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Samantha R Fashler,1 M Gabrielle Pagé,2 Anton Svendrovski,3 David B Flora,1 P Maxwell Slepian,1,4,5 Aliza Z Weinrib,1,4 Alexander Huang,4,5 Joseph Fiorellino,4,5 Hance Clarke,4,5 Joel Katz1,4,5 1Department of Psychology, York University, Toronto, ON, Canada; 2Department of Anesthesiology & Pain Medicine and Department of Psychology, Université de Montréal; Research Center of the Centre hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada; 3UZIK Consulting Inc, Toronto, ON, Canada; 4Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; 5Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, CanadaCorrespondence: Samantha R Fashler; Joel Katz, Department of Psychology, York University, 4700 Keele St., BSB 232, Toronto, ON, M3J 1P3, Canada, Email samantha.fashler@vch.ca; jkatz@yorku.caPurpose: The Sensitivity to Pain Traumatization Scale (SPTS-12) was developed to assess the propensity to develop a traumatic stress response to pain. The SPTS-12 is a reliable and valid scale with a one-factor structure. The aim of the present study is to further examine the psychometric properties of the SPTS-12 by evaluating its criterion validity and how scores change over time in a sample of postsurgical patients at the Toronto General Hospital Transitional Pain Service.Participants and Methods: 361 adults (55% male; Mage = 50.6 years, SDage = 14.3) completed questionnaires assessing symptoms of pain, anxiety, depression, and trauma at multiple visits to the Transitional Pain Service after surgery. Latent-class growth mixture modeling defined prototypical longitudinal patterns (latent trajectories) of SPTS-12 scores up to two years after surgery. One-way ANOVAs examined how trajectory classes differed over time on measures of daily opioid use (mg morphine equivalents (MME)), average pain intensity, pain interference, and depressive symptoms.Results: The final model consisted of five SPTS-12 trajectory groups; two characterized by a flat and unchanging pattern and three showing a small but statistically significant decrease over time. Analysis of pain-related outcomes predicted by SPTS-12 trajectories provided evidence of criterion validity of the SPTS-12. SPTS-12 trajectories did not significantly differ on daily MME at any time. Average pain, pain interference, and depression scores significantly differed across SPTS-12 trajectory groups at two or more postsurgical visits (all p < 0.05).Conclusion: The SPTS-12 shows fairly stable patterns and predicts important pain-related and psychosocial outcomes over time. Two SPTS-12 trajectories (#2 and #5) with high scores, comprising ∼ 28% of the total sample, are associated with problematic outcomes on several pain and psychosocial measures. Targeting patients with high SPTS-12 scores for presurgical psychological treatment may prove beneficial in reducing the impact of CPSP.Keywords: chronic pain, chronic postsurgical pain, trauma, psychology, scale validation, psychosocial factors, trajectory

