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Complex astrophysical systems often exhibit low-scatter relations between observable properties (e.g., luminosity, velocity dispersion, oscillation period). These scaling relations illuminate the underlying physics, and can provide observational tools for estimating masses and distances. Machine learning can provide a fast and systematic way to search for new scaling relations (or for simple extensions to existing relations) in abstract high-dimensional parameter spaces. We use a machine learning tool called symbolic regression (SR), which models patterns in a dataset in the form of analytic equations. We focus on the Sunyaev-Zeldovich flux-cluster mass relation (YSZ - M), the scatter in which affects inference of cosmological parameters from cluster abundance data. Using SR on the data from the IllustrisTNG hydrodynamical simulation, we find a new proxy for cluster mass which combines YSZ and concentration of ionized gas (cgas): M â Yconc3/5 ≡ YSZ3/5(1 - A cgas). Yconc reduces the scatter in the predicted M by â¼20 - 30% for large clusters (M â³ 1014 h-1 Mâ), as compared to using just YSZ. We show that the dependence on cgas is linked to cores of clusters exhibiting larger scatter than their outskirts. Finally, we test Yconc on clusters from CAMELS simulations and show that Yconc is robust against variations in cosmology, subgrid physics, and cosmic variance. Our results and methodology can be useful for accurate multiwavelength cluster mass estimation from upcoming CMB and X-ray surveys like ACT, SO, eROSITA and CMB-S4.
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Dark photons that kinetically mix with the Standard Model photon give rise to new spectral anisotropies (patchy dark screening) in the cosmic microwave background (CMB) due to conversion of photons to dark photons within large-scale structure. We utilize predictions for this patchy dark screening signal to provide the tightest constraints to date on the dark photon kinetic mixing parameter [ϵâ²4.5×10^{-8} (95% confidence level)] over the mass range 10^{-13} eVâ²m_{A^{'}}â²10^{-11} eV, almost an order of magnitude stronger than previous limits, by applying state-of-the-art component separation techniques to the cross-correlation of Planck CMB and unWISE galaxy survey data.
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New aug-cc-pVnZ-PP-F12 basis sets (n = D, T, Q) for the heavy p-block elements, Ga-Kr, In-Xe, and Tl-Rn, have been developed by augmenting the cc-pVnZ-PP-F12 sets with additional higher angular momentum diffuse functions. These basis sets have been optimized for use in explicitly correlated F12 calculations, and matching auxiliary basis sets for density fitting of conventional and F12 integrals have also been developed. The new sets have been validated with benchmark CCSD(T)-F12b calculations of electron affinities, where an accelerated convergence to the complete basis set limit is evident. The effect of the additional diffuse functions on electron affinities is shown to be comparable to the effect of correlating the outer-core d electrons.
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BACKGROUND: Non-pharmaceutical interventions (NPIs) were crucial in the response to the COVID-19 pandemic, although uncertainties about their effectiveness remain. This work aimed to better understand the evidence generated during the pandemic on the effectiveness of NPIs implemented in the UK. METHODS: We conducted a rapid mapping review (search date: 1 March 2023) to identify primary studies reporting on the effectiveness of NPIs to reduce COVID-19 transmission. Included studies were displayed in an interactive evidence gap map. RESULTS: After removal of duplicates, 11 752 records were screened. Of these, 151 were included, including 100 modelling studies but only 2 randomized controlled trials and 10 longitudinal observational studies.Most studies reported on NPIs to identify and isolate those who are or may become infectious, and on NPIs to reduce the number of contacts. There was an evidence gap for hand and respiratory hygiene, ventilation and cleaning. CONCLUSIONS: Our findings show that despite the large number of studies published, there is still a lack of robust evaluations of the NPIs implemented in the UK. There is a need to build evaluation into the design and implementation of public health interventions and policies from the start of any future pandemic or other public health emergency.
