Background Understanding the kinematic characteristics of relapse clubfoot compared to successfully treated clubfoot could aid early identification of a relapse and improve treatment planning. The usage of a multi segment foot model is essential in order to grasp the full complexity of the multi-planar and multi-joint deformity of the clubfoot. Research question The purpose of this study was to identify differences in foot kinematics, using a multi-segment foot model, during gait between patients with Ponseti treated clubfoot with and without a relapse and age-matched healthy controls. Methods A cross-sectional study was carried out including 11 patients with relapse clubfoot, 11 patients with clubfoot and 15 controls. Gait analysis was performed using an extended Helen Hayes model combined with the Oxford Foot Model. Statistical analysis included statistical parametric mapping and discrete analysis of kinematic gait parameters of the pelvis, hip, knee, ankle, hindfoot and forefoot in the sagittal, frontal and transversal plane. Results The relapse group showed significantly increased forefoot adduction in relation with the hindfoot and the tibia. Furthermore, this group showed increased forefoot supination in relation with the tibia during stance, whereas during swing increased forefoot supination in relation with the hindfoot was found in patients with relapse clubfoot compared with non-relapse clubfoot. Significance Forefoot adduction and forefoot supination could be kinematic indicators of relapse clubfoot, which might be useful in early identification of a relapse clubfoot. Subsequently, this could aid the optimization of clinical decision making and treatment planning for children with clubfoot.
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With summaries in Dutch, Esperanto and English. DOI: 10.4233/uuid:d7132920-346e-47c6-b754-00dc5672b437 "The subject of this study is deformation analysis of the earth's surface (or part of it) and spatial objects on, above or below it. Such analyses are needed in many domains of society. Geodetic deformation analysis uses various types of geodetic measurements to substantiate statements about changes in geometric positions.Professional practice, e.g. in the Netherlands, regularly applies methods for geodetic deformation analysis that have shortcomings, e.g. because the methods apply substandard analysis models or defective testing methods. These shortcomings hamper communication about the results of deformation analyses with the various parties involved. To improve communication solid analysis models and a common language have to be used, which requires standardisation.Operational demands for geodetic deformation analysis are the reason to formulate in this study seven characteristic elements that a solid analysis model needs to possess. Such a model can handle time series of several epochs. It analyses only size and form, not position and orientation of the reference system; and datum points may be under influence of deformation. The geodetic and physical models are combined in one adjustment model. Full use is made of available stochastic information. Statistical testing and computation of minimal detectable deformations is incorporated. Solution methods can handle rank deficient matrices (both model matrix and cofactor matrix). And, finally, a search for the best hypothesis/model is implemented. Because a geodetic deformation analysis model with all seven elements does not exist, this study develops such a model.For effective standardisation geodetic deformation analysis models need: practical key performance indicators; a clear procedure for using the model; and the possibility to graphically visualise the estimated deformations."
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This paper focuses on the topical and problematic area of social innovations. The aim of this paper is to develop an original approach to the allocation of social innovations, taking into account characteristics such as the degree of state participation, the scope of application, the type of initiations as well as the degree of novelty, which will be elaborated on further in this article. In order to achieve this goal, the forty-two most successful social innovations were identified and systematized. The results of this study demonstrated that 73.5% of social innovations are privately funded, most of them operating on an international level with a high degree of novelty. Moreover, 81% of all social innovations are civic initiatives. Social innovations play an important role in the growth of both developed and less developed countries alike as highlighted in our extensive analysis
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Background Altered muscle-tendon properties in clubfoot patients could play a role in the occurrence of a relapse and negatively affect physical functioning. However, there is a lack of literature about muscle-tendon properties of clubfoot relapse patients. Research question The aim of this study was to determine whether the muscle architecture of the medial gastrocnemius and the morphology of the Achilles tendon differ between typically developing children (TDC) and clubfoot patients with and without a relapse clubfoot and to determine the relationships between morphological and functional gait outcomes. Methods A cross-sectional study was carried out in clubfoot patients treated according to the Ponseti method and TDC aged 4–8 years. A division between clubfoot patients with and without a relapse was made. Fifteen clubfoot patients, 10 clubfoot relapse patients and 19 TDC were included in the study. Morphologic properties of the medial head of the Gastrocnemius muscle and Achilles tendon were assessed by ultrasonography. Functional gait outcomes were assessed using three-dimensional gait analysis. Mean group differences were analysed with ANOVA and non-parametric alternatives. Relationships between functional and morphologic parameters were determined for all clubfoot patients together and for TDC with Spearman’s rank correlation. Results Morphological and functional gait parameters did not differ between clubfoot patients with and without a relapse, with exception of lower maximal dorsiflexor moment in clubfoot relapse patients. Compared to TDC, clubfoot and relapse patients did show lower functional gait outcomes, as well as shorter and more pennate muscles with a longer Achilles tendon. In all clubfoot patients, this longer relative tendon was related to higher ankle power and plantarflexor moment. Significance In clubfoot and relapse patients, abnormalities in morphology did not always relate to worse functional gait outcomes. Understanding these relationships in all clubfoot patients may improve the knowledge about clubfoot and aid future treatment planning.
