SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis

This 2012 Consensus paper reviews the literature on side effects of x-ray exposure in the pediatric population as it relates to scoliosis evaluation and treatment. Alternative methods of spinal assessment and imaging are reviewed, and strategies for reducing the number of radiographs are developed. Using the Delphi technique, SOSORT members developed consensus statements that describe how often radiographs should be taken in each of the pediatric and adolescent sub-populations

The anterolateral complex of the knee: results from the International ALC Consensus Group Meeting

The structure and function of the anterolateral complex (ALC) of the knee has created much controversy since the 're-discovery' of the anterolateral ligament (ALL) and its proposed role in aiding control of anterolateral rotatory laxity in the anterior cruciate ligament (ACL) injured knee. A group of surgeons and researchers prominent in the field gathered to produce consensus as to the anatomy and biomechanical properties of the ALC. The evidence for and against utilisation of ALC reconstruction was also discussed, generating a number of consensus statements by following a modified Delphi process. Key points include that the ALC consists of the superficial and deep aspects of the iliotibial tract with its Kaplan fibre attachments on the distal femur, along with the ALL, a capsular structure within the anterolateral capsule. A number of structures attach to the area of the Segond fracture including the capsule-osseous layer of the iliotibial band, the ALL and the anterior arm of the short head of biceps, and hence it is not clear which is responsible for this lesion. The ALC functions to provide anterolateral rotatory stability as a secondary stabiliser to the ACL. Whilst biomechanical studies have shown that these structures play an important role in controlling stability at the time of ACL reconstruction, the optimal surgical procedure has not yet been defined clinically. Concern remains that these procedures may cause constraint of motion, yet no clinical studies have demonstrated an increased risk of osteoarthritis development. Furthermore, clinical evidence is currently lacking to support clear indications for lateral extra-articular procedures as an augmentation to ACL reconstruction. The resulting statements and scientific rationale aim to inform readers on the most current thinking and identify areas of needed basic science and clinical research to help improve patient outcomes following ACL injury and subsequent reconstruction. Level of evidence V

Adaptive governance:The role of loyalty

This paper is concerned with the governance of vertical interfirm relations, i.e. relations between buyers and their suppliers on industrial, intermediate-goods markets. Networks of interacting, adaptive buyers and suppliers axe viewed as complex adaptive systems (Holland and Miller, 1991), which leads to the use of computer simulations to explore the strategies that boundedly rational, adaptive agents learn to use to manage their relations with suppliers. Starting from a static transaction cost economic perspective, the model is extended with allowance for loyal behavior and for trust to build up, with network embeddedness of relations and with the possibility for the agents to adapt their governance to changing circumstances and to the changing relation, rendering economic organization path-dependent. The paper analyzes how relations develop in time: actors making and breaking relations, on the basis of evaluations of expected profitability and loyalty. When allowance is made for adaptation of the relative weights attached to each of these criteria, the result is that buyers adaptively shift the weight from profitability to loyalty. Copyright (C) 1998 IFAC.</p

Knowledge discovery in virtual community texts: Clustering virtual communities

Automatic knowledge discovery from texts (KDT) is proving to be a promising method for businesses today to deal with the overload of textual information. In this paper, we first explore the possibilities for KDT to enhance communication in virtual communities, and then we present a practical case study with real-life Internet data. The problem in the case study is to manage the very successful virtual communities known as 'clubs' of the largest Dutch Internet Service Provider. It is possible for anyone to start a club about any subject, resulting in over 10,000 active clubs today. At the beginning, the founder assigns the club to a predefined category. This often results in illogical or inconsistent placements, which means that interesting clubs may be hard to locate for potential new members. The ISP therefore is looking for an automated way to categorize clubs in a logical and consistent manner. The method used is the so-called bag-of-words approach, previously applied mostly to scientific texts and structured documents. Each club is described by a vector of word occurrences of all communications within that club. Latent Semantic Indexing (LSI) is applied to reduce the dimensionality problem prior to clustering. Clustering is done by the Within Groups Clustering method using a cosine distance measure appropriate for texts. The results show that KDT and the LSI method can successfully be applied for clustering the very volatile and unstructured textual communication on the Internet

Context matters-using an agent-based model to investigate the influence of market context on the supply of local biomass for anaerobic digestion

Biogas plant managers often face difficulties in obtaining feedstock at stable and affordable prices. The context in which the biogas plant manager needs to purchase the feedstock could be important when the biomass is also used in valorization trajectories besides anaerobic digestion. Using a combination of qualitative research and agent-based modelling, we investigated the effect of market context on the purchase of local biomass for anaerobic digestion. This paper details the institutional arrangements of our case study, the silage maize market in Flanders and the results of a scenario analysis, simulating nine different market contexts. Silage maize is an interesting case study, as it is both used for feed by farmers and as an input in biogas plants. The results show that mainly the time of entry into the market explains the difficulties in obtaining a stable supply of silage maize to biogas plants. Furthermore, we found a silage maize price increase for farmers in competition with a biogas plant, especially in case of a silage maize deficit in the market. The different institutional arrangements used have no significant effect. Our findings may guide biogas plant managers in assessing and reducing the consequences of the establishment of a biogas plant, competing for local biomass resources