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COVID-19 , SARS-CoV-2 , COVID-19/prevenção & controle , COVID-19/transmissão , COVID-19/epidemiologia , Humanos , Reino Unido/epidemiologia , Pandemias/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Lacunas de EvidênciasRESUMO
Current prospective reports suggest a pandemic-related increase in adolescent mental health problems. We examine whether age-related change over 11-14 years accounts for this increase. Mothers and adolescents in a UK-based birth cohort (Wirral Child Health and Development Study; WCHADS; N = 737) reported on adolescent depression and behavioural problems pre-pandemic (December 2019-March 2020), mid-pandemic (June 2020-March 2021) and late pandemic (July 2021-March 2022). Analysis used repeated measures models for over-dispersed Poisson counts with an adolescent-specific intercept with age as a time-varying covariate. Maturational curves for girls, but not for boys, showed a significant increase in self-reported depression symptoms over ages 11-14 years. Behavioural problems decreased for both. After adjusting for age-related change, girls' depression increased by only 13% at mid-pandemic and returned to near pre-pandemic level at late pandemic (mid versus late - 12%), whereas boys' depression increased by 31% and remained elevated (mid versus late 1%). Age-adjusted behavioural problems increased for both (girls 40%, boys 41%) and worsened from mid- to late pandemic (girls 33%, boys 18%). Initial reports of a pandemic-related increase in depression in young adolescent girls could be explained by a natural maturational rise. In contrast, maturational decreases in boys' depression and both boys' and girls' behavioural problems may mask an effect of the pandemic.
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COVID-19 , Depressão , Saúde Mental , Humanos , Adolescente , COVID-19/epidemiologia , COVID-19/psicologia , Feminino , Masculino , Criança , Reino Unido/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Comportamento Problema/psicologia , Fatores SexuaisRESUMO
INTRODUCTION: Previous studies have identified that there is limited, although expanding, access to acute hand care in Tennessee. Because of the rapid changes that occurred in health delivery and access during the coronavirus disease pandemic, we reassessed access to acute hand care, with particular interest in the utilization of telemedicine to assess if this increased access. METHOD: We surveyed Tennessee hospitals listed by the Tennessee Hospital Association on their management of hand trauma and availability of telemedicine programs. Census data including population demographics such as race, age, income, and county size were merged with the survey data. Descriptive analysis was performed comparing the 2021 cohort with the historic 2018 cohort and between counties that had hand care versus counties that had no hand care. RESULT: Survey response rate was 71.4% (n = 80 of 112). Telemedicine was used in 80% of the hospitals for other specialties but was not used for hand care. Overall, counties that offered hand trauma care reduced from 60% to 26% from 2018 to 2021 ( P < 0.001). This change was associated with a significant reduction of acute hand care among counties that were classified micropolitan (from 56.3% to 6.7%, P < 0.01). Percentage of hand specialists on staff and 24/7 specialists availability remained low and were similar to the availability in 2018. CONCLUSIONS: There was a decrease of acute hand care access in Tennessee during the coronavirus disease pandemic despite widespread utilization of telemedicine for other specialty consults. Expansion of telemedicine in acute hand care, targeted to micropolitan areas, may help to reduce variability in access to care.
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COVID-19 , Traumatismos da Mão , Telemedicina , Humanos , Tennessee/epidemiologia , COVID-19/epidemiologia , Pandemias , HospitaisRESUMO
INTRODUCTION: Whether endoscopic carpal tunnel release (ECTR) versus open carpal tunnel release (OCTR) has superior outcomes remains a controversial topic. Therefore, we sought to perform an umbrella review and meta-analysis to compare ECTR and OCTR with regards to (1) postoperative functional ability, (2) operative outcomes, and (3) time to return to work. METHODS: A PubMed, Scopus, and Cochrane database search was conducted for all meta-analyses comparing ECTR and OCTR performed between 2000 and 2022 in accordance to PRISMA and Joanna Briggs Institute guidance for umbrella reviews. The primary outcomes were as follows: (1) functional ability-symptoms severity, postoperative grip strength, postoperative pinch strength, 2-point discrimination, and pain; (2) operative outcomes-operation time, total complications, nerve injury, and scar-related complication; and (3) time to return to work. Quality was assessed using the Assessment of Multiple Systematic Reviews. Pooled analysis was performed to compare several clinical outcome measures between groups, depending on the availability of data using Review Manager Version 5.2.11. RESULTS: A total of 9 meta-analyses were included, 5 were of high quality and 4 were moderate quality. For functional ability, ECTR was associated with better pinch strength after 3 months (0.70, 95% confidence interval [CI] = 0.00, 1.40, P = 0.05) and 6 months (0.77, 95% CI = 0.14, 1.40, P = 0.02, I2 = 84%). For return to work, OCTR was associated with longer return to work compared with ECTR (-10.89, 95% CI = -15.14, -6.64, P < 0.00001, I2= 83%). There were no significant differences between OCTR and ECTR in the hand function, symptom severity, grip strength, pain, operation time, and total complications. CONCLUSIONS: In an umbrella review and meta-analysis of ECTR versus OCTR, ECTR was associated with a higher pinch strength, and a shorter time to return to work. Differences in major complications, such as nerve injury, were unclear due to statistical inconsistency and bias.
