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  • 1
    Online Resource
    Online Resource
    C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases
    SAGE Publications ; 2017
    In:  Global Spine Journal Vol. 7, No. 1_suppl ( 2017-04), p. 64S-70S
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 7, No. 1_suppl ( 2017-04), p. 64S-70S
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568216688189
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2648287-3
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  • 2
    Online Resource
    Online Resource
    Rare Complications of Cervical Spine Surgery: Pseudomeningocoele
    SAGE Publications ; 2017
    In:  Global Spine Journal Vol. 7, No. 1_suppl ( 2017-04), p. 109S-114S
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 7, No. 1_suppl ( 2017-04), p. 109S-114S
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568216687769
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2648287-3
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  • 3
    Online Resource
    Online Resource
    Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review
    SAGE Publications ; 2017
    In:  Global Spine Journal Vol. 7, No. 1_suppl ( 2017-04), p. 115S-119S
    Details
    In: Global Spine Journal, SAGE Publications, Vol. 7, No. 1_suppl ( 2017-04), p. 115S-119S
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/2192568216688194
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2648287-3
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  • 4
    Online Resource
    Online Resource
    Sustained improvement in Expanded Disability Status Scale as a new efficacy measure of neurological change in multiple sclerosis: treatment effects with natalizumab in patients with relapsing multiple sclerosis
    SAGE Publications ; 2011
    In:  Multiple Sclerosis Journal Vol. 17, No. 8 ( 2011-08), p. 970-979
    Details
    In: Multiple Sclerosis Journal, SAGE Publications, Vol. 17, No. 8 ( 2011-08), p. 970-979
    Abstract: Background: Validated measures of sustained improvements in neurological function have not been established for multiple sclerosis (MS) clinical studies. Objective: To evaluate sustained Expanded Disability Status Scale (EDSS) change as a potential indicator of neurological improvement and as an outcome measure in MS clinical studies. Methods: Analyses were performed on patients ( n = 620) from the pivotal natalizumab study AFFIRM with baseline EDSS scores ≥2.0. Cumulative probabilities of neurological improvement, defined as a 1.0-point decrease in EDSS score sustained for ≥12 weeks, were estimated by Kaplan–Meier analysis. A Cox proportional hazards model identified associated baseline factors and examined treatment effects. Results: Sustained improvement (as well as sustained worsening) in neurological disability was seen in AFFIRM patients. Sustained EDSS changes correlated well with quality of life measurements (SF36 and VAS). Natalizumab increased the cumulative probability of improvement over 2 years by 69% versus placebo (HR = 1.69; 95% CI 1.16–2.45; p = 0.006). Sensitivity analyses showed consistent benefits of natalizumab with variations in improvement magnitude and duration, and baseline disease activity. Conclusion: These analyses demonstrate that sustained EDSS improvement is an additional measure that is sensitive to treatment effects over 2 years and correlates with quality of life. Further research is warranted to validate its use as an MS study clinical outcome.
    Type of Medium: Online Resource
    ISSN: 1352-4585 , 1477-0970
    URL: Article
    DOI: 10.1177/1352458511399611
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
    detail.hit.zdb_id: 2008225-3
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  • 5
    Online Resource
    Online Resource
    Sustainable Development Awareness and Policy Making in Malta
    SAGE Publications ; 2019
    In:  Journal of Education for Sustainable Development Vol. 13, No. 2 ( 2019-09), p. 152-167
    Details
    In: Journal of Education for Sustainable Development, SAGE Publications, Vol. 13, No. 2 ( 2019-09), p. 152-167
    Abstract: Policymakers’ understanding of the holistic nature and implications of sustainable development (SD) determines a nation’s commitment to sustainability. The study involved in-depth interviews with 20 policymakers. The study identified underlying interconnections between policymakers’ perceptions, commitment and awareness of SD and whether they developed the necessary values and attitudes required to promote sustainability at both local and national levels. These findings provided reflections for the development of Education for Sustainable Development programmes targeting policy makers to expedite implementation of SD in Malta.
