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To evaluate the diagnostic accuracy of ultrasound secondary signs of fractures in pediatric patients aged 5–15 y presenting to the emergency department with a clinically non-deformed distal forearm injury. This diagnostic study was conducted in South East Queensland, Australia. Emergency clinicians performed point-of-care ultrasound on eligible patients and recorded secondary signs of fractures (pronator quadratus hematoma [PQH] sign, periosteal hematoma, visible angulation) or physeal fractures (fracture-to-physis distance [FPD], physis alteration). The reference standard was the final fracture diagnosis determined by expert panel. The primary outcome was the diagnostic accuracy of secondary signs for cortical breach and physeal fractures. Diagnostic statistics were reported for each relevant secondary sign. A total of 135 participants were enrolled. The expert panel diagnosed 48 "no" fracture, 52 "buckle" fracture and 35 "other" fracture. All "other" fractures were cortical breach fractures and included 15 Salter–Harris II fractures. The PQH sign demonstrated high sensitivity and moderate specificity to diagnose cortical breach fractures (91%, 95% Confidence Interval [CI] 78%–97% and 82%, 73%–88%). Poor sensitivity but high specificity was observed for the visible angulation and periosteal hematoma secondary signs. FPD <1cm showed perfect sensitivity and moderate specificity (100%, 80%–100% and 85%, 78%–90%) for diagnosis of Salter–Harris II fracture. Conversely, physis alteration showed poor sensitivity but excellent specificity (40%, 20%–64% and 99%, 95%–100%) for the diagnosis of Salter–Harris II fractures. Ultrasound secondary signs showed good diagnostic accuracy for both cortical breach fractures and Salter–Harris II fractures. Future research should consider optimal use of secondary signs to improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Protein α-N-methylation is an evolutionarily conserved type of post-translational modification; however, little is known about the regulatory mechanisms for this modification. Methylation at the N 6 position of adenosine in mRNAs is dynamic and modulates their stability, splicing, and translational efficiency. Here, we found that the expression of N-terminal methyltransferase 1 (NTMT1) protein is altered by depletion of those genes encoding the reader/writer/eraser proteins of N 6-methyladenosine (m6A). We also observed that MRG15 is N-terminally methylated by NTMT1, and this methylation could also be modulated by reader/writer/eraser proteins of m6A. Together, these results revealed a novel m6A-based epitranscriptomic mechanism in regulating protein N-terminal methylation. Image 1 • Studied for the first time the m6A-mediated epi-transcriptomic regulation of NTMT1. • Revealed that MRG15 is subjected to α-N-methylation. • Demonstrated that α-N-methylation of MRG15 is regulated by the m6A pathway. [ABSTRACT FROM AUTHOR]

Rosenstock-Huessy argued that language originates – always and everywhere – from the need to respond to a world that addresses us and calls us by name. Thus in his view, unlike much contemporary theory which concerns itself with an autonomous system, language is understood as a human activity, a social phenomena or power brought into existence by preexisting social forces and involving the varied capabilities of the human mind and body. In this paper, Rosenstock-Huessy's philosophy of language is briefly presented and questioned from the perspective of Integrational Linguistics, a recent approach to language and semiology that stresses social relations and time in the making of meaning. [ABSTRACT FROM PUBLISHER]

This article responds to Jonathan Tuttle's article “The Aphasia of Modern Subject Access” in which Roman Jakobson's semiology of “shared codes” consisting of preexisting signs is offered as the explanation for two redundant linguistic tools associated with cataloging: LCSH and LCC. The article criticizes Tuttle's terminology, his semiology, and his argument that selection and combination are both necessary for the operation of language but each are associated with only one of these tools. [ABSTRACT FROM PUBLISHER]

Seven recent monographs on the philosophical foundations of library science are discussed in light of the questions the authors ask and the assumptions that underlie the questions asked. The author finds that epistemological discussions frequently identify epistemology with philosophy of science while ontological discussions rest upon reifications, and in both cases there is an absence of attention to ethical and political questions. The author's critique links the absence of ethical and political dimensions in several of the works discussed to an approach to philosophy that offers the reader answers rather than questions. [ABSTRACT FROM AUTHOR]

The article discusses the design of cataloging systems, with particular attention given to what the author describes as increasingly complex systems created by designers who regard human users as problems. An overview of French approaches to this problem from authors including Victor Scardigli, Joëlle Le Marec, and Roy Harris is provided, and the author's prediction that designers of new catalogs will blame users rather than themselves for any problems is examined. Discussion of the problems of observation altering behavior in library user studies is also offered.

