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The academic landscape is fraught with challenges, particularly for scholars whose identities intersect with marginalised backgrounds. This reflective paper explores the nuanced implications of revisions, corrections or rejections (RCRs) on the academic journey of a Black isiZulu-speaking African woman scholar in Audiology from South Africa. It contends that the effects of RCRs extend beyond the confines of a single manuscript, impacting the scholar’s sense of self, existence within the academic realm, and the deliberate ‘cancelling’ of one’s knowledge. Focusing on the unique challenges faced by African scholars, particularly the perceived emphasis on publishing as a measure of belonging, the paper employs a benefit-risk evaluation lens. This approach delves into the complex interaction between personal and environmental factors, shedding light on the multifaceted considerations that African scholars grapple with to establish their presence within the academic sphere. The paper outlines the well-known ‘publish or perish’ phenomenon, emphasising the hypercompetitive nature of the academic and research environment. Peer review, considered a critical component in the publication process, is explored for its role in quality assurance. However, the paper contends that the peer review process can inadvertently perpetuate inequalities, especially for scholars from underrepresented backgrounds. Thematic analysis of reviewer reports from papers I recently submitted forms the core of the paper. Seven emergent themes, such as the influence of proximity to native English speakers and the dominance of Western narratives, illustrate the challenges I faced in both local and international journals. Notably, the paper provides direct quotes exemplifying each theme, offering a very personalised perspective on the adversities encountered during the publication journey. The paper situates the field of audiology within the broader context of institutional and systemic racism, highlighting the underrepresentation of certain racial groups within the profession. It argues that this underrepresentation extends to knowledge generation and publishing, perpetuating the normalisation of Euro-American-centric norms and the exoticisation of Afrocentric standards. The reflective paper concludes by asserting that epistemological racism, intertwined with individual and institutional racism, stifles my pursuit of decolonisation and Africanisation of speech-language and hearing knowledge and practice. It contends that the peer review process, often Euro-American-centric, contributes to the silencing and exclusion of diverse knowledges, hindering local knowledge development and intellectual practices. In navigating the academic minefield, the paper calls for a re-evaluation of existing norms and practices within the peer review process to create a more inclusive and equitable academic environment for scholars with diverse backgrounds. [ABSTRACT FROM AUTHOR]

Intraoperative calcar fractures (IOCFs) are an established complication of cementless total hip arthroplasty (THA). Prompt recognition and management may prevent subsequent postoperative complications. This study aimed to evaluate the outcomes and revision rates of THAs with IOCFs identified and managed intraoperatively. There were 11,438 primary cementless THAs performed at a single institution from 2009 to 2022. Prospectively collected data on cases with an IOCF was compared to cases without the complication. The fracture group had a lower body mass index (26.9 versus 28.9 kg/m2; P =.01). Patient age, sex, and mean follow-up (3.2 (0 to 12.8) versus 3.5 years (0 to 14); P =.45) were similar between groups. An IOCF occurred in 62 of 11,438 (0.54%) cases. The THAs done via a direct anterior approach experienced the lowest rate of fractures (31 of 7,505, 0.4%) compared to postero-lateral (27 of 3,759, 0.7%; P =.03) and lateral (4 of 165, 2.4%; P <.01) approaches. Of the IOCFs, 48 of 62 (77%) were managed with cerclage cabling, 4 of 62 (6.5%) with intraoperative stem design change and cabling, 4 of 62 (6.5%) with restricted weight-bearing, and 6 of 62 (9.7%) with no modification to the standard postoperative protocol. The IOCF group experienced one case of postoperative component subsidence. No subjects in the IOCF cohort required revision, and rates were similar between groups (0 of 62, 0% versus 215 of 11,376, 1.9%; P =.63). Postoperative Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement scores were comparable (85.7 versus 86.4; P =.80). Cementless THA complicated by IOCF had similar postoperative revision rates and patient-reported outcome measures at early follow-up when compared to patients not experiencing this complication. Surgeons may use these data to provide postoperative counseling on expectations and outcomes following these rare intraoperative events. [ABSTRACT FROM AUTHOR]