Objective: The aim of this study was to visualize the postoperative clinical course using the comprehensive complication index (CCI) and to propose an early alarming sign for subsequent serious outcomes in perihilar cholangiocarcinoma. Background: Surgery for this disease carries a high risk of morbidity and mortality. The developmental course of the overall morbidity burden and its clinical utility are unknown. Methods: Patients who underwent major hepatectomy for perihilar cholan-giocarcinoma between 2010 and 2019 were reviewed retrospectively. All postoperative complications were evaluated according to the Clavien-Dindo classification (CDC), and the CCI was calculated on a daily basis until postoperative day 14 to construct an accumulating graph as a trajectory. Group-based trajectory modeling was conducted to categorize the trajectory into clinically distinct patterns and the predictive power of early CCI for a subsequent serious course was assessed. Results: A total of 4230 complications occurred in the 484 study patients (CDC grade I, n = 27; II, n = 132; IlIa, n = 290; IIIb, n = 4; IVa, n = 21; IVb, n = 1; and V, n = 9). The trajectory was categorized into 3 patterns: mild (n = 209), moderate (n = 235), and severe (n = 40) morbidity courses. The 90-day mortality rate significantly differed among the courses: 0%, 0.9%, and 17.5%, respectively (P<0.001). The cutoff values of the CCI on postoperative days 1, 4, and 7 for predicting a severe morbidity course were 15.0, 28.5, and 40.6 with areas under the curves of 0.780, 0.924, and 0.984, respectively. Conclusions: The CCI could depict the chronological increase in the overall morbidity burden, categorized into 3 patterns. Early CCI potentially predicted sequential progression to serious outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES To identify the distinct trajectories of sedentary behavior (SB) and explore whether reduced cardiovascular disease (CVD) risk was associated with a distinct trajectory of physical activity (PA). METHODS We analyzed data from 6,425 people who participated in the Korean Health Panel Survey over a period of 10 years. The participants’ self-reported SB and PA were assessed annually, and trajectory groups were identified using a group-based trajectory model for longitudinal data analysis. Logistic regression analysis was performed to assess the association between CVD risk (10-year cumulative incidence) and the trajectories of SB and PA. The adjusted variables included socio-demographic factors, the predisposing diseases of CVD, and baseline health behaviors. RESULTS Trajectory analysis identified 4 SB trajectory groups: SB group 1 (low and slightly increasing trend, 53.1%), SB group 2 (high and rapidly decreasing trend, 14.7%), SB group 3 (high and slightly decreasing trend, 9.9%), and SB group 4 (low and rapidly increasing trend, 22.2%). The 3 PA trajectory groups were PA group 1 (moderate and slightly decreasing trend, 32.1%), PA group 2 (low and slightly decreasing trend, 57.3%), and PA group 3 (maintained inactivity, 10.7%). By the 10-year follow-up, 577 cases of incident CVD had occurred. We also noted a 50% reduction in the risk of CVD when SB group 4 was accompanied by PA group 1 (odds ratio, 0.50; 95% confidence interval, 0.28 to 0.90). CONCLUSIONS Despite increased time spent in SB, maintaining PA about 2 days to 3 days per week reduced the occurrence of CVD.

BackgroundPhysical activity and physical functioning have been reported to change over retirement transition, but the results have been inconsistent, and the two constructs have not been studied concurrently. The objective of this study was to examine concurrent changes in physical activity and physical functioning during transition to retirement among public sector employees, and to examine if occupation, sex, marital status, body mass index (BMI), alcohol consumption and smoking status are associated with observed different multi-trajectory paths.Methods3,550 participants of the Finnish Retirement and Aging study responded to an annual survey on physical activity and physical functioning (SF-36) before and after retirement. Group-based multi-trajectory analysis was used to identify clusters with dissimilar concurrent changes in physical activity and physical functioning. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain cluster.ResultsParticipants were 63.4 (SD 1.4) years old, 83% women, 65% professional workers. Four trajectories of concurrent changes in physical activity and physical functioning were identified, one with decreasing physical functioning and low activity, one with increasing high activity and stable high functioning and two with fluctuating moderate physical activity and stable high functioning. Single, women, obese participants and risk-users of alcohol were more likely to be classified into group with low physical activity and declining physical functioning.ConclusionsLow physical activity below the level usually recommended was associated with lower physical functioning during retirement transition. These findings could be useful when planning interventions for retirees to maintain their physical functioning level.

Motivation: Trajectories, which are sequentially measured quantities that form a path, are an important presence in many different fields, from hadronic beams in physics to electrocardiograms in medicine. Trajectory analysis requires the quantification and classification of curves, either by using statistical descriptors or physics-based features. To date, no extensive and user-friendly package for trajectory analysis has been readily available, despite its importance and potential application across various domains., Results: We have developed TrajPy, a free, open-source Python package that serves as a complementary tool for empowering trajectory analysis. This package features a user-friendly graphical user interface and offers a set of physical descriptors that aid in characterizing these complex structures. TrajPy has already been successfully applied to studies of mitochondrial motility in neuroblastoma cell lines and the analysis of in silico models for cell migration, in combination with image analysis., Availability and Implementation: The TrajPy package is developed in Python 3 and is released under the GNU GPL-3.0 license. It can easily be installed via PyPi, and the development source code is accessible at the repository: https://github.com/ocbe-uio/TrajPy/. The package release is also automatically archived with the DOI 10.5281/zenodo.3656044., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press.)

