“Only 50% of randomized trials have high level of confidence in arthroscopy and sports medicine”—a spin-based assessment

2021 ◽  
Author(s):  
Girinivasan Chellamuthu ◽  
Sathish Muthu ◽  
Udaya Kumar Damodaran ◽  
Rajkumar Rangabashyam
Keyword(s):  
Sports Medicine ◽  
Randomized Trials ◽  
Level Of Confidence ◽  
High Level

scholarly journals THE PREVENTION METHOD OF SPORTS MEDICINE IMAGING MODELING

2021 ◽  
Vol 27 (8) ◽  
pp. 833-836
Author(s):  
Fei Wu ◽  
Xuejun Ma ◽  
Wenjiang Zhao ◽  
Shuhua Qu
Keyword(s):  
Sports Medicine ◽  
Main Type ◽  
Sports Injury ◽  
Acute Injury ◽  
Chronic Injury ◽  
Level Of Evidence ◽  
Prevention Method ◽  
High Level ◽  
And Control ◽  
Type Of Injury

ABSTRACT Introduction: Sports injury is an important reason to interfere with sports training and physical exercise since it will not only bring unnecessary pain to the injured body, but also bring out negative emotions in athletes. Objective: To study the sports injury characteristics of high level competitive aerobics athletes in China. Methods: Literature data, questionnaire survey, expert interviews, field observation, mathematical statistics and physiotherapy tracking were used. Results: Wrists, ankles, waist and knees were the most frequently injured parts in high level competitive aerobics athletes in China. The main type of injury was acute injury, but chronic injury (48.18%) could not be ignored. Ninety percent of active high-level competitive aerobics athletes train with injuries, and 10 percent of them completely stop training because of injuries. Conclusions: Athletes should pay attention to their physical reserve and strengthen physical training. They must also be attentive to self-supervision, their own subjective feelings, and control the amount of exercise done. Level of evidence II; Therapeutic studies - investigation of treatment results.

Association Between 45° Flexion Anteroposterior Elbow Radiographs and Diagnostic Accuracy of Capitellum Osteochondritis Dissecans

2021 ◽  
pp. 036354652110271
Author(s):  
Michael G. Saper ◽  
Viviana Bompadre ◽  
Gregory A. Schmale ◽  
Sarah Menashe ◽  
Monique Burton ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Osteochondritis Dissecans ◽  
Predictive Value ◽  
Interobserver Reliability ◽  
Intraobserver Reliability ◽  
Control Group ◽  
Level Of Evidence ◽  
Level Of Confidence ◽  
High Level ◽  
Sensitivity Specificity

Background: An anteroposterior (AP) radiograph of the elbow in 45° of flexion has been suggested to increase the diagnostic accuracy of capitellum osteochondritis dissecans (OCD). Purpose: To assess the diagnostic performance, inter- and intraobserver reliability, and confidence level for identifying capitellum OCD using plain radiographs (AP, lateral, and 45° flexion AP). Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: This was a retrospective study of pediatric and adolescent patients with capitellum OCD and a control group. Six independent clinicians who were blinded to the official radiologists’ reports reviewed images on 2 separate occasions, 1 week apart. A 5-point Likert scale was used to assess the clinicians’ level of confidence. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for individual and combinations of radiographic views. Inter- and intraobserver reliability was determined using Cohen kappa (κ) coefficients. Results: A total of 28 elbows (mean age, 12.5 ± 2 years) were included. There were no differences in age ( P = .18), sex ( P = .62), or laterality ( P > .999) between groups. There were marked variations in the diagnostic accuracy between views: sensitivity (AP, 85.1; lateral, 73.2; 45° flexion AP, 91.7), specificity (AP, 89.3; lateral, 91.7; 45° flexion AP, 91.1), PPV (AP, 88.8; lateral, 89.8; 45° flexion AP, 91.1), NPV (AP, 85.7; lateral, 77.4; 45° flexion AP, 91.6), and accuracy (AP, 87.2; lateral, 82.4; 45° flexion AP, 91.4). Standard radiographs (AP and lateral views) failed to diagnose capitellum OCD in 4.8% of cases. The sensitivity of the 3 combined views was 100%. Confidence intervals in the clinicians’ diagnostic assessments were similar for each view (AP, 4.0; lateral, 4.0; and 45° flexion AP, 4.1). Interobserver reliability was substantial for AP and lateral views (κ = 0.65 and κ = 0.60, respectively) but highest for the 45° flexion AP radiographs (κ = 0.72). Intraobserver reliability for the 45° flexion AP view was moderate to almost perfect (κ = 0.45 to 0.93). Conclusion: The 45° flexion AP view can detect capitellum OCD with excellent accuracy, a high level of confidence, and substantial interobserver agreement. When added to standard AP and lateral radiographs, the 45° flexion AP view aids in the identification of capitellum OCD.

