Global trends of hand and wrist trauma: A systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study

Background: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations. Results: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%. Conclusions: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions. keywords: burden of disease, descriptive epidemiology, hand injur

Mentalizing in an economic games context is associated with enhanced activation and connectivity in the left temporoparietal junction.

Prior studies in Social Neuroeconomics have consistently reported activation in social cognition regions during interactive economic games, suggesting mentalizing during economic choice. Such mentalizing occurs during active participation in the game, as well as during passive observation of others' interactions. We designed a novel version of the classic false-belief task (FBT) in which participants read vignettes about interactions between agents in the ultimatum and trust games and were subsequently asked to infer the agents' beliefs. We compared activation patterns during the economic games FBT to those during the classic FBT using conjunction analyses. We find significant overlap in the left temporoparietal junction (TPJ) and dorsal medial prefrontal cortex, as well as the temporal pole (TP) during two task phases: belief formation and belief inference. Moreover, generalized Psychophysiological Interaction (gPPI) analyses show that during belief formation, the right TPJ is a target of both the left TPJ and the right TP seed regions, whereas during belief inferences all seed regions show interconnectivity with each other. These results indicate that across different task types and phases, mentalizing is associated with activation and connectivity across central nodes of the social cognition network. Importantly, this is the case for both the novel economic games and the classic FBTs

Experimental and numerical investigation of an air-to-water heat pipe-based heat exchanger

An experimental and analytical investigation was conducted on an air-to-water heat exchanger equipped with six wickless heat pipes (thermosyphons) charged with water as the working fluid. The flow pattern consisted of a double pass on the evaporator and condenser sections. The six thermosyphons were all made from carbon steel, measured 2m in length and were installed in a staggered arrangement. The objectives of the reported experimental investigation were to analyse the effect of multiple air passes at different air inlet temperatures (100 to 250°C) and air mass flow rates (0.05 to 0.14kg/s) on the thermal performance of the heat exchanger unit including the heat pipes. The results were compared with a CFD model that assumed the heat pipes were solid rods with a constant conductivity. The conductivity of the pipes was extracted from modifications of correlations available in the literature based around the theory of Thermal Resistance. The results proved to be very accurate within 10% of the experimental values

Leveraging real-world data to assess treatment sequences in health economic evaluations: a study protocol for emulating target trials using the English Cancer Registry and US Electronic Health Records-Derived Database

