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This study demonstrates the potential for the estimation of cold pain intensity from facial expression analysis and shows that the personalized spatial-temporal framework has better performance in cold pain intensity estimation.

This cold pain intensity estimator could allow convenient, automatic, and real-time use to provide continuous objective pain intensity estimations of subjects and patients.

This cold pain intensity estimator could allow convenient, automatic, and real-time use to provide continuous objective pain intensity estimations of subjects and patients.

Examine health resources that physically active older adults consider meaningful when participating in physical activity initiatives. Health resources are protective factors, including attitudes, knowledge, material factors or social support, that potentially enable people to understand and make sense of their lives or to cope with life stressors.

A cross-sectional quantitative study was conducted with two questionnaires used to serve as a compiled 'ageing well' survey the Salutogenic Physical Activity Health Resources Questionnaire (SPAHRQ) and the short form of the Sense of Coherence questionnaire, SOC-13.

The study included 372 participants ranging from 60 to 96 years of age (mean age 74.4 ± 7 years; 60% women). Social relations, positive energy, the habit of exercising and embodied satisfaction were considered important by more than 70% of the participants. Social relations were the most meaningful health resource for both men and women (89%). Women rated positive energy as a significantly more imponding of health resources that older adults consider meaningful in their participation in organised physical activity initiatives.

The global COVID-19 pandemic has had a significant impact on the physical and mental health of people everywhere. The aim of the study is to understand how people living in 15 countries around the globe experience an unexpected crisis which threatens their health and that of loved ones, and how they make meaning of this disruption in their narratives.

Data were collected through an anonymous online survey during May-September 2020, which was during or just after the first wave of the COVID-19 pandemic, depending on the country. The questionnaire included demographic and three open-ended questions as prompts for stories about experiences during the initial months of the pandemic. The text was analyzed through inductive thematic content analysis and quantified for full sample description, demographic and subsequently international comparisons.

The final qualitative dataset included stories from

= 1685 respondents. The sample was 73.6% women and 26.4% men. The mean age of participants was 39.55 years (Se stories and differences according to select demographic variables. We identify several major ways of making meaning of the pandemic. The pandemic has impacted many aspects of people's lives which give it meaning, no matter where they live.Combination immunotherapy with sequential administration may enhance metastatic melanoma (MM) patients with long-term disease control. High Dose Aldesleukin/Recombinant Interleukin-2 (HD rIL-2) and ipilimumab (IPI) offer complementary mechanisms against MM. This phase IV study assessed the sequenced use of HD rIL-2 and IPI in MM patients. Eligible Stage IV MM patients were randomized to treatment with either two courses of HD rIL-2(600,000 IU/kg) followed by four doses of IPI 3 mg/kg or vice-versa. The primary objective was to compare one-year overall survival (OS) with historical control (46%, Hodi et al., NEJM 2010). Smad activation Secondary objectives were 1-year progression-free survival (PFS), objective response rate (ORR), and adverse events (AEs) profile. Evaluable Population (EP) included patients who received at least 50% of planned treatment with each drug. Thirteen and 16 patients were randomized to receive HD rIL-2 first, and IPI first, respectively. One-year OS rate was 75% for intention to treat population. Eighteen patients were included in EP, 8 in HD rIL-2, 10 in IPI first arm. In EP, 1-year OS, PFS and ORR rates were 87%, 68%, and 50%, respectively. The frequency of AEs was similar in both arms with 13 patients experiencing Grade 3 or higher AEs, 3 resulting in the end of study participation. There was one HD rIL-2-related death, from cerebral hemorrhage due to thrombocytopenia. In this study with small sample size, HD rIL-2 and IPI were safe to administer sequentially in MM patients and showed more than additive effects. 1-year OS was superior to that of IPI alone from historical studies.Fractures of the medial epicondyle are often a marker of injury of the medial collateral ligament complex of the elbow, regardless of displacement. The medial epicondyle serves as the origin for the flexor/pronator mass superficially and the medial collateral ligament near the base. These fractures occur most commonly through the apophysis at the base of the epicondyle, making differentiation of muscular versus ligamentous avulsion difficult. Fractures associated with elbow dislocation and fractures with an intra-articular incarcerated medial epicondyle are ligamentous injuries, requiring at least intraoperative examination and most likely fixation of the fracture. Degree of displacement has traditionally been considered the deciding factor for fracture fixation, but this concept has been proven unreliable both in the literature and in our experience. Regardless of the degree of displacement, we recommend examination under anesthesia for all displaced fractures, with fixation of any fractures that render the er closure of the wound with buried absorbable sutures.

Nonoperative treatment in a cast has been suggested. Surgical variations include supine positioning, bicortical screws, and use of washers.

Lateral decubitus positioning and wrapping of the hand and wrist in flexion facilitate reduction by both applying a varus load and relaxing the flexor/pronator mass. Unicortical fixation is sufficient and does not risk injury to anterolateral structures. Washers have a higher complication rate than screws alone and may not be necessary in most cases

.