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Síndrome do Túnel Carpal , Endoscopia , Humanos , Síndrome do Túnel Carpal/cirurgia , Endoscopia/métodos , Retorno ao Trabalho/estatística & dados numéricos , Recuperação de Função Fisiológica , Resultado do Tratamento , Descompressão Cirúrgica/métodosRESUMO
BACKGROUND: The prevalence of failed reverse total shoulder arthroplasty (rTSA) is increasing. This can often present a challenging clinical situation with substantial bone loss and limited reconstruction options. This study reports a single tertiary referral center's experience with revision of failed rTSA managed with revision rTSA of bone-interfacing components. METHODS: After institutional review board approval, all revision shoulder arthroplasty cases performed at a single institution between 2012 and 2020 were reviewed. Cases in which rTSA was revised to a new rTSA construct with revision of at least 1 bone-interfacing implant (humeral stem and/or baseplate) with a minimum 2-year follow-up were identified. Characteristics of revision cases-including indications, bony stock, revised components, and use of bone graft-were collected. All patients were contacted for patient-reported outcome measures at a minimum of 2 years after surgery. In addition, the incidence and indication for any reoperation after revision were determined. RESULTS: Thirty-three patients with an average age of 66 years (range: 46-82 years), with 19 (58%) being female, met the inclusion criteria and had a mean follow-up of 4.2 years (range: 2-8 years). The most common indication for revision rTSA included humeral component loosening (33%; 11/33), baseplate loosening (27%; 9/33), and instability (21%; 7/33). Prerevision infectious workup demonstrated no cases of periprosthetic shoulder infection. Thirteen cases had massive bone loss-5 treated with humeral allograft prosthetic composite, 5 with glenoid bone grafting, and 3 with custom glenoid implant. In total, 10 of 33 cases (30%) required reoperation at a mean of 13 months (range: 1-44 months) for instability (4), humeral loosening (2), infection (1), baseplate loosening (1), or periprosthetic fracture (1). The reoperation rate for patients with revised baseplates only, humerus only, or combined was 23% (3/13), 28% (5/18), and 27% (3/11), respectively. Overall, the visual analog scale pain score improved from 6.5 preoperatively to 2.0 (P < .001), and the American Shoulder and Elbow Surgeons score improved from 30.7 to 67.5 (P < .001). However, the postoperative Single Assessment Numeric Evaluation score averaged only 51.2% (range: 2-100%). CONCLUSION: This study demonstrates that failed rTSA can be salvaged with a revision rTSA. However, patient expectations for functional improvements should be tempered, and a high reoperation rate should be expected.
