthopaedic surgeon.

Science.gov (United States)

Bertrand, Catherine; Van Riet, Roger; Verstreken, Frederik; Michielsen, Jef

2012-02-01

Orthopaedic surgeons should review the orthopaedic literature in order to keep pace with the latest insights and practices. A good understanding of basic statistical principles is of crucial importance to the ability to read articles critically, to interpret results and to arrive at correct conclusions. This paper explains some of the key concepts in statistics, including hypothesis testing, Type I and Type II errors, testing of normality, sample size and p values.

Associations between rice, noodle, and bread intake and sleep quality in Japanese men and women.

Science.gov (United States)

Yoneyama, Satoko; Sakurai, Masaru; Nakamura, Koshi; Morikawa, Yuko; Miura, Katsuyuki; Nakashima, Motoko; Yoshita, Katsushi; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Nogawa, Kazuhiro; Suwazono, Yasushi; Sasaki, Satoshi; Nakagawa, Hideaki

2014-01-01

Previous studies have shown that a diet with a high-glycemic index is associated with good sleep quality. Therefore, we investigated the association of sleep quality with the intake of 3 common starchy foods with different glycemic indexes-rice, bread, and noodles-as well as the dietary glycemic index in a Japanese population. The participants were 1,848 men and women between 20 and 60 years of age. Rice, bread, and noodle consumption was evaluated using a self-administered diet history questionnaire. Sleep quality was evaluated by using the Japanese version of the Pittsburgh Sleep Quality Index, and a global score >5.5 was considered to indicate poor sleep. Multivariate-adjusted odds ratios (95% confidence intervals) for poor sleep across the quintiles of rice consumption were 1.00 (reference), 0.68 (0.49-0.93), 0.61 (0.43-0.85), 0.59 (0.42-0.85), and 0.54 (0.37-0.81) (p for trend = 0.015); those for the quintiles of noodle consumption were 1.00 (reference), 1.25 (0.90-1.74), 1.05 (0.75-1.47), 1.31 (0.94-1.82), and 1.82 (1.31-2.51) (p for trend = 0.002). Bread intake was not associated with sleep quality. A higher dietary glycemic index was significantly associated with a lower risk of poor sleep (p for trend = 0.020). A high dietary glycemic index and high rice consumption are significantly associated with good sleep in Japanese men and women, whereas bread intake is not associated with sleep quality and noodle consumption is associated with poor sleep. The different associations of these starchy foods with sleep quality might be attributable to the different glycemic index of each food.

Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women

OpenAIRE

Tsujimoto, Ritsu; Abe, Yasuyo; Arima, Kazuhiko; Nishimura, Takayuki; Tomita, Masato; Yonekura, Akihiko; Miyamoto, Takashi; Matsubayashi, Shohei; Tanaka, Natsumi; Aoyagi, Kiyoshi; Osaki, Makoto

2016-01-01

Background: Lumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women. Methods: Lateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at ...

Bio-psychosocial determinants of time lost from work following non life threatening acute orthopaedic trauma.

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Clay, Fiona J; Newstead, Stuart V; Watson, Wendy L; Ozanne-Smith, Joan; McClure, Roderick J

2010-01-05

To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30)] whereas "financial security" and "because they felt able to" did not achieve significance. Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may provide important opportunities for social

Helicobacter pylori dupA gene is not associated with clinical outcomes in the Japanese population.

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Nguyen, L T; Uchida, T; Tsukamoto, Y; Kuroda, A; Okimoto, T; Kodama, M; Murakami, K; Fujioka, T; Moriyama, M

2010-08-01

The dupA gene of Helicobacter pylori was suggested to be a risk factor for duodenal ulcer but protective against gastric cancer. The present study aimed to re-examine the role of dupA in H. pylori-infected Japanese patients. We found that dupA status was not associated with any gastroduodenal disease, histological score of chronic gastritis or with the extent of interleukin-8 production from gastric cell lines. These results indicate that dupA is unlikely to be a virulence factor of H. pylori in the Japanese population.

Readability of Orthopaedic Patient-reported Outcome Measures: Is There a Fundamental Failure to Communicate?

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Perez, Jorge L; Mosher, Zachary A; Watson, Shawna L; Sheppard, Evan D; Brabston, Eugene W; McGwin, Gerald; Ponce, Brent A

2017-08-01

Patient-reported outcome measures (PROMs) are increasingly used to quantify patients' perceptions of functional ability. The American Medical Association and NIH suggest patient materials be written at or below 6th to 8th grade reading levels, respectively, yet one recent study asserts that few PROMs comply with these recommendations, and suggests that the majority of PROMs are written at too high of a reading level for self-administered patient use. Notably, this study was limited in its use of only one readability algorithm, although there is no commonly accepted, standard readability algorithm for healthcare-related materials. Our study, using multiple readability equations and heeding equal weight to each, hopes to yield a broader, all-encompassing estimate of readability, thereby offering a more accurate assessment of the readability of orthopaedic PROMS. (1) What proportion of orthopaedic-related PROMs and orthopaedic-related portions of the NIH Patient Reported Outcomes Measurement Information System (PROMIS ® ) are written at or below the 6th and 8th grade levels? (2) Is there a correlation between the number of questions in the PROM and reading level? (3) Using systematic edits based on guidelines from the Centers for Medicare and Medicaid Services, what proportion of PROMs achieved American Medical Association and NIH-recommended reading levels? Eighty-six (86) independent, orthopaedic and general wellness PROMs, drawn from commonly referenced orthopaedic websites and prior studies, were chosen for analysis. Additionally, owing to their increasing use in orthopaedics, four relevant short forms, and 11 adult, physical health question banks from the PROMIS ® , were included for analysis. All documents were analyzed for reading grade levels using 19 unique readability algorithms. Descriptive statistics were performed using SPSS Version 22.0. The majority of the independent PROMs (64 of 86; 74%) were written at or below the 6th grade level, with 81 of 86

77 FR 66848 - Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and...

Science.gov (United States)

2012-11-07

...] Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation... Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation.'' FDA is co... (MCID) for patient-reported outcome (PRO) instruments used in orthopaedic extremity device-related...

Access to Orthopaedic Surgical Care in Northern Tanzania: A Modelling Study.

Science.gov (United States)

Premkumar, Ajay; Ying, Xiaohan; Mack Hardaker, W; Massawe, Honest H; Mshahaba, David J; Mandari, Faiton; Pallangyo, Anthony; Temu, Rogers; Masenga, Gileard; Spiegel, David A; Sheth, Neil P

2018-04-25

The global burden of musculoskeletal disease and resulting disability is enormous and is expected to increase over the next few decades. In the world's poorest regions, the paucity of information defining and quantifying the current state of access to orthopaedic surgical care is a major problem in developing effective solutions. This study estimates the number of individuals in Northern Tanzania without adequate access to orthopaedic surgical services. A chance tree was created to model the probability of access to orthopaedic surgical services in the Northern Tanzanian regions of Arusha, Kilimanjaro, Tanga, Singida, and Manyara, with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. Timeliness was estimated by the proportion of people living within a 4-h driving distance from a hospital with an orthopaedic surgeon, capacity by comparing number of surgeries performed to the number of surgeries indicated, safety by applying WHO Emergency and Essential Surgical Care infrastructure and equipment checklists, and affordability by approximating the proportion of the population protected from catastrophic out-of-pocket healthcare expenditure. We accounted for uncertainty in our model with one-way and probabilistic sensitivity analyses. Data sources included the Tanzanian National Bureau of Statistics and Ministry of Finance, World Bank, World Health Organization, New Zealand Ministry of Health, Google Corporation, NASA population estimator, and 2015 hospital records from Kilimanjaro Christian Medical Center, Machame Hospital, Nkoroanga Hospital, Mt. Meru Hospital, and Arusha Lutheran Medical Center. Under the most conservative assumptions, more than 90% of the Northern Tanzanian population does not have access to orthopaedic surgical services. There is a near absence of access to orthopaedic surgical care in Northern Tanzania. These findings utilize more precise country and region-specific data and are consistent with prior published

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda.

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Bouchard, Maryse; Kohler, Jillian C; Orbinski, James; Howard, Andrew

2012-05-03

Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants' experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

Directory of Open Access Journals (Sweden)

Bouchard Maryse

2012-05-01

Full Text Available Abstract Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

Science.gov (United States)

2012-01-01

Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher

"Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application.

Science.gov (United States)

Datillo, Jonathan R; Gittings, Daniel J; Sloan, Matthew; Hardaker, William M; Deasey, Matthew J; Sheth, Neil P

2017-08-16

Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of

Association of maternal age with child health: A Japanese longitudinal study.

Directory of Open Access Journals (Sweden)

Tsuguhiko Kato

Full Text Available Average maternal age at birth has been rising steadily in Western and some Asian countries. Older maternal age has been associated with adverse pregnancy and birth outcomes; however, studies on the relationship between maternal age and young children's health remain scarce. Therefore, we sought to investigate the association of maternal age with child health outcomes in the Japanese population. We analyzed data from two birth cohorts of the nationwide Japanese Longitudinal Survey of Babies in 21st Century (n2001 = 47,715 and n2010 = 38,554. We estimated risks of unintentional injuries and hospital admissions at 18 and 66 months according to maternal age, controlling for the following potential confounders: parental education; maternal parity, smoking status, and employment status; household income; paternal age, and sex of the child. We also included the following as potential mediators: preterm births and birthweight. We observed a decreasing trend in the risks of children's unintentional injuries and hospital admissions at 18 months according to maternal age in both cohorts. In the 2001 cohort, compared to mothers 40.0 years, respectively, controlling for confounders. Our findings were in line with previous findings from population-based studies conducted in the United Kingdom and Canada suggesting that older maternal age may be beneficial for early child health.

Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children.

Science.gov (United States)

Carvalho, F R; Lentini-Oliveira, D; Machado, M A C; Prado, G F; Prado, L B F; Saconato, H

2007-04-18

Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adenotonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbities and, in some patients, by recurrence that can be associated with craniofacial problems. Oral appliances and functional orthopaedic appliances have been used for patients who have OSAS and craniofacial anomalies because they change the mandible posture forwards and potentially enlarge the upper airway and increase the upper airspace, improving the respiratory function. To assess the effectiveness of oral appliances or functional orthopaedic appliances for OSAS in children. A sensitive search was developed for the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3); PubMed (January 1966 to September 2005); EMBASE (1980 to September 2005); Lilacs (1982 to September 2005); BBO-Bibliografia Brasileira de Odontologia (1986 to September 2005); and SciELO (1997 to September 2005). There was no restriction of language or source of information. All randomised or quasi-randomised controlled trials comparing all types of oral and functional orthopaedic appliances with placebo or no treatment, in children 15 years old or younger. reduction of apnoea to less than one episode per hour. dental and skeletal relationship, sleep parameters improvement, cognitive and phonoaudiologic function, behavioural problems, drop outs and withdrawals, quality of life, side effects (tolerability), economic evaluation. Data were independently extracted by two review authors. Authors were contacted for additional information. Risk ratios with 95% confidence intervals were calculated for all important dichotomous outcomes. The initial search identified 384 trials

Socioeconomic status is significantly associated with the dietary intakes of folate and depression scales in Japanese workers (J-HOPE Study).

Science.gov (United States)

Miyaki, Koichi; Song, Yixuan; Taneichi, Setsuko; Tsutsumi, Akizumi; Hashimoto, Hideki; Kawakami, Norito; Takahashi, Masaya; Shimazu, Akihito; Inoue, Akiomi; Kurioka, Sumiko; Shimbo, Takuro

2013-02-18

The association of socioeconomic status (SES) with nutrient intake attracts public attention worldwide. In the current study, we examined the associations of SES with dietary intake of folate and health outcomes in general Japanese workers. This Japanese occupational cohort consisted off 2266 workers. SES was assessed by a self-administered questionnaire. Intakes of all nutrients were assessed with a validated, brief and self-administered diet history questionnaire (BDHQ). The degree of depressive symptoms was measured by the validated Japanese version of the K6 scale. Multiple linear regression and stratified analysis were used to evaluate the associations of intake with the confounding factors. Path analysis was conducted to describe the impacts of intake on health outcomes. Education levels and household incomes were significantly associated with intake of folate and depression scales (p workers, and the effort to increase the folate intake may alleviate the harms of social disparities on mental health.

Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols.

Science.gov (United States)

Madry, H; Alini, M; Stoddart, M J; Evans, C; Miclau, T; Steiner, S

2014-05-06

Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols

Directory of Open Access Journals (Sweden)

H Madry

2014-05-01

Full Text Available Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

Genome-wide association studies in the Japanese population identify seven novel loci for type 2 diabetes

DEFF Research Database (Denmark)

Imamura, Minako; Takahashi, Atsushi; Yamauchi, Toshimasa

2016-01-01

Genome-wide association studies (GWAS) have identified more than 80 susceptibility loci for type 2 diabetes (T2D), but most of its heritability still remains to be elucidated. In this study, we conducted a meta-analysis of GWAS for T2D in the Japanese population. Combined data from discovery...... and subsequent validation analyses (23,399 T2D cases and 31,722 controls) identify 7 new loci with genome-wide significance (P2, rs7107784 near MIR4686 and rs67839313 near INAFM2....... Of these, the association of 4 loci with T2D is replicated in multi-ethnic populations other than Japanese (up to 65,936 T2Ds and 158,030 controls, P

Pediatric Orthopaedic Workforce in 2014: Current Workforce and Projections for the Future.

Science.gov (United States)

Sawyer, Jeffrey R; Jones, Kerwyn C; Copley, Lawson A; Chambers, Stephanie

2017-01-01

The changing nature of the United States (US) health care system has prompted debate concerning the physician supply. The basic questions are: do we have an adequate number of surgeons to meet current demands and are we training the correct number of surgeons to meet future demands? The purpose of this analysis was to characterize the current pediatric orthopaedic workforce in terms of supply and demand, both present and future. Databases were searched (POSNA, SF Match, KID, MGMA) to determine the current pediatric orthopaedic workforce and workforce distribution, as well as pediatric orthopaedic demand. The number of active Pediatric Orthopaedic Society of North America (POSNA) members increased over the past 20 years, from 410 in 1993 to 653 in 2014 (155% increase); however, the density of POSNA members is not equally distributed, but correlates to population density. The number of estimated pediatric discharges, orthopaedic and nonorthopaedic, has remained relatively stable from 6,348,537 in 1997 to 5,850,184 in 2012. Between 2003 and 2013, the number of pediatric orthopaedic fellows graduating from Accreditation Council for Graduate Medical Education and non-Accreditation Council for Graduate Medical Education programs increased from 39 to 50 (29%), with a peak of 67 fellows (71%) in 2009. Although predicting the exact need for pediatric orthopaedic surgeons (POS) is impossible because of the complex interplay among macroeconomic, governmental, insurance, and local factors, some trends were identified: the supply of POS has increased, which may offset the expected numbers of experienced surgeons who will be leaving the workforce in the next 10 to 15 years; macroeconomic factors influencing demand for physician services, driven by gross domestic product and population growth, are expected to be stable in the near future; expansion of the scope of practice for POS is expected to continue; and further similar assessments are warranted. Level II-economic and

Etiology of Readmissions Following Orthopaedic Procedures and Medical Admissions. A Comparative Analysis.

Science.gov (United States)

Maslow, Jed; Hutzler, Lorraine; Slover, James; Bosco, Joseph

2015-12-01

The Federal Government, the largest payer of health care, considers readmission within 30 days of discharge an indicator of quality of care. Many studies have focused on causes for and strategies to reduce readmissions following medical admissions. However, few studies have focused on the differences between them. We believe that the causes for readmission following orthopaedic surgery are markedly different than those following medical admissions, and therefore, the strategies developed to reduce medical readmissions will not be as effective in reducing readmissions after elective orthopaedic surgery. All unplanned 30-day readmissions following an index hospitalization for an elective orthopaedic procedure (primary and revision total joint arthroplasty and spine procedure) or for one of the three publicly reported medical conditions (AMI, HF, and pneumonia, which accounted for 11% of readmissions) were identified at our institution from 2010 through 2012. A total of 268 patients and 390 medical patients were identified as having an unplanned 30-day readmission. We reviewed a prospectively collected data base to determine the reason for readmission in each encounter. A total of 233 (86.9%) orthopaedic patients were readmitted for surgical complications, most commonly for a wound infection (56.0%) or wound complication (11.6%). Following an index admission of HF or AMI, the primary reason for readmission was a disease of the circulatory system (55.9% and 57.4%, respectively). Following an index admission for pneumonia, the primary reason for readmission was a disease of the respiratory system (34.5%). The causes of readmissions following orthopaedic surgery and medical admissions are different. Patients undergoing orthopaedic procedures are readmitted for surgical complications, frequently unrelated to aftercare, and medicine patients are readmitted for reasons related to the index diagnosis. Interventions designed to reduce orthopaedic readmissions must focus on

Readability of Orthopaedic Oncology-related Patient Education Materials Available on the Internet.

Science.gov (United States)

Shah, Akash K; Yi, Paul H; Stein, Andrew

2015-12-01

A person's health literacy is one of the most important indicators of a patient's health status. According to national recommendations, patient education materials should be written at no higher than the sixth- to eighth-grade reading level. The purpose of our study was to assess the readability of online patient education materials related to orthopaedic oncology on the websites of the American Academy of Orthopaedic Surgeons (AAOS), American Cancer Society (ACS), Bone and Cancer Foundation (BCF), and National Cancer Institute (NCI). We searched the online patient education libraries of the AAOS, ACS, BCF, and NCI for all articles related to orthopaedic oncology. The Flesch-Kincaid (FK) readability score was calculated for each article and compared between sources. A total of 227 articles were identified with an overall mean FK grade level of 9.8. Stratified by source, the mean FK grade levels were 10.1, 9.6, 11.1, and 9.5 for the AAOS, ACS, BCF, and NCI, respectively (P education materials related to orthopaedic oncology appear to be written at a level above the comprehension ability of the average patient. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Long Sick Leave after Orthopaedic Inpatient Rehabilitation: Treatment Failure or Relapse?

Science.gov (United States)

Mangels, Marija; Schwarz, Susanne; Worringen, Ulrike; Holme, Martin; Rief, Winfried

2011-01-01

We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission,…

Progress in the Full-Text Publication Rate of Orthopaedic and Sport Physical Therapy Abstracts Presented at the American Physical Therapy Association's Combined Sections Meeting.

Science.gov (United States)

Warden, Stuart J; Fletcher, Jacquelyn M; Barker, Rick G; Guildenbecher, Elizabeth A; Gorkis, Colleen E; Thompson, William R

2017-10-07

Study Design Descriptive study. Background Professional meetings, such as the American Physical Therapy Association's (APTA's) Combined Sections Meeting (CSM), provide forums for sharing information. However, it was reported that only one-quarter of orthopaedic and sports physical therapy abstracts presented at the CSM between 2000 and 2004 went on to full-text publication. This low conversion rate raises a number of concerns regarding the full dissemination of work within the profession. Objectives The purpose of this study was to determine the full-text publication rate of work presented in abstract form at subsequent CSMs and investigate factors influencing the rate. Methods A systematic search was undertaken to locate full-text publications of orthopaedic and sports physical therapy abstracts presented at CSMs between 2005 and 2011. Eligible publications were published within 5 years following abstract presentation. The influences of year of abstract presentation, APTA section, presentation type, institution of origin, study design, and study significance were assessed. Results Over one-third (38.6%) of presented abstracts progressed to full-text publication. Odds of full-text publication increased if the abstract was presented as a platform presentation, originated from a doctorate-granting institution, reported findings of an experimental study, or reported a statistically significant finding. Conclusion The full-text publication rate for orthopaedic and sports physical therapy abstracts presented at recent CSMs has increased by over 50% compared to that reported for the preceding period. The rate is now in the range of that reported in comparable clinical disciplines, demonstrating important progress in the full dissemination of work within the profession. J Orthop Sports Phys Ther, Epub 7 Oct 2017. doi:10.2519/jospt.2018.7581.

Associations between the intake of miso soup and Japanese pickles and the estimated 24-hour urinary sodium excretion: a population-based cross-sectional study.

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Wakasugi, Minako; James Kazama, Junichiro; Narita, Ichiei

2015-01-01

In Japan, reducing the consumption of miso soup and Japanese pickles, both traditional Japanese dishes, is recommended in order to decrease dietary salt intake. With the Westernization of dietary habits, however, these dishes are now consumed less frequently, and thus a reduction in their effect on sodium intake is suspected. This study examined cross-sectional associations between the frequency of intake of miso soup and Japanese pickles and the estimated 24-hour urine sodium excretion using data obtained from health examination surveys conducted in 2013 in Sado City, Japan. The level of daily salt intake was estimated based on spot urine sodium and creatinine measurements. The frequency of intake of miso soup and Japanese pickles was determined using a self-reported questionnaire. Multiple linear regression models were used to assess associations. Among a total of 8,821 participants (3,956 men; age range, 19-97 years), the mean daily salt intake was 9.4 g/day. The frequency of intake of miso soup and Japanese pickles increased with age and was associated with the level of daily salt intake (p for trend soup (psoup and Japanese pickles may be an effective approach for decreasing the level of dietary salt intake in the general Japanese population, although not in octogenarians or nonagenarians.

Socioeconomic Status Is Significantly Associated with the Dietary Intakes of Folate and Depression Scales in Japanese Workers (J-HOPE Study

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Takuro Shimbo

2013-02-01

Full Text Available The association of socioeconomic status (SES with nutrient intake attracts public attention worldwide. In the current study, we examined the associations of SES with dietary intake of folate and health outcomes in general Japanese workers. This Japanese occupational cohort consisted off 2266 workers. SES was assessed by a self-administered questionnaire. Intakes of all nutrients were assessed with a validated, brief and self-administered diet history questionnaire (BDHQ. The degree of depressive symptoms was measured by the validated Japanese version of the K6 scale. Multiple linear regression and stratified analysis were used to evaluate the associations of intake with the confounding factors. Path analysis was conducted to describe the impacts of intake on health outcomes. Education levels and household incomes were significantly associated with intake of folate and depression scales (p < 0.05. After adjusting for age, sex and total energy intake, years of education significantly affect the folate intake (β = 0.117, p < 0.001. The structural equation model (SEM shows that the indirect effect of folate intake is statistically significant and strong (p < 0.05, 56% of direct effect in the pathway of education level to depression scale. Our study shows both education and income are significantly associated with depression scales in Japanese workers, and the effort to increase the folate intake may alleviate the harms of social disparities on mental health.

Genome-wide association study for levels of total serum IgE identifies HLA-C in a Japanese population.

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Yohei Yatagai

Full Text Available Most of the previously reported loci for total immunoglobulin E (IgE levels are related to Th2 cell-dependent pathways. We undertook a genome-wide association study (GWAS to identify genetic loci responsible for IgE regulation. A total of 479,940 single nucleotide polymorphisms (SNPs were tested for association with total serum IgE levels in 1180 Japanese adults. Fine-mapping with SNP imputation demonstrated 6 candidate regions: the PYHIN1/IFI16, MHC classes I and II, LEMD2, GRAMD1B, and chr13∶60576338 regions. Replication of these candidate loci in each region was assessed in 2 independent Japanese cohorts (n = 1110 and 1364, respectively. SNP rs3130941 in the HLA-C region was consistently associated with total IgE levels in 3 independent populations, and the meta-analysis yielded genome-wide significance (P = 1.07×10(-10. Using our GWAS results, we also assessed the reproducibility of previously reported gene associations with total IgE levels. Nine of 32 candidate genes identified by a literature search were associated with total IgE levels after correction for multiple testing. Our findings demonstrate that SNPs in the HLA-C region are strongly associated with total serum IgE levels in the Japanese population and that some of the previously reported genetic associations are replicated across ethnic groups.

Churg-Strauss syndrome from an orthopaedic perspective.

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Kung, K L; Yee, P K

2015-12-01

Churg-Strauss syndrome, which has been frequently described by physicians in the literature, is a small and medium-sized vessel systemic vasculitis typically associated with asthma, lung infiltrates, and hypereosinophilia. We report a case of Churg-Strauss syndrome with presenting symptoms of bilateral lower limb weakness and numbness only. The patient was admitted to an orthopaedic ward for management and a final diagnosis was reached following sural nerve biopsy. The patient's symptoms responded promptly to steroid treatment and she was able to walk with a stick 3 weeks following admission. This report emphasises the need to be aware of this syndrome when managing patients with neurological deficit in order to achieve prompt diagnosis and treatment.

Association between statin use and physical function among community-dwelling older Japanese adults.

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Kawai, Hisashi; Ihara, Kazushige; Kera, Takeshi; Hirano, Hirohiko; Fujiwara, Yoshinori; Tanaka, Masashi; Kojima, Motonaga; Obuchi, Shuichi

2018-04-01

Statin-associated muscle symptoms (SAMS) are the muscle-related side-effects of statins, but the association between statin use and physical function among community-dwelling older adults is unclear. The objective of the present study was to examine the association between statin use and physical function among community-dwelling older Japanese adults by considering the risk factors of statin-associated muscle symptoms. The participants were 1022 community-dwelling older adults aged 65-88 years, who participated in comprehensive health checkups from 2013 to 2015. Statin use in the participants (381 men and 559 women) was verified by using data from their medicine notebooks. The differences between statin use (users and non-users) and physical functions (grip strength, knee extension torque, normal and maximum gait speed, Timed Up & Go test, one-legged stance, quadriceps muscle thickness and echo intensity) were analyzed using the t-test. Multiple regression analyses were also carried out to examine the association between statin use and physical function. A total of 93 men (24.4%) and 154 women (27.5%) were statin users. Grip strength, normal gait speed and one-legged stance declined significantly in statin users compared with the non-users. In multiple regression analysis while controlling for the risk factors of statin-associated muscle symptoms, including age, sex, body mass index and number of medicines, no independent association, between statin use and the reduction of physical functions, was observed. Statin use was not associated with the decline of physical function in community-dwelling older Japanese adults. Geriatr Gerontol Int 2018; 18: 623-630. © 2017 Japan Geriatrics Society.

The Association between Sarcopenic Obesity and Depressive Symptoms in Older Japanese Adults.

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Shinya Ishii

Full Text Available The effects of sarcopenic obesity, the co-existence of sarcopenia and obesity, on mood disorders have not been studies extensively. Our objective was to examine the association of depressive symptoms with sarcopenia and obesity status in older Japanese adults. We analyzed data from 1731 functionally-independent, community-dwelling Japanese adults aged 65 years or older (875 men, 856 women randomly selected from the resident register of Kashiwa city, Chiba, Japan in 2012. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. Obesity was defined as the highest sex-specific quintile of the percentage body fat. Depressive symptoms were defined as a Geriatric Depression Scale 15-item score ≥ 6. Multiple logistic regression was employed to examine the association of depressive symptoms with four groups defined by the presence/absence of sarcopenia and obesity. The prevalence of depressive symptoms was 10.1% and the proportions of sarcopenia/obesity, sarcopenia/non-obesity, non-sarcopenia/obesity, non-sarcopenia/non-obesity were 3.7%, 13.6%, 16.9% and 65.8%, respectively. After adjustment for potential confounders, sarcopenia/obesity was positively associated with depressive symptoms compared with non-sarcopenia/non-obesity, whereas either sarcopenia or obesity alone was not associated with depressive symptoms. The association was particularly pronounced in those aged 65 to 74 years in age-stratified analysis. We conclude that our findings suggest a synergistic impact exerted by sarcopenic obesity on the risk of depressive symptoms, particularly in those aged 65 to 74 years.

International Patients on Operation Vacation – Perspectives of Patients Travelling to Hungary for Orthopaedic Treatments

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Eszter Kovacs

2014-11-01

Full Text Available Background The importance of cross-border healthcare, medical and health tourism plays a significant role in the European health policy and health management. After dentistry, orthopaedic treatments are the leading motivation for seeking care in Hungary, as patients with rheumatic and motion diseases are drawn to the thermal spas and well-established orthopaedic centres. This paper aims to gain insight into foreign patients’ perspectives on their experience of having sought medical tourism in orthopaedic care in Hungary. Methods A patient survey was conducted in 2012 on motivations for seeking treatment abroad, orthopaedic care received and overall satisfaction. In addition, health professionals’ interviews, and 17 phone interviews were conducted in 2013 with Romanian patients who had orthopaedic treatment in Hungary. Finally, medical records of foreign patients were analysed. Results The survey was completed by 115 participants – 61.1% females, mean age= 41.9, 87% Romanian origin. Most of the patients came to Hungary for orthopaedic surgeries, e.g. arthroscopy, knee/hip prosthesis or spinal surgery. 72.6% chose Hungary because of related to perceived better quality and longstanding culture of Hungarian orthopaedic care. Over 57% of patients reported being ‘very satisfied’ with care received and 41.6% ‘satisfied’. The follow-up interviews further reflected this level of satisfaction, therefore many respondents stating they have already recommended the Hungarian healthcare to others. Conclusion Based on the findings, patients from neighbouring regions are increasingly seeking orthopaedic care in Hungary. Patients having orthopaedic care are highly satisfied with the quality of care, the whole treatment process from the availability of information to discharge summaries and would consider returning for further treatments.

Use of spoken and written Japanese did not protect Japanese-American men from cognitive decline in late life.

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Crane, Paul K; Gruhl, Jonathan C; Erosheva, Elena A; Gibbons, Laura E; McCurry, Susan M; Rhoads, Kristoffer; Nguyen, Viet; Arani, Keerthi; Masaki, Kamal; White, Lon

2010-11-01

Spoken bilingualism may be associated with cognitive reserve. Mastering a complicated written language may be associated with additional reserve. We sought to determine if midlife use of spoken and written Japanese was associated with lower rates of late life cognitive decline. Participants were second-generation Japanese-American men from the Hawaiian island of Oahu, born 1900-1919, free of dementia in 1991, and categorized based on midlife self-reported use of spoken and written Japanese (total n included in primary analysis = 2,520). Cognitive functioning was measured with the Cognitive Abilities Screening Instrument scored using item response theory. We used mixed effects models, controlling for age, income, education, smoking status, apolipoprotein E e4 alleles, and number of study visits. Rates of cognitive decline were not related to use of spoken or written Japanese. This finding was consistent across numerous sensitivity analyses. We did not find evidence to support the hypothesis that multilingualism is associated with cognitive reserve.

Use of Spoken and Written Japanese Did Not Protect Japanese-American Men From Cognitive Decline in Late Life

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Gruhl, Jonathan C.; Erosheva, Elena A.; Gibbons, Laura E.; McCurry, Susan M.; Rhoads, Kristoffer; Nguyen, Viet; Arani, Keerthi; Masaki, Kamal; White, Lon

2010-01-01

Objectives. Spoken bilingualism may be associated with cognitive reserve. Mastering a complicated written language may be associated with additional reserve. We sought to determine if midlife use of spoken and written Japanese was associated with lower rates of late life cognitive decline. Methods. Participants were second-generation Japanese-American men from the Hawaiian island of Oahu, born 1900–1919, free of dementia in 1991, and categorized based on midlife self-reported use of spoken and written Japanese (total n included in primary analysis = 2,520). Cognitive functioning was measured with the Cognitive Abilities Screening Instrument scored using item response theory. We used mixed effects models, controlling for age, income, education, smoking status, apolipoprotein E e4 alleles, and number of study visits. Results. Rates of cognitive decline were not related to use of spoken or written Japanese. This finding was consistent across numerous sensitivity analyses. Discussion. We did not find evidence to support the hypothesis that multilingualism is associated with cognitive reserve. PMID:20639282

Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

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Bill G. X. Zhang

2014-07-01

Full Text Available Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants.

Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

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Natarajan, Vivek; Bosch, Patrick; Dede, Ozgur; Deeney, Vincent; Mendelson, Stephen; Ward, Timothy; Brooks, Maria; Kenkre, Tanya; Roach, James

2017-06-01

The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic. A retrospective review was performed of all patients who had plain radiographs obtained in the pediatric orthopaedic clinic at an academic children's hospital over a 4-month period. For each radiographic series, the orthopaedist's note and the radiology interpretation were reviewed and a determination was made of whether the radiology read provided new clinically useful information and/or a new diagnosis, whether it recommended further imaging, or if it missed a diagnosis that was reflected in the orthopaedist's note. The hospital charges associated with the radiology read for each study were also quantified. The charts of 1570 consecutive clinic patients who were seen in the pediatric orthopaedic clinic from January to April, 2012 were reviewed. There were 2509 radiographic studies performed, of which 2264 had both a documented orthopaedist's note and radiologist's read. The radiologist's interpretation added new, clinically important information in 1.0% (23/2264) of these studies. In 1.7% (38/2264) of the studies, it was determined that the radiologist missed the diagnosis or clinically important information that could affect treatment. The total amount of the professional fees charged for the radiologists' interpretations was $87,362. On average, the hospital charges for each occurrence in which the radiologist's read provided an additional diagnosis or clinically important information beyond the orthopaedist's note were $3798. The results of this study suggest that eliminating the

Association and interaction between dietary pattern and VEGF receptor-2 (VEGFR2) gene polymorphisms on blood lipids in Chinese Malaysian and Japanese adults.

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Yap, Roseline Wai Kuan; Shidoji, Yoshihiro; Hon, Wei Min; Masaki, Motofumi

2012-01-01

Dietary pattern and genetic predisposition of each population have different impacts on lifestyle-related chronic diseases. This study was conducted to evaluate the association and interaction between dietary patterns and VEGFR2 or KDR gene polymorphisms on physical and biochemical risk factors of cardiovascular disease in two Asian populations (179 Chinese Malaysian and 136 Japanese adults). Dietary patterns were constructed from food frequency questionnaire using factor analysis. Genotyping of rs1870377 and rs2071559 was performed by real-time PCR using TaqMan probes. Physical measurements: body mass index, systolic and diastolic blood pressures and biochemical parameters: glycated hemoglobin A1c and blood lipids (total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol and total cholesterol/HDL-C ratio) were measured. Two dietary patterns were extracted for: Japanese ('Japanese diet' and 'Western diet') and Chinese Malaysians ('Balanced diet'; and 'Meat, rice and noodles diet'). In Japanese, 'Western Diet' and rs2071559 were associated with LDL-C and HDL-C, respectively. In Chinese Malaysians, 'Meat, rice and noodles diet' was asso-ciated with triglycerides, HDL-C and total cholesterol/HDL ratio while rs1870377 and rs2071559 were associated with total cholesterol and/or LDL-C. The interaction between 'Western Diet' and rs2071559 in Japanese and 'Meat, rice and noodles diet' and rs1870377 in Malaysians had significant effects on blood lipids after adjusting for confounders. The association and interaction of dietary patterns and VEGFR2 gene polymorphisms on blood lipids differ between Chinese Malaysian and Japanese subjects by either decreasing or increasing the risk of cardiovascular disease.

Cough associated with gastro-oesophageal reflux disease (GORD): Japanese experience.

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Niimi, Akio

2017-12-01

Differences in the aetiology as well as patient background of chronic cough have been recognised among US, UK, and Japan. One of the marked differences has been the prevalence of gastro-oesophageal reflux disease (GORD), which has been one of the top three causes in Western countries. It was indeed uncommon or rare in Japan, but, with the increasing prevalence of GOR itself, chronic cough associated with GORD seems to have become more common. In this article, cough associated with GORD will be reviewed based on literature and our Japanese experience. Further, potentially broader relevance of GORD in chronic cough will also be mentioned, highlighting the potential importance of dysmotiliy/non-acid reflux. Copyright © 2017 Elsevier Ltd. All rights reserved.

Orthopaedic Disorders in Myotonic Dystrophy Type 1: descriptive clinical study of 21 patients

Science.gov (United States)

2013-01-01

Background Myotonic Dystrophy Type 1 (DM1) is the most common form of hereditary myopathy presenting in adults. This autosomal-dominant systemic disorder is caused by a CTG repeat, demonstrating various symptoms. A mild, classic and congenital form can be distinguished. Often the quality of life is reduced by orthopaedic problems, such as muscle weakness, contractures, foot or spinal deformities, which limit patients’ mobility. The aim of our study was to gather information about the orthopaedic impairments in patients with DM1 in order to improve the medical care of patients, affected by this rare disease. Methods A retrospective clinical study was carried out including 21 patients (11 male and 10 female), all diagnosed with DM1 by genetic testing. All patients were seen during our special consultations for neuromuscular diseases, during which patients were interviewed and examined. We also reviewed surgery reports of our hospitalized patients. Results We observed several orthopaedic impairments: spinal deformities (scoliosis, hyperkyphosis, rigid spine), contractures (of the upper extremities and the lower extremities), foot deformities (equinus deformity, club foot, pes cavus, pes planovalgus, pes cavovarus, claw toes) and fractures. Five patients were affected by pulmonary diseases (obstructive airway diseases, restrictive lung dysfunctions). Twelve patients were affected by cardiac disorders (congenital heart defects, valvular heart defects, conduction disturbances, pulmonary hypertension, cardiomyopathy). Our patients received conservative therapy (physiotherapy, logopaedic therapy, ergotherapy) and we prescribed orthopaedic technical devices (orthopaedic custom-made shoes, insoles, lower and upper leg orthoses, wheelchair, Rehab Buggy). We performed surgery for spinal and foot deformities: the scoliosis of one patient was stabilized and seven patients underwent surgery for correction of foot deformities. Conclusions An orthopaedic involvement in DM1

An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice.

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Thornley, P; de Sa, D; Evaniew, N; Farrokhyar, F; Bhandari, M; Ghert, M

2016-04-01

Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. A total of 353 surgeons completed the survey. Surgeons achieved consensus on the 'importance' of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality.Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130-136. DOI: 10.1302/2046-3758.54.2000578. © 2016 Ghert et al.

Independent and Combined Associations of Physical Activity and Sedentary Behavior with Depressive Symptoms Among Japanese Adults.

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Liao, Yung; Shibata, Ai; Ishii, Kaori; Oka, Koichiro

2016-08-01

Associations between levels of sedentary behavior and depressive symptoms independently and in combination with different levels of physical activity remain unclear. This study aimed to examine independent and combined associations of physical activity (PA) and sedentary behavior (SB) with depressive symptoms among Japanese adults. An Internet-based survey collected data on depression levels (Center for Epidemiologic Studies Depression Scale), self-reported time spent in PA and SB (Japanese short version of the International Physical Activity Questionnaire), and sociodemographic variables from 2,914 adults in 2009. Binary logistic regression analyses were conducted to examine the odds ratios (ORs) for being depressed (depression scores ≥16) according to independent PA levels (none, insufficient, sufficient), SB levels (low, moderate, high), and nine combinations of PA and SB categories. After adjusting for potential confounders, sufficient PA level was found to be related to lower risk of depressive symptoms independently (OR = 0.61), whereas no significant associations were observed between SB levels and depression. In the combined associations, adults in the sufficient PA/high SB (OR = 0.44), sufficient PA/moderate SB (OR = 0.56), and sufficient PA/low SB (OR = 0.57) categories were significantly less likely to have depressive symptoms in comparison with the no PA/high SB category. Meeting physical activity recommendations is associated with a lower risk of depressive symptoms, regardless of time spent in total sedentary behavior. These results suggest that promoting physical activity may be an effective strategy against depressive symptoms among Japanese adults.

A review of virtual reality based training simulators for orthopaedic surgery.

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Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

2016-02-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

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Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

2017-12-01

Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year

High incidence of hemiarthroplasty for shoulder osteoarthritis among recently graduated orthopaedic surgeons.

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Mann, Tobias; Baumhauer, Judith F; O'Keefe, Regis J; Harrast, John; Hurwitz, Shepard R; Voloshin, Ilya

2014-11-01

Primary glenohumeral osteoarthritis is a common indication for shoulder arthroplasty. Historically, both total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) have been used to treat primary glenohumeral osteoarthritis. The choice between procedures is a topic of debate, with HSA proponents arguing that it is less invasive, faster, less expensive, and technically less demanding, with quality of life outcomes equivalent to those of TSA. More recent evidence suggests TSA is superior in terms of pain relief, function, ROM, strength, and patient satisfaction. We therefore investigated the practice of recently graduated orthopaedic surgeons pertaining to the surgical treatment of this disease. We hypothesized that (1) recently graduated, board eligible, orthopaedic surgeons with fellowship training in shoulder surgery are more likely to perform TSA than surgeons without this training; (2) younger patients are more likely to receive HSA than TSA; (3) patient sex affects the choice of surgery; (4) US geographic region affects practice patterns; and (5) complication rates for HSA and TSA are not different. We queried the American Board of Orthopaedic Surgery's database to identify practice patterns of orthopaedic surgeons taking their board examination. We identified 771 patients with primary glenohumeral osteoarthritis treated with TSA or HSA from 2006 to 2011. The rates of TSA and HSA were compared based on the treating surgeon's fellowship training, patient age and sex, US geographic region, and reported surgical complications. Surgeons with fellowship training in shoulder surgery were more likely (86% versus 72%; OR 2.32; 95% CI, 1.56-3.45, pguidelines for the treatment of glenohumeral osteoarthritis published by the American Academy of Orthopaedic Surgeons. These guidelines favor using TSA over HSA in the treatment of shoulder arthritis. Further investigation is needed to clarify if these practice patterns are isolated to recently graduated board

Substantial variation in the interpretation of financial disclosure policies for orthopaedic society meetings.

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Jegede, Kolawole; Whang, Peter; Grauer, Jonathan N

2011-07-06

Physician disclosure of potential conflicts of interest is currently controversial. To address this issue, orthopaedic societies have implemented a variety of guidelines related to potential conflict-of-interest disclosure. Transparency is crucial to address the concerns about potential conflict-of-interest disclosure. Nonetheless, prior studies have noted substantial discrepancies in disclosures to societies for individual authors who present their research work at multiple conferences. Our goal was to evaluate the ability of orthopaedic surgeons to interpret disclosure policy statements regarding project-specific or global disclosure instructions. The disclosure policy statements of the ten conferences most frequently attended by this group were collected, and selected statements were compiled into a questionnaire survey that was administered to orthopaedic faculty and trainees at our institution. Subjects were asked to read each statement and identify whether they interpreted the policy to be requesting project-specific disclosures (potential conflict of interest related to the research work in the abstract being submitted) or global disclosure (inclusive of all potential conflicts of interest, including those not associated with the abstract being submitted). The correct responses were identified by communicating with the individual societies and determining the responses desired by the society. The study had a 100% return rate from seventeen orthopaedic faculty, twenty-five orthopaedic residents and fellows, and twenty-five medical students. The average number of incorrect responses to the ten questions was 2.8. Forty-six percent of respondents had three or more incorrect responses, 24% had two incorrect responses, 19% had one incorrect response, and 10% had no incorrect responses. There was no significant difference in responses between those of different training levels. Subjects were no more likely to answer a project-specific question incorrectly than they

Worldwide orthopaedic research activity 2010-2014: Publication rates in the top 15 orthopaedic journals related to population size and gross domestic product.