Background Considering the sequence of treatments is vital for optimising healthcare resource allocation, especially in cancer care, where sequence changes can affect patients’ overall survival and associated costs. A key challenge in evaluating treatment sequences in health technology assessments (HTA) is the scarce evidence on effectiveness, leading to uncertainties in decision making. While randomised controlled trials (RCTs) and meta-analyses are viewed as the gold standards for evidence, applying them to determine the effectiveness of treatment sequences in economic models often necessitates making arbitrary assumptions due to insufficient information on patients' treatment histories and subsequent therapies. In contrast, real-world data (RWD) presents a promising alternative source of evidence, often encompassing details across treatment lines. However, due to its non-randomised nature, estimates of the treatment effectiveness based on RWD analyses can be susceptible to biases if not properly adjusted for confounding factors. To date, several international initiatives have been investigating methods to derive reliable treatment effects from RWD — by emulating Target Trials that replicate existing RCTs (i.e. benchmarks) and comparing the emulated results against the benchmarks. These studies primarily seek to determine the viability of obtaining trial-equivalent results through deploying specific analytical methodologies and study designs within the Target Trial emulation framework, using a given database. Adopting the Target Trial emulation framework facilitates the analyses to be operated under causal inference principles. Upon validation in a particular database, these techniques can be applied to address similar questions (e.g., same disease area, same outcome type), but in populations lacking clinical trial evidence, leveraging the same RWD source. Studies to date, however, have predominantly focused on the comparison of individual treatments rather than treatment sequences. Moreover, the majority of these investigations have been undertaken in non-English contexts. Consequently, the use of RWD in evaluating treatment sequences for HTA, especially in an English setting, remains largely unexplored. Objectives The goal of this project is to investigate the feasibility of leveraging RWD to produce reliable, trial-like effectiveness estimates for treatment sequences. We aim to assess the capability of two oncology databases: the US-based Flatiron electronic health record and the National Cancer Registration and Analysis Service (NCRAS) database of England. To achieve this, we plan to harness the Target Trial Emulation (TTE) framework for replicating two existing oncology RCTs that compared treatment sequences, with the intent of benchmarking our results against the original studies. Further, we aim to detail the practicalities involved with implementing TTE in diverse databases and outline the challenges encountered. Methods 1. We aim to emulate existing RCTs that compare the effect of different treatment sequences by constructing the study design and analysis plan following the TTE framework. Specifically, the following case studies are planned: (1) Prostate cancer case study 1 (PC1) - US direct proof-of-concept study (method direct validation): replicating the GUTG-001 trial using Flatiron data (2) Prostate cancer case study 2 (PC2) - US-England bridging study (method extension): emulating Target Trials that compare treatment sequences that have been common in England using Flatiron data (3) Prostate cancer case study 3 (PC3) - English indirect proof-of-concept study (method indirect validation): emulating the same Target Trial in PC2 using English NCRAS data (4) Renal cell carcinoma case study (RCC) - method direct validation in a single-arm setting: emulating the sunitinib followed by everolimus arm in the RECORD-3 trial using English NCRAS data 2. We will compare results of the emulated Target Trials with those from the benchmark trials. 3. We plan to compare different advanced causal inference methods (e.g. marginal structural models using IPW and other g-methods) in estimating the effect of treatment sequences in RWD. Expected results This study will provide evidence on whether it is feasible to obtain reliable estimates of the (comparative) effectiveness of treatment sequences using Flatiron data and English NCRAS data. If applicable, we intend to develop a framework that provides a systematic way of obtaining the (comparative) effectiveness of treatment sequences using RWD. It is possible that the data quality is insufficient to emulate the planned Target Trials. In this case, we will report reasons for the implausibility of data analysis. If applicable, we will make suggestions to whether the national health data collection may be enhanced to make the analyses possible. The results of this study will be submitted to peer-reviewed journals and international conferences

Heat Kernel Coefficients for Laplace Operators on the Spherical Suspension

In this paper we compute the coefficients of the heat kernel asymptotic expansion for Laplace operators acting on scalar functions defined on the so called spherical suspension (or Riemann cap) subjected to Dirichlet boundary conditions. By utilizing a contour integral representation of the spectral zeta function for the Laplacian on the spherical suspension we find its analytic continuation in the complex plane and its associated meromorphic structure. Thanks to the well known relation between the zeta function and the heat kernel obtainable via Mellin transform we compute the coefficients of the asymptotic expansion in arbitrary dimensions. The particular case of a $d$-dimensional sphere as the base manifold is studied as well and the first few heat kernel coefficients are given explicitly.Comment: 26 Pages, 1 Figur

Thermal Field Theory and Generalized Light Front Coordinates

The dependence of thermal field theory on the surface of quantization and on the velocity of the heat bath is investigated by working in general coordinates that are arbitrary linear combinations of the Minkowski coordinates. In the general coordinates the metric tensor $g_{\bar{\mu\nu}}$ is non-diagonal. The Kubo, Martin, Schwinger condition requires periodicity in thermal correlation functions when the temporal variable changes by an amount $-i\big/(T\sqrt{g_{\bar{00}}})$. Light front quantization fails since $g_{\bar{00}}=0$, however various related quantizations are possible.Comment: 10 page

Resonant forcing of select degrees of freedom of multidimensional chaotic map dynamics