Introduction: In the last few years, short metaphyseal-socket prosthetic humeral stems have been introduced for reverse shoulder arthroplasty (RSA). A short stem may have advantages in humeral force distribution, reducing shear stress and preserving bone stock, keeping in mind the need for possible future revision surgery. The main objective of our study was to validate the use of a short stem prosthesis in the surgical treatment of humeral fractures by comparing clinical and radiological outcomes of our studied implant with those obtained with the use of traditional long-stem implants. Methods: In this multicentric, controlled prospective study, 125 patients with proximal three- or four-fragment humerus fractures were selected and treated with RSA. A short stem was used in group A (n = 53, mean age: 75.6 ± 5.6 years old), and a long stem was used in group B (n = 72, mean age: 71.76 ± 3). Active range of motion (ROM), Constant score (CS), Quick DASH, American Shoulder and Elbow Surgeons Shoulder (ASES) score, and Visual Analog Scale (VAS) scores were collected and analyzed at 2 years mean follow-up, as well as humeral and glenoid bone resorption (sum Inoue scores and Sirveaux scores were used). Results: No statistically significant differences were observed between group A and B in ROM, Constant score (51.69 ± 15.8 vs. 53.46 ± 15.96, p > 0.05), Quick DASH (31.5 ± 21.81 vs. 28.79 ± 13.72, p = 0.85), ASES (82.53 ± 17.79 vs. 84.34 ± 15.24, p = 0.57), or the VAS (0.53 ± 1 vs. 0.56 ± 1.07, p = 0.14) at the final follow-up. No statistically significant differences were found in the radiographic parameters between the two groups. No statistically significant differences were found for the average degree of humeral and glenoid bone resorption either. Conclusions: The use of a short metaphyseal-socket stem can be considered a safe, effective, and feasible option in reverse shoulder arthroplasty for treating proximal humerus fractures. Our results are encouraging, with no statistically significant differences identified between the proposed treatment and traditional long stems. [ABSTRACT FROM AUTHOR]

Lumbar discectomy is a commonly performed surgery following which surgical site infection (SSI) may occur. Prior literature has suggested that, following SSI related to lumbar fusion, the rate of subsequent lumbar surgeries is increased over prolonged periods of time. This has not been studied specifically for lumbar discectomy. To define factors associated with SSI following lumbar discectomy and determine if subsequently matched cohorts with and without SSI have differential rates of subsequent lumbar surgery beyond irrigation and debridement (I&Ds) over time. Retrospective cohort study. Adult patients undergoing isolated primary lumbar laminotomy/discectomy were identified from the 2010-2021 M157 PearlDiver database. Exclusion criteria included: age<18 years, preoperative diagnosis of infection, neoplastic, or traumatic diagnoses within 90 days prior to index surgery, additional spinal surgeries on the same day as lumbar discectomy, and not being active in the database for at least 90 days postoperative. From this study population, those who developed SSI were identified based on undergoing I&D within 90 days after surgery. Those with versus without SSI were then matched 1:4 based on age, sex, Elixhauser Comorbidity Index (ECI), and obesity. Following initial I&D, incidence of revision lumbar surgery (revision lumbar discectomy, lumbar laminectomy, lumbar fusion) out to 5 years after lumbar discectomy. Following index isolated lumbar discectomy, those with versus without SSI requiring I&D were matched and compared for incidence of secondary surgery in defined time intervals (0–6 months, 6–12 months, 1–2 years, 2–5 years) using multivariable logistic regression, controlling for patient age, sex, ECI, and obesity status. Of 323,025 isolated lumbar discectomy patients, SSI requiring I&D was identified for 583 (0.18%). Multivariable analysis revealed several independent predictors of these SSIs: younger age (odds ratio [OR] 0.85 per decade increase), ECI (OR 1.22 per 2-point increase), and obesity (OR 1.30). Following matching of those with versus without SSI requiring I&D, rates of subsequent surgery beyond I&D were compared. Those with SSI had significantly increased odds of lumbar revision in the first six months (OR 5.26, p<.001), but not 6–12 months (p=.462), 1–2 years (p=.515), or 2–5 years (p=.677). Overall, SSI requiring I&D is a rare postoperative complication following lumbar discectomy. If occurring, subsequent surgery beyond I&D was higher in the first 6 months, but then not increased at subsequent time points out to five years. [ABSTRACT FROM AUTHOR]

Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are commonly performed operations to address cervical radiculopathy and myelopathy. Trends in utilization and revision surgery rates warrant investigation. To explore the epidemiology, postoperative complications, and reoperation rates of ACDF and CDA. Retrospective cohort study. A total of 433,660 patients who underwent ACDF or CDA between 2011 and 2021 were included in this study. The following data were observed for all cases: patient demographics, complications, and revisions. The PearlDiver database was queried to identify patients who underwent ACDF and CDA between 2011 and 2021. Epidemiological analyses were performed to examine trends in cervical procedure utilization by age group and year. After matching by age, sex, Charlson Comorbidity Index (CCI), levels of operation, and reason for surgery, the early postoperative (2-week), short-term (2-year), and long-term (5-year) complications of both cervical procedures were examined. In total, 404,195 ACDF and 29,465 CDA patients were included. ACDF utilization rose by 25.25% between 2011 and 2014 while CDA utilization rose by 654.24% between 2011-2019 followed by relative plateauing in both procedures. Mann-Kendall trend test confirmed a significant but small rise in ACDF and large rise in CDA procedures from 2011 to 2021 (p<.001). After matching, ACDF and CDA had an overall complication rate of 12.20% and 8.77%, respectively, with the most common complications being subsequent anterior revision (4.96% and 3.35%) and dysphagia (3.70% and 2.98%). The ACDF cohort, especially multilevel ACDF patients, generally had more complications and higher revision rates than the CDA cohort (p<.05). While ACDF utilization has plateaued since 2014, CDA rates have risen by a staggering 654.24% over the past decade. ACDF and CDA complication and revision rates were relatively low in comparison to previously published values, with significantly lower rates in CDA. Although a lack of radiographic data in this study limits its power to recommend either procedure for individual patients with cervical radiculopathy or myelopathy, CDA may be associated with minor improvement in the complication and revision profile. [ABSTRACT FROM AUTHOR]

Introduction: Patients with sleep apnea, affecting up to 1 in 4 older men in the United States, may be at increased risk of postoperative complications after total knee arthroplasty (TKA), including increased thromboembolic and cerebrovascular events, as well as respiratory, cardiac, and digestive complications. However, the extent to which the use of CPAP in patients with sleep apnea has been studied in TKA is limited. Methods: A national, all-payer database was queried to identify all patients who underwent a primary TKA between 2010 and 2021. Patients who had any history of sleep apnea were identified and then stratified based on the use of CPAP. A propensity score match analysis was conducted to limit the influence of confounders. Medical complications, such as cardiac arrest, stroke, pulmonary embolism, transfusion, venous thromboembolism, and wound complications, were collected at 90-days, 1-year, and 2-years. Results: The bivariate analysis showed inferior outcomes for sleep apnea with CPAP use compared to sleep apnea with no CPAP use, in terms of length of stay (5.9 vs. 5.2, p < 0.001), PJI (1.31% vs. 1.14%, p < 0.001), stroke (0.97% vs. 0.82%, p < 0.001), VTE (1.04% vs. 0.82, p < 0.001), and all other complications at 90-days (p < 0.001) except cardiac arrest (0.14% vs. 0.11%, p = 0.052), and aseptic revision (0.40% vs. 0.39%, p = 0.832), PJI (1.81% vs. 1.55%, p < 0.001) and aseptic revision (1.25% vs. 1.06%, p < 0.001) at 1-year, and PJI (2.07 vs. 1.77, p < 0.001) and aseptic revision (1.98 vs. 1.17, p < 0.001) at 2-years. Conclusion: Patients with sleep apnea have increased postoperative complications after undergoing TKA in comparison to patients without sleep apnea. More severe sleep apnea, represented by CPAP usage in this study led to worse postoperative outcomes but further analysis is required signify the role of CPAP in this patient population. Patients with sleep apnea should be treated as a high-risk group. [ABSTRACT FROM AUTHOR]

Introduction: In Western countries, there has been a rise in the prevalence of Crohn's Disease (CD) and primary total knee arthroplasty (TKA). This study delves deeper into the effects of CD on TKA patients by examining (1) the length of in-hospital stay (LOS); (2) the rates of readmission; (3) complications related to implants; and (4) the costs associated with care. Methods: A retrospective analysis using the PearlDiver database was conducted, encompassing the time frame between January 1st, 2005 and March 31st, 2014, focusing on patients who underwent TKA and were either diagnosed with CD or not. Patients with CD were paired with control subjects at a 1:5 ratio based on age, gender, and medical comorbidities. The analysis comprised a total of 96,229 patients (CD = 16,039; non-CD = 80,190). Results: Patients with CD had a notably longer hospital stay (3 v. 2 days, p < 0.0001) and faced significantly higher rates of 90-day readmissions and complications (19.80% v. 14.91%, OR: 1.40, p < 0.0001; 6.88% v. 4.88%, OR: 1.43, p < 0.0001 respectively). Additionally, CD patients incurred greater expenses on the surgery day ($18,365.98 v. $16,192.00) and within 90 days post-surgery ($21,337.46 v. $19,101.42). Conclusion: This study demonstrates longer in-hospital LOS, higher rates of readmissions, implant-related complications, and costs of care among CD patients following primary TKA. [ABSTRACT FROM AUTHOR]