    Type of Medium: Online Resource
    ISSN: 0973-4082 , 0973-4074
    URL: Article
    DOI: 10.1177/0973408219872081
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2387723-6
    SSG: 5,3
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  • 6
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    Online Resource
    Reliability of Radiographic Imaging Characteristics for Osteochondritis Dissecans of the Capitellum
    SAGE Publications ; 2022
    In:  The American Journal of Sports Medicine Vol. 50, No. 14 ( 2022-12), p. 3948-3955
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 50, No. 14 ( 2022-12), p. 3948-3955
    Abstract: A primary challenge in the treatment of capitellar osteochondritis dissecans (OCD) is accurate imaging assessment. Radiographic classification consensus is not available in the current literature, and correlation of radiographs with lesion stability and resultant best treatment is lacking. Purpose: To determine the inter- and intrarater reliability of the presence or absence and common radiographic characteristics of capitellar OCD lesions. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Anteroposterior, lateral, and oblique radiographs for 29 cases were reviewed by 7 orthopaedic surgeons. Images were assessed for elbow anthropometry and morphology, OCD presence, lesion characteristics, the presence of progeny bone and progeny features, and radial head abnormalities. Intra- and interrater reliability was assessed using Fleiss and Cohen kappa for nominal variables and intraclass correlation coefficients (ICCs) for continuous variables. Results: Surgeons demonstrated substantial to excellent inter- and intrarater reliability when assessing elbow characteristics: anthropometric (interrater ICC, 0.94-0.99; intrarater ICC, 0.82-0.96) and morphologic (Fleiss, 0.61-0.76; Cohen, 0.68). When the OCD lesion was assessed, fair to moderate interrater agreement was found for classifying the absence or presence of a lesion (Fleiss, 0.28-0.46) and the location of the OCD (Fleiss, 0.24-0.52), poor agreement for assessing the contour of the lesion (Fleiss, 0.00-0.09), and excellent agreement for measuring the size of the lesion (ICC, 0.82-0.94). Poor to fair interrater agreement was found for radial head abnormalities (Fleiss, 0.00-0.27). Progeny bone visualization and fragmentation demonstrated moderate interrater agreement (Fleiss, 0.43-0.47) where displacement of the bone demonstrated poor interrater agreement (Fleiss, 0.11-0.16). Intrarater agreement for OCD lesion characteristics, progeny bone visualization, and progeny bone features was moderate to excellent. Conclusion: Given only the fair to moderate agreement among raters for identifying OCD on radiographs, this imaging modality may not serve as a dependable screening tool in isolation. Additional imaging should be obtained if the clinical presentation suggests capitellar OCD and a definitive diagnosis is not possible with radiographs. However, clinicians can reliability measure the size of radiographically apparent OCD, suggesting that radiographs may serve as an appropriate imaging modality for follow-up care.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/03635465221130452
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 7
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    Online Resource
    Ideal Anatomic Location for Saphenous Nerve Block for Foot and Ankle Surgeries: A Prospective Randomized Clinical Evaluation
    SAGE Publications ; 2019
    In:  Foot & Ankle Orthopaedics Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0003-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 4, No. 4 ( 2019-10-01), p. 2473011419S0003-