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Artroplastia do Ombro , Articulação do Ombro , Prótese de Ombro , Humanos , Feminino , Idoso , Masculino , Artroplastia do Ombro/efeitos adversos , Articulação do Ombro/cirurgia , Resultado do Tratamento , Estudos Retrospectivos , Escápula/cirurgia , Reoperação , Amplitude de Movimento ArticularRESUMO
INTRODUCTION: Optimal management of retroversion in anatomic total shoulder arthroplasty (aTSA) remains controversial and limited attention has been directed to the impact of glenoid inclination. Prior biomechanical study suggest that residual glenoid inclination generates shear stresses that may lead to early glenoid loosening. Combined biplanar glenoid deformities may complicate anatomic glenoid reconstruction and affect outcomes. The goal of this matched-cohort analysis was to assess the relationship between biplanar deformities and mid-term radiographic loosening in aTSA. METHODS: The study cohort was identified via an institutional repository of 337 preoperative CT scans from 2010-2017. Glenoid retroversion, inclination, and humeral head subluxation were assessed via 3D-planning software. Patients with retroversion ≥ 20Ë and inclination ≥ 10Ë who underwent aTSA with eccentric reaming and non-augmented components were matched by age, sex, retroversion, and Walch classification to patients with retroversion ≥ 20Ë only. Primary outcome was glenoid component Lazarus radiolucency score. RESULTS: Twenty-eight study subjects were matched to 28 controls with retroversion only. No difference in age (61.3 vs. 63.6 years, p=0.26), sex (19 [68%] vs. 19 [68%] male, p=1.0), or follow-up (6.1 vs. 6.4 years, p=0.59). Biplanar deformities had greater inclination (14.5Ë versus 5.3Ë, p<0.001), retroversion (30.0Ë versus 25.6Ë, p=0.01) and humeral subluxation (86.3% versus 82.1%, p=0.03). Biplanar patients had greater postoperative implant superior inclination (5.9 [4.6] vs. 3.0 [3.6] degrees, p=0.01) but similar rate of complete seating 24 [86%] vs. 24 [86%] p=1.0). At final follow-up, biplanar subjects had higher Lazarus radiolucent scores (2.4 [1.7] vs. 1.6 [1.1], p=0.03) and higher proportion of patients with glenoid radiolucency (19 [68%] vs. 11 [39%], p=0.03). No difference in complete component seating (86% versus 86%, p=0.47) or initial radiolucency grade (0.21 versus 0.29, p=0.55) on immediate postop radiographs. Biplanar patients demonstrated a greater amount of posterior subluxation at immediate postop(3.5% [1.3%] versus 1.8% [0.6%]; p=0.03) and final follow-up (7.6% [2.8%] versus 4.0% [1.8%]; p=0.04). At final radiographic follow-up, biplanar subjects had higher Lazarus radiolucent scores (2.4 [1.7] vs. 1.6 [1.1], p=0.03; ICC=0.82). Bivariate regression analysis demonstrated biplanar deformity was the only significant predictor (OR 3.3, p=0.04) of glenoid radiolucency. CONCLUSION: Biplanar glenoid deformity resulted in time-zero glenoid implant superior inclination and increased mid-term radiographic loosening and posterior subluxation. Attention to glenoid inclination is important for successful anatomical glenoid reconstruction. Future research is warranted to understand the long-term implications of these findings and impact of utilizing augmented implants or reverse shoulder arthroplasty to manage biplanar deformities.
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BACKGROUND: Descriptions of glenoid deformities in glenohumeral osteoarthritis (GHOA) have focused on the axial plane. Less is known regarding arthritic glenoids with higher amounts of superior inclination and little evidence exists to guide management of inclination or combined version-inclination deformity when performing anatomic total shoulder arthroplasty (aTSA). We hypothesized that biplanar deformities (BD) would be present in a higher proportion of GHOA patients than previously appreciated, and these deformities would be difficult to adequately reconstruct with contemporary aTSA implants. METHODS: A retrospective query was performed of GHOA patients indicated for TSA 2012-2017 with a computed tomography (CT) scan within three months of surgery. Images were uploaded to three-dimensional (3D) software for automated measurements. Glenoids with superior inclination ≥10°, and retroversion ≥20° were considered to have BD. Walch classification was determined, and C-type glenoids were excluded. Rotator-cuff muscle cross-sectional area (CSA) was measured and fatty infiltration was graded. Glenoids with BD were virtually planned for aTSA with correction to neutral inclination and version, then with 5° superior inclination and 10° retroversion. RESULTS: Two-hundred and sixty-eight shoulders in 250 patients were included; average age was 65 years, 67% male. There were no differences in inclination between Walch types (P = .25). Twenty-nine shoulders with BD were identified (11%). These deformities were not associated with age (P = .47) or gender (P = .50) but were skewed towards Walch B-type, specifically B2 (P = .03). Acromial index and posterior humeral head subluxation were higher in BD patients (P = .04, P < .001, respectively). Biplanar deformities had similar cuff CSA compared to those without but were less frequently associated with fatty infiltration of the subscapularis (P = .05). When correcting to neutral version and inclination, 41% BD could not be reconstructed. Of those that could, 94% required augmented implants. When correcting to 5° superior inclination and 10° retroversion, 10% could not be reconstructed. Of those that could, 58% required augmented implants. With partial correction, augment use was predicted by retroversion >26° (P = .009). Inclination did not predict augment use (P = .90). Final implant position commonly involved unseating in the posterosuperior quadrant and cancellous exposure in the anteroinferior quadrant. CONCLUSIONS: This retrospective computed tomography (CT)-based study of 268 shoulders with GHOA found an 11% prevalence of BD. These deformities were commonly associated with Walch B2 wear patterns. Virtual aTSA planning showed a high failure rate (41%) when correcting to neutral version and inclination. Posteriorly augmented implants were frequently required, and often still involved unseating in the posterosuperior quadrant, increased cancellous exposure in the anteroinferior quadrant, and vault perforation.
