Dynamic contact area ratio in shoulder instability: an innovative diagnostic technique measuring interplay of bony lesions

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Study protocol subacromial impingement syndrome: the identification of pathophysiologic mechanisms (SISTIM)

<p>Abstract</p> <p>Background</p> <p>The Subacromial Impingement Syndrome (SIS) is the most common diagnosed disorder of the shoulder in primary health care, but its aetiology is unclear. Conservative treatment regimes focus at reduction of subacromial inflammatory reactions or pathologic scapulohumeral motion patterns (<it>intrinsic </it>aetiology). Long-lasting symptoms are often treated with surgery, which is focused at enlarging the subacromial space by resection of the anterior part of the acromion (based on <it>extrinsic </it>aetiology). Despite that acromionplasty is in the top-10 of orthopaedic surgical procedures, there is no consensus on its indications and reported results are variable (successful in 48-90%). We hypothesize that the aetiology of SIS, i.e. an increase in subacromial pressure or decrease of subacromial space, is multi-factorial. SIS can be the consequence of pathologic scapulohumeral motion patterns leading to humerus cranialisation, anatomical variations of the scapula and the humerus (e.g. hooked acromion), a subacromial inflammatory reaction (e.g. due to overuse or micro-trauma), or adjoining pathology (e.g. osteoarthritis in the acromion-clavicular-joint with subacromial osteophytes).</p> <p>We believe patients should be treated according to their predominant etiological mechanism(s). Therefore, the objective of our study is to identify and discriminate etiological mechanisms occurring in SIS patients, in order to develop tailored diagnostic and therapeutic strategies.</p> <p>Methods</p> <p>In this cross-sectional descriptive study, applied clinical and experimental methods to identify intrinsic and extrinsic etiologic mechanisms comprise: MRI-arthrography (eligibility criteria, cuff status, 3D-segmented bony contours); 3D-motion tracking (scapulohumeral rhythm, arm range of motion, dynamic subacromial volume assessment by combining the 3D bony contours and 3D-kinematics); EMG (adductor co-activation) and dynamometry instrumented shoulder radiographs during arm tasks (force and muscle activation controlled acromiohumeral translation assessments); Clinical phenotyping (Constant Score, DASH, WORC, and SF-36 scores).</p> <p>Discussion</p> <p>By relating anatomic properties, kinematics and muscle dynamics to subacromial volume, we expect to identify one or more predominant pathophysiological mechanisms in every SIS patient. These differences in underlying mechanisms are a reflection of the variations in symptoms, clinical scores and outcomes reported in literature. More insight in these mechanisms is necessary in order to optimize future diagnostic and treatment strategies for patients with SIS symptoms.</p> <p>Trial registration</p> <p>Dutch Trial Registry (Nederlands Trial Register) <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2283">NTR2283</a>.</p

Does the Burglar Also Disturb the Neighbor? Crime Spillovers on Individual Well-Being

Indirect psychological effects induced by crime are likely to contribute significantly to the total costs of crime beyond the financial costs of direct victimization. Using detailed crime statistics for the whole of Germany and linking them to individual-level mental health information from the German Socio-Economic Panel, we analyze whether local crime rates affect the mental health of residents. We estimate that a one standard deviation increase in local violent crime rates significantly decreases individual mental well-being among residents by, on average, one percent. Smaller effects are found for property and total crime rates. Results are insensitive to migration and not isolated to urban areas, but are rather driven by less densely populated regions. In contrast to previous literature on vulnerability to crime, we find that men, more educated and singles react more to variation in violent crime rates in their neighborhoods. One potential explanation could be that those who are more fearful of crime have developed better coping strategies and, hence, react less to changes in crime.Indirekte psychologische Effekte stellen möglicherweise einen erheblichen Teil der durch Kriminalität verursachten Gesamtkosten dar. Um zu analysieren, ob regionale Kriminalitätsraten die mentale Gesundheit beeinflussen, nutzen wir detaillierte Kriminalitätsinformationen für Deutschland und verknüpfen diese mit Informationen zu individueller mentaler Gesundheit aus dem Sozio-ökonomischen Panel. Unsere Schätzergebnisse implizieren, dass der Anstieg um eine Standardabweichung in der Gewaltverbrechensrate das mentale Wohlbefinden der lokalen Bevölkerung signifikant um durchschnittlich ein Prozent reduziert. Für Eigentumsdelikte und die Gesamtkriminalitätsrate beobachten wir geringere Effekte. Die Ergebnisse werden weder durch Wohnortwechsler beeinflusst noch sind sie auf urbane Regionen begrenzt, sondern sind vielmehr durch weniger dicht besiedelte Regionen getrieben. Im Gegensatz zur Literatur zur Angst vor Kriminalität beobachten wir, dass Männer, höher Gebildete und Alleinstehende sensibler auf Veränderungen in der regionalen Gewaltverbrechensrate reagieren. Eine Erklärung hierfür könnte sein, dass diejenigen, die mehr Angst vor Kriminalität haben, entsprechende Coping-Strategien entwickelt haben und daher auch weniger auf Veränderungen in der Kriminalitätsrate reagieren

Sowing the Wind and Reaping the Whirlwind? The Effect of Wind Turbines on Residential Well-Being

This paper investigates the effect of wind turbines on residential well-being in Germany, using panel data from the German Socio-Economic Panel (SOEP) and a unique, novel data set on wind turbines for the time period between 2000 and 2012. Using a Geographical Information System (GIS), it calculates the distance from households to the nearest wind turbines to determine whether an individual is affected by disamenities, e.g. through visual pollution. The depth of our unique, novel data set on wind turbines, which has been collected at the regional level and which includes, besides their exact geographical coordinates, their construction dates, allows estimating the causal effect of wind turbines on residential well-being, using difference-in-difference propensity-score and spatial matching techniques. We demonstrate that the construction of a new wind turbine in a treatment area of 4000 metres around households has a significantly negative impact on life satisfaction. Moreover, this effect is found to be of transitory nature. Contrasting the implicit monetary valuation with the damage through CO2 emissions avoided by wind turbines, wind power turns out to be a favorable technology despite robust evidence for negative externalities

Méthodes algébriques pour les langages formels (applications à la logique et à la dynamique symbolique)

PARIS7-Bibliothèque centrale (751132105) / SudocSudocFranceF