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Purpose To assess the relationship between pre-operative psychological state, postoperative pain and function one year after total shoulder, hip or knee arthroplasty. Methods Patients undergoing shoulder, hip or knee arthroplasty between March 2014 and November 2015 were included. Pain catastrophizing score (PCS) was determined preoperatively, at six months and at one year follow-up. Joint pain at rest was quantified using a Visual Analogue Scale (0‒100). Depressive symptoms were measured using the Beck Depression Inventory or Geriatric Depression Score, situational anxiety and dispositional anxiety were measured using the State-Trait Inventory and joint function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index for the hip and knee and Oxford Shoulder Score for the shoulder. Results A total of 266 patients were included (65% female; mean (± SD) age: 71.8 ± 10.3 years; mean body mass index: 27.5 ± 5.0 kg/m2). Pre-operative PCS was significantly correlated with pain > 30/100 at one year and with functional scores, for all joints. Multivariate analysis identified the following variables as risk factors for pain intensity > 30/100 at one year: pre-operative PCS > 20/52 (OR = 3.5 ± 1.1 [95% CI: 1.9‒6.6]; p = 0.0001), trait-anxiety score ≥ 46 (OR = 2.4 ± 0.9 [95% CI: 1.1‒5.2]; p = 0.03), pre-operative pain ≥ 60/100 (OR = 3.2 ± 1 [95% CI: 1.8‒6.1]; p = 0.0001) and pain for at least 3 years (OR = 1.8 ± 0.6 [95% CI: 1‒3.4]; p = 0.04). Conclusion Pre-operative pain catastrophizing and trait-anxiety are risk factors for post-operative pain after shoulder, hip and knee arthroplasty. Trial registration number www.clinicaltrials.gov NCT02361359.

Predictive Signal Phase and Timing (SPAT) message set is one fundamental building block for vehicle-to-infrastructure (V2I) applications such as Eco-Approach and Departure (EAD) at traffic signal controlled urban intersections. Among the two complementary communication methods namely short-range sidelink (PC5) and long-range cellular radio link (Uu), this paper documents the work with long-range link: the complete data chain includes connecting to the traffic signals via existing backhaul communication network, collecting the raw signal phase state data, predicting the signal state changes and delivering the SPAT data via a geofenced service to requests over HTTP protocols. An Application Programming Interface (API) library is developed to support various cellular data transmission reduction and latency improvement techniques. An emulation-based algorithm is applied to predict the traffic signal state changes to provide adequate prediction horizon (e.g., at minimum 2 minutes) for the cohort energy optimization. In fact, the same connectivity and SPAT delivery methodology has been applied to traffic signalized intersections nationwide in the United States upon public agency approvals for access to their firewalled traffic control network and signal control systems or directly to individual controllers. This methodology proves its effectiveness and potential for rapid growth of such SPAT deliveries at mass production scale without needing infrastructure hardware retrofit or excessive communication means. To support the energy optimization of light and heavy-duty vehicle cohorts of mixed automation and propulsion systems (EV, ICE and hybrid), the connection and SPAT deliveries at two sites were completed, including public roads in Washtenaw County, Michigan and closed track test sites at American Center for Mobility (ACM) in Ypsilanti, Michigan. However, only closed test track results at ACM will be presented in this paper. A neuroevolution based optimizer is developed and implemented to control the speed of a vehicle cohort with different propulsion systems and automation levels. Closed track tests showed significant energy savings of the cohort operation.

Number of samples used on different platforms for training and validation sets

Numbers of genes selected and designed based on different criteria

Ranking of Nanostring Custom panel probes in nPNC classifier

Performance of the Pulmonary Nodule Classifier

NanoString platform quality controls

Demographics for patients used in the microarray study

Comparison of Illumina and NanoString Classification

Performance of NanoString Lung Nodule Classifier on training, testing and all sample set using different number of genes

Low-dose CT (LDCT) is widely accepted as the preferred method for detecting pulmonary nodules. However, the determination of whether a nodule is benign or malignant involves either repeated scans or invasive procedures that sample the lung tissue. Noninvasive methods to assess these nodules are needed to reduce unnecessary invasive tests. In this study, we have developed a pulmonary nodule classifier (PNC) using RNA from whole blood collected in RNA-stabilizing PAXgene tubes that addresses this need. Samples were prospectively collected from high-risk and incidental subjects with a positive lung CT scan. A total of 821 samples from 5 clinical sites were analyzed. Malignant samples were predominantly stage 1 by pathologic diagnosis and 97% of the benign samples were confirmed by 4 years of follow-up. A panel of diagnostic biomarkers was selected from a subset of the samples assayed on Illumina microarrays that achieved a ROC-AUC of 0.847 on independent validation. The microarray data were then used to design a biomarker panel of 559 gene probes to be validated on the clinically tested NanoString nCounter platform. RNA from 583 patients was used to assess and refine the NanoString PNC (nPNC), which was then validated on 158 independent samples (ROC-AUC = 0.825). The nPNC outperformed three clinical algorithms in discriminating malignant from benign pulmonary nodules ranging from 6–20 mm using just 41 diagnostic biomarkers. Overall, this platform provides an accurate, noninvasive method for the diagnosis of pulmonary nodules in patients with non–small cell lung cancer.Significance:These findings describe a minimally invasive and clinically practical pulmonary nodule classifier that has good diagnostic ability at distinguishing benign from malignant pulmonary nodules.

