470 research outputs found

    Percutane schroeffixatie voor osteoporotische sacrumfracturen bij oudere patiënten

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    Abstract: In older patients, pubic rami fractures resulting from low-impact falls are generally considered to be stable and treated non-operatively. An associated sacral fracture is easily missed on plain radiography but can result in debilitating pain. The objective of this report is to present our experience with percutaneous sacro-iliac screw fixation in 2 elderly patients with (missed) osteoporotic sacral fractures. We conclude that "isolated" pubic rami fractures in elderly patients should prompt careful investigation to rule out an associated sacral fracture particularly in patients with lower back or sacral pain. In the presence of a sacral fracture, early percutaneous sacro-iliac screw fixation to allow rapid mobilization should be considered in selected patients

    Predicting Dropout From Organized Football:A Prospective 4-Year Study Among Adolescent and Young Adult Football Players

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    Previous studies have shown that enjoyment is one of the key predictors of dropout from organized sport, including organized football. However, prospective studies, particularly studies focused on long-term dropout, are largely lacking. Drawing on the basic principles of interdependence theory, in the present prospective study among 1,762 adolescent and young adult football players (27.1% women, mean age 17.74 years, SD = 1.35), we tested the predictive value of sport enjoyment, perceived alternatives, and restraining forces on football players' short-term (6 months) and long-term (4 years) dropout from organized football. As anticipated, the results of the logistic regression and follow-up analyses indicate that players' enjoyment was the main predictor of (short-term and long-term) dropout. In addition, relative to remainers, dropouts perceived more alternatives in terms of other sports, had fewer family members involved in their football club, and were older at the time they started playing organized football. We conclude that particularly measures aimed at enhancing sport enjoyment may prevent players from dropping out from organized football in both the short and long term. In addition, dropout rates may be reduced by attracting and engaging youth at a very young age (from 6 years), and their siblings, parents, and other family members as well

    Quality of reporting and risk of bias:a review of randomised trials in occupational health

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    OBJECTIVES: To assess the reporting quality of randomisation and allocation methods in occupational health and safety (OHS) trials in relation to Consolidated Standards of Reporting Trials (CONSORT) requirements of journals, risk of bias (RoB) and publication year. METHODS: We systematically searched for randomised controlled trials (RCTs) in PubMed between 2010 and May 2019 in 18 OHS journals. We measured reporting quality as percentage compliance with the CONSORT 2010 checklist (items 8–10) and RoB with the ROB V.2.0 tool (first domain). We tested the mean difference (MD) in % in reporting quality between CONSORT-requiring and non-requiring journals, trials with low, some concern and high RoB and publications before and after 2015. RESULTS: In 135 articles reporting on 129 RCTs, average reporting quality was at 37.4% compliance (95% CI 31.9% to 43.0%), with 10% of articles reaching 100% compliance. Reporting quality was significantly better in CONSORT-requiring journals than non-requiring journals (MD 31.0% (95% CI 21.4% to 40.7%)), for studies at low RoB than high RoB (MD 33.1% (95% CI 16.1% to 50.2%)) and with RoB of some concern (MD 39.8% (95% CI 30.0% to 49.7%)). Reporting quality did not improve over time (MD −5.7% (95% CI −16.8% to 5.4%). CONCLUSIONS: Articles in CONSORT-requiring journals and of low RoB studies show better reporting quality. Low reporting quality is linked to unclear RoB judgements (some concern). Reporting quality did not improve over the last 10 years and CONSORT is insufficiently implemented. Concerted efforts by editors and authors are needed to improve CONSORT implementation

    Comparing the prediction of prostate biopsy outcome using the Chinese Prostate Cancer Consortium (CPCC) Risk Calculator and the Asian adapted Rotterdam European Randomized Study of Screening for Prostate Cancer (ERSPC) Risk Calculator in Chinese and European men

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    Purpose: To externally validate the clinical utility of Chinese Prostate Cancer Consortium Risk Calculator (CPCC-RC) and Asian adapted Rotterdam European Randomized Study of Screening for Prostate Cancer Risk Calculator 3 (A-ERSPC-RC3) for prediction prostate cancer (PCa) and high-grade prostate cancer (HGPCa, Gleason Score ≄ 3 + 4) in both Chinese and European populations. Materials and methods: The Chinese clinical cohort, the European population-based screening cohort, and the European clinical cohort included 2,508, 3,616 and 617 prostate biopsy-naive men, respectively. The area under the receiver operating characteristic curve (AUC), calibration plot and decision curve analyses were applied in the analysis. Results: The CPCC-RC’s predictive ability for any PCa (AUC 0.77, 95% CI 0.75–0.79) was lower than the A-ERSPC-RC3 (AUC 0.79, 95% CI 0.77–0.81) in the European screening cohort (p < 0.001), but similar for HGPCa (p = 0.24). The CPCC-RC showed lower predictive accuracy for any PCa (AUC 0.65, 95% CI 0.61–0.70), but acceptable predictive accuracy for HGPCa (AUC 0.73, 95% CI 0.69–0.77) in the European clinical cohort. The A-ERSPC-RC3 showed an AUC of 0.74 (95% CI 0.72–0.76) in predicting any PCa, and a similar AUC of 0.74 (95% CI 0.72–0.76) in predicting HGPCa in Chinese cohort. In the Chinese population, decision curve analysis revealed a higher net benefit for CPCC-RC than A-ERSPC-RC3, while in the European screening and clinical cohorts, the net benefit was higher for A-ERSPC-RC3. Conclusions: The A-ERSPC-RC3 accurately predict the prostate biopsy in a contemporary Chinese multi-center clinical cohort. The CPCC-RC can predict accurately in a population-based screening cohort, but not in the European clinical cohort