    Abstract: Regional anesthesia for foot and ankle surgery Introduction/Purpose: Regional anesthesia has resulted in significant improvements in patient outcomes including reduced postoperative pain, opioid consumption, opioid-related adverse effects, and decreased postoperative length of stay. Saphenous nerve blocks provide distal analgesia while minimizing the reduction in quadriceps strength seen with more proximal femoral nerve blocks. Saphenous nerve blocks may be performed at the mid-thigh with the subsartorial technique or just proximal to the knee with the transsartorial technique. The present study compares these two techniques in terms of analgesia effectiveness and quadriceps motor preservation. Methods: This study was approved by our institutional IRB committee. A power analysis was conducted prior to the study. Patients, aged 18 to 65, were prospectively identified from a list of elective foot and ankle surgeries performed by one of the study investigators. Preoperatively, bilateral isometric knee extension strength was measured, and subjects completed a PROMIS global health survey. The surgeon was blinded to the randomization of patients to proximal or distal blocks. Bilateral isometric knee extension strength was reassessed following the block as well as sensation, post-operative visual analogue pain score (VAS), and subjective satisfaction. Due to non-normality of the sample, the Wilcoxon rank-sum test was employed to analyze continuous variables such as strength measures. For categorical variables such as gender, pain score, and patient satisfaction, the Pearson chi- square test was used. Results: Twenty-four patients (24 lower extremities) were enrolled in the study and 12 randomized to each group. The two groups were not significantly different in age, gender, or pre-operative PROMIS Mental and Physical Summary Scores. The nerve block procedure was successfully performed in a single attempt in all cases. The VAS was not significantly different at 2 in the distal group and 3 in the proximal group. In each group 11 patients were totally satisfied with the block and 1 was moderately satisfied. The knee extension strength decreased in both the operative and non-operative lower extremity following administration of the nerve block. When normalized to the effect in the non-operative extremity, there was no significant difference in strength decrease between the two groups (p=0.89). Conclusion: This randomized, single-blinded trial compared proximal subsartorial saphenous nerve block with distal transsartorial saphenous nerve block outside of the adductor canal. There was no significant difference in the efficacy of the two techniques was observed in terms of VAS pain score or patient satisfaction and no difference in post-operative weakness. This is the first randomized trial on saphenous nerve blocks to normalize strength to the non-operative lower extremity, reducing the confounding effect of peri-operative narcotic and sedative medications. This study offers evidence for equivalence of the subsartorial and transsartorial saphenous nerve block techniques.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011419S00030
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2874570-X
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  • 8
    Online Resource
    Online Resource
    The role of students’ voices and their influence on adults in creating more sustainable environments in three schools
    SAGE Publications ; 2007
    In:  Improving Schools Vol. 10, No. 1 ( 2007-03), p. 72-85
    Details
    In: Improving Schools, SAGE Publications, Vol. 10, No. 1 ( 2007-03), p. 72-85
    Abstract: This article draws on the Sustainability Education in European Primary Schools (SEEPS) Project, which was an EU-funded project examining approaches to sustainability education. As part of that project the team developed a case study approach to the individual country contributions to the overall project, which concluded by developing a model based on whole institution approaches to school improvement towards sustainability. These case studies form the basis of this article. In the article we draw on case study materials from a range of European countries to examine how learners perceive their participation in school improvements towards sustainability to be conceived and received by school administrators and teachers. The article tries to develop a meta-analytical rather than descriptive account of the case studies in order to identify commonalities across the cases relating to the learner’s participation in decisions about learning.