Abstract: Standard linguistic theory assumes that meanings are attached to linguistic artefacts by some semantic component during their production yet prior to their material realization, and it is those meanings that are decoded by the recipient/interpreter of the realized signs according to the same mental machinery/semantic component inside their brain. Rather than theorizing a single sign that is encoded, materialized, transmitted and then decoded, integrationism assumes that signs are created not only by speakers/writers but also by hearers/readers. This paper looks at linguistic artefacts that are not created to mean anything but to do something. The successful accomplishment of those actions depends entirely upon the recipient recreating them as meaningful linguistic signs, no matter what the meaning assigned to them. Examples of such linguistic artifacts to be examined are simulated language as a product of “user-friendly” software, whether programmed as potential aids for human use of technical systems (e.g. Google’s “Did you mean…? and machine translation) or as deceptions (spam and texts inserted into emails to “fool” anti-spam programs), and utterances whose meanings have no relation to what the standard theory regards as lexical meaning nor to interpretative rules (e.g. glossalalia). Of particular interest are the hypothetical language of examples in linguistic theory (Bill is a farmer but John is not; Colorless green ideas sleep furiously) in which nothing is meant other than “this text represents a certain structure,” and the reproduction of texts that would be meaningful in one context but whose sole meaning is reduced to technical manipulation. In all of these cases a linguistic sign is produced (or its production programmed) by someone intent on accomplishing a certain end not through the recipient’s comprehension of a sign and its lexical or discourse meaning but by the human recipient’s creation of a linguistic sign on the one hand, or software unable to distinguish meaningful signs from meaningless textual strings on the other. [Copyright &y& Elsevier]

Abstract: The movement of trains in the United States is coordinated by the use of a small number of standard codes of operating rules and variations upon them as well as various systems of signs, including railroad signs directed at railroad employees and highway signs directed at pedestrians and motorists. These signs, their intended meanings and the responses appropriate to them have been established by railroads and railroad associations, as well as federal, state and local agencies and laws. Nearly 200years of accidents involving railroads has revealed that the interpretation of both train operating rules and signs associated with the railroad does not always follow the prescribed meanings. Understanding the reasons for these interpretations at variance with the prescribed meanings has been the object of extensive research over the past two decades and what has been learned has considerable importance for understanding all manner of signs, including linguistic signs. [Copyright &y& Elsevier]

This article examines the methodologies employed for my doctoral research into the issues and tensions of managing cultural heritage on conservation islands in New Zealand. I examined two case studies, Rangitoto Island and Motutapu Island (both in Auckland's Hauraki Gulf, New Zealand), though the use of documentary analysis, in-depth semi-structured interviews and participant observation. The strengths and weaknesses of these methods are outlined and evaluated in this article with reference to my own personal experiences. It is hoped that this article may assist others using, or considering using, these methodological approaches. [ABSTRACT FROM AUTHOR]

The article explores the writings of librarian Carlo Revelli as they pertain to cataloging, with particular focus given to the books "Il Catalogo," "Citazione bibliografica," and "La biblioteca come teoria e come pratica: antologia degli scritti." Particular focus is given to the relation between the practices of citation, cataloging, bibliography, and catalog searching. The author notes that cataloging is not an autonomous practice, but that it is connected with a variety of other library activities and literary practices.