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Artroplastia do Ombro , Imageamento Tridimensional , Osteoartrite , Articulação do Ombro , Prótese de Ombro , Tomografia Computadorizada por Raios X , Humanos , Artroplastia do Ombro/métodos , Estudos Retrospectivos , Masculino , Feminino , Osteoartrite/cirurgia , Osteoartrite/diagnóstico por imagem , Idoso , Articulação do Ombro/cirurgia , Articulação do Ombro/diagnóstico por imagem , Pessoa de Meia-Idade , Cavidade Glenoide/diagnóstico por imagem , Cavidade Glenoide/cirurgiaRESUMO
BACKGROUND: Prior rotator cuff disease natural history studies have focused on tear-related factors that predict disease progression within a given shoulder. The purpose of this study was to examine both patient- and tear-related characteristics of a painful rotator cuff tear that predict future pain development and functional impairment in a shoulder with a contralateral asymptomatic cuff tear. METHODS: This was a prospective longitudinal cohort study of patients aged ≤65 years who underwent surgery for a painful degenerative rotator cuff tear and possessed an asymptomatic contralateral tear. Patients were followed up prospectively by shoulder ultrasound, physical examination, and functional score assessment. The primary outcome was change in the American Shoulder and Elbow Surgeons (ASES) score at 2 years. Secondary outcomes included the Western Ontario Rotator Cuff Index (WORC) score, Patient-Reported Outcomes Measurement Information System (PROMIS) score, Hospital Anxiety Depression Scale (HADS) depression and anxiety scores, and Veterans RAND-12 (VR-12) mental component score (MCS). RESULTS: Sixty-five patients were included, with a mean follow-up period of 37 months (range, 24-42 months). In 17 patients (26%), contralateral shoulder pain developed at a median of 15.2 months (interquartile range [IQR], 10.5 months). No difference in age, sex, Charlson Comorbidity Index, or occupational demand was noted between patients in whom pain developed and those in whom pain did not develop. In the presenting painful shoulder, there was no difference in baseline tear size, muscle degeneration, or biceps pathology between groups. The mean baseline tear length (8.6 mm vs. 3.8 mm, P = .0008) and width (8.4 mm vs. 3.2 mm, P = .0004) were larger in asymptomatic shoulders in which pain subsequently developed compared with those in which pain did not develop. However, there was no difference in mean tear enlargement (P = .51 for length and P = .90 for width). There were no differences in baseline ASES, WORC, Patient-Reported Outcomes Measurement Information System (PROMIS), or HADS depression and anxiety scores between shoulders in which pain developed and those in which pain did not develop; however, patients in whom pain developed reported a lower baseline VR-12 MCS (53.3 vs. 57.6, P = .04). Shoulders in which pain developed had higher visual analog scale pain scores (2.9 [standard deviation (SD), 2.5] vs. 0.6 [SD, 1.0]; P = .016), lower ASES scores 75 [SD, 33] vs. 100 [SD, 11.6]; P = .001), and significant changes in all WORC scales with pain onset compared with those that remained asymptomatic. The study showed no significant difference in changes in the HADS anxiety and depression scores but found a significant increase in the VR-12 MCS in patients in whom pain developed (7.1 [interquartile range, 12.6] vs. -1.9 [interquartile range, 8.7]; P = .036). CONCLUSION: In one-quarter of patients with painful cuff tears, pain developed in a contralateral asymptomatic cuff tear that resulted in a measurable decline in function within 3 years. Our analysis showed that only the baseline tear size of the asymptomatic shoulder was predictive of pain development. There were no tear-related features of the presenting painful rotator cuff tear or indices of mental health and physical function or occupational demand that were predictive of future pain development at short-term follow-up.