    CO2 and non-CO2 balanced environmental scores module for flight performance evaluation and optimisation

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    The SESAR2020 exploratory research (ER4) programme CREATE (Grant 890898) developed a climate and weather aware Concept of Operations (ConOps) which encompasses a multi-aircraft 4D trajectory optimisation framework, which utilises a CO2 and non-CO2 balanced Environmental Scores Module (ESM) for the en-route flight phase. The ESM provides a computational method to evaluate the “greenness” of aircraft trajectories. Some components related to the internal ESM scoring are based on expert judgement, which is in line with the technology readiness level (TRL) 1 of the solution. Fast-time simulations were performed to demonstrate the proof-of-concept of the ESM in a multi-aircraft tactical optimisation scenario in the North-Atlantic region. The results show that, because of the simplicity of the metric, the ESM could be well used for trajectory optimisation and tactical replanning, and most likely as well as flight and ATC sector environmental performance evaluations.The work presented in this paper has received funding from the SESAR Joint Undertaking (JU) under grant agreement No 890898, corresponding to the project “Innovative Operations and Climate and Weather Models to Improve ATM Resilience and Reduce Impacts” (SESAR-H2020-ER4 CREATE) within the European Union's Horizon 2020 research and innovation program.Peer ReviewedPostprint (published version

    Allowing Visitors Back in the Nursing Home During the COVID-19 Crisis:A Dutch National Study Into First Experiences and Impact on Well-Being

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    Objectives: To prevent and control COVID-19 infections, nursing homes across the world have taken very restrictive measures, including a ban for visitors. These restrictive measures have an enormous impact on residents' well-being and pose dilemmas for staff, although primary data are lacking. A Dutch guideline was developed to cautiously open nursing homes for visitors during the COVID-19 pandemic. This study reports the first findings on how the guideline was applied in the local context; the compliance to local protocols; and the impact on well-being of residents, their family caregivers, and staff.Design: A mixed-methods cross-sectional study was conducted.Setting and Participants: In total, 26 nursing homes were permitted to enlarge their possibilities for allowing visitors in their facility. These nursing homes were proportionally representative of the Netherlands as they were selected by their local Area Health Authority for participation. At each nursing home, a contact person was selected for participation in the current study.Methods: A mixed-methods cross-sectional study was conducted, consisting of questionnaire, telephone interviews, analyses of documentation (ie, local visiting protocols), and a WhatsApp group.Results: Variation in local protocols was observed, for example, related to the use of personal protective equipment, location, and supervision of visits. In general, experiences were very positive. All nursing homes recognized the added value of real and personal contact between residents and their loved ones and indicated a positive impact on well-being. Compliance with local guidelines was sufficient to good. No new COVID-19 infections were reported during this time.Conclusions and Implications: These results indicate the value of family visitation in nursing homes and positive impact of visits. Based on these results, the Dutch government has decided to allow all nursing homes in the Netherlands to cautiously open their homes using the guidelines. More research is needed on impact and long-term compliance. (C) 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.</p

    Prostate cancer upgrading with serial prostate magnetic resonance imaging and repeat biopsy in men on active surveillance: are confirmatory biopsies still necessary?

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    Objectives: To investigate whether serial prostate magnetic resonance imaging (MRI) may guide the utility of repeat targeted (TBx) and systematic biopsy (SBx) when monitoring men with low-risk prostate cancer (PCa) at 1-year of active surveillance (AS). Patients and Methods: We retrospectively included 111 consecutive men with low-risk (International Society of Urological Pathology [ISUP] Grade 1) PCa, who received protocolled repeat MRI with or without TBx and repeat SBx at 1-year of AS. TBx was performed in Prostate Imaging-Reporting and Data System (PI-RADS) score ≄3 lesions (MRI-positive men). Upgrading defined as ISUP Grade ≄2 PCa (I), Grade ≄2 with cribriform growth/intraductal carcinoma PCa (II), and Grade ≄3 PCa (III) was investigated. Upgrading detected by TBx only (not by SBx) and SBx only (not by TBx) was investigated in MRI-positive and -negative men, and related to radiological progression on MRI (Prostate Cancer Radiological Estimation of Change in Sequential Evaluation [PRECISE] score). Results: Overall upgrading (I) was 32% (35/111). Upgrading in MRI-positive and -negative men was 48% (30/63) and 10% (5/48) (P < 0.001), respectively. In MRI-positive men, there was upgrading in 23% (seven of 30) by TBx only and in 33% (10/30) by SBx only. Radiological progression (PRECISE score 4–5) in MRI-positive men was seen in 27% (17/63). Upgrading (I) occurred in 41% (seven of 17) of these MRI-positive men, while this was 50% (23/46) in MRI-positive men without radiological progression (PRECISE score 1–3) (P = 0.534). Overall upgrading (II) was 15% (17/111). Upgrading in MRI-positive and -negative men was 22% (14/63) and 6% (three of 48) (P = 0.021), respectively. In MRI-positive men, there was upgrading in three of 14 by TBx only and in seven of 14 by SBx only. Overall upgrading (III) occurred in 5% (five of 111). Upgrading in MRI-positive and -negative men was 6% (four of 63) and 2% (one of 48) (P = 0.283), respectively. In MRI-positive men, there was upgrading in one of four by TBx only and in two of four by SBx only. Conclusion: Upgrading is significantly lower in MRI-negative compared to MRI-positive men with low-risk PCa at 1-year of AS. In serial MRI-negative men, the added value of repeat SBx at 1-year surveillance is limited and should be balanced individually against the harms. In serial MRI-positive men, the added value of repeat SBx is substantial. Based on this cohort, SBx is recommended to be performed in combination with TBx in all MRI-positive men at 1-year of AS, also when there is no radiological progression
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