Leg Injury - World Champion Super-Heavyweight Weightlifter

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Structural Rounding: Approximation Algorithms for Graphs Near an Algorithmically Tractable Class

We develop a framework for generalizing approximation algorithms from the structural graph algorithm literature so that they apply to graphs somewhat close to that class (a scenario we expect is common when working with real-world networks) while still guaranteeing approximation ratios. The idea is to edit a given graph via vertex- or edge-deletions to put the graph into an algorithmically tractable class, apply known approximation algorithms for that class, and then lift the solution to apply to the original graph. We give a general characterization of when an optimization problem is amenable to this approach, and show that it includes many well-studied graph problems, such as Independent Set, Vertex Cover, Feedback Vertex Set, Minimum Maximal Matching, Chromatic Number, (l-)Dominating Set, Edge (l-)Dominating Set, and Connected Dominating Set. To enable this framework, we develop new editing algorithms that find the approximately-fewest edits required to bring a given graph into one of a few important graph classes (in some cases these are bicriteria algorithms which simultaneously approximate both the number of editing operations and the target parameter of the family). For bounded degeneracy, we obtain an O(r log{n})-approximation and a bicriteria (4,4)-approximation which also extends to a smoother bicriteria trade-off. For bounded treewidth, we obtain a bicriteria (O(log^{1.5} n), O(sqrt{log w}))-approximation, and for bounded pathwidth, we obtain a bicriteria (O(log^{1.5} n), O(sqrt{log w} * log n))-approximation. For treedepth 2 (related to bounded expansion), we obtain a 4-approximation. We also prove complementary hardness-of-approximation results assuming P != NP: in particular, these problems are all log-factor inapproximable, except the last which is not approximable below some constant factor 2 (assuming UGC)

A psycho-educational curriculum for sport career transition practitioners: Development and evaluation

Research question: This paper is an integration of three studies. Study 1 investigates sport career transition organisational intervention programmes for high performance athletes and training and development programmes for sport career transition practitioners in order to find a research gap with regard to sport career transition supporting services. A psycho-educational curriculum was developed for sport career transition practitioner in Study 2 to fill the research gap. In Study 3, the curriculum was examined to see if the curriculum contributed to enhancing practitioners’ confidence in key competences.  Research methods: A range of methods were applied to the studies including One Group Pre- and Post-test design, Case Study, Focus Group, Semi-Structured Interview, two-round Delphi-Method and Questionnaires. The data for Study 1 collected from 19 countries worldwide and total 16 participants based in seven different countries were invited to development and evaluation of the curriculum.  Results and Findings: A novel psycho-educational curriculum for sport career transition practitioner was developed and evaluated concerning four competences as a form of curriculum package. The findings revealed that the curriculum package increased the participants’ confidence in key competences concerning sport career transition.  Implications: The findings deepen the knowledge of sport career transition in the areas of organisational intervention programmes focusing on high performance athletes and sport career transition practitioners. These findings contribute to modifying the Conceptual Model of Adaptation to Career Transition (Lavallee, Park, & Taylor, 2014) by strengthening the organisational intervention perspective and applied work in respect of sporting organisation management strategie

Overlapping and Robust Edge-Colored Clustering in Hypergraphs

A recent trend in data mining has explored (hyper)graph clustering algorithms for data with categorical relationship types. Such algorithms have applications in the analysis of social, co-authorship, and protein interaction networks, to name a few. Many such applications naturally have some overlap between clusters, a nuance which is missing from current combinatorial models. Additionally, existing models lack a mechanism for handling noise in datasets. We address these concerns by generalizing Edge-Colored Clustering, a recent framework for categorical clustering of hypergraphs. Our generalizations allow for a budgeted number of either (a) overlapping cluster assignments or (b) node deletions. For each new model we present a greedy algorithm which approximately minimizes an edge mistake objective, as well as bicriteria approximations where the second approximation factor is on the budget. Additionally, we address the parameterized complexity of each problem, providing FPT algorithms and hardness results

Translating clinical and patient-reported data to tailored shared decision reports with predictive analytics for knee and hip arthritis

INTRODUCTION: New informatics tools can transform evidence-based information to individualized predictive reports to serve shared decisions in clinic. We developed a web-based system to collect patient-reported outcomes (PROs) and medical risk factors and to compare responses to national registry data. The system generates predicted outcomes for individual patients and a report for use in clinic to support decisions. We present the report development, presentation, and early experience implementing this PRO-based, shared decision report for knee and hip arthritis patients seeking orthopedic evaluation. METHODS: Iterative patient and clinician interviews defined report content and visual display. The web-system supports: (a) collection of PROs and risk data at home or in office, (b) automated statistical processing of responses compared to national data, (c) individualized estimates of likely pain relief and functional gain if surgery is elected, and (d) graphical reports to support shared decisions. The system was implemented at 12 sites with 26 surgeons in an ongoing cluster randomized trial. RESULTS: Clinicians and patients recommended that pain and function as well as clinical risk factors (e.g., BMI, smoking) be presented to frame the discussion. Color and graphics support patient understanding. To date, 7891 patients completed the assessment before the visit and 56% consented to study participation. Reports were generated for 98% of patients and 68% of patients recalled reviewing the report with their surgeon. CONCLUSIONS: Informatics solutions can generate timely, tailored office reports including PROs and predictive analytics. Patients successfully complete the pre-visit PRO assessments and clinicians and patients value the report to support shared surgical decisions

