Evaluation Plan Research Articles

Comparative analysis of school food policies in Australian jurisdictions: Insights for more effective policy action.

School food policies in Australia have the potential to positively impact healthy eating in schools. While the policies are reviewed regularly, it is unknown if revised school food policies have incorporated the recommendations from a 2020 review of nutrition policies in publicly funded institutions. This review aims to examine the current state of Australian school food policy environment, including national-level guidelines, food safety, allergy, and anaphylaxis management policies. School food policy documents were identified by searching the federal government, and Departments of Health and Education websites of Australian jurisdictions. The L'Abbé framework for monitoring and evaluation of nutrition policies guided the data analysis. Eleven policies/guidelines from Australian national and state/territory governments were reviewed in 2023. Four state/territory policies had major updates since 2020. The consistency of nutrition standards improved across five jurisdictions, although a common nutrient classification system would have allowed better comparison. Implementation guides/tools and supporting resources were provided in all policies although their comprehensiveness varied. Policy monitoring and evaluation guide/tools, and local food procurement were incorporated in two additional policies. School principals were responsible for policy implementation and schools for independent compliance monitoring. Continued improvement in monitoring and evaluation plans, policy review timelines, and support systems for schools is needed to enhance implementation and impact of school food policies. External stakeholder support may help school leadership in more effective policy implementation. SO WHAT?: Limited progress in incorporating recommendations into current school food policies calls for additional support and strategies to enhance policy implementation and monitoring.

An evaluation of a multi-partner approach to increase routine immunization coverage in six northern Nigerian States

BackgroundGlobal health partnerships are increasingly being used to improve coordination, strengthen health systems, and incentivize government commitment for public health programs. From 2012 to 2022, the Bill & Melinda Gates Foundation (BMGF) and Aliko Dangote Foundation (ADF) forged Memorandum of Understanding (MoU) partnership agreements with six northern state governments to strengthen routine immunization (RI) systems and sustainably increase immunization coverage. This mixed methods evaluation describes the RI MoUs contribution to improving program performance, strengthening capacity and government financial commitment as well as towards increasing immunization coverage.MethodsDrawing from stakeholder interviews and a desk review, we describe the MoU inputs and processes and adherence to design. We assess the extent to which the program achieved its objectives as well as the benefits and challenges by drawing from a health facility assessment, client exit interview and qualitative interviews with service providers, community leaders and program participants. Finally, we assess the overall impact of the MoU by evaluating trends in immunization coverage rates.ResultsWe found the RI MoUs across the six states to be mostly successful in strengthening health systems, improving accountability and coordination, and increasing the utilization of services and financing for RI. Across all six states, pentavalent 3 vaccine coverage increased from 2011 to 2021 and in some states, the gains were substantial. For example, in Yobe, vaccination coverage increased from 10% in 2011 to nearly 60% in 2021. However, in Sokoto, the change was minimal increasing from only 4% in 2011 to nearly 8% in 2021. However, evaluation findings indicate that issues pertaining to human resources for health, insecurity that inhibits supportive supervision and vaccine logistics as well as harmful socio-cultural norms remain a persistent challenge in the states. There is also a need for a rigorous monitoring and evaluation plan with well-defined measures collected prior to and throughout implementation.ConclusionIntroducing a multi-partner approach grounded in a MoU agreement provides a promising approach to addressing health system challenges that confront RI programs.

Right upper lobectomy for lung cancer associated with a displaced anomalous bronchus: two case reports