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Lacerações , Lesões do Manguito Rotador , Humanos , Lesões do Manguito Rotador/complicações , Lesões do Manguito Rotador/cirurgia , Estudos Prospectivos , Estudos Longitudinais , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/cirurgia , Ruptura , Dor de Ombro/etiologia , Dor de Ombro/complicações , Resultado do Tratamento , ArtroscopiaRESUMO
BACKGROUND: The natural history of rotator cuff tears often involves progressive pain development, tear enlargement, and advancing muscle fatty degeneration. Both surgery and conservative management have proven to be effective treatments. Our study purpose was to compare the short- to mid-term effects of rotator cuff repair on shoulder function, progression of tear size, and muscle degeneration compared to controls with asymptomatic tears that developed pain and were managed nonoperatively. METHODS: This comparative study consists of 2 separate longitudinal study arms. The control group consisted of asymptomatic degenerative cuff tears followed until pain development and then managed nonoperatively with continued surveillance. The surgical group consisted of subjects with degenerative tears that failed nonoperative treatment and underwent surgical intervention with a minimum of 2 years follow-up. Outcomes included visual analog scale pain, American Shoulder and Elbow Surgeons, active range of motion, strength, and ultrasonography. RESULTS: There were 83 controls and 65 surgical shoulders. The surgical group was younger at enrollment (58.9 ± 5.3 yr vs. 61.2 ± 7.8 yr, P = .04). The median follow-up for control subjects after pain development was 5.1 years (interquartile range [IQR] 3.6) and the median postoperative follow-up for the surgical group was 3.0 years (IQR 0.2). Baseline tear widths (median 14 mm, IQR 9 vs. 13 mm, IQR 8; P = .45) and tear lengths (median 14 mm, IQR 13 vs. median 11 mm, IQR 8; P = .06) were similar between the surgical group and controls. There were no differences in the baseline prevalence of fatty degeneration of the supraspinatus or infraspinatus muscles between groups (P = .43 and P = .58, respectively). At final follow-up, the surgical group demonstrated significantly lower visual analog scale pain (0 [IQR 2] vs. 3.5 [IQR 4], P = .0002), higher composite American Shoulder and Elbow Surgeons (95 [IQR 13] vs. 65.8 [IQR 32], P = .0002), and activities of daily living scores (29 [IQR 4] vs. 22 [IQR 8], P = .0002), greater abduction strength (69.6 N [standard deviation {SD} 29] vs. 35.9 N [SD 29], P = .0002), greater active forward elevation (155° [SD 8] vs. 142° [SD 28], P = .002), greater active external rotation in abduction (mean 98.5°, SD 12 vs. mean 78.2°, SD 20; P = .0002) compared to controls. Additionally, the prevalence of fatty muscle degeneration was lower in the surgical group for the supraspinatus and infraspinatus (25% vs. 41%, P = .05; 17% vs. 34%, P = .03; respectively). CONCLUSION: This prospective longitudinal study comparing a surgical cohort undergoing rotator cuff repair with a control group treated nonoperatively supports the notion that surgical intervention has the potential to alter the early natural history of degenerative rotator cuff disease. Patients in the surgical group demonstrated clinically relevant differences in pain and functional outcomes. Surgical intervention was protective against progressive muscle degeneration compared to nonoperative treatment.