The identification of interaction between protein and ligand including binding positions and strength plays a critical role in drug discovery. Molecular docking and molecular dynamics (MD) techniques have been widely applied to predict binding positions and binding affinity. However, there are few works that describe the systematic exploration of the MD trajectory evolution in this context, potentially leaving out important information. To address the problem, we build a framework, Moira (molecular dynamics trajectory analysis), which enables automating the whole process ranging from docking, MD simulations and various analyses as well as visualizations. We utilized Moira to analyze 400 MD simulations in terms of their geometric features (root mean square deviation and protein-ligand interaction profiler) and energetics (molecular mechanics Poisson-Boltzmann surface area) for these trajectories. Finally, we demonstrate the performance of different analysis techniques in distinguishing native poses among four poses.

In practice, Airy beams can only be reproduced in an approximate manner, with a limited spatial extension and hence a finite energy content. To this end, different procedures have been reported in the literature, based on a convenient tuning of the transmission properties of aperture functions. In order to investigate the effects generated by the truncation and hence the propagation properties displayed by the designed beams, here we resort to a new perspective based on a trajectory methodology, complementary to the density plots more commonly used to study the intensity distribution propagation. We consider three different aperture functions, which are convoluted with an ideal Airy beam. As it is shown, the corresponding trajectories reveals a deeper physical insight about the propagation dynamics exhibited by the beams analyzed due to their direct connection with the local phase variations undergone by the beams, which is in contrast with the global information provided by the usual standard tools. Furthermore, we introduce a new parameter, namely, the escape rate, which allow us to perform piecewise analyses of the intensity distribution without producing any change on it, e.g., determining unambiguously how much energy flux contributes to the leading maximum at each stage of the propagation, or for how long self-accelerating transverse propagation survives. The analysis presented in this work thus provides an insight into the behavior of finite-energy Airy beams, and therefore is expected to contribute to the design and applications exploiting this singular type of beams.

Emergency remote teaching is a temporary change in the way education occurs, whereby an educational system unexpectedly becomes entirely remote. This article analyzes the motivation of students undertaking a university course over one semester of emergency remote teaching in the context of the COVID-19 pandemic. University students undertaking a programming course were surveyed three times during one semester, about motivation and COVID concern. This work explores which student motivation profiles existed, how motivation evolved, and whether concern about the pandemic was a factor affecting motivation throughout the course. The most adaptive profile was highly motivated, more prepared and less frustrated by the conditions of the course. However, this cluster experienced the highest levels of COVID-19 concern. The least adaptive cluster behaved as a mirror image of the most adaptive cluster. Clear differences were found between the clusters that showed the most and least concern about COVID-19., Competing Interests: The authors declare that they have no competing interests., (© 2024 Jahr et al.)

Aim: To provide a comprehensive analysis for accurate screw size selection and insertion angle during surgical procedures., Material and Methods: In this retrospective study, a total of 120 patients participated, resulting in the analysis of 240 occipital condyles using coronal, sagittal, and axial planes on CT scans. Statistical evaluation was performed using the Wilcoxon rank-sum test, with p < 0.05 considered statistically significant., Results: The mean sagittal length and height were measured at 17.2 ± 1.7 mm and 9.1 ± 1.5 mm, respectively. The average condyle angle, a crucial factor for screw insertion, was assessed at 38.0 ± 5.5 mm in length, 19.6 ± 2.6 mm in width, and 9.5 ± 1.0 mm in height. Condyle height in the anterior and posterior hypoglossal canals was measured at 10.8 ± 1.4 mm and 9.0 ± 1.4 mm, respectively. Screw angle and condyle width were statistically smaller in females compared to the male population., Conclusion: The OC is a significant anatomical structure in the craniovertebral junction, playing a crucial role in stability. The obtained morphological values are applicable to the Turkish population and offer statistically significant findings for preoperative planning involving occipital condyle screw instrumentation.

