Arthroscopic treatment of synovial chondromatosis in the ankle joint

AbstractINTRODUCTIONSynovial chondromatosis is characterized by the presence of metaplastic cartilage nodules originating from the synovia, bursa and tendon sheaths. Although it is extremely rare in the ankle joint, malignant transformation is possible. The choice of treatment is usually open surgery for excision of loose bodies and synovectomy. Limited data is available concerning arthroscopic approaches.PRESENTATION OF CASEA 28-year-old male patient was evaluated for pain and swelling of the right ankle joint. Based on the findings of physical examination and radiographic investigations, arthroscopic surgery was performed due to ankle impingement syndrome. A diagnosis of synovial osteochondromatosis was made following the pathological survey.DISCUSSIONSynovial chondromatosis is slowly progressive and is considered to be a self-limiting situation. Treatment strategies are decided on according to the patient's complaints, age and disease stage. Open or arthroscopic surgery. can be performed. Some advantages of arthroscopic surgery are wide visualization areas, easy access to areas difficult to reach, lower morbidity, no necessity for casting and immobilization, early rehabilitation and quick recovery period.CONCLUSIONIn conclusion, arthroscopic management can be successful in selected patients with synovial osteochondromatosis localized to the ankle joint

WRT-1006 Technical Report: Developing the Digital Engineering Competency Framework (DECF) – Phase 2

17 USC 105 interim-entered record; under review.This material is based upon work supported, in whole or in part, by the U.S. Department of Defense through the Office of the Assistant Secretary of Defense for Research and Engineering (ASD(R&E)) under Contract HQ0034-19-D-003 (Task Order 0286).This material is based upon work supported, in whole or in part, by the U.S. Department of Defense through the Office of the Assistant Secretary of Defense for Research and Engineering (ASD(R&E)) under Contract HQ0034-19-D-003 (Task Order 0286). U.S. Government affiliation is unstated in article tex

WRT-1006 Technical Report: Developing the Digital Engineering Competency Framework (DECF), Version 1.0

17 USC 105 interim-entered record; under review.Digital engineering is ‘‘an integrated digital approach that uses authoritative sources of systems’ data and models as a continuum across disciplines to support lifecycle activities from concept through disposal. A DE ecosystem is an interconnected infrastructure, environment, and methodology that enables the exchange of digital artifacts from an authoritative source of truth.”1 Digital transformation is fundamentally changing the way acquisition and engineering are per-formed across a wide range of government agencies, industries, and academia and is characterized by the integration of digital technology into all areas of a business, changing fundamental operations and how results are delivered in terms of new value to customers. It includes cultural change centered on alignment across leadership, strategy, customers, operations, and workforce evolution.This material is based upon work supported, in whole or in part, by the U.S. Department of Defense through the Office of the Assistant Secretary of Defense for Research and Engineering (ASD(R&E)) under Contract HQ0034-13-D-004 (Task Order 0082).This material is based upon work supported, in whole or in part, by the U.S. Department of Defense through the Office of the Assistant Secretary of Defense for Research and Engineering (ASD(R&E)) under Contract HQ0034-13-D-004 (Task Order 0082). U.S. Government affiliation is unstated in article tex

City of Hitchcock Comprehensive Plan 2020-2040

Hitchcock is a small town located in Galveston County (Figure 1.1), nestled up on the Texas Gulf Coast. It lies about 40 miles south-east of Houston. The boundaries of the city encloses an area of land of 60.46 sq. miles, an area of water of 31.64 sq. miles at an elevation just 16 feet above sea level. Hitchcock has more undeveloped land (~90% of total area) than the county combined. Its strategic location gives it a driving force of opportunities in the Houston-Galveston Region.The guiding principles for this planning process were Hitchcock’s vision statement and its corresponding goals, which were crafted by the task force. The goals focus on factors of growth and development including public participation, development considerations, transportation, community facilities, economic development, parks, and housing and social vulnerabilityTexas Target Communitie

Multidifferential study of identified charged hadron distributions in ZZ-tagged jets in proton-proton collisions at s=\sqrt{s}=13 TeV

