Digital Rights to the City: Local Practices and Negotiations of Urban Space on Decidim

The organization, management, and production of urban space through digital information and communication technologies have become a central means for governing urban life. To overcome a lack of citizen-centered practices in today's smart cities, governments and municipalities institutionalize citizen-centered digital infrastructures such as Decidim, a digital infrastructure proposing non-corporate, decentralized, and collaborative forms of digital production to evoke participatory governance practices and ultimately social transformation (Barandiaran et al., 2018). Swiss city administrations have adapted the Decidim platform for participatory budgeting processes and city-wide participation platforms since 2019. This article explores the process of institutional adoption, focusing on how the use of Decidim impacts local practices and negotiations for governing urban space. The examination of the Decidim platform in the Swiss cities of Zurich and Lucerne will be framed by re-conceptualizing Lefebvre's right to the city in the age of digital transformation. The findings show that for a successful introduction of the Decidim platform based on principles of the right to the city (a) local needs for a new digital democratic instrument need to be pre-existent, (b) government employees must implement a scope of action which allows organized civil society and grassroots initiatives to appropriate the infrastructure for their own purposes, and (c) local practices of hybrid communication and organizing must be aligned with the structure of the platform. Nevertheless, digital participation tools such as Decidim cannot solve entrenched inequalities such as the financialization of land, the issue of disadvantaged neighborhoods, or the absence of voting rights for certain communities. Therefore, city administrations need to integrate hybrid participation strategies which prioritise collective power over distributive power as well as tackle urban inequalities through political means

Watertightness of wound closure in lumbar spine-a comparison of different techniques

Background: Since a primary watertight dural suture after incidental durotomies has a failure rate of 5-10%, a watertight closure technique of the overlying layers (fascia, subcutis and skin) is essential. The purpose of this cadaveric study was to find the most watertight closure technique for fascia, subcutis and skin. Methods: Different suturing techniques were tested for each layer in a sheep cadaveric model by measuring the leakage pressure. The specimens were mounted on a pressure chamber connected to a manometer and a water tube system. Subsequently, the leakage was over-sewed with a cross stitch and the experiment was repeated. Results: Cross stitch suturing [median =180 mbar (43; 660)] performed best compared to continuous [median =16 mbar (6; 52)] (P=0.003) but not to single knot [median =118 mbar (21; 387)] (P=1.0) or locking stitch suturing [median =109 mbar (3; 149)] (P=0.93) for fascia closure. Continuous suture [median =9 mbar (3; 14)] resulted in a higher leakage pressure than single knot [median =1 mbar (1; 6)] (P=0.017) for subcutaneous closure. No significant differences were found between intracutaneous, Donati-continuous, single knot and locking stitch for skin closures (P=0.075). However, the Donati-continuous stitch closure resulted in higher pressures in tendency. Over-sewing increased median leakage pressure from 8.0 to 11.0 mbar (P=0.068) and from 4.0 to 13.0 mbar (P=0.042) for single knot and for locking stitch skin closures, respectively. Conclusions: Cross stitches for the fascia, continuous suturing technique for the subcutis and Donati-continuous stitch for the skin resulted in the most watertight closure within this experimental setting. If leakage occurs, over-sewing might relevantly improve the watertightness of the wound

MedShapeNet -- A Large-Scale Dataset of 3D Medical Shapes for Computer Vision

Prior to the deep learning era, shape was commonly used to describe the objects. Nowadays, state-of-the-art (SOTA) algorithms in medical imaging are predominantly diverging from computer vision, where voxel grids, meshes, point clouds, and implicit surface models are used. This is seen from numerous shape-related publications in premier vision conferences as well as the growing popularity of ShapeNet (about 51,300 models) and Princeton ModelNet (127,915 models). For the medical domain, we present a large collection of anatomical shapes (e.g., bones, organs, vessels) and 3D models of surgical instrument, called MedShapeNet, created to facilitate the translation of data-driven vision algorithms to medical applications and to adapt SOTA vision algorithms to medical problems. As a unique feature, we directly model the majority of shapes on the imaging data of real patients. As of today, MedShapeNet includes 23 dataset with more than 100,000 shapes that are paired with annotations (ground truth). Our data is freely accessible via a web interface and a Python application programming interface (API) and can be used for discriminative, reconstructive, and variational benchmarks as well as various applications in virtual, augmented, or mixed reality, and 3D printing. Exemplary, we present use cases in the fields of classification of brain tumors, facial and skull reconstructions, multi-class anatomy completion, education, and 3D printing. In future, we will extend the data and improve the interfaces. The project pages are: https://medshapenet.ikim.nrw/ and https://github.com/Jianningli/medshapenet-feedbackComment: 16 page

