Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations

The different approaches used in arthroscopic stabilisation of the acromioclavicular joint are well known. However, and despite a great incidence of ectopic pectoralis minor insertion, an alternative choice for the use of arthroscopic portal has not being sufficiently described. Here, we describe a case of acute acromioclavicular dislocation grade III. The arthroscopic stabilisation was achieved using the TightRope (Arthrex, Naples, USA) implant. Through this technique, the approach to the articular portion of the coracoid process can be made intra-articularly or from the subacromial space. We accessed intra-articularly, by opening the rotator interval to reach the coracoid process from the joint cavity. After opening the rotator interval, an ectopic insertion of the pectoralis minor was observed. The choice of approach of the coracoid process from the subacromial space would have complicated the intervention, making it necessary to sever the ectopic tendon to complete the technique, lengthening the surgical time and increasing the chance of complications. For this reason, the use of a standard posterior portal providing intra-articular arthroscopic access through the rotator interval is recommended since the aforementioned anatomical variation is not infrequent. Level of evidence Therapeutic studies—investigating the results of treatment, Level V.

Technical efficiency in the retail food industry: the influence of inventory investment, wage levels, and age of the firm

The objective of this paper is to estimate technical efficiency in retailing; and the influence of inventory investment, wage levels, and firm age on this efficiency. We use the output supermarket chains’ sales volume, calculated isolating the retailer price effect on its sales revenue. This output allows us to estimate a strictly technical concept of efficiency. The methodology is based on the estimation of a stochastic parametric function. The empirical analyses applied to panel data on a sample of 42 supermarket chains between 2000 and 2002 show that inventory investment and wage level have an impact on technical efficiency. In comparison, the effect of these factors on efficiency calculated through a monetary output (sales revenue) shows some differences that could be due to aspects related to product prices.

A three-stage DEA model to evaluate learning-teaching technical efficiency: Key performance indicators and contextual variables

This study evaluates the technical efficiency of the learning-teaching process in higher education using a three-stage procedure that offers advances in comparison to previous studies and improves the quality of the results. First, it utilizes a multiple stage Data Envelopment Analysis (DEA) with contextual variables. Second, the levels of super efficiency are calculated in order to prioritize the efficiency units. And finally, through sensitivity analysis, the contribution of each key performance indicator (KPI) is established with respect to the efficiency levels without omission of variables. The analytical data was collected from a survey completed by 633 tourism students during the 2011/12, 2012/13 and 2013/14 academic course years. The results suggest that level of satisfaction with the course, diversity of materials and satisfaction with the teacher were the most important factors affecting teaching performance. Furthermore, the effect of the contextual variables was found to be significant.

The relevance of harmonising the technical level of social housing with the urban level of the neighbourhood through the example of the 500 dwellings in Albacete

The Architecture and Household Trade Union built nearly 2,000 subsidized dwellings in Albacete from 1941 to 1971. It was the responsible entity from the end of the Civil War until the beginning of Democracy of the social policy programs in Spain. Later on, and together with the National Housing Institute, were responsible for the construction activity. Its limited budget, scarcity of technical and human resources and an urgent need for new housing developments, constituted the basis for producing a vast housing market of low construction qualities. However, thanks to the true architectonic expertise of some of the professionals, some of the developments were designed with a clear urban strategy and in direct relation with the city, which characterizes them to be studied and conserved. This is the case for the selected development for the analysis, the urban complex of the 500 dwellings in Albacete, the Hermanos Falcó Neighborhood. Designed and built between 1963, Alfonso Crespo and Adolfo Gil architects, and 1977 second reformed project by the architect Fernando Rodríguez. It is characterized by its layout on the territory, its controlled relation with the city and its different types of open blocks. Above all, its spatial and human scale strengths, directly related to the European post-war proposals, have to be emphasized; although its technical deficiencies affect the interior quality of the houses. This paper examines its virtues and failures and proposes, using current tools, its renovation. This proposal main aims are to extend its lifetime and develop the particular and urban sustainability levels.

Queries &c about Colleges, ca. 1798

One leaf containing handwritten research questions regarding the holding of real estate and related taxation.

Medical Curriculum Change at Queen's-affiliated Medical Colleges: 1881 – 1910

This study explores the curriculum at Queen’s-affiliated medical colleges, specifically The Royal College of Physicians and Surgeons, Kingston, the Kingston Women’s Medical College, and Queen’s Medical College, from 1881 to 1910, using the textbooks prescribed by these institutions as primary sources. The central question encompasses what factors primarily motivated the curriculum at Queen’s-affiliated medical colleges to change. Within the historiographical scholarship on Queen’s College, this question has not yet been addressed and, to my knowledge, this is the first medical education history to specifically address textbooks as part of a medical school curriculum. During this period, these institutions experienced reorganizational shifts, such as the reunification of Queen’s Medical College with The Royal College of Physicians and Surgeons, Kingston, as well as the introduction and subsequent exclusion of female students. Within this context, this study examines how the forces of scientific innovation and co-education impacted the curriculum during the period under study, as measured by textbook change, specifically in the courses of obstetrics and gynaecology, the theory and practice of medicine, and surgery. To what degree was curriculum in these courses responsive to scientific inventions and discoveries, changing therapeutic practices, and possible gender biases? From 1881 to 1910, innovations such as x-ray and anaesthesia became commonplace within medical practice. Some technologies gained acceptance in the curriculum, while others fell out of favour. This study tracks these scientific discoveries through the textbooks used at Queen’s-affiliated medical colleges in order to demonstrate how the evolving nature of medicine was represented in the curriculum. To address how gender influenced the curriculum, textbooks from the Kingston Women’s Medical College and The Royal College of Physicians and Surgeons, Kingston, were compared. For two out of the three examined courses, it was found that sections of textbooks discussing various topics at the Kingston Women’s Medical College contained significantly more detail than their corresponding sections within The Royal College’s textbooks. It was speculated that the instructors preferred to teach their female students through textbooks, rather than lectures.