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BACKGROUND: In typically developing children, participation in sports has been proven to be positively correlated to both physical and psychosocial health outcomes. In children and adolescents with a physical disability or chronic disease participation in both recreational and competitive sports is often reduced, while for this population an active lifestyle may be even more important in reaching optimal levels of physical and psychosocial health. Therefore, the aim of the Health in Adapted Youth Sports (HAYS) Study is to determine both negative and positive effects of sports on children and adolescents with a chronic disease or physical disability. METHODS: In this cross-sectional study differences will be compared in regards to physical and psychosocial health, cognitive functioning, school performance, daily physical activity and injuries between children and adolescents with a chronic disease or physical disability who participate in sports and those who do not. Children and adolescents, both ambulatory and wheelchair dependent, in the age of 10-19 years with a physical disability or chronic disease will be included. "Sports" is defined as participation in an organized sport at least two times a week for a duration of 3 months or more prior to the assessment. Parametric and non-parametric statistics will be used to determine the differences between the two groups. DISCUSSION: This study provides insight in the effects of sports participation in relation to health, psychosocial functioning, physical activity and school performance in children and adolescents (10-19 years) with a chronic disease or physical disability. Results will guide healthcare professionals working with these children to better guide this population in reaching optimal levels of health and physical activity levels.
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Background: The concept of Functional Independence (FI), defined as ‘functioning physically safe and independent from other persons, within one’s context”, plays an important role in maintaining the functional ability to enable well-being in older age. FI is a dynamic and complex concept covering four clinical outcomes: physical capacity, empowerment, coping flexibility, and health literacy. As the level of FI differs widely between older adults, healthcare professionals must gain insight into how to best support older people in maintaining their level of FI in a personalized manner. Insight into subgroups of FI could be a first step in providing personalized support This study aims to identify clinically relevant, distinct subgroups of FI in Dutch community-dwelling older people and subsequently describe them according to individual characteristics. Results: One hundred fifty-three community-dwelling older persons were included for participation. Cluster analysis identified four distinctive clusters: (1) Performers – Well-informed; this subgroup is physically strong, well-informed and educated, independent, non-falling, with limited reflective coping style. (2) Performers – Achievers: physically strong people with a limited coping style and health literacy level. (3) The reliant- Good Coper representing physically somewhat limited people with sufficient coping styles who receive professional help. (4) The reliant – Receivers: physically limited people with insufficient coping styles who receive professional help. These subgroups showed significant differences in demographic characteristics and clinical FI outcomes. Conclusions: Community-dwelling older persons can be allocated to four distinct and clinically relevant subgroups based on their level of FI. This subgrouping provides insight into the complex holistic concept of FI by pointing out for each subgroup which FI domain is affected. This way, it helps to better target interventions to prevent the decline of FI in the community-dwelling older population.
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Longitudinal criminological studies greatly improved our understanding of the longitudinal patterns of criminality. These studies, however, focused almost exclusively on traditional types of offending and it is therefore unclear whether results are generalizable to online types of offending. This study attempted to identify the developmental trajectories of active hackers who perform web defacements. The data for this study consisted of 2,745,311 attacks performed by 66,553 hackers and reported to Zone-H between January 2010 and March 2017. Semi-parametric group-based trajectory models were used to distinguish six different groups of hackers based on the timing and frequency of their defacements. The results demonstrated some common relationships to traditional types of crime, as a small population of defacers accounted for the majority of defacements against websites. Additionally, the methods and targeting practices of defacers differed based on the frequency with which they performed defacements generally.