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Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-06-18

To perform a bibliometric analysis of publications rates in orthopedics in the top 15 orthopaedic journals. Based on their 2015 impact factor, the fifteen highest ranked orthopaedic journals between January 2010 and December 2014 were used to establish the total number of publications; cumulative impact factor points (IF) per country were determined, and normalized to population size, GDP, and GDP/capita, comparison to the median country output and the global leader. Twenty-three thousand and twenty-one orthopaedic articles were published, with 66 countries publishing. The United States had 8149 publications, followed by the United Kingdom (1644) and Japan (1467). The highest IF was achieved by the United States (24744), United Kingdom (4776), and Japan (4053). Normalized by population size Switzerland lead. Normalized by GDP, Croatia was the top achiever. Adjusting GDP/capita, for publications and IF, China, India, and the United States were the leaders. Adjusting for population size and GDP, 28 countries achieved numbers of publications to be considered at least equivalent with the median academic output. Adjusting GDP/capita only China and India reached the number of publications to be considered equivalent to the current global leader, the United States. Five countries were responsible for 60% of the orthopaedic research output over this 5-year period. After correcting for GDP/capita, only 28 of 66 countries achieved a publication rate equivalent to the median country. The United States, United Kingdom, South Korea, Japan, and Germany were the top five countries for both publication totals and cumulative impact factor points.

The effectiveness of methicillin-resistant Staphylococcus aureus colonisation screening in asymptomatic healthcare workers in an Irish orthopaedic unit.

LENUS (Irish Health Repository)

Edmundson, S P

2012-01-31

Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality, costs and length of stay compared to non-MRSA infections. This observational 4-year study analyses the impact of screening and treating orthopaedic healthcare workers for MRSA colonisation. A total of 1,011 swabs were taken from 566 healthcare workers. Positive healthcare workers were treated with topical mupirocin to both anterior nares. The prevalence of MRSA colonisation on initial testing was 4.77%. The rate of positive MRSA colonisation of those tested on more than one occasion fell from 5.88% to 2.71% (p = 0.055) on subsequent screening. All healthcare workers receiving treatment were successfully cleared of colonisation; however, some required more than one course of treatment. These results show that there could be a role for screening and treating orthopaedic staff for MRSA colonisation as part of a strategy to reduce the prevalence of MRSA infections in orthopaedic units.

Hyperuricemia and associated factors: a cross-sectional study of Japanese-Brazilians

Directory of Open Access Journals (Sweden)

Juliana Poletto

2011-02-01

Full Text Available This cross-sectional study aimed to estimate the prevalence of hyperuricemia and associated risk factors among Japanese-Brazilians. We obtained data on demographic, health history, food intake, and laboratory variables. Chi-square and prevalence ratios were used as measures of association. 35.3% of the subjects presented hyperuricemia, which was more frequent in smokers, males, age > 55 years, with co-morbidities, individuals on uric acid-increasing medication, serum creatinine > 1.4mg/dL, high alcohol consumption, and low consumption of milk and dairy products. In the multivariate analysis, the associations remained significant with gender, overweight, central obesity, hypertriglyceridemia, and use of specific drugs. Among males, low intake of saturated fat was associated with hyperuricemia. Individuals with hypertension showed a negative association with dairy product consumption. The high hyperuricemia prevalence suggests that changes in nutritional profile and control of associated co-morbidities could help minimize occurrence of this condition.

Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit.

Science.gov (United States)

Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana

2014-01-01

In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting

National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools.

Science.gov (United States)

Silvestre, Jason; Ahn, Jaimo; Levin, L Scott

2017-01-18

The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes. Trends in NIH funding were determined for 2005 to 2014 and compared with total NIH extramural research funding. Funding awarded to orthopaedic surgery departments was compared with that awarded to departments of other surgical specialties in 2014. Characteristics of NIH-funded principal investigators were obtained from department web sites. In 2014, 183 grants were awarded to 132 investigators at 44 departments of orthopaedic surgery. From 2005 to 2014, NIH funding increased 24.3%, to $54,608,264 (p = 0.030), but the rates of increase seen did not differ significantly from those of NIH extramural research funding as a whole (p = 0.141). Most (72.6%) of the NIH funding was awarded through the R01 mechanism, with a median annual award of $343,980 (interquartile range [IQR], $38,372). The majority (51.1%) of the total funds supported basic science research, followed by translational (33.0%), clinical (10.0%), and educational (5.9%) research. NIH-funded orthopaedic principal investigators were predominately scientists whose degree was a PhD (71.1%) and who were male (79.5%). Eleven NIH institutes were represented, with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) providing the preponderance (74.2%) of the funding. In 2014, orthopaedic surgery ranked below the surgical departments of general surgery, ophthalmology, obstetrics and gynecology, otolaryngology, and urology in terms of NIH funding received. The percentage increase of NIH

Metabolic syndrome is directly associated with gamma glutamyl transpeptidase elevation in Japanese women

Institute of Scientific and Technical Information of China (English)

Hiroshi Sakugawa; Fukunori Kin jo; Atsushi Saito; Tomofumi Nakayoshi; Kasen Kobashigawa; Hiroki Nakasone; Yuko Kawakami; Tsuyoshi Yamashiro; Tatsuji Maeshiro; Ko Tomimori; Satoru Miyagi

2004-01-01

AIM: This study aimed to determine whether metabolic syndrome is directly or indirectly, through fatty liver, associated with elevated gamma-glutamyl transpeptidase (GGT) levels in Japanese women.METHODS: From 4 366 women who received their annual health check-up, 4 211 women were selected for analysis.All 4 211 women were negative for both hepatitis B surface antigen and antibody to hepatitis C virus. Clinical and biochemical variables were examined by using univariate and multivariate analysis.RESULTS: A raised GGT level (＞68 IU/L) was seen in 258 (6.1%) of the 4 211 women. In univariate analysis, all variables examined (age, body mass index, blood pressure,hemoglobin concentration, fasting blood glucose,glycosylated hemoglobin A1c, cholesterol, triglyceride, and uric acid) were associated with the elevated GGT level,whereas in multivariate analysis, four variables (age ≥ 50 yr,hemoglobin ≥14 g/dL, triglyceride ≥ 150 mg/dL, and presence of diabetes) were significantly and independently associated with raised GGT level. Clinical variables predicting the presence of ultrasonographic evidence of fatty liver were also examined by multivariate analysis; four variables were associated with the presence of fatty liver: BMI ≥ 25 kg/m2,hemoglobin ≥ 14 g/dL, triglyceride≥150 mg/dL, and uric acid≥ 7 mg/dL. There was no significant association between the raised GGT level and the presence of fatty liver.Hypertriglyceridemia was significantly and independently associated with both the raised GGT level and the presence of fatty liver.CONCLUSION: Metabolic syndrome seemed to be directly,not indirectly through fatty liver, associated with the raised GGT level in Japanese women.

Regenerative orthopaedics: in vitro, in vivo...in silico.

Science.gov (United States)

Geris, Liesbet

2014-09-01

In silico, defined in analogy to in vitro and in vivo as those studies that are performed on a computer, is an essential step in problem-solving and product development in classical engineering fields. The use of in silico models is now slowly easing its way into medicine. In silico models are already used in orthopaedics for the planning of complicated surgeries, personalised implant design and the analysis of gait measurements. However, these in silico models often lack the simulation of the response of the biological system over time. In silico models focusing on the response of the biological systems are in full development. This review starts with an introduction into in silico models of orthopaedic processes. Special attention is paid to the classification of models according to their spatiotemporal scale (gene/protein to population) and the information they were built on (data vs hypotheses). Subsequently, the review focuses on the in silico models used in regenerative orthopaedics research. Contributions of in silico models to an enhanced understanding and optimisation of four key elements-cells, carriers, culture and clinics-are illustrated. Finally, a number of challenges are identified, related to the computational aspects but also to the integration of in silico tools into clinical practice.

State Variation in Medicaid Reimbursements for Orthopaedic Surgery.

Science.gov (United States)

Lalezari, Ramin M; Pozen, Alexis; Dy, Christopher J

2018-02-07

Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. The 10 most commonly performed inpatient orthopaedic procedures, as ranked by the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, were identified for study. Medicaid reimbursement amounts for those procedures were benchmarked to state Medicare reimbursement amounts in 3 ways: (1) ratio, (2) dollar difference, and (3) dollar difference divided by the relative value unit (RVU) amount. Variability was quantified by determining the range and coefficient of variation for those reimbursement amounts. The range of variability of Medicaid reimbursements among states exceeded $1,500 for all 10 procedures. The coefficients of variation ranged from 0.32 (hip hemiarthroplasty) to 0.57 (posterior or posterolateral lumbar interbody arthrodesis) (a higher coefficient indicates greater variability), compared with 0.07 for Medicare reimbursements for all 10 procedures. Adjusted as a dollar difference between Medicaid and Medicare per RVU, the median values ranged from -$8/RVU (total knee arthroplasty) to -$17/RVU (open reduction and internal fixation of the femur). Variability of Medicaid reimbursement for inpatient orthopaedic procedures among states is substantial. This variation becomes especially remarkable given recent policy shifts toward focusing reimbursements on value.

Surgical skills simulation in trauma and orthopaedic training.

Science.gov (United States)

Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

2014-12-19

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

EXPERIMENTAL AND CLINICAL STUDY OF PHENOTYPIC FEATURES OF S. EPIDERMIDIS STRAINS AND THEIR ROLE IN THE EMERGENCE AND DEVELOPMENT OF IMPLANT-ASSOCIATED INFECTION AFTER ORTHOPAEDIC SURGERY

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S. A. Bozhkova

2014-01-01

Full Text Available S. epidermidis is one of the most common cause of implant-associated infections. Infections due to S. epidermidis rarely develops into life-threatening, however, its prevalence and the difficulties in treating constitute a serious financial burden to the health care system. This study is based on the investigation of phenotypic features (ability to biofilm formation and resistance to antibiotics of S. epidermidis strains isolated from patients with deep surgical site infection after implantation of orthopaedic devices, and on the investigation of the dynamics of clinical and morphological changes during the development of implant-associated infection due to S. epidermidis based on in vivo experimental models. Multidrug-resistance was found in 23% MSSE isolates and 97,3% - MRSE. Vancomycin, linezolid and fosfomycin were the most active in relation to these pathogens. About 40% of the tested isolates were strong biofilm-producing strains. 43,2% of MRSE strains and only 21,4% of MSSE isolates demonstrated strong biofilm production. The proposed experimental model shows that intra-operative infection of implant by multidrug-resistant clinical MRSE strain led to the development of osteomyelitis in rats for 4 weeks after surgery, in spite of the revision operation and installation of antimicrobial cement spacer in the area of bone defect. Thus, S. epidermidis is a clinically significant aetiological factor with high risk of development of infections after major orthopaedic surgery.

The spectrum of orthopaedics at Chris Hani Baragwanath Academic Hospital

OpenAIRE

Pillay, J; Ramokgopa, MT

2013-01-01

Chris Hani Baragwanath Academic Hospital (CHBAH) is the third largest hospital in the world and is the largest in the Southern hemisphere, serving a population of more than 3.5 million people.¹ The purpose of this review is to identify the orthopaedic-related health events that occur within the population being serviced by the hospital, and in doing so provide a tool to be used for improving orthopaedic-related patient care and outcomes in public health services.² We also took special interes...

Orthopaedic nurses' perception of research utilization - A cross sectional survey

DEFF Research Database (Denmark)

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2015-01-01

The call for evidence-based knowledge in clinical nursing practice has increased during recent decades and research in orthopaedic nursing is needed to improve patients' conditions, care and treatment. A descriptive cross-sectional survey was conducted to determine the self-perceived theoretical....... The results indicated that despite the majority of orthopaedic nurses having low self-perceived theoretical knowledge and practical research competencies, their interest and motivation to improve these were high, especially their inner motivation. However, the nurses' inner motivation was inhibited by a lack...

Burnout and quality of life among orthopaedic trainees in a modern educational programme

NARCIS (Netherlands)

van Vendeloo, S. N.; Brand, P. L. P.; Verheyen, C. C. P. M.

We aimed to determine quality of life and burnout among Dutch orthopaedic trainees following a modern orthopaedic curriculum, with strict compliance to a 48-hour working week. We also evaluated the effect of the clinical climate of learning on their emotional wellbeing. We assessed burnout, quality

Burnout and quality of life among orthopaedic trainees in a modern educational programme: importance of the learning climate.

Science.gov (United States)

van Vendeloo, S N; Brand, P L P; Verheyen, C C P M

2014-08-01

We aimed to determine quality of life and burnout among Dutch orthopaedic trainees following a modern orthopaedic curriculum, with strict compliance to a 48-hour working week. We also evaluated the effect of the clinical climate of learning on their emotional well-being. We assessed burnout, quality of life and the clinical climate of learning in 105 orthopaedic trainees using the Maslach Burnout Inventory, linear analogue scale self-assessments, and Dutch Residency Educational Climate Test (D-RECT), respectively. A total of 19 trainees (18%) had poor quality of life and 49 (47%) were dissatisfied with the balance between their personal and professional life. Some symptoms of burnout were found in 29 trainees (28%). Higher D-RECT scores (indicating a better climate of learning) were associated with a better quality of life (r = 0.31, p = 0.001), more work-life balance satisfaction (r = 0.31, p = 0.002), fewer symptoms of emotional exhaustion (r = -0.21, p = 0.028) and depersonalisation (r = -0,28, p = 0.04). A reduced quality of life with evidence of burnout were still seen in a significant proportion of orthopaedic trainees despite following a modern curriculum with strict compliance to a 48-hour working week. It is vital that further work is undertaken to improve the quality of life and reduce burnout in this cohort. ©2014 The British Editorial Society of Bone & Joint Surgery.

Decellularized Tissue and Cell-Derived Extracellular Matrices as Scaffolds for Orthopaedic Tissue Engineering

Science.gov (United States)

Cheng, Christina W.; Solorio, Loran D.; Alsberg, Eben

2014-01-01

The reconstruction of musculoskeletal defects is a constant challenge for orthopaedic surgeons. Musculoskeletal injuries such as fractures, chondral lesions, infections and tumor debulking can often lead to large tissue voids requiring reconstruction with tissue grafts. Autografts are currently the gold standard in orthopaedic tissue reconstruction; however, there is a limit to the amount of tissue that can be harvested before compromising the donor site. Tissue engineering strategies using allogeneic or xenogeneic decellularized bone, cartilage, skeletal muscle, tendon and ligament have emerged as promising potential alternative treatment. The extracellular matrix provides a natural scaffold for cell attachment, proliferation and differentiation. Decellularization of in vitro cell-derived matrices can also enable the generation of autologous constructs from tissue specific cells or progenitor cells. Although decellularized bone tissue is widely used clinically in orthopaedic applications, the exciting potential of decellularized cartilage, skeletal muscle, tendon and ligament cell-derived matrices has only recently begun to be explored for ultimate translation to the orthopaedic clinic. PMID:24417915

[The Summer School of the German Society for Orthopaedics and Traumatology - A Success Story].

Science.gov (United States)

Merschin, D; Mutschler, M; Stange, R; Kopschina, C; Schüttrumpf, J P; Doepfer, A K; Achatz, G; Niethard, M; Hoffmann, R; Kladny, B; Perl, M; Münzberg, M

2016-10-01

Background: It has been known for several years that orthopaedic and trauma clinics suffer from a shortage of young people, due to the substantial loss in attractiveness. The Youth Forum OU has been addressing this problem for many years, by initiating many projects such as the Summer School to counteract this trend. The purpose of this research is to evaluate the success of Summer Schools since 2009. Methods: The Youth Forum OU performed a survey in December 2014 to answer the research question on the basis of an internet-based poll of the student participants in all Summer Schools between 2009 and 2014. Following data cleansing, 121 students and former students were included in the survey. Results: Seventy-two completed questionnaires were collected and included in the evaluation. The survey included 40 % of Summer School participants, with a mean age of 27.3 years (SD ± 2.95); 50 % were female. Participation in the Summer School helped 50 % of the respondents to decide to start advanced study in orthopaedics and/or traumatology (OU). One third of these Summer School participants had already finished a university degree; 100 % are now residents in orthopaedics and/or traumatology. Regardless of prior plans, 87.2 % of participants are now residents in OU. Thirty-three are still students: 78.8 % have already decided to work in OU. The survey also served to identify the factors positively and negatively associated with OU. Unfavourable factors included the reputation of OU, and the difficulty of reconciling family and work. Favourable factors included surgical work and personal experience during university studies. Discussion: The aim of this study was to evaluate whether the efforts of the Youth Forum OU, the German Society for Orthopaedics and Traumatology (DGOU) and the local hospitals lead to increased interest in OU. The answer to this question is positive. This is particularly true for those students who did not plan to become an orthopaedic or

A review of virtual reality based training simulators for orthopaedic surgery

OpenAIRE

Vaughan, Neil; Dubey, Venketesh N.; Wainwright, Tom; Middleton, Robert

2015-01-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 total hip replacement pre-operative planning tools were analysed, plus 9 hip trauma fracture tr...

Reno Orthopaedic Trauma Fellowship business curriculum.

Science.gov (United States)

Althausen, Peter L; Bray, Timothy J; Hill, Austin D

2014-07-01

The Reno Orthopaedic Center (ROC) Trauma Fellowship business curriculum is designed to provide the fellow with a graduate level business practicum and research experience. The time commitments in a typical 12-month trauma fellowship are significant, rendering a traditional didactic master's in business administration difficult to complete during this short time. An organized, structured, practical business education can provide the trauma leaders of tomorrow with the knowledge and experience required to effectively navigate the convoluted and constantly changing healthcare system. The underlying principle throughout the curriculum is to provide the fellow with the practical knowledge to participate in cost-efficient improvements in healthcare delivery. Through the ROC Trauma Fellowship business curriculum, the fellow will learn that delivering healthcare in a manner that provides better outcomes for equal or lower costs is not only possible but a professional and ethical responsibility. However, instilling these values without providing actionable knowledge and programs would be insufficient and ineffective. For this reason, the core of the curriculum is based on individual teaching sessions with a wide array of hospital and private practice administrators. In addition, each section is equipped with a suggested reading list to maximize the learning experience. Upon completion of the curriculum, the fellow should be able to: (1) Participate in strategic planning at both the hospital and practice level based on analysis of financial and clinical data, (2) Understand the function of healthcare systems at both a macro and micro level, (3) Possess the knowledge and skills to be strong leaders and effective communicators in the business lexicon of healthcare, (4) Be a partner and innovator in the improvement of the delivery of orthopaedic services, (5) Combine scientific and strategic viewpoints to provide an evidence-based strategy for improving quality of care in a

Japanese wives in Japanese-Australian intermarriages

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Jared Denman

2009-12-01

Full Text Available The diasporic experiences of Japanese partners married to Australians and living in Australia are largely unexamined. This article is based on a study, conducted for an honours thesis, which invited four Japanese wives living in South East Queensland to describe, together with their Australian husbands, their family’s interactions with Japan, its language and culture, and the local Japanese community. It was recognised that the extensive social networks these wives had established and maintained with local Japanese women from other Japanese-Australian intermarriage families were an important part of their migrant experience. This article will firstly review the literature on contemporary Japanese- Australian intermarriage in Australia and Japanese lifestyle migration to Australia. It will then describe and examine the involvement and motivations of the four wives in their social networks. Entry into motherhood was found to be the impetus for developing and participating in informal, autonomous networks. Additionally, regular visits to Japan were focused on engagement with existing family and friendship networks. The contemporary experience of intermarriage for these women is decidedly transnational and fundamentally different from that of the war brides, or sensō hanayome.

Preliminary genome-wide association study of bipolar disorder in the Japanese population.

Science.gov (United States)

Hattori, Eiji; Toyota, Tomoko; Ishitsuka, Yuichi; Iwayama, Yoshimi; Yamada, Kazuo; Ujike, Hiroshi; Morita, Yukitaka; Kodama, Masafumi; Nakata, Kenji; Minabe, Yoshio; Nakamura, Kazuhiko; Iwata, Yasuhide; Takei, Nori; Mori, Norio; Naitoh, Hiroshi; Yamanouchi, Yoshio; Iwata, Nakao; Ozaki, Norio; Kato, Tadafumi; Nishikawa, Toru; Kashiwa, Atsushi; Suzuki, Mika; Shioe, Kunihiko; Shinohara, Manabu; Hirano, Masami; Nanko, Shinichiro; Akahane, Akihisa; Ueno, Mikako; Kaneko, Naoshi; Watanabe, Yuichiro; Someya, Toshiyuki; Hashimoto, Kenji; Iyo, Masaomi; Itokawa, Masanari; Arai, Makoto; Nankai, Masahiro; Inada, Toshiya; Yoshida, Sumiko; Kunugi, Hiroshi; Nakamura, Michiko; Iijima, Yoshimi; Okazaki, Yuji; Higuchi, Teruhiko; Yoshikawa, Takeo

2009-12-05

Recent progress in genotyping technology and the development of public databases has enabled large-scale genome-wide association tests with diseases. We performed a two-stage genome-wide association study (GWAS) of bipolar disorder (BD) in Japanese cohorts. First we used Affymetrix 100K GeneChip arrays in the analysis of 107 cases with bipolar I disorder and 107 controls, and selected markers that were nominally significant (P < 0.01) in at least one of the three models (1,577 markers in total). In the follow-up stage, we analyzed these markers using an Illumina platform (1,526 markers; 51 markers were not designable for the platform) and an independent sample set, which consisted of 395 cases (bipolar I + II) and 409 controls. We also assessed the population stratification of current samples using principal components analysis. After the two-stage analysis, 89 markers remained nominally significant (allelic P < 0.05) with the same allele being consistently over-represented in both the first and the follow-up stages. However, none of these were significant after correction for multiple-testing by false discovery rates. Sample stratification was virtually negligible. Collectively, this is the first GWAS of BD in the Japanese population. But given the small sample size and the limited genomic coverage, these results should be taken as preliminary. 2009 Wiley-Liss, Inc.

[Dentistry in Korean during the Japanese occupation].

Science.gov (United States)

Shin, Jae-Eu

2004-12-01

The Japanese introduction of dentistry into Korea was for treating the Japanese residing in Korea Noda-Oji was the first Japanese dentist for Japanese people in Korea in 1893, and Narajaki doyoyo, an invited dentist was posted in the Korean headquarter of Japanese army in September, 1905. The imperialist Japan licensed the dental technicians (yipchisa) without limit and controlled them generously so they could practice dentistry freely. This measure was contrary to that in Japan. (In Japan no new dental technician was licensed.) Komori, a dental technician opened his laboratory at Chungmuro in 1902. The dental technician had outnumbered by 1920. In 1907, the first Korean dental technician Sung-Ryong Choi practiced dentistry in Jongno. The imperialist Japan made the regulations for dental technicians to set a limit to the advertisement and medical practice of dental technicians. The first Korean dentists Suk-Tae Ham was register No. 1 in the dentist license. The Kyungsung dental school was established by Nagira Dasoni for the purpose of educating some Korean people that contributed to Japanese colonization. It made progress with the help of Japan, it was was given the approval of the establishment of the professional school in January the 25th, 1929. It was intended to produce Korean dentists in the first place but became the school for Japanese students later on. The association of Chosun dentist, which had been founded by Narajaki doyoyo, was managed by Japanese dentists in favor of the colonial ruling. The Hansung Association of Dentists established in 1925 was the organization made by the necessity of the association for Koreans only. The Japanese forcefully annexed the Association of Hansung Dentists (Koreans only) to the Association of Kyungsung Dentists to avoid collective actions of Korean dentists in the name of 'Naesunilche' -- 'Japan and Korea and one'. Their invading intention was shown in the event of 'decayed tooth preventive day'. Japanese controlled

Dentistry in Korea during the Japanese Occupation

Directory of Open Access Journals (Sweden)

SHIN Jae-Eu

2004-12-01

Full Text Available The Japanese introduction of dentistry into Korea was for treating the Japanese residing in Korea Noda-Oji was the first Japanese dentist for Japanese people in Korea in 1893. and Narajaki doyoyo, an invited dentist was posted in the Korean headquarter of Japanese army in september, 1905. The imperialist Japan licensed the dental technicians(yipchisa without limit and controled them generously so they could practice dentistry freely. This measure was contrary to that in Japan. (In Japan no new dental technician was licensed. Komori, a dental technician opened his laboratory at Chungmuro in 1902. The dental technician had outnumerbered by 1920. In 1907, the first Korean dental technician Sung-Ryong Choi practiced dentistry in Jongno. The imperialist Japan made the regulation for dental technicians to set a limit to the advertisement and medical practice of dental technicians. The first Korean dentist Suk-Tae Ham was registered No. 1 in the dentist license. The Kyungsung dental school was established by Nagira Dasoni for the purpose of educating some korean people that contributed to Japanese colonization. It made progress with the help of Japan. it was given the approval of the establishment of the professional school in January the 25th, 1929. it was intended to produce Korean dentists in the first place but became the school for Japanese students later on. The association of Chosun dentist, which had been founded by Narajaki doyoyo, was managed by Japanese dentists in favor of the colonial ruling. The Hansung Association of Dentists established in 1925 was the organization made by the necessity of the association for Koreans only. the Japanese forcefully annexed the Association of Hansung Dentists (Koreans only to the Association of Kyungsung Dentists to avoid collective actions of Korean dentists in the name of 'Naesunilche'--'Japan and Korea are one'. Their invading intention was shown in the event of 'decayed tooth preventive day'. Japanese

Association between Pulse Wave Velocity and Coronary Artery Calcification in Japanese men.

Science.gov (United States)

Torii, Sayuki; Arima, Hisatomi; Ohkubo, Takayoshi; Fujiyoshi, Akira; Kadota, Aya; Takashima, Naoyuki; Kadowaki, Sayaka; Hisamatsu, Takashi; Saito, Yoshino; Miyagawa, Naoko; Zaid, Maryam; Murakami, Yoshitaka; Abbott, Robert D; Horie, Minoru; Miura, Katsuyuki; Ueshima, Hirotsugu

2015-01-01

Pulse wave velocity (PWV) is a simple and valid clinical method for assessing arterial stiffness. Coronary artery calcification (CAC) is an intermediate stage in the process leading to overt cardiovascular disease (CVD) and an established determinant of coronary artery disease. This study aimed to examine the association between PWV and CAC in a population-based sample of Japanese men. This is a cross-sectional study of 986 randomly selected men aged 40-79 years from Shiga, Japan. CVD-free participants were examined from 2006 to 2008. Brachial-ankle PWV (baPWV) was measured using an automatic waveform analyzer. CAC was assessed using computed tomography. Agatston scores ≥ 10 were defined as the presence of CAC. Prevalence of CAC progressively increased with rising levels of baPWV: 20.6%, 41.7%, 56.3%, and 66.7% across baPWV quartiles ＜ 1378, 1378-1563, 1564-1849, and ＞ 1849 cm/s (P ＜ 0.001 for trend). Associations remained significant after adjusting for age and other factors, including body mass index, systolic blood pressure, pulse rate, total and high-density lipoprotein cholesterol, hemoglobin A1c, drinking, smoking and exercise status, and the use of medication to treat hypertension, dyslipidemia and diabetes (P=0.042 for trend). The optimal cutoff level of baPWV to detect CAC was 1612 cm/s using receiver operating characteristic curve analysis. Arterial stiffness as defined by an elevated baPWV is associated with an increased prevalence of CAC in a general population-based setting among Japanese men.

Research on the Influence of Orthopaedic Inserts on Pressure Distribution in the Foot

Directory of Open Access Journals (Sweden)

Ignas Rutulys

2011-02-01

Full Text Available The article examines the influence of individual orthopaedic inserts on pressure distribution in the foot. Feet deformations, types of orthopaedic inserts, materials and pressure in the foot testing methods are discussed. Experimental computer measurements of pressure in the foot before and after the use of inserts have been done. During research, the inserts made of different kinds of materials selected according to human weight, pathology, skin sensitivity and many other reasons has been used. It has been determinated that orthopaedic inserts have a more noticeable impact on children whose feet is adjusted easier if compared with those of adults.Article in Lithuanian

Orthopaedic research in Australia: a bibliographic analysis of the publication rates in the top 15 journals.

Science.gov (United States)

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-09-01

To investigate the publications rates and characteristics of the authors for manuscripts originating from Australia in the 15 highest ranked orthopaedic journals over a 5-year period. The 15 highest ranked journals in orthopaedics, based on their 2015 impact factor, were used to establish the total number of publications and cumulative impact factor points between January 2010 and December 2014. The affiliations of the primary author and co-authors were used to determine the involvement of Australian trained orthopaedic surgeons. Study location, research topic and anatomic areas were recorded. A total of 478 publications were identified; 110 of these manuscripts were principally authored by Australian trained orthopaedic surgeons or medical professionals affiliated with orthopaedics. In addition, 158 articles were published with orthopaedic surgery involvement where one of the co-authors was an Australian trained surgeon. Australian orthopaedic surgeon (FRACS) involvement was most commonly observed in the knee (n = 90; 33.6%) followed by the hip (n = 69; 25.7%) and basic sciences (n = 27; 10.1%). Surgeons in Sydney had the highest number of publications (n = 95; 35.4%), followed by Adelaide (n = 55; 20.5%) and Melbourne (n = 54; 20.1%). The results of this study demonstrate that the minority (23%) of the publications originating from Australia in the 15 highest-ranking orthopaedic journals were principally authored by either an Australian trained surgeon or a trainee surgeon. A total of 59% of the publications focused on the hip and knee. Sydney was the leading region, followed by Adelaide and Melbourne. These three regions published 76% of all manuscripts identified during the 5-year study period. © 2017 Royal Australasian College of Surgeons.

Quality of online pediatric orthopaedic education materials.

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Feghhi, Daniel P; Komlos, Daniel; Agarwal, Nitin; Sabharwal, Sanjeev

2014-12-03

Increased availability of medical information on the Internet empowers patients to look up answers to questions about their medical conditions. However, the quality of medical information available on the Internet is highly variable. Various tools for the assessment of online medical information have been developed and used to assess the quality and accuracy of medical web sites. In this study we used the LIDA tool (Minervation) to assess the quality of pediatric patient information on the AAOS (American Academy of Orthopaedic Surgeons) and POSNA (Pediatric Orthopaedic Society of North America) web sites. The accessibility, usability, and reliability of online medical information in the "Children" section of the AAOS web site and on the POSNA web site were assessed with use of the LIDA tool. Flesch-Kincaid (FK) and Flesch Reading Ease (FRE) values were also calculated to assess the readability of the pediatric education material. Patient education materials on each web site scored in the moderate range in assessments of accessibility, usability, and reliability. FK and FRE values indicated that the readability of each web site remained at a somewhat higher (more difficult) level than the recommended benchmark. The quality and readability of online information for children on the AAOS and POSNA web sites are acceptable but can be improved further. The quality of online pediatric orthopaedic patient education materials may affect communication with patients and their caregivers, and further investigation and modification of quality are needed. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Coffee consumption but not green tea consumption is associated with adiponectin levels in Japanese males.

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Imatoh, T; Tanihara, S; Miyazaki, M; Momose, Y; Uryu, Y; Une, H

2011-06-01

Coffee is among the most widely consumed beverages in the world. Numerous epidemiological studies have reported a significant inverse association between coffee consumption and risk of type 2 diabetes mellitus, but the underlying mechanisms are still not fully understood. Therefore, we conducted an epidemiological study to clarify the relationship between coffee consumption and adiponectin levels in Japanese males. We also evaluated whether green tea consumption affected adiponectin levels. We carried out a cross-sectional study. The subjects were 665 male employees in Japan. Coffee consumption was assessed, using a self-administered questionnaire, as the number of times per week and cups per day respondents drank, and subjects were grouped into four levels (non, 1-5 times/week, 1-2 cups/day and ≥3 cups/day). The means of adiponectin levels were positively associated with coffee consumption. A dose-response relationship was found between coffee consumption and circulating adiponectin levels. The relationship remained significant after adjustment for potential confounding factors (P for trend coffee consumption is associated with higher adiponectin levels in Japanese males but also found a dose-dependent association between coffee consumption and adiponectin levels. Therefore, our study suggested that coffee components might play an important role in the elevation of adiponectin level.

Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?

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Bartlett, J D; Lawrence, J E; Stewart, M E; Nakano, N; Khanduja, V

2018-05-01

Aims The aim of this study was to assess the current evidence relating to the benefits of virtual reality (VR) simulation in orthopaedic surgical training, and to identify areas of future research. Materials and Methods A literature search using the MEDLINE, Embase, and Google Scholar databases was performed. The results' titles, abstracts, and references were examined for relevance. Results A total of 31 articles published between 2004 and 2016 and relating to the objective validity and efficacy of specific virtual reality orthopaedic surgical simulators were identified. We found 18 studies demonstrating the construct validity of 16 different orthopaedic virtual reality simulators by comparing expert and novice performance. Eight studies have demonstrated skill acquisition on a simulator by showing improvements in performance with repeated use. A further five studies have demonstrated measurable improvements in operating theatre performance following a period of virtual reality simulator training. Conclusion The demonstration of 'real-world' benefits from the use of VR simulation in knee and shoulder arthroscopy is promising. However, evidence supporting its utility in other forms of orthopaedic surgery is lacking. Further studies of validity and utility should be combined with robust analyses of the cost efficiency of validated simulators to justify the financial investment required for their use in orthopaedic training. Cite this article: Bone Joint J 2018;100-B:559-65.

Intimate partner violence in orthopaedic trauma patients

NARCIS (Netherlands)

Sprague, S.A.

2013-01-01

Intimate partner violence (IPV) or domestic violence is a common and serious public health problem around the globe. Victims of IPV frequently present to health care practitioners including orthopaedic surgeons. Substantial research has been conducted on IPV over the past few decades, but very

Associations among gastroesophageal reflux disease, psychological stress, and sleep disturbances in Japanese adults.

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Okuyama, Masatsugu; Takaishi, Osamu; Nakahara, Kenichi; Iwakura, Narika; Hasegawa, Tomoki; Oyama, Maizumi; Inoue, Ayumi; Ishizu, Hirotaka; Satoh, Hiroshi; Fujiwara, Yasuhiro

2017-01-01

Gastroesophageal reflux disease (GERD) and psychological stress are associated with sleep disturbances. The aim of the present study was to examine the prevalence of sleep disturbances, anxiety, and depression by GERD subtypes and to identify factors associated with sleep disturbances in general population. A total of 2002 Japanese subjects, who underwent annual health checkups, were enrolled and asked to fill out a questionnaire, including the frequency scale for the symptoms of GERD (FSSG), Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression Scale (HADS). GERD was divided into asymptomatic erosive reflux disease (a-ERD), symptomatic ERD (s-ERD), and non-erosive reflux disease (NERD), according to the presence or absence of esophageal mucosal injury on endoscopy, and the FSSG scores. Sleep disturbances were diagnosed in subjects with AIS score ≥6. Prevalence of sleep disturbances was significantly higher in GERD subjects than in controls (35.9 and 14.7%, respectively), especially, in the NERD group (45.1%). Sleep duration was significantly shorter in the s-ERD group compared with other groups. Subjects in the NERD and s-ERD groups showed higher HADS scores, resulting in higher incidences of anxiety and depression than those in the control and a-ERD groups. Reflux symptoms, anxiety, depression, and coexisting functional dyspepsia, but not the presence of esophageal mucosal injury, were associated with an increased odds ratio for sleep disturbances. There were significant positive associations among reflux symptoms, psychological stress, and sleep disturbance in Japanese adults. Further studies investigating the efficacy of therapy are needed.

Role of STAT4 polymorphisms in systemic lupus erythematosus in a Japanese population: a case-control association study of the STAT1-STAT4 region

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Kawasaki, Aya; Ito, Ikue; Hikami, Koki; Ohashi, Jun; Hayashi, Taichi; Goto, Daisuke; Matsumoto, Isao; Ito, Satoshi; Tsutsumi, Akito; Koga, Minori; Arinami, Tadao; Graham, Robert R; Hom, Geoffrey; Takasaki, Yoshinari; Hashimoto, Hiroshi; Behrens, Timothy W; Sumida, Takayuki; Tsuchiya, Naoyuki

2008-01-01

Introduction Recent studies identified STAT4 (signal transducers and activators of transcription-4) as a susceptibility gene for systemic lupus erythematosus (SLE). STAT1 is encoded adjacently to STAT4 on 2q32.2-q32.3, upregulated in peripheral blood mononuclear cells from SLE patients, and functionally relevant to SLE. This study was conducted to test whether STAT4 is associated with SLE in a Japanese population also, to identify the risk haplotype, and to examine the potential genetic contribution of STAT1. To accomplish these aims, we carried out a comprehensive association analysis of 52 tag single nucleotide polymorphisms (SNPs) encompassing the STAT1-STAT4 region. Methods In the first screening, 52 tag SNPs were selected based on HapMap Phase II JPT (Japanese in Tokyo, Japan) data, and case-control association analysis was carried out on 105 Japanese female patients with SLE and 102 female controls. For associated SNPs, additional cases and controls were genotyped and association was analyzed using 308 SLE patients and 306 controls. Estimation of haplotype frequencies and an association study using the permutation test were performed with Haploview version 4.0 software. Population attributable risk percentage was estimated to compare the epidemiological significance of the risk genotype among populations. Results In the first screening, rs7574865, rs11889341, and rs10168266 in STAT4 were most significantly associated (P rs7574865) (P = 1.5 × 10-6). The association was stronger in subgroups of SLE with nephritis and anti-double-stranded DNA antibodies. Population attributable risk percentage was estimated to be higher in the Japanese population (40.2%) than in Americans of European descent (19.5%). Conclusions The same STAT4 risk allele is associated with SLE in Caucasian and Japanese populations. Evidence for a role of STAT1 in genetic susceptibility to SLE was not detected. The contribution of STAT4 for the genetic background of SLE may be greater in the

Analysis of scientific articles published in two general orthopaedic journals.

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Holzer, Lukas A; Holzer, Gerold

2013-01-01

To give an overview of the behaviour and scientific contributions of the Journal of Bone and Joint Surgery American (JBJS-A) and British Volume (JBJS-B). 480 original articles published in 2009 were identified through a combined comprehensive computer and manual library search. Articles were assigned to 11 orthopaedic categories and by country, type and specialty of the institution. Possible grants and citations were analysed. USA led all countries in published articles (36,87%), followed by UK (20,62%) and South Korea (5,83%). Most studies published were performed at academic institutions (65,83 %), only 4,16% at private practices. Almost half of the articles (46,24%) were published in three categories: hip (19.16%), knee (13.75%) and trauma (13.33%). In both journals 47.15% articles had at least one funding source. A review of articles published in major journals allows to show how research in orthopaedics is distributed worldwide. This study shows that a variety of different journals is neccessary to reflect the broad spectrum of orthopaedics in depth. Level of Evidence III, Retrospective Comparative Study.

Orthopaedic complications of osteogenesis imperfecta

International Nuclear Information System (INIS)

Azrak, S.; Ksyar, R.; Ben Rais, N.

2009-01-01

Osteogenesis imperfecta is a genetic disease characterized by bone frailty. It is generally caused by an abnormal production of collagen, which is the main fibrous protein of the bone. Collagen is also present in the skin, tendons, the sclera of the eye and dentin. The most frequent manifestation of osteogenesis imperfecta is the occurrence of multiple fractures without major trauma. Severity and timing of the attack varies widely: some patients sustain a significant number of fractures during early childhood which may have a serious impact on growth, while others will have some fractures separated by a few years. In all cases, the bone strength improves in adulthood. The bone fractures cause pain and bone deformities sometimes result in a smaller size. Scoliosis is frequent and associated with painful vertebral collapses. We present a case of osteogenesis imperfecta in a 40-year-old adult and we describe the various orthopaedic complications of the disease, stressing the role of bone scintigraphy in the diagnosis and monitoring of these complications. (authors)

The burden of gunshot injuries on orthopaedic healthcare resources in South Africa.

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Martin, Case; Thiart, Gerhard; McCollum, Graham; Roche, Stephen; Maqungo, Sithombo

2017-06-30

Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective. To estimate the burden and average cost of treating GSW victims requiring orthopaedic interventions in an SA tertiary level hospital. This retrospective study surveyed more than 1 500 orthopaedic admissions over a 12-month period (2012) at Groote Schuur Hospital, Cape Town, SA. Chart review subsequently yielded data that allowed analysis of cost, theatre time, number and type of implants, duration of admission, diagnostic imaging studies performed, blood products used, laboratory studies ordered and medications administered. A total of 111 patients with an average age of 28 years (range 13 - 74) were identified. Each patient was hit by an average of 1.69 bullets (range 1 - 7). These patients sustained a total of 147 fractures, the majority in the lower extremities. Ninety-five patients received surgical treatment for a total of 135 procedures, with a cumulative surgical theatre time of >306 hours. Theatre costs, excluding implants, were in excess of USD94 490. Eighty of the patients received a total of 99 implants during surgery, which raised theatre costs an additional USD53 381 cumulatively, or USD667 per patient. Patients remained hospitalised for an average of 9.75 days, and total ward costs exceeded USD130 400. Individual patient costs averaged about USD2 940 (ZAR24 945) per patient. This study assessed the burden of orthopaedic firearm injuries in SA. It was estimated that on average, treating an orthopaedic GSW patient

The orthopaedic management of myelomeningocele | Horn | South ...

African Journals Online (AJOL)

The orthopaedic management of myelomeningocele. A Horn, S Dix-Peek, S Mears, EB Hoffman. Abstract. Despite improvement in antenatal care and screening, myelomeningocele remains the most common congenital birth defect, with a reported incidence of 1 - 2.5/1000 patients in the Western Cape, South Africa.

Nigerian Journal of Orthopaedics and Trauma: Submissions

African Journals Online (AJOL)

The Nigerian Journal of Orthopaedics and Trauma is a peer reviewed journal publishing original research articles on all aspects of trauma, musculoskeletal ... initials and surnames of all authors, their highest academic degrees, affiliations / institutions and the name, address and e-mail address of the corresponding author.