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Prosocial behavior is a relevant indicator of children's socio-emotional development linked to decreased conduct and emotional problems. The present study aimed to identify cross-sectional direct effects of parental involvement on prosocial behavior in three-time assessments at ages 3, 5, and 7 years, to identify carryover effects of the study constructs, and to identify the evolution of these effects over time. A sample of 235 Colombian families participated at t0, 220 at t1, and 145 at t2 by completing self-reported questionnaires for prosocial behavior using the Strengths and Difficulties Questionnaire and the Alabama Parenting Questionnaire for parental involvement. Using PLS-SEM path modeling, we found that the contribution of parental involvement to prosocial behavior was significant in the three assessments. Carryover analyses indicated that initial levels of parental involvement and initial levels of prosocial behavior predict later levels. Using multigroup analysis, we tested significant changes in the path coefficients of direct effects, finding nonsignificant results. For carryover effects, we found changes in parental involvement between t0/t1 and t1/t2. Finally, t-test analyses were used to identify changes in the construct's means over time, finding significant changes between parental involvement at t1 and t2. No mean differences were found for prosocial behavior. Results from this study highlight the relevance of parental involvement during childhood for maintaining children's levels of prosocial behavior and reducing the risk of socio-emotional problems. Preventive approaches for these problems should include parents' training on parental involvement from age 3.5 years or earlier.
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Current cosmological data exhibit discordance between indirect and some direct inferences of the present-day expansion rate H_{0}. Early dark energy (EDE), which briefly increases the cosmic expansion rate prior to recombination, is a leading scenario for resolving this "Hubble tension" while preserving a good fit to cosmic microwave background (CMB) data. However, this comes at the cost of changes in parameters that affect structure formation in the late-time universe, including the spectral index of scalar perturbations n_{s}. Here, we present the first constraints on axionlike EDE using data from the Lyman-α forest, i.e., absorption lines imprinted in background quasar spectra by neutral hydrogen gas along the line of sight. We consider two independent measurements of the one-dimensional Lyα forest flux power spectrum from the Sloan Digital Sky Survey (SDSS eBOSS) and from the MIKE/HIRES and X-Shooter spectrographs. We combine these with a baseline dataset comprised of Planck CMB data and baryon acoustic oscillation (BAO) measurements. Combining the eBOSS Lyα data with the CMB and BAO dataset reduces the 95% confidence level (C.L.) upper bound on the maximum fractional contribution of EDE to the cosmic energy budget f_{EDE} from 0.07 to 0.03 and constrains H_{0}=67.9_{-0.4}^{+0.4} km/s/Mpc (68% C.L.), with maximum a posteriori value H_{0}=67.9 km/s/Mpc. Similar results are obtained for the MIKE/HIRES and X-Shooter Lyα data. Our Lyα-based EDE constraints yield H_{0} values that are in >4σ tension with the SH0ES distance-ladder measurement and are driven by the preference of the Lyα forest data for n_{s} values lower than those required by EDE cosmologies that fit Planck CMB data. Taken at face value, the Lyα forest severely constrains canonical EDE models that could resolve the Hubble tension.
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BACKGROUND: Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS: Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS: Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS: Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.
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Transtorno Autístico , Comportamento Problema , Pré-Escolar , Humanos , Criança , Masculino , Feminino , Emoções , Pais , AtençãoRESUMO
The accuracy and efficiency of molecular quantum chemical calculations depend critically on the basis set used. However, the development of novel basis sets is hindered because much of the literature relies on the use of opaque processes and tools that are not publicly available. We present here BasisOpt, a tool for the automated optimization of basis sets with an easy-to-use framework. It features an open and accessible workflow for basis set optimization that can be easily adapted to almost any quantum chemistry program, a standardized approach to testing basis sets, and visualization of both the optimized basis sets and the optimization process. We provide examples of usage in realistic basis set optimization scenarios where: (i) a density fitting basis set is optimized for He, Ne, and Ar; (ii) the exponents of the def2-SVP basis are re-optimized for a set of molecules rather than atoms; and (iii) a large, almost saturated basis of sp primitives is automatically reduced to (10s5p) while achieving the lowest energy for such a basis set composition.