Abstract Background Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Although some risk factors of PJI were well studied, the association between trauma and PJI remains unknown in revision patients. Materials and methods Between 2015 and 2018, a total of 71 patients with trauma history before revisions (trauma cohort) were propensity score matched (PSM) at a ratio of 1 to 5 with a control cohort of revision patients without a history of trauma. Then, the cumulative incidence rate of PJI within 3 years after operation between the two groups was compared. The secondary endpoints were aseptic revisions within 3 postoperative years, complications up to 30 postoperative days, and readmission up to 90 days. During a minimal 3-year follow-up, the survival was comparatively analyzed between the trauma cohort and the control cohort. Results The cumulative incidence of PJI was 40.85% in patients with trauma history against 27.04% in the controls (P = 0.02). Correspondingly, the cumulative incidence of aseptic re-revisions was 12.68% in patients with trauma history compared with 5.07% in the control cohort (P = 0.028). Cox regression revealed that trauma history was a risk factor of PJI (HR, 1.533 [95%CI, (1.019,2.306)]; P = 0.04) and aseptic re-revisions (HR, 3.285 [95%CI, (1.790,6.028)]; P

"Annabel Lee" is Poe's final poem, and although it was intended for publication, it appeared in print only after his death. It was, however, distributed during his lifetime in the form of five manuscripts, all of which survive to this day as cherished relics of the author. The speculative date assigned to each of these manuscripts, and consequently the sequence of revisions, has traditionally been based on when Poe gave them away over the course of the last five or six months of his life. This approach has historically granted the Thompson copy, which Poe had with him in Richmond, the high status of the final and thus the definitive authorized version. Two minor verbal changes have generally been accepted as of little consequence, but many commentators have lamented that the final line of the Thompson version changes "In her tomb by the sounding sea" to "In her tomb by the side of the sea." Looking carefully at the circumstances surrounding the creation and distribution of these manuscripts, as well as the texts themselves, suggests a radically different opinion of the sequence of revisions and a reconsideration of some importance in the matter of textual criticism of these texts for one of Poe's most studied and popular poems. [ABSTRACT FROM AUTHOR]

This study aims to establish a methodological framework for investigating deception in both spoken and written language production. A foundational premise is that the production of deceitful narratives induces a heightened cognitive load that has a discernable influence on linguistic processes during real-time language production. This study includes meticulous analysis of spoken and written data from two participants who told truthful and deceitful narratives. Spoken processes were captured through audio recordings and subsequently transcribed, while written processes were recorded using keystroke logging, resulting in final texts and corresponding linear representations of the writing activity. By grounding our study in a linguistic approach for understanding cognitive load indicators in language production, we demonstrate how linguistic processes, such as text length, pauses, fluency, revisions, repetitions, and reformulations can be used to capture instances of deception in both speaking and writing. Additionally, our findings underscore that markers of cognitive load are likely to be more discernible and more automatically measured in the written modality. This suggests that the collection and examination of writing processes have substantial potential for forensic applications. By highlighting the efficacy of analyzing both spoken and written modalities, this study provides a versatile methodological framework for studying deception during language production, which significantly enriches the existing forensic toolkit. [ABSTRACT FROM AUTHOR]

