Factors Associated With Publication Impact at Shoulder and Elbow Surgery Fellowships

Seth R. Cope; Emma B. Holliday; Jeremy S. Somerson

doi:10.1016/j.jsurg.2017.02.008

Factors associated with surgeon recommendation for additional cast immobilization of a CT-verified nondisplaced scaphoid waist fracture

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-04062-0 ◽

2021 ◽

Author(s):

Anne Eva J. Bulstra ◽

Tom J. Crijns ◽

Stein J. Janssen ◽

Geert A. Buijze ◽

David Ring ◽

...

Keyword(s):

The United States ◽

Clinical Factors ◽

Cast Immobilization ◽

Radiographic Appearance ◽

Factors Associated ◽

Included Patient ◽

Elbow Surgery ◽

Mixed Regression ◽

Fracture Consolidation ◽

The Impact

Abstract Introduction Data from clinical trials suggest that CT-confirmed nondisplaced scaphoid waist fractures heal with less than the conventional 8–12 weeks of immobilization. Barriers to adopting shorter immobilization times in clinical practice may include a strong influence of fracture tenderness and radiographic appearance on decision-making. This study aimed to investigate (1) the degree to which surgeons use fracture tenderness and radiographic appearance of union, among other factors, to decide whether or not to recommend additional cast immobilization after 8 or 12 weeks of immobilization; (2) identify surgeon factors associated with the decision to continue cast immobilization after 8 or 12 weeks. Materials and methods In a survey-based study, 218 surgeons reviewed 16 patient scenarios of CT-confirmed nondisplaced waist fractures treated with cast immobilization for 8 or 12 weeks and recommended for or against additional cast immobilization. Clinical variables included patient sex, age, a description of radiographic fracture consolidation, fracture tenderness and duration of cast immobilization completed (8 versus 12 weeks). To assess the impact of clinical factors on recommendation to continue immobilization we calculated posterior probabilities and determined variable importance using a random forest algorithm. Multilevel logistic mixed regression analysis was used to identify surgeon characteristics associated with recommendation for additional cast immobilization. Results Unclear fracture healing on radiographs, fracture tenderness and 8 (versus 12) weeks of completed cast immobilization were the most important factors influencing surgeons’ decision to recommend continued cast immobilization. Women surgeons (OR 2.96; 95% CI 1.28–6.81, p = 0.011), surgeons not specialized in orthopedic trauma, hand and wrist or shoulder and elbow surgery (categorized as ‘other’) (OR 2.64; 95% CI 1.31–5.33, p = 0.007) and surgeons practicing in the United States (OR 6.53, 95% CI 2.18–19.52, p = 0.01 versus Europe) were more likely to recommend continued immobilization. Conclusion Adoption of shorter immobilization times for CT-confirmed nondisplaced scaphoid waist fractures may be hindered by surgeon attention to fracture tenderness and radiographic appearance.

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Factors associated with satisfaction in patients undergoing elbow surgery: A prospective study

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2010.02.003 ◽

2010 ◽

Vol 19 (5) ◽

pp. 635-644 ◽

Cited By ~ 8

Author(s):

Jill Dawson ◽

Helen Doll ◽

Irene Boller ◽

Ray Fitzpatrick ◽

Christopher Little ◽

...

Keyword(s):

Prospective Study ◽

Factors Associated ◽

Elbow Surgery ◽

A Prospective Study

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Stain contamination and embedding in electron microscopy

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100141986 ◽

1986 ◽

Vol 44 ◽

pp. 50-53

Author(s):

Hilton H. Mollenhauer

Keyword(s):

Electron Microscopy ◽

Information Retrieval ◽

Epoxy Resins ◽

Image Contrast ◽

Sample Preservation ◽

Factors Associated ◽

Amount Of Information ◽

Electron Microscopical ◽

Contrast Information

Many factors (e.g., resolution of microscope, type of tissue, and preparation of sample) affect electron microscopical images and alter the amount of information that can be retrieved from a specimen. Of interest in this report are those factors associated with the evaluation of epoxy embedded tissues. In this context, informational retrieval is dependant, in part, on the ability to “see” sample detail (e.g., contrast) and, in part, on tue quality of sample preservation. Two aspects of this problem will be discussed: 1) epoxy resins and their effect on image contrast, information retrieval, and sample preservation; and 2) the interaction between some stains commonly used for enhancing contrast and information retrieval.

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