Correlating femoral shape with patellar kinematics in patients with patellofemoral pain

The etiology of patellofemoral pain is likely related to pathological femoral shape and soft-tissue restraints imbalance. These factors may result in various maltracking patterns in patients with patellofemoral pain. Thus, we hypothesized that femoral shape influences patellofemoral kinematics, but that this influence differs between kinematically unique subgroups of patients with patellofemoral pain. 3D MRIs of 30 knees with patellofemoral pain and maltracking (“maltrackers”) and 33 knees of asymptomatic subjects were evaluated, retrospectively. Dynamic MRI was acquired during a flexion-extension task. Maltrackers were divided into two subgroups (nonlateral and lateral maltrackers) based on previously defined kinematic criteria. Nine measures of femoral trochlear shape and two measures of patellar shape were quantified. These measures were correlated with patellofemoral kinematics. Differences were found in femoral shape between the maltracking and asymptomatic cohorts. Femoral shape parameters were associated with patellar kinematics in patients with patellofemoral pain and maltracking, but the correlations were unique across subgroups within this population. The ability to better categorize patients with patellofemoral pain will likely improve treatment by providing a more specific etiology of maltracking in individual patients. © 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 28:865–872, 2010Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75790/1/21101_ftp.pd

Introduction of Plastered Bamboo Creative Eco-Design to Support Creative Infrastructure Improvement in Kediri

Abstract#65533The UIA#65533s Sustainable by Design Strategy (SBD) in Copenhagen Declaration highlighted the importance of reducing the impact of climate change in the Architectural Design. SbD recommended the healthy materials for healthy buildings design which also could improve the quality of life in the local scale. SbD also endorsed UNESCO#65533s recommendation to preserve the cultural diversity. Ecological design is the answer to the phenomenon. It could be defined as the use ecological considerations in the design to seamlessly integrate the human built environment, human activities and the natural environment. This recommendation was fulfilled with plastered - bamboo technology and creative design. The abundant bamboo resources and bamboo craftsmen in Kediri area, Jatiwekas Sub-Village were the rationale for selecting the plastered - bamboo creative eco-design. The bamboo also fulfilled the healthy or sustainable materials criteria, such as low energy consumptions, low impact to environment, low construction cost. The need of the Jatiwekas Sub-Village Community for integrated communal bathing-washing #65533 toilet #65533 water tank facility for housing infrastructure was found during the observation and community focus group discussion. The program involved socialisation and training of the plastered #65533 bamboo design in the village. After accepting the technology, the people mapped out the need in the village (Participatory Rural Appraisal) and conducted a participatory design, facilitated by the Petra University Team. And it produced culturally-accepted and creative facility design. Finally, it would provide the community with alternative creative design options

Communicative Competence for Researchers working with LGBTQ Communities

The ethical principles of respect and justice oblige the use of culturally sensitive approaches when engaging participants in research, however cultural competence training is lacking for researchers who work with LGBTQ populations. The purpose of this study was to explore how researchers can create a welcoming research environment for LGBTQ research participants in the context of historical distrust of medical research as a barrier to research participation among minority populations. Grounded by a framework of communicative competence, this study explored elements of preferred communication during recruitment and informed consent for research involving LGBTQ participants. Grammatical, sociolinguistic, strategic and discourse competence domains aided exploration of the preferences held by participants in LGBTQ sub-groups, as well as the perceived barriers to research. Thirty-six participants, who self-identified as part of the LGBTQ community and were recruited through our community partner, the Center for Health Impact, took part in either focus groups or individual interviews. Preliminary analysis reveals community engagement and building trust are key, particularly in an academic medical center where a patient\u27s clinical experiences may impact their willingness to become a research participant. Participants offered insight into each competence domain, covering: terminology to promote inclusivity, body language to avoid, reducing stigma by being up front and feedback on crafting a more LGBTQ-friendly basic demography questionnaire. These findings will aid in the refinement of an LGBTQ-focused version of our Simulation-based Community-engaged Research Intervention for Informed Consent Protocol Testing and Training (SCRIIPTT) to build communicative competence among clinical researchers

