1,720,957 research outputs found

    Ipsilateral free semitendinosus graft with interference screw fixation for surgical management of insertional acute Achilles tendon tears

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    Introduction: Very distal tears of the Achilles tendon are uncommon, and poor quality tendinous tissue of the calcaneal stump can compromise healing. Little has been published about the characteristics and surgical management of such injuries. We present a surgical technique, developed by the senior author, to restore continuity of the gastrosoleus-Achilles tendon-calcaneus complex using a free ipsilateral semitendinosus graft, and clinical outcomes of a case series of 28 consecutive patients. Our hypothesis was that this is a safe technique, and patients can return to pre-injury occupation and athletic activities. Patients and Methods: A total of 28 patients (mean age 46 years) underwent minimally invasive reconstruction using a free ipsilateral semitendinosus graft for acute insertional rupture of tendo Achillis. The procedure required two small incisions along the course of the Achilles tendon, and one posteromedial incision at level of the ipsilateral knee to harvest the semitendinosus tendon. Patients were assessed at minimum 2 years (range, 2–2.5 years) following the index procedure. Results: The median Achilles tendon Rupture Score (ATRS) at the latest follow-up was 88. Two patients developed a superficial wound infection. All patients returned to their preinjury occupation, whilst 22 out of 28 patients (79%), returned to their preinjury level of physical activity at a mean of 6.7 months after surgery, reporting good or excellent overall satisfaction in 88.5% of cases. Conclusion: This minimally invasive technique was safe, and allowed most of patients to return to preinjury daily and sport activities within 9 months from surgery

    Delayed (14-30 Days) Percutaneous Repair of Achilles Tendon Ruptures Offers Equally Good Results As Compared With Acute Repair

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    Background: Minimally invasive repair of acute Achilles tendon ruptures has been performed for several years, resulting in reduced morbidity as compared with open repair. Hypothesis: A minimally invasive technique can be used to manage Achilles tendon ruptures in patients presenting between 14 and 30 days from injury. Study Design: Cohort study; Level of evidence, 3. Methods: We prospectively recruited 21 consecutive patients who presented between 14 and 30 days after the index injury, and we compared them with 21 patients who were matched according to sex, age (±2 years), and level of activity, who presented within 14 days of the index injury. All patients underwent the same minimally invasive procedure under local anesthesia: a core suture repair consisting of a modified Bunnell suture in the proximal stump and a modified Kessler suture in the distal stump. Results: At 12 months after minimally invasive repair, patients with delayed treatment had a median Achilles tendon rupture score of 91 (SD, 2.4; range, 87-96) as compared with 91 (SD, 2.2; range, 86-96) in patients treated acutely, who presented at a median 2.4 days (range 1-6 days) from the injury. There were no significant differences between groups in terms of mean (SD) Achilles tendon resting angle: delayed repair group, −3.9° (2.0); acute repair group, −3.7° (1.9) (P =.69). No patient in either group developed a wound infection. One patient in the acute group experienced an iatrogenic sural nerve injury. Conclusion: Patients with Achilles tendon rupture treated by percutaneous repair 14 to 30 days after injury achieved similar results at 1 year as patient treated <14 after injury

    Participation to Leisure Activities and Well-Being in a Group of Residents of Naples-Italy: The Role of Resilience

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    We explored the relationship between cultural and social participation, physical activity, and well-being in a group of residents of the metropolitan area of Naples, Italy and the role that resilience plays in this relationship. Naples offers a remarkable urban environment with the potentially beneficial psychological effects of outstanding natural beauty, and one of the world's most impressive repositories of tangible and intangible cultural heritage. However, Naples was also, and still is, heavily affected by the 2008 economic crisis, in addition to preexisting social and economic issues. The major finding of this study is that, despite this highly contrasting urban environment, the combination of physical activity and engagement in social and cultural activities has a positive effect on subjective (self-reported) psychological well-being (SPWB) in a group of residents, and that resilience mediates this relationship

    Dorsally Based Closing Wedge Osteotomy of the Calcaneus for Insertional Achilles Tendinopathy

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    Background: Surgical management may be indicated for patients with insertional Achilles tendinopathy (IAT) after failure of nonoperative management, and various surgical techniques have been described. Hypothesis: We present the technique and results of modified dorsal closing wedge calcaneal osteotomy, performed in a cohort of 28 consecutive patients. We hypothesized that this will be a safe procedure that can improve hindfoot pain and function for most patients who will return to preoperative daily life and sports activities. Study Design: Case series; Level of evidence, 4. Methods: A modified dorsal closing wedge osteotomy was performed in 28 patients (mean age, 54.7 years) from November 2015 to December 2016. All patients were followed for at least 2 years postoperatively. Results: All osteotomies united at a mean of 5 weeks. The mean anatomic change in calcaneal length was 4 mm (range, 3-6 mm). The overall complication rate was 10.7%. There were 2 superficial wound infections (7.1%) and 1 instance of sural nerve–related paresthesia (3.5%) reported. All patients returned to their presurgical level of activities at a mean of 23 ± 8.0 weeks. Further, 3 of 4 patients who participated in recreational sports activities returned to their preinjury level. Visual analog scale and Victorian Institute of Sports of Australia–Achilles scores significantly improved postoperatively (P <.001) and continued to improve for 24 months. Conclusion: The modified dorsal closing wedge calcaneal osteotomy is a safe procedure and significantly improved pain and function in patients with IAT at 2 years after surgery

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods
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