BackgroundBronchial bifurcation abnormalities are often discovered incidentally on chest computed tomography or bronchoscopy. As this condition is asymptomatic, it has little effect on the disease course of patients with lung cancer. However, this abnormality must be considered when performing lung resection.Case presentationPatient 1 was a 73-year-old man with suspected simultaneous triple lung cancers [cT1c (3) N0M0, Stage IA3] in the right and left upper lobes. He was initially scheduled to undergo right upper lobectomy and systematic nodal dissection. Chest computed tomography revealed a displaced B3 that arose from the right middle lobe bronchus. V1+2 was transected first, followed by the superior truncus of the pulmonary artery, and B1+2, respectively. After the branches of V3 were ligated, B3 was identified smoothly. Finally, the incomplete interlobar fissure between the upper and middle lobes was separated using an auto-stapler. No vascular abnormalities were observed. Patient 2 was a 62-year-old woman with suspected lung cancer (cT1cN0M0, Stage IA3) in the right upper lobe, and was scheduled to undergo right upper lobectomy and lobe-specific nodal dissection. Chest computed tomography revealed a right top pulmonary vein and a displaced B1 that arose from the right main bronchus independently. Because V1+3 was resected simultaneously during upper and middle lobe resection during robot-assisted thoracic surgery, the procedure was cool-converted to video-assisted thoracic surgery. An independently A1 was observed, followed by A2b and A3, which branched off as a common stem. A right top pulmonary vein was smoothly detected. Each blood vessel was transected using an auto-stapler. B2+3 was transected first using an auto-stapler, followed by B1.ConclusionsThe displaced anomalous bronchus is often accompanied by pulmonary arterial or venous abnormalities and an incomplete interlobar fissure. A “hilum first, fissure last” technique is often useful. Preoperative evaluation and surgical planning are important.

Transesophageal echocardiography: Revolutionizing perioperative cardiac care.

Cardiovascular diseases (CVDs) are a major challenge in global health. Despite significant advances in treatment and management, the incidence and mortality rates of CVDs have been rising in recent years, particularly in the United States. With continuous advancements in medical technology, perioperative transesophageal echocardiography (TEE) has become a key technology in cardiac surgery, enhancing surgical success rates and patient safety. The application of TEE spans preoperative planning, intraoperative monitoring, and postoperative evaluation, especially in complex procedures such as mitral valve repair and aortic valve replacement, where it plays an indispensable role. Simultaneously, the introduction of artificial intelligence (AI) brings new prospects for TEE image analysis and diagnostic support, significantly improving diagnostic accuracy and real-time decision-making capabilities. However, the application of TEE technology faces challenges such as high costs, uneven technological diffusion, and the high skill requirements for medical personnel. Therefore, establishing standardized training protocols and strengthening multidisciplinary collaboration are crucial. This paper reviews the application of TEE in cardiac surgery and its path toward educational and practical standardization from a global perspective, emphasizing its importance in improving the postoperative quality of life for patients and exploring future directions in technological innovation and educational optimization.

Measuring transport-associated urban inequalities: Where are we and where do we go from here?

ABSTRACT Reducing urban inequalities is at the forefront of the global sustainable development agenda, as well as national and local policies. While existing measures of inequality are mostly focused on income and wealth, it is widely recognised that non-monetary disparities such as in health, education, and housing play a crucial role in creating and reinforcing inequalities. Transport plays a central role in mitigating inequalities by enhancing access to employment, education, and essential services. It is also directly and indirectly related to disparities in housing, neighbourhoods, and health. Policymakers increasingly recognize the potential of transport policies in addressing inequalities; however, the effects of interventions need to be understood beyond the transport sector only and should consider wider impacts. In this review, we concentrate on three interlinked sectors – housing, land-use, and transportation – where local governments possess some capacity to influence the processes by which inequalities are created and exacerbated. Currently, empirical research on inequalities within these domains is fragmented. Models and datasets used for scenario testing, planning, and intervention evaluation are often disjointed, sector-focused, and rarely consider distributional effects. Our aim is to critically review the literature across different disciplines and perspectives and propose future interdisciplinary directions towards better measurement and modelling of transport-associated inequalities.

Domain-Adaptive Framework for ACL Injury Diagnosis Utilizing Contrastive Learning Techniques

In sports medicine, anterior cruciate ligament (ACL) injuries are common and have a major effect on knee joint stability. For the sake of prognosis evaluation and treatment planning, an accurate clinical auxiliary diagnosis of ACL injuries is essential. Although existing deep learning techniques for ACL diagnosis work well on single datasets, research on cross-domain data transfer is still lacking. Building strong domain-adaptive diagnostic models requires addressing domain disparities in ACL magnetic resonance imaging (MRI) from different hospitals and making efficient use of multiple ACL datasets. This work uses the publicly available KneeMRI dataset from Croatian hospitals coupled with the publicly available MRnet dataset from Stanford University to investigate domain adaptation and transfer learning models. First, an optimized model efficiently screens training data in the source domain to find unusually misclassified occurrences. Subsequently, before being integrated into the contrastive learning module, a target domain feature extraction module processes features of target domain samples to improve extraction efficiency. By using contrastive learning between positive and negative sample pairs from source and target domains, this method makes domain adaptation easier and improves the efficacy of ACL auxiliary diagnostic models. Utilizing a spatially augmented ResNet-18 backbone network, the suggested approach produces notable enhancements in experimentation. To be more precise, the AUC for transfer learning improved by 3.5% from MRnet to KneeMRI and by 2.5% from KneeMRI to MRnet (from 0.845 to 0.870). This method shows how domain transfer can be used to improve diagnostic accuracy on a variety of datasets and effectively progresses the training of a strong ACL auxiliary diagnostic model.

