Introduction The literature regarding undisplaced femoral neck fractures (FNF) is sparse. The aim of this prospective feasibility study is to compare the clinical outcome after undisplaced FNF treated with internal fixation (IF) and displaced FNF treated with hip arthroplasty. We hypothesized that hip arthroplasty would give a lower incidence of reoperations. Methods A total of 235 patients were included with a median age of 84 years (range 65–99). A consecutive series of 65 patients with undisplaced FNF were treated with IF, and 170 patients with displaced FNF were treated with either a total hip arthroplasty or a hemiarthroplasty. Follow-up interviews were conducted at 1 year using the Harris Hip Score (HHS), WOMAC, and pain numeric rating scale (PNRS). The minimum follow-up time was 22 months. There was no difference in baseline data between the groups. Results Nineteen (8%) hips required reoperation at least once at a mean of 6 months (range 0–35). The rate of reoperation was higher in the IF group compared to the hip arthroplasty group (13.8% vs. 5.9%, 95% CI 0.9–6.4). The overall 1-year and 2-year mortality was 28% and 40%, respectively, with no difference between the groups. The most common reasons for reoperations in the IF group were non-union and avascular necrosis, and 6 patients were treated with hip or excision arthroplasty. In the arthroplasty group, the most common indications were deep infection and dislocation. We did not find any differences between the groups in terms of HHS, WOMAC, and PNRS. Conclusions In this feasibility study, we found no differences in patient-reported outcomes between the groups although IF required a higher rate of reoperations. Further randomized trials are needed to establish the optimal treatment of undisplaced FNF in the elderly. Trial registration ClinicalTrial.org , NCT03392285. Retrospectively registered on 5 February 2018.

BACKGROUND The existence of an association between cardiovascular diseases (CVDs) and apical periodontitis (AP) remains unclear because results obtained from previous clinical studies and reviews are inconsistent or inconclusive. OBJECTIVE To conduct an umbrella review to determine whether there is an association between CVDs and the prevalence of the AP in adults. METHODS The protocol of the review was registered in the PROSPERO database (CRD42020185753). The literature search was conducted using the following electronic databases: Clarivate Analytics' Web of Science Scopus, PubMed, and Cochrane Database of Systematic Reviews (CDSR), from inception to May, 2020, with no language restrictions. Systematic reviews with or without meta-analysis that evaluated the association between CVDs and AP were included. Other types of studies, including narrative reviews, were excluded. Two reviewers independently performed a literature search, data extraction, and quality assessment of included studies. Any disagreements or doubts were resolved by a third reviewer. The quality of the reviews was assessed using the AMSTAR 2 tool (A measurement tool to assess systematic reviews), with 16 items. A final categorization of the systematic reviews classified each as of "high", "moderate", "low", or "critically low" quality. RESULTS Four systematic reviews were included in the current review. Three reviews were graded by AMSTAR 2 as "moderate" quality, whereas one review was graded as "critically low" quality. DISCUSSION Only one systematic review included a meta-analysis. Substantial heterogeneity amongst the primary studies included within each systematic review was notable in preventing pooled analysis. CONCLUSIONS From the limited and moderate to low quality evidence available, the current umbrella review concluded that a weak association exists between CVDs and AP. In future, well-designed, longitudinal clinical studies with long-term follow-up are required.

The “essence” of a family firm is thought to be a function of a family’s influence on the culture, functioning, and behavior of the firm owing to the pursuit of a family’s vision for the firm. Accordingly, a family firm’s strategic behaviors tend to be oriented toward preserving the economic as well as noneconomic value of the firm for the family in the long run. In this chapter, the profile family firm Sheetz exhibits growth as a primary strategy through employee care and empowerment, community engagement, and social responsibility. The fast growth of the convenience store chain is proficiently managed by the family as well as employee ownership. The strategies such as employee care, community engagement, and social responsibility are reflective of the family’s strong commitment to values such as unity, harmony, and continuity not only within the family but also in the communities they serve in.

The key factor distinguishing family firms from others is the family’s involvement in the governance of their firm through participation in ownership, management, and board (if any) along with their intentions for maintaining family control over the firm across generations. Firma Roleski in the profile of this chapter is an example. The level of family involvement in governance depends on a firm’s being private or publicly traded, firm age, firm size, industry in which it operates, and family size as well as other family dynamics. In the profile firm Firma Roleski, aside from 100% family ownership and involvement in management, a family constitution is in place not only to ensure the continuity of the family business success but also to facilitate the succession to future generations.

Background Machine learning algorithms have been drawing attention at the joining of pathology and radiology in prostate cancer research. However, due to their algorithmic learning complexity and the variability of their architecture, there is an ongoing need to analyze their performance. Objective This study assesses the source of heterogeneity and the performance of machine learning applied to radiomic, genomic, and clinical biomarkers for the diagnosis of prostate cancer. One research focus of this study was on clearly identifying problems and issues related to the implementation of machine learning in clinical studies. Methods Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, 816 titles were identified from the PubMed, Scopus, and OvidSP databases. Studies that used machine learning to detect prostate cancer and provided performance measures were included in our analysis. The quality of the eligible studies was assessed using the QUADAS-2 (quality assessment of diagnostic accuracy studies–version 2) tool. The hierarchical multivariate model was applied to the pooled data in a meta-analysis. To investigate the heterogeneity among studies, I2 statistics were performed along with visual evaluation of coupled forest plots. Due to the internal heterogeneity among machine learning algorithms, subgroup analysis was carried out to investigate the diagnostic capability of machine learning systems in clinical practice. Results In the final analysis, 37 studies were included, of which 29 entered the meta-analysis pooling. The analysis of machine learning methods to detect prostate cancer reveals the limited usage of the methods and the lack of standards that hinder the implementation of machine learning in clinical applications. Conclusions The performance of machine learning for diagnosis of prostate cancer was considered satisfactory for several studies investigating the multiparametric magnetic resonance imaging and urine biomarkers; however, given the limitations indicated in our study, further studies are warranted to extend the potential use of machine learning to clinical settings. Recommendations on the use of machine learning techniques were also provided to help researchers to design robust studies to facilitate evidence generation from the use of radiomic and genomic biomarkers.