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BACKGROUND: Existing evidence suggests that clinician and organisation engagement in research can improve healthcare performance. With the increase in allied health professional (AHP) research activity, it is imperative for healthcare organisations, clinicians, managers, and leaders to understand research engagement specifically within allied health fields. This systematic review aims to examine the value of research engagement by allied health professionals and organisations on healthcare performance. METHODS: This systematic review had a two-stage search strategy. Firstly, the papers from a previous systematic review examining the effect of research engagement in healthcare were screened to identify papers published pre-2012. Secondly, a multi-database search was used to conduct a re-focused update of the previous review, focusing specifically on allied health to identify publications from 2012-2021. Studies which examined the value of allied health research engagement on healthcare performance were included. All stages of the review were conducted by two reviewers independently. Each study was assessed using the appropriate Joanna Briggs Institute critical appraisal tool. A narrative synthesis was completed to analyse the similarities and differences between and within the different study types. RESULTS: Twenty-two studies were included, comprising of mixed research designs, of which six were ranked as high importance. The findings indicated that AHP research engagement appears related to positive findings in improvements to processes of care. The review also identified the most common mechanisms which may link research engagement with these improvements. DISCUSSION: This landmark systematic review and narrative synthesis suggests value in AHP research engagement in terms of both processes of care and more tentatively, of healthcare outcomes. While caution is required because of the lack of robust research studies, overall the findings support the agenda for growing AHP research. Recommendations are made to improve transparent reporting of AHP research engagement and to contribute essential evidence of the value of AHP research engagement. TRIAL REGISTRATION: This systematic review protocol was registered with the international prospective register of systematic reviews, PROSPERO (registration number CRD42021253461 ).
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Pessoal Técnico de Saúde , Atenção à Saúde , Humanos , Instalações de Saúde , OrganizaçõesRESUMO
Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist-either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein's Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF. Participants included children aged 6-12 years with obesity (M = 9.46, SD = 1.74). The Framework for Reporting Adaptations and Modifications-Expanded guided our classification of modifications across BHF cohorts. Using the FRAME reporting structure, the changes that were documented were (1) planned and occurred pre-implementation, (2) based on decisions from local stakeholders (e.g., school administrator, members of the implementation team), and (3) specific to changes in content and context-with a focus on implementation and potential for local scale-up. The nature of the adaptations included adding elements (whole of family approach), removing elements (calorie counting), and substituting elements (steps for minutes of physical activity). Across 9 cohorts, 84 families initiated the BHF program, 69 families successfully completed the 12-week program, and 45 families returned for 6-month follow-up assessments. Results indicated that the BMI z score in children was reduced by 0.31 ± 0.17 at 6 months across all cohorts. Reduction in BMI z score ranged from 0.41 in cohort 4 to 0.13 in cohort 5. Iterative adaptations to BHF were completed to improve the fit of BHF to the setting and participants and have contributed to a sustained community PWMI that adheres to the underlying principles and core elements of other evidence-based PWMIs. Monitoring adaptations and related changes to outcomes can play a role in long-term sustainability and effectiveness.
RESUMO
Energies of linear, halogen-bonded complexes in the isoelectronic series YX···ClF (YX = FB, OC, or N2) are calculated at several levels of theory as a function of the intermolecular distance r(X···Cl) to yield radial potential energy functions. When YX = OC, a secondary minimum is observed corresponding to lengthened and shortened distances r(ClF) and r(CCl), respectively, relative to the primary minimum, suggesting a significant contribution from the Mulliken inner complex structure [OâC-Cl]+···F-. A conventional weak, halogen-bond complex OC···ClF occurs at the primary minimum. For YX = FB, the primary minimum corresponds to the inner complex [FâB-Cl]+···F-, while the outer complex FB···ClF is at the secondary minimum. The effects on the potential energy function of systematic substitution of Y and X by second-row congeners and of reversing the order of X and Y are also investigated. Symmetry-adapted perturbation theory and natural population analyses are applied to further understand the nature of the various halogen-bond interactions.
RESUMO
New correlation consistent basis sets for the second-row atoms (Al-Ar) to be used with the neon-core correlation consistent effective core potentials (ccECPs) have been developed. The basis sets, denoted cc-pV(n+d)Z-ccECP (n = D, T, Q), include the "tight"-d functions that are known to be important for second-row elements. Sets augmented with additional diffuse functions are also reported. Effective core polarization potentials (CPPs) to account for the effect of core-valence correlation have been adjusted for the same elements, and two different forms of the CPP cutoff function have been analyzed. The accuracy of both the basis sets and the CPPs is assessed through benchmark calculations at the coupled-cluster level of theory for atomic and molecular properties. Agreement with all-electron results is much improved relative to the basis sets that originally accompanied the ccECPs; moreover, the combination of cc-pV(n+d)Z-ccECP and CPPs is found to be a computationally efficient and accurate alternative to including core electrons in the correlation treatment.