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Reverse total shoulder arthroplasty provides better shoulder function than hemiarthroplasty for displaced 3- and 4-part proximal humeral fractures in patients aged 70 years or older: a multicenter randomized controlled trial. CORR Insights®: Reverse Total Shoulder Arthroplasty Is the Most Cost-effective Treatment Strategy for Proximal Humerus Fractures in Older Adults: A Cost-utility Analysis Footnotes 1 I This i CORR Insights® I is a commentary on the article i "Reverse Total Shoulder Arthroplasty Is the Most Cost-effective Treatment Strategy for Proximal Humerus Fractures in Older Adults: A Cost-utility Analysis" I by Khalik and colleagues available at: i DOI: 10.1097/CORR.0000000000002244. [Extracted from the article]

Context: Neuromuscular dysfunction is common after anterior cruciate ligament reconstruction (ACL-R). However, little is known about quadriceps spinal-reflex and descending corticomotor excitability after ACL-R. Understanding the effects of ACL-R on spinal-reflex and corticomotor excitability will help elucidate the origins of neuromuscular dysfunction. Context: Neuromuscular dysfunction is common after anterior cruciate ligament reconstruction (ACL-R). However, little is known about quadriceps spinal-reflex and descending corticomotor excitability after ACL-R. Understanding the effects of ACL-R on spinal-reflex and corticomotor excitability will help elucidate the origins of neuromuscular dysfunction. Design: Case-control study. Setting: Laboratory. Patients or Other Participants: A total of 28 patients with unilateral ACL-R (9 men, 19 women; age = 21.28 ± 3.79 years, height = 170.95 ± 10.04 cm, mass = 73.18 ± 18.02 kg, time after surgery = 48.10 ± 36.17 months) and 29 participants serving as healthy controls (9 men, 20 women; age = 21.55 ± 2.70 years, height = 170.59 ± 8.93 cm, mass = 71.89 ± 12.70 kg) volunteered. Main Outcome Measure(s): Active motor thresholds (AMTs) were collected from the vastus medialis (VM) using transcranial magnetic stimulation. We evaluated VM spinal reflexes using the Hoffmann reflex normalized to maximal muscle responses (H : M ratio). Voluntary quadriceps activation was measured with the superimposed-burst technique and calculated using the central activation ratio (CAR). We also evaluated whether ACL-R patients with high or low voluntary activation had different outcomes. Results: The AMT was higher in the injured than in the uninjured limb in the ACL-R group (t27 = 3.32, P = .003) and in the matched limb of the control group (t55 = 2.05, P = .04). The H : M ratio was bilaterally higher in the ACL-R than the control group (F1,55 = 5.17, P = .03). The quadriceps CAR was bilaterally lower in the ACL-R compared with the control group (F1,55 = 10.5, P = .002). The ACL-R group with low voluntary activation (CAR < 0.95) had higher AMT than the control group (P = .02), whereas the ACL-R group with high voluntary activation (CAR > 0.95) demonstrated higher H : M ratios than the control group (P = .05). Conclusions: The higher VM AMT in the injured limbs of ACL-R patients suggested that corticomotor deficits were present after surgery. Higher bilateral H : M ratios in ACL-R patients may be a strategy to reflexively increase excitability to maintain voluntary activation. [ABSTRACT FROM AUTHOR]

Not all medical injuries are the result of negligence. In fact, most medical injuries are the result either of the inherent risk in the practice of medicine, or due to system errors, which cannot be prevented simply through fear of disciplinary action. This paper will discuss the differences between adverse events, negligence, and system errors; the current medical malpractice tort system in the United States; and review current and future solutions, including medical malpractice reform, alternative dispute resolution, health courts, and no-fault compensation systems. The current political environment favors investigation of non-cap tort reform remedies; investment into more rational oversight systems, such as health courts or no-fault systems may reap both quantitative and qualitative benefits for a less costly and safer health system. [ABSTRACT FROM AUTHOR]

The psychological literature has little to say about the constancy of experimental effects, whether those effects are the same for all individuals or vary with the individual. Investigators rarely specify whether the effects noted in research findings apply to every individual or are an average of varying individual effects. Where it does address the matter at all, namely in experimental design texts, the literature gives conflicting messages. It is argued here that a deterministic view of causation, which is implied in most propositions in psychology, leads to the expectation that effects are constant. The problems and confusion that result from viewing such effects as variable are explicated. The consequences of not addressing the issue of effect constancy are to leave statements of findings and propositions unacceptably vague and to encourage, in general, imprecise thinking about substantive matters. [ABSTRACT FROM AUTHOR]

he article discusses the meaning of the interaction concept in scientific discourse and in the analysis of variance and the correspondence between the two. Reasons and examples are given to show that the correspondence is poor. It is recommended that the researcher pay more attention to substantive interactions, of which one way is by using assessment means that are sensitive to the such interactions. [ABSTRACT FROM PUBLISHER]

Focuses on the concept of meta-analysis. Speculation over whether meta-analysis would bring about change in psychological science; Criticism of the concept of meta-analysis.

