Subsidiarity and Proportionality in the Single Market: An EU fit for inclusive growth

This report offers a fresh perspective on the principles of subsidiarity and proportionality in the European Union based on a thorough-going economic analysis. Specifically, the report uses the EU Single Market as a case to discuss shortcomings and potential improvements in five key policy areas. It reviews how the principles of subsid- iarity and proportionality can help boost growth in the EU at the aggregate country level – while at the same time allowing EU regions to benefit from growth. The report focuses on the regional level as economic growth has been uneven across the EU’s regions over the last decade and, consequently, growing disparities between re- gions have emerged. This alone merits a review on how we can reconcile the twin objectives in the future

Sociokulturelle aspekter i diagnose og behandling af rygpatienter i Danmark

Artiklen omhandler, hvorledes psykiske og sociokulturelle aspekter inddrages i den biomedicinske praksis, der udspiller sig på et rygambulatorium. På baggrund af feltarbejde i et rygambulatorium og blandt rygpatienter viser artiklen, at hvor ryglidelsen er tydelig diagnostiserbar med ’objektive fund’, kan den diagnostiske og behandlende praksis i rygambulatoriet rumme psykiske, sociale og kulturelle elementer i sin forståelse af et sygdomsforløb. Hvor en ryglidelse ikke kan diagnostiseres med ’objektive fund’, kan patientens psykiske, social og kulturelle forhold i behandlernes opfattelse af diagnose og behandling ikke indgå i en frugtbar dialog med patientens kropslige erfaringer. De psykiske, sociale og kulturelle forhold bliver i stedet tegn på noget andet, som regel psykisk konflikt, psykopatologi eller udtryk for patientens bevidste eller ubevidste interesser

Risk factors for nonunion following surgically managed, traumatic, diaphyseal fractures:a systematic review and meta-analysis

BACKGROUND: There are several studies on nonunion, but there are no systematic overviews of the current evidence of risk factors for nonunion. The aim of this study was to systematically review risk factors for nonunion following surgically managed, traumatic, diaphyseal fractures. METHODS: Medline, Embase, Scopus, and Cochrane were searched using a search string developed with aid from a scientific librarian. The studies were screened independently by two authors using Covidence. We solely included studies with at least ten nonunions. Eligible study data were extracted, and the studies were critically appraised. We performed random-effects meta-analyses for those risk factors included in five or more studies. PROSPERO registration number: CRD42021235213. RESULTS: Of 11,738 records screened, 30 were eligible, and these included 38,465 patients. Twenty-five studies were eligible for meta-analyses. Nonunion was associated with smoking (odds ratio (OR): 1.7, 95% CI: 1.2–2.4), open fractures (OR: 2.6, 95% CI: 1.8–3.9), diabetes (OR: 1.6, 95% CI: 1.3–2.0), infection (OR: 7.0, 95% CI: 3.2–15.0), obesity (OR: 1.5, 95% CI: 1.1–1.9), increasing Gustilo classification (OR: 2.2, 95% CI: 1.4–3.7), and AO classification (OR: 2.4, 95% CI: 1.5–3.7). The studies were generally assessed to be of poor quality, mainly because of the possible risk of bias due to confounding, unclear outcome measurements, and missing data. CONCLUSION: Establishing compelling evidence is challenging because the current studies are observational and at risk of bias. We conclude that several risk factors are associated with nonunion following surgically managed, traumatic, diaphyseal fractures and should be included as confounders in future studies

Surgical or non-surgical treatment of plantar fasciopathy (SOFT):study protocol for a randomized controlled trial

BACKGROUND: Plantar fasciopathy is the most common reason for complaints of plantar heel pain and one of the most prevalent musculoskeletal conditions with a reported lifetime incidence of 10%. The condition is normally considered self-limiting with persistent symptoms that often last for several months or years. Multiple treatments are available, but no single treatment appears superior to the others. Heavy-slow resistance training and radiofrequency microtenotomy for the treatment of plantar fasciopathy have shown potentially positive effects on short- and long-term outcomes (> 3 months). However, the effect of heavy-slow resistance training compared with a radiofrequency microtenotomy treatment is currently unknown. This trial compares the efficacy of heavy-slow resistance training and radiofrequency microtenotomy treatment with supplemental standardized patient education and heel inserts in improving the Foot Health Status Questionnaire pain score after 6 months in patients with plantar fasciopathy. METHODS: In this randomized superiority trial, we will recruit 70 patients with ultrasound-confirmed plantar fasciopathy and randomly allocate them to one of two groups: (1) heavy-slow resistance training, patient education and a heel insert (n = 35), and (2) radiofrequency microtenotomy treatment, patient education and a heel insert (n = 35). All participants will be followed for 1 year, with the 6-month follow-up considered the primary endpoint. The primary outcome is the Foot Health Status Questionnaire pain domain score. Secondary outcomes include the remaining three domains of the Foot Health Status Questionnaire, a Global Perceived Effect scale, the physical activity level, and Patient Acceptable Symptom State, which is the point at which participants feel no further need for treatment. DISCUSSION: By comparing the two treatment options, we should be able to answer if radiofrequency microtenotomy compared with heavy-slow resistance training is superior in patients with plantar fasciopathy. TRIAL REGISTRATION: ClinicalTrials.gov NCT03854682. Prospectively registered on February 26, 2019. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-022-06785-w

Bidirectional UML Visualisation of VDM Models

The VDM-PlantUML Plugin enables translations between the text based UML tool PlantUML and VDM++ and has been released as a part of the VDM VSCode extension. This enhances already extensive feature-set of VDM VSCode with support for UML. The link between VDM and UML is thoroughly described with a set of translation rules that serve as the base of the implementation of the translation plugin. This is however still an early rendition of the plugin with limited usability due to the loss of information between translations and a lack of workflow optimisations, which we plan to solve in the future