Association between serum organochlorines and global methylation level of leukocyte DNA among Japanese women: a cross-sectional study

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Itoh, Hiroaki [Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113–8421 Japan (Japan); Iwasaki, Motoki, E-mail: moiwasak@ncc.go.jp [Epidemiology Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104–0045 Japan (Japan); Kasuga, Yoshio [Department of Surgery, Nagano Matsushiro General Hospital, 183 Matsushiro, Matsushiro-cho, Nagano City, Nagano Prefecture 381–1231 Japan (Japan); Yokoyama, Shiro; Onuma, Hiroshi [Department of Breast and Thyroid Surgery, Nagano Red Cross Hospital, 5-22-1 Wakasato, Nagano City, Nagano Prefecture 380–8582 Japan (Japan); Nishimura, Hideki [Department of Respiratory Surgery and Breast Surgery, Nagano Municipal Hospital, 1333–1 Tomitake, Nagano City, Nagano Prefecture 381–8551 Japan (Japan); Kusama, Ritsu [Department of Surgery, Hokushin General Hospital, 1-5-63 Nishi, Nakano City, Nagano Prefecture 383–8505 Japan (Japan); Yoshida, Teruhiko [Division of Genetics, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104–0045 Japan (Japan); Yokoyama, Kazuhito [Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113–8421 Japan (Japan); Tsugane, Shoichiro [Dierctor Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104–0045 Japan (Japan)

2014-08-15

While the global methylation level of leukocyte DNA may be a suitable biomarker for cancer risk, the level may be influenced by multiple factors, both environmental and host-related, one of which is exposure to environmental pollutants. To date, three epidemiologic studies have examined associations between serum organochlorine levels and global DNA methylation level, but their findings are not fully consistent, and the associations thus require confirmation in other well-characterized populations. We tested the association between organochlorine exposure and the global DNA methylation level of leukocytes in Japanese women. We conducted a cross-sectional study using the control group of a breast cancer case–control study in Japan. Subjects were 403 Japanese women who provided blood samples. Serum polychlorinated biphenyls (PCBs) and nine pesticide-related organochlorines were measured by gas chromatography isotope-dilution high-resolution mass spectrometry. Further, global methylation level of peripheral leukocyte DNA among 399 women was measured by luminometric methylation assay. Linear trends in the association between methylation and quartile levels of organochlorines were evaluated by regression coefficients in a multivariable linear regression model. We found significant inverse associations between the global methylation level in leukocyte DNA and many of the organochlorine levels measured. Global methylation level was significantly decreased by 0.33–0.83% per quartile category for serum o,p′-dichlorodiphenyltrichloroethane (o,p′-DDT), p,p′-DDT, p,p′-dichlorodiphenyldichloroethylene, trans-nonachlor, oxychlordane, hexachlorobenzene, β-hexachlorocyclohexane, PCB17, PCB52/69, PCB74, PCB114, and PCB183. Serum organochlorine levels were inversely associated with the global methylation level of leukocyte DNA in a relatively large sample of Japanese women. - Highlights: • Many serum organochlorine pesticides were inversely associated with the global

The First World War and its influence on the development of orthopaedic surgery.

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Scotland, T

2014-01-01

By December 1914, overwhelming numbers of soldiers with infected musculoskeletal wounds had filled hospitals in France and Britain. Frequently initial management had been inadequate. In 1915, patients with orthopaedic wounds were segregated for the first time when Robert Jones established an experimental orthopaedic unit in Alder Hey Hospital, Liverpool. In 1916 he opened the first of 17 orthopaedic centres in Britain to surgically treat and rehabilitate patients. Henry Gray from Aberdeen emerged as the leading authority in the management of acute musculoskeletal wounds in casualty clearing stations in France and Flanders. Gray had particular expertise in dealing with compound fractures of the femur for which he documented an 80% mortality rate in 1914-15.

Sense of coherence is associated with reduced psychological responses to job stressors among Japanese factory workers

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Urakawa Kayoko

2012-07-01

Full Text Available Abstract Background Job stress is associated with adverse health effects. The present study was conducted to examine the association between sense of coherence (SOC, as advocated by Antonovsky, and psychological responses to job stressors among Japanese workers. Methods A self-administered questionnaire containing a Japanese version of the 13-item SOC scale, the Brief Job Stress Questionnaire, and a self-rated health item were distributed to 1968 workers in X Prefecture. Anonymous responses were recovered by postal mail. Results Complete responses were received from 299 workers (response rate 15.2%, 191 males and 108 females who consented to participate in the study. Participants were 186 office clerks, 38 sales representatives, 22 technical engineers, 16 service trade workers, eight information processing workers, eight technical experts, and 21 other workers of various types. SOC scores were associated with age, self-rated health, job title, and marriage status. According to regression analyses stratified by gender, SOC was inversely associated with tension, fatigue, anxiety, depression and subjective symptoms in males, and tension, depression and subjective symptoms in females. SOC was positively associated with vigor in both males and females. Conclusions Having a strong SOC may reduce worker’s negative job stress responses and increase their vigor. Longitudinal studies are required to confirm this finding.

Polymorphysims of Gene in the Exons Were Associated with the Reproductive Endocrine of Japanese Flounder (

Directory of Open Access Journals (Sweden)

R. Q. Ma

2012-06-01

Full Text Available The cytochrome P450c17-I (CYP17-I is one of the enzymes critical to gonadal development and the synthesis of androgens. Two single nucleotide polymorphisms (SNPs were detected within the coding region of the CYP17-I gene in a population of 75 male Japanese flounder (Paralichthys olivaceus. They were SNP1 (c.C445T located in exon2 and SNP2 (c.T980C (p.Phe307Leu located in exon5. Four physiological indices, which were serum testosterone (T, serum 17β-estradiol (E2, Hepatosomatic index (HSI, and Gonadosomatic index (GSI, were studied to examine the effect of the two SNPs on the reproductive endocrines of Japanese flounder. Multiple comparisons revealed that CT genotype of SNP1 had a much lower T level than CC genotype (p<0.05 and the GSI of individuals with CC genotype of SNP2 was higher than those with TT genotype (p<0.05. Four diplotypes were constructed based on the two SNPs and the diplotype D3 had a significantly lower T level and GSI. In conclusion, the two SNPs were significantly associated with reproductive traits of Japanese flounder.

The personal interview: assessing the potential for personality similarity to bias the selection of orthopaedic residents.

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Quintero, Andres J; Segal, Lee S; King, Tonya S; Black, Kevin P

2009-10-01

The selection of medical students for training in orthopaedic surgery consists of an objective screening of cognitive skills to secure interviews for the brightest candidates, followed by subjective measures of candidates to confirm whether applicants are worthy of further consideration. The personal interview and its potential biased impact on the orthopaedic workforce were evaluated. During 2004-2006 at the Penn State College of Medicine, the authors performed a prospective cohort study in which 30 consenting interviewers and 135 interviewees completed the Myers-Briggs Type Indicator before the interviews. Completed surveys were evaluated after submitting the resident selection list to the National Residency Matching Program, and candidate rankings based solely on the personal interview were analyzed. Clinicians ranked candidates more favorably when they shared certain personality preferences (P = .044) and when they shared the preference groupings of the quadrant extrovert-sensing and either the function pair sensing-thinking (P = .007) or the temperament sensing-judging (P = .003), or the function pair sensing-feeling and the temperament sensing-judging (P = .029). No associations existed between personality preferences and interviewee rankings performed by basic scientists and resident interviewers. The results support the hypothesis that, within the department studied, there was a significant association between similarities in personality type and the rankings that individual faculty interviewers assigned to applicants at the completion of each interview session. The authors believe that it is important for the faculty member to recognize that this tendency exists. Finally, promoting diversity within the admission committee may foster a diverse resident body and orthopaedic workforce.

Inverse association between yoghurt intake and upper aerodigestive tract cancer risk in a Japanese population.

Science.gov (United States)

Kawakita, Daisuke; Sato, Fumihito; Hosono, Satoyo; Ito, Hidemi; Oze, Isao; Watanabe, Miki; Hanai, Nobuhiro; Hatooka, Shunzo; Hasegawa, Yasuhisa; Shinoda, Masayuki; Tajima, Kazuo; Murakami, Shingo; Tanaka, Hideo; Matsuo, Keitaro

2012-09-01

Although the combination of tobacco smoking and alcohol drinking account for approximately 80% of upper aerodigestive tract (UADT) cancer risk, the role of dietary factors, including dairy products, in the risk of these cancers remains controversial. We aimed to evaluate the association between dairy product intake and UADT cancer risk in a Japanese population. We conducted a case-control study in 959 patients with UADT cancer and 2877 sex- and age-matched noncancer control subjects who visited the Aichi Cancer Center in Nagoya, Japan. Data on lifestyle factors, including diet, were obtained by self-administered questionnaire. Associations were assessed by multivariate logistic regression models that considered potential confounders. We found a significant inverse association between yoghurt intake and UADT cancer risk with multivariate-adjusted odds ratios and 95% confidence intervals for <1 time/week, ≥ 1 time/week and <1 time/day, and ≥ 1 time/day consumption of yoghurt of 0.70 (95% confidence interval: 0.54-0.91), 0.67 (0.54-0.84), and 0.73 (0.55-0.95) relative to nonconsumers (P trend=0.005). When stratified by primary tumor site, this association was significant among patients with hypopharyngeal, laryngeal, and esophageal cancer. However, we saw no significant association between milk or butter intake and UADT cancer risk. In this study, we found that a high intake of yoghurt may lower the risk of developing UADT cancer in a Japanese population. Further investigation of this association is warranted.

Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

Directory of Open Access Journals (Sweden)

Guoyan eZheng

2015-12-01

Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

Randomized phase III trial of regorafenib in metastatic colorectal cancer: analysis of the CORRECT Japanese and non-Japanese subpopulations.

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Yoshino, Takayuki; Komatsu, Yoshito; Yamada, Yasuhide; Yamazaki, Kentaro; Tsuji, Akihito; Ura, Takashi; Grothey, Axel; Van Cutsem, Eric; Wagner, Andrea; Cihon, Frank; Hamada, Yoko; Ohtsu, Atsushi

2015-06-01

In the international, phase III, randomized, double-blind CORRECT trial, regorafenib significantly prolonged overall survival (OS) versus placebo in patients with metastatic colorectal cancer (mCRC) that had progressed on all standard therapies. This post hoc analysis evaluated the efficacy and safety of regorafenib in Japanese and non-Japanese subpopulations in the CORRECT trial. Patients were randomized 2 : 1 to regorafenib 160 mg once daily or placebo for weeks 1-3 of each 4-week cycle. The primary endpoint was OS. Outcomes were assessed using descriptive statistics. One hundred Japanese and 660 non-Japanese patients were randomized to regorafenib (n = 67 and n = 438) or placebo (n = 33 and n = 222). Regorafenib had a consistent OS benefit in the Japanese and non-Japanese subpopulations, with hazard ratios of 0.81 (95 % confidence interval [CI] 0.43-1.51) and 0.77 (95 % CI 0.62-0.94), respectively. Regorafenib-associated hand-foot skin reaction, hypertension, proteinuria, thrombocytopenia, and lipase elevations occurred more frequently in the Japanese subpopulation than in the non-Japanese subpopulation, but were generally manageable. Regorafenib appears to have comparable efficacy in Japanese and non-Japanese subpopulations, with a manageable adverse-event profile, suggesting that this agent could potentially become a standard of care in patients with mCRC.

Vitamin D insufficiency in the elderly orthopaedic patient: an epidemic phenomenon.

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Maier, Gerrit Steffen; Horas, Konstantin; Seeger, Jörn Bengt; Roth, Klaus Edgar; Kurth, Andreas Alois; Maus, Uwe

2015-04-01

The purpose of this observational study was to evaluate serum levels of 25-OH-D of elderly patients presenting with orthopaedic illness. Furthermore, we enquired about potential confounders and risk factors of hypovitaminosis D in comorbidities and daily medication of the elderly. Vitamin D levels in 1,083 patients aged >70 years and admitted to an orthopaedic surgery department were measured. Univariate and multivariate analyses were used to assess risk factors for insufficient vitamin D levels. Overall, 86 % of patients had insufficient serum levels of 25-OH-D and >60 % were vitamin D deficient. Serum vitamin D levels were lower during winter and months with fewer sunshine hours. Patients presenting with obesity, hypertension and osteoporosis were more likely to have low vitamin D levels. We found a high prevalence of hypovitaminosis D in elderly, nonhospitalized orthopaedic patients. Given the well-known effects of vitamin D on bone metabolism and muscle health, as well as its nonskeletal effects, vitamin D insufficiency may have a negative impact.

Thromboembolism prophylaxis practices in orthopaedic arthroplasty patients.

LENUS (Irish Health Repository)

Cawley, D

2010-10-01

Thromboembolic events are a post-operative complication of arthroplasty surgery for up to 3 months. The incidence however, is not fully known. Some form of prophylaxis should be provided to all arthroplasty patients. Clinicians are wary of side effects, compliance profile and the associated cost. The objective of this study is to investigate practice patterns and their relevance to 3 risk groups. Ninety questionnaires were sent to orthopaedic surgeons with 3 hypothetical clinical scenarios and 10 prophylaxis regimes for thromboembolism across different risk groups. The response rate was 81\\/90 (90%). The most popular options in all 3 cases were early mobilisation, thrombo-embolism deterrant (TED) stockings and low molecular weight heparin (LMWH) (51\\/81, 62% of all cases). An inconsistent relationship exists between preferred practice and relevant guidelines. Preferred practice does not correlate with each level of risk.

Level of Perception of Individualized Care and Satisfaction With Nursing in Orthopaedic Surgery Patients.

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Tekin, Fatma; Findik, Ummu Yildiz

2015-01-01

Lately, individualized nursing care and patient satisfaction are important and current issues being discussed. But there is not enough information for patients undergoing orthopaedic surgery. The aim of this study was to determine the individualized care perception and satisfaction in nursing care levels in orthopaedic surgery patients. This descriptive cross-sectional study was conducted with 156 patients who underwent orthopaedic surgery. Data were collected using the personal information form, the Individualized Care Scale, and the Newcastle Satisfaction With Nursing Scale. The Spearman correlation analysis and descriptive statistics were performed. The mean individualized care and satisfaction with nursing care scores were found to be close to the preset maximum value, and it was determined that an increase in the level of awareness about nursing interventions and the level of perceived individualized care caused an increase in satisfaction levels regarding nursing care. Nurses should recognize the importance of performing individualized care in order to increase the level of satisfaction with nursing care in orthopaedic surgery patients.

Association of ghrelin receptor gene polymorphism with bulimia nervosa in a Japanese population.

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Miyasaka, K; Hosoya, H; Sekime, A; Ohta, M; Amono, H; Matsushita, S; Suzuki, K; Higuchi, S; Funakoshi, A

2006-09-01

Eating disorders (EDs) have a highly heterogeneous etiology and multiple genetic factors might contribute to their pathogenesis. Ghrelin, a novel growth hormone-releasing peptide, enhances appetite and increases food intake, and human ghrelin plasma levels are inversely correlated with body mass index. In the present study, we examined the 171T/C polymorphism of the ghrelin receptor (growth hormone secretagogue receptor, GHSR) gene in patients diagnosed with EDs, because the subjects having ghrelin gene polymorphism (Leu72Met) was not detected in a Japanese population, previously. In addition, beta3 adrenergic receptor gene polymorphism (Try64Arg) and cholecystokinin (CCK)-A receptor (R) gene polymorphism (-81A/G, -128G/T), which are both associated with obesity, were investigated. The subjects consisted of 228 Japanese patients with EDs [96 anorexia nervosa (AN), 116 bulimia nervosa (BN) and 16 not otherwise specified (NOS)]. The age- and gender-matched control group consisted of 284 unrelated Japanese subjects. The frequency of the CC type of the GHSR gene was significantly higher in BN subjects than in control subjects (chi(2) = 4.47, p = 0.035, odds ratio = 2.05, Bonferroni correction: p = 0.070), while the frequency in AN subjects was not different from that in controls. The distribution of neither beta3 adrenergic receptor gene nor CCK-AR polymorphism differed between EDs and control subjects. Therefore, the CC type of GHSR gene polymorphism (171T/C) is a risk factor for BN, but not for AN.

How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico?

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Lingg, Myriam; Wyss, Kaspar; Durán-Arenas, Luis

2016-07-08

In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico. We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation. The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed. The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we

Customizable orthopaedic oncology implants: one institution's experience with meeting current IRB and FDA requirements.

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Willis, Alexander R; Ippolito, Joseph A; Patterson, Francis R; Benevenia, Joseph; Beebe, Kathleen S

2016-01-01

Customizable orthopaedic implants are often needed for patients with primary malignant bone tumors due to unique anatomy or complex mechanical problems. Currently, obtaining customizable orthopaedic implants for orthopaedic oncology patients can be an arduous task involving submitting approval requests to the Institutional Review Board (IRB) and the Food and Drug Administration (FDA). There is great potential for the delay of a patient's surgery and unnecessary paperwork if the submission pathways are misunderstood or a streamlined protocol is not in place. The objective of this study was to review the existing FDA custom implant approval pathways and to determine whether this process was improved with an institutional protocol. An institutional protocol for obtaining IRB and FDA approval for customizable orthopaedic implants was established with the IRB at our institution in 2013. This protocol was approved by the IRB, such that new patients only require submission of a modification to the existing protocol with individualized patient information. During the two-year period of 2013-2014, eight patients were retrospectively identified as having required customizable implants for various orthopaedic oncology surgeries. The dates of request for IRB approval, request for FDA approval, and total time to surgery were recorded, along with the specific pathway utilized for FDA approval. The average patient age was 12 years old (7-21 years old). The average time to IRB approval of a modification to the pre-approved protocol was 14 days (7-21 days). Average time to FDA approval after submission of the IRB approval to the manufacturer was 12.5 days (7-19 days). FDA approval was obtained for all implants as compassionate use requests in accordance with Section 561 of the Federal Food Drug and Cosmetic Act's expanded access provisions. Establishment of an institutional protocol with pre-approval by the IRB can expedite the otherwise time-consuming and complicated

Regenerative Medicine Will Make Orthopaedic Implants Obsolete In Our Time Orthopaedic Research Society First Annual Meeting Debate, San Diego, March 21st , 2017.

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Johnstone, Brian; Jacobs, Joshua J; Sandell, Linda J; Wilkinson, J Mark

2018-05-10

The mission of the Orthopaedic Research Society is to promote and advance musculoskeletal research worldwide. With this in mind, the Annual Meeting Program Committee sought to establish a debate as a key component of the meeting. Our purpose was to provoke discussion on topics that are core to our mission and to engage all constituencies within the society by examining questions of broad relevance. To this end, the topic "Regenerative medicine will make orthopaedic implants obsolete in our time" was selected as the title of the inaugural debate. The arguments for and against the motion are presented in this perspectives article. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Factors driving physician-hospital alignment in orthopaedic surgery.

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Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

2013-06-01

The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

Find an Orthopaedic Foot and Ankle MD/DO

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... All Site Content AOFAS / FootCareMD / Find a Surgeon Find a Foot & Ankle Orthopaedic Surgeon Page Content Who ... your prescribed treatment (surgical and/or non-surgical) ​ Find a Surgeon ​ Click here to find a foot ...

Napping and associated factors: a Japanese nationwide general population survey.

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Furihata, Ryuji; Kaneita, Yoshitaka; Jike, Maki; Ohida, Takashi; Uchiyama, Makoto

2016-04-01

The objective of this study was to investigate napping habits and their associated factors in the Japanese adult general population. The cross-sectional survey was conducted in November 2007 for subjects selected randomly from among 300 districts throughout Japan. Data from 7664 people (3527 men and 4137 women), aged 20-99 years, were analyzed. Participants completed a self-administered questionnaire on frequency and duration of napping. The percentage of responders for high-frequency napping, four or more days per week, was 21.2% among men and 17.1% among women. The percentage of responders for long-duration napping, 2 h or more per one nap, was 2.9% among men and 2.6% among women. Multivariate logistic regression analyses revealed that men, older age, smoking, insomnia symptoms, long sleep duration, excessive daytime sleepiness, and having sufficient rest obtained by sleep were positively associated with high-frequency napping, whereas alcohol drinking showed a negative association. Older age was negatively associated with long-duration napping whereas living in a large community, smoking, long sleep duration, excessive daytime sleepiness, and psychological stress showed a positive association. These findings provide important data for future studies aimed at improvement of sleep habits. Copyright © 2016 Elsevier B.V. All rights reserved.

The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

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Taylor, Anita; Staruchowicz, Lynda

This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

The older orthopaedic patient: general considerations.

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Potter, Jane F

2004-08-01

People older than 65 years are more likely to need elective and emergent orthopaedic surgery compared with younger persons. They also experience significant benefits. Although age-related changes increase the risk of perioperative complications, understanding those changes allows prevention or at least early recognition and treatment when problems arise. Because of comorbidities, older persons take more medications that need to be managed in the perioperative period. Care could be simplified if patients were to bring their medications to the preoperative evaluation. Central nervous system sensitivity to certain pain medications (meperidine and propoxyphene) means that these drugs are best avoided as good alternatives exist (morphine and oxycodone). Adverse reactions to drugs are an important cause of acute confusion (delirium) that often complicates orthopaedic care. Early mobilization after surgery, avoiding certain drugs, avoiding restraints (including Foley catheters), attending to hydration, promoting normal sleep, compensating for sensory disorders, and stimulating daytime activities can prevent delirium. Patients with dementia are more likely to have delirium develop and, like many older people, will present special challenges in communication and decision making. Including family members in discussions may be helpful in ensuring truly informed consent.

Lack of association of genetic variation in chromosome region 15q14-22.1 with type 2 diabetes in a Japanese population

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Ichiishi Eiichiro

2008-03-01

Full Text Available Abstract Background Chromosome 15q14-22.1 has been linked to type 2 diabetes (T2D and its related traits in Japanese and other populations. The presence of T2D disease susceptibility variant(s was assessed in the 21.8 Mb region between D15S118 and D15S117 in a Japanese population using a region-wide case-control association test. Methods A two-stage association test was performed using Japanese subjects: The discovery panel (Stage 1 used 372 cases and 360 controls, while an independent replication panel (Stage 2 used 532 cases and 530 controls. A total of 1,317 evenly-spaced, common SNP markers with minor allele frequencies > 0.10 were typed for each stage. Captured genetic variation was examined in HapMap JPT SNPs, and a haplotype-based association test was performed. Results SNP2140 (rs2412747 (C/T in intron 33 of the ubiquitin protein ligase E3 component n-recognin 1 (UBR1 gene was selected as a landmark SNP based on repeated significant associations in Stage 1 and Stage 2. However, the marginal p value (p = 0.0043 in the allelic test, OR = 1.26, 95% CI = 1.07–1.48 for combined samples was weak in a single locus or haplotype-based association test. We failed to find any significant SNPs after correcting for multiple testing. Conclusion The two-stage association test did not reveal a strong association between T2D and any common variants on chromosome 15q14-22.1 in 1,794 Japanese subjects. A further association test with a larger sample size and denser SNP markers is required to confirm these observations.

Possible association between interleukin-1β gene and schizophrenia in a Japanese population.

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Sasayama, Daimei; Hori, Hiroaki; Teraishi, Toshiya; Hattori, Kotaro; Ota, Miho; Iijima, Yoshimi; Tatsumi, Masahiko; Higuchi, Teruhiko; Amano, Naoji; Kunugi, Hiroshi

2011-08-16

Several lines of evidence have implicated the pro-inflammatory cytokine interleukin-1beta (IL-1β) in the etiology of schizophrenia. Although a number of genetic association studies have been reported, very few have systematically examined gene-wide tagging polymorphisms. A total of 533 patients with schizophrenia (302 males: mean age ± standard deviation 43.4 ± 13.0 years; 233 females; mean age 44.8 ± 15.3 years) and 1136 healthy controls (388 males: mean age 44.6 ± 17.3 years; 748 females; 46.3 ± 15.6 years) were recruited for this study. All subjects were biologically unrelated Japanese individuals. Five tagging polymorphisms of IL-1β gene (rs2853550, rs1143634, rs1143633, rs1143630, rs16944) were examined for association with schizophrenia. Significant difference in allele distribution was found between patients with schizophrenia and controls for rs1143633 (P = 0.0089). When the analysis was performed separately in each gender, significant difference between patients and controls in allele distribution of rs1143633 was observed in females (P = 0.0073). A trend towards association was also found between rs16944 and female patients with schizophrenia (P = 0.032). The present study shows the first evidence that the IL-1β gene polymorphism rs1143633 is associated with schizophrenia susceptibility in a Japanese population. The results suggest the possibility that the influence of IL-1β gene variations on susceptibility to schizophrenia may be greater in females than in males. Findings of the present study provide further support for the role of IL-1β in the etiology of schizophrenia.

Possible association between Interleukin-1beta gene and schizophrenia in a Japanese population

Directory of Open Access Journals (Sweden)

Sasayama Daimei

2011-08-01

Full Text Available Abstract Background Several lines of evidence have implicated the pro-inflammatory cytokine interleukin-1beta (IL-1β in the etiology of schizophrenia. Although a number of genetic association studies have been reported, very few have systematically examined gene-wide tagging polymorphisms. Methods A total of 533 patients with schizophrenia (302 males: mean age ± standard deviation 43.4 ± 13.0 years; 233 females; mean age 44.8 ± 15.3 years and 1136 healthy controls (388 males: mean age 44.6 ± 17.3 years; 748 females; 46.3 ± 15.6 years were recruited for this study. All subjects were biologically unrelated Japanese individuals. Five tagging polymorphisms of IL-1β gene (rs2853550, rs1143634, rs1143633, rs1143630, rs16944 were examined for association with schizophrenia. Results Significant difference in allele distribution was found between patients with schizophrenia and controls for rs1143633 (P = 0.0089. When the analysis was performed separately in each gender, significant difference between patients and controls in allele distribution of rs1143633 was observed in females (P = 0.0073. A trend towards association was also found between rs16944 and female patients with schizophrenia (P = 0.032. Conclusions The present study shows the first evidence that the IL-1β gene polymorphism rs1143633 is associated with schizophrenia susceptibility in a Japanese population. The results suggest the possibility that the influence of IL-1β gene variations on susceptibility to schizophrenia may be greater in females than in males. Findings of the present study provide further support for the role of IL-1β in the etiology of schizophrenia.

Possible association between Interleukin-1beta gene and schizophrenia in a Japanese population

Science.gov (United States)

2011-01-01

Background Several lines of evidence have implicated the pro-inflammatory cytokine interleukin-1beta (IL-1β) in the etiology of schizophrenia. Although a number of genetic association studies have been reported, very few have systematically examined gene-wide tagging polymorphisms. Methods A total of 533 patients with schizophrenia (302 males: mean age ± standard deviation 43.4 ± 13.0 years; 233 females; mean age 44.8 ± 15.3 years) and 1136 healthy controls (388 males: mean age 44.6 ± 17.3 years; 748 females; 46.3 ± 15.6 years) were recruited for this study. All subjects were biologically unrelated Japanese individuals. Five tagging polymorphisms of IL-1β gene (rs2853550, rs1143634, rs1143633, rs1143630, rs16944) were examined for association with schizophrenia. Results Significant difference in allele distribution was found between patients with schizophrenia and controls for rs1143633 (P = 0.0089). When the analysis was performed separately in each gender, significant difference between patients and controls in allele distribution of rs1143633 was observed in females (P = 0.0073). A trend towards association was also found between rs16944 and female patients with schizophrenia (P = 0.032). Conclusions The present study shows the first evidence that the IL-1β gene polymorphism rs1143633 is associated with schizophrenia susceptibility in a Japanese population. The results suggest the possibility that the influence of IL-1β gene variations on susceptibility to schizophrenia may be greater in females than in males. Findings of the present study provide further support for the role of IL-1β in the etiology of schizophrenia. PMID:21843369

Use of the WHO surgical safety checklist in trauma and orthopaedic patients.

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Sewell, Mathew; Adebibe, Miriam; Jayakumar, Prakash; Jowett, Charlie; Kong, Kin; Vemulapalli, Krishna; Levack, Brian

2011-06-01

The World Health Organisation (WHO) recommends routine use of a surgical safety checklist prior to all surgical operations. The aim of this study was to prospectively audit checklist use in orthopaedic patients before and after implementation of an educational programme designed to increase use and correlate this with early complications, mortality and staff perceptions. Data was collected on 480 patients before the educational program and 485 patients after. Pre-training checklist use was 7.9%. The rates of early complications and mortality were 8.5% and 1.9%, respectively. Forty-seven percent thought the checklist improved team communication. Following an educational program, checklist use significantly increased to 96.9% (RR12.2; 95% CI 9.0-16.6). The rate of early complications and mortality was 7.6% (RR 0.89; 95% CI 0.58-1.37) and 1.6% (RR 0.88; 95% CI 0.34-2.26), respectively. Seventy-seven percent thought the checklist improved team communication. Checklist use was not associated with a significant reduction in early complications and mortality in patients undergoing orthopaedic surgery. Education programs can significantly increase accurate use and staff perceptions following implementation.

Increased Academic Productivity of Orthopaedic Surgery Residents Following 2011 Duty Hour Reform.

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Johnson, Joey P; Savage, Kevin; Gil, Joseph A; Eberson, Craig P; Mulcahey, Mary K

2017-12-19

In 2003 and again in 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated increasingly stringent resident duty hour restrictions. With less time required at the hospital, residents theoretically have more time for other academic activities, such as research. Our study seeks to examine whether the number of research publications by orthopaedic residents increased following implementation of the 2011 ACGME duty hour restrictions. Pubmed was queried using publicly available alumni lists from programs across the United States. The years 2008 to 2011 were included to assess pre-2011 productivity. The years 2012 to 2015 were included in the post 2011 group. Paired t tests were used to assess differences between groups. Statistical significance was set to p care in any meaningful way. In our study, there was a statistically significant increase in publications after 2011; however, the number of publications between NIH funded and non-NIH funded programs did not differ. Our study is the first to demonstrate that with increasing duty hour restrictions, orthopaedic surgery residents may be using more of their free time to conduct research. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

New design of care: Assessment of an interdisciplinary orthopaedic clinic with a pivot nurse in the province of Quebec.

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Poder, Thomas G; Bellemare, Christian; Bédard, Suzanne K; He, Jie; Lemieux, Renald

2010-01-01

New designs of care in orthopaedic clinics are needed to cope with the shortage of orthopaedic surgeons and the lengthening of waiting times. To assess the effectiveness of an interdisciplinary orthopaedic clinic with a pivot nurse in the Canadian province of Quebec with regard to accessibility, quality of care, efficacy and efficiency of the clinic, and patient's quality of life. Two strategies were developed: (1) a selected cohort of new patients attending an orthopaedic service from February to September 2008 were entered into a database recording patient details, source of referral, diagnosis, satisfaction, and quality of life (36-Item Short Form Health Survey version 2). In this setting, 2 sets of questionnaires were administered to the patients: the first one during the first visit and the second one, 2 months later. A total of 243 patients from the case control were compared with 89 patients of the case study, where an interdisciplinary orthopaedic clinic with a pivot nurse has been developed; (2) costs per patient were calculated using the staff timesheets provided by the two orthopaedic clinics. The results showed a significant reduction in the waiting-list duration (accessibility) in the case study clinic owing to a strong decrease in the inappropriate consultations with the orthopaedic consultant. The quality of care remained high, and the target surgeries for total hip and knee replacement were reached, despite a strong shortage of orthopaedic doctors. Interdisciplinary orthopaedic clinic with a pivot nurse is a new approach in the province of Quebec and first results are encouraging.

Work–family conflict and self-rated health among Japanese workers: How household income modifies associations

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Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

To examine associations between work–family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011–2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work–family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04–2.97) for men and 3.54 (95% CI; 2.92–4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work–family conflict were likely to be more evident in the low income group only among women. Work–family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women. PMID:28207757

Work-family conflict and self-rated health among Japanese workers: How household income modifies associations.

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Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

To examine associations between work-family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011-2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work-family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04-2.97) for men and 3.54 (95% CI; 2.92-4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work-family conflict were likely to be more evident in the low income group only among women. Work-family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women.

Vancouver winters: Environmental influences on inpatient adult orthopaedic trauma demographics

International Nuclear Information System (INIS)

Noordin, S.; Masri, B. A.

2014-01-01

Objective: To compare the pattern of adult inpatient orthopaedic injuries admitted at three Vancouver hospitals following one of the worst winter snowstorms in the region with the preceding control winter period. Methods: The surveillance study was conducted at the University of British Columbia, Vancouver, Canada, 2007 to 2010. Inpatient adult admissions for orthopaedic injuries at three hospitals were recorded, including age, gender, anatomic location of injury, type of fracture (open or closed), fixation method (internal versus external fixation), and length of acute care hospital stay. Comparisons between admissions during this weather pattern and admission during a previous winter with minimal snow were made. SPSS 19 was used for statistical analysis. Results: Of the 511 patients admitted under Orthopaedic trauma service during the significant winter snowstorms of December 2008 - January 2009, 100 (19.6%) (CI: 16.2%-23.2%) were due to ice and snow, whereas in the preceding mild winter only 18 of 415 (4.3%) (CI: 2.5%-6.8%) cases were related to snow (p<0.05). Ankle and wrist fractures were the most frequent injuries during the index snow storm period (p<0.05). At all the three institutions, 97 (96.5%) fractures were closed during the snowstorm as opposed to 17 (95%) during the control winter period. Internal fixation in 06 (89%) fractures as opposed to external fixation in 12 (11%) patients was the predominant mode of fixation across the board during both time periods. Conclusion: The study demonstrated a significantly higher inpatient orthopaedic trauma volume during the snowstorm more rigorous prospective studies need to be designed to gain further insight to solving these problems from a public health perspective. (author)

Competency-based education: a new model for teaching orthopaedics.

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Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K

2013-01-01

The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

P-Hacking in Orthopaedic Literature: A Twist to the Tail.

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Bin Abd Razak, Hamid Rahmatullah; Ang, Jin-Guang Ernest; Attal, Hersh; Howe, Tet-Sen; Allen, John Carson

2016-10-19

"P-hacking" occurs when researchers preferentially select data or statistical analyses until nonsignificant results become significant. We wanted to evaluate if the phenomenon of p-hacking was evident in orthopaedic literature. We text-mined through all articles published in three top orthopaedic journals in 2015. For anonymity, we cipher-coded the three journals. We included all studies that reported a single p value to answer their main hypothesis. These p values were then charted and frequency graphs were generated to illustrate any evidence of p-hacking. Binomial tests were employed to look for evidence of evidential value and significance of p-hacking. Frequency plots for all three journals revealed evidence of p-hacking. Binomial tests for all three journals were significant for evidence of evidential value (p hacking was significant only for one journal (p = 0.0092). P-hacking is an evolving phenomenon that threatens to jeopardize the evidence-based practice of medicine. Although our results show that there is good evidential value for orthopaedic literature published in our top journals, there is some evidence of p-hacking of which authors and readers should be wary. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Cross-Sectional Study of Obstructive Sleep Apnea Syndrome in Japanese Public Transportation Drivers: Its Prevalence and Association With Pathological Objective Daytime Sleepiness.

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Sasai-Sakuma, Taeko; Kikuchi, Katsunori; Inoue, Yuichi

2016-05-01

This study investigates obstructive sleep apnea syndrome (OSAS) prevalence among Japanese occupational drivers and factors associated with a pathological level of objective daytime sleepiness. Portable monitoring device (PMD) screening was applied to 2389 Japanese male public transportation traffic drivers. Nocturnal polysomnography (n-PSG) and multiple sleep latency tests (MSLT) were administered to subjects with apnea-hypopnea index (AHI) at least 15 on PMD. In all, 235 subjects were diagnosed as having OSAS (9.8%). AHI on n-PSG at least 40 and Epworth Sleepiness Scale score at least 11 were extracted as factors associated with mean sleep latency on MSLT less than 5 minutes. Prevalence of OSAS in male Japanese public transportation traffic drivers was 9.8% or greater. Individuals aware of excessive daytime sleepiness and with severe OSAS were inferred as exhibiting a pathological level of objective daytime sleepiness.

Handling Japanese without a Japanese Operating System.

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Hatasa, Kazumi; And Others

1992-01-01

The Macintosh HyperCard environment has become a popular platform for Japanese language courseware because of its flexibility and ease of programing. This project created Japanese bitmap font files for the JIS Levels 1 and 2, and writing XFCNs for font manipulation, Japanese kana input, and answer correction. (12 references) (Author/LB)

Surgical advances during the First World War: the birth of modern orthopaedics.

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Ramasamy, Arul; Eardley, W G P; Edwards, D S; Clasper, J C; Stewart, M P M

2016-02-01

The First World War (1914-1918) was the first truly industrial conflict in human history. Never before had rifle fire and artillery barrage been employed on a global scale. It was a conflict that over 4 years would leave over 750,000 British troops dead with a further 1.6 million injured, the majority with orthopaedic injuries. Against this backdrop, the skills of the orthopaedic surgeon were brought to the fore. Many of those techniques and systems form the foundation of modern orthopaedic trauma management. On the centenary of 'the War to end all Wars', we review the significant advances in wound management, fracture treatment, nerve injury and rehabilitation that were developed during that conflict. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon.

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Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer; Mayberry, John

2018-01-01

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.

Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon

Science.gov (United States)

Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer

2018-01-01

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization. PMID:29766123

Association of STAT4 polymorphisms with susceptibility to type-1 autoimmune hepatitis in the Japanese population.

Science.gov (United States)

Migita, Kiyoshi; Nakamura, Minoru; Abiru, Seigo; Jiuchi, Yuka; Nagaoka, Shinya; Komori, Atsumasa; Hashimoto, Satoru; Bekki, Shigemune; Yamasaki, Kazumi; Komatsu, Tatsuji; Shimada, Masaaki; Kouno, Hiroshi; Hijioka, Taizo; Kohjima, Motoyuki; Nakamuta, Makoto; Kato, Michio; Yoshizawa, Kaname; Ohta, Hajime; Nakamura, Yoko; Takezaki, Eiichi; Nishimura, Hideo; Sato, Takeaki; Ario, Keisuke; Hirashima, Noboru; Oohara, Yukio; Naganuma, Atsushi; Muro, Toyokichi; Sakai, Hironori; Mita, Eiji; Sugi, Kazuhiro; Yamashita, Haruhiro; Makita, Fujio; Yatsuhashi, Hiroshi; Ishibashi, Hiromi; Yasunami, Michio

2013-01-01

Recent studies demonstrated an association of STAT4 polymorphisms with autoimmune diseases including systemic lupus erythematosus and rheumatoid arthritis, indicating multiple autoimmune diseases share common susceptibility genes. We therefore investigated the influence of STAT4 polymorphisms on the susceptibility and phenotype of type-1 autoimmune hepatitis in a Japanese National Hospital Organization (NHO) AIH multicenter cohort study. Genomic DNA from 460 individuals of Japanese origin including 230 patients with type-1 autoimmune hepatitis and 230 healthy controls was analyzed for two single nucleotide polymorphisms in the STAT4 gene (rs7574865, rs7582694). The STAT4 rs7574865T allele conferred risk for type-1 autoimmune hepatitis (OR = 1.61, 95% CI = 1.23-2.11; P = 0.001), and patients without accompanying autoimmune diseases exhibited an association with the rs7574865T allele (OR = 1.50, 95%CI = 1.13-1.99; P = 0.005). Detailed genotype-phenotype analysis of type-1 autoimmune hepatitis patients with (n = 44) or without liver cirrhosis (n = 186) demonstrated that rs7574865 was not associated with the development of liver cirrhosis and phenotype (biochemical data and the presence of auto-antibodies). This is the first study to show a positive association between a STAT4 polymorphism and type-1 autoimmune hepatitis, suggesting that autoimmune hepatitis shares a gene commonly associated with risk for other autoimmune diseases.

Risk factors for surgical site infections following clean orthopaedic ...

African Journals Online (AJOL)

Risk factors for surgical site infections following clean orthopaedic operations. ... the host and environmental risk factors for surgical site infections following clean ... Materials and Methods: Consecutive patients who satisfied the inclusion ...

Infections in orthopaedic surgery : clinical and experimental studies

NARCIS (Netherlands)

Vogely, Henri Charles

2000-01-01

The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable

Flash autoclave settings may influence eradication but not presence of well-established biofilms on orthopaedic implant material.

Science.gov (United States)

Williams, Dustin L; Taylor, Nicholas B; Epperson, Richard T; Rothberg, David L

2017-10-04

Flash autoclaving is one of the most frequently utilized methods of sterilizing devices, implants or other materials. For a number of decades, it has been common practice for surgeons to remove implantable devices, flash autoclave and then reimplant them in a patient. Data have not yet indicated the potential for biofilms to survive or remain on the surface of orthopaedic-relevant materials following flash autoclave. In this study, monomicrobial and polymicrobial biofilms were grown on the surface of clinically relevant titanium materials and exposed to flash autoclave settings that included varying times and temperatures. Data indicated that when the sterilization and control temperatures of an autoclave were the same, biofilms were able to survive flash autoclaving that was performed for a short duration. Higher temperature and increased duration rendered biofilms non-viable, but none of the autoclave settings had the ability to remove or disperse the presence of biofilms from the titanium surfaces. These findings may be beneficial for facilities, clinics, or hospitals to consider if biofilms are suspected to be present on materials or devices, in particular implants that have had associated infection and are considered for re-implantation. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

European Working Time Directive and the use of simulators and models in Irish orthopaedics.

LENUS (Irish Health Repository)

Egan, C

2011-09-07

OBJECTIVE: To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. METHODS: A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. RESULTS: There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. CONCLUSIONS: While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

European Working Time Directive and the use of simulators and models in Irish orthopaedics.

Science.gov (United States)

Egan, C; Elliott, R; Fleming, P

2012-03-01

To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

Perioperative Management of Patients with Inflammatory Rheumatic Diseases Undergoing Major Orthopaedic Surgery: A Practical Overview.