Presents reasons why the affirmation of the research hypothesis on the basis of the null rejection is unwarranted. Suggestions for the task of corroborating the research hypothesis in science; Insufficient grounds for affirming the research hypothesis; Affirmation of a scientific hypothesis based primarily on substantive evidence that is independent of hypothesis test.

The empirical base of Trope's position on achievement-task choice is critiqued here. Attention is focused on Trope's earliest studies (Trope, 1975; Trope & Brickman, 1975) because they provide this position's most critical tests. Support for the following three propositions of the position is assessed: (1) diagnosticity information, rather than task difficulty information, is the basis of task selection; (2) desire for information about one's ability, not the wish for certain affective consequences, is what motivates achievement-task choice; and (3) the success of the Atkinson model is owed to the adventitious confounding existing between task diagnosticity and task difficulty, and the resulting confounding between ability-informational and affective consequences. The major findings are that (1) the tests of all propositions have such serious logical flaws that they cannot answer the questions they seek to answer, (2) the task choice situation containing the diagnosticity manipulation employed by Trope is so different from real-life task choice situations as to call into question the relevance of Trope's findings for the latter situations, (3) Trope's diagnosticity manipulation is a meaningless one as it gives rise to situations that are logical impossibilities (e.g., skill tasks that are performed equally well by high- and low-skilled people), and (4) the tests of Atkinson's position are invalidated by a serious misinterpretation of that position by Trope. [ABSTRACT FROM AUTHOR]

Commentators agree with me that statistical significance does not betoken replicability, but not for the reasons I give. Chow (1998) defends the use of significance tests by arguing that they are useful for assessing the role of chance in findings. I dispute this by pointing out that the Type II error rate may be as high as 1 - ct. Falk (1998) defends Bayesian inference, which was impugned by me. She also makes a case for the use of replications for the purpose of testing hypotheses. I complain that the supporters of Bayesian inference have not explained adequately what its purpose or role in science is, and for this reason it is an impediment to understanding in this area. I also dispute Falk's view of the role of replications in that I would require a successful replication to be one that produces an effect that is clearly discernible, meaning the effect is consistently noticeable with the aid of nothing more than descriptive statistics. [ABSTRACT FROM PUBLISHER]

Meta-analytic writers have argued that psychological science is not working and that the solution to the problem is meta-analysis (MA), quantitative summaries of the research literature. This paper assesses these claims by evaluating MA as a means of scientific discovery and by considering the nature of effective science. It is shown that MA should not be credited as a means of discovery because its database, the research literature, is an untrustworthy source of information about nature. The difference between scientific activity, on the one hand, and literature study, on the other, is highlighted in the analyses. Both MA and empirical science are said to be misguided by a hypothesis-testing approach to science, which approach leads to an obliviousness with respect to mechanisms that underlie phenomena. [ABSTRACT FROM PUBLISHER]

Data Augmentation is an essential technology for improving the performance of deep learning models. However, the semantic information change in current data augmentation methods may impair the model performance, especially in randomly erasing-based data augmentation. We focus on exploiting a Significant Areas Preserved Data Augmentation (SAPDA) method to mitigate this issue, where the most informative areas are preserved. Moreover, the significant areas (SA) are derived from perceptions of current models during the model training process. Therefore, the areas preserved by SAPDA are different for each stage of training. Inspired by hard sample mining, first, we define the SA of images by employing a Class Activation Map (CAM). The SA consists of Discriminative Area (DA), Misclassified Area (MA), and Uncertain Area (UA). Further, the SA is preserved during data augmentation, which could keep the semantic information unchanged and make the model focus on difficult and uncertain areas. Extensive experiments are conducted on CIFAR-10, CIFAR-100, and ImageNet, which show that our proposed SAPDA could further improve the model performance in combination with existing SOTA data augmentation methods. Also, the SAPDA could enhance the model's ability in semi-supervised learning and noisy label learning. [ABSTRACT FROM AUTHOR]

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How to effectively utilize unlabeled data for training is a key problem in Semi-Supervised Learning (SSL). Existing SSL methods often consider the unlabeled data whose predictions are beyond a fixed threshold (e.g., 0.95) and discard those less than 0.95. We argue that these discarded data have a large proportion, are of hard sample, and will benefit the model training if used properly. In this article, we propose a novel method to take full advantage of the unlabeled data, termed DTS-SimL, which includes two core designs: Dual-Threshold Screening and Similarity Learning. Except for the fixed threshold, DTS-SimL extracts another class-adaptive threshold from the labeled data. Such a class-adaptive threshold can screen many unlabeled data whose predictions are lower than 0.95 but over the extracted one for model training. On the other hand, we design a new similar loss to perform similarity learning for all the highly similar unlabeled data, which can further mine the valuable information from the unlabeled data. Finally, for more effective training of DTS-SimL, we construct an overall loss function by assigning four different losses to four different types of data. Extensive experiments are conducted on five benchmark datasets, including CIFAR-10, CIFAR-100, SVHN, Mini-ImageNet, and DomainNet-Real. Experimental results show that the proposed DTS-SimL achieves state-of-the-art classification accuracy. The code is publicly available at https://github.com/GZHU-DVL/DTS-SimL. [ABSTRACT FROM AUTHOR]