Historical structuring and technological evolution of the national geodetic network of Chile - horizontal

The Military Geographic Institute (IGM) wasset up in accordance with the Decree Law N°1.664 of the 29th of August, 1922 and is currently the official technical and permanent service of the State, in all geographic matters, in compliance with the second point of Article N.° 2 of Law N.° 15284 of 1963. Among the most important of its tasks is the mission of providing a Reference Frame in accordance with the requirements of the international standards of each epoch, for the production of geo-referenced information. The National Geodesic Network (RGN in Spanish initials) has been thereference framefor all geodesic and cartographic activities and portrayals over time. It is made up of geodesic points set up at strategic locations across and along this territory, measured and calculated by this Institute; these have plane, geographic and altitude coordinate values. Currently, the horizontal component of the SIRGAS-Chile RGN consists of a set of Continuous Operation Reference Stations (CORS), providing daily GNSS data and official coordinates for the various uses of national development.Chile, due to its special geographic situation, arising from its location and its long, narrow, and elongated territory has had to adopt, over time, various geodesic reference systems in accordance with the requirements of international organisations that support and promote geodesy. Moreover, since 1922, these reference systems have evolved due to substantial progress in technology, defining a RGN that is modern and precise at this time.

Minimizing the landing zone of complex aortic repair using a physician-modified endograft to preserve a prominent Adamkiewicz artery

AbstractThere are increasing number of clinical cases with physician-modified endograft (PMEG) endograft for urgent reconstruction of large pararenal aneurysms to reduce the perioperative complication risks of fragile patients, but the risk of spinal cord ischemia due to the coverage of longer segment of thoracic aorta is relatively high.We demonstrate an expedited endovascular treatment of an 88 mm pararenal aneurysm by performing a 4-vessel fenestrated endovascular aortic repair. A prominent Adamkiewicz artery, ectatic supraceliac aortic segment, median arcuate ligament compression of the celiac artery and severe tortuosity of the common iliac arteries made the endovascular repair more challenging. A PMEG was implanted with simultaneous deployment technique to achieve a short proximal landing zone to preserve the Adamkiewicz artery.The proper risk assessment and preparation of the patient based on the clinical evaluation and procedure planning is essential for the clinical success of PMEG in urgent indication.

Traumatic Pseudoaneurism of the Vertebral and Right Common Carotid Artery Caused by Rare Water Event

Introduction: The pseudoaneurysm of the common carotid artery represents a rare but highly severe clinical entity, particularly when secondary to hydraulic trauma, defined as damage resulting from the impact of high-pressure water, such as that from industrial hoses. This type of trauma is uncommon and often underestimated in its potential to cause significant vascular injuries, including those to vital structures in the neck. Clinical Case: Forty-one-year-old female patient with no significant medical history who 3 weeks ago suffered a closed hydraulic trauma in the right cervical region (high-pressure water coming out of a hose while she was washing her car). A color and spectral Doppler ultrasound of the neck vessels was performed with a high-frequency linear transducer in B mode, which reported: on the right side: pseudo aneurysmal image with a path to the vertebral artery measuring 27 x 23 mm, with Yin-Yang sign on Doppler. A diagnosis of a pseudoaneurysm with arteriovenous fistula (towards the right internal jugular vein) of the right vertebral artery was made. After an adequate anatomical evaluation and surgical planning, an endovascular treatment was decided to be performed. Conclusion: The management of common carotid and vertebral artery pseudoaneurysms secondary to hydraulic trauma involves a nuanced approach, integrating advanced diagnostic imaging and tailored treatment strategies. Both open surgical and endovascular approaches have their respective advantages and limitations. Early recognition, appropriate intervention, and rigorous follow-up are essential to optimize patient outcomes and mitigate risks associated with this challenging condition.