Jet fragmentation functions are measured for the first time in proton-proton collisions for charged pions, kaons, and protons within jets recoiling against a $Z$ boson. The charged-hadron distributions are studied longitudinally and transversely to the jet direction for jets with transverse momentum 20 $< p_{\textrm{T}} < 100$ GeV and in the pseudorapidity range $2.5 < \eta < 4$. The data sample was collected with the LHCb experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 1.64 fb$^{-1}$. Triple differential distributions as a function of the hadron longitudinal momentum fraction, hadron transverse momentum, and jet transverse momentum are also measured for the first time. This helps constrain transverse-momentum-dependent fragmentation functions. Differences in the shapes and magnitudes of the measured distributions for the different hadron species provide insights into the hadronization process for jets predominantly initiated by light quarks.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-013.html (LHCb public pages

Study of the B−→Λc+Λˉc−K−B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-} decay

The decay $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ is studied in proton-proton collisions at a center-of-mass energy of $\sqrt{s}=13$ TeV using data corresponding to an integrated luminosity of 5 $\mathrm{fb}^{-1}$ collected by the LHCb experiment. In the $\Lambda_{c}^+ K^{-}$ system, the $\Xi_{c}(2930)^{0}$ state observed at the BaBar and Belle experiments is resolved into two narrower states, $\Xi_{c}(2923)^{0}$ and $\Xi_{c}(2939)^{0}$, whose masses and widths are measured to be $$m(\Xi_{c}(2923)^{0}) = 2924.5 \pm 0.4 \pm 1.1 \,\mathrm{MeV}, \\ m(\Xi_{c}(2939)^{0}) = 2938.5 \pm 0.9 \pm 2.3 \,\mathrm{MeV}, \\ \Gamma(\Xi_{c}(2923)^{0}) = \phantom{000}4.8 \pm 0.9 \pm 1.5 \,\mathrm{MeV},\\ \Gamma(\Xi_{c}(2939)^{0}) = \phantom{00}11.0 \pm 1.9 \pm 7.5 \,\mathrm{MeV},$$ where the first uncertainties are statistical and the second systematic. The results are consistent with a previous LHCb measurement using a prompt $\Lambda_{c}^{+} K^{-}$ sample. Evidence of a new $\Xi_{c}(2880)^{0}$ state is found with a local significance of $3.8\,\sigma$, whose mass and width are measured to be $2881.8 \pm 3.1 \pm 8.5\,\mathrm{MeV}$ and $12.4 \pm 5.3 \pm 5.8 \,\mathrm{MeV}$, respectively. In addition, evidence of a new decay mode $\Xi_{c}(2790)^{0} \to \Lambda_{c}^{+} K^{-}$ is found with a significance of $3.7\,\sigma$. The relative branching fraction of $B^{-} \to \Lambda_{c}^{+} \bar{\Lambda}_{c}^{-} K^{-}$ with respect to the $B^{-} \to D^{+} D^{-} K^{-}$ decay is measured to be $2.36 \pm 0.11 \pm 0.22 \pm 0.25$, where the first uncertainty is statistical, the second systematic and the third originates from the branching fractions of charm hadron decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-028.html (LHCb public pages

Measurement of the ratios of branching fractions R(D∗)\mathcal{R}(D^{*}) and R(D0)\mathcal{R}(D^{0})

The ratios of branching fractions $\mathcal{R}(D^{*})\equiv\mathcal{B}(\bar{B}\to D^{*}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(\bar{B}\to D^{*}\mu^{-}\bar{\nu}_{\mu})$ and $\mathcal{R}(D^{0})\equiv\mathcal{B}(B^{-}\to D^{0}\tau^{-}\bar{\nu}_{\tau})/\mathcal{B}(B^{-}\to D^{0}\mu^{-}\bar{\nu}_{\mu})$ are measured, assuming isospin symmetry, using a sample of proton-proton collision data corresponding to 3.0 fb${ }^{-1}$ of integrated luminosity recorded by the LHCb experiment during 2011 and 2012. The tau lepton is identified in the decay mode $\tau^{-}\to\mu^{-}\nu_{\tau}\bar{\nu}_{\mu}$. The measured values are $\mathcal{R}(D^{*})=0.281\pm0.018\pm0.024$ and $\mathcal{R}(D^{0})=0.441\pm0.060\pm0.066$, where the first uncertainty is statistical and the second is systematic. The correlation between these measurements is $\rho=-0.43$. Results are consistent with the current average of these quantities and are at a combined 1.9 standard deviations from the predictions based on lepton flavor universality in the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-039.html (LHCb public pages