Science.gov (United States)

Gualtierotti, Roberta; Parisi, Marco; Ingegnoli, Francesca

2018-04-01

Patients with inflammatory rheumatic diseases often need orthopaedic surgery due to joint involvement. Total hip replacement and total knee replacement are frequent surgical procedures in these patients. Due to the complexity of the inflammatory rheumatic diseases, the perioperative management of these patients must envisage a multidisciplinary approach. The frequent association with extraarticular comorbidities must be considered when evaluating perioperative risk of the patient and should guide the clinician in the decision-making process. However, guidelines of different medical societies may vary and are sometimes contradictory. Orthopaedics should collaborate with rheumatologists, anaesthesiologists and, when needed, cardiologists and haematologists with the common aim of minimising perioperative risk in patients with inflammatory rheumatic diseases. The aim of this review is to provide the reader with simple practical recommendations regarding perioperative management of drugs such as disease-modifying anti-rheumatic drugs, corticosteroids, non-steroidal anti-inflammatory drugs and tools for a risk stratification for cardiovascular and thromboembolic risk based on current evidence for patients with inflammatory rheumatic diseases.

Does a Weekly Didactic Conference Improve Resident Performance on the Pediatric Domain of the Orthopaedic In-Training Examination?

Science.gov (United States)

Franklin, Corinna C; Bosch, Patrick P; Grudziak, Jan S; Dede, Ozgur; Ramirez, Rey N; Mendelson, Steven A; Ward, W Timothy; Brooks, Maria; Kenkre, Tanya; Lubahn, John D; Deeney, Vincent F; Roach, James W

2017-03-01

Performance on the Orthopaedic In-training Examination (OITE) has been correlated with performance on the written portion of the American Board of Orthopaedic Surgery examination. Herein we sought to discover whether adding a regular pediatric didactic lecture improved residents' performance on the OITE's pediatric domain. In 2012, a didactic lecture series was started in the University of Pittsburgh Medical Center (UPMC) Hamot Orthopaedic Residency Program (Hamot). This includes all topics in pediatric orthopaedic surgery and has teaching faculty present, and occurs weekly with all residents attending. A neighboring program [UMPC Pittsburgh (Pitt)] shares in these conferences, but only during their pediatric rotation. We sought to determine the effectiveness of the conference by comparing the historic scores from each program on the pediatric domain of the OITE examination to scores after the institution of the conference, and by comparing the 2 programs' scores. Both programs demonstrated improvement in OITE scores. In 2008, the mean examination score was 19.6±4.3 (11.0 to 30.0), and the mean percentile was 57.7±12.6 (32.0 to 88.0); in 2014, the mean examination score was 23.5±4.2 (14.0 to 33.0) and the mean percentile was 67.1±12.1 (40.0 to 94.0). OITE scores and percentiles improved with post graduate year (Pdidactic pediatric lecture improved residents' scores on the OITE and indirectly suggests that more frequent attendance is associated with better scores. Level III-retrospective case-control study.

Feasibility of establishing an Australian ACL registry: a pilot study by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).

Science.gov (United States)

Lekkas, Christina; Clarnette, Richard; Graves, Stephen E; Rainbird, Sophia; Parker, David; Lorimer, Michelle; Paterson, Roger; Roe, Justin; Morris, Hayden; Feller, Julian A; Annear, Peter; Forster, Ben; Hayes, David

2017-05-01

Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL is crucial to the development of improved outcomes. The Australian Knee Society (AKS) asked the Australian Orthopaedic Association (AOA) to consider establishing a national ACL registry. As a first step, a pilot study was undertaken by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) to test the hypothesis that collecting the required information in the Australian setting was possible. Surgeons completed an operative form which provided comprehensive information on the surgery undertaken. Patients provided pre- and post-operative questionnaires including the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Marx Activity Scale (MA Scale). The number of ACL procedures undertaken at each hospital during the recruitment period was compared against State Government Health Department separation data. A total of 802 patients were recruited from October 2011 to January 2013. The overall capture rate for surgeon-derived data was 99%, and the capture rate for the pre-operative patient questionnaire was 97.9%. At 6 months, patient-reported outcomes were obtained from 55% of patients, and 58.5% of patients at 12 months. When checked against State Government Health Department separation data, 31.3% of procedures undertaken at each study hospital were captured in the study. It is possible to collect surgeon-derived and pre-operative patient-reported data, following ACL reconstruction in Australia. The need to gain patient consent was a limiting factor to participation. When patients did consent to participate in the study, we were able to capture nearly 100% of surgical procedures. Patient consent

Genome-wide association studies in the Japanese population identify seven novel loci for type 2 diabetes

DEFF Research Database (Denmark)

Imamura, Minako; Takahashi, Atsushi; Yamauchi, Toshimasa

2016-01-01

Genome-wide association studies (GWAS) have identified more than 80 susceptibility loci for type 2 diabetes (T2D), but most of its heritability still remains to be elucidated. In this study, we conducted a meta-analysis of GWAS for T2D in the Japanese population. Combined data from discovery and ...

Impact of smoking on the age at diagnosis of upper tract urothelial carcinoma: Subanalysis of the Japanese Urological Association multi-institutional national database.

Science.gov (United States)

Miyazaki, Jun; Nishiyama, Hiroyuki; Fujimoto, Hiroyuki; Ohyama, Chikara; Koie, Takuya; Hinotsu, Shiro; Kikuchi, Eiji; Sakura, Mizuaki; Inokuchi, Junichi; Hara, Tomohiko

2015-11-01

To examine the influence of smoking history on the diagnosis and other tumor characteristics of upper tract urothelial carcinoma in Japan. A total of 1509 patients with upper tract urothelial carcinoma who were diagnosed in 2005 from 348 Japanese institutions were registered using the multi-institutional national database of the Japanese Urological Association and included in this analysis. Clinical data of the patients were collected in 2011. The associations between the patients' self-reported smoking history and their age at the diagnosis of upper tract urothelial carcinoma, sex, pathological T stage and tumor grade were analyzed. The mean age at the diagnosis of upper tract urothelial carcinoma was approximately 5 years earlier for the 238 current smokers than for the 618 current non-smokers (P smokers, the age at diagnosis for the smoking ≥ 20 cigarettes per day group was 6.5 years lower than that of the perspective of both healthcare and medical economies. © 2015 The Japanese Urological Association.

Potential Association between Breakfast Skipping and Concomitant Late-Night-Dinner Eating with Metabolic Syndrome and Proteinuria in the Japanese Population

Directory of Open Access Journals (Sweden)

Ayano Kutsuma

2014-01-01

Full Text Available Skipping breakfast is considered to be an unhealthy eating habit linked to predispositions to obesity and type 2 diabetes. Because eating dinner late at night can elicit subsequent breakfast skipping, we investigated if skipping breakfast concomitant with late-night-dinner eating (LNDE was associated with metabolic syndrome (MetS and proteinuria in the general Japanese population. We examined self-reported habitual breakfast skipping and LNDE, MetS (modified ATP-III criteria, and proteinuria in a cross-sectional study of 60,800 Japanese adults aged 20–75 years. A total of 14,068 subjects (23.1% skipped breakfast, of whom approximately half (52.8% skipped breakfast alone (without LNDE. The percentages of subjects who skipped breakfast showed a J-shaped relationship with body mass index (BMI. Multivariate logistic regression analysis showed that skipping breakfast concomitant with LNDE (n = 6,645 was significantly associated with MetS and proteinuria, even after adjusting for relevant confounders (odds ratio (95% CI, 1.17 (1.08–1.28, P=0.0003, and 1.37 (1.24–1.52, P<0.0001, resp.. Skipping breakfast alone and LNDE alone were not associated with MetS and proteinuria, respectively. In conclusion, habitual breakfast skipping concomitant with LNDE may represent poorer eating behavior than skipping breakfast alone, associated with MetS, asymptomatic proteinuria, obesity, and low body weight in the general Japanese population.

Potential Association between Breakfast Skipping and Concomitant Late-Night-Dinner Eating with Metabolic Syndrome and Proteinuria in the Japanese Population.

Science.gov (United States)

Kutsuma, Ayano; Nakajima, Kei; Suwa, Kaname

2014-01-01

Skipping breakfast is considered to be an unhealthy eating habit linked to predispositions to obesity and type 2 diabetes. Because eating dinner late at night can elicit subsequent breakfast skipping, we investigated if skipping breakfast concomitant with late-night-dinner eating (LNDE) was associated with metabolic syndrome (MetS) and proteinuria in the general Japanese population. We examined self-reported habitual breakfast skipping and LNDE, MetS (modified ATP-III criteria), and proteinuria in a cross-sectional study of 60,800 Japanese adults aged 20-75 years. A total of 14,068 subjects (23.1%) skipped breakfast, of whom approximately half (52.8%) skipped breakfast alone (without LNDE). The percentages of subjects who skipped breakfast showed a J-shaped relationship with body mass index (BMI). Multivariate logistic regression analysis showed that skipping breakfast concomitant with LNDE (n = 6,645) was significantly associated with MetS and proteinuria, even after adjusting for relevant confounders (odds ratio (95% CI), 1.17 (1.08-1.28), P = 0.0003, and 1.37 (1.24-1.52), P < 0.0001, resp.). Skipping breakfast alone and LNDE alone were not associated with MetS and proteinuria, respectively. In conclusion, habitual breakfast skipping concomitant with LNDE may represent poorer eating behavior than skipping breakfast alone, associated with MetS, asymptomatic proteinuria, obesity, and low body weight in the general Japanese population.

No association between catechol-O-methyltransferase (COMT) genotype and attention deficit hyperactivity disorder (ADHD) in Japanese children.

Science.gov (United States)

Yatsuga, Chiho; Toyohisa, Daiki; Fujisawa, Takashi X; Nishitani, Shota; Shinohara, Kazuyuki; Matsuura, Naomi; Ikeda, Shinobu; Muramatsu, Masaaki; Hamada, Akinobu; Tomoda, Akemi

2014-08-01

This study ascertained the association between attention deficit/hyperactivity disorder (ADHD) in Japanese children and a polymorphism of catechol-O-methyltransferase (COMT), a dopamine-control gene. The secondary aim of the study was the evaluation of a putative association between methylphenidate (MPH) effect/adverse effects and the COMT genotype. To ascertain the distribution of the Val158Met variant of COMT, 50 children meeting ADHD inclusion criteria were compared with 32 healthy children. Clinical improvement and the occurrence of adverse effects were measured before and 3 months after MPH administration in children with ADHD, and analyzed for genotype association. Wechsler Intelligence Scale for Children-Third Edition (WISC-III), age, MPH dose were included as co-variables. The occurrence of the COMT Val/Val genotype was significantly higher in children with ADHD (χ(2)(1)=7.13, pADHD rating scale scores, after correcting for the interaction between disorder and COMT genotype. Furthermore, no significant difference in MPH effect/adverse effects was observed in association with the COMT genotype in the ADHD group. These results showed a lack of association between the COMT Val/Val genotype and ADHD in Japan. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

The Use of Twitter by the Trauma and Orthopaedic Surgery Journals: Twitter Activity, Impact Factor, and Alternative Metrics.

Science.gov (United States)

Hughes, Hannah; Hughes, Andrew; Murphy, Colin

2017-12-10

Aim Social media (SoMe) platforms have become leading methods of communication and dissemination of scientific information in the medical community. They allow for immediate discussion and widespread engagement around important topics. It has been hypothesized that the activity on Twitter positively correlates with highly cited articles. The purpose of this study was to analyze the prevalence and activity of Trauma and Orthopaedic Surgery journals on Twitter, with the hypothesis that the impact factor is positively associated with the Twitter usage. Methods The top 50 Trauma and Orthopaedic Surgery journals, ranked by 2016 Impact Factor were analyzed. The Twitter profiles of each journal or affiliated society were identified. Other SoMe platforms used were also recorded. The Twitonomy software (Digonomy Pty Ltd, New South Wales, Australia) was used to analyze the Twitter profiles over a one-year period. The Twitter Klout scores were recorded for each journal to approximate the SoMe influence. The Altmetric scores (the total number of mentions via alternative metrics) were also recorded. The statistical analysis was carried out to identify correlations between journal Impact Factors, SoMe activity, Twitter Klout scores and Altmetric scores.  Results Twenty-two journals (44%) were dedicated to the Twitter profiles. Fourteen journals (28%) were associated with societies that had profiles and 14 journals (28%) had no Twitter presence. The mean Impact Factor overall was 2.16 +/- 0.14 (range, 1.07-5.16). The journals with dedicated Twitter profiles had higher Impact Factors than those without (mean 2.41 vs. 1.61; P=0.005). A greater number of Twitter followers were associated with higher Impact Factors (R2 0.317, P=0.03). The journals with higher Twitter Klout scores had higher Impact Factors (R2 0.357, P=0.016). The Altmetric score was positively associated with an Impact Factor (R2 0.310, P=0.015). The journals with higher numbers of retweets (virtual citations in

Professional liability in orthopaedics and traumatology in Italy.

Science.gov (United States)

Tarantino, Umberto; Giai Via, Alessio; Macrì, Ernesto; Eramo, Alessandro; Marino, Valeria; Marsella, Luigi Tonino

2013-10-01

Interest in medical errors has increased during the last few years owing to the number of medical malpractice claims. Reasons for the increasing number of claims may be related to patients' higher expectations, iatrogenic injury, and the growth of the legal services industry. Claims analysis provides helpful information in specialties in which a higher number of errors occur, highlighting areas where orthopaedic care might be improved. We determined: (1) the number of claims involving orthopaedics and traumatology in Rome; (2) the risk of litigation in elective and trauma surgery; (3) the most common surgical procedures involved in claims and indemnity payments; (4) the time between the adverse medical event and the judgment date; and (5) issues related to informed consent. We analyzed 1925 malpractice judgments decided in the Civil Court of Rome between 2004 and 2010. In total, 243 orthopaedics claims were filed, and in 75% of these cases surgeons were found liable; 149 (61%) of these resulted from elective surgery. Surgical teams were sued in 30 claims and found liable in 22. The total indemnity payment ordered was more than €12,350,000 (USD 16,190,000). THA and spinal surgery were the most common surgical procedures involved. Inadequate informed consent was reported in 5.3% of cases. Our study shows that careful medical examination, accurate documentation in medical records, and adequate informed consent might reduce the number of claims. We suggest monitoring of court judgments would be useful to develop prevention strategies to reduce claims.

Aarhus Regenerative Orthopaedics Symposium (AROS)

DEFF Research Database (Denmark)

Foldager, Casper B.; Bendtsen, Michael; Berg, Lise C.

2016-01-01

to musculoskeletal pain and disability. The Aarhus Regenerative Orthopaedics Symposium (AROS) 2015 was motivated by the need to address regenerative challenges in an ageing population by engaging clinicians, basic scientists, and engineers. In this position paper, we review our contemporary understanding of societal......, patient-related, and basic science-related challenges in order to provide a reasoned roadmap for the future to deal with this compelling and urgent healthcare problem. © 2017 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation....

Behavioral Economics and Physician Board Meetings: Opportunity Cost, Regret, and Their Mitigation in Orthopaedic Surgery.

Science.gov (United States)

Sinicrope, Brent J; Roberts, Craig S; Sussman, Lyle

2018-01-01

Health care is a business. Health care providers must become familiar with terms such as opportunity costs, the potential loss or gain when one choice is made in lieu of another. The purpose of this study was to calculate the opportunity cost of two orthopaedic surgery society board meetings and discuss these in the context of behavioral economics and regret. A literature search was conducted to determine an orthopaedic surgeon's average yearly salary, hours worked per week, and weeks worked per year. The details of two orthopaedic surgery professional society meetings that one senior author (CSR) attended were used to calculate opportunity cost. Although the true benefits are multifactorial and difficult to objectively quantify, awareness of the cost-benefit ratio can help guide time and resource management to maximize the return on investment while minimizing buyer's remorse and perhaps influence the media by which medical meetings are held in the future. (Journal of Surgical Orthopaedic Advances 27(1):10-13, 2018).

Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma ...

African Journals Online (AJOL)

Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma: Surgical Practice in a Tertiary Hospital, North-West Nigeria. ... or international guide lines, to reap the expected benefit of prophylactic antibiotics and avoid unwanted adverse effects like emergence of resistant bacteria strains and extra cost of healthcare.

Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

Energy Technology Data Exchange (ETDEWEB)

Agarwal, Sankalp [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland); School of Food Science and Environmental Health, Cathal Brugha Street, Dublin Institute of Technology (Ireland); Curtin, James [School of Food Science and Environmental Health, Cathal Brugha Street, Dublin Institute of Technology (Ireland); Duffy, Brendan [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland); Jaiswal, Swarna, E-mail: swarna.jaiswal@dit.ie [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland)

2016-11-01

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

International Nuclear Information System (INIS)

Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna

2016-01-01

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

The mediating and moderating effects of workplace social capital on the associations between adverse work characteristics and psychological distress among Japanese workers.

Science.gov (United States)

Oshio, Takashi; Inoue, Akiomi; Tsutsumi, Akizumi

2014-01-01

Our current study investigated how workplace social capital (WSC) mediates and moderates the associations between adverse work characteristics and psychological distress among Japanese workers. We collected cross-sectional data (N=9,350) from a baseline survey of an occupational Japanese cohort study. We focused on individual WSC and considered job demands/control, effort/reward, and two types (i.e., procedural and interactional) of organizational justice as work-characteristic variables. We defined psychological distress as a score of ≥5 on the Kessler Psychological Distress Scale (K6 scale). Multivariate logistic regression analyses predicted a binary variable of psychological distress by individual WSC and adverse work characteristics, adjusting for individual-level covariates. Individual WSC mediated the associations between adverse work characteristics and psychological distress in almost all model specifications. Additionally, individual WSC moderated the associations of psychological distress with high job demands, high effort, and low interactional justice when we used a high WSC cutoff point. In contrast, individual WSC did not moderate such interactions with low job control, reward, or procedural justice. We concluded that individual WSC mediated the associations between adverse work characteristics and psychological distress among Japanese workers while selectively moderating their associations at high levels of WSC.

Replication study for the association of 9 East Asian GWAS-derived loci with susceptibility to type 2 diabetes in a Japanese population.

Directory of Open Access Journals (Sweden)

Kensuke Sakai

Full Text Available AIMS: East Asian genome-wide association studies (GWAS for type 2 diabetes identified 8 loci with genome-wide significance, and 2 loci with a borderline association. However, the associations of these loci except MAEA locus with type 2 diabetes have not been evaluated in independent East Asian cohorts. We performed a replication study to investigate the association of these susceptibility loci with type 2 diabetes in an independent Japanese population. METHODS: We genotyped 7,379 Japanese participants (5,315 type 2 diabetes and 2,064 controls for each of the 9 single nucleotide polymorphisms (SNPs, rs7041847 in GLIS3, rs6017317 in FITM2-R3HDML-HNF4A, rs6467136 near GCCI-PAX4, rs831571 near PSMD6, rs9470794 in ZFAND3, rs3786897 in PEPD, rs1535500 in KCNK16, rs16955379 in CMIP, and rs17797882 near WWOX. Because the sample size in this study was not sufficient to replicate single SNP associations, we constructed a genetic risk score (GRS by summing a number of risk alleles of the 9 SNPs, and examined the association of the GRS with type 2 diabetes using logistic regression analysis. RESULTS: With the exception of rs1535500 in KCNK16, all SNPs had the same direction of effect (odds ratio [OR]>1.0 as in the original reports. The GRS constructed from the 9 SNPs was significantly associated with type 2 diabetes in the Japanese population (p = 4.0 × 10(-4, OR = 1.05, 95% confidence interval: 1.02-1.09. In quantitative trait analyses, rs16955379 in CMIP was nominally associated with a decreased homeostasis model assessment of β-cell function and with increased fasting plasma glucose, but neither the individual SNPs nor the GRS showed a significant association with the glycemic traits. CONCLUSIONS: These results indicate that 9 loci that were identified in the East Asian GWAS meta-analysis have a significant effect on the susceptibility to type 2 diabetes in the Japanese population.

Multilayer scaffolds in orthopaedic tissue engineering.

Science.gov (United States)

Atesok, Kivanc; Doral, M Nedim; Karlsson, Jon; Egol, Kenneth A; Jazrawi, Laith M; Coelho, Paulo G; Martinez, Amaury; Matsumoto, Tomoyuki; Owens, Brett D; Ochi, Mitsuo; Hurwitz, Shepard R; Atala, Anthony; Fu, Freddie H; Lu, Helen H; Rodeo, Scott A

2016-07-01

The purpose of this study was to summarize the recent developments in the field of tissue engineering as they relate to multilayer scaffold designs in musculoskeletal regeneration. Clinical and basic research studies that highlight the current knowledge and potential future applications of the multilayer scaffolds in orthopaedic tissue engineering were evaluated and the best evidence collected. Studies were divided into three main categories based on tissue types and interfaces for which multilayer scaffolds were used to regenerate: bone, osteochondral junction and tendon-to-bone interfaces. In vitro and in vivo studies indicate that the use of stratified scaffolds composed of multiple layers with distinct compositions for regeneration of distinct tissue types within the same scaffold and anatomic location is feasible. This emerging tissue engineering approach has potential applications in regeneration of bone defects, osteochondral lesions and tendon-to-bone interfaces with successful basic research findings that encourage clinical applications. Present data supporting the advantages of the use of multilayer scaffolds as an emerging strategy in musculoskeletal tissue engineering are promising, however, still limited. Positive impacts of the use of next generation scaffolds in orthopaedic tissue engineering can be expected in terms of decreasing the invasiveness of current grafting techniques used for reconstruction of bone and osteochondral defects, and tendon-to-bone interfaces in near future.

Medical opinions, beliefs and prescription of orthopaedic footwear: A survey of Dutch orthopaedists and rehabilitation practitioners.

NARCIS (Netherlands)

Boer, Hendrik; Seydel, E.R.

1998-01-01

Objectives: To get insight into medical opinions about the use of orthopaedic footwear and the medical and social factors related to the prescription of orthopaedic footwear by orthopaedists and rehabilitation practitioners. Methods: In this study 85 orthopaedists and 96 rehabilitation practitioners

Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis

Directory of Open Access Journals (Sweden)

S. Hawkey

2015-01-01

Full Text Available Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports’ material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

Current cat ownership may be associated with the lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis in schoolchildren in Himeji, Japan.

Science.gov (United States)

Kurosaka, Fumitake; Nakatani, Yuji; Terada, Tadayuki; Tanaka, Akira; Ikeuchi, Haruki; Hayakawa, Akira; Konohana, Atsuo; Oota, Kenji; Nishio, Hisahide

2006-02-01

The aim of the study was to clarify the relationship between current pet ownership, passive smoking, and allergic diseases among the Japanese children. From 1995 to 2001, we distributed the Japanese edition of the questionnaire of the American Thoracic Society and the Division of Lung Diseases (ATS-DLD) to survey allergic diseases among 35,552 6-yr-old children at primary school in the city of Himeji, Japan. We analyzed the data by multiple logistic regression and calculated adjusted odds ratios for environmental factors, including passive smoking and pet (dog and/or cat) ownership. There were no significant relationships between the prevalence of asthma and current pet ownership and passive smoking. However, current cat ownership was related to a significantly lower prevalence of atopic dermatitis [adjusted odds ratio (aOR) 0.79, 95% confidence interval (CI) 0.67-0.93], allergic rhinitis (aOR: 0.71, 95% CI 0.57-0.89) and Japanese cedar pollinosis (aOR 0.57, 95% CI 0.44-0.75). Strikingly, passive smoking was also related to a significantly lower prevalence of allergic rhinitis (aOR 0.83, 95% CI 0.77-0.89) and Japanese cedar pollinosis (aOR 0.81, 95% CI 0.74-0.88). Current cat ownership was associated with a lower prevalence of atopic dermatitis, allergic rhinitis, and Japanese cedar pollinosis. In addition, passive smoking was also associated with a lower prevalence of allergic rhinitis and Japanese cedar pollinosis.

Joint associations of physical activity and screen time with overweight among japanese adults

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Liao Yung

2011-11-01

Full Text Available Abstract Background Although both insufficient physical activity (PA and high screen time (ST are independent risk factors for obesity, how the combination of sufficient/insufficient PA and high/low ST could increase obesity risk among the adult population of Japan is not known. This study examined joint associations of PA and ST with overweight among Japanese adults. Methods An Internet-based survey collected data on height, weight, self-reported time spent in PA and ST, and sociodemographic variables from 2832 adults. Respondents were categorized into sufficient PA/low ST, sufficient PA/high ST, insufficient PA/low ST, or insufficient PA/high ST categories as per public PA guidelines and the median of ST. Logistic regression analysis examined the odds ratios (OR of being overweight (body mass index, ≥ 25 kg/m2 according to the categories of PA and ST. Results In comparison with the sufficient PA/low ST category, participants in the insufficient PA/high ST category were significantly more likely overweight (OR, 1.48; 95% confidence interval [95%CI, 1.14, 1.93 after adjusting for sociodemographic variables. A significantly higher OR for overweight (including obesity among insufficient PA/high ST category was also observed in men, but no significant association was found in women. Conclusions Both insufficient PA and prolonged ST contribute to overweight and obesity among Japanese adults. Public health initiatives addressing obesity in Japan need to consider both promoting PA and reducing ST, especially in men.

Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications.

Science.gov (United States)

Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna

2016-11-01

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. Copyright © 2016 Elsevier B.V. All rights reserved.

Association of STAT4 polymorphisms with susceptibility to type-1 autoimmune hepatitis in the Japanese population.

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Kiyoshi Migita

Full Text Available BACKGROUND/AIMS: Recent studies demonstrated an association of STAT4 polymorphisms with autoimmune diseases including systemic lupus erythematosus and rheumatoid arthritis, indicating multiple autoimmune diseases share common susceptibility genes. We therefore investigated the influence of STAT4 polymorphisms on the susceptibility and phenotype of type-1 autoimmune hepatitis in a Japanese National Hospital Organization (NHO AIH multicenter cohort study. METHODOLOGY/PRINCIPAL FINDINGS: Genomic DNA from 460 individuals of Japanese origin including 230 patients with type-1 autoimmune hepatitis and 230 healthy controls was analyzed for two single nucleotide polymorphisms in the STAT4 gene (rs7574865, rs7582694. The STAT4 rs7574865T allele conferred risk for type-1 autoimmune hepatitis (OR = 1.61, 95% CI = 1.23-2.11; P = 0.001, and patients without accompanying autoimmune diseases exhibited an association with the rs7574865T allele (OR = 1.50, 95%CI = 1.13-1.99; P = 0.005. Detailed genotype-phenotype analysis of type-1 autoimmune hepatitis patients with (n = 44 or without liver cirrhosis (n = 186 demonstrated that rs7574865 was not associated with the development of liver cirrhosis and phenotype (biochemical data and the presence of auto-antibodies. CONCLUSIONS/SIGNIFICANCE: This is the first study to show a positive association between a STAT4 polymorphism and type-1 autoimmune hepatitis, suggesting that autoimmune hepatitis shares a gene commonly associated with risk for other autoimmune diseases.

Orthopaedic Implants And Prosthesis: Economic Costs Of Post ...

African Journals Online (AJOL)

OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.

Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children.

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Carvalho, Fernando R; Lentini-Oliveira, Débora A; Prado, Lucila Bf; Prado, Gilmar F; Carvalho, Luciane Bc

2016-10-05

Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adeno-tonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbidities and, in some patients, by recurrence that can be associated with craniofacial problems. Oral appliances and functional orthopaedic appliances have been used for patients who have OSAS and craniofacial anomalies because they hold the lower jaw (mandible) forwards which potentially enlarges the upper airway and increases the upper airspace, improving the respiratory function. To assess the effects of oral appliances or functional orthopaedic appliances for obstructive sleep apnoea in children. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 7 April 2016); Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3) in the Cochrane Library (searched 7 April 2016); MEDLINE Ovid (1946 to 7 April 2016); Embase Ovid (1980 to 7 April 2016); LILACS BIREME (from 1982 to 7 April 2016); BBO BIREME (from 1986 to 7 April 2016) and SciELO Web of Science (from 1997 to 7 April 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials on 7 April 2016. We placed no restrictions on the language or date of publication when searching the electronic databases. All randomised or quasi-randomised controlled trials comparing all types of oral and functional orthopaedic appliances with placebo or no treatment, in children 15 years old or younger. reduction of apnoea to less than one episode per hour. dental and skeletal relationship, sleep parameters improvement, cognitive and phonoaudiological function, behavioural problems, quality of life, side effects

Multicenter collaborative for orthopaedic research in India: An opportunity for global leadership

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Mathew George

2008-01-01

Full Text Available Road traffic accidents are increasing at an alarming rate and have become a major public health concern in India. In addition, there is a lack of trauma research output and reliable data from India. There are several issues and challenges that have presented an opportunity for researchers and surgeons in India to develop a collaborative aimed at improving the quality and productivity of orthopaedic trauma research. Establishing a network of surgical researchers across India is a necessary first step towards global leadership in orthopaedic surgery trials.

Evaluation of free or anchored antimicrobial peptides as candidates for the prevention of orthopaedic device-related infections.

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D'Este, Francesca; Oro, Debora; Boix-Lemonche, Gerard; Tossi, Alessandro; Skerlavaj, Barbara

2017-10-01

The prevention of implant-associated infection, one the most feared complications in orthopaedic surgery, remains a major clinical challenge and urges development of effective methods to prevent bacterial colonization of implanted devices. Alpha-helical antimicrobial peptides (AMPs) may be promising candidates in this respect due to their potent and broad-spectrum antimicrobial activity, their low tendency to elicit resistance and possible retention of efficacy in the immobilized state. The aim of this study was to evaluate the potential of five different helical AMPs, the cathelicidins BMAP-27 and BMAP-28, their (1-18) fragments and the rationally designed, artificial P19(9/G7) peptide, for the prevention of orthopaedic implant infections. Peptides were effective at micromolar concentrations against 22 Staphylococcus and Streptococcus isolates from orthopaedic infections, while only BMAP-28 and to a lesser extent BMAP-27 were active against Enterococcus faecalis. Peptides in solution showed activities comparable to those of cefazolin and linezolid, on a molar basis, and also a variable capacity to neutralize bacterial lipopolysaccharide, while devoid of adverse effects on MG-63 osteoblast cells at concentrations corresponding to the MIC. The (1-18) BMAP fragments and P19(9/G7) were selected for further examination, based on better selectivity indices, and showed effectiveness in the presence of hyaluronic acid and in synovial fluid, while human serum affected their activity to variable extents, with BMAP-27(1-18) best retaining activity. This peptide was immobilized on streptavidin-resin beads and retained activity against reference Staphylococcus epidermidis and Staphylococcus aureus strains, with negligible toxicity towards osteoblasts, underlining its potential for the development of infection-resistant biomaterials for orthopaedic application. Copyright © 2017 European Peptide Society and John Wiley & Sons, Ltd. Copyright © 2017 European Peptide Society and

Authorship trends in the Journal of Orthopaedic Research: A bibliometric analysis.

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Seetharam, Abhijit; Ali, Mohammed T; Wang, Christine Y; Schultz, Katherine E; Fischer, James P; Lunsford, Shatoria; Whipple, Elizabeth C; Loder, Randall T; Kacena, Melissa A

2018-05-18

Publications are an important tool to measure one's success and achievement in academia. They can help propel a career forward and move one into a position of leadership. The overall purpose of this study was to investigate changes in bibliometric variables, authorship, and collaboration trends in the Journal of Orthopaedic Research (JOR®), since its inception in 1983. A bibliometric analysis was completed for all manuscripts meeting the inclusion criteria (638), which were published throughout the inaugural year plus one representative year of each decade. Several parameters were investigated including numbers of manuscripts, authors, collaborating institutions/countries, references, pages, and citations; region of origin and gender of authors over time and by region were main focuses. Significant increases over time were observed in all bibliometric variables analyzed except in the number of pages and citations. There was an approximate 27% point increase for both female first and corresponding authors from 1983 to 2015. While this is most likely due to the increase in the number of women that have entered the field over time, similar increases in the percentage of women holding positions on the JOR editorial board or in leadership positions within in the field may have also contributed to improvements in gender parity. Understanding changes in publishing characteristics over time, by region, and by gender are critical, especially with the rising demands of publishing in academia. JOR has seen increase in most variables analyzed, including improvements in authorship by women in the field of orthopaedic research. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Fifth joint meeting of the American Urological Association and the Japanese Urological Association International Affiliate Society Meeting at the 105th Annual Meeting of the American Urological Association.

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Myers, Robert P; Seki, Narihito; Gotoh, Momokazu; Chai, Toby C; Kaplan, Steven A; Inoue, Keiji; Trachtenberg, John; Kikuchi, Eiji; Nishiyama, Hiroyuki; Chang, Sam S; Lee, Cheryl; Muto, Satoru; Ito, Kazuto; Andriole, Gerald L; Eto, Masatoshi; Sumitomo, Makoto; Kamba, Tomomi; Wood, Chrsitopher G; Margulis, Vitaly; Naito, Seiji; Egawa, Shin

2010-08-01

We are heartily grateful for the warm support of all of the people concerned, including the moderators and panelists of both societies for giving us the opportunity to hold the 5(th) American Urological Association/Japanese Urological Association (AUA/JUA) International Affiliate Society Meeting, held once again at the 105th Annual Meeting of the American Urological Association (29 May-3 June 2010, San Francisco, California, USA). The year of 2010 is a memorable one, being the start of reciprocal collaborations between the AUA and the JUA. The JUA, in collaboration with the AUA, is promoting an academic exchange program whereby outstanding and promising Japanese and American junior faculty members will be given the opportunity to work in the USA and Japan for 1 month. The program not only allows the sharing of knowledge and experience, but also is designed to foster a closer alliance between the AUA and JUA, and assists in identifying future leaders within both organizations. The AUA and JUA will have an exhibit booth at each other's annual meeting, promoting our new joint activities. Both the JUA and AUA will organize educational courses in Hawaii in 2011. With all of these activities, the JUA hopes it will provide greater opportunities for young Japanese urologists to participate in educational projects in the USA. We would like to thank Professor Anton J. Bueschen, President of AUA, Professor Robert C Flanigan, Secretary General of AUA and the staff of the AUA and JUA for supporting our program. At the same time, we need the support of all the members and their valuable suggestions. We look forward to further participation of AUA members to this meeting. Seiji Naito md, President of JUA Shin Egawa md, Chairman of the International Committee of JUA.

Variability of Arthroscopy Case Volume in Orthopaedic Surgery Residency.

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Gil, Joseph A; Waryasz, Gregory R; Owens, Brett D; Daniels, Alan H

2016-05-01

To examine orthopaedic surgery case logs for arthroscopy case volume during residency training and to evaluate trends in case volume and variability over time. Publicly available Accreditation Council for Graduate Medical Education surgical case logs from 2007 to 2013 for orthopaedic surgery residency were assessed for variability and case volume trends in shoulder, elbow, wrist, hip, knee, and ankle arthroscopy. The national average number of procedures performed in each arthroscopy category reported was directly compared from 2009 to 2013. The 10th and 90th percentile arthroscopy case volume was compared between 2007 and 2013 for shoulder and knee arthroscopy procedures. Subsequently, the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2007 was compared with the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2013. From 2007 to 2013, shoulder arthroscopy procedures performed per resident increased by 43.1% (P = .0001); elbow arthroscopy procedures increased by 28.0% (P = .00612); wrist arthroscopy procedures increased by 8.6% (P = .05); hip arthroscopy procedures, which were first reported in 2012, increased by 588.9%; knee arthroscopy procedures increased by 8.5% (P = .0435); ankle arthroscopy increased by 27.6% (P = .00149). The difference in knee and shoulder arthroscopy volume between residents in the 10th and 90th percentile in 2007 and residents in the 10th and 90th percentile in 2013 was not significant (P > .05). There was a 3.66-fold difference in knee arthroscopy volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 3.36-fold in 2013 (P = .70). There was a 5.86-fold difference in shoulder arthroscopy case volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 4.96-fold in 2013 (P = .29). The volume of arthroscopy cases performed by graduating orthopaedic surgery residents has

Random effect modelling of patient-related risk factors in orthopaedic procedures: results from the Dutch nosocomial infection surveillance network 'PREZIES'.

NARCIS (Netherlands)

Muilwijk, J; Walenkamp, G H I M; Voss, Andreas; Wille, Jan C; Hof, Susan van den

2006-01-01

In the Dutch surveillance for surgical site infections (SSIs), data from 70277 orthopaedic procedures with 1895 SSIs were collected between 1996 and 2003. The aims of this study were: (1) to analyse the trends in SSIs associated with Gram-positive and Gram-negative bacteria; (2) to estimate

Orthopaedic injuries in children: Federal Medical Centre, Umuahia ...

African Journals Online (AJOL)

Background: Worldwide, trauma is a recognized leading cause of childhood morbidity, mortality and disability. Aim: To review the causes and consequences of orthopaedic injuries in children. Methods: A retrospective study of all injuries in children 14 years and below seen at the Federal Medical Centre Umuahia from 1st ...

Local corticosteroid injections: Rational use in common orthopaedic ...

African Journals Online (AJOL)

The use of local corticosteroid injections in orthopaedic practice is common due to their anti- inflammatory and analgesic effect. However, the use may result in local or systemic complications. Moreover, the conflicting reports on their benefits versus side effects, throws the average user in confusion or fear. This review ...

[The Development and Application of the Orthopaedics Implants Failure Database Software Based on WEB].

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Huang, Jiahua; Zhou, Hai; Zhang, Binbin; Ding, Biao

2015-09-01

This article develops a new failure database software for orthopaedics implants based on WEB. The software is based on B/S mode, ASP dynamic web technology is used as its main development language to achieve data interactivity, Microsoft Access is used to create a database, these mature technologies make the software extend function or upgrade easily. In this article, the design and development idea of the software, the software working process and functions as well as relative technical features are presented. With this software, we can store many different types of the fault events of orthopaedics implants, the failure data can be statistically analyzed, and in the macroscopic view, it can be used to evaluate the reliability of orthopaedics implants and operations, it also can ultimately guide the doctors to improve the clinical treatment level.

Association of genetic variants of the incretin-related genes with quantitative traits and occurrence of type 2 diabetes in Japanese.

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Enya, Mayumi; Horikawa, Yukio; Iizuka, Katsumi; Takeda, Jun

2014-01-01

None of the high frequency variants of the incretin-related genes has been found by genome-wide association study (GWAS) for association with occurrence of type 2 diabetes in Japanese. However, low frequency and rare and/or high frequency variants affecting glucose metabolic traits remain to be investigated. We screened all exons of the incretin-related genes ( GCG , GLP1R , DPP4 , PCSK1 , GIP , and GIPR ) in 96 patients with type 2 diabetes and investigated for association of genetic variants of these genes with quantitative metabolic traits upon test meal with 38 young healthy volunteers and with the occurrence of type 2 diabetes in Japanese subjects comprising 1303 patients with type 2 diabetes and 1014 controls. Two mutations of GIPR , p.Thr3Alafsx21 and Arg183Gln, were found only in patients with type 2 diabetes, and both of them were treated with insulin. Of ten tagSNPs, we found that risk allele C of SNP393 (rs6235) of PCSK1 was nominally associated with higher fasting insulin and HOMA-R ( P  = 0.034 and P  = 0.030), but not with proinsulin level, incretin level or BMI. The variant showed significant association with occurrence of type 2 diabetes after adjustment for age, sex, and BMI ( P  = 0.0043). Rare variants of GIPR may contribute to the development of type 2 diabetes, possibly through insulin secretory defects. Furthermore, the genetic variant of PCSK1 might influence glucose homeostasis by altered insulin resistance independently of BMI, incretin level or proinsulin conversion, and may be associated with the occurrence of type 2 diabetes in Japanese.

Multimedia Campaign Enhances Orthopaedic Patient Perceptions of Health Care Quality: A Prospective Analysis of Effect at a Military Treatment Facility.

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Sheean, Andrew J; Foster, James N; Aden, James K; Tubb, Creighton C; Johnson, Anthony E; Stinner, Daniel J

2017-07-01

multimedia campaign resulted in significant improvements among indices of orthopaedic patient satisfaction. We believe this model could be used at other military or nonmilitary treatment facilities as a means to engender patients' familiarity with their surgeon and prompt an appreciation for his/her expertise and enhance overall patient perceptions of department-wide health care quality. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Association of HK2 and NCK2 with normal tension glaucoma in the Japanese population.

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Dong Shi

Full Text Available Although family studies and genome-wide association studies have shown that genetic factors play a role in glaucoma, it has been difficult to identify the specific genetic variants involved. We tested 669 single nucleotide polymorphisms (SNPs from the region of chromosome 2 that includes the GLC1B glaucoma locus for association with primary open-angle glaucoma (POAG and normal tension glaucoma (NTG in the Japanese population. We performed a two-stage case-control study. The first cohort consisted of 123 POAG cases, 121 NTG cases and 120 controls: the second cohort consisted of 187 POAG cases, 286 NTG cases, and 271 controls. Out of six SNPs showing significant association with POAG in the first round screening, seven SNPs were tested in the second round. Rs678350 in the HK2 gene coding sequence showed significant allelic (p=0.0027 in Stage Two, 2.7XE-4 in meta-analysis association with POAG, and significant allelic (p=4.7XE-4 in Stage Two, 1.0XE-5 in meta-analysis association with NTG. Although alleles in the TMEM182 gene did not show significant association with glaucoma in the second round, subjects with the A/A allele in TMEM182 rs869833 showed worse visual field mean deviation (p=0.01. Even though rs2033008 in the NCK2 gene coding sequence did not show significant association in the first round, it had previously shown association with NTG so it was tested for association with NTG in round 2 (p=0.0053 in Stage Two. Immunohistochemistry showed that both HK2 and NCK2 are expressed in the retinal ganglion cell layer. Once multi-testing was taken into account, only HK2 showed significant association with POAG and NTG in Stage Two. Our data also support previous reports of NCK2 association with NTG, and raise questions about what role TMEM182 might play in phenotypic variability. Our data suggest that HK2 may play an important role in NTG in the Japanese population.

78 FR 21129 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2013-04-09

... radiofrequency band ranging between 13 megahertz to 27.12 megahertz and is intended for the treatment of medical...] Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: Orthopaedic and Rehabilitation Devices Panel of the Medical Devices...

[Association between GSK3β polymorphisms and the smoking habits in young Japanese].

Science.gov (United States)

Nagahori, Kenta; Iwahashi, Kazuhiko; Narita, Shin; Numajiri, Maki; Yoshihara, Eiji; Nishizawa, Daisuke; Ikeda, Kazutaka; Ishigooka, Jun

2015-06-01

Schizophrenia and bipolar disorder show high comorbidity with smoking dependence. Several previous studies reported that glycogen synthase kinase 3β (GSK3β), which is widely expressed in the brain including the dopamine projection areas such as the amygdala, nucleus accumbens and hippocampus, may play a role in neuropsychiatric disorders and dopamine- and serotonin-mediated behavior. In this study, we have analyzed the association of three single nucleotide polymorphisms (SNPs) within GSK3β gene (rs3755557, rs334558, rs6438552) with the smoking habits and age at smoking initiation in a sample of 384 young adult Japanese, which included 172 smokers and 212 non-smokers. As a result, rs334558 was significantly associated with smoking habits in genotype frequency and allelic frequency (P smoking habits.