Evaluation of the Effect of Nutrition Education on Osteopathic Medical Students' Personal Nutrition Choices and Incorporation Into Future Medical Practice.

Our current research project evaluates the impact of nutrition education on the medical student's personal nutrition goals and the likelihood of incorporating nutrition needs into patient evaluation and treatment plans in future practice. The growing popularity of lifestyle medicine has further emphasized the importance of nutrition in the treatment of all patients, especially those suffering from chronic diseases. The paucity of formal medical nutrition education in medical school curricula leaves a significant gap in the knowledge base of physicians in practice. In an attempt to close the gap, we increased nutrition education in first-year osteopathic medical students by establishing a nutrition course emphasizing modern competencies and their importance in clinical practice. Methods: The course evaluation utilized a two-group quasi-experimental pre-test/post-test study design. The intervention group consisted of medical students participating in the newly established course, and the control group consisted of second-year medical students who had not taken the course as part of their curriculum. Information was collected about students' knowledge, attitudes, behaviors around nutrition, their plans to pursue a residency with a focus on culinary medicine and incorporate medical nutrition into their medical practice in the future, and their intention to incorporate culinary medicine into future treatment plans. Participation rates within a voluntary culinary medicine interest group were also tracked. Students in the intervention group were 26% more likely to report that proper nutrition for patient care had been addressed in coursework. This suggests that medical students exposed to the medical nutrition course have received more training that is critical in proper patient care than students in the control group. Students in the intervention group were 93% more likely to believe that proper nutrition can be used to prevent disease. Lastly, significantly more students in the intervention group (33% more) intend to explore residency programs with a focus on culinary medicine than those students in the control group. These results demonstrate that nutritional education promotes an awareness of the effectiveness of nutritional counseling in disease prevention and management. Furthermore, it will hopefully prompt future physicians to consider nutritional counseling during their clinical rotations, through residency, and into their independent practice. The presentation of nutrition in the first year of medical school is critical to develop increasing numbers of primary care physicians that promote the importance of nutrition and a healthy lifestyle for patients.

Shadow-constrained shape-from-shading for pixel-wise 3D surface reconstruction at the lunar south pole

ABSTRACT High-resolution digital elevation models (DEMs) of the lunar surface are crucial for lunar exploration missions and scientific research. The emergence of advanced technologies, such as Shape-from-Shading (SfS), has enabled the generation of pixel-wise high-resolution DEMs from monocular images of the lunar surface. However, SfS encounters significant challenges in locations with limited illumination, such as the lunar south pole, where the surface is largely covered by shadows. Therefore, this paper presents a novel shadow-constrained SfS approach for pixel-wise 3D surface reconstruction at the lunar south pole. The proposed approach uses multiple high-resolution images captured under different illumination conditions and an existing low-resolution DEM as the inputs and generates a high-resolution DEM with the same resolution as that of the input image through hierarchical SfS processing incorporating shadow constraints. Experiments were conducted using actual images collected by the Lunar Reconnaissance Orbiter (LRO) Narrow Angle Camera (NAC) at the lunar south pole. Comparisons with respect to photogrammetric DEMs generated from stereo NAC images show that the DEMs generated using the proposed approach exhibit the smallest root mean square error (RMSE). Moreover, shaded relief images rendered from the DEMs generated using the proposed approach demonstrate the highest similarity to the actual NAC images. Detailed profile comparisons further validate the effectiveness of the shadow constraint in optimizing 3D reconstruction in regions in proximity to shadows and within shadowed regions. The proposed shadow-constrained SfS approach can be used to generate high-resolution DEMs to support future missions to explore the lunar south pole, with applications including landing site evaluation and route planning for lunar probes or astronauts.