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Rationale: Sarcopenia is a major problem and is common in community-dwelling elderly. In daily practice, there is need for low cost and easily assessable measurement tools to assess depletion of skeletal muscle (SM) mass, for example as one of the indicators of sarcopenia. Bio-electrical impedance analysis (BIA) is often used to estimate body composition, whereas ultrasound measurement is an upcoming and promising tool, as it is quick, easy to use and inexpensive in comparison with other tools that assess SM mass. Ultrasound could assess site-specific loss of SM mass and determine myoesteatosis. Therefore, in this pilot study we aimed to assess agreement between muscle thickness of rectus femoris (RF) by ultrasound and SM mass by BIA in an older population. Methods: Twenty-six older adults (mean± standard deviation (SD) age 64 ±5.0 y, 62% women) from the Hanze Health and Ageing Study were included. SM mass by BIA was estimated using the Janssen equation. Muscle thickness of RF was assessed by analyzing ultrasound images from the right leg. Two non-parametric tests were used for analysis. Correlation between ultrasound and BIA was assessed with Spearman Rho. Agreement was determined with Kendall’s coefficient of concordance (Kendall’s W). In both tests a score ≥ 0.7 was considered a strong correlation.Results: Mean (±SD) RF thickness was 18.9 (±3.8) mm. Median SM mass (Interquartile range) was 23.5 (20.8-34.7) kg. Correlation between RF thickness and SM mass was moderately positive (Spearman r=0.611; P = 0.001), whereas Kendall’s W showed a strong agreement (W= 0.835; P=0.002).Conclusion: Ultrasound measurement of RF showed an acceptable agreement with skeletal muscle mass assessed by BIA in our sample of older adults. Therefore, ultrasound could be a promising portable tool to estimate muscle size.
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The seismic assessment of unreinforced masonry (URM) buildings with cavity walls is a relevant issue in many countries, such as in Central and Northern Europe, Australia, New Zealand, China and several other countries. A cavity wall consists of two separate parallel masonry walls (called leaves) connected by metal ties: an inner loadbearing wall and an outer veneer having mostly aesthetic and insulating functions. Cavity walls are particularly vulnerable structural elements. If the two leaves of the cavity wall are not properly connected, their out-of-plane strength may be significantly smaller than that of an equivalent solid wall with the same thickness.The research presented in this paper focuses on a mechanical model developed to predict the failure mode and the strength capacity of metal tie connections in masonry cavity walls. The model considers six possible failures, namely tie failure, cone break-out failure, pull-out failure, buckling failure, piercing failure and punching failure. Tie failure is a predictable quantity when the possible failure modes can be captured. The mechanical model for the ties has been validated against the outcomes of an experimental campaign conducted earlier by the authors. The mechanical model is able to capture the mean peak force and the failure mode obtained from the tests. The mechanical model can be easily adopted by practising engineers who aim to model the wall ties accurately in order to assess the strength and behaviour of the structures against earthquakes. Furthermore, the proposed mechanical model is used to extrapolate the experimental results to untested configurations, by performing parametric analyses on key parameters including a higher strength mortar of the calcium silicate brick masonry, a different cavity depth, a different tie embedment depth, and solid versus perforated clay bricks.
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Background Physical activity after bariatric surgery is associated with sustained weight loss and improved quality of life. Some bariatric patients engage insufficiently in physical activity. The aim of this study was to examine whether and to what extent both physical activity and exercise cognitions have changed at one and two years post-surgery, and whether exercise cognitions predict physical activity. Methods Forty-two bariatric patients (38 women, 4 men; mean age 38 ± 8 years, mean body mass index prior to surgery 47 ± 6 kg/m²), filled out self-report instruments to examine physical activity and exercise cognitions pre- and post surgery. Results Moderate to large healthy changes in physical activity and exercise cognitions were observed after surgery. Perceiving less exercise benefits and having less confidence in exercising before surgery predicted less physical activity two years after surgery. High fear of injury one year after surgery predicted less physical activity two years after surgery. Conclusion After bariatric surgery, favorable changes in physical activity and exercise cognitions are observed. Our results suggest that targeting exercise cognitions before and after surgery might be relevant to improve physical activity.
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