Study Design. Retrospective analysis on prospectively collected data. Objectives. To compare posterior lumbar fusions with versus without an interbody in: (1) Patient-reported outcomes (PROs) at 1 year and (2) postoperative complications, readmission, and reoperations. Summary of Background Data. Elective lumbar fusion is commonly used to treat various lumbar pathologies. Two common approaches for open posterior lumbar fusion include posterolateral fusion (PLF) alone without an interbody and with an interbody through techniques, like transforaminal lumbar interbody fusion. Whether fusion with or without an interbody leads to better outcomes remains an area of active research. Patients and Methods. The Lumbar Module of the Quality Outcomes Database was queried for adults undergoing elective primary posterior lumbar fusion with or without an interbody. Covariates included demographic variables, comorbidities, primary spine diagnosis, operative variables, and baseline PROs, including Oswestry Disability Index, North American Spine Society satisfaction index, numeric rating scale-back/leg pain, and Euroqol 5-dimension. Outcomes included complications, reoperations, readmissions, return to work/activities, and PROs. Propensity score matching and linear regression modeling were used to estimate the average treatment effect on the treated to assess the impact of interbody use on patient outcomes. Results. After propensity matching, there were 1044 patients with interbody and 215 patients undergoing PLF. The average treatment effect on the treated analysis showed that having an interbody or not had no significant impact on any outcome of interest, including 30-day complications and reoperations, 3-month readmissions, 12-month return to work, and 12-month PROs. Conclusion. There were no discernible differences in outcomes between patients undergoing PLF alone versus with an interbody in elective posterior lumbar fusion. These results add to the growing body of evidence that posterior lumbar fusions with and without an interbody seem to have similar outcomes up to 1 year postoperatively when treating degenerative lumbar spine conditions. [ABSTRACT FROM AUTHOR]

Although the sleeve gastrectomy (SG) is the dominant bariatric procedure, studies have shown conversion rates of up to 30%. These conversions are generally for weight regain (WR), insufficient weight loss (IWL) or gastroesophageal reflux disease (GERD). Before 2020, details on why conversions were being performed were not collected in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use Data File (PUF). Now, the indication for sleeve conversion is noted in the PUF, allowing identification and reporting sleeve conversion reasons. We aimed to examine the reasons for SG conversions nationwide. The 2020 MBSAQIP PUF. The 2020 MBSAQIP PUF was examined to determine the reasons why SG were converted to other operations. The data field of "Revision/Conversion Final Indication" was used along with "Procedure type." Primary bariatric operations were excluded. Descriptive statistics were applied. Different reasons for conversion and operations were compared by preoperative characteristics and operative outcomes. There were 103,782 primary SG reported in the 2020 PUF. There were 7181 SG that were converted to other operations. The most common conversion (86.2%) was to Roux-en-Y gastric bypass (RYGB). The main reason for SG conversion was GERD at 48.4%, followed by WR/IWL (41.9%). Biliopancreatic diversion with duodenal switch and single-anastomosis duodenoileal bypass with sleeve patients differed significantly from RYGB patients in specific preoperative characteristics and operative outcomes. The most common procedure SG is converted to is the RYGB. GERD was the most common reason for SG conversion, followed by WR/IWL. • The most common conversion procedure is SG to RYGB. • The main reason for SG conversion is GERD followed by WR/IWL. [ABSTRACT FROM AUTHOR]

This study aims to establish a methodological framework for investigating deception in both spoken and written language production. A foundational premise is that the production of deceitful narratives induces a heightened cognitive load that has a discernable influence on linguistic processes during real-time language production. This study includes meticulous analysis of spoken and written data from two participants who told truthful and deceitful narratives. Spoken processes were captured through audio recordings and subsequently transcribed, while written processes were recorded using keystroke logging, resulting in final texts and corresponding linear representations of the writing activity. By grounding our study in a linguistic approach for understanding cognitive load indicators in language production, we demonstrate how linguistic processes, such as text length, pauses, fluency, revisions, repetitions, and reformulations can be used to capture instances of deception in both speaking and writing. Additionally, our findings underscore that markers of cognitive load are likely to be more discernible and more automatically measured in the written modality. This suggests that the collection and examination of writing processes have substantial potential for forensic applications. By highlighting the efficacy of analyzing both spoken and written modalities, this study provides a versatile methodological framework for studying deception during language production, which significantly enriches the existing forensic toolkit.

Researchers and practitioners in foreign language learning continue investigating evolving technologies like machine translators and other artificial intelligence-assisted programs in classrooms. However, less attention has been given to less commonly taught languages, which often lack relevant resources compared to widely taught foreign languages such as English, despite machine translators’ potential in facilitating foreign language writing. This exploratory case study aims to address this gap by examining how US university students learning a less commonly taught language, Korean, use machine translators to revise their writing. Students were trained in a modified version of the Guided Use of Machine Translation model, which requires active engagement from students in selecting, comparing, revising, and justifying their writing choices. By analyzing their cognitive and behavioral engagement, the study sheds light on students’ approaches to incorporating machine translators’ output as feedback into their writing process. The findings suggest that students primarily focus on differences in word choice between their original writing and machine translators’ output over other areas such as particle usage. Students generally demonstrated the ability to accurately identify and correct their errors. Various revision strategies were implemented but adopting exact machine translators’ output was more commonly used, while students also exercised autonomy in their language choices. [ABSTRACT FROM AUTHOR]

