The Recovery of Weight-Bearing Symmetry After Total Hip Arthroplasty Is Activity-Dependent

This study aimed to characterize ipsilateral loading and return to weight-bearing symmetry (WBS) in patients undergoing total hip arthroplasty (THA) during activities of daily living (ADLs) using instrumented insoles. A prospective study in 25 THA patients was performed, which included controlled pre- and postoperative follow-ups in a single rehabilitation center of an orthopedic department. Ipsilateral loading and WBS of ADLs were measured with insoles in THA patients and in a healthy control group of 25 participants. Measurements in the THA group were performed at 4 different visits: a week pre-THA, within a week post-THA, 3-6 weeks post-THA, and 6-12 weeks post-THA, whereas the healthy control group was measured once. ADLs included standing comfortably, standing evenly, walking, and sit-to-stand-to-sit (StS) transitions. All ADLs were analyzed using discrete methods, and walking included a time-scale analysis to provide temporal insights in the ipsilateral loading and WBS waveforms. THA patients only improved beyond their pre-surgery levels while standing comfortably (ipsilateral loading and WBS, p < 0.05) and during StS transitions (WBS, p < 0.05). Nevertheless, patients improved upon their ipsilateral loading and WBS deficits observed within a week post-surgery across all investigated ADLs. Ipsilateral loading and WBS of THA patients were comparable to healthy participants at 6-12 weeks post-THA, except for ipsilateral loading during walking (p < 0.05) at the initial and terminal double-leg support period of the stance phase. Taken together, insole measurements allow for the quantification of ipsilateral loading and WBS deficits during ADLs, identifying differences between pre- and postoperative periods, and differentiating THA patients from healthy participants. However, post-THA measurements that lack pre-surgery assessments may not be sensitive to identifying patient-specific improvements in ipsilateral loading and WBS. Moreover, StS transitions and earlier follow-up time points should be considered an important clinical metric of biomechanical recovery after THA

Quantifying Asymmetry in Gait: The Weighted Universal Symmetry Index to Evaluate 3D Ground Reaction Forces

Though gait asymmetry is used as a metric of functional recovery in clinical rehabilitation, there is no consensus on an ideal method for its evaluation. Various methods have been proposed to analyze single bilateral signals but are limited in scope, as they can often use only positive signals or discrete values extracted from time-scale data as input. By defining five symmetry axioms, a framework for benchmarking existing methods was established and a new method was described here for the first time: the weighted universal symmetry index (wUSI), which overcomes limitations of other methods. Both existing methods and the wUSI were mathematically compared to each other and in respect to their ability to fulfill the proposed symmetry axioms. Eligible methods that fulfilled these axioms were then applied using both discrete and continuous approaches to ground reaction force (GRF) data collected from healthy gait, both with and without artificially induced asymmetry using a single instrumented elbow crutch. The wUSI with a continuous approach was the only symmetry method capable of identifying GRF asymmetry differences in different walking conditions in all three planes of motion. When used with a continuous approach, the wUSI method was able to detect asymmetries while avoiding artificial inflation, a common problem reported in other methods. In conclusion, the wUSI is proposed as a universal method to quantify three-dimensional GRF asymmetries, which may also be expanded to other biomechanical signals

Intramuscular and intratendinous placenta‐derived mesenchymal stromal‐like cell treatment of a chronic quadriceps tendon rupture

Background: Quadriceps tendon ruptures (QTRs) are rare but debilitating injuries, often associated with chronic metabolic conditions or long-term steroid treatment. While the surgical treatment for acute QTRs is described thoroughly, no common strategy exists for the often frustrating treatment of chronic, reoccurring QTRs. The pro-angiogenic and immunomodulatory properties of placenta-derived adherent mesenchymal stromal-like (PLX-PAD) cells have been described to protect musculoskeletal tissues from inflammation and catabolic cytokine migration, yet little is known about the regenerative potential of PLX-PAD cells in repetitively damaged tendon tissue. Case: We report the case of an 80-year-old male patient with a chronic three-time QTR of his right knee. The quadriceps tendon was reconstructed applying a conventional suture anchor repair procedure combined with a synthetic mesh augmentation and additional intramuscular and intratendineous PLX-PAD cell injections as an individualized treatment approach. No adverse events were reported, and excellent radiological and functional outcomes with a passive range of motion of 0/0/120 degrees knee extension-flexion were observed at the 12 month follow-up. Gait analysis confirmed restoration of joint motion, including gait speed, deficit in step length, and knee extensor muscle strength (pre-surgery: 0.98 m/s, 40 cm, 42.4 +/- 12.4 N; 9 months post-surgery: 1.07 m/s, 0 cm, 10.4 +/- 18.9 N) as well as hyperextension throughout stance and late swing phases (pre-surgery: -11.2 +/- 0.9 degrees; 9 months post-surgery: -2.7 +/- 1.6 degrees). Postoperative lymphocyte and cytokine analyses from the patient's peripheral blood serum suggested a systemic short-term immunoregulatory reaction with postoperatively increased interleukin (IL)-6 (pre-surgery: 0.79 pg/mL; day 1: 139.97 pg/mL; day 5: 5.58 pg/mL; 9 months: 1.76 pg/mL) and IL-10 (pre-surgery: 0.9 pg/mL; day 1: 1.21 pg/ mL; day 5: 0.3 pg/mL; 9 months: 0.34 pg/mL) levels that decreased again over time. Conclusions: Herein, we demonstrate a successfully treated chronic QTR with a synergistic surgical and biological reconstructive treatment approach. This local add-on treatment with PLX-PAD cells may be considered in specific cases of chronic QTRs, not susceptible to traditional suture anchor procedures and which exhibit a high risk of treatment failure. Further scientific engagement is warranted to explore underlying immunomodulatory mechanisms of action behind PLX-PAD cell treatment for tendon injuries