This paper draws on a New Zealand case study, Motuihe Island, to examine the challenges of conserving cultural heritage in places renowned for natural heritage values. In keeping with the broader trend toward the ecological restoration of islands close to Auckland, Motuihe Island is undergoing conversion into an ecosystem of native flora and fauna. Issues and tensions relating to the management of natural and cultural heritage will be discussed and influencing aspects investigated: the nature/culture dualism, the effect of New Zealand's history and identity, and the influence of islandness on heritage management. [ABSTRACT FROM AUTHOR]

In this article I contrast the view of communication in Shannon and Weaver (1949) with Michel Meyer's rhetorical approach to communication. Meyer's critique of philosophy is founded on the recognition that every statement is an answer to a question arising from a particular problem. If something can be questioned, it can be debated, and how we debate any issue is a matter of rhetorical practices, all of which involve ethos, logos, and pathos. These concepts, familiar from Aristotelian rhetoric, have their counterparts in information science: sender, message, receiver. Unlike the ethos, logos, and pathos of rhetoric, the concepts of information science are rooted in a technical understanding of sender markedly different from the ethical ethos of classical antiquity, an ontologically based propositional understanding of message, and an abstract understanding of receiver as human or machine with a straightforward, statable, interpretable, and answerable question. Meyer's rhetorical approach to communication illuminates many aspects of information production and use, from spamming and computer viruses to user supplied metadata and reuse of metadata in different contexts. Of particular interest are the ethical implications of a rhetorical approach to Shannon and Weaver's “information source,” and the creation of metadata for (1) human users of IT and (2) machine interoperability (e.g., the Semantic Web). [ABSTRACT FROM AUTHOR]

In Banush and LeBlanc (2007), the utilitarianism of Bentham was resurrected and offered as a "philosophical backdrop for dealing with competing library choices." This article discusses two serious failures in that article: the failure to situate utility in the current context (shared bibliographic databases, cooperative cataloging programs, automated data manipulation, and exchange) and the simplistic assumptions about library users and their diverse needs which allow the authors to reduce all metadata- related issues to a simple managerial task of triage. [ABSTRACT FROM AUTHOR]

Discussions of quality in library catalogs and bibliographic databases often refer to "the perfect record." This paper examines the usage of that phrase in the library literature, finding that its predominant use is as a rhetorical strategy for reducing the complex and context-dependent issue of quality to an absurdity, thus permitting the author to ignore or dismiss all issues of quality. Five documents in which the phrase is not used in this fashion are examined and their value for understanding the inextricably intertwined values of quantity and quality are discussed. The author recommends rejecting both the rhetoric of "the perfect record" and satisfaction with "the imperfect record." [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to examine the significance of the differences between the actual technical principles determining relevance ranking, and how relevance ranking is understood, described and evaluated by the developers of relevance ranking algorithms and librarians. Design/methodology/approach - The discussion uses descriptions by PLWeb Turbo and C2 of their relevance ranking products and a librarian's description on her blog with the responses which it drew, contrasting these with relevancy as it is indicated in studies of the ISI citation record reported by White. Findings - The study finds that product descriptions and librarians consistently use the term "relevance ranking" to mean both the artificial relevance ranking by statistical methods using various surrogates assumed to reliably indicate relevance and the real relevance as determined by the searcher. The paper indicates the misunderstandings arising from this terminological confusion and its consequences in the context of the invalid user models and artificial searches which accompany discussions of "relevance ranking". Research limitations/implications - Evaluations of relevance ranking must be based on real users and real searches. Theorising relevance as a judgement about information rather than a property of information clarifies many issues. Practical implications - The design of search engines and OPACs will benefit from incorporating metadata that contain indications of user-determined relevance. Originality/value - The activity of subject analysis and indexing by human beings is presented as an activity identical in kind to the real searcher's determination of relevance, a definite statement of relevancy arising from a real communication situation rather than a statistically indicated probability. [ABSTRACT FROM AUTHOR]

This paper analyses the presuppositions, goals, and implementations of policies for rapid cataloging in three large academic libraries in the United States. In the first model, The University of Chicago's W-Collection, there was no attempt to catalog materials; the order record alone is used and the items are shelved in a publicly accessible area by accession number. The second model, Princeton's ATA Procedure, made cataloging the initial activity upon receipt, the purpose of which was "to give the future librarians enough information to know if the item is already in the collection or not" and also to serve (with subject headings and classification) the library's users. Finally, Cornell's COR Procedure in which all information in the records is assumed to be temporary and therefore unimportant; the necessary information is expected to be acquired later from commercial sources. [ABSTRACT FROM AUTHOR]

