NeXCLass: A DECISION SUPPORT SYSTEM FOR NON-ORDERED MULTICRITERIA CLASSIFICATION

This paper presents NexClass, a Decision Support System (DSS) which supports classification of alternatives into predefined non-ordered categories according to their performance on evaluation criteria and implements a novel classification algorithm based on multicriteria analysis and outranking relations. More detailed, assignment to classes is based on the concept of non-exclusivity, which defines at what degree an alternative can be included in a specific category. For each category, a threshold is defined by the decision maker, which indicates its limit with respect to the evaluation criteria. Alternatives are next evaluated according to the criteria and non-excluding degrees are calculated for each category. Finally, an alternative is assigned to the category for which non-excluding degree gets the lowest value. NexClass DSS implements the above classification algorithm, providing a user-friendly interface, which supports decision makers to formulate and solve classification problems. In addition to the methodology and the DSS, we present a real world application at a classification problem in banking environment. Our findings derived from evaluation experiments in the banking environment provide valid evidence that the proposed methodology and the DSS effectively support decision makers in classification decisions.Multicriteria decision analysis, nominal classification, decision support systems

Mid-Term Radiological and Functional Outcomes of Bicondylar Tibial Plateau Fractures Managed with Open Reduction and Internal Fixation Using Dual Plates

Objectives: This study aimed to evaluate the mid-term radiological and functional outcome of tibial plateau fractures treated by plating. Methods: This study was conducted at the General Hospital of Thessaloniki ‘Papageorgiou’, Thessaloniki, Greece. Patients with Schatzker type V and VI tibial plateau fractures who were managed with open reduction and internal fixation using dual plates between January 2011 and December 2018 were included in this retrospective study. The functional evaluation of the patients was carried out with the visual analogue scale (VAS), the health-related quality of life status was measured using the Short Form-36 and the dimensions of pain, stiffness and function were assessed using the Western Ontario and McMaster Universities Arthritis Index. For the radiological outcome evaluation, the modified Rasmussen criteria were used. Results: Fifty-seven patients (30 male and 27 female) were included in the study with a mean follow-up of 50.88 months. There were 23 Schatzker type V and 34 type VI fractures. The majority of patients (86%) had a good to excellent radiological outcome. The mean VAS score was 1.65 for all the patients. The functional outcome was excellent in the majority of the patients. Among them, 5.3% (n = 3) suffered wound infection and all wounds healed after different treatments. All patients returned to their pre-injury activities of daily living and employment status, while 53% of the patients returned to sporting activities. Conclusion: The findings support previous literature which has demonstrated that bicondylar tibial plateau fractures can provide good-to-excellent radiological and functional outcomes if they are treated with open reduction and internal fixation with dual plating. Keywords: Tibial; Fracture; Classification; Surgical Procedure; Plating.

Double Interphalangeal Joint Dislocation of the Finger in Adolescent Athletes: A Review of Two Cases and the Relevant Literature

Double interphalangeal joint dislocation of the same finger is a rare condition. We report two cases of adolescent athletes with distal and proximal interphalangeal joint dislocation. The diagnosis was confirmed with plain radiograph, while anatomical reduction was easily obtained with gentle longitudinal traction. A simple immobilization of the injured finger was applied by buddy taping for two weeks. Early mobilization as tolerated was recommended, and they have made a full return to their previous status of activities within 5 months. We also provide a review of the literature detailing demographic characteristics, cause and mechanism of injury with associated injuries, treatment options, and functional outcomes in this population

Inter-Limb Asymmetry in the Kinematic Parameters of the Long Jump Approach Run in Female Paralympic-Level Class T63/T64 Athletes

The purpose of this study was to evaluate the inter-limb asymmetry in the kinematic parameters of the approach run in elite-level female Class T63/T64 long jumpers and its relationship to performance. Three Class T63 and nine Class T64 female long jumpers were examined during a competition. The temporal and kinematic parameters of their approach steps (step length: SL; step frequency: SF; average step velocity: SV) were measured using a panning video method and speed radar. The symmetry angle was the measure of inter-limb asymmetry. The results revealed that SF and SV were significantly (p p p < 0.05) positively correlated with the maximum velocity attained during the approach and negatively correlated with the symmetry angle for SF. It is concluded that the observed asymmetry in SF was compensated for by the modifications observed in the SL that consequently resulted in no asymmetry in SV, leading the participants to effectively utilize their approach speed optimally in terms of long jump performance

European consensus on the concepts and measurement of the pathophysiological neuromuscular responses to passive muscle stretch

Background and purpose To support clinical decision-making in central neurological disorders, a physical examination is used to assess responses to passive muscle stretch. However, what exactly is being assessed is expressed and interpreted in different ways. A clear diagnostic framework is lacking. Therefore, the aim was to arrive at unambiguous terminology about the concepts and measurement around pathophysiological neuromuscular response to passive muscle stretch. Methods During two consensus meetings, 37 experts from 12 European countries filled online questionnaires based on a Delphi approach, followed by plenary discussion after rounds. Consensus was reached for agreement ≥75%. Results The term hyper-resistance should be used to describe the phenomenon of impaired neuromuscular response during passive stretch, instead of for example ‘spasticity’ or ‘hypertonia’. From there, it is essential to distinguish non-neural (tissue-related) from neural (central nervous system related) contributions to hyper-resistance. Tissue contributions are elasticity, viscosity and muscle shortening. Neural contributions are velocity dependent stretch hyperreflexia and non-velocity dependent involuntary background activation. The term ‘spasticity’ should only be used next to stretch hyperreflexia, and ‘stiffness’ next to passive tissue contributions. When joint angle, moment and electromyography are recorded, components of hyper-resistance within the framework can be quantitatively assessed. Conclusions A conceptual framework of pathophysiological responses to passive muscle stretch is defined. This framework can be used in clinical assessment of hyper-resistance and will improve communication between clinicians. Components within the framework are defined by objective parameters from instrumented assessment. These parameters need experimental validation in order to develop treatment algorithms based on the aetiology of the clinical phenomena