Collaboration, coordination and communication as facilitators of transitions for patients with advanced cancer: a scoping review linked to the Pal-Cycles project

BackgroundPerson-centred care is becoming increasingly recognised as an important element of palliative care. The current review syntheses evidence in relation to transitions in advanced cancer patients with palliative care needs. The review focuses on specific elements which will inform the Pal-Cycles programme, for patients with advanced cancer transitioning from hospital care to community care. Elements of transitional models for cancer patients may include, identification of palliative care needs, compassionate communication with the patient and family members, collaborative effort to establish a multi-dimensional treatment plan, review and evaluation of the treatment plan and identification of the end of life phase.MethodsA scoping review of four databases (MEDLINE, EMBASE, CINAHL, PsycINFO) was conducted to identify peer-reviewed studies published from January 2013 to October, 2022. A further hand-search of references to locate additional relevant studies was also undertaken. Inclusion criteria involved cancer patients transitions of care with a minimum of two of components from those listed above. Studies were excluded if they were literature reviews, if transition of care was related to cancer survivors, involved non-cancer patients, had paediatric population, if the transition implied a change of therapy and or a lack of physical transit to a non-hospital place of care. This review was guided by Arksey and O’Malley’s framework and narrative synthesis was used.ResultsOut of 5695 records found, 14 records were selected. Transition models identified: increases in palliative care consultations, hospice referrals, reduction in readmission rates and the ability to provide end of life care at home. Transition models highlight emotional and spiritual support for patients and families. No uniform model of transition was apparent, this depends on the healthcare system where it is implemented.ConclusionsThe findings highlight the importance of collaboration, coordination and communication as central mechanisms for transitional model for patients with advanced cancer. This may require careful planning and will need to be tailored to the contexts of each healthcare system.

Polystyrene microplastics aggravate radiation-induced intestinal injury in mice

Radiotherapy is a common treatment for abdominal and pelvic tumors, while the radiation-induced intestinal injury (RIII) is one of the major side-effects of radiotherapy, which reduces the life quality and impedes the treatment completion of cancer patients. Previous studies have demonstrated that environmental pollutant microplastics led to various kinds of injury in the gut, but its effects on RIII are still uncovered. In this study, we fed the C57BL/6J mice with distilled water or 50 μg/d polystyrene microplastics (PSMPs) for 17 days and exposed the mice to total abdominal irradiation (TAI) at day 14. Then the severity of RIII was examined by performing histopathological analysis and microbial community analysis. The results demonstrated that PSMPs significantly aggravated RIII in small intestine rather than colon of mice upon TAI. PSMPs increased levels of the histopathological damage and the microbial community disturbance in mice small intestine, shown by the overabundance of Akkermansiaceae and the decrease of microflora including Lactobacillaceae, Muribaculaceae and Bifidobacteriaceae. In conclusion, our results suggested that more microplastics exposure might led to more severe RIII, which should be considered in patients’ daily diet adjustment and clinical radiotherapy plan evaluation. Furthermore, this study also called for the further researches to uncover the underlying mechanism and develop novel strategies to attenuate RIII in mice intestine.

COST AND MANAGEMENT ACCOUNTING PRACTICES OF 4 AND 5 STAR HOTELS IN KONYA PROVINCE

In the tourism sector today, where competition is intensely felt and high risk and uncertainty are present, businesses need to effectively and efficiently use their resources to sustain their existence. Hotel busineses, established with high capitals, aim to increase their profitability by controlling costs in these challenging market conditions. Especially, hotel businesses facing situations such as seasonal fluctuations in demand and changing customer needs and expectations, need good management and accounting systems for both performance evaluation and strategic planning. At this point, the presence of management accounting, which provides all the financial and non-financial information needed by the managements and affects decision-making, is of great importance for hotel businesses. Thus, the aim of this study is to examine the management accounting practices of 4 and 5-star hotel businesses in Konya province and to determine their current situation. According to the findings of the research, it has been determined that 50% of the hotel businesses have a separate management accounting department, and 58.3% have a separate cost accounting department. In terms of costing approaches, 66.7% have adopted activity-based costing, 58.3% have adopted full costing approach, and the standard costing approach, at 33.3%, is relatively lower compared to others. Moreover, it has been found that the use of actual costing, budgeting activities, performance evaluation methods, and strategic management accounting practices have a high level of benefit for the businesses.

Evaluation Resources for Asthma Programs and Beyond.