Following the Swiss Railway. Politics of Land, Spatial Logics of Capital and State-driven Financialization Processes

This work “follows the Swiss Railway” through time and space to uncover relationships between infrastructure development, the politics of land, and processes of financial capitalism. Using postcolonial perspectives to understand the social effects of the railway expansion in nineteenth and twentieth century Switzerland creates the basis for analyzing the contemporary complicity of the SBB (company of the Swiss Federal Railway) in the financialization of real estate. In understanding and disrupting processes of spatially constructed identities in relation to land and property, I question the approach of reusing land, expropriated initially for a governmental framework supporting the private railway companies, in a way to maximize the profit. Based on a general approach of questioning common discursive logics, I aim to highlight the connection between symbolic and material practices. I combine conventional qualitative methods such as archival and interview work with more experimental methods such as ‘conceptual walks’ and critical mapping. I demonstrate how land is used as a financialized asset in the case of the Swiss railway and envision alternative modes of dealing with land. While I study the built environment across spatial and temporal scales, from the security designs of Europaallee and the iconography of SBB real estate visions to the railway network across Switzerland as a whole, themes such as the relationship between infrastructure development and new forms of financing or SBB’s land-banking practices over the centuries in and outside of Switzerland emerge

Reverse total shoulder arthroplasty for massive, irreparable rotator cuff tears before the age of 60 years: long-term results

BACKGROUND: There has been serious concern regarding the longevity and durability of outcomes of reverse total shoulder arthroplasty (RTSA) in younger patients. It was the purpose of this study to analyze long-term outcomes and complications of RTSA for irreparable rotator cuff tears in patients younger than 60 years. METHODS: Twenty patients (23 shoulders) with a mean age of 57 years (range, 47 to 59 years) were evaluated at a mean of 11.7 years (range, 8 to 19 years) after RTSA. Fifteen shoulders (65%) had undergone previous non-arthroplasty surgery. Longitudinal clinical and radiographic outcomes were assessed. RESULTS: At the time of final follow-up, the mean absolute and relative preoperative Constant score (CS) (and standard deviation) had improved from 24 ± 9 to 59 ± 19 points (p < 0.001) and from 29% ± 11% to 69% ± 21% (p < 0.001), respectively. The mean Subjective Shoulder Value (SSV) had increased from 20% ± 13% to 71% ± 27% (p < 0.001). There were also significant improvements in the mean active anterior elevation (from 64° to 117°), active abduction (from 58° to 111°), pain scores, and strength (all p ≤ 0.001). Clinical outcomes did not significantly deteriorate beyond 10 years and the functional results of patients with previous surgical procedures were not significantly inferior to the results of those with primary RTSA. The grade of, and number of patients with, radiographically apparent notching increased over time; the mean relative CS was lower in patients in whom the notching was grade 2 or higher (57%) than it was in those with no or grade-1 notching (81%; p = 0.006). Nine (39%) had ≥1 complication, with 2 failed RTSAs (9%). CONCLUSIONS: RTSA in patients younger than 60 years leads to substantial subjective and functional improvement without clinical deterioration beyond 10 years. It is associated with a substantial complication rate, and complications compromise ultimate subjective and objective outcomes. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence

MR findings associated with positive distraction of the hip joint achieved by axial traction

Purpose: To determine which MR-arthrography findings are associated with positive hip joint distraction. Materials and methods: One hundred patients with MR arthrography of the hip using axial traction were included. Traction was applied during the MR examination with an 8kg (females) or 10kg (males) water bag, attached to the ankle over a deflection pulley. Fifty patients showing joint space distraction were compared to an age- and gender-matched control group of 50 patients that did not show a joint distraction under axial traction. Two radiologists assessed the neck-shaft angle, lateral and anterior center-edge (CE) angles, CE angles in the transverse plane, extrusion index of the femoral head, acetabular depth, alpha angle, acetabular version, ligamentum teres, joint capsule and ligaments, iliopsoas tendon and the labrum. Results: Mean joint space distraction in the study group was 0.9 ± 0.6mm. Patients with positive joint space distraction had significantly higher neck-shaft angles (control group 131.6 ± 5.4°/study group 134.1 ± 6.1°, p < 0.05), smaller lateral CE angles (38.1 ± 5.9°/34.6 ± 7.2°, p < 0.05), smaller overall transverse CE angles (161.4 ± 9.9°/153.6 ± 9.6°, p < 0.001), smaller acetabular depth (4.1 ± 2.4mm/5.8 ± 2.5mm, p < 0.01), higher alpha angles (53.5 ± 7.8°/59.2 ± 10.1°, p < 0.01) and a thicker ligamentum teres (4.7 ± 1.4mm/5.4 ± 1.8mm, p < 0.05). The other parameters revealed no significant differences. ICC values for interobserver agreement were 0.71-0.95 and kappa values 0.43-0.92. Conclusion: Increased neck-shaft angles, small CE angles, small acetabular depth, higher alpha angles and a thick ligamentum teres are associated with positive joint distraction