Association of menstrual phase with smoking behavior, mood and menstrual phase-associated symptoms among young Japanese women smokers.

Science.gov (United States)

Sakai, Hiroko; Ohashi, Kazutomo

2013-03-02

Previous studies of the relationship between the menstrual phases and smoking behavior have been problematic, so the association of menstrual phases with smoking behavior and correlations among smoking, psychological and physical conditions in each phase of the menstrual cycle are unclear. To accurately examine the association between menstrual phases and the amount of smoking (number of cigarettes smoked and breath CO concentration), craving of smoking on visual analogue scale (VAS), depression in the Center for Epidemiologic Studies Depression (CES-D) Scale, and menstrual phase-associated symptoms in the Menstrual Distress Questionnaire (MDQ), we improved various methodological issues, specifically, 1) Ovulation was confirmed by measuring the basal body temperature and identifying a urinary luteinizing hormone (LH) surge in two cycles; 2) The menstrual, follicular, and luteal phases were clearly defined for subjects with different menstrual cycles; 3) The breath CO concentration was measured every day. A notice was posted on public bulletin boards to recruit research subjects and twenty-nine young Japanese women smokers aged 19 to 25 years old were analyzed. The number of cigarettes smoked was greater and the CO concentration was higher in the luteal phase than in the follicular phase. The levels of craving for smoking (VAS), depressiveness (CES-D), and menstrual phase-associated symptoms (MDQ) in the menstrual and luteal phases were higher than those in the follicular phase. The mean score for CES-D was 16 points (the cut-off value in screening for depression) or higher in the menstrual (16.9 ± 8.2) and luteal phases (17.2 ± 8.4).The number of cigarettes smoked and CO concentration were significantly correlated with the levels of craving for smoking, depressiveness, and menstrual phase-associated symptoms in all phases except for MDQ scores in follicular phase. The amount of smoking in the luteal phase was most strongly correlated with these symptoms

Similarities and differences in coatings for magnesium-based stents and orthopaedic implants

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Jun Ma

2014-07-01

Full Text Available Magnesium (Mg-based biodegradable materials are promising candidates for the new generation of implantable medical devices, particularly cardiovascular stents and orthopaedic implants. Mg-based cardiovascular stents represent the most innovative stent technology to date. However, these products still do not fully meet clinical requirements with regards to fast degradation rates, late restenosis, and thrombosis. Thus various surface coatings have been introduced to protect Mg-based stents from rapid corrosion and to improve biocompatibility. Similarly, different coatings have been used for orthopaedic implants, e.g., plates and pins for bone fracture fixation or as an interference screw for tendon-bone or ligament-bone insertion, to improve biocompatibility and corrosion resistance. Metal coatings, nanoporous inorganic coatings and permanent polymers have been proved to enhance corrosion resistance; however, inflammation and foreign body reactions have also been reported. By contrast, biodegradable polymers are more biocompatible in general and are favoured over permanent materials. Drugs are also loaded with biodegradable polymers to improve their performance. The key similarities and differences in coatings for Mg-based stents and orthopaedic implants are summarized.

Tribology considerations for hip joint articulations in relation to the "new orthopaedic patient".

Science.gov (United States)

Rieker, C B

2006-01-01

The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the "New Orthopaedic Patient". As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.

Transient aphasia following spinal anaesthesia in an orthopaedic ...

African Journals Online (AJOL)

A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory ...

Stress and coping among orthopaedic surgery residents and faculty.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2004-07-01

Evaluations of physicians and residents have revealed concerning levels of psychosocial dysfunction. The purposes of this study were to determine the quality of life of orthopaedic residents and faculty and to identify the risk factors for decompensation. Twenty-one orthopaedic residents and twenty-five full-time orthopaedic faculty completed a 102-question voluntary, anonymous survey. The survey consisted of three validated instruments, i.e., the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale; and three novel question sets addressing background and demographic information, stress reaction and management, and the balance between work and home life. Descriptive statistics, pairwise correlations, simple t tests, and Pearson and nonparametric Spearman correlations were calculated. The simple correlation coefficient was used to assess bivariate relationships. The mean overall quality-of-life score, on a scale of 0 to 4 points, was 2.5 points for residents compared with 3.6 points for faculty members. Residents reported considerable burnout, showing a high level of emotional exhaustion and depersonalization and an average level of personal achievement, whereas faculty reported minimal burnout, showing a low level of emotional exhaustion (p burnout and psychiatric morbidity correlated with weekly work hours; conflict between the commitments of work and home life; discord with faculty, nursing staff, and senior residents; debt load; and work-related stress. Protective factors included being a parent, spending time with a spouse, having a physician father, and deriving satisfaction from discussing concerns with colleagues, friends, and family. In pursuit of our goal of determining the quality of life of orthopaedic residents and faculty, we identified a large disparity between the two groups. The resident group reported much greater levels of dysfunction particularly with regard to burnout and psychiatric morbidity

Association of Lifestyle with Physical and Mental Health in Japanese Radiological Technologists

OpenAIRE

Tahara, Hiroyuki; Kondo, Hisayoshi; Ueya, Etsuo

2003-01-01

To elucidate the effects of low-dose radiation exposure and lifestyle on physical health and mental health, we evaluated the relationship of age, cumulative radiation dose, and lifestyle (cigarette smoking, alcohol drinking and physical exercise) to physical and mental health in Japanese radiological technologists. The study subjects were 932 Japanese radiological technologists who participated in a health study from 1981 to 1985. A self-administered questionnaire was mailed to each subject t...

Generalized Vitiligo Associated Autoimmune Diseases in Japanese Patients Their Families

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Tomohiko Narita

2011-01-01

Conclusions: Among Japanese vitiligo patients, there is a subgroup with strong evidence of genetically determined susceptibility to not only vitiligo, but also to autoimmune thyroid disease and other autoimmune disorders.

Hand-arm vibration in orthopaedic surgery: a neglected risk.

Science.gov (United States)

Mahmood, F; Ferguson, K B; Clarke, J; Hill, K; Macdonald, E B; Macdonald, D J M

2017-12-30

Hand-arm vibration syndrome is an occupational disease caused by exposure to hand-arm transmitted vibration. The Health and Safety Executive has set limits for vibration exposure, including an exposure action value (EAV), where steps should be taken to reduce exposure, and an exposure limit value (ELV), beyond which vibrating equipment must not be used for the rest of the working day. To measure hand-arm transmitted vibration among orthopaedic surgeons, who routinely use hand-operated saws. We undertook a cadaveric study measuring vibration associated with a tibial cut using battery-operated saws. Three surgeons undertook three tibial cuts each on cadaveric tibiae. Measurements were taken using a frequency-weighted root mean square acceleration, with the vibration total value calculated as the root of the sums squared in each of the three axes. A mean (SD) vibration magnitude of 1 (0.2) m/s2 in the X-axis, 10.3 (1.9) m/s2 in the Y-axis and 4.2 (1.3) m/s2 in the Z-axis was observed. The weighted root mean squared magnitude of vibration was 11.3 (1.7) m/s2. These results suggest an EAV of 23 min and ELV of 1 h 33 min using this equipment. Our results demonstrate that use of a battery-operated sagittal saw can transmit levels of hand-arm vibration approaching the EAV or ELV through prolonged use. Further study is necessary to quantify this risk and establish whether surveillance is necessary for orthopaedic surgeons. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Association of Job Demands with Work Engagement of Japanese Employees: Comparison of Challenges with Hindrances (J-HOPE)

OpenAIRE

Inoue, Akiomi; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Miyaki, Koichi; Takahashi, Masaya; Kurioka, Sumiko; Eguchi, Hisashi; Tsuchiya, Masao; Enta, Kazuhiko; Kosugi, Yuki; Sakata, Tomoko; Totsuzaki, Takafumi

2014-01-01

Objectives Recent epidemiological research in Europe has reported that two groups of job demands, i.e., challenges and hindrances, are differently associated with work engagement. The purpose of the present study was to replicate the cross-sectional association of workload and time pressure (as a challenge) and role ambiguity (as a hindrance) with work engagement among Japanese employees. Methods Between October 2010 and December 2011, a total of 9,134 employees (7,101 men and 1,673 women) fr...

Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?

Science.gov (United States)

Labrum, Joseph T; Paziuk, Taylor; Rihn, Theresa C; Hilibrand, Alan S; Vaccaro, Alexander R; Maltenfort, Mitchell G; Rihn, Jeffrey A

2017-06-01

A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion. In the survey, the caller assumed a fictitious identity as a 38-year-old male who experienced an ankle fracture 1 day before calling, and attempted to secure an appointment within 2 weeks. During initial contact, the fictitious patient reported Medicaid insurance status. One month later, the fictitious patient contacted the same orthopaedic practice and reported private insurance coverage status. National Orthopaedic Survey: Private and academic orthopaedic practices operating in each state in the United States were called and asked to complete a survey assessing their practice model of Medicaid insurance acceptance. State reimbursement rates for three different Current Procedural Terminology (CPT ®) codes were collected from state Medicaid agencies. Results Simulated Patient Survey: Offices were less likely to accept Medicaid than commercial insurance (30 of 64 [47%] versus 62 of 64 [97%]; odds ratio [OR], 0.0145; 95% CI, 0

Association of cardiorespiratory fitness and overweight with risk of type 2 diabetes in Japanese men.

Directory of Open Access Journals (Sweden)

Keisuke Kuwahara

Full Text Available OBJECTIVE: Existing evidence is limited on what extent fitness can counterbalance type 2 diabetes mellitus (T2DM risk associated with obesity. We investigated the joint association of weight status and estimated VO2max, a marker of fitness, with the risk of developing T2DM among Japanese men using haemoglobin A1c and fasting glucose criterion. METHODS: The present study included 3,523 male employees aged 18-61 years without diabetes who provided health check-up and fitness data in Japan in 2003-2005. We calculated hazard ratios and 95% confidence intervals for incident diabetes using the Cox regression model. RESULTS: During a mean follow-up of 6.0 years, 199 men developed diabetes. Multivariable-adjusted hazard ratios (95% confidence interval of diabetes were 1.00 (reference, 1.44 (1.01-2.07, and 1.48 (1.03-2.13 for the highest through the lowest tertile of fitness (P for trend  = 0.04. Additional adjustment for body mass index largely attenuated the association of fitness with diabetes. Joint analysis showed that adjusted hazard ratios of diabetes were 1.00, 1.32, 2.94, and 1.83 in normal weight high-fit men, normal weight low-fit men, overweight high-fit men, and overweight low-fit men, respectively. CONCLUSION: The results suggest that weight control is more important than fitness in prevention of type 2 diabetes in Japanese men.

The Japanese Histologic Classification and T-score in the Oxford Classification system could predict renal outcome in Japanese IgA nephropathy patients.

Science.gov (United States)

Kaihan, Ahmad Baseer; Yasuda, Yoshinari; Katsuno, Takayuki; Kato, Sawako; Imaizumi, Takahiro; Ozeki, Takaya; Hishida, Manabu; Nagata, Takanobu; Ando, Masahiko; Tsuboi, Naotake; Maruyama, Shoichi

2017-12-01

The Oxford Classification is utilized globally, but has not been fully validated. In this study, we conducted a comparative analysis between the Oxford Classification and Japanese Histologic Classification (JHC) to predict renal outcome in Japanese patients with IgA nephropathy (IgAN). A retrospective cohort study including 86 adult IgAN patients was conducted. The Oxford Classification and the JHC were evaluated by 7 independent specialists. The JHC, MEST score in the Oxford Classification, and crescents were analyzed in association with renal outcome, defined as a 50% increase in serum creatinine. In multivariate analysis without the JHC, only the T score was significantly associated with renal outcome. While, a significant association was revealed only in the JHC on multivariate analysis with JHC. The JHC and T score in the Oxford Classification were associated with renal outcome among Japanese patients with IgAN. Superiority of the JHC as a predictive index should be validated with larger study population and cohort studies in different ethnicities.

Evaluating the use of preoperative antibiotics in pediatric orthopaedic surgery.

Science.gov (United States)

Formaini, Nathan; Jacob, Paul; Willis, Leisel; Kean, John R

2012-01-01

To evaluate the rate of infection after minimally invasive procedures on a consecutive series of pediatric orthopaedic patients. We hypothesized that the use of preoperative antibiotics for minimally invasive pediatric orthopaedic procedures does not significantly reduce the incidence of surgical site infection requiring surgical debridement within 30 days of the primary procedure. We retrospectively reviewed 2330 patients having undergone minimally invasive orthopaedic procedures at our institution between March 2008 and November 2010. Knee arthroscopy, closed reduction with percutaneous fixation, soft tissue releases, excision of bony or soft-tissue masses, and removal of hardware constituted the vast majority of included procedures. Two groups, based on whether prophylactic antibiotics were administered before surgery, were created and the incidence of a repeat procedure required for deep infection was recorded. Statistical analysis was performed to determine significance, if any, between the 2 groups. Chart review of the 2330 patients identified 1087 as having received preoperative antibiotics, whereas the remaining 1243 patients did not receive antibiotics before surgery. Only 1 patient out of the 1243 cases in which antibiotics were not given required additional surgery within 30 days of the primary procedure due to a complicated surgical site infection (an incidence of 0.0008%). No patients in the antibiotic group developed a postoperative infection within 30 days requiring a return to the operating room for management. Our data revealed no significant increase in the incidence of complicated infection requiring additional procedures when antibiotics were not administered before surgery. Though prophylactic antibiotics have been shown to confer numerous benefits for patients undergoing relatively major operations, their use in cases of minimally invasive and/or percutaneous orthopaedic surgery is not well defined. Our data suggest that the use of

Association between shift work and the risk of death from biliary tract cancer in Japanese men.

Science.gov (United States)

Lin, Yingsong; Nishiyama, Takeshi; Kurosawa, Michiko; Tamakoshi, Akiko; Kubo, Tatsuhiko; Fujino, Yoshihisa; Kikuchi, Shogo

2015-10-21

There is increasing evidence suggesting that shift work involving night work may increase cancer risk. We examined the association between working rotating shifts and the risk of death from biliary tract cancer among Japanese men who participated in the Japan Collaborative Cohort Study. Of the 46,395 men recruited, 22,224 men aged 40-65 at baseline (1988-1990) who reported working full-time or were self-employed were included in the present analysis. The study subjects were followed through December 31, 2009. Information regarding occupation and lifestyle factors was collected using a self-administered questionnaire. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95 % confidence interval (CI) for the risk of death from biliary tract cancer in relation to shift work. During a mean 17-year follow-up, we observed 94 biliary tract cancer deaths, including 23 deaths from gallbladder cancer and 71 deaths from extrahepatic bile duct cancer. Overall, shift work was associated with a statistically non-significant increase in the risk of biliary tract cancer, with an HR of 1.50 (95 % CI: 0.81-2.77), among rotating shift workers. When the analysis was limited to extrahepatic bile duct cancer, a significant association appeared, with a multivariable-adjusted HR of 1.93 (95 % CI: 1.00-3.72) for rotating shift workers. Our data indicate that shift work may be associated with increased risk of death from extrahepatic bile duct cancer in this cohort of Japanese men. The association with gallbladder cancer remains unclear because of the small number of deaths.

Prevalence of lumbar spondylosis and its association with low back pain among community-dwelling Japanese women.

Science.gov (United States)

Tsujimoto, Ritsu; Abe, Yasuyo; Arima, Kazuhiko; Nishimura, Takayuki; Tomita, Masato; Yonekura, Akihiko; Miyamoto, Takashi; Matsubayashi, Shohei; Tanaka, Natsumi; Aoyagi, Kiyoshi; Osaki, Makoto

2016-12-01

Lumbar spondylosis is more prevalent among the middle-aged and elderly, but few population-based studies have been conducted, especially in Japan. The purpose of this study was to explore the prevalence of lumbar spondylosis and its associations with low back pain among community-dwelling Japanese women. Lateral radiographs of the lumbar spine were obtained from 490 Japanese women ≥ 40 years old, and scored for lumbar spondylosis using the Kellgren-Lawrence (KL) grade at lumbar intervertebral level from L1/2 to L5/S1. Height and weight were measured, and body mass index (BMI) was calculated. Low back pain in subjects was assessed using a self-administered questionnaire. Stiffness index (bone mass) was measured at the calcaneal bone using quantitative ultrasound. Prevalence of radiographic lumbar spondylosis for KL ≥ 2, KL ≥ 3 and low back pain were 76.7%, 38.8% and 20.0%, respectively. Age was positively associated with radiographic lumbar spondylosis (KL = 2, KL ≥ 3) and low back pain. Greater BMI was associated with lumbar spondylosis with KL = 2, but not with KL ≥ 3. Stiffness index was associated with neither radiographic lumbar spondylosis nor low back pain. Multiple logistic regression analysis identified radiographic lumbar spondylosis (KL ≥ 3) at L3/4, L4/5 and L5/S1 was associated with low back pain, independent of age, BMI and stiffness index. Severe lumbar spondylosis at the middle or lower level may contribute to low back pain.

An evaluation of orthopaedic nurses’ participation in an educational intervention promoting research utilization – A triangulation convergence model

DEFF Research Database (Denmark)

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2016-01-01

Aims and objectives To describe the orthopaedic nurses' experiences regarding the relevance of an educational intervention and their personal and contextual barriers to participation in the intervention. Background One of the largest barriers against nurses' research usage in clinical practice...... is the lack of participation. A previous survey identified 32 orthopaedic nurses as interested in participating in nursing research. An educational intervention was conducted to increase the orthopaedic nurses' research knowledge and competencies. However, only an average of six nurses participated. Design...... A triangulation convergence model was applied through a mixed methods design to combine quantitative results and qualitative findings for evaluation. Methods Data were collected from 2013–2014 from 32 orthopaedic nurses in a Danish regional hospital through a newly developed 21-item questionnaire and two focus...

Genetic characteristics of inflammatory bowel disease in a Japanese population.

Science.gov (United States)

Fuyuno, Yuta; Yamazaki, Keiko; Takahashi, Atsushi; Esaki, Motohiro; Kawaguchi, Takaaki; Takazoe, Masakazu; Matsumoto, Takayuki; Matsui, Toshiyuki; Tanaka, Hiroki; Motoya, Satoshi; Suzuki, Yasuo; Kiyohara, Yutaka; Kitazono, Takanari; Kubo, Michiaki

2016-07-01

Crohn's disease (CD) and ulcerative colitis (UC) are two major forms of inflammatory bowel disease (IBD). Meta-analyses of genome-wide association studies (GWAS) have identified 163 susceptibility loci for IBD among European populations; however, there is limited information for IBD susceptibility in a Japanese population. We performed a GWAS using imputed genotypes of 743 IBD patients (372 with CD and 371 with UC) and 3321 controls. Using 100 tag single-nucleotide polymorphisms (SNPs) (P Japanese and European populations. In the IBD GWAS, two East Asia-specific IBD susceptibility loci were identified in the Japanese population: ATG16L2-FCHSD2 and SLC25A15-ELF1-WBP4. Among 163 reported SNPs in European IBD patients, significant associations were confirmed in 18 (8 CD-specific, 4 UC-specific, and 6 IBD-shared). In Japanese CD patients, genes in the Th17-IL23 pathway showed stronger genetic effects, whereas the association of genes in the autophagy pathway was limited. The association of genes in the epithelial barrier and the Th17-IL23R pathways were similar in the Japanese and European UC populations. We confirmed two IBD susceptibility loci as common for CD and UC, and East Asian-specific. The genetic architecture in UC appeared to be similar between Europeans and East Asians, but may have some differences in CD.

Consultation of orthopaedics cases using multimedia messaging services.

Science.gov (United States)

Eranki, Vivek; Munt, Justin; Lim, Ming J; Atkinson, Robert

2010-04-23

Frequently, radiological data is transferred verbally between the Emergency Department (ED) and orthopaedic registrar. Given the different language skills and medical experience of health staff, there is often a limit to the adequacy of the verbal description that could lead to suboptimal patient care. This study proposes that concurrent review of MMS teleradiology with traditional verbal reporting results in a significant therapeutic benefit. Case notes of 40 patients who presented to ED were reviewed. Images were captured and sent to an Orthopaedic registrar along with a brief clinical synopsis. Information was collected on the diagnosis of the MMS radiograph, need for urgent admission and management plan outlined to ED. Correct diagnosis was made in 27 of 40 cases. Using the latest technology available, MMS teleradiology had 79% sensitivity, 83% specificity and an accuracy of 80%. 50% of paediatric fractures and 60% of undisplaced fractures were diagnosed successfully. MMS teleradiology is not suitable by itself as a remote diagnostic tool. However, when combined with existing clinical practice, it is effective in screening patients, enhances confidence in decision making and communication between doctors.

Improved Safety and Cost Savings from Reductions in Cast-Saw Burns After Simulation-Based Education for Orthopaedic Surgery Residents.

Science.gov (United States)

Bae, Donald S; Lynch, Hayley; Jamieson, Katherine; Yu-Moe, C Winnie; Roussin, Christopher

2017-09-06

The purpose of this investigation was to characterize the clinical efficacy and cost-effectiveness of simulation training aimed at reducing cast-saw injuries. Third-year orthopaedic residents underwent simulation-based instruction on distal radial fracture reduction, casting, and cast removal using an oscillating saw. The analysis compared incidences of cast-saw injuries and associated costs before and after the implementation of the simulation curriculum. Actual and potential costs associated with cast-saw injuries included wound care, extra clinical visits, and potential total payment (indemnity and expense payments). Curriculum costs were calculated through time-derived, activity-based accounting methods. The researchers compared the costs of cast-saw injuries and the simulation curriculum to determine overall savings and return on investment. In the 2.5 years prior to simulation, cast-saw injuries occurred in approximately 4.3 per 100 casts cut by orthopaedic residents. For the 2.5-year period post-simulation, the injury rate decreased significantly to approximately 0.7 per 100 casts cut (p = 0.002). The total cost to implement the casting simulation was $2,465.31 per 6-month resident rotation. On the basis of historical data related to cast-saw burns (n = 6), total payments ranged from $2,995 to $25,000 per claim. The anticipated savings from averted cast-saw injuries and associated medicolegal payments in the 2.5 years post-simulation was $27,131, representing an 11-to-1 return on investment. Simulation-based training for orthopaedic surgical residents was effective in reducing cast-saw injuries and had a high theoretical return on investment. These results support further investment in simulation-based training as cost-effective means of improving patient safety and clinical outcomes. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Association between frequency of fried food consumption and resilience to depression in Japanese company workers: a cross-sectional study.

Science.gov (United States)

Yoshikawa, Eisho; Nishi, Daisuke; Matsuoka, Yutaka J

2016-09-15

Long-chain n-3 and n-6 polyunsaturated fatty acids (LC n-3/n-6 PUFA) play important roles in emotional regulation. We previously reported an association between fish consumption, which is major source of LC n-3 PUFA, and resilience to depression, where resilience is the ability to cope with stress in the face of adversity. Although the traditional Japanese dietary pattern of high fish consumption is associated with low depressive symptoms, the current Japanese diet pattern has become westernized. Westernized diets contain excessive amounts of LC n-6 PUFA due to high intake of vegetable oils commonly used in fried food and are associated with risk of depression. The aim of this study was to examine the association between frequency of fried food consumption and resilience to depression. Participants were 715 Japanese company workers. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, and the 14-item Resilience Scale (RS-14) was used to measure resilience. Frequency of fish and fried food consumption was assessed using a self-report questionnaire based on the Food Frequency Questionnaire. Regression analyses using Preacher and Hayes' bootstrap script were used to adjust for demographic factors, frequency of physical exercise, and fish consumption. Significant associations were identified between frequency of fried food consumption and total CES-D score (path c, B = 0.72; P frequency of fried food consumption and total RS-14 score (path a, B = -1.73, P food consumption and total CES-D score was not significant when we controlled for RS-14 score. Bootstrapping results showed that there was a significant positive indirect association between frequency of fried food and CESD score through RS-14 (95 % bias-corrected and accelerated confidence interval = 0.34 to 0.92). Frequency of fried food consumption was associated with lower resilience to depression. Further nutritional interventional studies to

Bone Graft Substitutes : Developed for Trauma and Orthopaedic Surgery

NARCIS (Netherlands)

J. van der Stok (Johan)

2015-01-01

markdownabstract__Abstract__ Bone grafting was established in the 19th century and has become a common procedure in which bone defects are filled with bone grafts or bone graft substitutes. Bone defects that require bone grafting are encountered in approximately 10% of trauma and orthopaedic

Association of habitual dietary intake with morningness-eveningness and rotating shift work in Japanese female nurses.

Science.gov (United States)

Yoshizaki, Takahiro; Komatsu, Taiki; Tada, Yuki; Hida, Azumi; Kawano, Yukari; Togo, Fumiharu

2018-03-01

Rotating shift workers are associated with imbalanced dietary intakes. Rotating shift workers and dietary intakes in adults who do not engage in night work have also been shown to be associated with chronotype. However, no studies have examined associations between morningness-eveningness (i.e., the degree to which people prefer to be active in the morning or the evening), rotating shift work and dietary intakes. Therefore, our first purpose was to elucidate the association between morningness-eveningness and habitual food group intakes in rotating shift workers. The second purpose was to elucidate the association of morningness-eveningness and rotating shift work with food group intakes, considering habitual sleep durations. Japanese nurses (1095 day workers and 1464 rotating shift workers) were studied using a self-administered questionnaire. The questionnaire covered habitual dietary intakes, morningness-eveningness and demographic characteristics of the participants. A Japanese version of the Morningness-Eveningness Questionnaire (MEQ) was used to measure self-rated morningness-eveningness. Dietary intakes over the previous 1 month were evaluated using a semi-quantitative food frequency questionnaire. Intakes of pulses, green/yellow vegetables, white vegetables, fruits, algae, eggs, confectioneries/savory snacks and sugar-sweetened beverages were significantly (p food groups, intakes of green/yellow vegetables, white vegetables, fruits and algae were significantly (p food groups were also significantly (p food groups, while rotating shift work was associated only with confectioneries/savory snacks. These results suggest that morningness-eveningness is associated with unbalanced dietary intakes in rotating shift workers as well as day workers, which may partially explain associations between rotating shift work and unfavorable dietary intakes. These findings have important implications for the development of novel strategies for preventing poor health caused

Cytokine profile and proviral load among Japanese immigrants and non-Japanese infected with HTLV-1 in a non-endemic area of Brazil.

Directory of Open Access Journals (Sweden)

João Américo Domingos

Full Text Available The lifetime risk of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP development differs among ethnic groups. To better understand these differences, this prospective cohort study was conducted to investigate the cytokine profile and the HTLV-1 proviral load (PVL in Japanese and non-Japanese populations with HAM/TSP and asymptomatic carriers (ACs. The serum IL-2, IL-4, IL-6, IL-10, IL-17, TNF-α, and IFN-γ levels were quantified using the Cytometric Bead Array in 40 HTLV-1-infected patients (11 HAM/TSP and 29 ACs and 18 healthy controls (HCs in Brazil. Among ACs, 15 were Japanese descendants and 14 were non-Japanese. Of 11 patients with HAM/TSP, only one was a Japanese descendant. The HTLV-1 PVL was quantified by real-time PCR. The HTLV-1 PVL was 2.7-fold higher in HAM/TSP patients than ACs. Regardless of the clinical outcome, the PVL was significantly higher in patients younger than 60 years than older patients. The HAM/TSP and ACs had higher IL-10 serum concentrations than that of HCs. The ACs also showed higher IL-6 serum levels than those of HCs. According to age, the IL-10 and IL-6 levels were higher in ACs non-Japanese patients older than 60 years. HAM/TSP patients showed a positive correlation between IL-6 and IL-17 and a negative correlation between the PVL and IL-17 and IFN-γ. In the all ACs, a significant positive correlation was observed between IL-2 and IL-17 and a negative correlation was detected between IL-10 and TNF-α. Only 6.25% of the Japanese patients were symptomatic carriers, compared with 41.67% of the non-Japanese patients. In conclusion, this study showed that high levels of HTLV-1 PVL was intrinsicaly associated with the development of HAM/TSP. A higher HTLV-1 PVL and IL10 levels found in non-Japanese ACs over 60 years old, which compared with the Japanese group depicts that the ethnic background may interfere in the host immune status. More researches also need to be undertaken regarding the host

A Radiographic Study on the Associations of Age and Prevalence of Vertebral Fractures with Abdominal Aortic Calcification in Japanese Postmenopausal Women and Men

Directory of Open Access Journals (Sweden)

Jun Iwamoto

2010-01-01

Full Text Available The purpose of the present study was to determine the associations of age and history of non- and low-traumatic fractures with the severity of abdominal aortic calcification in Japanese postmenopausal women and men. Four hundred and one Japanese persons (24 men and 377 postmenopausal women, mean age: 73.8 years for whom thoracic and lumbar spine radiographs had been obtained to evaluate their posture prior to patient participation in a fall-prevention exercise program were enrolled. The associations of sex, age, history of hip fracture, prevalence of vertebral fracture, and spondylosis grade (the Nathan degree with the severity of abdominal aortic calcification (length of calcification, as evaluated according to the number of vertebral bodies were analyzed. Nine subjects (2.2% had a history of hip fracture, and 221 (55.1% had at least one prevalent vertebral fracture. Two hundred and sixty-seven subjects (66.6% had first-degree spondylosis. Age and the number of prevalent vertebral fractures, but not sex, history of hip fracture, or spondylosis grade, were significantly associated with the severity of abdominal aortic calcification. The present study confirmed that age and the number of vertebral fractures were associated with the severity of abdominal aortic calcification in Japanese postmenopausal women and men.

Demographics, nature and treatment of orthopaedic trauma injuries occurring in an agricultural context in the West of Ireland.

LENUS (Irish Health Repository)

Byrne, F J

2011-03-01

Farming is a major industry in the West of Ireland. This prospective study examined the age profile, nature and treatment of orthopaedic injuries occurring in agricultural surroundings presenting at the Orthopaedic Unit of Merlin Park Hospital, Galway.

Allelic frequencies and association with carcass traits of six genes in local subpopulations of Japanese Black cattle.

Science.gov (United States)

Nishimaki, Takahiro; Ibi, Takayuki; Siqintuya; Kobayashi, Naohiko; Matsuhashi, Tamako; Akiyama, Takayuki; Yoshida, Emi; Imai, Kazumi; Matsui, Mayu; Uemura, Keiichi; Eto, Hisayoshi; Watanabe, Naoto; Fujita, Tatsuo; Saito, Yosuke; Komatsu, Tomohiko; Hoshiba, Hiroshi; Mannen, Hideyuki; Sasazaki, Shinji; Kunieda, Tetsuo

2016-04-01

Marker-assisted selection (MAS) is expected to accelerate the genetic improvement of Japanese Black cattle. However, verification of the effects of the genes for MAS in different subpopulations is required prior to the application of MAS. In this study, we investigated the allelic frequencies and genotypic effects for carcass traits of six genes, which can be used in MAS, in eight local subpopulations. These genes are SCD, FASN and SREBP1, which are associated with the fatty acid composition of meat, and NCAPG, MC1R and F11, which are associated with carcass weight, coat color and blood coagulation abnormality, respectively. The frequencies of desirable alleles of SCD and FASN were relatively high and that of NCAPG was relatively low, and NCAPG was significantly associated with several carcass traits, including carcass weight. The proportions of genotypic variance explained by NCAPG to phenotypic variance were 4.83 for carcass weight. We thus confirmed that NCAPG is a useful marker for selection of carcass traits in these subpopulations. In addition, we found that the desirable alleles of six genes showed no negative effects on carcass traits. Therefore, selection using these genes to improve target traits should not have negative impacts on carcass traits. © 2015 Japanese Society of Animal Science.

Quality of life during orthopaedic training and academic practice: part 2: spouses and significant others.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2012-10-03

Orthopaedic residents and attending physicians who report having a supportive spouse show lower levels of burnout and psychological distress than those without supportive spouses. However, little is known about the experiences of the spouses. This nationwide study examines burnout, psychological distress, and marital satisfaction of the spouses and significant others (collectively referred to hereafter as spouses) of orthopaedists in training and in orthopaedic practice in an academic setting. Employing previously reported methodology, 259 spouses of orthopaedic residents and 169 spouses of full-time orthopaedic faculty completed a voluntary, anonymous survey. The survey included three validated instruments (the Maslach Burnout Inventory, the General Psychological Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and three novel question sets addressing demographic information, relationship issues, stress, and work/life balance. Psychological distress was noted in 18% of resident spouses compared with only 10% of faculty spouses (p = 0.014). Resident spouses reported greater loneliness (p < 0.0009) and stress (p = 0.03) than faculty spouses. Among working spouses, 30% of resident spouses and 13% of faculty spouses showed high levels of emotional exhaustion (p < 0.003). Twenty-eight percent of employed resident spouses and 5% of employed faculty spouses showed problematic levels of depersonalization (p < 0.0001). Twenty-six percent of employed resident spouses and 12% of employed faculty spouses showed a diminished sense of personal accomplishment (p = 0.012). Marital satisfaction was high for both resident and faculty spouses. Decreased satisfaction correlated with excessive mate irritability and fatigue that precluded their mate's involvement in family activities. A gratifying sex life, full-time work outside the home, and spending more than ninety minutes a day with their mate correlated significantly with marital satisfaction. Many orthopaedic

Non-Steroidal Anti Inflammatory Drugs Usage In Orthopaedics And ...

African Journals Online (AJOL)

Background: Non steroidal anti-inflammatory drugs NSAIDs) are a group of heterogeneous compounds with nti inflammatory, analgesic and often times anti pyretic roperties. They are weak organic acids and are the most commonly used drugs in Orthopaedic/Trauma practice. hey provide mild to moderate pain relief.

Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

Science.gov (United States)

Fennelly, Orna; Blake, Catherine; FitzGerald, Oliver; Breen, Roisin; Ashton, Jennifer; Brennan, Aisling; Caffrey, Aoife; Desmeules, François; Cunningham, Caitriona

2018-06-01

Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services. Throughout 2014, APPs (n = 22) entered clinical data on a national database. Analysis of these data using descriptive statistics determined patient wait times, Consultant Doctor involvement in clinical decisions, and patient clinical outcomes. Chi square tests were used to compare patient clinical outcomes across orthopaedic and rheumatology clinics. A pilot study at one site identified re-referral rates to orthopaedic/rheumatology services of patients managed by the APPs. In one year, 13,981 new patients accessed specialist orthopaedic and rheumatology consultations via the APP. Median wait time for an appointment was 5.6 months. Patients most commonly presented with knee (23%), lower back (22%) and shoulder (15%) disorders. APPs made autonomous clinical decisions regarding patient management at 77% of appointments, and managed patient care pathways without onward referral to Consultant Doctors in more than 80% of cases. Other onward clinical pathways recommended by APPs were: physiotherapy referrals (42%); clinical investigations (29%); injections administered (4%); and surgical listing (2%). Of those managed by the APP, the pilot study identified that only 6.5% of patients were re-referred within one year. This national evaluation of APP services demonstrated that the majority of patients assessed by an APP did not require onward referral for a Consultant Doctor appointment. Therefore, patients gained earlier access to orthopaedic and rheumatology consultations in secondary care, with most patients conservatively managed.

HOMA-IR Values are Associated With Glycemic Control in Japanese Subjects Without Diabetes or Obesity: The KOBE Study.

Science.gov (United States)

Hirata, Takumi; Higashiyama, Aya; Kubota, Yoshimi; Nishimura, Kunihiro; Sugiyama, Daisuke; Kadota, Aya; Nishida, Yoko; Imano, Hironori; Nishikawa, Tomofumi; Miyamatsu, Naomi; Miyamoto, Yoshihiro; Okamura, Tomonori

2015-01-01

Several studies have reported that insulin resistance was a major risk factor for the onset of type 2 diabetes mellitus in individuals without diabetes or obesity. We aimed to clarify the association between insulin resistance and glycemic control in Japanese subjects without diabetes or obesity. We conducted a community-based cross-sectional study including 1083 healthy subjects (323 men and 760 women) in an urban area. We performed multivariate regression analyses to estimate the association between the homeostasis model assessment of insulin resistance (HOMA-IR) values and markers of glycemic control, including glycated haemoglobin (HbA1c), 1,5-anhydroglucitol (1,5-AG), and fasting plasma glucose (FPG) levels, after adjustment for potential confounders. Compared with the lowest tertile of HOMA-IR values, the highest tertile was significantly associated with HbA1c and FPG levels after adjustment for potential confounders, both in men (HbA1c: β = 1.83, P = 0.001; FPG: β = 0.49, P HOMA-IR values was inversely associated with 1,5-AG levels compared with the lowest tertile (β = -18.42, P = 0.009) only in men. HOMA-IR values were associated with markers of glycemic control in Japanese subjects without diabetes or obesity. Insulin resistance may influence glycemic control even in a lean, non-diabetic Asian population.

No association between the protein tyrosine phosphatase, receptor-type, Z Polypeptide 1 (PTPRZ1) gene and schizophrenia in the Japanese population.

Science.gov (United States)

Ito, Yoshihito; Yamada, Shinnosuke; Takahashi, Nagahide; Saito, Shinichi; Yoshimi, Akira; Inada, Toshiya; Noda, Yukihiro; Ozaki, Norio

2008-10-05

NRG1-ERBB signaling influences the risk for schizophrenia pathology. A recent study has reported that MAGI1, MAGI2, and protein tyrosine phosphatase, receptor-type, Z polypeptide 1 (PTPRZ1; located on 7q31.3) gene products regulate the NRG1-ERBB4 signaling pathway, and PTPRZ1 is associated with schizophrenia in a Caucasian population. By applying a gene-based association concept, we analyzed any association between PTPRZ1 tagging SNPs and schizophrenia in the Japanese population (576 schizophrenics and 768 controls). After linkage disequilibrium analysis, 29 single nucleotide polymorphisms (SNPs) were genotyped using a 5'-exonuclease allelic discrimination assay. We found a significant association of one tagging SNP in a genotype-wise analysis (P = 0.007); however, this might be resulted from type I error due to multiple testing (P = 0.17 after SNPSpD correction). No association was observed between schizophrenic patients and controls in either allelic, genotypic, or haplotypic analyses. Our results therefore suggest that PTPRZ1 is unlikely to be related to the development of schizophrenia in the Japanese population.

Reference Japanese man

International Nuclear Information System (INIS)

Tanaka, Giichiro

1985-01-01

To make real and accurate dose assessment method so far, it is necessitated to provide ''Reference Japanese Man'' based on anotomical, physiological and biochemical data of Japanese people instead of the Reference Man presented in ICRP Publications 23 and 30. This review describes present status of researched for the purpose of establishing of Reference Japanese Man. The Reference Japanese Man is defined as a male or female adult who lives in Japan with a Japanese life-style and food custom. His stature and body weight, and the other data was decided as mean values of male or female people of Japan. As for food custom, Japanese people take significantly smaller amount of meat and milk products than Western people, while larger intake amount of cereals and marine products such as fish or seaweeds. Weight of organs is a principal factor for internal dose assessment and mean values for living Japanese adult has been investigated and the value employable for dose assessment for organs and tissues are shown. To employ these values of Reference Japanese Man, it should be taken into account of age. Metabolic parameters should also be considered. Iodine metabolism in Japanese is quite different from that of Western people. The above-mentioned data are now tentatively employing in modification of table of MIRD method and others. (Takagi, S.)

Work Environment and Japanese Fathers' Involvement in Child Care

Science.gov (United States)

Ishii-Kuntz, Masako

2013-01-01

Previous studies mainly examined individual and family factors affecting Japanese fathers' involvement in child care. Along with these factors, we examine how work-related factors such as father-friendly environment at work, workplace's accommodation of parental needs, job stress, and autonomy are associated with Japanese men's participation in…

Strong influence of dietary intake and physical activity on body fatness in elderly Japanese men: age-associated loss of polygenic resistance against obesity.

Science.gov (United States)

Tanisawa, Kumpei; Ito, Tomoko; Sun, Xiaomin; Ise, Ryuken; Oshima, Satomi; Cao, Zhen-Bo; Sakamoto, Shizuo; Tanaka, Masashi; Higuchi, Mitsuru

2014-09-01

Genome-wide association studies identified single nucleotide polymorphisms (SNPs) associated with body mass index (BMI) in middle-aged populations; however, it is unclear whether these SNPs are associated with body fatness in elderly people. We examined the association between genetic risk score (GRS) from BMI-associated SNPs and body fatness in elderly Japanese men. We also examined the contribution of GRS, dietary macronutrient intake, and physical activity to body fatness by different age groups. GRS was calculated from 10 BMI-associated SNPs in 84 middle-aged (30-64 years) and 97 elderly (65-79 years) Japanese men; subjects were divided into low, middle, and high GRS groups. Dietary macronutrient intake was assessed using a questionnaire, and physical activity was evaluated using both a questionnaire and an accelerometer. The middle-aged individuals with a high GRS had greater BMI; waist circumference; and total abdominal fat, visceral fat, and subcutaneous fat areas than the middle-aged individuals with low GRS, whereas the indicators were not different between the GRS groups in elderly individuals. Multiple linear regression analysis showed that GRS was the strongest predictor of BMI, total abdominal fat, and visceral fat in the middle-aged group, whereas fat, alcohol, and protein intakes or vigorous-intensity physical activity were more strongly associated with these indicators than was GRS in the elderly group. These results suggest that GRS from BMI-associated SNPs is not predictive of body fatness in elderly Japanese men. The stronger contribution of dietary macronutrient intake and physical activity to body fatness may attenuate the genetic predisposition in elderly men.

Work-hour restrictions and orthopaedic resident education: a systematic review.