An Enquiry into the Determinants of a Differentiation between Elderly “Organic” and “Non-Organic” Psychiatric Patients on the Bender Gestalt Test

1957 ◽  
Vol 103 (431) ◽  
pp. 364-374 ◽  
Author(s):  
M. B. Shapiro ◽  
Jack Field ◽  
F. Post
Keyword(s):  
Psychiatric Patients ◽  
General Purpose ◽  
The Other ◽  
Level Of Confidence ◽  
Visual Motor ◽  
High Level ◽  
Bender Gestalt Test ◽  
And Control

In a previous study, Shapiro, Post, Lofving and Inglis (10) found that a modified version of the Bender Visual-Motor Gestalt Test differentiated, at a high level of confidence, three groups of elderly psychiatric patients: brain-damaged patients, functionals and a group of doubtful diagnosis. This level of confidence was far higher than that of any of the other 24 tests used. Furthermore, a number of recent studies have shown that the Bender test differentiated Organic from non-Organic subjects (2, 4, 6, 7, 8). In our own Department Yates (13) found significant differences on measures of the reproductions of other designs between Organics and Functionals. In view of these findings we decided to investigate our own results further. Our general purpose was to measure and control some of the variables appearing relevant in the performance of the task and in this way make possible testable explanations for the results.

scholarly journals Return-to-Play Considerations Following a COVID-19 Infection in Elite Athletes

2021 ◽  
Author(s):  
Ryan Ross ◽  
Laura Irvin ◽  
Rich Severin ◽  
Brian Ellis
Keyword(s):  
Sports Medicine ◽  
Sport Participation ◽  
Elite Athletes ◽  
Return To Play ◽  
Strength And Conditioning ◽  
Unique Challenge ◽  
Orthopedic Injuries ◽  
High Level ◽  
Isolation Period ◽  
Prolonged Absence

Abstract The COVID-19 pandemic has created a unique challenge for sports medicine staffs as they are attempting to safely transition elite athletes into sport participation after a COVID-19 infection. Athletes must isolate for a period of time after testing positive for COVID-19 to prevent the spread of the virus within a community. After an isolation period, a battery of cardiac tests must be given to assess whether or not an athlete is ready to begin a reconditioning protocol. A return-to-play plan should be established to safely re-integrate high-level athletes into strength and conditioning, sport-specific drill work, and contact drill work. Elite athletes should also be gradually eased back into full training loads in order to avoid increases in orthopedic injuries after a prolonged absence from training.

scholarly journals The impact of attacks on urban services II: Reverberating effects of damage to water and wastewater systems on infectious disease

2021 ◽  
pp. 1-33
Author(s):  
Michael Talhami ◽  
Mark Zeitoun
Keyword(s):  
Infectious Disease ◽  
Armed Conflict ◽  
Evidence Base ◽  
Armed Conflicts ◽  
Strong Base ◽  
Untreated Wastewater ◽  
Level Of Confidence ◽  
Water And Wastewater ◽  
High Level ◽  
The Impact

Abstract This article investigates the effects that attacks during armed conflict which damage water and wastewater services have on the outbreak and transmission of infectious disease. It employs a lens of uncertainty to assess the level of knowledge about the reverberations along this consequential chain and to discuss the relevance to military planning and targeting processes, and to the laws of armed conflict. It draws on data in policy reports and research from a wide variety of contexts, and evidence from protracted armed conflicts in Iraq, Yemen and Gaza. The review finds a strong base of evidence of the impact of attacks on water and wastewater services, and a high level of confidence in information about the transmission of infectious disease. One clear risk identified is when people are exposed to water supplies which are contaminated by untreated wastewater. Obtaining a similar level of confidence about the cause and effect along the full consequential chain is challenged by numerous compounding variables, though there are a number of patterns related to the duration of the armed conflict within which the attacks occur. As the conflict protracts, both the risk of the spread of infectious disease and the evidence base for gauging the reverberating effects becomes stronger, for example. The article concludes that the reverberating effects of damage from an attack can be foreseen in some contexts and can be expected to become more foreseeable over time. The analysis suggests that the most pragmatic path for military institutions and those involved in targeting operations to take this knowledge into account is through a “precautionary approach” which assumes the existence of the reverberating effects, and works them in to the standard information-gathering and planning processes.

scholarly journals Multicenter study on the diagnostic performance of multiframe volumetric laser endomicroscopy targets for Barrett’s esophagus neoplasia with histopathology correlation