Abstract: Cataloguing in libraries was formerly done by cataloguers with a wide range of academic backgrounds and linguistic abilities. With the rise of networked databases much of this work is now automated, outsourced to vendors, or done by persons lacking the requisite skills. The removal of this activity from libraries leads to a generic product produced for a generic user, with no possibility for a library-internal evaluation of the product. Librarians demand “a bibliographic record” of a certain form in a manner analogous to the generative grammar’s production of sentences. So long as the form is correct, it is not evaluated for appropriateness or usefulness. The resulting information is often equivalent to colorless green ideas. [Copyright &y& Elsevier]

Abstract: Proper names present special problems not only for theories of language but also for indexing and language identification, whether performed by human or mechanical agents, especially so when the names may also be understood otherwise than as names. The problem is compounded in the case of transliterated text and multilingual publications. If the indexer cannot understand the meaning of the text – whether name, phrase or sentence – a heuristic decision process cannot decide amongst various possibilities. [Copyright &y& Elsevier]

Purpose: To establish the content validity of LIMB-Q Kids, a new patient-reported outcome measure (PROM) for children with lower limb deformities. This study focused on three key components of content validity, i.e., comprehension, comprehensiveness, and relevance. Methods: Cognitive debriefing interviews (CDIs) with children with lower limb deformities were performed, and expert input from parents and clinicians directly involved in the care of children with lower limb deformities was obtained. CDIs were conducted with children from sites in Australia, Canada, and the USA. All interviews were recorded and transcribed verbatim. Analyses were conducted using the reparative approach, which involved close examination of the transcribed interviews and summarising edits after each interview. Results: Forty patients, experts, and parents reviewed LIMB-Q Kids and provided feedback. At the start, LIMB-Q Kids had 10 scales and 124 total items. Five rounds of input was obtained from children, parents, and experts. Overall, 37 new items were added. Thirty-three of the new items were included to measure symptoms experienced in different parts of the legs. Final version of LIMB-Q Kids had 11 scales and 159 items. Conclusion: This study established content validity of the LIMB-Q Kids, a new PROM for children with lower limb deformities. An international field-test study is underway. Translation and cultural adaptation are underway for sites where English is not the first language. Scoring algorithms will be developed, following which the scale could be used to inform clinical practice and research. [ABSTRACT FROM AUTHOR]

Examining references to proverbs in African political discourses in light of Integrational semiology and Southern Theory, we find not fossils of ancient wisdom but the creative construction of desired futures that may grow out of the present situation in light of what has been learned from the past. Proverbial discourse, always speaking to the present situation and commenting on available possibilities while being open to multiple interpretations, suggests an important argument about the provisional and contextual nature of all our knowledge. Beginning with the assumption that each of us is in a better position to understand our own situation than any foreign observer or abstract schemata could ever be, we argue that the indeterminacy of creative proverbial discourse can present a better epistemological foundation for dealing with the uncertainties of natural events. We suggest that proverbial discourse as it is practiced in various African societies can be utilized as a way of framing and approaching Southern Theories. [ABSTRACT FROM AUTHOR]

A response to David Bade to letters to the editors about his article "Rapid Cataloging: Three Models for Addressing Timeliness as an Issue of Quality in Library Catalogs," in the June 6, 2007 issue is presented.