Background Context: As surgical indications for cervical disc arthroplasty (CDA) continue to expand, a growing patient population is now becoming indicated for this procedure. Little is known about whether CDA is safe in the overweight and obese populations, and how this procedure compares to anterior cervical discectomy and fusion (ACDF) in this particular demographic., Purpose: To evaluate the outcomes of CDA across varying levels of body mass indices and to compare these to ACDF., Design: Retrospective cohort study., Patient Sample: A total of 12,454 patients who underwent CDA and 45,513 patients who underwent ACDF between 2011 and 2020 were included in this study., Outcome Measures: The following data were observed for all cases: patient demographics, complications, revisions., Methods: The PearlDiver database was queried to identify all adults who underwent single-level CDA. Patients were stratified by body mass index (BMI), defined as Healthy Weight (<25kg/m2), Overweight (25-30kg/m2), Obese (30-40kg/m2), and Morbidly Obese (>40kg/m2). Patient demographics and comorbidities were compared before matching, and medical and surgical complications were compared after matching for age, sex, and Charlson Comorbidity Index (CCI). Similar comparative analyses were performed on all obese patients (>30kgm/2) who underwent single-level CDA and single-level ACDF., Results: In total, 1907 Healthy Weight, 3295 Overweight, 5431 Obese, and 1821 Morbidly Obese patients were included. The mean age was between 45.43-47.41 years, 57.12-71.68% were female, and mean CCI was 1.16-1.73 across groups (all p<0.001). Mean CCI (Healthy Weight=1.16, Overweight=1.31, Obese=1.47, Morbidly Obese=1.63) and rate of comorbidities, such as diabetes (19.19%, 25.74%, 37.51%, 48.65%), hypertension (45.20%, 56.18%, 69.21%, 76.22%), and hyperlipidemia (49.34%, 60.61%, 65.33%, 64.96%), generally increased with increasing BMI (p<0.001). After matching, mean age was 44.59 years, 70.98% were female, and mean CCI was 1.07 for all groups. At 90 days postoperatively, medical complications, including infection, wound dehiscence, and readmissions, were comparable (p>0.05). At 2 years postoperatively, anterior revision was higher in Healthy Weight patients (30.27%, 28.11%, 24.71%, 24.96%, p=0.005) but other surgical complications, including dysphagia, dysphonia, and implant failure, were otherwise comparable (p>0.05). Comparison of all obese patients across cervical procedures revealed higher rates of 90-day emergency department visits (ACDF=21.56% vs 16.65%, p<0.001) and 1-year hardware removal (1.49% vs 0.81%, p=0.002), wound exploration (0.73% vs 0.35%, p=0.018), and posterior fusion (1.14% vs 0.44%, p<0.001) and lower rates of anterior revision (18.82% vs 23.68%, p<0.001) in ACDF patients compared to CDA patients., Conclusion: CDA may be safe across varying levels of obesity without any appreciable change in medical and surgical complications. In addition, single-level ACDF may result in higher complications than single-level CDA in the obese population., (Copyright © 2024. Published by Elsevier Inc.)

Automated writing evaluation (AWE) is increasingly used to provide formative feedback on second language (L2) students’ writing. A key factor influencing the effectiveness of AWE feedback on L2 writing performance is the learners’ revision behaviors as they process the feedback. Adopting a quasi-experiment, this study aims to evaluate the impacts of Criterion automated corrective feedback (ACF) on English as a foreign language (EFL) students’ writing performance based on two measures of accuracy: overall writing accuracy and accuracy of English article usage. Learners’ textual operations in response to Criterion ACF were examined for possible explanations for recorded gains (if any) in their writing accuracy. The main findings indicate a lack of intervention and retention effects on learners’ accuracy over the semester during which Criterion ACF was incorporated to supplement the writing instructor's feedback on organization and content. In addition, across four writing entries conducted on Criterion, learners’ revisions to their essays following Criterion ACF were primarily at the local level, dominated by addition, deletion, or substitution of individual words or short phrases rather than substantive revisions to their scripts. About one third of all Criterion feedback points did not result in textual changes to the first drafts, indicating a moderate uptake rate of the feedback. Implications related to formative feedback practices in the EFL writing classroom and the adaptation of Criterion's technical capacities are accordingly presented. [ABSTRACT FROM AUTHOR]

