Stratification of patellofemoral pain using clinical, biomechanical and imaging features

Patellofemoral pain (PFP) is a common musculoskeletal complaint and the efficacy of current therapies aimed at PFP is limited. The aetiology of PFP is widely considered to be multifactorial and as a result the clinical presentation is often heterogeneous. In an attempt to address this issue, an international PFP consensus statement, published in 2013, highlighted the need to sub-group patients with PFP to enable more stratified interventions. A multi-methodological approach was used in this thesis. A systematic review of the existing imaging literature in PFP demonstrated that PFP is associated with a number of imaging features in particular MRI bisect offset and CT congruence angle and that some of these features should be modifiable with conservative treatment. A retrospective analysis investigating the overall 3D shape and 3D equivalents of commonly used PFJ imaging features demonstrated no differences between a group with and without PFP, challenging the current perceptions on the structural associations to PFP. A cross-sectional cluster analysis using modifiable clinical, biomechanical and imaging features identified four subgroups that are present in PFP cohort with a Weak group showing the worst prognosis at 12 months. Lastly, a pragmatic randomised controlled feasibility study comparing matched treatment to usual care management showed that matching treatment to a specific subgroup is feasible in terms of adherence, retention and conversion to consent. In summary, the findings of this thesis improves our understanding of the structural associations to PFP; the subgroups that exist within the PFP population; the natural prognosis of these PFP subgroups; and the feasibility of targeting treatment at PFP subgroups within a clinical trial

Parameter space metric for 3.5 post-Newtonian gravitational-waves from compact binary inspirals

We derive the metric on the parameter space of 3.5 post-Newtonian (3.5PN) stationary phase compact binary inspiral waveforms for a single detector, neglecting spin, eccentricity, and finite-body effects. We demonstrate that this leads to better template placement than the current practice of using the 2PN metric to place 3.5PN templates: The recovered event rate is improved by about 10% at a cost of nearly doubling the number of templates. The cross-correlations between mass parameters are also more accurate, which will result in better coincidence tests.Comment: 10 pages, 7 figure

Self-reported Mental Disorders Negatively Influence Surgical Outcomes After Arthroscopic Treatment of Femoroacetabular Impingement.

Background:Femoroacetabular impingement (FAI) is responsible for hip pain and dysfunction, and surgical outcomes depend on multiple factors. The presence of mental disorders negatively influences outcomes of multiple orthopaedic conditions, although the impact on FAI surgery is unclear. Hypothesis:The authors hypothesized that a preoperative self-reported history of mental disorders would negatively influence patient-reported outcome measures after FAI surgery. Study Design:Cohort study; Level of evidence, 3. Methods:A matched-cohort study was performed by reviewing a prospectively collected database of cases of arthroscopic management of FAI with a single surgeon over a 2-year period. Demographics and radiographic parameters were recorded for all patients. Patients completed the Hip Outcome Score-Activity of Daily Living Subscale (HOS-ADL), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), and modified Harris Hip Score (mHHS) prior to surgery and 2 years after surgery. Unpaired and paired t tests were used to compare results between and within cohorts at baseline and follow-up. Statistical significance was defined as P < .05. Results:The cohort included 301 patients, with 75 and 226 patients reporting and not reporting a history of mental disorders, respectively. Before treatment, all patient-reported outcome measures were significantly lower among patients reporting a history of mental disorders (P < .01 for HOS-ADL, HOS-SSS, and mHHS). Patients in both groups demonstrated significant improvements (P < .0001) in HOS-ADL, HOS-SSS, and mHHS when preoperative outcome measures were compared with follow-up. Patients with reported mental disorders had significantly lower scores after surgery as compared with patients without mental disorders (P < .0001 for HOS-ADL, HOS-SSS, and mHHS). Conclusion:The presence of a reported mental disorder is associated with lower patient-reported outcomes before and after surgical management of FAI. Statistically significant and clinically relevant improvements were observed for patients who reported mental disorders. The magnitude of these improvements was not as large as that for an age- and sex-matched control group without a self-reported mental disorder

Racing Academy: A preliminary evaluation of an online racing car simulation game for supporting students learning of engineering

This paper reports a study which evaluates an online racing car simulation game designed to support undergraduate students learning. A game based learning community was created to support undergraduate students learning of engineering at the University of Bath. One hundred and sixty one students (146 males and 15 females), aged between 18 and 22, average age 18, participated in the study. The results indicated that there was a significant increase in the students’ knowledge of engineering. They also felt that Racing Academy was motivating. They found it enjoyable, they felt competent playing the game and they put effort into the game. The analysis of the qualitative data is ongoing and will be focussed on investigating whether the students felt that Racing Academy helped their learning. Preliminary analysis suggests that the students did feel that Racing Academy supported their learning, but that further work is needed to fully embed Racing Academy into the course

High temporal resolution measurements of movement reveal novel early-life physiological decline in C. elegans