Science.gov (United States)

Mauser, Nathan S; Michelson, James D; Gissel, Hannah; Henderson, Corey; Mauffrey, Cyril

2016-05-01

The ACGME (US) and The European Working Time Directive (UK) placed work-hour restrictions on medical trainees with the goal of improved patient safety. However, there has been concern over a potential decrease in medical education. Orthopaedic training is the focus of this study. We examined previously published subjective and objective data regarding education and work-hour restrictions and developed the questions: Do specific perceptions emerge within the subjective studies examined? Are there objective differences in educational measures before and after work-hour restrictions? Is there a difference between the subjective and objective data? A systematic review was conducted via MedLine, regarding orthopaedic studies in the USA and UK, with reference to work-hour restrictions and education. Subjective survey studies demonstrate that residents and attending physicians have a negative response to work-hour restrictions because of the perceived impact on their overall education and operating room experience. Conversely, limited objective studies demonstrated no change in operative volume before or after implementation of restrictions. This review highlights the need for more objective studies on the educational implications of work-hour restrictions. Studies to date have not demonstrated a measurable difference based on case logs or training scores. Opinion-based surveys demonstrate an overall negative perception by both residents and attending physicians, on the impact of work-hour restrictions on orthopaedic education. Current published data is limited and stronger evidence-based data are needed before definitive conclusions can be reached.

On the Formation of Verb Compounds in Early Middle Japanese

Directory of Open Access Journals (Sweden)

Wenchao LI

2013-12-01

Full Text Available This paper is dedicated to the formation of verb compounds in Early Middle Japanese, a stage of the Japanese language used in the Heian Period (794–1185. The findings reveal that current verb compounds have come a long way from Old Japanese. Multiple verbs in Old Japanese are assigned to an associate type, rather than a compounding type of relation. Thus, the serial constituents receive equal syntactic weight, giving rise to the extensive use of the coordinate type and succession type of multi-verbs. In Early Middle Japanese, the combinations of the two constituents seem much tighter, giving rise the frequent use of the modifier-predicate V-V. The conclusion emerging from this study is that it was not until Early Middle Japanese that verb compounds in the strict sense appeared. Moreover, two types of verb weakening are observed in Early Middle Japanese: (a transformation of the first verb into a prefix, (b grammaticalization of the second verb into a directional/resultative complement.

Motives for seeking a second opinion in orthopaedic surgery.

NARCIS (Netherlands)

Dalen, I. van; Groothoff, J.; Stewart, R.; Spreeuwenberg, P.; Groenewegen, P.; Horn, J. van

2001-01-01

The number of second opinions in orthopaedic surgery is increading rapidly, yet the grounds on which patients and their doctors decide to seek a second opinion have been little studied. The goal of the study was to identify patient and consultant factors that appeared to contribute to a second

Imaging in scoliosis from the orthopaedic surgeon's point of view

Energy Technology Data Exchange (ETDEWEB)

Thomsen, Marc [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany); Abel, Rainer [Stiftung Orthopaedische Universitaetsklinik Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg (Germany)]. E-mail: rainer.abel@ok.uni-heidelberg.de

2006-04-15

For treating patients with scoliosis orthopaedic surgeons need diagnostic imaging procedures in order to provide answers about a possible underlying disease, choice of treatment, and prognosis. Once treatment is instituted, imaging is also critical for monitoring changes of the deformity so as to optimize therapy. The combined effort of orthopaedic surgeons and radiologists helps detect treatable causes of scoliosis at an early stage, define the need and timing for surgery, and ensure that every precaution is taken to minimize the risks of surgery. Neurosurgical causes, with particular reference to spinal cord tumours and syringomyelia, need to be addressed before scoliosis surgery can be contemplated.

Women among First Authors in Japanese Cardiovascular Journal.

Science.gov (United States)

Fujii, Tomoko; Matsuyama, Tasuku; Takeuchi, Jiro; Hara, Masahiko; Kitamura, Tetsuhisa; Yamauchi-Takihara, Keiko

2018-03-30

The representation of women in Japanese academic medicine is not evident. We aimed to assess trends related to the proportion of female first authors in Japanese cardiovascular journals.We reviewed original research articles in 6 journals published in English by Japanese societies between 2006 and 2015 related to cardiovascular fields. We conducted a multivariable logistic regression analysis to assess the factors associated with the gender of first authors and plotted the trend of predicted probability for female first authors over the study period. Of 7,005 original articles, 1,330 (19.0%) had female first authors. Affiliations located in Japan (adjusted odds ratio [aOR], 0.76; 95% confidence interval [CI], 0.71-0.81), concurrent first and corresponding authors (aOR, 0.69; 95% CI, 0.64-0.74), and the total number of listed authors (aOR, 0.97; 95% CI, 0.95-0.99) were negatively associated with female first authors. The adjusted probability of a female first author increased from 13% to 20% on an average between 2006 and 2009, but the increase reached a plateau after 2010.Female first authors of original research articles published in Japanese cardiovascular journals increased over the examined decade. However, the representation of women is still low and has plateaued in recent years. A gender gap in authorship for Japanese cardiovascular journals remains.

Did the American Academy of Orthopaedic Surgeons osteoarthritis guidelines miss the mark?

Science.gov (United States)

Bannuru, Raveendhara R; Vaysbrot, Elizaveta E; McIntyre, Louis F

2014-01-01

The American Academy of Orthopaedic Surgeons (AAOS) 2013 guidelines for knee osteoarthritis recommended against the use of viscosupplementation for failing to meet the criterion of minimum clinically important improvement (MCII). However, the AAOS's methodology contained numerous flaws in obtaining, displaying, and interpreting MCII-based results. The current state of research on MCII allows it to be used only as a supplementary instrument, not a basis for clinical decision making. The AAOS guidelines should reflect this consideration in their recommendations to avoid condemning potentially viable treatments in the context of limited available alternatives. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Modifiable Factors Associated with Cognitive Impairment in 1,143 Japanese Outpatients: The Project in Sado for Total Health (PROST

Directory of Open Access Journals (Sweden)

Kaori Kitamura

2016-08-01

Full Text Available Background/Aims: Evidence on modifiable factors associated with cognitive impairment in Japanese patients is scarce. This study aimed to determine modifiable factors for cognitive impairment in a Japanese hospital-based population. Methods: Subjects of this cross-sectional study were 1,143 patients of Sado General Hospital (Niigata, Japan registered in the Project in Sado for Total Health (PROST between June 2008 and September 2014. We assessed disease history, body mass index (BMI, leisure time physical activity, walking time, smoking and drinking habits, and consumption of vegetables, fruits, and green tea as predictors, with cognitive impairment defined by the Mini-Mental State Examination (score Results: The mean subject age was 68.9 years, and the prevalence of cognitive impairment was 21.5%. Multivariate analysis revealed that age (p Conclusions: Modifiable factors, such as low BMI, low fruit consumption, and low green tea consumption, are associated with cognitive impairment. Longitudinal studies will be needed to confirm these findings.

No meaningful association of neighborhood food store availability with dietary intake, body mass index, or waist circumference in young Japanese women.

Science.gov (United States)

Murakami, Kentaro; Sasaki, Satoshi; Takahashi, Yoshiko; Uenishi, Kazuhiro

2010-08-01

The affordability of food is considered as an important factor influencing people's diet and hence health status. The objective of this cross-sectional study was to test the hypothesis that neighborhood food store availability is associated with some aspects of dietary intake and thus possibly with body mass index (BMI) and waist circumference in young Japanese women. Subjects were 989 female Japanese dietetic students 18 to 22 years of age. Neighborhood food store availability was defined as the number of food stores within a 0.5-mile (0.8-km) radius of residence (meat stores, fish stores, fruit and vegetable stores, confectionery stores/bakeries, rice stores, convenience stores, and supermarkets/grocery stores). Dietary intake was estimated using a validated, comprehensive self-administered diet history questionnaire. No association was seen between any measure of neighborhood food store availability and dietary intake, except for a positive association between confectionery and bread availability (based on confectionery stores/bakeries, convenience stores, and supermarkets/grocery stores) and intake of these items (P for trend = .02). Further, no association was seen for BMI or waist circumference, except for an inverse relationship between availability of convenience stores and BMI and a positive relationship between store availability for meat (meat stores and supermarkets/grocery stores) and fish (fish stores and supermarkets/grocery stores) and waist circumference. In conclusion, this study of young Japanese women found no meaningful association between neighborhood food store availability and dietary intake, BMI, or waist circumference, with the exception of a positive relationship between availability and intake for confectionery and bread. Copyright © 2010 Elsevier Inc. All rights reserved.

The dilemma for Japanese students

DEFF Research Database (Denmark)

Martinsen, Anders

2014-01-01

The Japanese job hunting system inhibits Japanese students from studying abroad. A Japanese professor says it is a huge dilemma for the students.......The Japanese job hunting system inhibits Japanese students from studying abroad. A Japanese professor says it is a huge dilemma for the students....

The impact of orthopaedic research evidence on health financing in Australia.

Science.gov (United States)

Hua, Martin; Myers, Daniel; Host, Lachlan

2018-05-02

In Australia, approval by the Medical Services Advisory Committee (MSAC) is an important step in the implementation of new health technologies. The MSAC considers health technology assessments (HTA) when submitting a recommendation to the Minister of Health on a new technology's suitability for public funding. Despite being such a critical tool in formulating policy, there has been little scrutiny on the impact of limited evidence on the performance of a national HTA agency's mandate. We aim to determine the proportion of HTAs of orthopaedic technologies prepared for the MSAC that were supported by higher levels of evidence for effectiveness, and whether this affected the MSAC's ability to conclude on efficacy. We also investigated whether the availability of higher level evidence affected the performance of cost-effectiveness analyses. We performed a cohort study of all HTAs prepared for the MSAC from 1998 to 2017 with regards to new technologies in orthopaedic surgery. We identified seven HTAs encompassing nine orthopaedic technologies for inclusion. Higher levels of evidence were available for assessing the technology's effectiveness in six out of the nine technologies. The results did not show a statistically significant relationship between the availability of higher level evidence and MSAC's ability to make a clear conclusion on the assessment of effectiveness (P = 0.5). The proportion of HTAs where a cost-effectiveness analysis was performed was significantly higher (P decision-making.

[Understanding the symbolic values of Japanese onomatopoeia: comparison of Japanese and Chinese speakers].

Science.gov (United States)

Haryu, Etsuko; Zhao, Lihua

2007-10-01

Do non-native speakers of the Japanese language understand the symbolic values of Japanese onomatopoeia matching a voiced/unvoiced consonant with a big/small sound made by a big/small object? In three experiments, participants who were native speakers of Japanese, Japanese-learning Chinese, or Chinese without knowledge of the Japanese language were shown two pictures. One picture was of a small object making a small sound, such as a small vase being broken, and the other was of a big object making a big sound, such as a big vase being broken. Participants were presented with two novel onomatopoetic words with voicing contrasts, e.g.,/dachan/vs./tachan/, and were told that each word corresponded to one of the two pictures. They were then asked to match the words to the corresponding pictures. Chinese without knowledge of Japanese performed only at chance level, whereas Japanese and Japanese-learning Chinese successfully matched a voiced/unvoiced consonant with a big/small object respectively. The results suggest that the key to understanding the symbolic values of voicing contrasts in Japanese onomatopoeia is some basic knowledge that is intrinsic to the Japanese language.

Polycystic ovary syndrome: association of a C/T single nucleotide polymorphism at tyrosine kinase domain of insulin receptor gene with pathogenesis among lean Japanese women.

Science.gov (United States)

Kashima, Katsunori; Yahata, Tetsuro; Fujita, Kazuyuki; Tanaka, Kenichi

2013-01-01

To assess whether the insulin receptor (INSR) gene contributes to genetic susceptibility to polycystic ovary syndrome (PCOS) in a Japanese population. We ex-amined the frequency of the His 1058 C/T single nucleotide polymorphism (SNP) found in exon 17 of the INSR gene in 61 Japanese PCOS patients and 99 Japanese healthy controls. In addition, we analyzed the association between the genotype of this SNP and the clinical phenotypes. The frequency of the C/C genotype was not significantly different between all PCOS patients (47.5%) and controls (35.4%). However, among the lean cases (body mass index PCOS patients (65.0%) as compared with controls (36.6%). We concluded that the His 1058 C/T polymorphism at the tyrosine kinase domain of the INSR gene had a relationship to the pathogenesis of lean PCOS patients in a Japanese population.

Socioeconomic status is significantly associated with dietary salt intakes and blood pressure in Japanese workers (J-HOPE Study).

Science.gov (United States)

Miyaki, Koichi; Song, Yixuan; Taneichi, Setsuko; Tsutsumi, Akizumi; Hashimoto, Hideki; Kawakami, Norito; Takahashi, Masaya; Shimazu, Akihito; Inoue, Akiomi; Kurioka, Sumiko; Shimbo, Takuro

2013-03-11

The association of socioeconomic status (SES) with nutrients intakes attracts public attention worldwide. In the current study, we examined the associations of SES with dietary salt intake and health outcomes in general Japanese workers (2,266) who participated in this Japanese occupational cohort. SES was assessed by a self-administered questionnaire. Dietary intakes were assessed with a validated, brief, self-administered diet history questionnaire (BDHQ). Multiple linear regression and stratified analysis were used to evaluate the associations of salt intake with the confounding factors. Education levels and household incomes were significantly associated with salt intake, as well as blood pressures (P < 0.05). After adjusting for age, sex and total energy intake, both years of education and household income significantly affect the salt intake (for education, β = -0.031, P = 0.040; for household income, β = -0.046, P = 0.003). SES factors also affect the risk of hypertension, those subjects with higher levels of education or income had lower risk to become hypertensive (ORs for education was 0.904, P < 0.001; ORs for income was 0.956, P = 0.032). Our results show that SES is an independent determinant of salt intake and blood pressure, in order to lower the risk of hypertension, the efforts to narrow the social status gaps should be considered by the health policy-makers.

A Perspective on the Effect of the 80-Hour Work Week: Has It Changed the Graduating Orthopaedic Resident?

Science.gov (United States)

Pellegrini, Vincent D

2017-06-01

Orthopaedic residency education has changed substantially in recent decades because of the imposition of the 80-hour work week, a decrease in quality and quantity of general surgical education, regulations mandating closer trainee supervision, and an expansion of orthopaedic subspecialty rotations. These factors pose a challenge in efforts to prepare competent, confident, cautious, caring, and communicative orthopaedic residents within the traditional 5-year program. Evidence suggests that contemporary graduates are more intelligent, better balanced in life and work, and more in touch with humanistic aspects of medicine than were earlier graduates. Yet insufficient competence and confidence in surgical skills after residency and a lack of "ownership" of patient care have become an increasing concern of educators and trainees. The concept of 10,000 hours of deliberate practice to achieve mastery of a technical skill applies to orthopaedic residency education. A different approach to graduate medical education must address the critical minimum training time required to achieve the necessary skills to support independent medical and surgical practice.

The Japanese Mind: Understanding Contemporary Japanese Culture.

Science.gov (United States)

Davies, Roger J., Ed.; Ikeno, Osamu, Ed.

This collection of essays offers an overview of contemporary Japanese culture, and can serve as a resource for classes studying Japan. The 28 essays offer an informative, accessible look at the values, attitudes, behavior patterns, and communication styles of modern Japan from the unique perspective of the Japanese people. Filled with examples…

Rearticulating Japanese Cinematic Style : Exemplified by Contemporary Japanese Melodrama

OpenAIRE

Syversen, Robin

2011-01-01

Japanese cinema has always been valued by film theorists as an alternative filmic expression of the highest quality. Nevertheless, Japanese cinema is never described with the same respect as European and American filmic paradigms. Classical cinema, Russian montage, German expressionism, Italian neorealism and the French new wave are all regarded as distinctive filmic paradigms of their time. So why isn’t Japanese cinema discussed with the same reverence as above mentioned paradigms? ...

A Case of Acromioclavicular Joint Dislocation Associated with Coracoid Process Fracture.

Science.gov (United States)

Nakamura, Yosuke; Gotoh, Masafumi; Mitsui, Yasuhiro; Shirachi, Isao; Yoshikawa, Eiichiro; Uryu, Takuya; Murakami, Hidetaka; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto

2015-01-01

Rupture of any two or more parts of the superior shoulder suspensory complex (SSSC) including the distal clavicle, acromion, coracoid process, glenoid cavity of the scapula, acromioclavicular ligament, and coracoclavicular ligament is associated with shoulder girdle instability and is an indication for surgery. Here we report a case of acromioclavicular joint dislocation associated with coracoid process fracture. A 48-year-old man sustained a hard blow to the left shoulder from a fall, and simple radiography detected a coracoid process fracture and acromioclavicular joint dislocation. The injury consisted of a rupture of two parts of the SSSC. For the coracoid process fracture, osteosynthesis was performed using hollow cancellous bone screws. For the acromioclavicular joint dislocation, hook plate fixation and the modified Neviaser's procedure were performed. The bone healed well 5 months after surgery, at which time the screws were removed. At 18 months after initial surgery, the coracoid process fracture had healed with a 10% rate of dislocation on radiography, and the patient currently has no problem performing daily activities, no range of motion limitations, and a Japanese Orthopaedic Association scale score of 93.

Language, Culture and Ethnicity: Interplay of Ideologies within a Japanese Community in Brazil

Science.gov (United States)

Sakuma, Tomoko

2011-01-01

This dissertation is a sociolinguistic study of the ideologies about language, culture and ethnicity among Japanese immigrants and descendants in Brazil (hereafter, Nikkeis) who gather at a local Japanese cultural association, searching for what it means to be "Japanese" in Brazil. This study focuses on how linguistic behaviors are…

Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

Science.gov (United States)

Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

2012-07-01

A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

Prospective assessment of NSAIDs induced ADRs in orthopaedic in-patients

Directory of Open Access Journals (Sweden)

Padmanabha TS, Bhaskara K, Nandini T

2014-04-01

Full Text Available Background and Objectives: nonsteroidal anti-inflammatory drugs (NSAIDs are one among the most widely used medications to treat pain and inflammation condition. But inadvertent use of NSAIDs have resulted in gastric upset and even death. Hence to minimize such consequences and to identify the incidence of the Adverse drug reaction (ADRs due to NSAIDs in orthopaedic in-patients to promote rational prescribing. Materials and Methods: A prospective study was done in one hundred orthopaedic in-patients of a tertiary care hospital for 3 months from June-Augest 2012. The ADRs pattern were noted with respect to age, gender and drugs involved . The causality of ADRs were assessed by Naranjo’s Algorithm. Results: Among one hundred in- patients 16% developed ADR due to NSAIDs and 1.92% due to Antimicrobial agents (AMAs. The ADRs were more in males (11% than females (5%. Most prescribed NSAID was Diclofenac (76 %, and least was nimesulide (2%. Others were Paracetamol (16%, Ibuprofen (3% and Etoricoxib (3% . Out of 16 ADRs Tablet (Tab Diclofenac accounted for maximum number {87.5%, (n=14} of ADRs, followed by Tab. Paracetamol {12.5 % (n=2}. Conclusion: ADR incidence rate in orthopaedic in-patient due to NSAIDs was 16%. Educating, establishment and encouragement of Pharmacovigilance system among medical and non-health professionals including medical undergraduates improve ADRs identification and to identify the drugs causing it, therefore prolonged hospitalization, treatment cost, morbidity and mortalities can be minimized. Hence, further ADRs due to particular drugs can be reduced in other patients with rational prescription.

Evaluation of the content and accessibility of web sites for accredited orthopaedic sports medicine fellowships.

Science.gov (United States)

Mulcahey, Mary K; Gosselin, Michelle M; Fadale, Paul D

2013-06-19

The Internet is a common source of information for orthopaedic residents applying for sports medicine fellowships, with the web sites of the American Orthopaedic Society for Sports Medicine (AOSSM) and the San Francisco Match serving as central databases. We sought to evaluate the web sites for accredited orthopaedic sports medicine fellowships with regard to content and accessibility. We reviewed the existing web sites of the ninety-five accredited orthopaedic sports medicine fellowships included in the AOSSM and San Francisco Match databases from February to March 2012. A Google search was performed to determine the overall accessibility of program web sites and to supplement information obtained from the AOSSM and San Francisco Match web sites. The study sample consisted of the eighty-seven programs whose web sites connected to information about the fellowship. Each web site was evaluated for its informational value. Of the ninety-five programs, fifty-one (54%) had links listed in the AOSSM database. Three (3%) of all accredited programs had web sites that were linked directly to information about the fellowship. Eighty-eight (93%) had links listed in the San Francisco Match database; however, only five (5%) had links that connected directly to information about the fellowship. Of the eighty-seven programs analyzed in our study, all eighty-seven web sites (100%) provided a description of the program and seventy-six web sites (87%) included information about the application process. Twenty-one web sites (24%) included a list of current fellows. Fifty-six web sites (64%) described the didactic instruction, seventy (80%) described team coverage responsibilities, forty-seven (54%) included a description of cases routinely performed by fellows, forty-one (47%) described the role of the fellow in seeing patients in the office, eleven (13%) included call responsibilities, and seventeen (20%) described a rotation schedule. Two Google searches identified direct links for

Statistical associations between radiation exposure and the clinical examination data of Japanese radiology technicians

International Nuclear Information System (INIS)

Kondo, Hisayoshi; Okumura, Yutaka; Aoyama, Takashi; Sugahara, Tsutomu; Hashimoto, Tetsuaki; Yamamoto, Yoichi.

1995-01-01

The associations between occupational irradiation, cigarette smoking, alcohol drinking and clinical examination data were investigated in Japanese male radiology technicians. The number of investigated examination items was 35, including 29 biochemical serum test, four hematological tests and systolic and diastolic blood pressure. The associations with each factor were evaluated using the multiple linear regression model. As single factors, radiation associated with urea nitrogen, alkaline phosphatase, monoamine oxidase and leukocyte count (four items), smoking associated with albumin-globulin index, zinc sulfate turbidity test, urea nitrogen, creatinine, neutral fat, amylase, serum iron, leukocyte count, hemoglobin and hematocrit (10 items), and drinking associated with creatinine, uric acid, glutamate oxaloacetate transaminase, leucine aminopeptidase, alkaline phosphatase and erythrocyte count (six items). As synergistic factors, the combination of radiation and smoking associated with nine items, radiation and drinking 10 items, smoking and drinking four items, and radiation, smoking and drinking two items. These results suggested that the number of items which radiation associated as single-factor were less than that of smoking and of drinking, however suggested that associations between radiation and examination data was synergistic when combined with smoking or drinking. (author)

Statistical associations between radiation exposure and the clinical examination data of Japanese radiology technicians

Energy Technology Data Exchange (ETDEWEB)

Kondo, Hisayoshi; Okumura, Yutaka [Nagasaki Univ. (Japan). School of Medicine; Aoyama, Takashi; Sugahara, Tsutomu; Hashimoto, Tetsuaki; Yamamoto, Yoichi

1995-06-01

The associations between occupational irradiation, cigarette smoking, alcohol drinking and clinical examination data were investigated in Japanese male radiology technicians. The number of investigated examination items was 35, including 29 biochemical serum test, four hematological tests and systolic and diastolic blood pressure. The associations with each factor were evaluated using the multiple linear regression model. As single factors, radiation associated with urea nitrogen, alkaline phosphatase, monoamine oxidase and leukocyte count (four items), smoking associated with albumin-globulin index, zinc sulfate turbidity test, urea nitrogen, creatinine, neutral fat, amylase, serum iron, leukocyte count, hemoglobin and hematocrit (10 items), and drinking associated with creatinine, uric acid, glutamate oxaloacetate transaminase, leucine aminopeptidase, alkaline phosphatase and erythrocyte count (six items). As synergistic factors, the combination of radiation and smoking associated with nine items, radiation and drinking 10 items, smoking and drinking four items, and radiation, smoking and drinking two items. These results suggested that the number of items which radiation associated as single-factor were less than that of smoking and of drinking, however suggested that associations between radiation and examination data was synergistic when combined with smoking or drinking. (author).

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

At present the program has a total of 29 clinics, which .... Thus a total of 1154 paediatric orthopaedic operations were known to have taken place in Malawi during the 10th year of operational services with 53% of cases being performed at BCIH. ... regional hip replacement course, 1 regional knee replacement course for ...

The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014.

Science.gov (United States)

Ng, Colin; Mifsud, Max; Borg, Joseph N; Mizzi, Colin

2015-11-20

The purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries. Our aims were to assess acute outcomes and short term mortality of surgery within the perspective of a damage control orthopaedic strategy whereby aggressive wound management, early fixation using relative stability principles, antibiotic cover with adequate soft tissue cover are paramount. We also aim to describe the variety of war injuries we came across, with a goal for future improvement in regards to service providing. Prospective collection of six interesting cases with severe limb and spinal injuries sustained in Libya during the Libyan civil war between June and November 2014. We applied current trends in the treatment of war injuries, specifically in damage control orthopaedic strategy and converting to definitive treatment where permissible. The majority of our cases were classified as most severe (Type IIIB/C) according to the Gustilo-Anderson classification of open fractures. The injuries treated reflected the type of standard and improved weaponry available in modern warfare affecting both militants and civilians alike with increasing severity and extent of damage. Due to this fact, multidisciplinary team approach to patient centred care was utilised with an ultimate aim of swift recovery and early mobilisation. It also highlighted the difficulties and complex issues required on a hospital management level as a neighbouring country to war zone countries in transforming care of civil trauma to military trauma.

The effect of inclement weather on trauma orthopaedic workload.

LENUS (Irish Health Repository)

Cashman, J P

2012-01-31

BACKGROUND: Climate change models predict increasing frequency of extreme weather. One of the challenges hospitals face is how to make sure they have adequate staffing at various times of the year. AIMS: The aim of this study was to examine the effect of this severe inclement weather on hospital admissions, operative workload and cost in the Irish setting. We hypothesised that there is a direct relationship between cold weather and workload in a regional orthopaedic trauma unit. METHODS: Trauma orthopaedic workload in a regional trauma unit was examined over 2 months between December 2009 and January 2010. This corresponded with a period of severe inclement weather. RESULTS: We identified a direct correlation between the drop in temperature and increase in workload, with a corresponding increase in demand on resources. CONCLUSIONS: Significant cost savings could be made if these injuries were prevented. While the information contained in this study is important in the context of resource planning and staffing of hospital trauma units, it also highlights the vulnerability of the Irish population to wintery weather.

Association between a C8orf13-BLK polymorphism and polymyositis/dermatomyositis in the Japanese population: an additive effect with STAT4 on disease susceptibility.

Science.gov (United States)

Sugiura, Tomoko; Kawaguchi, Yasushi; Goto, Kanako; Hayashi, Yukiko; Gono, Takahisa; Furuya, Takefumi; Nishino, Ichizo; Yamanaka, Hisashi

2014-01-01

Accumulating evidence has shown that several non-HLA genes are involved in the susceptibility to polymyositis/dermatomyositis. This study aimed to investigate the involvement of C8orf13-BLK, one of the strongest candidate genes for autoimmune diseases, in susceptibility to polymyositis/dermatomyositis in the Japanese population. A possible gene-gene interaction between C8orf13-BLK and STAT4, which we recently showed to be associated with Japanese polymyositis/dermatomyositis, was also analyzed. A single-nucleotide polymorphism in C8orf13-BLK (dbSNP ID: rs13277113) was investigated in the Japanese population using a TaqMan assay in 283 polymyositis patients, 194 dermatomyositis patients, and 656 control subjects. The C8orf13-BLK rs13277113A allele was associated with overall polymyositis/dermatomyositis (Prs7574865 T alleles had an additive effect on polymyositis/dermatomyositis susceptibility. The strongest association was observed in dermatomyositis, with an OR of 3.07 (95% CI; 1.57-6.02) for the carriers of four risk alleles at the two SNP sites, namely, rs1327713 and rs7574865. This study established C8orf13-BLK as a new genetic susceptibility factor for polymyositis/dermatomyositis. Both C8orf13-BLK and STAT4 exert additive effects on disease susceptibility. These observations suggested that C8orf13-BLK, in combination with STAT4, plays a pivotal role in creating genetic susceptibility to polymyositis/dermatomyositis in Japanese individuals.

Most American Academy of Orthopaedic Surgeons' online patient education material exceeds average patient reading level.

Science.gov (United States)

Eltorai, Adam E M; Sharma, Pranav; Wang, Jing; Daniels, Alan H

2015-04-01

Advancing health literacy has the potential to improve patient outcomes. The American Academy of Orthopaedic Surgeons' (AAOS) online patient education materials serve as a tool to improve health literacy for orthopaedic patients; however, it is unknown whether the materials currently meet the National Institutes of Health/American Medical Association's recommended sixth grade readability guidelines for health information or the mean US adult reading level of eighth grade. The purposes of this study were (1) to evaluate the mean grade level readability of online AAOS patient education materials; and (2) to determine what proportion of the online materials exceeded recommended (sixth grade) and mean US (eighth grade) reading level. Reading grade levels for 99.6% (260 of 261) of the online patient education entries from the AAOS were analyzed using the Flesch-Kincaid formula built into Microsoft Word software. Mean grade level readability of the AAOS patient education materials was 9.2 (SD ± 1.6). Two hundred fifty-one of the 260 articles (97%) had a readability score above the sixth grade level. The readability of the AAOS articles exceeded the sixth grade level by an average of 3.2 grade levels. Of the 260 articles, 210 (81%) had a readability score above the eighth grade level, which is the average reading level of US adults. Most of the online patient education materials from the AAOS had readability levels that are far too advanced for many patients to comprehend. Efforts to adjust the readability of online education materials to the needs of the audience may improve the health literacy of orthopaedic patients. Patient education materials can be made more comprehensible through use of simpler terms, shorter sentences, and the addition of pictures. More broadly, all health websites, not just those of the AAOS, should aspire to be comprehensible to the typical reader.

Association between depressive symptoms and morningness-eveningness, sleep duration and rotating shift work in Japanese nurses.

Science.gov (United States)

Togo, Fumiharu; Yoshizaki, Takahiro; Komatsu, Taiki

2017-01-01

Higher depressive symptoms have been reported in rotating shift workers compared with day workers. Depressive symptoms in adults who do not engage in night work have also been shown to be associated with chronotype and sleep duration. This study examines associations between depressive symptoms, morningness-eveningness (i.e. the degree to which people prefer to be active in the morning or the evening), sleep duration and rotating shift work. Japanese nurses (1252 day workers and 1780 rotating shift workers, aged 20-59) were studied using a self-administered questionnaire. The questionnaire covered depressive symptoms, morningness-eveningness, sleep habits and demographic characteristics of the participants. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the levels of depressive symptoms. A Japanese version of the Morningness-Eveningness Questionnaire (MEQ) was used to measure morningness-eveningness. The CES-D score of shift workers was significantly (p shift workers than in day workers. Sleep duration on the day shift was significantly (p shift workers than in day workers. Simple linear regression revealed that the MEQ score, sleep duration on the day shift and current work shift (i.e. rotating shift work) were significantly (p shift work was not. These associations between the MEQ score, the sleep duration and the CES-D score were also confirmed in both day workers and shift workers when the groups were analyzed separately. These results suggest that greater eveningness and shorter sleep duration on the day shift were independently associated with higher levels of depressive symptoms, which may explain associations between rotating shift workers and depressive symptoms. These findings have important implications for the development of novel strategies for preventing poor mental health in day workers and rotating shift workers.

HLA-DQB1*03 confers susceptibility to chronic hepatitis C in Japanese: a genome-wide association study.

Directory of Open Access Journals (Sweden)

Daiki Miki

Full Text Available Hepatitis C virus (HCV establishes a chronic infection in 70-80% of infected individuals. Many researchers have examined the effect of human leukocyte antigen (HLA on viral persistence because of its critical role in the immune response against exposure to HCV, but almost all studies have proven to be inconclusive. To identify genetic risk factors for chronic HCV infection, we analyzed 458,207 single nucleotide polymorphisms (SNPs in 481 chronic HCV patients and 2,963 controls in a Japanese cohort. Next, we performed a replication study with an independent panel of 4,358 cases and 1,114 controls. We further confirmed the association in 1,379 cases and 25,817 controls. In the GWAS phase, we found 17 SNPs that showed suggestive association (P < 1 × 10⁻⁵. After the first replication study, we found one intronic SNP in the HLA-DQ locus associated with chronic HCV infection, and when we combined the two studies, the association reached the level of genome-wide significance. In the second replication study, we again confirmed the association (P(combined = 3.59 × 10⁻¹⁶, odds ratio [OR] = 0.79. Subsequent analysis revealed another SNP, rs1130380, with a stronger association (OR=0.72. This nucleotide substitution causes an amino acid substitution (R55P in the HLA-DQB1 protein specific to the DQB1*03 allele, which is common worldwide. In addition, we confirmed an association with the previously reported IFNL3-IFNL4 locus and propose that the effect of DQB1*03 on HCV persistence might be affected by the IFNL4 polymorphism. Our findings suggest that a common amino acid substitution in HLA-DQB1 affects susceptibility to chronic infection with HCV in the Japanese population and may not be independent of the IFNL4 genotype.

High strength, surface porous polyether-ether-ketone for load-bearing orthopaedic implants

Science.gov (United States)

Evans, Nathan T.; Torstrick, F. Brennan; Lee, Christopher S.D.; Dupont, Kenneth M.; Safranski, David L.; Chang, W. Allen; Macedo, Annie E.; Lin, Angela; Boothby, Jennifer M.; Whittingslow, Daniel C.; Carson, Robert A.; Guldberg, Robert E.; Gall, Ken

2015-01-01

Despite its widespread clinical use in load-bearing orthopaedic implants, polyether-ether-ketone (PEEK) is often associated with poor osseointegration. In this study, a surface porous PEEK material (PEEK-SP) was created using a melt extrusion technique. The porous layer thickness was 399.6±63.3 µm and possessed a mean pore size of 279.9±31.6 µm, strut spacing of 186.8±55.5 µm, porosity of 67.3±3.1%, and interconnectivity of 99.9±0.1%. Monotonic tensile tests showed that PEEK-SP preserved 73.9% of the strength (71.06±2.17 MPa) and 73.4% of the elastic modulus (2.45±0.31 GPa) of as-received, injection molded PEEK. PEEK-SP further demonstrated a fatigue strength of 60.0 MPa at one million cycles, preserving 73.4% of the fatigue resistance of injection molded PEEK. Interfacial shear testing showed the pore layer shear strength to be 23.96±2.26 MPa. An osseointegration model in the rat revealed substantial bone formation within the pore layer at 6 and 12 weeks via µCT and histological evaluation. Ingrown bone was more closely apposed to the pore wall and fibrous tissue growth was reduced in PEEK-SP when compared to non-porous PEEK controls. These results indicate that PEEK-SP could provide improved osseointegration while maintaining the structural integrity necessary for load-bearing orthopaedic applications. PMID:25463499

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

Science.gov (United States)

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the

Associations between Japanese schoolchildren's involvement in at-home meal preparation, their food intakes, and cooking skills

OpenAIRE

Nozue, Miho; Ishida, Hiromi; Hazano, Sayaka; Nakanishi, Akemi; Yamamoto, Taeko; Abe, Aya; Nishi, Nobuo; Yokoyama, Tetsuji; Murayama, Nobuko

2016-01-01

BACKGROUND/OBJECTIVES This study aimed to examine the association of Japanese schoolchildren's involvement in at-home meal preparation with food intake and cooking skill. SUBJECTS/METHODS We included 1,207 fifth-grade children aged 10-11 years and one parent of each child. A cross-sectional survey was used to collect data on involvement in at-home meal preparation. Correspondence analysis was used to classify involvement in at-home meal preparation into three groups: food-related activities (...

The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics.

Science.gov (United States)

Bozic, Kevin J; Smith, Amanda R; Hariri, Sanaz; Adeoye, Sanjo; Gourville, John; Maloney, William J; Parsley, Brian; Rubash, Harry E

2007-05-01

Direct-to-consumer advertising (DTCA) has become an influential factor in healthcare delivery in the United States. We evaluated the influence of DTCA on surgeon and patient opinions and behavior in orthopaedics by surveying orthopaedic surgeons who perform hip and knee arthroplasties and patients who were scheduled to have hip or knee arthro-plasty. Respondents were asked for their opinions of and experiences with DTCA, including the influence of DTCA on surgeon and patient decision making. Greater than 98% of surgeon respondents had experience with patients who were exposed to DTCA. The majority of surgeon respondents reported DTCA had an overall negative impact on their practice and their interaction with patients (74%), and their patients often were confused or misinformed about the appropriate treatment for their condition based on an advertisement (77%). Fifty-two percent of patient respondents recalled seeing or hearing advertisements related to hip or knee arthroplasty. These patients were more likely to request a specific type of surgery or brand of implant from their surgeon and to see more than one surgeon before deciding to have surgery. Direct-to-consumer advertising seems to play a substantial role in surgeon and patient decision making in orthopaedics. Future efforts should be aimed at improving the quality and accuracy of information contained in consumer-directed advertisements related to orthopaedic implants and procedures.

Gender Differences in Pediatric Orthopaedics: What Are the Implications for the Future Workforce?

Science.gov (United States)

Amoli, Marielle A; Flynn, John M; Edmonds, Eric W; Glotzbecker, Michael P; Kelly, Derek M; Sawyer, Jeffrey R

2016-09-01

Although the number of women in surgical specialties has increased dramatically over the past two decades, little research exists regarding how a surgeon's gender impacts job selection and practice models. Because the number of women specializing in pediatric orthopaedics continues to increase, it is important to understand how one's gender affects practice choices and how this may affect the future workforce. (1) Among pediatric orthopaedic surgeons, is gender associated with choice of practice type (academic, private practice, hospital-based, solo)? (2) For men and women, what are the most common reasons for choosing a job? (3) For new graduates, do men and women have equal starting salaries? (4) Do men have a higher chance of getting job offers? (5) Is there a difference in workload (call frequency and surgical case volume) for men and women? (6) Finally, is there a difference in imminent retirement plans for men and women? The 2015 Pediatric Orthopaedic Society of North American (POSNA) Needs Assessment Survey was sent to POSNA members and a special 36-question survey was sent to recent pediatric orthopaedic fellowship graduates. Both surveys included questions about self-reported gender, practice type, reasons for job selection, and call frequency. In addition, the new graduates' survey also included questions about starting salary, job offers, and number of additional fellowships completed. Responses were analyzed by gender. Chi-square and Fisher's exact tests assessed for statistical significance. Among the new graduates, women are more likely to choose academic practice (women: 13 of 18 [72%], men: 21 of 44 [48%], odds ratio [OR], 3.10 [confidence interval {CI}, 0.86-11.10], p women: one of 18 [6%], OR, 0.12 [CI, 0.015-1.001], p job were not different between men and women. Among the new graduates, geography/family considerations were reported as being highly important when selecting a job (men: 33 of 44 [75%], women: 16 of 18 [89%]) followed by academic

Five-year follow-up of a woman with pregnancy and lactation-associated osteoporosis and vertebral fractures

Directory of Open Access Journals (Sweden)

Sato Y

2012-04-01

Full Text Available Jun Iwamoto1, Yoshihiro Sato2, Mitsuyoshi Uzawa3, Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, 2Department of Neurology, Mitate Hospital, Fukuoka, 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the 5-year follow-up of a young woman who developed vertebral fractures after pregnancy and lactation and was treated with active vitamin D hormone. A 32-year-old Japanese woman consulted us because of acute lower back pain caused by L2 and L5 vertebral fractures after pregnancy and lactation. Following cessation of breast-feeding, analgesia, bed rest, and wearing of a hard brace, her lower back pain disappeared within 2 months. After 5 years of treatment with alfacalcidol 1 µg daily, the lumbar spine (L1, L3, L4 bone mineral density increased by 21.4% following vigorous reductions in bone turnover markers. No osteoporotic fractures occurred, and the vertebral fractures healed. The patient experienced no side effects, including hypercalcemia. Thus, the present case report shows long-term changes in bone turnover markers and lumbar spine bone mineral density, as well as long-term safety of alfacalcidol treatment in a young woman with pregnancy and lactation-associated osteoporosis and vertebral fractures.Keywords: young woman, pregnancy, alfacalcidol, bone mineral density, osteoporosis, vertebral fracture

A systematic survey of the quality of research reporting in general orthopaedic journals.

Science.gov (United States)

Parsons, N R; Hiskens, R; Price, C L; Achten, J; Costa, M L

2011-09-01

The poor reporting and use of statistical methods in orthopaedic papers has been widely discussed by both clinicians and statisticians. A detailed review of research published in general orthopaedic journals was undertaken to assess the quality of experimental design, statistical analysis and reporting. A representative sample of 100 papers was assessed for compliance to CONSORT and STROBE guidelines and the quality of the statistical reporting was assessed using a validated questionnaire. Overall compliance with CONSORT and STROBE guidelines in our study was 59% and 58% respectively, with very few papers fulfilling all criteria. In 37% of papers patient numbers were inadequately reported; 20% of papers introduced new statistical methods in the 'results' section not previously reported in the 'methods' section, and 23% of papers reported no measurement of error with the main outcome measure. Taken together, these issues indicate a general lack of statistical rigour and are consistent with similar reviews undertaken in a number of other scientific and clinical research disciplines. It is imperative that the orthopaedic research community strives to improve the quality of reporting; a failure to do so could seriously limit the development of future research.

The Association between Use of Mobile Phones after Lights Out and Sleep Disturbances among Japanese Adolescents: A Nationwide Cross-Sectional Survey

Science.gov (United States)

Munezawa, Takeshi; Kaneita, Yoshitaka; Osaki, Yoneatsu; Kanda, Hideyuki; Minowa, Masumi; Suzuki, Kenji; Higuchi, Susumu; Mori, Junichiro; Yamamoto, Ryuichiro; Ohida, Takashi

2011-01-01

Study Objective: The objective of this study was to examine the association between the use of mobile phones after lights out and sleep disturbances among Japanese adolescents. Design and Setting: This study was designed as a cross-sectional survey. The targets were students attending junior and senior high schools throughout Japan. Sample schools were selected by cluster sampling. Self-reported anonymous questionnaires were sent to schools for all students to fill out. Participants: A total of 95,680 adolescents responded. The overall response rate was 62.9%, and 94,777 questionnaires were subjected to analysis. Intervention: N/A Measurements and Results: Daily mobile phone use, even if only for a brief moment every day, was reported by 84.4%. Moreover, as for use of mobile phones after lights out, 8.3% reported using their mobile phone for calling every day and 17.6% reported using it for sending text messages every day. Multiple logistic regression analysis showed that mobile phone use for calling and for sending text messages after lights out was associated with sleep disturbances (short sleep duration, subjective poor sleep quality, excessive daytime sleepiness, and insomnia symptoms) independent of covariates and independent of each other. Conclusion: This study showed that the use of mobile phones for calling and for sending text messages after lights out is associated with sleep disturbances among Japanese adolescents. However, there were some limitations, such as small effect sizes, in this study. More studies that examine the details of this association are necessary to establish strategies for sleep hygiene in the future. Citation: Munezawa T; Kaneita Y; Osaki Y; Kanda H; Minowa M; Suzuki K; Higuchi S; Mori J; Yamamoto R; Ohida T. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. SLEEP 2011;34(8):1013-1020. PMID:21804663

99m Tc-labeled heparin test in orthopaedic surgery

International Nuclear Information System (INIS)

Bouvier, J.F.; Lafon, J.C.; Colin, M.; Chatelut, J.; Beaubatie, F.