Background: Proximal humerus nonunion is a challenging complication of fractures that can be treated surgically with either open reduction internal fixation (ORIF) or reverse total shoulder arthroplasty (RTSA). The few studies published on this subject have shown high rates of complications and revision surgery when RTSA has been performed for proximal humerus nonunion. The purpose of this study was to determine the rates of complications and revision of this procedure at our institution, as well as to identify any variables that may impact risks of complications and reoperations., Methods: A single-institution retrospective review of all patients who underwent RTSA for proximal humerus nonunion between 2005 and 2021 was performed. Nonunion was defined as imaging evidence of lack of union, at least 90 days after the index fracture. Patients with less than 1 year of clinical follow-up were excluded. Fifty patients were included, with the majority being female (78%). The mean age at time of RTSA was 71 (range: 54-86) years and most patients were initially treated nonoperatively (74%). Mean total follow-up was 49 (range: 11-130) months. Demographic and surgical variables were recorded. Primary outcomes were complications and reoperations. Complications were divided into surgical (those directly related to RTSA), or other (those unrelated to RTSA). Secondary outcomes included visual analog scale pain scores and range of motion., Results: A total of 17 shoulders (34%) sustained complications after revision shoulder arthroplasty, with 10 (20%) requiring reoperation. Six patients (12%) sustained dislocations and 5 (10%) had radiographic evidence of humeral loosening. No variables examined, including nonoperative vs. surgical management of the index fracture, prosthesis type, or management of tuberosities, influenced the risk of dislocation. Survivorship free from reoperation at 2 years was 73%. Younger age at time of RTSA and the presence of diabetes mellitus both increased the risk of reoperation significantly (P = .013 and P = .037, respectively). There was a trend towards increased risk of reoperation in patients who were treated with initial ORIF (hazard ratio = 2.95); however, this did not reach statistical significance (P = .088). Three patients (6%) sustained a periprosthetic fracture after a fall., Conclusion: RTSA provides improved pain and function for properly selected patients with proximal humerus nonunion. Dislocation, humeral loosening, and reoperation rates remain high when RTSA is performed for nonunion compared to other diagnoses. In this study, younger age and diabetes mellitus increased the odds of reoperation. Every effort must be made to optimize implant stability and humeral component fixation when RTSA is performed for proximal humerus nonunion., (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Background: Complex regional pain syndrome (CRPS) can profoundly affect many aspects of everyday life. Spinal cord stimulation (SCS) is a potential therapeutic option. This retrospective, single-site evaluation explored health-related quality of life (HRQoL) in individuals with CRPS treated with SCS in our Pain Service., Materials and Methods: All patients aged ≥18 years with fully implanted SCS for CRPS between June 2013 and January 2023 were identified from hospital records. The following data were collected: sex, age, chronic pain diagnosis, CRPS type (I or II), location of CRPS (upper or lower limb), years of CRPS before first SCS implant, SCS system, preimplant and follow-up scores for HRQoL (euroqol 5 dimensions 3 levels [EQ-5D-3L] index score), average pain, worst pain and the influence of pain on aspects of everyday life (all numerical rating scale [NRS]), patient and clinician global impression of change at follow-up, and the occurrence and reasons for revisions and explants. An intention-to-treat approach was used and data statistically analyzed., Results: The final cohort comprised 83 patients (46 women), with a median (minimum, maximum) follow-up duration of 29 months (seven, 72). There were statistically and clinically significant improvements in HRQoL, despite relatively low pain response rates. The pain response rate was 34% (reduction of ≥30% in average pain NRS); the pain remission rate was 13% (average pain score ≤3 NRS), and all patients had preimplant EQ-5D-3L index values below the population norm of 0.82. However, 60% of patients reported EQ-5D-3L index scores greater than the published minimally important difference of 0.074, and scores were better at follow-up than at preimplant (p < 0.001); 44% of patients and 41% of clinicians reported improved symptoms at the most recent follow-up. Explants occurred in eight of 83 patients (10%)., Conclusions: Patients had meaningful improvements in HRQoL, which is a key outcome in ascertaining the overall outcome of SCS in CRPS. Randomized controlled clinical trials should build on the findings to improve understanding of the benefits and risks of treating CRPS with SCS., Competing Interests: Conflict of Interest Beatrice Bretherton has provided consultancy to Abbott and Platform 14. Ganesan Baranidharan has a consulting agreement with Saluda, Nevro Corp, Abbott, Medtronic, Boston Scientific, Stryker, and Mainstay Medical. Ganesan Baranidharan had educational and research grants from Nevro Corp, Abbott, and Boston Scientific. Ganesan Baranidharan is on the advisory board for Abbott and Nalu Medical. The remaining authors reported no conflict of interest., (Copyright © 2024. Published by Elsevier Inc.)