BACKGROUND Data on whether ultrasonography for the initial diagnostic imaging of forearm fractures in children and adolescents is noninferior to radiography for subsequent physical function of the arm are limited. METHODS In this open-label, multicenter, noninferiority, randomized trial in Australia, we recruited participants 5 to 15 years ofage who presented to the emergency department with an isolated distal forearm injury, without a clinically visible deformity, in whom further evaluation with imaging was indicated. Participants were randomly assigned to initially undergo pointoficare ultrasonography or radiography, and were then followed for 8 weeks. The primary outcome was physical function of the affected arm at 4 weeks as assessed with the use of the validated Pediatric Upper Extremity Short Patient-Reported Outcomes Measurement Information System (PROMIS) score (range, 8 to 40, with higher scores indicating better function); the noninferiority margin was 5 points. RESULTS A total of-270 participants were enrolled, with outcomes for 262 participants (9790) available at 4 weeks (with a window of +3 days) as prespecified. PROMIS scores at 4 weeks in the ultrasonography group were noninferior to those in the radiography group (mean, 36.4 and 36.3 points, respectively; mean difference, 0.1 point; 95% confidence interval ICI], -1.3 to 1.4). Intention-to-treat analyses (in 266 participants with primary outcome data recorded at any time) produced sirnilar results (mean difference, 0.1 point; 95% CI, -1.3 to 1.4). No clinically important fractures were missed, and there were no between-group differences in the occurrence of adverse events. CONCLUSIONS In children and adolescents with a distal forearm injury, the use of ultrasonography as the initial diagnostic imaging method was noninferior to radiography with regard to the outcome of physical function of the arm at 4 weeks. (Funded by the Emergency Medicine Foundation and others. [ABSTRACT FROM AUTHOR]

Salter-Harris II fractures of the distal radius can result in serious complications. The aim of this study was to measure the fracture-physis distance using point-of-care ultrasound (POCUS) to determine whether a certain distance is associated with Salter-Harris II fractures, compared with other fracture types, in a cohort of children with X-ray-identified distal radius fractures. Participants were from a parent diagnostic study conducted in an Australian tertiary pediatric emergency department, which prospectively evaluated the diagnosis of pediatric distal forearm fractures using POCUS compared against X-ray. Nurse practitioners, who underwent 2 h of training, administered a six-view POCUS protocol in clinically non-angulated pediatric forearm injuries prior to X-ray. This was a secondary analysis of data from the parent study. The 122 participants with X-ray-identified distal radius fractures from the parent study had their POCUS images interpreted by two emergency physician sonologists, who measured the fracture-physis distance. The median and maximum fracture-physis distances for Salter-Harris II fractures (n = 19) were 8.00 and 9.85 mm, whereas minimum and median distances for incomplete fractures (n = 22) were 10.20 and 15.98 mm, and those for complete fractures (n = 9) were 10.85 and 12.85 mm. Buckle fracture (n = 72) distances ranged from 4.35 to 26.55 mm, with a median of 13.65 mm. In children diagnosed with a distal radius fracture on X-ray, a fracture-physis distance cutoff of 1 cm differentiated Salter-Harris II fractures from other cortical breach fracture types, but not buckle fractures. Although this exploratory study suggests the "POCUS 1-cm rule" could be used as a secondary sign to augment the diagnosis of Salter-Harris II distal radius fractures using POCUS, further research is required to validate this measurement prospectively. [ABSTRACT FROM AUTHOR]

Background: The tibialis anterior tendon transfer (TATT) is the suggested surgical intervention in the Ponseti method for treatment of dynamic recurrent congenital talipes equinovarus (clubfoot) presenting as hindfoot varus and forefoot supination during the swing phase of gait. The indication for surgery, however, is typically based on visual assessment, which does not sufficiently examine the variability of foot motion in this cohort.Research Question: The aim of this research was to determine whether subgroups, based on foot model kinematics, existed within a clubfoot cohort being considered for TATT surgery.Methods: Sixteen children with recurrent clubfoot that had been previously treated with the Ponseti method and were being considered for tendon transfer surgery were prospectively recruited for this study and were required to attend a pre-surgery data collection session at the Queensland Children's Motion Analysis Service (QCMAS). Data collected included standard Plug-in-Gait (PiG) kinematics and kinetics, Oxford Foot Model (OFM) foot kinematics, and regional plantar loads based on anatomical masking using the integrated kinematic-pressure method.Results: Results of this study identified two clear subgroups within the cohort. One group presented with increased hindfoot inversion across 91 % of the gait cycle. The second group presented with increased hindfoot adduction across 100 % of the gait cycle. Hindfoot adduction was statistically significantly different between the two groups.Significance: The identification of these two groups propose a need for further classification of deformity within this cohort and query the appropriateness of this surgical intervention for both presentations. [ABSTRACT FROM AUTHOR]

