12,858 research outputs found

    Predicting Surgical Outcome in Patients with Recurrent Patellar Dislocation

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    Introduction Lateral dislocation of the patella is a common injury in active adolescents and young adults. Patients who are ultimately managed surgically have a significantly lower risk of recurrent dislocation. However, determining the optimal surgical treatment remains a challenge, with patients sometimes undergoing multiple surgeries prior to successful stabilization. The aim of this study is to computationally evaluate patients that have undergone multiple surgeries to correct for recurrent lateral patellar dislocation and predict their clinical outcome. Methods Our patient cohort consisted of 16 patients with patella dislocation. Patient-specific imaging were used to create three-dimensional (3D) finite element (FE) models of the knee joint and evaluate patellofemoral (PF) stability at multiple time points pre- and post-surgery for each patient. We applied these models to predict the clinical success or failure of each surgery. Specifically, the FE model simulated a knee extension activity while a tibia external torsion, a recognized cause of patellofemoral pain and instability, was applied to assess PF stability. A healthy control group of 12 participants was also included to assess the ability of the model to identify successful outcomes. In addition, five anatomic factors of risk were measured, and statistical analysis was performed to establish if significant differences exist among pre-surgery, post-surgery and healthy control groups. Lastly, a logistic regression model was implemented, trained with anatomic values, and used to classify subjects into likelihood of dislocation categories in order to differentiate between successful and unsuccessful surgical outcomes. Feature scaling and feature combination (namely, principal component analysis (PCA)) was applied to improve the predictive performance of the regression model. Results Of 12 control participants, 12 pre-surgery subjects (8 patients after an initial unsuccessful MRPLR and 4 without any), and 9 post-surgery subjects (5 after a successful trochleoplasty and 4 patients after MPFLR), the FE model correctly predicted 29 out of 33 surgery outcomes (87.9% accuracy). Post-surgery simulations predicted patellofemoral stability metrics similar to the healthy control group. Particularly, post-trochleoplasty subjects were associated with an increased ability to provide constraint force on the patella lateral facet, and a lower involvement of the medial patellofemoral ligament, particularly close to full extension. A one-way ANOVA showed that four out of five anatomic factors were significantly different between the pre-surgery and the control group, and three of them also between the pre- and post- surgery group, suggesting that the surgery was able to restore a physiological condition. Lastly, logistic regression classification performance demonstrated 72.2% and 78.9% accuracy before and after PCA, respectively. Conclusion The overall aim of this study is to provide surgeons with a useful and validated computational tool that can predict the likelihood of patellar dislocation and differentiate, prior to clinical intervention, between a successful versus unsuccessful surgery, to determine the optimal treatment pathways for individual patients. Preliminary results are promising, but an improvement of the model and a larger clinical dataset are necessary to improve accuracy and comprehensively validate model performance

    Nanowires of Molecule-Based Conductors

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    Folklorists in 1984: A Survey

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    This questionnaire project was originally conceived in the AFS Committee on the State of the Profession. A number of persons provided useful in-put into the project at various stages, including Alan Jabbour, Peter Bartis, Annellen Archbold, James Leary, Sylvia Grider, Lynwood Montell, Charles Camp, Rosan A. Jordan, Charles Perdue, Bruce Jackson, Katherine Paine, Marta Weigle, Rayna Green, and especially Susan Dwyer-Shick