Salvage reverse total shoulder arthroplasty for failed operative treatment of proximal humeral fractures in patients younger than 60 years: long-term results

HYPOTHESIS Is salvage reverse total shoulder arthroplasty (RTSA) a justifiable treatment for failed operative treatment (open reduction-internal fixation [ORIF] or primary and secondary hemiarthroplasty) of proximal humeral fractures in patients younger than 60 years? METHODS Thirty patients (mean age, 52 years; age range, 30-59 years) were reviewed after a mean follow-up period of 11 years (range, 8-18 years). Of the patients, 7 (23%) underwent RTSA for failed ORIF and 23 (77%) for failed hemiarthroplasty. Clinical and radiographic outcomes were assessed longitudinally. RESULTS At final follow-up, the mean relative Constant score had improved from 25% (±12%) to 58% (±21%, P < .001). Significant improvements were seen in the mean Subjective Shoulder Value (20% to 56%), active elevation (45° to 106°), abduction (42° to 99°), pain scores, and strength (P < .001). Clinical outcomes did not significantly deteriorate over a period of 10 years. Patients with salvage RTSA for failed secondary hemiarthroplasty (n = 8) vs. those for failed ORIF (n = 6) showed significantly inferior active abduction (77° vs. 116°, P = .023). Patients with a healed greater tuberosity (n = 9) showed significantly better external rotation than patients with a resorbed/resected greater tuberosity (n = 13, 21° vs. 3°, P = .025). One or more complications occurred in 18 shoulders (60%), and 6 (20%) resulted in explantation of the RTSA. CONCLUSIONS Salvage RTSA in patients younger than 60 years is associated with a high complication rate. It leads nonetheless to substantial and durable improvement beyond 10 years, provided the complications can be handled with implant retention. Inferior shoulder function is associated with greater tuberosity resorption or resection and inferior overhead elevation with the diagnosis of failed hemiarthroplasty

Supraacetabular fossa (pseudodefect of acetabular cartilage): frequency at MR arthrography and comparison of findings at MR arthrography and arthroscopy

PURPOSE: To evaluate the frequency of the supraacetabular fossa (SAF) (pseudodefect of acetabular cartilage) at magnetic resonance (MR) arthrography of the hip and to compare the MR findings with those from arthroscopy. MATERIALS AND METHODS: All patients gave written permission for anonymized use of their medical data for scientific purposes before the imaging examination. The study was submitted to the institutional review board, and the need to obtain additional approval was waived. A medical student, a radiology fellow, and two senior radiologists reviewed 1002 consecutive MR arthrograms for the presence of an accessory bony fossa in the roof of the acetabulum, or SAF. SAF was classified into two types: type 1, which was filled with contrast material on MR arthrograms, and type 2, which was filled with cartilage. The width of the SAF was measured on coronal and sagittal MR images. MR arthrograms showing SAF were evaluated for subchondral reactions. Findings at MR arthrography were compared with those from arthroscopy in four hip joints with SAF type 1 and 13 with SAF type 2. RESULTS: Sixteen of the 1002 hip joints (1.6%; four female and 12 male patients; mean age, 20.1 years) had SAF type 1 (mean width, 5.2 × 4.5 mm). Eighty-nine hip joints (8.9%; 43 female and 46 male patients; mean age, 37.8 years) had SAF type 2 (mean width, 5.1 × 4.7 mm). No subchondral changes were found around the SAF. No cartilage defect was seen at the site of the SAF at arthroscopy. CONCLUSION: The high frequency of SAF on MR arthrograms (10.5%), the absence of subchondral reaction, and the absence of cartilage defects at arthroscopy indicate that the SAF of the acetabulum likely represents a variant