Diagnostic value of measuring the talofibular space using stress sonography in chronic lateral ankle instability.

OBJECTIVES: To investigate the diagnostic value of measuring the talofibular space using stress sonography for chronic lateral ankle instability (CLAI). MATERIALS & METHODS: We recruited patients who were clinically diagnosed with CLAI between October 2018 and December 2019 (CLAI group). A control group of healthy volunteers was also included for this study. Both groups underwent a preliminary stress sonographic examination. First, the ultrasonic characteristics of the anterior talofibular ligament (ATFL), including length, thickness, relaxation, calcification, and rupture, were observed using conventional sonography. Second, the talofibular space at the passive neutral position (D1) and maximum varus position (D2) was measured (by stress sonographic images), and the difference (ΔD = D1-D2) between them was determined. Third, the parameters of the two groups were statistically compared. Finally, receiver operating characteristic (ROC) curves and area under the curve (AUC) analyses were performed for parameters with significant differences. RESULTS: The CLAI group comprised 60 patients, yielding data on 60 ankles, whereas the control group comprised 35 participants, yielding data for 70 ankles. Differences in D1, D2, and ΔD of the talofibular space between the two groups were significant, with ΔD proving to be the best diagnostic indicator (P < 0.001). Its AUC, optimal cutoff value, sensitivity, and specificity were 0.922, 0.11 cm, 73 %, and 94 %, respectively, followed by D2 (0.850, 0.47 cm, 67 %, and 94 %, respectively; P < 0.001) and D1 (0.635, 0.47 cm, 67 %, and 94 %, respectively; P = 0.006). CONCLUSION: Measurement of talofibular space in stress sonography is a valuable diagnostic indicator for CLAI, especially the ΔD between the neutral and stress position.

Multiple salary comparisons, distributive justice, and employee withdrawal.

Salary comparison has well-established implications for employees' attitudes and behaviors at work. Yet how employees process information about simultaneous comparisons, particularly when internal and external comparison information is incongruent, remains controversial. In this article, we draw from the model of dispositional attribution and equity theory to predict how the incongruence of internal and external salary comparisons affects perceptions of distributive justice and subsequent employee withdrawal behavior. We hypothesized that the effect of salary comparisons on perceived distributive justice follows a hierarchically restrictive schema in which a lower salary in comparison to a referent has a greater effect than a higher salary. This further affects employee withdrawal (neglect, turnover intention, and voluntary turnover). We also propose that the effects of salary comparisons are bounded by employees' zero-sum construal of success. Three studies were conducted to test our hypotheses: a quasi-experimental study and two time-lagged field studies. Consistent with our hypotheses, we observed that, when comparison information was incongruent, underpayment compared with others more strongly affected perceived distributive justice than overpayment did. The subsequent impact on perceived distributive justice was negatively related to employee withdrawal. As expected, the effect of incongruent salary comparison information was stronger for employees with lower zero-sum construal of success. The theoretical and practical implications of these findings are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Quantification of Acute Myocardial Damage Secondary to Implantation of Electrodes for the Left Bundle Branch Area Pacing

ABSTRACT Background: Different from the traditional right ventricular pacing, the left bundle branch area pacing (LBBAP) is accomplished with deeper lead implantation and more attempts. However, myocardial damage is unclear in LBBAP. Objective: The objective of the study was to observe the change of troponin T and explore possible factors associated with greater myocardial damage in LBBAP. Methods: Patients with an indication for pacemaker implantation underwent attempts for LBBAP by transventricular septal method. Levels of troponin T were determined before operation, 12 h and 1 week after the operation. Parameters of intraoperation and follow-up were recorded and analyzed. Results: In total, successful LBBAP was achieved in 126 patients. The levels of troponin T increased significantly at 12 h after the operation compared with those before operation (96.45 ± 11.07 [69.06] vs. 16.59 ± 1.84 [11.92] ng/L, p < 0.001), while there were no significant differences between pre- and post-operative levels at 1 week. Correlation and regression analysis showed that only the number of attempts was an independent factor related to the change of troponin T. During 1 year of follow-up, LBBAP was safe and feasible with few complications. Conclusions: Myocardial damage of LBBAP was clinically significant. The number of attempts was an independent factor related to the myocardial damage.