    The Folklore Muse

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    Folklore—the inherently creative expression, transmission, and performance of cultural traditions—has always provided a deep well of material for writers, musicians, and artists of all sorts. Folklorists usually employ descriptive and analytical prose, but they, like scholars in other social sciences, have increasingly sought new, creative and reflexive modes of discourse. Many folklorists are also creative writers, some well known as such, and the folk traditions they research often provide shape and substance to their work. This collection of creative writing grounded in folklore and its study brings together some of the best examples of such writing. Contributors to this collection include Teresa Bergen, John Burrison, Norma E. Cantu, Frank de Caro, Holly Everett, Danusha Goska, Neil R. Grobman, Carrie Hertz, Edward Hirsch, Laurel Horton, Rosan Augusta Jordan, Paul Jordan-Smith, Elaine J. Lawless, Cynthia Levee, Jens Lund, Mary Magoulick, Bernard McCarthy, Joanne B. Mulcahy, Kirin Narayan, Ted Olson, Daniel Peretti, Leslie Prosterman, Jo Radner, Susan Stewart, Jeannie Banks Thomas, Jeff Todd Titon, Libby Tucker, Margaret Yocom, and Steve Zeitlin.https://digitalcommons.usu.edu/usupress_pubs/1063/thumbnail.jp

    How I [We All] Became Folkloric: A Theoretical Autobiography

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    Paper

    Niccolo' Isouard

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    L-awtur jagħti tagħrif bijografiku dwar il-mużiċist u l-kompożistur Nicolò Isouard.N/

    Analysis of the molecular machinery implicated in multicellularity in bacillus cereus

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    Introduction: Bacillus cereus is a Gram-positive bacterium usually implicated in food poisoning outbreaks and human infections that sometimes result fatal. These events are closely related to the assembly of a biofilm that serves as a reservoir of cells, a nest for sporulation and protection from environmental stresses, host defenses or chemotherapy. Objectives: To perform a comprehensive comparative study of biofilm and planktonic cells to: i) delineate the molecular machinery implicated in the different steps of the biofilm life cycle, and ii) define new genes dedicated to biofilm formation. Materials & methods: Bacteria were grown under biofilm inducing conditions. Biofilm cells were separated from planktonic cells at different times and their whole mRNA was isolated, sequenced and analyzed. Results: Our results reveal a high number of genes associated to biofilm, many of them with unknown function, but highly conserved in others bacterial species. Besides, we found global changes in cell wall synthesis, metabolism and interspecies interaction molecules. ​ Conclusions: The interaction of B. cereus with other bacteria is conditioned by secondary metabolites, which are apparently overexpressed in biofilm. On the other hand, toxins are mainly expressed in planktonic cells, which are more oriented to interact with its hosts. These results reveal the defense and attacking positions of B. cereus in biofilm vs planktonic states.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

    Abordaje de la necesidad espiritual en la relación de ayuda

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    Resumen En la formación de los estudiantes de salud es importante el desarrollo de habilidades para abordar aspectos espirituales del paciente en la relación terapéutica que se establece con ellos. Así la atención se prestará en forma más humana, y en términos de calidad, el paciente estará satisfecho por la atención recibida. La relación terapéutica concebida más allá del diagnóstico y del tratamiento implica reconocer la íntima interrelación que mantienen los síntomas con el estado psicológico y afectivo del paciente; por lo tanto, la función de reconocimiento y de liberación catártica que tiene el escucharlo, puede disminuir la carga emocional que da la enfermedad, la vivencia de la misma y la muerte. Incorporar la comunicación a la relación facilitará ocuparse de los miedos, temores y la soledad que padecen las personas enfermas. Palabras clave: Relación de ayuda, necesidad espiritual, sufrimiento espiritual, interacción, comunicación humana. Abstract In the formation of health students it is important the development of abilities to approach the spiritual aspect of the patients in the therapeutic relationship that is established with them. Thus, the care will be provided in a more humane way and in terms of quality, the patients will be satisfied by the attention provided to them. The therapeutic relationship conceived beyond the diagnosis and the treatment, implies to recognize the close interrelation that the symptoms have with the psychological and affective state of the patients. Therefore the function of cathartic recognition and liberation that is provided by listening to them can reduce the emotional load that is brought about by the illness, by experiencing it, and by death. By integrating communication into the relationship will enable to take care of the fears, frights and loneliness that ill people suffer. Key words: Help relationship, spiritual needs, spiritual needs, spiritual suffering, human interaction, human communication
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