Lateral decubitus positioning and wrapping of the hand and wrist in flexion facilitate reduction by both applying a varus load and relaxing the flexor/pronator mass. Unicortical fixation is sufficient and does not risk injury to anterolateral structures. Washers have a higher complication rate than screws alone and may not be necessary in most cases1.Malunion, nonunion, congenital abnormalities, and osteometabolic diseases are the main causes of long bone deformities1. Although the exact incidence is unclear, it is estimated that about 10% of all fractures have some complication in terms of fracture-healing. In addition to the aesthetic impact, malunions generally substantially impair function and quality of life1. Every malunion is unique, and treatment is usually planned according to the degree of deformity and the postoperative expectations of the patient2. However, it is noteworthy that deformity correction usually requires a high degree of surgical expertise. Several techniques have been proposed over the years, and new techniques that utilize current technologies are available, such as computer-assisted single-cut osteotomy3. In 2009, Russell et al. proposed the clamshell technique for diaphyseal malunions4-6. This technique is our preferred treatment for diaphyseal malunions and acute fractures in the setting of a previous malunion or deformity. The to healing [and standard deviation], 6.8 ± 4.4)

. One of these 4 cases was a Gustilo-Anderson grade-IIIB open fracture that required muscle flap coverage and a subsequent Hernigou procedure

. When discussing treatment options with patients, it is important to clarify that there is currently no clear best technique to treat complex malunions; however, the clamshell osteotomy is a simpler procedure compared with others that have previously been described and has the benefits of quick rehabilitation and good deformity correction without the drawbacks of an external fixator

.

Preserve the blood supply in the opposite cortex.Close the fascia before reaming the medullary canal.Do not ream the osteotomy site.Be sure to perform a bicortical osteotomy.Create a stable construct.

Preserve the blood supply in the opposite cortex.Close the fascia before reaming the medullary canal.Do not ream the osteotomy site.Be sure to perform a bicortical osteotomy.Create a stable construct.The Latarjet surgical technique is one of the most effective and well-known techniques in the treatment of anterior shoulder instability1. The modified Latarjet technique is a history book of surgical details demonstrated by renowned masters of shoulder surgery. The procedure includes soft-tissue repair and osseous reconstruction to stabilize the glenohumeral joint in recurrent anterior instability. The procedure has been shown to have reliable success in reducing recurrent instability and minimizing risk of dislocation arthropathy2-4.

The Latarjet technique can be performed via a cosmetic axillary-based approach. The subscapularis is split horizontally without detachment as described by Neer

. The capsule is released like in a medially based T-plasty as described by Altchek et al.

. The coracoid osteotomy is performed with a 90° oscillating saw and prepared for en-face implantation as described by Edwards and Walch

. The inferior surface of the coracoid is decorticated and prepared per Molé

. Coracoid fize the glenoid exposure for direct coracoid implantation. Subsequently, the capsule may be shifted for capsular imbrication.Low-profile, non-bulky retractors will help to improve visualization.Adjusting the arm is a key technique in performing this surgical procedure. This adjustment will help to shift the surgical window, expose key anatomic structures, and allow a capsular shift without overtensioning. This cannot be overstated.The key to intralesional surgical treatment of giant cell tumor of bone (GCTB) is extended curettage. As GCTB is locally aggressive with a high propensity for local recurrence, a primary factor of surgical treatment is the ability to achieve local tumor clearance. GCTB commonly affects the epimetaphyseal region of the bone, which may compromise the integrity of the articular surface. With the exception of expendable bone that may be considered for resection without the challenge of reconstruction (e.g., the proximal aspect of the fibula or the distal aspect of the ulna), a large majority of cases of GCTB can be treated with joint-preserving techniques. In the present article, we share a video demonstration including the surgeon view of intralesional surgery for GCTB, with emphasis on the 360° visualization of the tumor cavity, dilemmas regarding use of adjuvants for extended curettage, and options in cavity reconstruction.

The surgical procedure involves 4 essential components.(1) Surgical exposure and isolaumor cavity provide better visualization.Isolation of the soft tissue around the tumor with use of hydrogen peroxide-soaked mops can prevent seeding and contamination.Meticulous tumor clearance is more important to minimize recurrence than the use of adjuvants.Use of a C-arm helps to better guide extension of the curettage and avoid inadvertent joint penetration.Maintaining joint congruity is essential.

Illumination and magnification within the tumor cavity provide better visualization.Isolation of the soft tissue around the tumor with use of hydrogen peroxide-soaked mops can prevent seeding and contamination.Meticulous tumor clearance is more important to minimize recurrence than the use of adjuvants.Use of a C-arm helps to better guide extension of the curettage and avoid inadvertent joint penetration.Maintaining joint congruity is essential.

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