Regenüberlaufbecken, Stauraumkanäle und Regenrückhaltebecken entlasten das Kanalnetz und Kläranlagen. Mit einer steigenden Zahl an Bauwerken wachsen auch die Aufgaben zu deren Überwachung, Unterhaltung und Störungsbeseitigung. Der Aggerverband hat alles im Blick.

Introduction: The profunda artery perforator (PAP) flap represents a valuable alternative to the deep inferior epigastric artery perforator flap which, nowadays, is considered the golden standard for autologous breast reconstruction. The goal of this study was to evaluate the long-term satisfaction, functional outcomes of the donor site following PAP flap-based breast reconstruction and to present our personal learning experience along with suggestions for technique refinements. Methods: In this prospective single-center appraisal, 18 patients who underwent PAP flap-based breast reconstruction between January 2016 and November 2019 were enrolled. The Patient and Observer Scar Assessment Scale (POSAS) and the Breast-Q questionnaire were employed to evaluate the results 12 months postoperative. Data were analyzed with the Q-Score program. Complications were recorded in the medical database and classified with the Clavien-Dindo classification. Results: In the questionable time frame, 164 female patients underwent free flap breast reconstruction. Of those, 18 patients that received PAP flaps (9 bilateral) were included in this study. We recorded one flap loss because of venous failure. Most complications concerned the donor site, including hematoma, seroma, and wound healing problems. Patients’ satisfaction was high at 12 months post-surgery, despite critical evaluation of the donor site scar. Conclusion: The PAP flap serves as an excellent option for breast reconstruction in patients who do not have abundant abdominal tissue. The overall clinical outcome was good and patients’ evaluation showed high satisfaction after 12 months despite high complication rates. Modifications in planning and flap harvesting might improve the donor site outcome and the overall complication rate.

Au cœur d’une industrie moderne où la culture populaire s’entremêle avec la culture matérielle, cette étude vise à décrypter, d’un point de vue sémiologique, la présence du langage marketing de Nike à l’intérieur du film Forrest Gump (1994) de Robert Zemeckis. Ce film a été réalisé dans un contexte où les propriétaires de la marque, qui sont remerciés pour leur assistance par les producteurs du film, tentaient de parfaire son image en déposant le nouveau slogan « Just Do It ». Il est donc intéressant d’appréhender la façon dont le réalisateur du film, dans la mise en scène de son personnage principal, Forrest Gump, suggère un lien de causalité entre la pratique du « running » et la chaussure de sport. Du fait de sa forte proéminence audiovisuelle dans l’ensemble du récit, l’histoire de la marque à la virgule se fond dans l’histoire racontée, laquelle contribue à perpétuer in fine sa propre mythologie.

Seshadri constants on abelian surfaces are fully understood in the case of Picard number one. Little is known so far for simple abelian surfaces of higher Picard number. In this paper we investigate principally polarized abelian surfaces with real multiplication. They are of Picard number two and might be considered the next natural case to be studied. The challenge is to not only determine the Seshadri constants of individual line bundles, but to understand the whole Seshadri function on these surfaces. Our results show on the one hand that this function is surprisingly complex: on surfaces with real multiplication in $$\mathbb {Z}[\sqrt{e}]$$ Z [ e ] it consists of linear segments that are never adjacent to each other—it behaves like the Cantor function. On the other hand, we prove that the Seshadri function is invariant under an infinite group of automorphisms, which shows that it does have interesting regular behavior globally.