1983-01-01

99m Tc-labeled heparin test was performed for early detection of phlebitis or pulmonary embolism after orthopaedic prothesis. Heparinic treatment and surgery per se were demonstrated to have no effect on the results. If this test demonstrates a statistical difference for pathologic patients, it is of greater value to consider ratio between rates before and after intervention [fr

Orthopaedic Section Poster Presentations (Abstracts OPO1-OPO300).

Science.gov (United States)

2018-01-01

These abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, OPO designates an Orthopaedic Section poster presentation. J Orthop Sports Phys Ther 2018;48(1):A67-A202. doi:10.2519/jospt.2018.48.1.A67.

Variability in Written Japanese: Towards a Sociolinguistics of Script Choice.

Science.gov (United States)

Smith, Janet S.; Schmidt, David L.

1996-01-01

Tests widely-held associations among script types, genres, writers, and target readers via statistical analysis in popular Japanese fiction. Subjects texts to lexical analysis to see whether choice of vocabulary can account for variability in script selection. Finds that Japanese writers fashion their script type choices to specific contexts, as…

The Evolving Treatment Patterns of NCAA Division I Football Players by Orthopaedic Team Physicians Over the Past Decade, 2008-2016.

Science.gov (United States)

Carver, Trevor J; Schrock, John B; Kraeutler, Matthew J; McCarty, Eric C

Previous studies have analyzed the treatment patterns used to manage injuries in National Collegiate Athletic Association (NCAA) Division I football players. Treatment patterns used to manage injuries in NCAA Division I football players will have changed over the study period. Descriptive epidemiology study. Level 5. The head orthopaedic team physicians for all 128 NCAA Division I football teams were asked to complete a survey containing questions regarding experience as team physician, medical coverage of the team, reimbursement issues, and treatment preferences for some of the most common injuries occurring in football players. Responses from the current survey were compared with responses from the same survey sent to NCAA Division I team physicians in 2008. Responses were received from 111 (111/119, 93%) NCAA Division I orthopaedic team physicians in 2008 and 115 (115/128, 90%) orthopaedic team physicians between April 2016 and April 2017. The proportion of team physicians who prefer a patellar tendon autograft for primary anterior cruciate ligament reconstruction (ACLR) increased from 67% in 2008 to 83% in 2016 ( P football players over the study period. In particular, physicians have changed their preferred techniques for ACLR, anterior shoulder stabilization, and PCL reconstruction. Physicians have also become more conservative with pregame Toradol injections. These opinions may help guide treatment decisions and lead to better care of all athletes.

Tribology of total hip arthroplasty prostheses: What an orthopaedic surgeon should know.

Science.gov (United States)

Rieker, Claude B

2016-02-01

Articulating components should minimise the generation of wear particles in order to optimize long-term survival of the prosthesis.A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing for each individual patient.Conventional and highly cross-linked polyethylene articulating either with metal or ceramic, ceramic-on-ceramic and metal-on-metal are the most commonly used bearing combinations.All combinations of bearing surface have their advantages and disadvantages. An appraisal of the individual patient's objectives should be part of the assessment of the best bearing surface. Cite this article: Rieker CB. Tribology of total hip arthroplasty prostheses: what an orthopaedic surgeon should know. EFORT Open Rev 2016;1:52-57. DOI: 10.1302/2058-5241.1.000004.

Association of smoking behavior and socio-demographic factors, work, lifestyle and mental health of Japanese civil servants.

Science.gov (United States)

Hu, Lizhen; Sekine, Michikazu; Gaina, Alexandru; Nasermoaddeli, Ali; Kagamimori, Sadanobu

2007-11-01

Few studies have examined the individual and social impact of smoking behavior in the Japanese population. The purpose of this study was to clarify the association between smoking behavior and socio-demographic factors, lifestyle, mental health and work characteristics of Japanese civil servants. A self-administered questionnaire survey of 1,439 employees (821 men and 618 women) aged 20-64 yr was conducted in a local government department in 2001. The questionnaire included items on socio-demographic factors, education level, grade of employment, lifestyle, affect balance scale, and work characteristics. Smoking status was divided into current smoker, ex-smoker and never smoked. Multiple logistic regression analysis was performed to evaluate the relationship between smoking and the other items. Men presented a higher smoking prevalence rate than women (53.1% vs. 4.9%). In men, a strong relationship between current smoker and advanced age (40 yr or older), low education level, less physical activity, irregular breakfast and negative affect balance was found. Among men with a low education, the prevalence of smoking cessation was significantly lower in comparison to men with a high education. In women, being young (20-29 yr), unmarried (single or other), having a hobby, and irregular breakfast were associated with smoking behavior. Furthermore, smoking cessation was significantly associated with having a hobby and negative affect balance. The above results suggest that socio-demographic, lifestyle and mental health characteristics are independently associated with current smoking. These factors should be considered in smoking cessation policies as program components.

Association of microsatellite polymorphisms of the GPDS1 locus with normal tension glaucoma in the Japanese population

Directory of Open Access Journals (Sweden)

Kayo Nakamura

2009-04-01

Full Text Available Kayo Nakamura1*, Masao Ota2*, Akira Meguro1, et al1Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan; 2Departmentof Legal Medicine, Shinshu University School of Medicine, Matsumoto, Nagano, JapanBackground: To investigate whether the GPDS1 locus, a potential causative locus of pigment-dispersion syndrome, is associated with normal-tension glaucoma (NTG in Japanese patients. Materials and methods: We used polymerase chain reaction amplification with sequencespecific primers to analyze 20 polymorphic microsatellite markers in and around the GPDS1 locus with an automated DNA analyzer and automated fragment detection by fluorescent-based technology. The DNA samples used for these analyses were obtained from ethnicity- and gendermatched patients, including 141 Japanese patients with NTG and 101 healthy controls. Patients exhibiting a comparatively early onset were selected as this suggests that genetic factors may show stronger involvement.Results: One allele of D7S2462 exhibited a frequency that was significantly decreased in NTG cases compared to controls (P = 0.0013, Pc = 0.019, OR = 0.48, 95% CI = 0.30–0.75. Alleles at another six microsatellite loci were positively or negatively associated with NTG, but these associations did not retain statistical significance after Bonferroni correction (P < 0.05, Pc > 0.05.Conclusion: Our study showed a significant association between the GPDS1 locus and NTG, suggesting that there may be some genetic risk factor(s in the development of NTG.Keywords: microsatellite, normal tension glaucoma, glaucoma-related pigment dispersion syndrome, GPDS1, DPP6

Japanese Visit CERN's Jardin d'Enfants

CERN Multimedia

2000-01-01

On 1 November twenty four Japanese teachers from the Association of Private Kindergartens in Osaka visited CERN’s Jardin d’Enfants to exchange experience and learn more about the Swiss educational system. The delegation was lead by Mrs. Nobuko Shirae, President of the Association, and Mr. Takeshi Kakimoto from the Japan Travel Bureau.

Hydrolytic Decomposition in a Polyamide/PDMS Composite for Orthopaedic Usage

Czech Academy of Sciences Publication Activity Database

Sochor, M.; Balík, Karel; Sucharda, Zbyněk; Suchý, Tomáš; Sedláček, R.

2011-01-01

Roč. 14, č. 103 (2011), s. 2-3 ISSN 1429-7248 R&D Projects: GA ČR(CZ) GAP108/10/1457 Institutional research plan: CEZ:AV0Z30460519 Keywords : composite * hydrolic decomposition * orthopaedics Subject RIV: BO - Biophysics http://www.biomat.krakow.pl/gazeta/archiwum/103.pdf

The orthopaedic error index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

Science.gov (United States)

Panesar, Sukhmeet S; Netuveli, Gopalakrishnan; Carson-Stevens, Andrew; Javad, Sundas; Patel, Bhavesh; Parry, Gareth; Donaldson, Liam J; Sheikh, Aziz

2013-11-21

The Orthopaedic Error Index for hospitals aims to provide the first national assessment of the relative safety of provision of orthopaedic surgery. Cross-sectional study (retrospective analysis of records in a database). The National Reporting and Learning System is the largest national repository of patient-safety incidents in the world with over eight million error reports. It offers a unique opportunity to develop novel approaches to enhancing patient safety, including investigating the relative safety of different healthcare providers and specialties. We extracted all orthopaedic error reports from the system over 1 year (2009-2010). The Orthopaedic Error Index was calculated as a sum of the error propensity and severity. All relevant hospitals offering orthopaedic surgery in England were then ranked by this metric to identify possible outliers that warrant further attention. 155 hospitals reported 48 971 orthopaedic-related patient-safety incidents. The mean Orthopaedic Error Index was 7.09/year (SD 2.72); five hospitals were identified as outliers. Three of these units were specialist tertiary hospitals carrying out complex surgery; the remaining two outlier hospitals had unusually high Orthopaedic Error Indexes: mean 14.46 (SD 0.29) and 15.29 (SD 0.51), respectively. The Orthopaedic Error Index has enabled identification of hospitals that may be putting patients at disproportionate risk of orthopaedic-related iatrogenic harm and which therefore warrant further investigation. It provides the prototype of a summary index of harm to enable surveillance of unsafe care over time across institutions. Further validation and scrutiny of the method will be required to assess its potential to be extended to other hospital specialties in the UK and also internationally to other health systems that have comparable national databases of patient-safety incidents.

Burnout in Orthopaedic Surgeons: A Challenge for Leaders, Learners, and Colleagues: AOA Critical Issues.

Science.gov (United States)

Ames, S Elizabeth; Cowan, James B; Kenter, Keith; Emery, Sanford; Halsey, David

2017-07-19

Burnout, depression, suicidal ideation, and dissatisfaction with work-life balance have been reported in all medical specialties and at all stages of medical education and practice experience. Burnout consists of progressive emotional, attitudinal, and physical exhaustion. Physicians with burnout may treat patients as objects and feel emotionally depleted. Burnout is characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment. The most complete study of emotional burnout among different medical specialties demonstrated that orthopaedic surgery is one of the specialties with the highest burnout rate. Qualitative descriptive studies are available. There was a 45.8% burnout rate among physicians in the U.S. in 2012, and a 2014 update suggested even higher rates. Burnout has a correlation with medical education. Burnout rates are similar to those in the general population when medical students enter school, and increase steadily through medical education prior to residency. Burnout rates in residents are high, reported to be between 41% and 74% across multiple specialties. This impacts our young physician workforce in orthopaedics. The purpose of this review is to provide the available information that characterizes burnout and addresses the issues inherent to preventing burnout, and to build awareness in orthopaedic surgeons. Wellness "goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life." The challenge for the orthopaedic community is to develop interventions and strategies that are personalized to the individuals in this specialty.

Association of genetic variants of the incretin-related genes with quantitative traits and occurrence of type 2 diabetes in Japanese

OpenAIRE

Mayumi Enya; Yukio Horikawa; Katsumi Iizuka; Jun Takeda

2014-01-01

Background: None of the high frequency variants of the incretin-related genes has been found by genome-wide association study (GWAS) for association with occurrence of type 2 diabetes in Japanese. However, low frequency and rare and/or high frequency variants affecting glucose metabolic traits remain to be investigated. Method: We screened all exons of the incretin-related genes (GCG, GLP1R, DPP4, PCSK1, GIP, and GIPR) in 96 patients with type 2 diabetes and investigated for association of...

USABILITY TESTING OF JAPANESE CAPTIONS SEGMENTATION SYSTEM TO SCAFFOLD BEGINNERS TO COMPREHEND JAPANESE VIDEOS

Directory of Open Access Journals (Sweden)

Ya-Fei Yang

2013-06-01

Full Text Available A major learning difficulty of Japanese foreign language (JFL learners is the complex composition of two syllabaries, hiragana and katakana, and kanji characters adopted from logographic Chinese ones. As the number of Japanese language learners increases, computer-assisted Japanese language education gradually gains more attention. This study aimed to adopt a Japanese word segmentation system to help JFL learners overcome literacy problems. This study adopted MeCab, a Japanese morphological analyzer and part-of-speech (POS tagger, to segment Japanese texts into separate morphemes by adding spaces and to attach POS tags to each morpheme for beginners. The participants were asked to participate in three experimental activities involvingwatching two Japanese videos with general or segmented Japanese captions and complete the Nielsen’s Attributes of Usability (NAU survey and the After Scenario Questionnaire (ASQ to evaluate the usability of the learning activities. The results of the system evaluation showed that the videos with the segmented captions could increase the participants’ learning motivation and willingness to adopt the word segmentation system to learn Japanese.

Japanese Buddhism, Relativization, and Glocalization

Directory of Open Access Journals (Sweden)

Ugo Dessì

2017-01-01

Full Text Available Within the field of study on Japanese religions, the issue of globalization tends to be associated with the missionary activities of some successful new religious movements, and there is a certain reluctance to approach analytically the dynamics of glocalization/hybridization and the power issues at stake. In this article, I address these and other related problems by taking my cue from the relativizing effects of globalization and a working definition of religion based on the concept of authority. To this aim, I focus on two case studies. The first concerns the ongoing greening of Japanese Buddhism. The second revolves around the adoption of meditational techniques by priests and lay practitioners in Hawaiian Shin Buddhism. My findings show that there are at least four factors underlying the glocalization of Japanese Buddhism, that is, global consciousness, resonance with the local tradition, decontextualization, and quest for power. Moreover, they indicate that it is possible to distinguish between two types of glocalization (glocalization and chauvinistic glocalization and two configurations of glocalization (juxtaposition and integration.

Do developmental orthopaedic disorders influence future jumping performances in Warmblood stallions?

DEFF Research Database (Denmark)

Verwilghen, Denis; Janssens, S; Busoni, V

2013-01-01

REASONS FOR PERFORMING THE STUDY: Few reports are available on the relationship between developmental orthopaedic diseases (DOD) and future performances in Warmblood horses. OBJECTIVES: To investigate the relationship between performance and the presence of DOD lesions. METHODS: Records of Warmbl...

Temporomandibular disorders in growing patients after treatment of class II and III malocclusion with orthopaedic appliances: a systematic review.

Science.gov (United States)

Jiménez-Silva, Antonio; Carnevali-Arellano, Romano; Venegas-Aguilera, Matías; Tobar-Reyes, Julio; Palomino-Montenegro, Hernán

2018-05-01

To determine if the use of orthopaedic appliances in growing patients applied to correct Class II and III malocclusion is related to the development of temporomandibular disorders (TMD). A systematic review was conducted between 1960 and July 2017, based on electronic databases: PubMed, Cochrane Library, Embase, Medline, Scopus, EBSCOhost, Scielo, Lilacs and Bireme. Controlled clinical trials (CCTs) and randomized controlled trials (RCTs) were identified. The articles were selected and analyzed by two authors independently. The quality of the evidence was determined according to the guidelines of the Cochrane Risk Bias Assessment Tool and the Cochrane Quality Study Guide. Seven articles were included, four CCTs and three RCTs. The studies were grouped according to malocclusion treatment in (a) class II appliances (n = 4) and (b) class III appliances (n = 3). The quality of evidence was low due to the high risk of bias, independent of the association reported. All studies concluded that the use of orthopaedic appliances would not contribute to the development of TMD. The quality of evidence available is insufficient to establish definitive conclusions, since the studies were very heterogeneous and presented a high risk of bias. However, it is suggested that the use of orthopaedic appliances to correct class II and III malocclusion in growing patients would not be considered as a risk factor for the development of TMD. High-quality RCTs are required to draw any definitive conclusions.

Efficacy of Bobath versus orthopaedic approach on impairment and function at different motor recovery stages after stroke: a randomized controlled study.

Science.gov (United States)

Wang, Ray-Yau; Chen, Hsiu-I; Chen, Chen-Yin; Yang, Yea-Ru

2005-03-01

To investigate the effectiveness of Bobath on stroke patients at different motor stages by comparing their treatment with orthopaedic treatment. A single-blind study, with random assignment to Bobath or orthopaedic group. Physical therapy department of a medical centre. Twenty-one patients with stroke with spasticity and 23 patients with stroke at relative recovery stages participated. Twenty sessions of Bobath programme or orthopaedic treatment programme given in four weeks. Stroke Impairment Assessment Set (SIAS), Motor Assessment Scale (MAS), Berg Balance Scale (BBS) and Stroke Impact Scale (SIS) for impairment and functional limitation level. Participants with spasticity showed greater improvement in tone control (change score: 1.20 +/- 1.03 versus 0.08 +/- 0.67, p = 0.006), MAS (change score: 7.64 +/- 4.03 versus 4.00 +/- 1.95, p = 0.011), and SIS (change score: 7.30 +/- 6.24 versus 1.25 +/- 5.33, p = 0.023) after 20 sessions of Bobath treatment than with orthopaedic treatment. Participants with relative recovery receiving Bobath treatment showed greater improvement in MAS (change score: 6.14 +/- 5.55 versus 2.77 +/- 9.89, p = 0.007), BBS (change score: 19.18 +/- 15.94 versus 6.85 +/- 5.23, p = 0.015), and SIS scores (change score: 8.50 +/- 3.41 versus 3.62 +/- 4.07, p = 0.006) than those with orthopaedic treatment. Bobath or orthopaedic treatment paired with spontaneous recovery resulted in improvements in impairment and functional levels for patient with stroke. Patients benefit more from the Bobath treatment in MAS and SIS scores than from the orthopaedic treatment programme regardless of their motor recovery stages.

[Management of war orthopaedic injuries in recent armed conflicts].

Science.gov (United States)

Frank, M; Mathieu, L

2013-01-01

The extremities continue to be the most frequent sites of wounding during armed conflicts despite the change of combat tactics, soldier armour and battlefield medical support. Due to the advances in prehospital care and timely transport to the hospital, orthopaedic surgeons deal with severe and challenging injuries of the limbs. In contrast to civilian extremity trauma, the most combat-related injuries are open wounds that often have infection-related complications. Data from two recent large armed conflicts (Iraq, Afghanistan) show that extremity injuries are associated with a high complication rate, morbidity and healthcare utilization. A systematic approach that consists of sequential surgical care and good transport capabilities can reduce the complication rate of these injuries. New medical technologies have been implemented in the treatment strategy during the last decade. This article reviews the published scientific data and current opinions on combat-related extremity injuries. Key words: extremity, combat, trauma, medical support system.

Attitudes towards the Use of Masculine and Feminine Japanese among Foreign Professionals: What Can Learners Learn from Professionals?

Science.gov (United States)

Itakura, Hiroko

2009-01-01

Subordinate femininity associated with feminine Japanese has been found to pose barriers for foreign language learners of Japanese, especially among Western female learners of Japanese. The present study investigates attitudes towards the use of both masculine and feminine Japanese among non-native professional speakers of Japanese. The latter's…

Japanese dreams

DEFF Research Database (Denmark)

Sejrup, Jens

2018-01-01

This paper traces the history of a Japanese-funded annex to the Van Gogh Museum in Amsterdam over the past twenty-five years. The analysis focuses on three key years in the building’s history: 1991, 1999, and 2015. Critically examining public debate and media coverage of the building in contempor......This paper traces the history of a Japanese-funded annex to the Van Gogh Museum in Amsterdam over the past twenty-five years. The analysis focuses on three key years in the building’s history: 1991, 1999, and 2015. Critically examining public debate and media coverage of the building...... in contemporary Dutch- and Japanese-language sources, I argue that changing claims and public perceptions of Japan reflected the country’s shifting economic fortunes and international position during the period. The sources consistently framed the Japanese-designed building within a language of dreams. However...

Biocompatibility of orthopaedic implants on bone forming cells

OpenAIRE

Kapanen, A. (Anita)

2002-01-01

Abstract Reindeer antler was studied for its possible use as a bone implant material. A molecular biological study showed that antler contains a growth factor promoting bone formation. Ectopic bone formation assay showed that antler is not an equally effective inducer as allogenic material. Ectopic bone formation assay was optimised for biocompatibility studies of orthopaedic NiTi implants. Ti-6Al-4V and stainless steel were used as reference materials. The assay...

Clinical application of helical CT 3D reconstruction for the dental orthopaedics

International Nuclear Information System (INIS)

Han Benyi; Jiang Xiaolu; Li Hongru

2005-01-01

Objective: To evaluate the clinical application of helical CT 3D reconstruction technique in the dental orthopaedics. Methods: The helical CT was performed with 3.0 mm slice thickness and 1.0 pitch in 41 patients with dental orthopaedics. The 3D reconstructions, including maximum intensity projection (MIP), surface shaded display (SSD), and multiplanar reconstructions (MPR), were made for all the cases. Results: Thirty-seven of the 41 patients showed malalignment, tilt, rotation, overlap of the teeth and the different space between the longitudinal axes of the teeth. Twenty-five cases of them have shown 36 buried teeth in all. The axial images covered all the information. SSD demonstrated the external contours and entire morphologies of the teeth and the mandible with the relationship of the teeth alignment and the mandible. MIP clearly manifested the full view and the longitudinal alignment of the teeth. Among the 36 buried teeth, there were 29 palatally and 7 labially presented teeth, and they were morphologically delineated on MIP through various angles. Conclusion: The helical CT 3D reconstruction is a new technique to display the stereoscopic configuration of teeth. The combination of axial images and MIP, SSD, and MPR provides valuable anatomic and diagnostic information helpful for the surgeons to structure and determine the treatment protocol for the dental orthopaedics. (authors)

Picture This Character: Using Imagery To Teach a Japanese Syllabary.

Science.gov (United States)

Thompson, Joyce D.; Wakefield, John F.

This study examined the effectiveness of imagery to teach native English speakers to associate hiragana characters (a Japanese script) with the spoken Japanese syllables that the characters represent. Twenty-one adults in a psychology of learning class for teachers were taught to picture a hiragana character in such a way as to establish an…

Orthopaedic Considerations for the Adult With Osteogenesis Imperfecta.

Science.gov (United States)

Roberts, Timothy T; Cepela, Daniel J; Uhl, Richard L; Lozman, Jeffery

2016-05-01

Osteogenesis imperfecta is a heritable group of collagen-related disorders that affects up to 50,000 people in the United States. Although the disease is most symptomatic in childhood, adults with osteogenesis imperfecta also are affected by the sequelae of the disease. Orthopaedic manifestations include posttraumatic and accelerated degenerative joint disease, kyphoscoliosis, and spondylolisthesis. Other manifestations of abnormal collagen include brittle dentition, hearing loss, cardiac valve abnormalities, and basilar invagination. In general, nonsurgical treatment is preferred for management of acute fractures. High rates of malunion, nonunion, and subsequent deformity have been reported with both closed and open treatment. When surgery is necessary, surgeons should opt for load-sharing intramedullary devices that span the entire length of the bone; locking plates and excessively rigid fixation generally should be avoided. Arthroplasty may be considered for active patients, but the procedure frequently is associated with complications in this patient population. Underlying deformities, such as malunion, bowing, rotational malalignment, coxa vara, and acetabular protrusio, pose specific surgical challenges and underscore the importance of preoperative planning.

Self-efficacy, pros, and cons as variables associated with adjacent stages of change for regular exercise in Japanese college students.

Science.gov (United States)

Horiuchi, Satoshi; Tsuda, Akira; Kobayashi, Hisanori; Fallon, Elizabeth A; Sakano, Yuji

2017-07-01

This study examined self-efficacy (confidence to exercise), pros (exercise's advantages), and cons (exercise's disadvantages) as variables associated across the transtheoretical model's six stages of change in 403 Japanese college students. A series of logistic regression analyses were conducted. Results showed that higher pros and lower cons were associated with being in contemplation compared to precontemplation. Lower cons were associated with being in preparation compared to contemplation. Higher self-efficacy was associated with being in action compared to preparation as well as being in maintenance compared to action. Lower cons were associated with being in termination compared to maintenance.

Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

OpenAIRE

R Magetsari; P Dewo; BK Saputro; Z Lanodiyu

2014-01-01

S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistantcompared to the planktonic form. This study was carried out determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 t...

Nanostructured diamond coatings for orthopaedic applications

Science.gov (United States)

CATLEDGE, S.A.; THOMAS, V.; VOHRA, Y.K.

2013-01-01

With increasing numbers of orthopaedic devices being implanted, greater emphasis is being placed on ceramic coating technology to reduce friction and wear in mating total joint replacement components, in order to improve implant function and increase device lifespan. In this chapter, we consider ultra-hard carbon coatings, with emphasis on nanostructured diamond, as alternative bearing surfaces for metallic components. Such coatings have great potential for use in biomedical implants as a result of their extreme hardness, wear resistance, low friction and biocompatibility. These ultra-hard carbon coatings can be deposited by several techniques resulting in a wide variety of structures and properties. PMID:25285213

[Clinical safety and professional liability claims in Orthopaedic Surgery and Traumatology].

Science.gov (United States)

Bori, G; Gómez-Durán, E L; Combalia, A; Trilla, A; Prat, A; Bruguera, M; Arimany-Manso, J

2016-01-01

The specialist in orthopaedic and traumatological surgery, like any other doctor, is subject to the current legal provisions while exercising their profession. Mandatory training in the medical-legal aspects of health care is essential. Claims against doctors are a reality, and orthopaedic and traumatological surgery holds first place in terms of frequency of claims according to the data from the General Council of Official Colleges of Doctors of Catalonia. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey.

Science.gov (United States)

de Sa, Darren; Thornley, Patrick; Evaniew, Nathan; Madden, Kim; Bhandari, Mohit; Ghert, Michelle

2015-01-01

Evidence Based Medicine (EBM) is increasingly being applied to inform clinical decision-making in orthopaedic surgery. Despite the promotion of EBM in Orthopaedic Surgery, the adoption of results from high quality clinical research seems highly unpredictable and does not appear to be driven strictly by randomized trial data. The objective of this study was to pilot a survey to determine if we could identify surgeon opinions on the characteristics of research studies that are perceived as being most likely to influence clinical decision-making among orthopaedic surgeons in Canada. A 28-question electronic survey was distributed to active members of the Canadian Orthopaedic Association (COA) over a period of 11 weeks. The questionnaire sought to analyze the influence of both extrinsic and intrinsic characteristics of research studies and their potential to influence practice patterns. Extrinsic factors included the perceived journal quality and investigator profiles, economic impact, peer/patient/industry influence and individual surgeon residency/fellowship training experiences. Intrinsic factors included study design, sample size, and outcomes reported. Descriptive statistics are provided. Of the 109 members of the COA who opened the survey, 95 (87%) completed the survey in its entirety. The overall response rate was 11% (95/841). Surgeons achieved consensus on the influence of three key designs on their practices: 1) randomized controlled trials 94 (99%), 2) meta-analysis 83 (87%), and 3) systematic reviews 81 (85%). Sixty-seven percent of surgeons agreed that studies with sample sizes of 101-500 or more were more likely to influence clinical practice than smaller studies (n = design influencing adoption included 1) reputation of the investigators (99%) and 2) perceived quality of the journal (75%). Although study design and sample size (i.e. minimum of 100 patients) have some influence on clinical decision making, surgeon respondents are equally influenced

The Anglo-Japanese Alliance and Japanese Expansionism 1902-1923.

Science.gov (United States)

1992-06-05

Alienation 1919-1952. London: Cambridge University Press. 1982. • The Oriains of the Russo-Japanese War. London: Longman Group Limited. 1985. Nitobe ... Inazo . Bushido - The Soul of Japan. Tokyo: Tuttle. 1981. Okamoto, Shumpei. The Japan Oliaarchv and the Russo-Japanese War. New York: Columbia

Direct cellular vs. indirect pager communication during orthopaedic surgical procedures: a prospective study.

Science.gov (United States)

Ortega, Gil R; Taksali, Sudeep; Smart, Ryan; Baumgaertner, Michael R

2009-01-01

Cellular phone use within the hospital setting has increased as physicians, nurses, and ancillary staff incorporate wireless technologies in improving efficiencies, cost, and maintaining patient safety and high quality healthcare [11]. Through the use of wireless, cellular communication, an overall improvement in communication accuracy and efficiency between intraoperative orthopaedic surgeons and floor nurses may be achieved. Both communication types occurred while the surgeon was scrubbed in the operating room (OR). Indirect communication occurred when the pager call was answered by the OR circulating nurse with communication between the surgeon, circulating nurse, and floor nurse. Direct communication consisted of cell phone and Jabra Bluetooth BT200 wireless ear piece used by the surgeon. The surgeon answered the floor nurse's cellular call by phone ring-activated automatic answering. The study was conducted during scheduled orthopaedic procedures. An independent observer measured time variables with a stop-watch while orthopaedic nurses randomly called via pager or cell phone. The nurses asked for patient caregiver confirmation and answers to 30 different patient-care questions. Sixty trials were performed with 30 cell and 30 page communications. Direct cellular communication showed a better response rate than indirect page (Cell 100%, Page 73%). Indirect page communication allowed a 27% and 33% error rate with patient problem and surgeon solution communications, respectively. There were no reported communication errors while using direct wireless, cellular communication. When compared to page communications, cellular communications showed statistically significant improvements in mean time intervals in response time (Cell = 11s, Page = 211s), correct patient identification (Cell = 5s, Page = 172s), patient problem and solution time (Cell = 13s, Page = 189s), and total communication time (Cell = 32s, Page = 250s) (s = seconds, all P < 0.001). Floor nurse

Japanese apricot improves symptoms of gastrointestinal dysmotility associated with gastroesophageal reflux disease.

Science.gov (United States)

Maekita, Takao; Kato, Jun; Enomoto, Shotaro; Yoshida, Takeichi; Utsunomiya, Hirotoshi; Hayashi, Hideyuki; Hanamitsu, Toshiko; Inoue, Izumi; Maeda, Yoshimasa; Moribata, Kosaku; Muraki, Yosuke; Shingaki, Naoki; Deguchi, Hisanobu; Ueda, Kazuki; Iguchi, Mikitaka; Tamai, Hideyuki; Ichinose, Masao

2015-07-14

To investigate the effects of Japanese apricot (JA) consumption on gastroesophageal reflux disease (GERD)-related symptoms. Participants included individuals living in Minabe-cho, a well-known JA-growing region, who received specific medical check-ups by the local community health service in 2010. GERD-related symptoms were examined in 1303 Japanese individuals using a validated questionnaire, the Frequency Scale for Symptoms of GERD (FSSG), which consists of 7 questions associated with acid reflux symptoms and 5 questions asking about gastrointestinal dysmotility symptoms. Each question was answered using a 4-point scale, with higher scores indicating more severe GERD-related symptoms. Subjects were divided into two groups according to their intake of dried and pickled JA: daily intake (≥ 1 JA daily) (392 subjects) and none or occasional intake (reflux score did not differ between subjects with and without daily intake of JA (1.08 ± 1.90 vs 1.24 ± 2.11, P = 0.177). Subanalysis indicated that improvement in dysmotility by JA intake was specifically observed in non-elderly (1.24 ± 1.68 vs 1.62 ± 2.22, P = 0.005) and H. pylori-negative subjects (0.99 ± 1.58 vs 1.57 ± 2.06, P < 0.001). GERD patients (total FSSG score ≥ 8) were less frequently observed among subjects with daily intake of JA as compared to those without daily intake of JA (6.1% vs 9.7%, P = 0.040). Daily JA intake may improve digestive dysmotility symptoms, resulting in relief of GERD symptoms. The effect is more obvious in non-elderly and H. pylori-negative subjects.

Surgical skills simulation in trauma and orthopaedic training

OpenAIRE

Stirling, Euan RB; Lewis, Thomas L; Ferran, Nicholas A

2014-01-01

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in orde...

Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

Science.gov (United States)

Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

2012-04-30

The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

Treating natural disaster victims is dealing with shortages: An orthopaedics perspective.

NARCIS (Netherlands)

Dewo, Punto; Magetsari, Rahadyan; Busscher, Henk J.; van Horn, Jim R.; Verkerke, Gijsbertus Jacob

2008-01-01

During natural disasters such as earthquakes or tsunamis, most of the casualties are known to suffer from musculoskeletal injuries. This leads to an enormous need of orthopaedic (surgical) implants such as osteosynthesis plates, which are difficult to provide in developing countries that rely on

Association of job demands with work engagement of Japanese employees: comparison of challenges with hindrances (J-HOPE).

Science.gov (United States)

Inoue, Akiomi; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Miyaki, Koichi; Takahashi, Masaya; Kurioka, Sumiko; Eguchi, Hisashi; Tsuchiya, Masao; Enta, Kazuhiko; Kosugi, Yuki; Sakata, Tomoko; Totsuzaki, Takafumi

2014-01-01

Recent epidemiological research in Europe has reported that two groups of job demands, i.e., challenges and hindrances, are differently associated with work engagement. The purpose of the present study was to replicate the cross-sectional association of workload and time pressure (as a challenge) and role ambiguity (as a hindrance) with work engagement among Japanese employees. Between October 2010 and December 2011, a total of 9,134 employees (7,101 men and 1,673 women) from 12 companies in Japan were surveyed using a self-administered questionnaire comprising the Job Content Questionnaire, National Institute for Occupational Safety and Health Generic Job Stress Questionnaire, short 10-item version of the Effort-Reward Imbalance Questionnaire, short nine-item version of the Utrecht Work Engagement Scale, and demographic characteristics. Multilevel regression analyses with a random intercept model were conducted. After adjusting for demographic characteristics, workload and time pressure showed a positive association with work engagement with a small effect size (standardized coefficient [β] = 0.102, Cohen's d [d] = 0.240) while role ambiguity showed a negative association with a large effect size (β = -0.429, d = 1.011). After additionally adjusting for job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward), the effect size of workload and time pressure was not attenuated (β = 0.093, d = 0.234) while that of role ambiguity was attenuated but still medium (β = -0.242, d = 0.609). Among Japanese employees, challenges such as having higher levels of workload and time pressure may enhance work engagement but hindrances, such as role ambiguity, may reduce it.

Short barb: a feather structure mutation in Japanese quail.

Science.gov (United States)

Fulton, J E; Roberts, C W; Nichols, C R; Cheng, K M

1982-12-01

A type of feather structure abnormality in Japanese quail resulting in shortened barbs on contour feathers was found to be controlled by a single autosomal recessive gene, sh (short barb). The mutation was first identified in a full-sib family from the University of British Columbia wild type line. Unlike other feather structure mutations in Japanese quail reported previously in literature, the short barb mutation is not associated with poor reproduction.

Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

Science.gov (United States)

Lovati, Arianna B; Drago, Lorenzo; Monti, Lorenzo; De Vecchi, Elena; Previdi, Sara; Banfi, Giuseppe; Romanò, Carlo L

2013-01-01

Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3) colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count), histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy). Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

Directory of Open Access Journals (Sweden)

Arianna B Lovati

Full Text Available BACKGROUND: Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. METHODOLOGY: A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3 colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count, histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy. RESULTS: Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. CONCLUSIONS: Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

Seasonal Patterns of Japanese Encephalitis and Associated Meteorological Factors in Taiwan.

Science.gov (United States)

Lin, Che-Liang; Chang, Hsiao-Ling; Lin, Chuan-Yao; Chen, Kow-Tong

2017-10-29

The persistent transmission of Japanese encephalitis virus (JEV) in Taiwan necessitates exploring the risk factors of occurrence of Japanese encephalitis (JE). The purpose of this study was to assess the relationship between meteorological factors and the incidence of JE in Taiwan. We collected data for cases of JE reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2000 to 2014. Meteorological data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of JE in Taiwan were determined via Poisson regression analysis and a case-crossover methodology. During the 15-year study period, a total of 379 cases of JE were reported. The incidence of JE showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, p Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.

Association of genetic variants of the incretin-related genes with quantitative traits and occurrence of type 2 diabetes in Japanese

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Mayumi Enya

2014-01-01

Conclusion: Rare variants of GIPR may contribute to the development of type 2 diabetes, possibly through insulin secretory defects. Furthermore, the genetic variant of PCSK1 might influence glucose homeostasis by altered insulin resistance independently of BMI, incretin level or proinsulin conversion, and may be associated with the occurrence of type 2 diabetes in Japanese.

Frequency of soup intake and amount of dietary fiber intake are inversely associated with plasma leptin concentrations in Japanese adults.

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Kuroda, Motonaka; Ohta, Masanori; Okufuji, Tatsuya; Takigami, Chieko; Eguchi, Masafumi; Hayabuchi, Hitomi; Ikeda, Masaharu

2010-06-01

Previous studies have shown that the intake of soup negatively correlates with the body mass index (BMI), suggesting that soup intake reduces the risk of obesity. In this study, to clarify the association of the intake of soup and various nutrients with plasma leptin concentration, a cross-sectional study on 504 Japanese adults aged 20-76 years (103 men and 401 women) was performed. The intake of soup and various nutrients was investigated by food frequency questionnaires. Plasma leptin concentration was measured in fasting blood by radioimmunoassay. The correlation was analyzed by multiple regression analysis. The average frequency of soup intake was 7.6 times/week. The average plasma leptin concentration was 7.76 ng/ml. After adjusting the confounding factors, the frequency of soup intake has a significant inverse association with plasma leptin concentration. Among the macronutrients, only dietary fiber intake negatively correlated with plasma leptin concentration after the adjustment for potential confounding factors. These results suggest that the intakes of soup and dietary fiber were negatively correlated with plasma leptin concentration in Japanese adults. Copyright 2010 Elsevier Ltd. All rights reserved.

Statistical Machine Translation of Japanese

Science.gov (United States)

2007-03-01

hiragana and katakana) syllabaries…………………….. 20 3.2 Sample Japanese sentence showing kanji and kana……………………... 21 3.5 Japanese formality example...syllabary. 19 Figure 3.1. Japanese kana syllabaries, hiragana for native Japanese words, word endings, and particles, and katakana for foreign...Figure 3.2. Simple Japanese sentence showing the use of kanji, hiragana , and katakana. Kanji is used for nouns and verb, adjective, and

Comparison of multiple linear regression and artificial neural network in developing the objective functions of the orthopaedic screws.

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Hsu, Ching-Chi; Lin, Jinn; Chao, Ching-Kong

2011-12-01

Optimizing the orthopaedic screws can greatly improve their biomechanical performances. However, a methodical design optimization approach requires a long time to search the best design. Thus, the surrogate objective functions of the orthopaedic screws should be accurately developed. To our knowledge, there is no study to evaluate the strengths and limitations of the surrogate methods in developing the objective functions of the orthopaedic screws. Three-dimensional finite element models for both the tibial locking screws and the spinal pedicle screws were constructed and analyzed. Then, the learning data were prepared according to the arrangement of the Taguchi orthogonal array, and the verification data were selected with use of a randomized selection. Finally, the surrogate objective functions were developed by using either the multiple linear regression or the artificial neural network. The applicability and accuracy of those surrogate methods were evaluated and discussed. The multiple linear regression method could successfully construct the objective function of the tibial locking screws, but it failed to develop the objective function of the spinal pedicle screws. The artificial neural network method showed a greater capacity of prediction in developing the objective functions for the tibial locking screws and the spinal pedicle screws than the multiple linear regression method. The artificial neural network method may be a useful option for developing the objective functions of the orthopaedic screws with a greater structural complexity. The surrogate objective functions of the orthopaedic screws could effectively decrease the time and effort required for the design optimization process. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Cognitive function in Japanese women with posttraumatic stress disorder: Association with exercise habits.

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Narita-Ohtaki, Ryoko; Hori, Hiroaki; Itoh, Mariko; Lin, Mingming; Niwa, Madoka; Ino, Keiko; Imai, Risa; Ogawa, Sei; Sekiguchi, Atsushi; Matsui, Mie; Kunugi, Hiroshi; Kamo, Toshiko; Kim, Yoshiharu

2018-08-15

Posttraumatic stress disorder (PTSD) has been associated with cognitive impairments, yet little is documented on the cognitive function of PTSD patients in Asian countries. It is shown that regular exercise can reduce PTSD symptoms, while no study has investigated the association between exercise and cognition in PTSD patients. This study aimed to examine cognitive functions of Japanese women with PTSD, and to explore the association between regular exercise and cognitive functions. Forty-two women with DSM-IV PTSD and 66 demographically matched healthy control women participated in this study. Most of the patients developed PTSD after experiencing interpersonal violence. Cognitive functions were assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Regular exercise habit was assessed by a self-reported questionnaire. Compared to controls, PTSD patients performed significantly more poorly in all cognitive domains examined, including immediate memory, visuospatial construction, language, attention, delayed memory, as well as the total score of RBANS (all p cognitive functions, including notable impairments in verbal memory. Such memory deficits might be improved by regular exercise, although further studies are needed to investigate the causal relationship between exercise and cognition in PTSD. Copyright © 2018 Elsevier B.V. All rights reserved.

Synesthetic Colors for Japanese Scripts in Japanese Synesthetes

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Kazuhiko Yokosawa

2011-10-01

Full Text Available The determinants of synesthetic colors for Japanese scripts were studied in six Japanese grapheme-color synesthetes. We investigated the influence of linguistic properties such as phonology, orthography, and meaning on synesthetic colors for logographic characters (Kanji, phonetic characters (hiragana and katakana, and digits. From a palette of 138 colors, the synesthetes selected colors for 79 Kanji, 71 hiragana, and 71 katakana characters, and 9 digits. The results revealed that the color choices for hiragana and katakana characters representing the same sound were remarkably consistent, indicating that color selection depended on phonology and not visual form. On the other hand, synesthetic colors for Kanji characters, which are usually learned later, depended on meaning and phonology. Kanji characters representing concepts that are highly related to colors (eg, names of objects with typical colors were associated with those colors. Digits and corresponding Kanji numerals elicited strikingly similar colors. Colors for Kanji and hiragana characters sharing the same sound were likely to be similar. These results suggest that synesthetic colors are generalized from digits and phonetic scripts to Kanji characters via meaning and phonology. This study provides insights into the generalization of synesthetic colors to later acquired sets of graphemes within a language.

Acculturation of Personality: A Three-Culture Study of Japanese, Japanese Americans, and European Americans.