Background: Typical gait is often considered to be highly symmetrical, with gait asymmetries typically associated with pathological gait. Whilst gait symmetry is often expressed in symmetry ratios, measures of symmetry do not provide insight into how these asymmetries affect gait variables. To fully understand changes caused by gait asymmetry, we must first develop a normative database for comparison. Therefore, the aim of this study was to describe normative reference values of regional plantar load and present comparisons with two pathological case studies.Methods: A descriptive study of the load transfer of plantar pressures in typically developed children was conducted to develop a baseline for comparison of the effects of gait asymmetry in paediatric clinical populations. Plantar load and 3D kinematic data was collected for 17 typically developed participants with a mean age of 9.4 ± 4.0 years. Two case studies were also included; a 10-year-old male with clubfoot and an 8-year-old female with a flatfoot deformity. Data was analysed using a kinematics-pressure integration technique for anatomical masking into 5 regions of interest; medial and lateral forefoot, midfoot, and medial and lateral hindfoot.Results: Clear differences between the two case studies and the typical dataset were seen for the load transfer phase of gait. For case study one, lateral bias was seen in the forefoot of the trailing foot across all variables, as well as increases in contact area, force and mean pressure in the lateral hindfoot of the leading foot. For case study two, the forefoot of the trailing foot produced results very similar to the typical dataset across all variables. In the hindfoot of the leading foot, medial bias presents most notably in the force and mean pressure graphs.Conclusions: This study highlights the clinical significance of the load transfer phase of gait, providing meaningful information for intervention planning. [ABSTRACT FROM AUTHOR]

Background: Children frequently present to the emergency department (ED) with forearm injuries and often have x-rays to determine if there is a fracture. Bedside ultrasound, also known as point-of-care ultrasound (POCUS), is an alternative diagnostic test used to rapidly diagnose a fracture at the time of examination, without exposing children to ionising radiation. Prospective studies have demonstrated high agreement between POCUS and x-ray findings. However, whether the initial imaging modality affects the patient's medium-term physical function is unknown.Methods: This is a multicentre, open-label, non-inferiority randomised controlled trial conducted in Australian EDs. Recruitment will continue until 112 children with distal forearm injuries (including 48 buckle fractures) per trial arm have achieved the primary outcome measure. Patients aged 5-15 years presenting with an isolated, acute, clinically non-angulated, distal forearm injury with suspected fracture will have their initial diagnostic approach randomised to either POCUS, performed by a credentialled practitioner, or x-ray imaging. If a cortical breach fracture is identified on POCUS, the patient will receive x-rays and have usual care. If a buckle fracture is identified, the patient will have their forearm placed in a splint and be discharged home. Patients will be followed up at 1, 4 and 8 weeks. The primary outcome is upper limb physical function at 4 weeks, as determined by the Pediatric Upper Extremity Short Patient-Reported Outcomes Measurement Information System (PROMIS) tool. Secondary outcomes include healthcare costs, satisfaction, pain, complications, rates of imaging, ED length of stay and diagnostic accuracy.Discussion: If POCUS is non-inferior to x-ray in terms of patient's medium-term physical function, it may have an effect on overall health care resource use, including the number of x-ray performed and earlier ED discharge. Although prospective studies have confirmed the accuracy of POCUS, this will be the first RCT to assess non-inferiority of functional outcomes of POCUS to diagnose non-angulated paediatric distal forearm injuries, compared to x-ray. POCUS may be of particular importance in settings where access to x-ray imaging can be limited either during or after-hours, as it can aid the triaging and management of patients.Trial Registration: Prospectively registered with the ANZCTR on 29 May 2020 ( ACTRN12620000637943 ). [ABSTRACT FROM AUTHOR]