ZusammenfassungDas Lesen und Verstehen von Beweisen ist eine wichtige Aktivität in der wissenschaftlichen Disziplin Mathematik. In der Studieneingangsphase eines Mathematikstudiums stellt der lernförderliche Umgang mit Beweisen für die meisten Studierenden eine große Herausforderung dar. Beweise zu verstehen heißt nicht nur, einzelne Begründungsschritte im Beweis nachvollziehen, sondern beispielsweise auch, Hauptideen des Beweises identifizieren zu können. Welche individuellen Merkmale mit dem Beweisverständnis zusammenhängen und wie Studierende im Prozess des Beweisverstehens durch die spezifische Strategie der Beispielnutzung unterstützt werden können, steht im Zentrum der präsentierten Studie. 166 Studierenden mehrerer Analysis-Veranstaltungen wurde der Beweis eines Satzes über monotone Teilfolgen von reellwertigen Folgen vorgelegt. Die Studierenden wurden aufgefordert, diesen durchzulesen und Beispiele zu nutzen, um jeden einzelnen Beweisschritt zu illustrieren. Die Art des Illustrierens am Beispiel wurde in verschiedenen Varianten anhand zweier Bedingungen konkretisiert (2 × 2-Design): In der ersten Bedingung („Lernaktivität“) wird unterschieden, ob die Studierenden ein zum gegebenen Beweis passendes Beispiel selbst konstruieren oder ob sie ein vorgegebenes Beispiel passiv nachvollziehen sollen. In der zweiten Bedingung („Darstellungsform des Beispiels“) wird das Beispiel entweder in symbolischer oder in graphischer Form genutzt. Die Ergebnisse zeigen, dass die schulischen Vorleistungen und insbesondere das inhaltliche Vorwissen das Beweisverständnis erwartungskonform stark prädizieren. Für einzelne Unterstützungsvarianten, konkretisiert in den Bedingungen, konnten wir hingegen keine Vorteile für das individuelle Beweisverstehen ausmachen, dagegen geben die konkreten Bearbeitungsprozesse erhellende Einblicke in die Nutzung von Beispielen durch die Lernenden. Die Ergebnisse diskutieren wir in Bezug auf theoretische und praktische Implikationen für Lernprozesse im Mathematikstudium.

In primary metatarsalgia, Distal Minimally invasive Metatarsal Osteotomy (DMMO) achieves a correct load distribution which is a factor in pain relief, but contrary to the elevation of the metatarsal head, shortening the metatarsal length has no influence on plantar-loading parameters, while the increased metatarsal length is a factor in the development of metatarsalgia. Thus, we hypothesized that metatarsalgia could be partly related to a functional imbalance between bone structure and soft tissues and pain relief after DMMO results from soft tissue relaxation. Many authors have highlighted the correlation between joint pressure and periarticular soft tissue tension. To test our hypothesis, we measured intra-operatively the MTPJ pressure of 19 patients suffering from primary metatarsalgia, before and after DMMO. This pressure is being analyzed as a reflection of joint decompression and forefoot soft tissue release. Many authors have highlighted the correlation between joint pressure and periarticular soft tissue tension. Lower metatarsals presenting metatarsalgia show a significantly lower MTPJ pressure compared to asymptomatic rays, and DMMO induces a significant increase of MTPJ pressure. Those variations reflect the functional imbalance between bone structure and soft tissue in primary metatarsalgia. The biomechanical rationale of the shortening effect of DMMO could therefore be explained by the release of forefoot soft tissue, which could take part in the pain relief by restoring this balance.

In this note we contribute to the study of Seshadri constants on abelian and bielliptic surfaces. We specifically focus on bounds that hold on all such surfaces, depending only on the self-intersection of the ample line bundle under consideration. Our result improves previous bounds and it provides rational numbers as bounds, which are potential Seshadri constants.

International audience; Introduction: Since the development of the last generation of implants total ankle replacements (TAR) is becoming more and more popular in patients and in specialized surgeon teams, the trend for outpatient surgery is growing, and protocols now are well established for hip or knee replacement. We adapted a protocol for outpatient TAR and hypothesized that it could be performed safely as standard procedure. Patients and methods: Twenty-five consecutive patients among 141 TAR were treated with our outpatient protocol relying on three fundamentals: bleed control, pain control, and autonomy. They received 1 g of tranexamic acid before surgery, and after discard from post-operative care unit, they were operated under long-lasting nerve block precociously relayed by oral NSAIDs and had an immediate full weight-bearing authorization at discharge. Results: No patients we readmitted for an acute care following TAR, especially for haematoma or uncontrolled pain. Mean VAS was < 1 before discharge from post-operative care unit and < 2 until day 90. One patient had a delayed wound healing treated surgically at day 30 without implant revision. Conclusion: Outpatient TAR is possible and safe if a risk management process is used, and the three basic principles for outpatient procedures are respected: bleed control, pain control, and patient autonomy. We consider now this modality as a routine.