Combined risk factors for melanoma in a Mediterranean population

A case–control study of non-familial melanoma including 183 incident cases and 179 controls was conducted in North-Eastern Italy to identify important risk factors and determine how combination of these affects risk in a Mediterranean population. Presence of dysplastic nevi (OR = 4.2, 95% CI = 2.4–7.4), low propensity to tan (OR = 2.4, 95% CI = 1.1–5.0), light eye (OR = 2.4, 95% CI = 1.1–5.2), and light skin colour (OR = 4.1, 95% CI = 1.4–12.1) were significantly associated with melanoma risk after adjustment for age, gender and pigmentation characteristics. A chart which identifies melanoma risk associated with combinations of these factors is presented; it can be used to identify subjects who would most benefit from preventive measures in Mediterranean populations. According to the combination of these factors, a relative risk range from 1 to 98.5 was found. Light skin colour, high number of sunburns with blistering, and low propensity to tan were significantly associated with melanoma thickness, possibly indicating that individuals with these characteristics underestimate their risk and seek attention when their lesion is already advanced. © 2001 Cancer Research Campaig

The Indonesian Electronic Information and Transactions Within Indonesia’s Broader Legal Regime: Urgency for Amendment?

Cyberspace is the interdependent network of information technology infrastructures such as the internet, telecommunications networks, and computer systems. Meanwhile, Indonesia’s Law Number 11 of 2008 and its amendment through Indonesian Law Number 19 of 2016 governing cyberspace have been viewed to contradict and infringe other areas of law, such as protection of press or freedom of expression. Hence, this study seeks to identify the controversies and problems regarding the law deemed urgent for amendment. Further, this study creates recommendations so the government may amend electronic information policy more fairly and efficiently. This study uses a judicial normative and comparative approach. This research tries to analyze the existing regulations and the implementation and compare Indonesia’s cyberspace regulation with other States’. This study finds that Articles 27(3) and 28(2) of the law criminalize defamation and hate speech in an overly broad manner and that Article 40(2)(b) allows the government to exercise problematic censorship. As a result, they have infringed the freedom of the press and general freedom of expression in practice. In response to this, this study compares similar provisions from other States and recommends amendment the articles to become narrower and more clearly defined

Interpretable Subgroup Discovery in Treatment Effect Estimation with Application to Opioid Prescribing Guidelines

The dearth of prescribing guidelines for physicians is one key driver of the current opioid epidemic in the United States. In this work, we analyze medical and pharmaceutical claims data to draw insights on characteristics of patients who are more prone to adverse outcomes after an initial synthetic opioid prescription. Toward this end, we propose a generative model that allows discovery from observational data of subgroups that demonstrate an enhanced or diminished causal effect due to treatment. Our approach models these sub-populations as a mixture distribution, using sparsity to enhance interpretability, while jointly learning nonlinear predictors of the potential outcomes to better adjust for confounding. The approach leads to human-interpretable insights on discovered subgroups, improving the practical utility for decision suppor

Sister Mary Joseph's Nodule at a University Teaching Hospital in Northwestern Tanzania: A Retrospective Review of 34 cases.

Sister Mary Joseph's nodule is a metastatic tumor deposit in the umbilicus and often represents advanced intra-abdominal malignancy with dismal prognosis. There is a paucity of published data on this subject in our setting. This study was conducted to describe the clinicopathological presentation and treatment outcome of this condition in our environment and highlight challenges associated with the care of these patients, and to proffer solutions for improved outcome. This was a retrospective study of histologically confirmed cases of Sister Mary Joseph's nodule seen at Bugando Medical Centre between March 2003 and February 2013. Data collected were analyzed using descriptive statistics. A total of 34 patients were enrolled in the study. Males outnumbered females by a ratio of 1.4:1. The vast majority of patients (70.6%) presented with large umbilical nodule > 2 cm in size. The stomach (41.1%) was the most common location of the primary tumor. Adenocarcinoma (88.2%) was the most frequent histopathological type. Most of the primary tumors (52.9%) were poorly differentiated. As the disease was advanced and metastatic in all patients, only palliative therapy was offered. Out of 34 patients, 11 patients died in the hospital giving a mortality rate of 32.4%. Patients were followed up for 24 months. At the end of the follow-up period, 14(60.9%) patients were lost to follow-up and the remaining 9 (39.1%) patients died. Patients survived for a median period of 28 weeks (range, 2 to 64 weeks). The nodule recurred in 6 (26.1%) patients after complete excision. Sister Mary Joseph's nodule of the umbilicus is not rare in our environment and often represents manifestation of a variety of advanced intra-abdominal malignancies. The majority of the patients present at a late stage and many with distant metastases. The patient's survival is very short leading to a poor outcome. Early detection of primary cancer at an early stage may improve the prognosis

