Between 2008 and 2016 we encountered multiple patients with acute mid palm pain encountered during rock climbing or other forceful gripping with the hand. Ultrasound demonstrated a characteristic mid palm fluid collection around the "bare area" of the flexor tendons. The exact mechanism of injury resulting in this presentation and appearance remained uncertain until recently. A careful review of archived cases was undertaken in an attempt to determine the exact injury leading to these symptoms and ultrasound findings. Time was spent in a cadaver laboratory reviewing the mid palm anatomy and possible causes for injury. Results: The cadaver sessions led us to hypothesise that the lumbricals muscle may have been torn from the flexor digitorum profundus tendon in the mid palm. The result is clearly establishing that the injury causing this characteristic clinical presentation and ultrasound appearance is in fact an avulsion of the lumbrical muscle from the flexor digitorum profundus tendon in the palm of the hand. This paper describes for the first time a pattern of pathology well demonstrated on ultrasound. Forceful blue-collar work involving extreme finger flexion loading or rock climbing activities are the common mechanisms leading to this injury. The patients preset with an acute pain in the palm of the hand and immediate loss of finger flexion strength. The ultrasound demonstrates a unique pattern representing an avulsion injury of the proximal lumbrical origins from the flexor digitorum profundus tendon. This gives rise to what we have described as the "theta sign" which corresponds to fluid in the mid palm component of the flexor tendons where there is no synovial sheath present. Dynamic ultrasound and high resolution static MRI images confirm the diagnosis and mechanism of injury.

There were eight occurrences of an incorrect spelling of the adjectival term language-learning as language-leaning in the original article (Bird, 2010). These typographical errors occurred in the first few pages only, which are reprinted herein. We regret these errors and any problems they may have caused.

ABSTRACTThe foreign language vocabulary learning research literature often attributes strong mnemonic potency to the cognitive processing of meaning when learning words. Routinely cited as support for this idea are experiments by Craik and Tulving (C&T) demonstrating superior recognition and recall of studied words following semantic tasks (“deep” encoding) compared to structure-related tasks (“shallow” encoding). However, participants in C&T were not language learners but native speakers of English studying known English nouns. These experiments have never been directly replicated using nonnatives to establish the relevance of the findings to nonnatives and learners. The present study replicated C&T Experiment 5, comparing effects of shallow and deep encoding tasks on subsequent recognition of target words by native and nonnative speakers of English with equivalent short-term memory function. The results showed depth effects similar to C&T for all participants, indicating that C&T's results do generalize to less proficient speakers of the target language. It is crucial, however, that nonnative speakers of English benefited less from semantic encoding than native speakers, suggesting an effect of preexisting knowledge representations on mnemonic effects derived from semantic processing, and hence, a limit to the relevance of C&T for learners. Results are discussed in terms of the constructs of the mental lexicon, expert knowledge, distinctiveness and levels of processing in memory research and language learning.

ABSTRACT A longitudinal study compared the effects of distributed and massed practice schedules on the learning of second language English syntax. Participants were taught distinctions in the tense and aspect systems of English at short and long practice intervals. They were then tested at short and long intervals. The results showed that distributed practice led to superior test scores on the long-term tests, indicating that the learning of second language syntax can benefit from distributed practice in a manner very similar to that reported for other skills and information types in the experimental psychology literature. Implications for intensive language-leaning programs and syllabus design in general are discussed.

Aim: Type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) are both associated with increased risk for atherosclerotic coronary heart disease (CHD). Thus, it is useful to know the relative efficacy of lipid-altering drugs in these patient populations.Methods: A double-blind, parallel group trial of adult patients with hypercholesterolaemia at high-CHD risk receiving atorvastatin 40 mg/day compared atorvastatin 40 mg plus ezetimibe 10 mg (ezetimibe) vs. doubling atorvastatin to 80 mg. This post hoc analysis reports lipid efficacy results in patients grouped by diagnosis of T2DM, MetS without T2DM or neither. Per cent change from baseline at week 6 was assessed for LDL-C, total cholesterol, HDL-C , non-HDL-C , Apo A-I, Apo B and triglycerides. Safety was monitored through clinical and laboratory adverse events (AEs).Results: Compared with doubling atorvastatin, atorvastatin plus ezetimibe resulted in greater reductions in LDL-C, triglycerides, Apo B, non-HDL-C, total cholesterol and lipid ratios in the T2DM, MetS and neither groups. Treatment effects were of similar magnitude across patient groups with both treatments, except triglycerides, which were slightly greater in the T2DM and MetS groups vs. neither group. Changes in HDL-C , Apo A-I and high sensitivity C-reactive protein (hs-CRP) were comparable for both treatments in all three groups. Safety and tolerability profiles were generally similar between treatments and across patient groups, as were the incidence of liver and muscle AEs.Conclusions: Compared with doubling atorvastatin to 80 mg, addition of ezetimibe to atorvastatin 40 mg produced greater improvements in multiple lipid parameters in high-CHD risk patients with T2DM, MetS or neither, consistent with the significantly greater changes observed in the full study cohort (clinical trial # NCT00276484).

Synopsis: Few clinical studies have focused on the efficacy of lipid-lowering therapies in the population of patients 65 years and older.