2020 ◽  
Vol 33 (12) ◽  
Author(s):  
M R Struyvenberg ◽  
A J de Groof ◽  
A Kahn ◽  
B L A M Weusten ◽  
D E Fleischer ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Barrett’S Esophagus ◽  
Sensitivity And Specificity ◽  
Barrett's Esophagus ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Random Order ◽  
Automatic Assessment ◽  
Level Of Confidence ◽  
High Level

Abstract Volumetric laser endomicroscopy (VLE) has been shown to improve detection of early neoplasia in Barrett’s esophagus (BE). However, diagnostic performance using histopathology-correlated VLE regions of interest (ROIs) has not been adequately studied. We evaluated the diagnostic accuracy of VLE assessors for identification of early BE neoplasia in histopathology-correlated VLE ROIs. In total, 191 ROIs (120 nondysplastic and 71 neoplastic) from 50 BE patients were evaluated in a random order using a web-based module. All ROIs contained histopathology correlations enabled by VLE laser marking. Assessors were blinded to endoscopic BE images and histology. ROIs were first scored as nondysplastic or neoplastic. Level of confidence was assigned to the predicted diagnosis. Outcome measures were: (i) diagnostic performance of VLE assessors for identification of BE neoplasia in all VLE ROIs, defined as accuracy, sensitivity, and specificity; (ii) diagnostic performance of VLE assessors for only high level of confidence predictions; and (iii) interobserver agreement. Accuracy, sensitivity, and specificity for BE neoplasia identification were 79% (confidence interval [CI], 75–83), 75% (CI, 71–79), and 81% (CI, 76–86), respectively. When neoplasia was identified with a high level of confidence, accuracy, sensitivity, and specificity were 88%, 83%, and 90%, respectively. The overall strength of interobserver agreement was fair (k = 0.29). VLE assessors can identify BE neoplasia with reasonable diagnostic accuracy in histopathology-correlated VLE ROIs, and accuracy is enhanced when BE neoplasia is identified with high level of confidence. Future work should focus on renewed VLE image reviewing criteria and real-time automatic assessment of VLE scans.

Aktualisasi Nilai-Nilai Keagamaan saat Menghadapi Pandemi Covid-19

2021 ◽  
Vol 4 (2) ◽  
pp. 189-196
Author(s):  
Ace Somantri ◽  
Erwan Komara ◽  
Nurlaela Hamidah
Keyword(s):  
Large Scale ◽  
Qualitative Approach ◽  
Religious Values ◽  
Spiritual Values ◽  
Time Data ◽  
Cross Sectional ◽  
Muslim Students ◽  
Work From Home ◽  
Level Of Confidence ◽  
High Level

The environment in its various forms, both of physical and in the form of situation, can change humans to be good or vice versa. The environment can also be a stimulant for humans to do something they think is good. With the Covid-19 pandemic, the environment around humans is in a state filled with anxiety. There are at least two main causes: 1) news of death that he hears all the time and 2) uncertainty about the end of this pandemic. Coupled with the government's policies for Work from Home (WfH) and Large-Scale Social Restrictions. it makes the community even more burdened. This research method and approach uses a descriptive qualitative approach and is expected to provide an overview of student religious behavior in dealing with the Covid-19 pandemic. In addition, the type of research is qualitative. Approach research used is a cross sectional studies approach, because this research is carried out at a certain time. Data collection techniques are generally carried out through the submission of a series of questions (questionaries) after which interviews (interviews) will be conducted to several respondents, both structured and unstructured. Presentation of data and submission of reports is done through descriptive method The level of confidence in students' faith in the Covid-19 period when in online learning activities (WFH) showed a very high value reaching a percentage of 99.7%, a high level of confidence increased Muslim students' trust in Allah SWT. In the face of covid-19, Muslim students to be more calm in doing dhikr to Allah SWT reached 70.9% and to actualize Islamic religious values, the majority of students made donations to those affected by covid-19 reaching 33.95% - 68.4%, this is the condition of students Muslims in dealing with Covid-19 psychologically prioritize religious spiritual values.  Keyword : Actualization of Religious Values, Islamic Behavior of Students, Overcoming the Covid-19

Efficiency Technological Ways in Economy of New Zealand

2019 ◽  
Vol 6 (6) ◽  
pp. 127-132
Author(s):  
Андрей Шишкин ◽  
Andrey Shishkin ◽  
Светлана Гришина ◽  
Svetlana Grishina
Keyword(s):  
Economic Evaluation ◽  
New Zealand ◽  
Fourth Order ◽  
Long Waves ◽  
Way Of Life ◽  
The Third ◽  
Maximum Productivity ◽  
Level Of Confidence ◽  
High Level ◽  
Technological Mode