Evaluation can ensure the quality of public health programs. Systematic efforts to identify and fully engage everyone involved with or affected by a program can provide critical information about asthma programs and the broader environment in which they operate. To assist evaluators working at programs funded by the Centers for Disease Control and Prevention (CDC's) National Asthma Control Program (NACP), we developed a package of tools that build on the CDC's 1999 Framework for Program Evaluation in Public Health. The resulting suite of evaluation tools guides evaluators through a structured but flexible process, engaging a diverse array of interest holders and actively involving them in evaluation planning and implementation, all while strengthening their capacity to meaningfully contribute to the evaluation process. For our newest tool, our team reviewed the recent evaluation literature to create an enhanced version of the 1999 framework that describes important elements of professional evaluation practice. Although the original framework describes the steps to take in conducting an evaluation and the standards for a high-quality evaluation, our enhanced framework includes an explanation of how evaluators should approach their work: by incorporating critical reflection, interpersonal competence, situational awareness, and cultural responsiveness. In this article, we highlight many of the evaluation resources our team has created since the NACP's inception, culminating in a free e-text called Planting the Seeds of High-Quality Program Evaluation in Public Health. Public health professionals working in many types of programs - not just asthma - may find these resources useful.

Dosimetric evaluation of adaptive planning for five-fraction gynecologic template-based interstitial brachytherapy

Purpose: The purpose of this work was to evaluate whether inter-fraction imaging and replanning enhance treatment delivery adherence to clinical planning objectives in the context of a 5-fraction template-based interstitial brachytherapy (TISB) approach for gynecologic cancer treatment. Methods and Materials: This retrospective study analyzed nineteen patients who underwent five fractions of interstitial brachytherapy over three days using the Syed-Neblett template. A verification CT scan was acquired for applicator assessment and reviewed by a radiation oncologist and medical physicist before each fraction. Eleven patients required replanning at least once during the treatment course. Replanning on the verification CT scan consisted of generating new target and organ-at-risk contours, digitizing catheter positions, and optimizing source dwell times to meet planning objectives. Dwell times and positions from the initial treatment plan were evaluated on the new contours to assess the dose that would have been delivered without replanning (non-adapted). Significance of non-adapted versus adapted dose differences were evaluated using a two-sided Wilcoxon sum rank test. Results: The average (min, max) change in dose (Gy) between the clinically delivered plans and the non-adapted plans were HR-CTV D90%: -6.5 (-0.6, -15.1), HR-CTV D98%: -6.5 (-0.4, -12.6), Bladder D2cc: -0.5 (0.0, -2.8), Bowel D2cc: -0.8 (0.0, -3.2), Rectum D2cc: -1.1 (0.0, -11.5), Sigmoid D2cc: -1.4 (-0.1, -5.4). Dosimetric changes in HR-CTV coverage were significantly improved with replanning while organ-at-risk differences were nonsignificant (p>0.05). Fraction 3 was the most common fraction indicated for replanning. Conclusions: Replanning template-based interstitial brachytherapy can improve target coverage and adherence to planning goals.

Adopting a stance of vulnerability in healthcare evaluation: Amplifying the patient voice.

This paper argues that one aspect of re-imagining evaluation in health planning and management is for leaders and clinicians to develop comfort with vulnerability when engaging in service evaluations. Starting with an exploration of how the service user voice is traditionally expressed in healthcare evaluation, the paper then proceeds to explore the particular role and challenges faced by clinician-evaluators, including their role as 'privileged interlocutors' in conversations with service users. The tensions in reconciling the role of the clinician as an expert, with the related but different skills needed for effective discourse in qualitative evaluation are explored, and it is asserted that it is important for clinicians and leaders to be comfortable in showing and working with vulnerability when evaluating healthcare interventions. Clinicians are already skilled in holding discourse with service users, and extending the communication repertoire to include the management of emotion and expression of vulnerability is achievable and rewarding. The paper concludes that the ability to hold a vulnerable stance when conducting evaluation can have benefits in reducing defensiveness, encouraging a truer sense of enquiry and amplifying the service user voice.

Anteromedial knee osteoarthritis (AMOA) evaluated with magnetic resonance imaging (MRI): a cohort study of 100 patients.