En partant du principe que la caricature constitue une « trace » du temps car « elle est un manifeste : politique, sociologique et psychologique » (Levy Suze, 1994), l’objet de cet article est de decrypter comment certains dessins deformes ont contribue a faconner l’histoire sociale des representations sportives, notamment dans le cadre d’une histoire culturelle. Il s’agit d’analyser les regards portes par divers caricaturistes sur les sœurs Goitschel en s’appuyant particulierement sur les travaux a propos des visual studies. L’idee est de montrer de quelle facon les caricatures, en tant qu’art sportif, permettent une meilleure comprehension de l’histoire du sport. Marielle et Christine Goitschel, toutes deux championnes olympiques de ski alpin en 1964 restent ancrees dans la memoire du sport francais et associees a certains stereotypes diffuses dans l’imaginaire collectif. Pour ce faire, l’etude s’appuie sur un corpus de six dessins, produits par trois dessinateurs aux sensibilites eparses et issus de differents organes de presse francais des annees 1960.

Symmetry-based tailoring of photonic systems recently heralded the advent of novel concepts, such as photonic topological insulators and bound states in the continuum. In optical microscopy systems, similar tailoring was shown to result in tighter focusing, spawning the field of phase- and polarization-tailored light. Here, we show that even in the fundamental case of 1D focusing using a cylindrical lens, symmetry-based phase tailoring of the input field can result in novel features. Dividing the beam or utilizing a π phase shift for half the input light along the non-invariant focusing direction, these features include a transverse dark focal line and a longitudinally polarized on-axis sheet. While the former can be used in dark-field light-sheet microscopy, the latter, similar to the case of a radially polarized beam focused by a spherical lens, results in a z polarized sheet with reduced lateral size when compared with the thickness of a transversely polarized sheet produced by focusing a non-tailored beam. Moreover, the switching between these two modalities is achieved by a direct 90° rotation of the incoming linear polarization. We interpret these findings in terms of the requirement to adapt the symmetry of the incoming polarization state to match the symmetry of the focusing element. The proposed scheme may find application in microscopy, probing anisotropic media, laser machining, particle manipulation, and novel sensor concepts.

Myositis ossificans traumatica (MOT) describes a benign form of ectopic ossification of soft tissue, most commonly skeletal muscle, that occurs in reaction to trauma. Treatment is indicated if important neurovascular structures are compressed or displaced and in case of functional restrictions that hamper movements of daily life. We report the case of a patient who developed increasing palsy of the left deltoid and biceps brachii muscles 8 weeks after multiple injuries sustained in a car accident. Ultrasound and x-rays pointed towards a calcified mass compressing the left brachial plexus. Four months after the precipitating trauma, the mass was surgically resected. Surgical exploration and histopathology yielded the diagnosis of MOT. At a 3-month follow-up visit, the patient experienced complete functional recovery and has remained recurrence free. To our knowledge, this case represents the first report in which MOT caused complete brachial plexus palsy. The findings support the argument that surgical treatment for MOT does not have to be delayed until 6–12 months after the initial trauma to await full maturation. Clinical symptoms extending to complete palsy can result from posttraumatic ectopic calcification. Early surgical intervention in the case of persistence or deterioration of symptoms is indicated. A full remission of nerve and motor function is possible. Level of evidence: Level V, risk/prognostic study.

Concentrated solar power (CSP) plants with thermal energy storage (TES) system are emerging as one kind of the most promising power plants in the future renewable energy system, since they can supply dispatchable and low-cost electricity with abundant but intermittent solar energy. In order to significantly reduce the levelized cost of electricity (LCOE) of the present commercial CSP plants, the next generation CSP technology with higher process temperature and energy efficiency is being developed. The TES system in the next generation CSP plants works with new TES materials at higher temperatures (> 565 °C) compared to that with the commercial nitrate salt mixtures. This paper reviews recent progress in research and development of the next generation CSP and TES technology. Emphasis is given on the advanced TES technology based on molten chloride salt mixtures such as MgCl2/NaCl/KCl which has similar thermo-physical properties as the commercial nitrate salt mixtures, higher thermal stability (> 800 °C), and lower costs (

International audience; cinematic studies support that the fiction film, though distorted by a socially constructed point of view, can be used to extract the salient elements circulating in the collective imaginary. if analyses on sports movies have been prolific these last years, ping-pong has often been left out, considered in collective representations as a pleasant form of entertainment rather than a real sport. Based on a representative sample of twenty nine international films in which the ping-pong ball plays a key narrative role, this article aims to go beyond the common interpretation of ping-pong which is based on its asian background and comical nature, and to establish a more comprehensive cinematic cartography. We conclude that directors interested in social values often take ping-pong as a suggestive metaphor to illustrate life, particularly love in all its forms, humanity in relation to history, education and cultural diversity.