Introduction: Pyrocarbon promises to be an optimal material choice for radial head arthroplasty (RHA) due to an elastic modulus comparable to the radial diaphysis and thus providing higher biocompatibility. Primary objective was to determine the complications and revision rates related to the usage of these prostheses. The secondary objective was to assess the clinical and radiological outcomes of Pyrocarbon RHAs., Hypothesis: Pyrocarbon RHAs have good clinical and radiological outcomes with low complications and revisions., Methods: Ovid MEDLINE and Embase databases were used to search for studies on outcomes and complications of the RHAs using Pyrocarbon radial head prostheses. The systematic review was designed in accordance with the PRISMA guidelines and included studies were appraised using the MINORS tool. Complications and RHA revision rates were assessed. Functional outcomes were reviewed using PROMs (like MEPI, DASH and BMS), post-op range of motion (using goniometer) and grip strength (using the dynamometer). Postoperative radiological outcomes like peri-prosthetic lucency, radial neck osteolysis, radio-capitellar congruence, capitellar erosion, overstuffing/understuffing and osteoarthritis were reported using radiographs., Results: A total of 12 studies cumulatively reporting 353 patients who underwent Pyrocarbon RHAs were included in the review. The mean age of patients across the studies ranged from 47 to 54 years of which 50.5% were males. The majority of radial head replacements were done for acute trauma (87.5%) with the remainder done for arthritis (1.7%) and trauma sequelae (10.8%). Mean follow-up period in the selected studies ranged from 18 to 110 months with minimum follow-up across all studies being 12 months. Modular Pyrocarbon (MoPyC, Tornier™) was the implant of choice in ten studies while two studies used the Ascension Pyrocarbon radial head (Ascension Orthopaedics™). Ten studies demonstrated mean MEPI ranging from 75.5 to 96. Mean extension deficit ranged from 6 to 19 degrees, mean flexion from 120 to 140 degrees, mean pronation from 71 to 87 degrees and mean supination from 63 to 85 degrees. Relative grip strength ranged from 69 to 96% of the contralateral limb. Revisions due to implant-related reasons (intra-prosthetic dissociation, prosthetic fracture, peri-prosthetic loosening, radio-capitellar subluxation and understuffed/overstuffed elbow) was 6.8% (24/353). Radial stress shielding and peri-prosthetic lucency was reported in 10 to 100% of patients across different studies but symptomatic implant loosening leading to revision remained rare (2%, 7/353). Radio-capitellar congruence was reported in 81% to 100% cases while capitellar erosion ranged from 0% to 89%. Pyrocarbon implants specific complications included head-neck intra-prosthetic decoupling (1.1%) and pyrocarbon head fractures (0.9%). In total, 5.7% cases underwent re-surgery due to non-RHA related reasons., Discussion: The pyrocarbon RHA shows good functional outcome, range of motion and low revision rates. This aligns with the working hypothesis of this review. However, pyrocarbon radial head implants have implant-specific complications like pyrocarbon radial head fractures and intra-prosthetic decoupling between stem and head. Despite promising in vitro biomechanical properties, capitellar wear is still a common finding with pyrocarbon RHAs. Despite these factors, pyrocarbon radial head implants are a viable option for radial head arthroplasty., Level of Evidence: II; Systematic review., (Copyright © 2023. Published by Elsevier Masson SAS.)

Prof. Kurtzke once said, "Multiple sclerosis is what a good clinician would call multiple sclerosis." Recent McDonald's diagnostic criteria revisions have allowed for earlier diagnoses over the past decades. Revisions often allowed increasing sensitivity but at the expense of lowering specificity. In this correspondence, I suggest that the multiple sclerosis expert community worldwide should be given the opportunity to comment and provide feedback on the proposed revisions of the diagnostic criteria before their publication via providing a duration where open commentaries are welcomed to allow for the expert panel to incorporate diverse feedback to improve the final product. [ABSTRACT FROM AUTHOR]