Magnetic resonance imaging (MRI) scans are increasingly used for knee osteoarthritis evaluation and preoperative planning before unicompartmental knee arthroplasty (UKA), and often patients already have MRI scans before their initial surgeon consultation. This highlights the need for surgeons to understand anteromedial osteoarthritis (AMOA) patterns on MRI. Hence, we aim to describe MRI findings in patients with AMOA meeting current indications for medial UKA. We analysed MRI scans from 100 knees evaluated for UKA between 2006 and 2013. Inclusion criteria comprised full-thickness medial compartment loss and intact lateral compartment joint space on preoperative radiographs. Assessment included cartilage lesions, osteophytes, meniscal damage, and anterior-cruciate ligament (ACL) status on tibial and femoral surfaces. Final decision to proceed with UKA relied on intraoperative findings, independent of MRI. Complete anteromedial tibial and femoral cartilage loss preserved posterior cartilage rims was evident in all cases. Cartilage thinning occurred in the lateral compartment in 34% of cases. While 62% displayed lateral osteophytes, only 6 exhibited small areas of full-thickness cartilage loss. ACL abnormalities varied: 27% normal, 3% ruptured, and 70% had intrasubstance high signal. Larger osteophytes in the medial (p = 0.012) and lateral (p = 0.002) intercondylar notch correlated significantly with ACL damage. All underwent medial UKA, with no evidence of areas with full lateral compartment cartilage loss intraoperatively. The MRI findings confirmed the radiographic diagnosis of bone-on-bone medial disease but highlights a range of findings in the ACL, lateral compartment, and patellofemoral joint compartment for patients who met the current x-ray and intraoperative indication for UKA. Further research is required to understand if these MRI changes will affect long-term outcomes.

Quantification of Bilateral Coordination Patterns & Relationship to Activities of Daily Living Performance in Children With Hemiparetic Cerebral Palsy

Abstract Date Presented 03/22/24 Identifying bilateral coordination patterns in children with hemiparetic cerebral palsy (HCP) and their relationship to activities of daily living (ADL) performance will provide clinicians with information needed for more comprehensive evaluation and treatment planning. Primary Author and Speaker: Annika Ward Additional Authors and Speakers: Jaclyn Gill, Kaitlyn Lee, Katherine Rogers, Brittany Glad Contributing Authors: Samuel T. Nemanich, Sheila Schindler-Ivens, Karin Goodfriend

Neural correlates of static and dynamic social decision-making in real-time sibling interactions.

In traditional game theory tasks, social decision-making is centered on the prediction of the intentions (i.e., mentalizing) of strangers or manipulated responses. In contrast, real-life scenarios often involve familiar individuals in dynamic environments. Further research is needed to explore neural correlates of social decision-making with changes in the available information and environmental settings. This study collected fMRI hyperscanning data (N = 100, 46 same-sex pairs were analyzed) to investigate sibling pairs engaging in an iterated Chicken Game task within a competitive context, including two decision-making phases. In the static phase, participants chose between turning (cooperate) and continuing (defect) in a fixed time window. Participants could estimate the probability of different events based on their priors (previous outcomes and representation of other's intentions) and report their decision plan. The dynamic phase mirrored real-world interactions in which information is continuously changing (replicated within a virtual environment). Individuals had to simultaneously update their beliefs, monitor the actions of the other, and adjust their decisions. Our findings revealed substantial choice consistency between the two phases and evidence for shared neural correlates in mentalizing-related brain regions, including the prefrontal cortex, temporoparietal junction (TPJ), and precuneus. Specific neural correlates were associated with each phase; increased activation of areas associated with action planning and outcome evaluation were found in the static compared with the dynamic phase. Using the opposite contrast, dynamic decision-making showed higher activation in regions related to predicting and monitoring other's actions, including the anterior cingulate cortex and insula. Cooperation (turning), compared with defection (continuing), showed increased activation in mentalizing-related regions only in the static phase, while defection, relative to cooperation, exhibited higher activation in areas associated with conflict monitoring and risk processing in the dynamic phase. Men were less cooperative and had greater TPJ activation. Sibling competitive relationship did not predict competitive behavior but showed a tendency to predict brain activity during dynamic decision-making. Only individual brain activation results are included here, and no interbrain analyses are reported. These neural correlates emphasize the significance of considering varying levels of information available and environmental settings when delving into the intricacies of mentalizing during social decision-making among familiar individuals.