Age-related physiological changes are most notable and best-studied late in life, while the nature of aging in early- or middle-aged individuals has not been explored as thoroughly. In C. elegans, many studies of movement vs. age generally focus on three distinct phases: sustained, youthful movement; onset of rapidly progressing impairment; and gross immobility. We investigated whether this first period of early-life adult movement is a sustained healthy level of high function followed by a discrete movement catastrophe -or whether there are early-life changes in movement that precede future physiological declines. To determine how movement varies during early adult life, we followed isolated individuals throughout life with a previously unachieved combination of duration and temporal resolution. By tracking individuals across the first six days of adulthood, we observed declines in movement starting as early as the first two days of adult life, as well as high interindividual variability in total daily movement. These findings suggest that movement is a highly dynamic behavior early in life, and that factors driving movement decline may begin acting as early as the first day of adulthood. Using simulation studies based on acquired data, we suggest that too-infrequent sampling in common movement assays limits observation of early-adult changes in motility, and we propose feasible strategies and a framework for designing assays with increased sensitivity for early movement declines

The impact of client information technology capability on audit pricing

This paper explores the question: “How does a client\u27s information technology (IT) capability influence audit pricing?” Company data for the years 2004 through 2012 are employed. Firms appearing on the InformationWeek 500 (IW500) annual list of U.S. organizations with superior IT functions serve as a proxy for companies with superior IT capability. Our findings suggest that companies with superior IT capabilities incur higher levels of audit fees. In addition, as client size increases, the audit fees of firms with advanced IT capabilities increase at a greater rate than firms without such capabilities. These findings contrast with prior research by Chen et al. (2014) that found in the immediate post-Sarbanes-Oxley Act (SOX) period for the years 2004 through 2007, client IT capability reduced audit fee increases. In addition, we replicate the Chen et al. (2014) results and find that IT capability did not influence audit fee increases during the subsequent recession and recovery periods. Further, superior capability clients see smaller audit fee increases when exogenous shocks such as SOX regulations occur. These results suggest a revised interpretation of Chen et al. (2014) may be warranted. This study contributes to the literature by providing a more complete picture of how a client\u27s IT capability affects audit fees

Reviews

J.R.R. Tolkien - Myth, Morality and Religion. Richard L. Purtill. Reviewed by Nancy-Lou Patterson. Love All / Busman\u27s Honeymoon. Dorothy L. Sayers and Muriel St. Clare Byrne. Reviewed by Nancy-Lou Patterson. The Terminator. Direc. by James Cameron. Reviewed by Benjamin Urrutia. Fantasists on Fantasy. Robert H. Boyer and Kenneth J. Zahorski. Reviewed by Mabel Drew

Factors Influencing Team Performance:What Can Support Teams in High-Performance Sport Learn from Other Industries? A Systematic Scoping Review

BACKGROUND: The primary aim of our systematic scoping review was to explore the factors influencing team function and performance across various industries and discuss findings in the context of the high-performance sport support team setting. These outcomes may also be used to inform future research into high-performance teamwork in sport. METHODS: A systematic scoping review of literature published in English since 2000 reporting team-based performance outcomes and included a performance metric that was ‘team outcome based’ was conducted using search of the Academic Search Ultimate, Medline, Business Source Ultimate, APA PsycInfo, CINAHL, SPORTDiscus, and Military database (ProQuest) using the terms: ‘team’, ‘function’ OR ‘dysfunction’, ‘Perform*’ OR ‘outcome’. RESULTS: Application of the search strategy identified a total of 11,735 articles for title and abstract review. Seventy-three articles were selected for full-text assessment with the aim to extract data for either quantitative or qualitative analysis. Forty-six of the 73 articles met our inclusion criteria; 27 articles were excluded as they did not report a performance metric. Eleven studies explored leadership roles and styles on team performance, three studies associated performance feedback to team performance, and 12 studies explored the relationship between supportive behaviour and performance. Team orientation and adaptability as key figures of team performance outcomes were explored in 20 studies. CONCLUSIONS: Our findings identified 4 key variables that were associated with team function and performance across a variety of industries; (i) leadership styles, (ii) supportive team behaviour, (iii) communication, and (iv) performance feedback. High-performance teams wishing to improve performance should examine these factors within their team and its environment. It is widely acknowledged that the dynamics of team function is important for outcomes in high-performance sport, yet there is little evidence to provide guidance. This inequality between real-world need and the available evidence should be addressed in future research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40798-021-00406-7

Anterior knee pain subgroups: the first step towards a personalized treatment

Identification of subgroups within the patellofemoral pain (PFP) population has gained a lot of interest and attention from the research community in recent years due to the recognition of the relatively poor patient outcomes associated with the multimodal approach and following the success of subgrouping approaches used in the management of low back pain. This paper reviews early attempts at PFP subgrouping and introduces readers to some of the modern methodological approaches employed to derive subgroups. Summaries of the results of two research projects illustrating the use of these more robust methods to derive subgroups in the PFP population are provided. In conclusion, it appears there are probably 3 or 4 discrete subgroups within the PFP population that may require a more personalised approach to treatment. However, to date no definitive randomized controlled trials (RCTs) have been conducted to evaluate the potential benefits of targeted interventions for PFP subgroups in terms of improved patient outcomes so this warrants further research