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Enabling the Digital Transformation of the Workforce: A Digital Engineering Competency Framework

The article of record as published may be found at http://dx.doi.org/10.1109/SysCon48628.2021.9447063This paper describes the goals, approaches, initial results, and preliminary implementation of WRT-1006, a multiphase research task within the Systems Engineering Research Center (SERC). Evidence across the Services and industry has affirmed digital engineering is a critical practice necessary to support acquisition in an environment of increasing global challenges, dynamic threats, rapidly evolving technologies, and increasing life expectancy of our systems currently in operation. Digital engineering updates the systems engineering practices to take full advantage of computational technology, modeling, data analytics, and data sciences. The Department of Defense's vision for digital engineering is to modernize how the Department designs, develops, delivers, operates, and sustains systems, while continuing to practice systems engineering efficiently and effectively. Digital transformation is fundamentally changing the way acquisition and engineering are performed across a wide range of government agencies, industries, and academia. As the Department of Defense (DoD) transitions to digital engineering, there is a need to develop and maintain an acquisition workforce and culture that is literate in model-based engineering, competent in digital engineering models, methods, processes, tools, and understands digital artifacts across the acquisition lifecycle. One of the critical steps that was identified to enable this digital transformation is the development of a competency model that can be used to modernize the workforce. This paper outlines the results after completion of Phase 1 of WRT-1006, which concluded in the initial release of the Digital Engineering Competency Framework (DECF) by SERC, and the initial Phase 2 efforts of implementing the framework as a benchmark for the content of a digital engineering training curriculum. The purpose of the DECF is to provide clear guidance for the DoD acquisition workforce, in particular the engineering acquisition workforce, through clearly defined competencies that illuminate the knowledge, skills, abilities, and behaviors required for digital engineering professionals. The approach taken to develop the DECF drew from existing competency models in fields neighboring digital engineering and from the feedback of experienced practicing digital engineering community. The initial version of the DECF v.1.0 was released as a key WRT1006 Phase 1 result with confidence in the maturity of the structure and general content. The overarching structure of the DECF v.1.0 consists of competency areas, proficiency levels within the competency, and constituting knowledge, skills, abilities, and behaviors (KSABs). Now that this benchmark is established, the second phase of our project involves the comparison of the DECF to the existing Defense Acquisition University (DAU) curriculum to determine what elements of such existing curriculum already support the competencies in the model. This is a bidirectional analysis that will both identify gaps in the training curriculum and potentially identify curriculum content that should be incorporated into the competency model. Although this project is specifically applying the DECF to the acquisition process, the model has applications in any area that will implement Digital Engineering initiatives. Furthermore, this framework has additional use cases that will be explored further including hiring for Digital Engineering positions and ensuring the current work force has the necessary skillsets to adequately implement a digital transformation.U.S. Department of Defense through the Office of the Assistant Secretary of Defense for Research and Engineering (ASD(R&E)) under Contract [HQ0034-19-D-000

Digital Transformation for Defense Acquisition: Digital Engineering Competency Framework (DECF)

Digital transformation is fundamentally changing the way acquisition and engineering are performed across a wide range of government agencies, industries, and academia and is characterized by the integration of digital technology into all areas of a business, changing fundamental operations and how results are delivered in terms of new value to customers. It includes cultural change centered on alignment across leadership, strategy, customers, operations, and workforce evolution. Digital engineering (DE) is ‘‘an integrated digital approach that uses authoritative sources of systems' data and models as a continuum across disciplines to support life-cycle activities from concept through disposal. A DE ecosystem is an interconnected infrastructure, environment, and methodology that enables the exchange of digital artifacts from an authoritative source of truth." (ODASD [SE], 2017) The purpose of the Digital Engineering Competency Framework (DECF) is to provide clear guidance for the DoD acquisition workforce, in particular the engineering (ENG) acquisition workforce, through clearly defined competencies that illuminate the knowledge, skills, abilities, and behaviors (KSABs) required for DE professionals. Though the DECF includes considerations specific to the Defense acquisition workforce, data was also gathered from outside the defense community.Prepared for the Naval Postgraduate School, Monterey, CA 93943.Naval Postgraduate SchoolApproved for public release; distribution is unlimited.Approved for public release; distribution is unlimited