In the present work new results were obtained characterizing the economic evaluation of efficiency of technological structures in New Zealand economy. This study is based on the analysis of Kondratiev long waves. With the help of Kondratiev wave was carried out an analysis of the dates of transition from one to another structure in New Zealand economy. The dating allowed us to determine the limits of the existence of one way of life as precisely as possible and the beginning of the birth of another. Thus, the productivity of relic structures in the economy of New Zealand, the fifth and sixth modes, was established. The productivity of the fourth order by using this model had a sufficiently high level of error, which did not allow to determine its productivity with the greatest accuracy. The productivity of relict structures in the New Zealand economy is 2,655.12 Geri-Hemis 2005 dollars. The maximum productivity of the fifth technological order in the New Zealand economy is 16,976.42 thousand Geri-Hemis dollars 2005. The maximum productivity of the sixth technological order in the economy of New Zealand is 27,915.42 thousand Geri-Hemis dollars 2005 The efficiency of the third technological mode when using this model with the highest level of confidence could not be determined.

scholarly journals Outcome of patients with pregnancy during or after breast cancer: a review of the recent literature

2014 ◽  
Vol 22 ◽  
pp. 8 ◽  
Author(s):  
J. Raphael ◽  
M.E. Trudeau ◽  
K. Chan
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Randomized Trials ◽  
Recent Literature ◽  
Stage At Diagnosis ◽  
Control Groups ◽  
Level Of Evidence ◽  
Web Based ◽  
High Level ◽  
Meta Analyses

BackgroundAn increasing number of young women are delaying childbearing; hence, more are diagnosed with breast cancer (bca) before having a family. No clear recommendations are currently available for counselling such a population on the safety of carrying a pregnancy during bca or becoming pregnant after treatment for bca.MethodsUsing a Web-based search of PubMed we reviewed the recent literature about bca and pregnancy. Our objective was to report outcomes for patients diagnosed with bca during pregnancy, comparing them with outcomes for non-pregnant women, and to evaluate prognosis in women diagnosed with and treated for bca who subsequently became pregnant.Results“Pregnancy and bca” should be divided into two entities. Pregnancy-associated bca tends to be more aggressive and advanced in stage at diagnosis than bca in control groups; hence, it has a poorer prognosis. With respect to pregnancy after bca, there is, despite the bias in reported studies and meta-analyses, no clear evidence for a different or worse disease outcome in bca patients who become pregnant after treatment compared with those who do not.ConclusionsPregnancy-associated bca should be treated as aggressively as and according to the standards applicable in nonpregnant women; pregnancy after bca does not jeopardize outcome. The guidelines addressing risks connected to pregnancy and bca lack a high level of evidence for better counselling young women about pregnancy considerations and preventing unnecessary abortions. Ideally, evidence from large prospective randomized trials would set better guidelines, and yet the complexity of such studies limits their feasibility.

scholarly journals Intracranial Pressure Monitoring in Severe Traumatic Brain Injury – Results of a Canadian Survey

2000 ◽  
Vol 27 (2) ◽  
pp. 143-147 ◽  
Author(s):  
Ramesh Sahjpaul ◽  
Murray Girotti
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Prospective Trial ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Level Of Confidence ◽  
Routine Monitoring ◽  
Severe Tbi ◽  
High Level

ABSTRACT:Objective:The purpose of this study was to obtain information from Canadian neurosurgeons regarding their opinions on, and utilization of, intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI).Methods:A brief survey was sent to practicing Canadian neurosurgeons questioning them about their utilization of, and confidence in, intracranial pressure monitoring in the management of patients with severe TBI.Results:One hundred and ninety-six surveys were mailed. There were 103 responses for a response rate of 52.6%. The vast majority of responding neurosurgeons (98.1%) utilized ICP monitoring in the management of patients with severe TBI, with most (63.4%) using it in more than 75% of their patients, 14.9% using it in 50-75% of patients, 14.9% in 25-50% of patients, and 6.9% using it in less than 25% of patients. The level of confidence that routine monitoring improves outcome from severe TBI ranged from 23.3% having a low level of confidence, 56.3% having an intermediate level of confidence, to 20.4% having a high level of confidence. Most respondents (78.6%) felt that some form of prospective trial evaluating the role of ICP monitoring in improving outcome from severe TBI was warranted; 17.4% felt such a trial was not warranted and 3.9% were uncertain.Conclusions:While ICP monitoring has gained almost universal acceptance among responding Canadian neurosurgeons, their level of confidence that routine monitoring improves outcome from severe TBI was quite variable, with only 20.4% of respondents having a high level of confidence. Over 75% of respondents felt that some form of prospective trial evaluating the utility of ICP monitoring is warranted. This information is being used in consideration of a prospective trial addressing this issue.

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