A total of 102 patients were randomized to either mono-therapy with simvastatin (40 mg daily) or triple-therapy with simvastatin (40 mg daily), extended-release niacin (1500 mg daily), and ezetimibe (10 mg daily). MRI was performed at baseline and 6, 12, and 24 months. SFA wall, lumen, and total vessel volumes were quantified. MRI-derived SFA parameters and lipids were analyzed with multilevel models and nonparametric tests, respectively.Baseline characteristics did not differ between mono and triple-therapy groups, except for ethnicity (p = 0.02). SFA wall, lumen, and total vessel volumes increased non-significantly for both groups between baseline and 24-months. Non–high-density lipoprotein cholesterol was significantly reduced at 12 months with triple-therapy compared with mono-therapy (p = 0.01).No significant differences were observed between mono-therapy using simvastatin and triple-therapy with simvastatin, extended-release niacin, and ezetimibe for 24-month changes in SFA wall, lumen, and total vessel volumes.Clinical Trial Registration Information: NCT00687076; Link: http://clinicaltrials.gov/ct2/show/NCT00687076.

As anyone involved in SLA research knows, the field is full of problems. Some are interesting ones for research, others are pointless, pernicious or otherwise uninteresting muddles and debates that...

Objective . To compare the efficacy of etoricoxib 30 mg with the generally maximum recommended dose of celecoxib, 200 mg, in the treatment of osteoarthritis (OA) in two identically designed studies. Methods . Two multi-centre, 26-week, double-blind, placebo-controlled, non-inferiority studies were conducted, enrolling patients who were prior non-steroidal anti-inflammatory drug (NSAID) or acetaminophen users. There were 599 patients in study 1 and 608 patients in study 2 randomized 4:4:1:1 to etoricoxib 30 mg qd, celecoxib 200 mg qd or one of two placebo groups for 12 weeks. After 12 weeks, placebo patients were evenly distributed to etoricoxib or celecoxib based on their initial enrollment randomization schedule. The primary hypothesis was that etoricoxib 30 mg would be at least as effective as celecoxib 200 mg for the time-weighted average change from baseline over 12 weeks for Western Ontario and McMaster (WOMAC) Pain Subscale, WOMAC Physical Function Subscale and Patient Global Assessment of Disease Status. Active treatments were also assessed over the full 26 weeks. Adverse experiences were collected for safety assessment. Results . In both studies, etoricoxib was non-inferior to celecoxib for all three efficacy outcomes over 12 and 26 weeks; both were superior to placebo ( P < 0.001) for all three outcomes in each study over 12 weeks. The safety and tolerability of etoricoxib 30 mg qd and celecoxib 200 mg qd were similar over 12 and 26 weeks. Conclusions . Etoricoxib 30 mg qd was at least as effective as celecoxib 200 mg qd and had similar safety in the treatment of knee and hip OA; both were superior to placebo. ClinicalTrials.gov Identifiers: NCT00092768; NCT00092791

There is no known research regarding the relationship between metabolic equivalents (MET) and shuttle-walking speed in post-myocardial infarction (MI) patients. Thus, MET values based on a healthy population (1 MET: 3.5 ml·kg−1·min−1) are used in the prescription of physical activity for cardiac patients. PURPOSE Explore the relationship between MET values and shuttle walking speed during an, on the flat, incremental shuttle-walking test (SWT) in male post-MI patients. METHODS 31 patients (mean±SD, 63.5±6.5, range 53–77 yrs) on two separate occasions performed the SWT. During the SWT each subjects' oxygen consumption (VO2) was collected using a portable gas analyser. Analysis comparing two linear regression lines was employed. The two SWTs were compared (P > 0.8) and averaged; mean values were used to explore the MET vs walking speed relationship. The relationship was also compared to MET values for walking on the flat (ACSM 1991 Guidelines for Exercise Testing and Prescription 298p). Differences in heart rate (beat·min−1) and VO2 during the SWT, between those taking and not taking β-blocker, and Statin medication were determined. Kruskall-Wallis analysis compared subject groups. RESULTS Patients on β-blockers (n=22) had lower heart rates (beat·min−1) during the SWT vs those not taking β-blockers (n=9) (P < 0.0001). This did not significantly affect their VO2 (ml·kg−1·min−1) (P > 0.5). Twenty-eight (∼90%) patients were on Statins. MET values at walking speeds 1.12 to 4.16 m·h-1 were significantly higher (P < 0.0001) for patients vs MET values given for healthy individuals (ACSM 1991) (figure 1).Figure 1: MET values during the SWT for post-MI patients vs MET values provided by the ACSM (1991) for walking on the flat (P < 0.0001).CONCLUSION The MET values were higher for the post-MI patients' vs the ACSM values for the same walking speed. Additional research is required, as physical activity is prescribed for these patients from the SWT, which uses MET values based on healthy individuals. Research is also needed to determine METs during the SWT. Supported by NHS Executive Grant SEO166.

Recent advances in digital video have lead to a convergence of mainstream entertainment (e.g., movies) and language learning tools. An example is a software system/media player called L1, which provides interactive subtitling and learning support for DVD entertainment products. Convergence of entertainment and learning resources raises challenging language learning software design tensions. The article reports a study of English language learners who were asked to use the L1 system and to rate the system features in terms of ease of use and learning. The results showed several distinct design preferences depending on the user's more general attitudes toward edutainment resources. The article discusses L1's consequent design modifications. as well as design considerations for language learning edutainment resources more generally.