Introduction: Previous studies have indicated different immunological recovery trajectories based on CD4 count or CD4/CD8 ratio. However, these immune indicators are interconnected, and relying solely on one indicator may lead to inaccurate estimates. Therefore, it is essential to develop a comprehensive trajectory model that integrates CD4 count, CD8 count and CD4/CD8 ratio., Methods: We utilized a group-based multi-trajectory model to characterize the latent cluster of recovery based on measurements of CD4 count, CD8 count and CD4/CD8 ratio over a period of up to 96 months following ART initiation. Subsequently, we investigated the characteristics associated with trajectory groups, especially sex and age. Cox model and Kaplan-Meier survival curve were employed to assess differences in all-cause, AIDS-related and non-AIDS related mortality between trajectory groups., Results: A total of 14,718 eligible individuals were followed for a median of 55 months. Longitudinal model identified four subgroups: group 1 (32.5%, low CD4 and CD4/CD8 inversion), group 2 (25.9%, high CD8 and CD4/CD8 inversion), group 3 (27.2%, slow recovery of CD4 and CD4/CD8 inversion) and group 4 (14.4%, rapid increase of CD4 and normal CD4/CD8). Immune recovery was slower in male than in female, and in elders than in youngers. Compared to group 2, group 1 (adjusted hazard ratio [aHR]=3.28; 95% CI 2.33-4.60) and group 3 (aHR=1.56; 95% CI 1.09-2.24) had increased risk of all-cause mortality after adjusting for other factors. Besides, group 1 (aHR=2.17) and group 3 (aHR=1.58) had higher risk of non-AIDS related mortality, and group 1 (aHR=5.92) had significantly increased risk of AIDS related mortality., Conclusion: Longitudinal trajectory analysis of multiple immune indicators can be employed to guide targeted interventions among vulnerable populations in clinical practice., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ma, Wang, Zhu, Li, Wang, Hao, Gao, Ma and Zhang.)

Aim: With an interest in providing knowledge for person-centred care, our overall goal is to contribute a greater understanding of diversity among patients in terms of their preparedness before and up to six months after colorectal cancer surgery. Our aim was to describe and provide a tentative explanation for differences in preparedness trajectory profiles., Material and Methods: The study was explorative and used prospective longitudinal data from a previously published intervention study evaluating person-centred information and communication. The project was conducted at three hospitals in Sweden. Patient-reported outcomes measures, including the Longitudinal Preparedness for Colorectal Cancer Surgery Questionnaire, were collected before surgery, at discharge, and four to six weeks, three months, and six months after surgery. Clinical data were retrospectively obtained from patients' medical records. We used latent class growth models (LCGMs) to identify latent classes that distinguish subgroups of patients who represent different preparedness trajectory profiles. To determine the most plausible number of latent classes, we considered statistical information about model fit and clinical practice relevance. We used multivariable regression models to identify variables that explain the latent classes., Results: The sample ( N  = 488) comprised people with a mean age of 68 years (SD = 11) of which 44% were women. Regarding diagnoses, 60% had colon cancer and 40% rectal cancer. The LCGMs identified six latent classes with different preparedness for surgery and recovery trajectories. The latent classes were predominantly explained by differences in age, sex, physical classification based on comorbidities, treatment hospital, global health status, distress, and sense of coherence (comprehensibility and meaningfulness)., Conclusion: Contrary to the received view that emphasizes standardized care practices, our results point to the need for adding person-centred and tailored approaches that consider individual differences in how patients are prepared before and during the recovery period related to colorectal cancer surgery.