Constant Murley Score on Patients Post Supraspinatus Reconstruction with Membrane Amnion Composite and Fat Tissue Allogenic Mesenchymal Stem Cell Augmentation

Background: Rotator cuff tears are the most common cases in nontrauma upper extremities in group patient more than 50 years old. Incidence on rotator cuff can't show the real population. New Approaches healing rotator cuff syndrome is tendon regeneration like mesenchymal stem cell injection and growth factor or tissue engineering that has been developed.Methods: Retrospective comparation study of 15 postsupraspinatus reparation patients who has been treated for more than 4 months at the Dr. Soetomo general hospital. Patients is divided into group undergone supraspinatus reparation and patient supraspinatus reparation with augmented by membrane amnion composite and mesenchymal stem cell. Its' functional results were evaluated using constant murley score.Results: Pain score average on supraspinatus reparation patients which augmented by membrane amnion and mesenchymal stem cell and those without augmentation is 15 and 13.7 (p=0.036). Daily activity score average on patients with and without augmentation are 20 and 17 (p=0.037). Flexion score average on patients with and without augmentation are 10 and 8.6 (p=0.114). External rotation score average on patients with and without augmentation are 9.6 and 7.2 (p=0.004). Internal rotation score average on patients with and without augmentation are 9.2 and 7.2 (p=0.012).Conclusion: The constant murley score pain score, ADL score, external rotation score, and internal rotation score in the group with the addition of amniotic membrane and mesenchymal stem cells were significantly better than the group with supraspinatus repair only, but not significantly on the flexion score and lateral elevation score components

Linear Estimating Equations for Exponential Families with Application to Gaussian Linear Concentration Models

In many families of distributions, maximum likelihood estimation is intractable because the normalization constant for the density which enters into the likelihood function is not easily available. The score matching estimator of Hyv\"arinen (2005) provides an alternative where this normalization constant is not required. The corresponding estimating equations become linear for an exponential family. The score matching estimator is shown to be consistent and asymptotically normally distributed for such models, although not necessarily efficient. Gaussian linear concentration models are examples of such families. For linear concentration models that are also linear in the covariance we show that the score matching estimator is identical to the maximum likelihood estimator, hence in such cases it is also efficient. Gaussian graphical models and graphical models with symmetries form particularly interesting subclasses of linear concentration models and we investigate the potential use of the score matching estimator for this case

Generalized Score Matching for Non-Negative Data

A common challenge in estimating parameters of probability density functions is the intractability of the normalizing constant. While in such cases maximum likelihood estimation may be implemented using numerical integration, the approach becomes computationally intensive. The score matching method of Hyv\"arinen [2005] avoids direct calculation of the normalizing constant and yields closed-form estimates for exponential families of continuous distributions over $\mathbb{R}^m$. Hyv\"arinen [2007] extended the approach to distributions supported on the non-negative orthant, $\mathbb{R}_+^m$. In this paper, we give a generalized form of score matching for non-negative data that improves estimation efficiency. As an example, we consider a general class of pairwise interaction models. Addressing an overlooked inexistence problem, we generalize the regularized score matching method of Lin et al. [2016] and improve its theoretical guarantees for non-negative Gaussian graphical models.Comment: 70 pages, 76 figure

A blinded, randomized, controlled trial assessing conservative management strategies for frozen shoulder

BACKGROUND: There is little evidence for the optimal form of nonoperative treatment in the management of frozen shoulder. This study assesses the efficacy of current physiotherapy strategies. METHODS: All primary care referrals of frozen shoulder to our physiotherapy department were included during a 12-month period. Of these referrals, 17% met the inclusion criteria for primary idiopathic frozen shoulder. The 75 patients were randomly assigned to 1 of 3 groups: group exercise class, individual physiotherapy, and home exercises alone. A single independent physiotherapist, who was blinded to the treatment groups, made all assessments. Range of motion, Constant score, Oxford Shoulder Score, Short Form 36, and Hospital Anxiety and Disability Scale (HADS) outcome measures were performed at baseline, 6 weeks, 6 months, and 1 year. RESULTS: The exercise class group improved from a mean Constant score of 39.8 at baseline to 71.4 at 6 weeks and 88.1 at 1 year. There was a significant improvement in shoulder symptoms on Oxford and Constant scores (P < .001). This improvement was greater than with individual physiotherapy or home exercises alone (P < .001). The improvement in range of motion was significantly greater in both physiotherapy groups over home exercises (P < .001). HADS scores significantly improved during the course of treatment (P < .001). The improvement in HADS anxiety score was significantly greater in both physiotherapy intervention groups than in home exercises alone. CONCLUSIONS: A hospital-based exercise class can produce a rapid recovery from a frozen shoulder with a minimum number of visits to the hospital and is more effective than individual physiotherapy or a home exercise program