Perioperative venous thromboembolism prophylaxis in prostate cancer surgery

Purpose To describe a patient and procedure specific approach to selecting Venous thromboembolism (VTE) prophylaxis for men who undergo radical prostatectomy. Methods We performed a literature search and narrative review of VTE after radical prostatectomy. We describe the current paradigm of perioperative thromboprophylaxis and underlying rationale. Relevant findings from the European Association of Urology thromboprophylaxis guidelines are interpreted and summarized. Results The use of extended post-operative thromboprophylaxis for patients who undergo radical prostatectomy is appropriate when the risk of symptomatic VTE outweighs the risk of major bleeding. Patient and procedure factors impact VTE risk. Patient risk can be stratified as low, moderate or high based on 4 factors; age \u3e 75, BMI \u3e 35, VTE in a first degree relative, and personal history of VTE. Procedure risk of VTE and bleeding can be stratified by modality of surgery (open, laparoscopic, robotic) and extent of pelvic lymphadenectomy. Using these factors, patients at the lowest risk for VTE will have an expected incidence of VTE of 0.4–0.8% and those at highest risk from 1.5 to 15.7%. Incidence of major bleeding ranges from 0.4 to 1.4%. These ranges emphasize the need to consider the net benefit for each specific patient. Use of mechanical prophylaxis is supported by weaker evidence but has fewer harms and is likely reasonable for most patients. Conclusion Many patients who undergo radical prostatectomy will benefit from extended post-operative thromboprophylaxis. Risk of thrombosis is likely higher with open approach and extended lymph node dissection. The net benefit of treatment should be considered using patient- and procedure-specific criteria. When the net benefit is negligible or possibly harmful no pharmacological thromboprophylaxis should be used

Traumatic pericardial rupture with skeletonized phrenic nerve

<p>Abstract</p> <p>Background</p> <p>Traumatic pericardial rupture is a rare presentation. Pericardial rupture itself is asymptomatic unless complicated by either hemorrhage or herniation of the heart through the defect. Following diagnosis surgical repair of the pericardium is indicated because cardiac herniation may result in vascular collapse and sudden death.</p> <p>Objectives</p> <p>Here we present a case of traumatic, non-herniated pericardial rupture with complete skeletonization of the phrenic nerve.</p> <p>Case report</p> <p>An 18-year-old healthy male suffered multi-trauma after falling 50 feet onto concrete. The patient could not be stabilized despite exploratory laparotomy with splenectomy, IR embolization and packing for a liver laceration. Right posterolateral thoracotomy revealed a ruptured pericardium with a completely skeletonized phrenic nerve. The pericardium was repaired with a Goretex(R) patch.</p> <p>Conclusion</p> <p>A high level of suspicion for pericardial rupture is necessary in all patients with high-velocity thoracic injuries.</p

Efficacy of Disease-Modifying Therapies in Relapsing Remitting Multiple Sclerosis: A Systematic Comparison

The treatment of relapsing-remitting multiple sclerosis (RRMS) has become more effective over the last decade with the advent of the currently available disease-modifying therapies (DMTs). Pivotal clinical studies differ in many characteristics, such that cross-comparisons of relative risk reductions are of limited value and can be misleading. Our objective was to compare the clinical efficacy of currently approved first-line DMTs in patients with RRMS, applying an evidence-based medicine approach. We reviewed all phase III pivotal trials of DMTs. Six clinical trials of Avonex®, Betaseron®, Copaxone®, Rebif® and Tysabri® in patients with RRMS were identified for analysis. Only randomized, placebo-controlled, double-blind studies were included. The clinical efficacy endpoints compared were: proportion of relapse-free patients at 1 and 2 years; annualized relapse rate at 2 years; proportion of progression-free patients at 2 years, and proportion of patients free of gadolinium-enhancing lesions at 1 year or 9 months. Based on these analyses, Betaseron, Rebif, and Tysabri show comparable effects, whereas for several endpoints Avonex or Copaxone did not significantly differ from placebo. In the absence of head-to-head studies for all products used to treat RRMS, it still may be possible to compare treatment effects by applying evidence-based medicine principles