High-resolution cervical auscultation (HRCA) is an evolving clinical method for noninvasive screening of dysphagia that relies on data science, machine learning, and wearable sensors to investigate the characteristics of disordered swallowing function in people with dysphagia. HRCA has shown promising results in categorizing normal and disordered swallowing (i.e., screening) independent of human input, identifying a variety of swallowing physiological events as accurately as trained human judges. The system has been developed through a collaboration of data scientists, computer-electrical engineers, and speech-language pathologists. Its potential to automate dysphagia screening and contribute to evaluation lies in its noninvasive nature (wearable electronic sensors) and its growing ability to accurately replicate human judgments of swallowing data typically formed on the basis of videofluoroscopic imaging data. Potential contributions of HRCA when videofluoroscopic swallowing study may be unavailable, undesired, or not feasible for many patients in various settings are discussed, along with the development and capabilities of HRCA. The use of technological advances and wearable devices can extend the dysphagia clinician's reach and reinforce top-of-license practice for patients with swallowing disorders.

Individuals with hearing loss allocate cognitive resources to comprehend noisy speech in everyday life scenarios. Such a scenario could be when they are exposed to ongoing speech and need to sustain their attention for a rather long period of time, which requires listening effort. Two well-established physiological methods that have been found to be sensitive to identify changes in listening effort are pupillometry and electroencephalography (EEG). However, these measurements have been used mainly for momentary, evoked or episodic effort. The aim of this study was to investigate how sustained effort manifests in pupillometry and EEG, using continuous speech with varying signal-to-noise ratio (SNR). Eight hearing-aid users participated in this exploratory study and performed a continuous speech-in-noise task. The speech material consisted of 30-second continuous streams that were presented from loudspeakers to the right and left side of the listener (±30° azimuth) in the presence of 4-talker background noise (+180° azimuth). The participants were instructed to attend either to the right or left speaker and ignore the other in a randomized order with two different SNR conditions: 0 dB and -5 dB (the difference between the target and the competing talker). The effects of SNR on listening effort were explored objectively using pupillometry and EEG. The results showed larger mean pupil dilation and decreased EEG alpha power in the parietal lobe during the more effortful condition. This study demonstrates that both measures are sensitive to changes in SNR during continuous speech.

Software plays a central role in all aspects of reversible computing. We survey the breadth of topics and recent activities on reversible software and systems including behavioural types, recovery, debugging, concurrency, and object-oriented programming. These have the potential to provide linguistic abstractions and tools that will lead to safer and more reliable reversible computing applications.

Quantum Key Distribution (QKD) protocols allow the establishment of symmetric cryptographic keys up to a limited distance at limited rates. Due to optical misalignment, noise in quantum detectors, disturbance of the quantum channel or eavesdropping, an error key reconciliation technique is required to eliminate errors. This chapter analyses different key reconciliation techniques with a focus on communication and computing performance. We also briefly describe a new approach to key reconciliation techniques based on artificial neural networks.

Apesar de decorrer das praticas sociais vivenciadas pelos universitarios, o ensino da escrita academica tem sido pouco presente nos cursos de licenciaturas. Isso se reflete na formacao desses estudantes e futuros professores, que costumam apresentar lacunas no ler-escrever textos da esfera academica. Considerada ainda a escassez de producoes cientificas brasileiras acerca desse tema, este estudo busca investigar as principais tendencias da producao cientifica sobre letramento academico na formacao de professores na area de Letras, publicadas no banco de teses da CAPES, entre 2013 e 2017, visando mapear os desafios e as contribuicoes do debate acerca do letramento academico na formacao de professores. Trata-se de uma pesquisa bibliografica do tipo estado da arte que considera os trabalhos completos de dissertacoes e teses publicadas nessa plataforma e desenvolvidas no contexto brasileiro. Nessa investigacao, encontraram-se apenas quatro trabalhos publicados sobre o tema na area de Letras, reafirmando a necessidade de investimento em pesquisa para avancar nas imbricacoes entre letramentos academicos e letramento docente.

The aim of this paper is to present and validate a framework for assessing healthcare facilities in low-resource settings to collect evidence and inform policies on the harmonisation, regulation and contextualised design of medical devices. A literature review and focus groups with several experts of medical device design, clinical engineering, health technology assessment and management, allowed the creation of a protocol, comprising two parts: a semi-structured interview and electrical safety measures. Three hospitals were assessed in Benin and three in Uganda. All the health centres resulted to be facing typical challenges for low-resource settings, including the lack of funding, expertise, a well-established maintenance program, spare parts and consumables, and unreliable power supplies. As there is a paucity of information regarding low-resource settings, the proposed framework can be used by clinical or biomedical engineers to assess and thereby propose actions for improving the conditions of healthcare settings.