Negotiation in strategy making teams : group support systems and the process of cognitive change

This paper reports on the use of a Group Support System (GSS) to explore at a micro level some of the processes manifested when a group is negotiating strategy-processes of social and psychological negotiation. It is based on data from a series of interventions with senior management teams of three operating companies comprising a multi-national organization, and with a joint meeting subsequently involving all of the previous participants. The meetings were concerned with negotiating a new strategy for the global organization. The research involved the analysis of detailed time series data logs that exist as a result of using a GSS that is a reflection of cognitive theory

Melody Generation using an Interactive Evolutionary Algorithm

Music generation with the aid of computers has been recently grabbed the attention of many scientists in the area of artificial intelligence. Deep learning techniques have evolved sequence production methods for this purpose. Yet, a challenging problem is how to evaluate generated music by a machine. In this paper, a methodology has been developed based upon an interactive evolutionary optimization method, with which the scoring of the generated melodies is primarily performed by human expertise, during the training. This music quality scoring is modeled using a Bi-LSTM recurrent neural network. Moreover, the innovative generated melody through a Genetic algorithm will then be evaluated using this Bi-LSTM network. The results of this mechanism clearly show that the proposed method is able to create pleasurable melodies with desired styles and pieces. This method is also quite fast, compared to the state-of-the-art data-oriented evolutionary systems.Comment: 5 pages, 4 images, submitted to MEDPRAI2019 conferenc

Conflict of Interest Policies at Canadian Universities: Clarity and Content

[À l'origine dans / Was originally part of : ESPUM - Dép. médecine sociale et préventive - Travaux et publications]Abstract Discussions of conflict of interest (COI) in the university have tended to focus on financial interests in the context of medical research; much less attention has been given to COI in general or to the policies that seek to manage COI. Are university COI policies accessible and understandable? To whom are these policies addressed (faculty, staff, students)? Is COI clearly defined in these policies and are procedures laid out for avoiding or remedying such situations? To begin tackling these important ethical and governance questions, our study examines the COI policies at the Group of Thirteen (G13) leading Canadian research universities. Using automated readability analysis tools and an ethical content analysis, we begin the task of comparing the strengths and weaknesses of these documents, paying particular attention to their clarity, readability, and utility in explaining and managing COI.This study was supported by a grant from the Institute of Genetics of the Canadian Institutes of Health Researc

Accelerated Multi-Organization Conflict Resolution

In this paper, we discuss two situations where two organizations with different aims recognized the dysfunctionality of their relationship. In each of these cases, which were long running (6–8 months), the organizations had worked hard to resolve this dysfunctionality, and conflict, by organizing off-site meetings designed to resolve the conflict. These 1-day meetings failed. Subsequently Group Support System workshops were used for 1 day workshops and in each case the conflict was essentially resolved within 55 min. The research reported in this paper seeks to answer the question: what happened in these cases that led to a resolution of the conflict in such a short time period, given other attempts had failed? Specifically the paper explores the impact of the GSS used to facilitate two organizations seeking to resolve a conflictual situation

Evaluation of Musical Creativity and Musical Metacreation Systems

The field of computational creativity, including musical metacreation, strives to develop artificial systems that are capable of demonstrating creative behavior or producing creative artefacts. But the claim of creativity is often assessed, subjectively only on the part of the researcher and not objectively at all. This article provides theoretical motivation for more systematic evaluation of musical metacreation and computationally creative systems and presents an overview of current methods used to assess human and machine creativity that may be adapted for this purpose. In order to highlight the need for a varied set of evaluation tools, a distinction is drawn among three types of creative systems: those that are purely generative, those that contain internal or external feedback, and those that are capable of reflection and self-reflection. To address the evaluation of each of these aspects, concrete examples of methods and techniques are suggested to help researchers (1) evaluate their systems' creative process and generated artefacts, and test their impact on the perceptual, cognitive, and affective states of the audience, and (2) build mechanisms for reflection into the creative system, including models of human perception and cognition, to endow creative systems with internal evaluative mechanisms to drive self-reflective processes. The first type of evaluation can be considered external to the creative system and may be employed by the researcher to both better understand the efficacy of their system and its impact and to incorporate feedback into the system. Here we take the stance that understanding human creativity can lend insight to computational approaches, and knowledge of how humans perceive creative systems and their output can be incorporated into artificial agents as feedback to provide a sense of how a creation will impact the audience. The second type centers around internal evaluation, in which the system is able to reason about its own behavior and generated output. We argue that creative behavior cannot occur without feedback and reflection by the creative/metacreative system itself. More rigorous empirical testing will allow computational and metacreative systems to become more creative by definition and can be used to demonstrate the impact and novelty of particular approaches