Complications, Reoperations, and Long-Term Outcomes after Open Reduction Internal Fixation of Mason Classification Type II and Type III Radial Head Fractures

Introduction The objectives of this study were to assess long-term outcomes, complications, and reoperations after open reduction internal fixation (ORIF) of radial head fractures. Materials and Methods 35 adult patients, who underwent ORIF of an isolated, displaced radial head fracture without elbow instability (Mason classification type II or III) at two tertiary care referral centers from 2000 to 2017, were identified. Patient satisfaction, pain, and QuickDASH scores were assessed by telephone follow-up at median 12.9 years. Results The mean age of the 35 patients in our study was 39 years, and 54% were women. The median length of clinical follow-up was 175 days. Postoperative complications occurred in 54% of patients, and reoperations in 23% of patients. Multivariable logistic regression identified fixation with plate and screws versus screws alone as a risk factor for complications and reoperations. The long-term telephone follow-up response rate was 54%. At 13-year median follow-up, the average patient satisfaction was 9.6/10, the average patient-reported pain was 0.7/10, and the average QuickDASH score was 10.5. Conclusion The long-term outcomes of ORIF of Mason classification type II and III radial head fractures are favorable; however, rates of complication and reoperation are notable and may be higher with plate-and-screw fixation.

Risk factors for refracture of the femoral shaft in children after removal of external fixation

Background External fixation is the primary treatment option in children for femoral shaft fractures, such as open femoral or multiple fractures. One complication is refracture, which is the biggest limitation of fixation devices. This study aims to investigate the risk factors associated with refracture after the removal of external fixation devices and decrease the frequency of refracture. Materials and methods Retrospectively reviewed clinical data of 165 patients treated at our hospital for fresh femoral shaft fractures with external fixation between May 2009 and February 2018 were included in this study. Patients with pathological fractures, fractures of the femoral neck, fractures that were fixed using plates or elastic stable intramedullary nailing, and old fractures, as well as those who underwent postoperative femoral surgery were excluded. Potential risk factors included: patient age, gender, and weight, fracture sides, open or closed fracture, fracture sites, reduction methods, operation time, perioperative bleeding, number and diameter of the screws, and immobilization time. These factors were identified by univariate and logistic regression analyses. Results Femoral shaft refracture developed in 24 patients. Univariate analysis revealed that refracture was not statistically significantly associated with any of the above factors, except AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) classification type 32-D/4.2 and L2/L3 ratio (L2, length of femur fixed by the two screws farthest from the fracture line; L3, the total length from the greater trochanter to the distal end of femur; P < 0.001 and P = 0.0141, respectively). Multivariate analysis showed that PCCF classification type 32-D/4.2 and L2/L3 ratio were also independent risk factors for femoral refracture. Conclusions Femoral shaft refracture is relatively common in children treated with external fixation. Because of the limited number of cases in this study, we cautiously concluded that the PCCF classification type 32-D/4.2 and L2/L3 ratio were independent risk factors for femoral shaft refracture in these patients. Level of evidence IV

Early gastric cancer with an Adachi type VI (group 26) vascular anomaly diagnosed preoperatively and treated by laparoscopic surgery: a case report

Background It is important to understand the branching pattern of the celiac artery for a safe surgery. Various branching anomalies of the celiac artery were classified by Adachi in 1928. In Adachi’s classification, type VI (group 26) is a rare anatomical anomaly (0.4%) that requires care when carrying out a surgery in gastric cancer patients with this anomaly. Herein, we reported a case treated successfully with laparoscopic distal gastrectomy with D1+ lymph node dissection for early gastric cancer. Case presentation An 84-year-old female was referred to our division for an additional surgical treatment for early gastric cancer that was resected by endoscopic submucosal dissection. A three-dimensional computed tomography angiography revealed an angioplany of the common hepatic artery branching from the left gastric artery. According to Adachi’s classification, the anomaly of this patient corresponded to type VI (group 26). Preoperative anatomical information of this rare anomaly helped us to safely perform a laparoscopic distal gastrectomy and lymph node dissection with common hepatic artery preservation. The patient had an uneventful postoperative course and was discharged on postoperative day 11. Conclusions We consider that Group 26 anomalies require the most precise anatomical understanding among Adachi classification type VIs, since it affects hepatic blood flow and can cause serious complications. In this time, we reported a successful case to perform laparoscopic distal gastrectomy with safety and accuracy by preoperative understanding of the precise vascular anatomy.