Medium to long-term outcome of thoracoscapular arthrodesis with screw fixation for facioscapulohumeral muscular dystrophy

Background: Shoulder girdle muscle weakness is the most constant feature of facioscapulohumeral muscular dystrophy and leads to scapular winging. Mechanical fixation of the scapula to the thoracic wall provides a stable fulcrum on which the deltoid muscle can exert its action on the humerus. The aim of this study was to evaluate the medium to long-term outcome of thoracoscapular arthrodesis with screw fixation (the modified Howard-Copeland technique). Methods: All patients with facioscapulohumeral dystrophy who underwent thoracoscapular arthrodesis with screw fixation and bone-grafting from July 1997 to July 2010 were retrospectively reviewed. Preoperative and postoperative clinical assessment included active shoulder elevation, the Constant score, a patient satisfaction score, and cosmetic satisfaction. Union was determined both clinically and radiographically. Results: Thoracoscapular arthrodesis was performed in thirty-five shoulders in twenty-four patients; eleven patients underwent bilateral procedures. The principal study group consisted of thirty-two shoulders in twenty-one patients with a minimum follow-up of twenty-four months (Mean, eighty-eight months; range, twenty-four to 174 months). The mean Constant score increased from 30 (range, 17 to 41) preoperatively to 61 (range, 30 to 90) postoperatively. The mean satisfaction score increased from 1 (range, 0 to 4) to 8.4 (range, 4 to 10). Early complications consisted of one pneumothorax, one superficial wound infection, and four early failures, two of which were associated with noncompliance with the postoperative regimen. Late complications consisted of one posttraumatic fracture resulting in loosening and one painful nonunion; both were treated successfully with revision. Conclusions: Thoracoscapular arthrodesis with screw fixation prevented scapular winging and improved short-term and long-term shoulder function in patients with facioscapulohumeral dystrophy. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence

On the Distortion of Voting with Multiple Representative Candidates

We study positional voting rules when candidates and voters are embedded in a common metric space, and cardinal preferences are naturally given by distances in the metric space. In a positional voting rule, each candidate receives a score from each ballot based on the ballot's rank order; the candidate with the highest total score wins the election. The cost of a candidate is his sum of distances to all voters, and the distortion of an election is the ratio between the cost of the elected candidate and the cost of the optimum candidate. We consider the case when candidates are representative of the population, in the sense that they are drawn i.i.d. from the population of the voters, and analyze the expected distortion of positional voting rules. Our main result is a clean and tight characterization of positional voting rules that have constant expected distortion (independent of the number of candidates and the metric space). Our characterization result immediately implies constant expected distortion for Borda Count and elections in which each voter approves a constant fraction of all candidates. On the other hand, we obtain super-constant expected distortion for Plurality, Veto, and approving a constant number of candidates. These results contrast with previous results on voting with metric preferences: When the candidates are chosen adversarially, all of the preceding voting rules have distortion linear in the number of candidates or voters. Thus, the model of representative candidates allows us to distinguish voting rules which seem equally bad in the worst case

Data Envelopment Analysis (Dea) approach In efficiency transport manufacturing industry in Malaysia

The objective of this study was to measure of technical efficiency, transport manufacturing industry in Malaysia score using the data envelopment analysis (DEA) from 2005 to 2010. The efficiency score analysis used only two inputs, i.e., capital and labor and one output i.e., total of sales. The results shown that the average efficiency score of the Banker, Charnes, Cooper - Variable Returns to Scale (BCC-VRS) model is higher than the Charnes, Cooper, Rhodes - Constant Return to Scale (CCR-CRS) model. Based on the BCC-VRS model, the average efficiency score was at a moderate level and only four sub-industry that recorded an average efficiency score more than 0.50 percent during the period study. The implication of this result suggests that the transport manufacturing industry needs to increase investment, especially in human capital such as employee training, increase communication expenses such as ICT and carry out joint ventures as well as research and development activities to enhance industry efficiency

Primary Shoulder Arthroplasty Versus Conservative Treatment for Comminuted Proximal Humeral Fractures: A Systematic Literature Review

The objective was to identify whether arthroplasty or conservative treatment is the best available treatment for three- and four-part proximal humeral fractures by analyzing the outcome measure of the Constant score. We conducted an electronic search. The systematic review included 33 studies encompassing 1096 patients with three- or four-part proximal humeral fractures that used the Constant score as outcome measure. The mean Constant score in the conservative group was 66.5 and in the arthroplasty group was 55.5. The difference could be attributed to selection bias, unreliable classification of the fractures and inter-observer differences in the assessment of the Constant score