    Type of Medium: Online Resource
    ISSN: 1365-4802 , 1475-7583
    URL: Article
    DOI: 10.1177/1365480207073723
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2171399-6
    SSG: 5,3
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  • 9
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    Online Resource
    Descriptive Epidemiology From the Research in Osteochondritis Dissecans of the Knee (ROCK) Prospective Cohort
    SAGE Publications ; 2022
    In:  The American Journal of Sports Medicine Vol. 50, No. 1 ( 2022-01), p. 118-127
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 50, No. 1 ( 2022-01), p. 118-127
    Abstract: Osteochondritis dissecans (OCD) occurs most commonly in the knees of young individuals. This condition is known to cause pain and discomfort in the knee and can lead to disability and early knee osteoarthritis. The cause is not well understood, and treatment plans are not well delineated. The Research in Osteochondritis Dissecans of the Knee (ROCK) group established a multicenter, prospective cohort to better understand this disease. Purpose: To provide a baseline report of the ROCK multicenter prospective cohort and present a descriptive analysis of baseline data for patient characteristics, lesion characteristics, and clinical findings of the first 1000 cases enrolled into the prospective cohort. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Patients were recruited from centers throughout the United States. Baseline data were obtained for patient characteristics, sports participation, patient-reported measures of functional capabilities and limitations, physical examination, diagnostic imaging results, and initial treatment plan. Descriptive statistics were completed for all outcomes of interest. Results: As of November 2020, a total of 27 orthopaedic surgeons from 17 institutions had enrolled 1004 knees with OCD, representing 903 patients (68.9% males; median age, 13.1 years; range, 6.3-25.4 years), into the prospective cohort. Lesions were located on the medial femoral condyle (66.2%), lateral femoral condyle (18.1%), trochlea (9.5%), patella (6.0%), and tibial plateau (0.2%). Most cases involved multisport athletes (68.1%), with the most common primary sport being basketball for males (27.3% of cases) and soccer for females (27.6% of cases). The median Pediatric International Knee Documentation Committee (Pedi-IKCD) score was 59.9 (IQR, 45.6-73.9), and the median Pediatric Functional Activity Brief Scale (Pedi-FABS) score was 21.0 (IQR, 5.0-28.0). Initial treatments were surgical intervention (55.4%) and activity restriction (44.0%). When surgery was performed, surgeons deemed the lesion to be stable at intraoperative assessment in 48.1% of cases. Conclusion: The multicenter ROCK group has been able to enroll the largest knee OCD cohort to date. This information is being used to further understand the pathology of OCD, including its cause, associated comorbidities, and initial presentation and symptoms. The cohort having been established is now being followed longitudinally to better define and elucidate the best treatment algorithms based on these presenting signs and symptoms.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/03635465211057103
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 10
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    The Effect of Bone Mineral Density on Anchor Function and Its Implication on the Pull-out Strength of Trans-osseous Sutures and Ultrafix Rotator Cuff Anchors
    SAGE Publications ; 2010
    In:  Shoulder & Elbow Vol. 2, No. 3 ( 2010-07), p. 175-181
    Details
    In: Shoulder & Elbow, SAGE Publications, Vol. 2, No. 3 ( 2010-07), p. 175-181
    Abstract: An experimental study was carried out to assess the influence of Bone Mineral Density (BMD) of the humeral head, neck and greater tuberosity in seven pairs of fresh frozen humeri on the pull out strength of the Ultra-Fix Anchor (Stryker, Inc, USA) and the standard intra-osseous sutures used to repair rotator cuff tears. Method An anchor and a transosseous suture were placed in a trough, created with a 6 mm burr in the cuff footprint of each humeral head by the same specialist shoulder surgeon (L.N.). The technique for intra-osseous suture and anchor localisation were standardised using a 5 Metric (No 2) braided polyester suture (Ethibond, Ethicon, UK). Both fixation methods were subjected to tensile testing with the humeri mounted at 30° of abduction corresponding to the direction of anatomical pull of the supraspinatus muscle. Results and discussion There was a significant linear correlation (p = 0.007) between Ultra-fix anchor pull-out strength and humeral head BMD as well as between bone suture failure strength and humeral neck BMD (p = 0.015) There was no correlation between the BMD of the greater tuberosity and failure strengths of both fixation methods. (p = 0.23 for anchor and p = 0.29 for bone suture) The Ultra-fix anchor was significantly stronger in pull-out when compared to the bone suture (p = 0.05). Conclusion The mean pull-out strength of the Ultrafix rotator cuff anchor is significantly higher when compared to the traditional bone suture technique for anchorage into a proximal humerus trough (141.7 N and 111.6 N, respectively).There is a significant correlation between the total BMD of the proximal humerus (head, neck and greater tuberosity regions) and the pull-out strength of both the anchor (p = 0.039) and bone sutures (p = 0.024).
    Type of Medium: Online Resource
    ISSN: 1758-5732 , 1758-5740
    URL: Article
    DOI: 10.1111/j.1758-5740.2010.00079.x
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 2503300-1
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