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Charlotte de Groot,1 Daniel E Verstift,2 Jelle Heisen,3 Derek FP van Deurzen,2 Michel PJ van den Bekerom2,4 1Department of Orthopaedic Surgery and Trauma Surgery, OLVG, Amsterdam, the Netherlands; 2Shoulder and Elbow Unit, Joint Research, Department of Orthopaedic Surgery and Trauma Surgery, OLVG, Amsterdam, the Netherlands; 3Movamento, Amsterdam, the Netherlands; 4Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the NetherlandsCorrespondence: Charlotte de Groot, Department of Orthopaedic Surgery and Trauma Surgery, OLVG, P.O. Box 95500, Amsterdam, 1090 HM, the Netherlands, Email C.deGroot2@olvg.nlIntroduction: Treatment of a patient with acromioclavicular joint (ACJ) injury remains challenging for orthopedic surgeons. To date, there is debate over the optimal management of ACJ injuries. This review provides an overview of assessment, treatment, and future perspectives for the treatment of and research into ACJ.Material and Methods: A scoping literature review was performed. The search was built including the following terms: acromioclavicular joint injuries or dislocation, and pathophysiology, etiology, anatomy, treatment, and trauma mechanism. The papers with evidence levels 1– 3 were included in the current narrative review.Results: A total of 2242 potential relevant studies were identified in the searches. After removal of duplicates, 432 studies were screened on their titles and abstracts, resulting in 35 studies being included in the review, based on the eligibility criteria.Conclusion: The management of acute and chronic ACJ injuries is not clarified in the current literature. However, there is currently insufficient high-level evidence for the overall treatment options for ACJ injuries. If surgical intervention is decided upon in consultation with the patient, the complications may not outweigh the benefits. The multitude of existing techniques is indicative of the uncertainty surrounding this issue, and no gold standard has yet been established for treatment methods. An ideal classification would include not only vertical and horizontal instability, but also the severity of kinematic alterations of the shoulder complex. This indicates the need for a new and improved diagnostic tool for the classification of ACJ injuries.Keywords: acromioclavicular joint injury, rehabilitation, operative treatment, Rockwood classification, instability, semitendinosus graft

The “one-to-many” problem is a typical challenge that faced by many machine learning aided inverse nanophotonics designs where one target optical response can be achieved by many solutions (designs). Although novel training approaches, such as tandem network, and network architecture, such as the mixture density model, have been proposed, the critical problem of solution degeneracy still exists where some possible solutions or solution spaces are discarded or unreachable during the network training process. Here, we report a solution to the “one-to-many” problem by employing a conditional generative adversarial network (cGAN) that enables generating sets of multiple solution groups to a design problem. Using the inverse design of a transmissive Fabry–Pérot-cavity-based color filter as an example, our model demonstrates the capability of generating an average number of 3.58 solution groups for each color. These multiple solutions allow the selection of the best design for each color which results in a record high accuracy with an average index color difference ΔE of 0.44. The capability of identifying multiple solution groups can benefit the design manufacturing to allow more viable designs for fabrication. The capability of our cGAN is verified experimentally by inversely designing the RGB color filters. We envisage this cGAN-based design methodology can be applied to other nanophotonic structures or physical science domains where the identification of multi-solution across a vast parameter space is required.

Conceptualizing sustainability: Duurzaamheid staat maatschappelijk volop in de belangstelling. Ook van ondernemingen wordt verwacht dat zij duurzaam ondernemen. Tegelijkertijd is het begrip duurzaamheid lastig te definiëren. Bestuurders van ondernemingen, de aandeelhouders van ondernemingen, en ook de andere stakeholders kunnen verschillende visies hebben op wat duurzaamheid is en wat wordt verwacht van de onderneming. De kernelementen van duurzaamheid zijn divers en er bestaat een toenemend aantal juridische initiatieven op het gebied van duurzaamheid. Het is lastig om de begrippen die binnen het duurzaamheidsdebat een rol spelen op een juiste wijze te duiden en om de hoofdlijnen van het uitdijende regelgevend kader te volgen. Dit vraagt om een samenvattende benadering op hoofdlijnen. [ABSTRACT FROM AUTHOR]

Copyright of Maandblad voor Ondernemingsrecht is the property of Boom uitgevers Den Haag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Onderneming en Financiering is the property of Boom uitgevers Den Haag and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

STUDY QUESTION What factors influence the decision-making process of fathers regarding multifetal pregnancy reduction or maintaining a triplet pregnancy, and how do these decisions impact their psychological well-being? SUMMARY ANSWER For fathers, the emotional impact of multifetal pregnancy reduction or caring for triplets is extensive and requires careful consideration. WHAT IS KNOWN ALREADY Multifetal pregnancy reduction is a medical procedure with the purpose to reduce the number of fetuses to improve chances of a healthy outcome for both the remaining fetus(es) and the mother, either for medical reasons or social considerations. Aspects of the decision whether to perform multifetal pregnancy reduction have been rarely investigated, and the impact on fathers is unknown. STUDY DESIGN, SIZE, DURATION Qualitative study with semi-structured interviews between October 2021 and February 2023. PARTICIPANTS/MATERIALS, SETTING, METHODS Fathers either after multifetal pregnancy reduction from triplet to twin or singleton pregnancy or ongoing triplet pregnancies 1–6 years after the decision were included. The interview schedule was designed to explore key aspects related to (i) the decision-making process whether to perform multifetal pregnancy reduction and (ii) the emotional aspects and psychological impact of the decision. Thematic analysis was used to identify patterns and trends in the father's data. The process involved familiarization with the data, defining and naming themes, and producing a final report. This study was a collaboration between a regional secondary hospital (OLVG) and a tertiary care hospital (Amsterdam University Medical Center, Amsterdam UMC), both situated in Amsterdam, The Netherlands. MAIN RESULTS AND THE ROLE OF CHANCE Data saturation was achieved after 12 interviews. Five main themes were identified: (i) initial responses and emotional complexity, (ii) experiencing disparities in counselling quality and post-decision care, (iii) personal influences on the decision journey, (iv) navigating parenthood: choices, challenges, and emotional adaptation, and (v) shared wisdom and lessons. For fathers, the decision whether to maintain or reduce a triplet pregnancy is complex, in which medical, psychological but mainly social factors play an important role. In terms of psychological consequences after the decision, this study found that fathers after multifetal pregnancy reduction often struggled with difficult emotions towards the decision; some expressed feelings of doubt or regret and were still processing these emotions. Several fathers after an ongoing triplet had experienced a period of severe stress in the first years after the pregnancy, with major consequences for their mental health. Help in emotional processing was not offered to any of the fathers after the decision or birth. LIMITATION, REASONS FOR CAUTION While our study focuses on the multifetal pregnancy reduction process in the Amsterdam region, we recognize the importance of further investigation into how this process may vary across different regions in The Netherlands and internationally. We acknowledge the potential of selection bias, as fathers with more positive experiences might have been more willing to participate. Caution is needed in interpreting the role of the mother in the recruitment process. Additionally, the time span of 1–6 years between the decision and the interviews may have influenced emotional processing and introduced potential reporting bias. WIDER IMPLICATIONS OF THE FINDINGS The emotional impact of multifetal pregnancy reduction or caring for triplets is significant, emphasizing the need for awareness among caregivers regarding the emotional challenges faced by fathers. A guided trajectory might optimize the decision-making and primarily facilitate the provision of appropriate care thereafter to optimize outcomes around decisions with potential traumatic implications. STUDY FUNDING/COMPETING INTEREST(S) This study received no funding. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]