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Güngör, Derya; Bornstein, Marc H; De Leersnyder, Jozefien; Cote, Linda; Ceulemans, Eva; Mesquita, Batja

2013-07-01

The present study tests the hypothesis that involvement with a new culture instigates changes in personality of immigrants that result in (a) better fit with the norms of the culture of destination and (b) reduced fit with the norms of the culture of origin. Participants were 40 Japanese first-generation immigrants to the United States, 57 Japanese monoculturals, and 60 U.S. monoculturals. All participants completed the Jackson Personality Inventory (JPI) as a measure of the Big Five; immigrants completed the Japanese American Acculturation Scale. Immigrants' fits with the cultures of destination and origin were calculated by correlating Japanese American mothers' patterns of ratings on the Big Five with the average patterns of ratings of European Americans and Japanese on the same personality dimensions. Japanese Americans became more "American" and less "Japanese" in their personality as they reported higher participation in the U.S. culture. The results support the view that personality can be subject to cultural influence.

Japanese supercomputer technology

International Nuclear Information System (INIS)

Buzbee, B.L.; Ewald, R.H.; Worlton, W.J.

1982-01-01

In February 1982, computer scientists from the Los Alamos National Laboratory and Lawrence Livermore National Laboratory visited several Japanese computer manufacturers. The purpose of these visits was to assess the state of the art of Japanese supercomputer technology and to advise Japanese computer vendors of the needs of the US Department of Energy (DOE) for more powerful supercomputers. The Japanese foresee a domestic need for large-scale computing capabilities for nuclear fusion, image analysis for the Earth Resources Satellite, meteorological forecast, electrical power system analysis (power flow, stability, optimization), structural and thermal analysis of satellites, and very large scale integrated circuit design and simulation. To meet this need, Japan has launched an ambitious program to advance supercomputer technology. This program is described

Association between a C8orf13–BLK Polymorphism and Polymyositis/Dermatomyositis in the Japanese Population: An Additive Effect with STAT4 on Disease Susceptibility

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Sugiura, Tomoko; Kawaguchi, Yasushi; Goto, Kanako; Hayashi, Yukiko; Gono, Takahisa; Furuya, Takefumi; Nishino, Ichizo; Yamanaka, Hisashi

2014-01-01

Background Accumulating evidence has shown that several non-HLA genes are involved in the susceptibility to polymyositis/dermatomyositis. This study aimed to investigate the involvement of C8orf13–BLK, one of the strongest candidate genes for autoimmune diseases, in susceptibility to polymyositis/dermatomyositis in the Japanese population. A possible gene–gene interaction between C8orf13–BLK and STAT4, which we recently showed to be associated with Japanese polymyositis/dermatomyositis, was also analyzed. Methods A single-nucleotide polymorphism in C8orf13–BLK (dbSNP ID: rs13277113) was investigated in the Japanese population using a TaqMan assay in 283 polymyositis patients, 194 dermatomyositis patients, and 656 control subjects. Results The C8orf13–BLK rs13277113A allele was associated with overall polymyositis/dermatomyositis (Prs7574865 T alleles had an additive effect on polymyositis/dermatomyositis susceptibility. The strongest association was observed in dermatomyositis, with an OR of 3.07 (95% CI; 1.57–6.02) for the carriers of four risk alleles at the two SNP sites, namely, rs1327713 and rs7574865. Conclusions This study established C8orf13–BLK as a new genetic susceptibility factor for polymyositis/dermatomyositis. Both C8orf13–BLK and STAT4 exert additive effects on disease susceptibility. These observations suggested that C8orf13–BLK, in combination with STAT4, plays a pivotal role in creating genetic susceptibility to polymyositis/dermatomyositis in Japanese individuals. PMID:24632671

Japanese Scholarship on the Sino-Japanese War, 2007–2012

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Duan Ruicong

2014-03-01

Full Text Available This article examines in detail the last five years of Japanese scholarship related to the Sino-Japanese War, highlighting its principle trends and achievements. Due to the broad range and large quantity of scholarship on the subject, Duan Ruicong focuses foremost on the 2007–2012 period, although by necessity this article also touches on pre-2007 scholarship. Additionally, this overview will primarily introduce Japanese-language, single-authored and co-authored books (monographs, collections of papers, and other single-issue publications; only when necessary will it refer to pertinent journal articles.

Monetary Diet Cost is Associated with not only Favorable but also Unfavorable Aspects of Diet in Pregnant Japanese Women: The Osaka Maternal and Child Health Study

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Kentaro Murakami

2009-01-01

Full Text Available While several observational studies in European countries have shown that higher monetary diet cost is associated with healthier diets, information on the relationship of cost to diet quality in other countries is sparse, including Japan. This cross-sectional study examined the association between monetary diet cost and dietary intake in a group of pregnant Japanese women. Subjects were 596 pregnant Japanese housewives. Dietary intake was estimated using a validated, self-administered, comprehensive diet history questionnaire. Monetary diet cost was calculated using retail food prices. Values of monetary diet cost and nutrient and food intake were energy-adjusted using the density method. Monetary diet cost was associated positively with the intake of protein, total fat, saturated fatty acids, dietary fiber, cholesterol, sodium, potassium, calcium, magnesium, iron, vitamins A, D, E, C, and folate, and inversely with that of carbohydrate. For foods, cost was associated positively with the intake of potatoes, pulses and nuts, fish and shellfish, meat, dairy products, vegetables, and fruits, and inversely with that of rice and bread. No association was seen for noodles, confectioneries and sugars, fats and oils, or eggs. Cost was also associated inversely with dietary energy density. In conclusion, monetary diet cost was associated with not only favorable aspects of diet, including a higher intake of dietary fiber, key vitamins and minerals, fruits, and vegetables and lower dietary energy density, but also unfavorable aspects, including a higher intake of fat and sodium and lower intake of carbohydrate and rice, in a group of pregnant Japanese women.

Monetary Diet cost is Associated with not only Favorable but also Unfavorable Aspects of Diet in pregnant Japanese Women: The Osaka Maternal and child Health study

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Yukihiro Ohya

2009-01-01

Full Text Available While several observational studies in European countries have shown that higher monetary diet cost is associated with healthier diets, information on the relationship of cost to diet quality in other countries is sparse, including Japan. This cross-sectional study examined the association between monetary diet cost and dietary intake in a group of pregnant Japanese women. Subjects were 596 pregnant Japanese housewives. Dietary intake was estimated using a validated, self-administered, comprehensive diet history questionnaire. Monetary diet cost was calculated using retail food prices. Values of monetary diet cost and nutrient and food intake were energy-adjusted using the density method. Monetary diet cost was associated positively with the intake of protein, total fat, saturated fatty acids, dietary fiber, cholesterol, sodium, potassium, calcium, magnesium, iron, vitamins A, D, E, C, and folate, and inversely with that of carbohydrate. For foods, cost was associated positively with the intake of potatoes, pulses and nuts, fish and shellfish, meat, dairy products, vegetables, and fruits, and inversely with that of rice and bread. No association was seen for noodles, confectioneries and sugars, fats and oils, or eggs. Cost was also associated inversely with dietary energy density. In conclusion, monetary diet cost was associated with not only favorable aspects of diet, including a higher intake of dietary fiber, key vitamins and minerals, fruits, and vegetables and lower dietary energy density, but also unfavorable aspects, including a higher intake of fat and sodium and lower intake of carbohydrate and rice, in a group of pregnant Japanese women.

Regional impact of climate on Japanese encephalitis in areas located near the three gorges dam.

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Yuntao Bai

Full Text Available BACKGROUND: In this study, we aim to identify key climatic factors that are associated with the transmission of Japanese encephalitis virus in areas located near the Three Gorges Dam, between 1997 and 2008. METHODS: We identified three geographical regions of Chongqing, based on their distance from the Three Gorges Dam. Collectively, the three regions consisted of 12 districts from which study information was collected. Zero-Inflated Poisson Regression models were run to identify key climatic factors of the transmission of Japanese encephalitis virus for both the whole study area and for each individual region; linear regression models were conducted to examine the fluctuation of climatic variables over time during the construction of the Three Gorges Dam. RESULTS: Between 1997 and 2008, the incidence of Japanese encephalitis decreased throughout the entire city of Chongqing, with noticeable variations taking place in 2000, 2001 and 2006. The eastern region, which is closest to the Three Gorges Dam, suffered the highest incidence of Japanese encephalitis, while the western region experienced the lowest incidence. Linear regression models revealed that there were seasonal fluctuations of climatic variables during this period. Zero-Inflated Poisson Regression models indicated a significant positive association between temperature (with a lag of 1 and 3 months and Japanese encephalitis incidence, and a significant negative association between rainfall (with a lag of 0 and 4 months and Japanese encephalitis incidence. CONCLUSION: The spatial and temporal trends of Japanese encephalitis incidence that occurred in the City of Chongqing were associated with temperature and rainfall. Seasonal fluctuations of climatic variables during this period were also observed. Additional studies that focus on long-term data collection are needed to validate the findings of this study and to further explore the effects of the Three Gorges Dam on Japanese

Visceral adiposity, not abdominal subcutaneous fat area, is associated with high blood pressure in Japanese men. The Ohtori study

International Nuclear Information System (INIS)

Koh, Hideo; Hayashi, Tomoshige; Kogawa Sato, Kyoko

2011-01-01

Visceral adiposity is considered to have a key role in cardiometabolic diseases. The purpose of this study is to investigate cross-sectionally the association between intra-abdominal fat area (IAFA) measured by computed tomography (CT) and high blood pressure independent of abdominal subcutaneous fat area (ASFA) and insulin resistance. Study participants included 624 Japanese men not taking oral hypoglycemic medications or insulin. Abdominal, thoracic and thigh fat areas were measured by CT. Total fat area (TFA) was calculated as the sum of abdominal, thoracic and thigh fat area. Total subcutaneous fat area (TSFA) was defined as TFA minus IAFA. Hypertension and high normal blood pressure were defined using the 1999 criteria of the World Health Organization. Multiple-adjusted odds ratios of hypertension for tertiles of IAFA were 2.64 (95% confidence interval, 1.35-5.16) for tertile 2, and 5.08 (2.48-10.39) for tertile 3, compared with tertile 1 after adjusting for age, fasting immunoreactive insulin, diabetes status, ASFA, alcohol consumption, regular physical exercise and smoking habit. IAFA remained significantly associated with hypertension even after adjustment for ASFA, TSFA, TFA, body mass index or waist circumference, and no other measure of regional or total adiposity was associated with the odds of hypertension in models, which included IAFA. Similar results were obtained for the association between IAFA and the prevalence of high normal blood pressure or hypertension. In conclusion, greater visceral adiposity was associated with a higher odds of high blood pressure in Japanese men. (author)

Yellow Tongue Coating is Associated With Diabetes Mellitus Among Japanese Non-smoking Men and Women: The Toon Health Study.

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Tomooka, Kiyohide; Saito, Isao; Furukawa, Shinya; Maruyama, Koutatsu; Eguchi, Eri; Iso, Hiroyasu; Tanigawa, Takeshi

2017-12-28

Yellow tongue coating is one of the clinical signs for diabetes mellitus according to traditional East Asian medicine. Few reports have been available on the association between yellow tongue coating and the prevalence of type 2 diabetes in the general population. We examined that association among population samples of non-smoking men and women. The study subjects were Japanese non-smoking men (n = 315) and women (n = 654) aged 30-79 years who resided in Toon city and participated in the Toon Health Study from July 2011 through November 2014. Tongue coating was assessed by a nationally licensed acupuncturist and classified into three categories of white (normal), light yellow, and yellow. We performed an oral glucose tolerance test to confirm the presence of diabetes mellitus and prediabetes. The associations between yellow tongue coating and the prevalence of diabetes mellitus and prediabetes were examined using multivariable logistic regression analyses, adjusting for age, sex, body mass index, drinking status, and physical activity. The multivariable odds ratios of diabetes mellitus were 1.39 (95% confidence interval [CI], 0.72-2.67) for light yellow tongue coating and 2.23 (95% CI, 1.16-4.30) for yellow tongue coating compared with white tongue coating. The respective multivariable odds ratios of prediabetes were 1.13 (95% CI, 0.80-1.61) and 1.43 (95% CI, 0.96-2.12). Yellow tongue coating was associated with higher prevalence of diabetes mellitus and tended to be associated with that of prediabetes among Japanese non-smoking men and women.

Association Between Sarcopenia and Mild Cognitive Impairment Using the Japanese Version of the SARC-F in Elderly Patients With Diabetes.

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Ida, Satoshi; Nakai, Mari; Ito, Sho; Ishihara, Yuki; Imataka, Kanako; Uchida, Akihiro; Monguchi, Kou; Kaneko, Ryutaro; Fujiwara, Ryoko; Takahashi, Hiroka; Murata, Kazuya

2017-09-01

The purpose of this study was to investigate the association between sarcopenia and mild cognitive impairment (MCI) in elderly patients with diabetes using the Japanese version of the simple 5-item questionnaire (SARC-F-J). Cross-sectional study. Community hospital in Japan. Subjects were people with diabetes aged 65 years and older being treated on an outpatient basis at the Ise Red Cross Hospital. We used the Japanese version of the self-administered cognitive test Test Your Memory (TYM-J) to measure MCI and the self-administered questionnaire SARC-F-J, consisting of 5 items, to evaluate sarcopenia. We conducted a multiple logistic regression analysis with MCI as the dependent variable and sarcopenia as the explanatory variable to calculate the odds ratio of sarcopenia in association with MCI. A total of 250 cases (150 men and 100 women) were included in our study. The prevalence of sarcopenia in this sample was 19.5% and that of MCI was 40.3%. The adjusted odds ratio of sarcopenia in association with MCI was 2.96 (95% confidence interval, 1.09-7.70, P = .032). A statistically significant association was found between sarcopenia and MCI in an assessment of elderly patients with diabetes using the SARC-F-J. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Bacteriophage Mediated Killing of Staphylococcus aureus In Vitro on Orthopaedic K Wires in Presence of Linezolid Prevents Implant Colonization

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Kaur, Sandeep; Harjai, Kusum; Chhibber, Sanjay

2014-01-01

Background Infections of bone and joint tissues following arthroplasty surgeries remain a major challenge in orthopaedic settings. Methicillin resistant Staphylococcus aureus (MRSA) is recognised as an established pathogen in such infections. Combination therapy using linezolid and bacteriophage impregnated in biopolymer was investigated in the present study as an alternative strategy to prevent MRSA colonisation on the orthopaedic implant surface. Methodology Coating of stainless steel orthopaedic grade K-wires was achieved using hydroxypropylmethlycellulose (HPMC) mixed with phage alone, linezolid alone and phage and linezolid together. The potential of these agents to inhibit adhesion of S.aureus (MRSA) 43300 on K-wires was assessed. Coated and naked wires were analysed by scanning electron microscopy (SEM) and fluorescent staining. Result Significant reduction in bacterial adhesion was achieved on phage/linezolid wires in comparison to naked as well as HPMC coated wires. However, maximum reduction in bacterial adherence (∼4 log cycles) was observed on the wires coated with phage-linezolid combination. The frequency of emergence of resistant mutants was also negligible in presence of both the agents. Conclusion This study provides evidence to confirm that local delivery system employing linezolid (a potent protein synthesis inhibitor) along with a broad spectrum lytic bacteriophage (capable of self-multiplication) is able to attack the adhered as well as surrounding bacteria present near the implant site. Unlike other antibiotic based therapies, this combination has the potential to significantly restrict the emergence of resistant mutants, thus paving the way for effective treatment of MRSA associated infection of medical implants. PMID:24594764

Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

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Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2016-08-01

To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.

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Tomita, Yoshihito; Arima, Kazuhiko; Tsujimoto, Ritsu; Kawashiri, Shin-Ya; Nishimura, Takayuki; Mizukami, Satoshi; Okabe, Takuhiro; Tanaka, Natsumi; Honda, Yuzo; Izutsu, Kazumi; Yamamoto, Naoko; Ohmachi, Izumi; Kanagae, Mitsuo; Abe, Yasuyo; Aoyagi, Kiyoshi

2018-01-01

To determine the prevalence of fear of falling and associated factors among Japanese community-dwelling older adults.Cross-sectional study between 2011 and 2013.Community in which residents voluntarily attended a health examination.We recruited 844 older adults (male, n = 350; female, n = 494) aged 60 to 92 years from among those who presented at the health examination.We assessed fear of falling, falls in the previous year, pain, comorbidity, and cataracts. Five times chair stand time was applied as an indicator of physical performance.The prevalence of fear of falling was 26.9% and 43.3% among the men and women, respectively. Men and women who feared falling were older (P fear of falling.The prevalence of fear of falling was similar to previous reports. Advanced age, falls in previous year, and pain were associated with fear of falling in men. A longer 5 times chair stand time was also associated with fear of falling among older adult women. Maintenance of physical function and pain management might be important for older adults with fear of falling.

Antimicrobial and Osseointegration Properties of Nanostructured Titanium Orthopaedic Implants

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Jäger, Marcus; Jennissen, Herbert P.; Dittrich, Florian; Fischer, Alfons; Köhling, Hedda Luise

2017-01-01

The surface design of titanium implants influences not only the local biological reactions but also affects at least the clinical result in orthopaedic application. During the last decades, strong efforts have been made to improve osteointegration and prevent bacterial adhesion to these surfaces. Following the rule of “smaller, faster, cheaper”, nanotechnology has encountered clinical application. It is evident that the hierarchical implant surface micro- and nanotopography orchestrate the bi...

Health attitudes and behaviors: comparison of Japanese and Americans of Japanese and European Ancestry.

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Gotay, Carolyn Cook; Shimizu, Hiroyuki; Muraoka, Miles; Ishihara, Yoko; Tsuboi, Koji; Ogawa, Hiroshi

2004-06-01

Adults living in Japan (N = 357) and the US (N = 223) completed semi-structured interviews assessing health-related attitudes and practices. The US respondents were of Japanese (N = 106) and European (N = 117) ancestry. Results indicated considerable similarity between the two US groups and significant differences between the Japanese and American respondents. The Japanese respondents placed less priority on health, had less belief in the efficacy of health screening tests, lower levels of internal health locus of control (HLOC), and higher levels of chance and powerful-others HLOC. While Japanese and Americans had similar overall levels of healthy behaviors, the Japanese were less likely to have obtained health screening tests (especially gynecologic exams). The findings have implications for adapting health promotion programs in the context of Japanese and American cultures.

Changes in body weight are significantly associated with changes in fasting plasma glucose and HDL cholesterol in Japanese men without abdominal obesity (waist circumference < 85 cm).

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Oda, Eiji; Kawai, Ryu

2011-06-01

The aims are to examine whether changes in body weight (dBW) are associated with changes in cardiovascular risk factors in Japanese men without abdominal obesity (waist circumference (WC) obesity. It is a retrospective study in 692 Japanese men without abdominal obesity who took annual health screening tests consecutively over one year. Standardized linear regression coefficients (SRCs) of dBW and dWC were calculated for changes in systolic blood pressure (dSBP), diastolic blood pressure (dDBP), fasting plasma glucose (dFPG), triglycerides (dTG), HDL cholesterol (dHDL), and high-sensitivity C-reactive protein (dCRP). The SRCs of dBW for dFPG and dHDL were significant in all men and in men with each risk factor corresponding to the component of metabolic syndrome (MetS). The SRCs of dWC for dTG and dCRP were significant in all men but not in men with each risk factor corresponding to the MetS component. In conclusions, dBW were significantly associated with dFPG and dHDL in Japanese men without abdominal obesity. Therefore, abdominal obesity should not be considered as a necessary component of MetS in Japanese men. dBW may be more useful than dWC as a marker of changes in cardiovascular risk factors in lifestyle intervention programs.

Single nucleotide polymorphisms in the SEPTIN12 gene may be associated with azoospermia by meiotic arrest in Japanese men.

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Miyamoto, Toshinobu; Tsujimura, Akira; Miyagawa, Yasushi; Koh, Eitetsu; Namiki, Mikio; Horikawa, Michiharu; Saijo, Yasuaki; Sengoku, Kazuo

2012-01-01

To investigate the association between SEPTIN12 gene variants and the risk of azoospermia caused by meiotic arrest. Mutational analysis of the SEPTIN12 gene was performed using DNA from 30 Japanese patients with azoospermia by meiotic arrest and 140 fertile male controls. The frequencies of the c.204G>C (Gln38His) allele and the CC genotype were significantly higher in patients than in fertile controls (p C (Gln38His) variant in the SEPTIN12 gene was associated with increased susceptibility to azoospermia caused by meiotic arrest.

The association between semantic dementia and surface dyslexia in Japanese.

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Fushimi, Takao; Komori, Kenjiro; Ikeda, Manabu; Lambon Ralph, Matthew A; Patterson, Karalyn

2009-03-01

One theory about reading suggests that producing the correct pronunciations of written words, particularly less familiar words with an atypical spelling-sound relationship, relies in part on knowledge of the word's meaning. This hypothesis has been supported by reports of surface dyslexia in large case-series studies of English-speaking/reading patients with semantic dementia (SD), but would have increased credibility if it applied to other languages and writing systems as well. The hypothesis predicts that, of the two systems used to write Japanese, SD patients should be unimpaired at oral reading of kana because of its invariant relationship between orthography and phonology. By contrast, oral reading of kanji should be impaired in a graded fashion depending on the consistency characteristics of the kanji target words, with worst performance on words whose component characters take 'minority' (atypical) pronunciations, especially if the words are of lower frequency. Errors in kanji reading should primarily reflect assignment of more typical readings to the component characters in these atypical words. In the largest-ever-reported case series of Japanese patients with semantic dementia, we tested and confirmed this hypothesis.

Communication attitudes of Japanese school-age children who stutter.

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Kawai, Norimune; Healey, E Charles; Nagasawa, Taiko; Vanryckeghem, Martine

2012-01-01

Past research with the Communication Attitude Test (CAT) has shown it to be a valid and reliable instrument for assessing speech-associated attitude of children who stutter (CWS). However, in Japan, the CAT has not been used extensively to examine the communication attitude of CWS. The purpose of this study was to determine if a Japanese version of the CAT could differentiate between the communication attitude of Japanese elementary school CWS and children who do not stutter (CWNS). A Japanese translation of the 1991 version of the Communication Attitude Test-Revised (CAT-R) was used in this study. Eighty Japanese CWS and 80 gender- and grade level-matched CWNS participated in the study. The results showed that CWS had a significantly more negative communication attitude than CWNS. Both CWS and CWNS in 1st grade showed significantly more positive communication attitudes than children in 2nd, 3rd, 4th, 5th, and 6th grades. Furthermore, a link between stuttering severity and CWS' communication attitude was found. Additional research is needed to confirm the results of the current study, which indicate that the communication attitude of Japanese CWS becomes more negative as they get older. The reader will be able to: (1) Describe the process that was used to develop a Japanese version of the Communication Attitude Test (CAT-J). (2) Discuss attitude differences between Japanese children who stutter and those who do not and how grade level impacts a negative attitude toward communication. (3) Explain the link between stuttering severity and attitudes of Japanese children who stutter. Copyright © 2012 Elsevier Inc. All rights reserved.

Correlations of radiological assessment of skeletal maturity and orthopaedic injuries in the standardbred

International Nuclear Information System (INIS)

Pasolini, M.P.; Meomartino, L.; Fatone, G.; Brunetti, A.; Laratta, I.

2003-01-01

The aim of this study was to define a correlation between the incidence of orthopaedic injuries and the skeletal maturity, radiologically assessed, in a group of 23 standardbred horses. Starting at 18 months of age, radiograms of calcaneus and distal radial physis were taken at two months intervals, until X-ray evidence of closure. All the physis were blindly graded as: C: open physis; B-: initial evidence of central closure; B: partially closed physis; B+: full closure of the central portion of the physis; A: closed physis. Based on this classification, the horses were grouped as I (immature subject - C, B- and B), or M (mature subject - B+ and A). Orthopaedic injuries were classified as major lesion, if causing prolonged or definitive interruption of training, or minor, if causing brief or no interruption of training. Estimation of injury incidence in the different groups was calculated using the chi-square test (significance level P0.01). The average ages of physis closure (mean +- SD) were 24.1 +- 2.6 months (range 19-28), for the calcaneal physis, and 28.2 +- 2 months (range 26-33), for the distal radial physis, without significant differences between colts and fillies. In our study, according to a previous report, no correlation between X-ray skeletal maturity and incidence of orthopaedic injuries was demonstrated [it

Orthopaedic Aspects of Marfan Syndrome: The Experience of a Referral Center for Diagnosis of Rare Diseases

Science.gov (United States)

Fichera, Alessandro; De Luna, Vincenzo; Mancini, Federico; Caterini, Roberto

2016-01-01

Marfan syndrome is caused by mutations in the fibrillin-1 gene (FBN1). The most important features affect the cardiovascular system, eyes, and skeleton. The aim of this study was to report the most frequent musculoskeletal alterations observed in 146 patients affected by Marfan syndrome. Fifty-four patients (37%) underwent cardiac surgery and 11 of them received emergent surgery for acute aortic dissection. Ectopia lentis was found in 68 patients (47%) whereas myopia above 3D occurred in 46 patients (32%). Musculoskeletal anomalies were observed in all patients with Marfan syndrome. In 88 patients (60.2%), the associated “wrist and thumb sign” was present; in 58 patients (39.7%), pectus carinatum deformity; in 44 patients (30.1%), pectus excavatum; in 49 patients (33.5%), severe flatfoot; in 31 patients (21.2%), hindfoot deformity; in 54 patients (36.9%), reduced US/LS ratio or increased arm span-height ratio; in 37 patients (25.3%), scoliosis or thoracolumbar kyphosis; in 22 patients (15%), reduced elbow extension (170° or less). Acetabular protrusion was ascertained on radiographs in 27 patients (18.4%). Orthopaedic aspects of the disease are very important for an early diagnosis; however, we have not observed definite correlations between the extent of orthopaedic involvement and aortic complications. PMID:28050285

Tips for a Healthy Long-Life Learned from Space Medicine

Science.gov (United States)

Ohshima, Hiroshi; Yamada, Shin; Matsuo, Tomoaki; Yamamoto, Masafumi; Mukai, Chiaki

2013-02-01

The field of space medicine is responsible for maintaining astronauts’ health and optimizing their performance. A prolonged stay in space with little gravity results in weakening of the bones and muscles that otherwise support body weight, which is precisely the problem faced by elderly people on Earth. Space medicine provides the means of alleviating such problems. Bone loss, muscle atrophy, and disturbed circadian rhythms are common issues for both astronauts and the elderly alike and can be prevented, if the risks are addressed correctly. To have a healthy long-life, it is important to practice effective health improvement techniques and take preventive measures. The space medicine technologies a for astronauts will provide helpful information to people living in a super aging society. and Japanese medical societies for health promotion. With the aids of the Japanese Society of Physical Fitness and Sports Medicine, the Japanese Orthopaedic Association, and the Japanese Association of Rehabilitation Medicine, JAXA has made a leaflet titled for general citizen to show the tips for a healthy long-life learned from space medicine from the viewpoints of their respective expertise.

Maternal variant in the upstream of FOXP3 gene on the X chromosome is associated with recurrent infertility in Japanese Black cattle.

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Arishima, Taichi; Sasaki, Shinji; Isobe, Tomohiro; Ikebata, Yoshihisa; Shimbara, Shinichi; Ikeda, Shogo; Kawashima, Keisuke; Suzuki, Yutaka; Watanabe, Manabu; Sugano, Sumio; Mizoshita, Kazunori; Sugimoto, Yoshikazu

2017-12-06

Repeat breeding, which is defined as cattle failure to conceive after three or more inseminations in the absence of clinical abnormalities, is a substantial problem in cattle breeding. To identify maternal genetic variants of repeat breeding in Japanese Black cattle, we selected 29 repeat-breeding heifers that failed to conceive following embryo transfer (ET) and conducted a genome-wide association study (GWAS) using the traits. We found that a single-nucleotide polymorphism (SNP; g.92,377,635A > G) in the upstream region of the FOXP3 gene on the X chromosome was highly associated with repeat breeding and failure to conceive following ET (P = 1.51 × 10 -14 ). FOXP3 is a master gene for differentiation of regulatory T (T reg ) cells that function in pregnancy maintenance. Reporter assay results revealed that the activity of the FOXP3 promoter was lower in reporter constructs with the risk-allele than in those with the non-risk-allele by approximately 0.68 fold. These findings suggest that the variant in the upstream region of FOXP3 with the risk-allele decreased FOXP3 transcription, which in turn, could reduce the number of maternal T reg cells and lead to infertility. The frequency of the risk-allele in repeat-breeding heifers is more than that in cows, suggesting that the risk-allele could be associated with infertility in repeat-breeding heifers. This GWAS identified a maternal variant in the upstream region of FOXP3 that was associated with infertility in repeat-breeding Japanese Black cattle that failed to conceive using ET. The variant affected the level of FOXP3 mRNA expression. Thus, the results suggest that the risk-allele could serve as a useful marker to reduce and eliminate animals with inferior fertility in Japanese Black cattle.

Synesthetic Colors for Japanese Scripts in Japanese Synesthetes

OpenAIRE

Kazuhiko Yokosawa; Michiko Asano

2011-01-01

The determinants of synesthetic colors for Japanese scripts were studied in six Japanese grapheme-color synesthetes. We investigated the influence of linguistic properties such as phonology, orthography, and meaning on synesthetic colors for logographic characters (Kanji), phonetic characters (hiragana and katakana), and digits. From a palette of 138 colors, the synesthetes selected colors for 79 Kanji, 71 hiragana, and 71 katakana characters, and 9 digits. The results revealed that the color...

Association of Job Demands with Work Engagement of Japanese Employees: Comparison of Challenges with Hindrances (J-HOPE)

Science.gov (United States)

Inoue, Akiomi; Kawakami, Norito; Tsutsumi, Akizumi; Shimazu, Akihito; Miyaki, Koichi; Takahashi, Masaya; Kurioka, Sumiko; Eguchi, Hisashi; Tsuchiya, Masao; Enta, Kazuhiko; Kosugi, Yuki; Sakata, Tomoko; Totsuzaki, Takafumi

2014-01-01

Objectives Recent epidemiological research in Europe has reported that two groups of job demands, i.e., challenges and hindrances, are differently associated with work engagement. The purpose of the present study was to replicate the cross-sectional association of workload and time pressure (as a challenge) and role ambiguity (as a hindrance) with work engagement among Japanese employees. Methods Between October 2010 and December 2011, a total of 9,134 employees (7,101 men and 1,673 women) from 12 companies in Japan were surveyed using a self-administered questionnaire comprising the Job Content Questionnaire, National Institute for Occupational Safety and Health Generic Job Stress Questionnaire, short 10-item version of the Effort-Reward Imbalance Questionnaire, short nine-item version of the Utrecht Work Engagement Scale, and demographic characteristics. Multilevel regression analyses with a random intercept model were conducted. Results After adjusting for demographic characteristics, workload and time pressure showed a positive association with work engagement with a small effect size (standardized coefficient [β] = 0.102, Cohen’s d [d] = 0.240) while role ambiguity showed a negative association with a large effect size (β = −0.429, d = 1.011). After additionally adjusting for job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward), the effect size of workload and time pressure was not attenuated (β = 0.093, d = 0.234) while that of role ambiguity was attenuated but still medium (β = −0.242, d = 0.609). Conclusions Among Japanese employees, challenges such as having higher levels of workload and time pressure may enhance work engagement but hindrances, such as role ambiguity, may reduce it. PMID:24614682

Association of job demands with work engagement of Japanese employees: comparison of challenges with hindrances (J-HOPE.

Directory of Open Access Journals (Sweden)

Akiomi Inoue

Full Text Available Recent epidemiological research in Europe has reported that two groups of job demands, i.e., challenges and hindrances, are differently associated with work engagement. The purpose of the present study was to replicate the cross-sectional association of workload and time pressure (as a challenge and role ambiguity (as a hindrance with work engagement among Japanese employees.Between October 2010 and December 2011, a total of 9,134 employees (7,101 men and 1,673 women from 12 companies in Japan were surveyed using a self-administered questionnaire comprising the Job Content Questionnaire, National Institute for Occupational Safety and Health Generic Job Stress Questionnaire, short 10-item version of the Effort-Reward Imbalance Questionnaire, short nine-item version of the Utrecht Work Engagement Scale, and demographic characteristics. Multilevel regression analyses with a random intercept model were conducted.After adjusting for demographic characteristics, workload and time pressure showed a positive association with work engagement with a small effect size (standardized coefficient [β] = 0.102, Cohen's d [d] = 0.240 while role ambiguity showed a negative association with a large effect size (β = -0.429, d = 1.011. After additionally adjusting for job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward, the effect size of workload and time pressure was not attenuated (β = 0.093, d = 0.234 while that of role ambiguity was attenuated but still medium (β = -0.242, d = 0.609.Among Japanese employees, challenges such as having higher levels of workload and time pressure may enhance work engagement but hindrances, such as role ambiguity, may reduce it.

Nurses' views of patient handoffs in Japanese hospitals

DEFF Research Database (Denmark)

Gu, Xiuzhu; Andersen, Henning Boje; Madsen, Marlene Dyrløv

2012-01-01

Staff perceptions of risks associated with patient handoffs were investigated in a survey of nurses in 6 Japanese hospitals. A total of 1462 valid responses were collected from nurses with an overall response rate of 74%. Respondents are moderately satisfied with the transfer of information and r...... and responsibility during handoffs. However, the handoff system was identified as immature. Hospital, work setting, and work experience affected nurses' views of handoff quality. Strategies for improving patient handoffs in Japan are proposed.......Staff perceptions of risks associated with patient handoffs were investigated in a survey of nurses in 6 Japanese hospitals. A total of 1462 valid responses were collected from nurses with an overall response rate of 74%. Respondents are moderately satisfied with the transfer of information...

Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

Directory of Open Access Journals (Sweden)

Brennan Sharon L

2012-04-01

Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

Prevalence of antibody to adult T-cell leukemia virus-associated antigens (ATLA) in Japanese monkeys and other non-human primates.

Science.gov (United States)

Hayami, M; Komuro, A; Nozawa, K; Shotake, T; Ishikawa, K; Yamamoto, K; Ishida, T; Honjo, S; Hinuma, Y

1984-02-15

The prevalence of adult T-cell-leukemia virus (ATLV) infection was examined in Japanese monkeys living naturally in various parts of Japan and in other species of non-human primates imported into and kept in Japan. Sera of 2,650 Japanese monkeys from 41 troops throughout Japan were tested. High incidences of anti-ATLV-associated antigen (ATLA)-positive monkeys were found in most troops, not only in the endemic area of human ATL(Southwestern Japan), but also in non-endemic areas. The incidence of sero-positive individuals increased gradually with age, reaching a maximum when the animals became adult, indicating age dependency, like that found by epidemiological studies on humans. Anti-ATLA antibodies were also detected in 90 of 815 sera of imported non-human primates of 33 species other than Japanese monkeys. All the anti-ATLA sero-positive monkeys were Catarrhines (Old World monkeys), mainly macaques of Asian origin. Some sero-positive monkeys were also found among animals of African origin, but no antibody was detected in Prosimians and Platyrrhines (New World monkeys). The clear-cut difference between the geographical distribution of sero-positive simians and that of humans indicates the improbability of direct transmission of ATLV from simians to humans.

Reliability of the SF-36 in Japanese patients with systemic lupus erythematosus and its associations with disease activity and damage: a two-consecutive year prospective study.

Science.gov (United States)

Baba, S; Katsumata, Y; Okamoto, Y; Kawaguchi, Y; Hanaoka, M; Kawasumi, H; Yamanaka, H

2018-03-01

We aimed to validate the reliability of the Medical Outcomes Study Short Form-36 (SF-36) among Japanese patients with systemic lupus erythematosus (SLE). Japanese patients with SLE ( n = 233) completed the SF-36 and other related demographic questionnaires, and physicians simultaneously completed the SLE Disease Activity Index 2000 (SLEDAI-2K) and the Systemic Lupus International Collaborating Clinics Damage Index (SDI). Patients were prospectively followed for a repeat assessment the following year. The SF-36 subscales demonstrated acceptable internal consistency (Cronbach's α of 0.85-0.89), and an overall good test-retest reliability (intraclass correlation coefficient >0.70). The average baseline SF-36 subscale/summary scores except for "bodily pain" were significantly lower than those of the Japanese general population ( p 36 subscale/summary scores except for "vitality" and "mental component summary" at baseline, whereas the SLEDAI-2K did not. In the second year, "social functioning" and "mental component summary" of the SF-36 deteriorated among patients whose SDI or SLEDAI-2K score increased (effect sizes 36 demonstrated acceptable reliability among Japanese patients with SLE. Health-related quality of life measured by the SF-36 was reduced in Japanese patients with SLE and associated with disease damage, rather than disease activity.

Protected Time for Research During Orthopaedic Residency Correlates with an Increased Number of Resident Publications.

Science.gov (United States)

Williams, Benjamin R; Agel, Julie A; Van Heest, Ann E

2017-07-05

The Accreditation Council for Graduate Medical Education (ACGME) requires orthopaedic residency programs to promote scholarship and research, which manifest differently among programs. We assess the impact of protected research time during orthopaedic residency on the number of resident publications. Rotation schedules and resident names were collected from 125 ACGME-accredited U.S. orthopaedic residency programs. Protected research time was classified as 1 of 3 types: (1) block time, (2) longitudinal time, or (3) no dedicated time. In April 2016, we searched residents in postgraduate year (PGY)-3 to PGY-5 on pubmed.gov to generate all orthopaedic publications with a PubMed identifier published during residency. Each publication's 2015 Thomson Reuters Journal Citation Reports 5-Year Journal Impact Factor and resident first authorship were noted. The number of PubMed identifiers for each program was summed and was divided by the number of residents in PGY-3 to PGY-5, giving a mean number of publications per resident. The relationship between output and program research time was compared using t tests and analysis of variance (ANOVA). A total of 1,690 residents were included, with an overall mean number (and standard deviation) of 1.2 ± 2.4 publications per resident. Eighty-seven programs reported block time, 14 programs reported longitudinal time, and 24 programs reported no time. There was a significant difference (p = 0.02) in the mean number of publications per resident when compared between programs with protected time (1.1 ± 1.2 publications) and programs with no protected time (0.6 ± 0.5 publication). One-way ANOVA demonstrated a significant mean difference across the 3 groups (p publications than block time at 1.0 ± 1.0 publication or no time at 0.6 ± 0.5 publication, a difference that persisted when adjusted to include only impact factors of >0 and exclude case reports (p = 0.0015). Both the presence of and the type of dedicated research time correlate

Readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine.

Science.gov (United States)

Ganta, Abhishek; Yi, Paul H; Hussein, Khalil; Frank, Rachel M

2014-04-01

Although studies have revealed high readability levels of orthopedic patient education materials, no study has evaluated sports medicine-related patient education materials. We conducted a study to assess the readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Society for Sports Medicine (AOSSM). All sports medicine patient education articles available online in 2012 from the AAOS and the AOSSM, including the Stop Sports Injuries Campaign (STOP), were identified, and their readability was assessed with the Flesch-Kinkaid (FK) readability test. Mean overall FK grade level of the 170 articles reviewed (104 from AAOS, 36 from AOSSM, 30 from STOP) was 10.2. Mean FK levels for the 3 sources were 9.5 (AAOS), 11.0 (AOSSM), and 11.5 (STOP) (P = .16). Fifteen (8.8%) of the 170 articles had a readability level at or below eighth grade (average reading level of US adults); only 2 (1.2%) of the 170 articles were at or below the recommended sixth-grade level. The majority of sports medicine-related patient education materials from AAOS and AOSSM had reading levels higher than recommended, indicating that the majority of the patient population may find it difficult to comprehend these articles.

Image guidance in orthopaedics and traumatology: A historical perspective.

Science.gov (United States)

Székely, Gabor; Nolte, Lutz-P

2016-10-01

In this note we summarize the history of computer aided surgery in orthopaedics and traumatology from the end of the nineteenth century to currently observable future trends. We concentrate on the two major components of such systems, pre-operative planning and intra-operative execution. The evolution of the necessary technological components, the numerous platforms and components offered commercially as well as their clinical use are surveyed. Copyright © 2016. Published by Elsevier B.V.

The presentation of rickets to orthopaedic clinics: return of the English disease.

Science.gov (United States)

Naseem, Haris; Wall, Alun P; Sangster, Marshall; Paton, Robin W

2011-04-01

Rickets is a potentially treatable disease of the bone that is most commonly due to deficiency of vitamin D and is increasing in incidence in developed countries. Risk factors include dietary factors, the practice of covering up and darker skin pigmentation. This small retrospective case study set out to examine all cases of rickets presenting to the Paediatric Orthopaedic clinic over a 15-month period. Rickets presented in a bimodal fashion in the 6 cases identified: in males and females aged 3 or less and female adolescents aged 10 and above. This is in keeping with what is known regarding the rapid phases of growth during development. Five cases were from ethnic minority groups. Both female adolescents presented with genu valgum. Rickets can present primarily to Orthopaedic clinics with vague musculoskeletal symptoms. We recommend that biochemical screening be performed on patients from ethnic minorities who may be 'at risk'.

Intimate partner violence against Japanese and non-Japanese women in Japan: a cross-sectional study in the perinatal setting.

Science.gov (United States)

Inami, Eriko; Kataoka, Yaeko; Eto, Hiromi; Horiuchi, Shigeko

2010-06-01

To identify the prevalence of intimate partner violence (IPV) against Japanese women (JW) and non-Japanese women (NJW) in a perinatal setting. Additional purposes were to identify the associated factors of IPV, describe the characteristics of IPV against NJW, and assess the acceptability of the Violence Against Women Screen (VAWS) instrument as a screening tool. A cross-sectional survey was conducted from September to November 2007 in an urban hospital maternity clinic in Tokyo, Japan. Women who attended the maternity clinic received the VAWS instrument, which was translated into four languages (Japanese with Kanji and Hiragana, English, Chinese, and Tagalog) and was used to identify IPV. A total of 400 women participated in the study: 357 were JW and 43 were NJW. The prevalence rate of IPV among the JW was 31.4% and 21.4% among the NJW. There was no statistical significance between the two groups. A multiple logistic regression with adjusted odds ratio identified two associated factors for IPV: being multipara and previous experience of physical violence from a partner. The prevalence of IPV was not statistically different among JW and NJW. Screening for IPV, early intervention, and support should be expanded in hospitals and maternity clinics in Japan.

Japanese Encephalitis: Frequently Asked Questions