EVALUATION OF GROUNDWATER QUALITY IN AL-WAFFA AND KUBAYSA AREAS USING MULTIVARIATE STATISTICAL ANALYSIS, AL-ANBAR, WESTERN IRAQ

The groundwater is a substantial source of fresh water and has been used for various anthropogenic uses. The aim of this work is to investigate groundwater quality and type in kubaysa and AL-Waffa areas, Anbar, Iraq using multivariate statistics approach. The groundwater was sampled from ten wells for each region during the period from October 2018 to March 2019. The levels of T, TUR, pH, EC, TDS, DO, COD, TH, Na+, K+, Ca2+, Mg2+, NH4+, Cl-, F-, SO42-,, NO3-, HCO3-, S-2 and SiO2, were measured. The majority of the physicochemical parameters exceed the permissible guidelines. Pearson’s Correlation technique, multivariate statistical tools such as cluster analysis and principle component analysis were applied to determine the groundwater type. For Al –Waffa area, the EC had a positive strong correlation with TDS, Na+, Cl-. The TDS had positive strong correlations with NO3-. TH and Ca2+ possess a very good positive correlation between each other and positive strong correlations with SO42-. Sodium has positive strong correlations with k+ and Cl-. For the kubaysa area, the EC has positive strong correlations with TDS, Na+, K+ and Cl-. The TDS have positive strong correlations with TH, Ca2+, Na+, K+, Cl-, and SO42-. The piper diagram indicates that the groundwater types in AL-Waffa and kubaysa regions are Ca2+, Mg2+, SO42- and Ca2+, Mg2+,Cl-, SO42 respectively. The results showed unsuitable water for drinking purposes and need to be treated. The main finding of the current study is a suggestion to use the multivariate statistics technique in determining the groundwater classification type as an alternative method for the piper diagram.

Is Automation Appropriate? Semi-autonomous Telepresence Architecture Focusing on Voluntary and Involuntary Movements

This research aims to clarify the type of autonomous movements appropriate for telepresence robots. The design of telepresence robots’ autonomous movements should take into account both local and remote users. From the perspective of local users, we need autonomous movements that enhance a social telepresence in order to smooth remote communication. On the other hand, from the perspective of remote users, autonomous movements should be considered not only to reduce the operation load but also to address the danger of causing discomfort. However, in previous studies on automation, the criteria about which type of movements should be automated has remained unsettled. In this paper, we focused on voluntary and intentional movements as a classification type of movements that can be the criteria. Voluntary movements are intentional movements, whereas involuntary movements are movements without intention. To verify the effect of the automation of these movements, we developed a semi-autonomous telepresence robot that automates voluntary and involuntary movements. Then, we evaluated the impressions from local and remote users by conducting two experiments from each perspective. As a result, when not used in excess, local users evaluated both voluntary and involuntary autonomous movements positively, while it was suggested that automation of voluntary movements for remote users should be implemented with care.

AN ANALYSIS OF SPEECH ACT CLASSIFICATION IN BEAUTY AND THE BEAST

Pragmatics is study of significance aspects and language use which are dependent to the speaker, the addressee and other characteristics about the context of utterance. Along with communication, we are as humans do it as speakers who deliver utterance or anything to the addressee. Therefore communication and language are related to another one with pragmatics. Usually people utilize language in spoken and written, for instance conversation writing ideas, thoughts and so on in the book. For example cerebration contained in fairy tale stories were poured through the writer that one may be understood by readers. These ideas are expressed in the form about speech acts as described in Yule's theory in his book Pragmatics: Speech Act Classification (1996), there are five classifications of speech act pragmatically that can be proposed with a speaker such as representatives, directives, commissives, expressives, and declarations. The researchers used Beauty and the Beast short story to be analyzed classification about speech act. The method used in this analysis is a descriptive qualitative method. The results in this study, there are 10 speech act in short story Beauty and the Beast. In the outcomes of this study, that speech act classified into 4 types. Speech act classification is mostly Directives (50%); Representatives (30%); Declarations (10%); and Commissives (10%). The classification type unfound in the story above is Expressives.

The Problem of the Approach Definition

The idea of approach in linguistic education has often been defined as a certain overall view of language and its acquisition. This kind of description evades distinct analysis as long as the two constituents are isolated crystallizations of largely different domains. The insulation of the major conceptual constituents causes the imprecision of current approach definitions which hampers specifying the concept's characteristics. The formulation of a precise definition implies extinguishing the concept's ambivalence for a new working model of the concept to be developed and its relations with coterminous notions to be explicated. The task of this chapter is to work out a conceptualization of an approach definition based on a variety of the concept's dimensions delineated due to establishing a new configuration of the concept perspectives viewed in terms of approach essentials. The main issues considered include the feasibility of approach definition, extinguishing the ambivalence of the approach concept, general principles of approach classification, type groups and taxonomies, antinomies of the approach concept definition issues, definition patterns of approach and the contiguous notions of method and technique, and conditions and criteria involved in the notional cluster.

Asymptotic analysis of the Ginzburg–Landau functional on point clouds

The Ginzburg–Landau functional is a phase transition model which is suitable for classification type problems. We study the asymptotics of a sequence of Ginzburg–Landau functionals with anisotropic interaction potentials on point clouds Ψnwherendenotes the number data points. In particular, we show the limiting problem, in the sense of Γ-convergence, is related to the total variation norm restricted to functions taking binary values, which can be understood as a surface energy. We generalize the result known for isotropic interaction potentials to the anisotropic case and add a result concerning the rate of convergence.