We study resonances of multidimensional chaotic map dynamics. We use the calculus of variations to determine the additive forcing function that induces the largest response, that is, the greatest deviation from the unperturbed dynamics. We include the additional constraint that only select degrees of freedom be forced, corresponding to a very general class of problems in which not all of the degrees of freedom in an experimental system are accessible to forcing. We find that certain Lagrange multipliers take on a fundamental physical role as the efficiency of the forcing function and the effective forcing experienced by the degrees of freedom which are not forced directly. Furthermore, we find that the product of the displacement of nearby trajectories and the effective total forcing function is a conserved quantity. We demonstrate the efficacy of this methodology with several examples.Comment: 11 pages, 3 figure

Typographic design of outdoor signage, restaurant authenticity, and consumers’ willingness to dine: extending semiotic theory

YesPurpose: Restaurants’ outdoor signage plays an irreplaceable role in attracting potential diners, as it conveys important functional and symbolic meanings of the businesses. The purpose of this study is to investigate the effect of typographic design elements of outdoor signage on consumers’ perceptions of authenticity. This study also tests the linkage between authenticity and willingness to dine, as well as the moderating effect of frequency of dining in ethnic restaurants on the relationship. Design/methodology/approach: Using a 2 (simplified vs traditional Chinese characters) × 2 (calligraphy vs computer font) × 2 (vertical vs horizontal text flow) between-subject design, the authors did two experiments with 786 Chinese diners. Restaurant authenticity and willingness to dine are dependent variables, and openness to ethnic cuisine is the control variable. Findings: Display characters and text flow significantly affect restaurant authenticity. Furthermore, the results of this study demonstrate that display characters interact with typeface to influence restaurant authenticity. Consumers’ perceived authenticity significantly increases their willingness to dine. The frequency of dining in ethnic restaurants moderates the relationship between restaurant authenticity and willingness to dine. Practical implications: Ethnic restaurateurs should pay attention to the outdoor signage design, as it affects potential consumers’ authenticity perceptions. Specifically, in Mainland China, traditional Chinese characters and vertical text direction increase potential consumers’ authenticity perceptions. Originality/value: This study extends the semiotic theory and applies the cue–judgment–behavior model in the hospitality literature. This study also provides new understanding of authenticity by identifying the influence of typographic design on authenticity, which confirms the semiotic theory that certain semiotic cues affect consumers’ judgments

Effects of the field modulation on the Hofstadter's spectrum

We study the effect of spatially modulated magnetic fields on the energy spectrum of a two-dimensional (2D) Bloch electron. Taking into account four kinds of modulated fields and using the method of direct diagonalization of the Hamiltonian matrix, we calculate energy spectra with varying system parameters (i.e., the kind of the modulation, the relative strength of the modulated field to the uniform background field, and the period of the modulation) to elucidate that the energy band structure sensitively depends on such parameters: Inclusion of spatially modulated fields into a uniform field leads occurrence of gap opening, gap closing, band crossing, and band broadening, resulting distinctive energy band structure from the Hofstadter's spectrum. We also discuss the effect of the field modulation on the symmetries appeared in the Hofstadter's spectrum in detail.Comment: 7 pages (in two-column), 10 figures (including 2 tables

Structure of wavefunctions in (1+2)-body random matrix ensembles

Abstrtact: Random matrix ensembles defined by a mean-field one-body plus a chaos generating random two-body interaction (called embedded ensembles of (1+2)-body interactions) predict for wavefunctions, in the chaotic domain, an essentially one parameter Gaussian forms for the energy dependence of the number of principal components NPC and the localization length {\boldmath l}_H (defined by information entropy), which are two important measures of chaos in finite interacting many particle systems. Numerical embedded ensemble calculations and nuclear shell model results, for NPC and {\boldmath l}_H, are compared with the theory. These analysis clearly point out that for realistic finite interacting many particle systems, in the chaotic domain, wavefunction structure is given by (1+2)-body embedded random matrix ensembles.Comment: 20 pages, 3 figures (1a-c, 2a-b, 3a-c), prepared for the invited talk given in the international conference on `Perspectives in Theoretical Physics', held at Physical Research Laboratory, Ahmedabad during January 8-12, 200