Wasserstein GAN:Deep Generation applied on Bitcoins financial time series

Modeling financial time series is challenging due to their high volatility and unexpected happenings on the market. Most financial models and algorithms trying to fill the lack of historical financial time series struggle to perform and are highly vulnerable to overfitting. As an alternative, we introduce in this paper a deep neural network called the WGAN-GP, a data-driven model that focuses on sample generation. The WGAN-GP consists of a generator and discriminator function which utilize an LSTM architecture. The WGAN-GP is supposed to learn the underlying structure of the input data, which in our case, is the Bitcoin. Bitcoin is unique in its behavior; the prices fluctuate what makes guessing the price trend hardly impossible. Through adversarial training, the WGAN-GP should learn the underlying structure of the bitcoin and generate very similar samples of the bitcoin distribution. The generated synthetic time series are visually indistinguishable from the real data. But the numerical results show that the generated data were close to the real data distribution but distinguishable. The model mainly shows a stable learning behavior. However, the model has space for optimization, which could be achieved by adjusting the hyperparameters

Long PHILOS plate fixation in a series of humeral fractures

Aim: The purpose of the article is to highlight a specific fracture pattern encountered by us in the osteoporotic upper humerus. We present our results of management of such metadiaphyseal fractures of the upper humerus with less invasive plating. The additional steps taken to improve final outcome and the reasoning behind each are discussed. Patients and methods: In our department, a total of 13 fractures (in 12 patients) were managed for a metadiaphyseal fracture of the upper humerus between 2010 and 2013. There were 2 males and 10 females. The average age in the cohort was 74.3 (52-95) years. In 9 fractures, the fracture line was extending above the surgical neck. All patients were managed with a locking compression plate (long PHILOS or LCP) using two approach windows (proximal deltopectoral and a distal anterior or lateral). Patients were evaluated for clinical outcome using the Quick DASH score and assessed for radiological union, complications or re-operations retrospectively. Results: The mean follow-up was 14.3months (4-36). All fractures were united, and there was no evidence of avascular necrosis or non-union. Two patients showed varus collapse of the anatomical head of which one patient needed change of screws at 12weeks from index surgery. In patients, when a distal lateral window was used, 2 patients out of 4 had radial nerve palsy post-operatively. In the rest, when the plate was twisted by 45° to allow anterior placement using the brachialis split, none had radial nerve injury. Conclusion: The osteoporotic bone failingunder a low-energy mechanism seemed to dictate this fracture pattern. The fracture is either a bending wedge or a long spiral with or without a large butterfly and often extends into the humeral head. The fractures are better managed surgically, a primary reduction allowing contact of fragments is essential, and using an anterior window distally with a 45° contoured plate will achieve good plate placement as well as decreases the risk of radial nerve injury considerably compared to total lateral plate positioning

Cardiovascular imaging following perioperative myocardial infarction/injury

Patients developing perioperative myocardial infarction/injury (PMI) have a high mortality. PMI work-up and therapy remain poorly defined. This prospective multicenter study included high-risk patients undergoing major non-cardiac surgery within a systematic PMI screening and clinical response program. The frequency of cardiovascular imaging during PMI work-up and its yield for possible type 1 myocardial infarction (T1MI) was assessed. Automated PMI detection triggered evaluation by the treating physician/cardiologist, who determined selection/timing of cardiovascular imaging. T1M1 was considered with the presence of a new wall motion abnormality within 30 days in transthoracic echocardiography (TTE), a new scar or ischemia within 90 days in myocardial perfusion imaging (MPI), and Ambrose-Type II or complex lesions within 7 days of PMI in coronary angiography (CA). In patients with PMI, 21% (268/1269) underwent at least one cardiac imaging modality. TTE was used in 13% (163/1269), MPI in 3% (37/1269), and CA in 5% (68/1269). Cardiology consultation was associated with higher use of cardiovascular imaging (27% versus 13%). Signs indicative of T1MI were found in 8% of TTE, 46% of MPI, and 63% of CA. Most patients with PMI did not undergo any cardiovascular imaging within their PMI work-up. If performed, MPI and CA showed high yield for signs indicative of T1MI.Trial registration: https://clinicaltrials.gov/ct2/show/NCT02573532

Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial

Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia.This study was supported by the Consejeria de Turismo, Comercio y Deporte (CTCD-201000019242-TRA), the Spanish Ministry of Science and Innovation (I + D + I DEP2010-15639, grants: BES-2009-013442, BES-2011-047133, RYC-2010-05957, RYC-2011-09011), the Swedish Heart-Lung Foundation (20090635), the Spanish Ministry of Education (AP-2009-3173), Granada Research of Excelence Initiative on Biohealth (GREIB), Campus BioTic, University of Granada, Spain and European University of Madrid. Escuela de Estudios Universitarios Real Madrid. 2010/04RM

Postoperative Betreuung nach operativer Frakturbehandlung

The postoperative management after open reduction and internal fixation (ORIF) of fractures is addressed with this article. The topics selected focus on topics that are of relevance for the family practitioner. Because of large differences in the treatment of adult - and geriatric fracture patients these two groups are separately looked at in Part 1 and Part 2 of the article. Fractures in children or fractures of the growing skeleton are not addressed. In the early postoperative phase, the fracture patient might seek for advice in case of complications, such as wound infection or complex regional pain syndrome (CRPS). After fracture healing, the decision on implant removal has to be made. Geriatric fracture patients mostly cannot return back home directly from the hospital. Instead they are transferred to a rehabilitation center. In these patients secondary fracture prevention should be in the focus of the family practitioner. This means osteoporosis diagnostics and treatment shall be initiated, if not done before. Another important task is to guarantee for compliance with the therapy once it is initiated

Differences of functional fitness in adults after 9 months of combined exercise training program

The main objective of this study was to evaluate the incidence of physical intervention program related quality of life on a set of physical tests that determine the physical condition of adults. 128 adults, aged between 50-70 years old, participated in a combined exercise training program, 3 sessions per week (two Physical Fitness Exercises and one swimming), during a period of 9 months. Their physical condition was assessed at the beginning and at the end of the study by the Senior Fitness Test (SFT). Results show significant improvements in the strength parameters of the legs and arms (p<0.01) and in the range of motion in the shoulders and trunk (p<0.05), no significant differences were found in tests of agility and resistance. These results suggest that participation in regular physical exercise programs, both aerobic and strength training causes a number of favourable responses that contribute to healthy aging and may play a role in the prevention or reduction of functional decline in older adults.Andalusian and Granada Governments, and PulevaBiotech SA

The effect of local bone mineral density on the rate of mechanical failure after surgical treatment of distal radius fractures: a prospective multicentre cohort study including 249 patients

Introduction: The aim of this prospective, multicentre study was to evaluate the influence of local bone mineral density (BMD) on the rate of mechanical failure after locking plate fixation of closed distal radius fractures. Materials and methods: Between June 2007 and April 2010, 230 women and 19 men with a mean age of 67years were enrolled. Dual energy X-ray absorptiometry measurements for BMD of the contralateral distal radius were made at 6weeks post-surgery. Follow-up evaluations at 6weeks, 3months and 1year included wrist mobility and strength as well as standard radiographs. Any local bone/fracture or implant/surgery-related complications were documented. The Disability of the Arm, Shoulder, and Hand (DASH), Patient Rated Wrist Evaluation (PRWE), and EuroQol-5D scores were also recorded at the nominated time points. Results: Nine patients were reported with mechanical failure at an estimated risk of 3.6%. The BMD measurements were generally low for the study population with no difference between patients with (0.561g/cm2) and without (0.626g/cm2) mechanical failure (p=0.148). None of the patients achieved their pre-injury functional level and quality of life status after 1year. 1-year DASH and PRWE scores as well as the difference in maximum grip strength of the affected wrist relative to the contralateral side were significantly higher for patients with mechanical failure (p≤0.036). Conclusions: Our study could not identify a clear association between bone mineral density status and the risk of mechanical failure. Although the risk for mechanical failure after treatment of distal radius fractures with palmar locking plates is low, these complications must be avoided to prevent negative impact on long-term patient functional and quality of life outcome