Triplet schedule of weekly 5-Fluorouracil and alternating irinotecan or oxaliplatin in advanced colorectal cancer: A dose-finding and phase II study

A weekly administration of alternating irinotecan or oxaliplatin associated to 5-Fluorouracil in advanced colorectal cancer was planned in order to evaluate a new schedule maintaining dose intensities of each drug as in double combinations and tolerability of the triplet association. The following weekly schedule was administered: irinotecan, days 1 and 15; oxaliplatin, days 8 and 22; 5-fluorouracil (5-FU) over 12-h (from 10:00 p.m. to 10:00 a.m.) timed flat infusion, days 1-2, 8-9, 15-16 and 22-23, every 4 weeks. Dosefinding and phase II study were planned. Thirteen patients were enrolled in the dose-finding study and 23 in the phase II study. The recommended doses of our study are: irinotecan 160 mg/m2; oxaliplatin 80 mg/m2; 5-FU 900 mg/m2. The doselimiting toxicity was diarrhea (35% of patients) but no cases of febrile neutropenia were observed. In 30 patients assessable for response two complete (6.7%) and 18 partial (60%) responses were observed, for an overall response rate of 66.7% (α0.05, CI±7). The triplet association using this weekly alternating schedule is an active and well-tolerated outpatient regimen. Surgical removal of residual disease was considered in 5 patients and a radical resection was performed in 5 patients (14%)

Contribution of Common Genetic Variants to Familial Aggregation of Disease and Implications for Sequencing Studies

Despite genetics being accepted as the primary cause of familial aggregation for most diseases, it is still unclear whether afflicted families are likely to share a single highly penetrant rare variant, many minimally penetrant common variants, or a combination of the two types of variants. We therefore use recent estimates of SNP heritability and the liability threshold model to estimate the proportion of afflicted families likely to carry a rare, causal variant. We then show that Polygenic Risk Scores (PRS) may be useful for identifying families likely to carry such a rare variant and therefore for prioritizing families to include in sequencing studies with that aim. Specifically, we introduce a new statistic that estimates the proportion of individuals carrying causal rare variants based on the family structure, disease pattern, and PRS of genotyped individuals. Finally, we consider data from the MelaNostrum consortium and show that, despite an estimated PRS heritability of only 0.05 for melanoma, families carrying putative causal variants had a statistically significantly lower PRS, supporting the idea that PRS prioritization may be a useful future tool. However, it will be important to evaluate whether the presence of rare mendelian variants are generally associated with the proposed test statistic or lower PRS in future and larger studies

Contribution of Common Genetic Variants to Familial Aggregation of Disease and Implications for Sequencing Studies

Despite genetics being accepted as the primary cause of familial aggregation for most diseases, it is still unclear whether afflicted families are likely to share a single highly penetrant rare variant, many minimally penetrant common variants, or a combination of the two types of variants. We therefore use recent estimates of SNP heritability and the liability threshold model to estimate the proportion of afflicted families likely to carry a rare, causal variant. We then show that Polygenic Risk Scores (PRS) may be useful for identifying families likely to carry such a rare variant and therefore for prioritizing families to include in sequencing studies with that aim. Specifically, we introduce a new statistic that estimates the proportion of individuals carrying causal rare variants based on the family structure, disease pattern, and PRS of genotyped individuals. Finally, we consider data from the MelaNostrum consortium and show that, despite an estimated PRS heritability of only 0.05 for melanoma, families carrying putative causal variants had a statistically significantly lower PRS, supporting the idea that PRS prioritization may be a useful future tool. However, it will be important to evaluate whether the presence of rare mendelian variants are generally associated with the proposed test statistic or lower PRS in future and larger studies