Manipulation of the foot in the treatment of patients with Morton’s neuroma

Introduction Manipulative therapy’s rationale is pragmatically appealing as a non-invasive treatment for Morton’s neuroma (MN), involving targeted manipulations of relevant joints. Nevertheless, manipulation’s efficacy has received limited scrutiny. This thesis comprised four data-driven chapters offering novel investigations associated with manipulation as a treatment for MN. The latter included a critical appraisal of the clinimetric utility of pressure testing for discomfort thresholds (PTT) as a novel outcome in this context (n = 26; Chapter 5), an exploratory pragmatic controlled trial investigating Manipulation versus Steroid Injection in the treatment of patients with Morton’s neuroma focusing on self-reported pain levels (VAS) and PTT (n = 61; Chapter 6) and other PROMs reflecting functionality and health (Chapter 7). A final data chapter (Chapter 8) contributed secondary analyses of data in Chapters 6 and 7 exploring novel factors in enhanced clinical outcomes of non-surgical treatment of Morton’s neuroma using descriptive multivariate modelling and discriminant analysis. Method The thesis’s primary study (Chapters 6 and 7) featured an exploratory, pragmatic randomised controlled trial was designed to investigate the efficacy of an acute, short dosage (6, weekly episodes) of physiologically-principled manipulations, featuring discrete, high-velocity thrusting manoeuvres for treating Morton’s Neuroma. Adults electing treatment for Morton’s neuroma were randomly allocated to manipulative therapy (n = 29) or corticosteroid injection (n = 32). Baseline and follow-up (at 1·5, 3, 6, 9 and 12 months following treatment cessation) outcome measures of self-reported pain levels (VAS), pressure testing for discomfort thresholds (PTT) and functionality (walking and standing [MOxFQws], pain [MOxFQp)] and social interaction [MOxFQsi]; activities of daily living [FAAMdl], sports participation [FAAMspt] and general health [SF-36 PCS & MCS]) were measured ipsilaterally and by inventory. Results Chapters 6 and 7 showed that manipulation elicited substantive gains immediately after intervention (VAS [Cohen’s d, 3·3; 84·4%]; PTT [d, 2·3; 147·0%]; MOxFQws [d, 1·4; 52·8%]; MOxFQp [d, 1·3; 45·5%]; MOxFQsi [d, 0·9; 39·2%]) or accumulated during follow-up (FAAMdl [d, 2·2; 40·8%]; FAAMspt [d, 1·5; 66·1%]). Concomitant gains interactively for control participants were modest (d, 0·4 to 1·0; 16·6% to 45·9%) (p < 0·05 to p < 0·0005). Retention of improvements following manipulation cessation was substantial for all metrics, significantly better than baseline scores (VAS, PTT, MOxFQws, MOxFQp, MOxFQsi, FAAMdl, FAAMspt, SF-36 PCS and SF-36 MCS [d, 1·1 to 3·4; 40·8% to 152·3%]) and consistently exceeded that for corticosteroid injection (p < 0·01 to p < 0·001). Group mean intra-session and inter-day variability (V%) of PTT (Chapter 5) ranged between 6.8% and 13.6% for experienced and inexperienced test administrators, respectively, and suggested compromised precision amongst serial measurements of PTT over extended periods of time. Within Chapter 8, predictive multivariate modelling showed that in internal classification analyses, 88.9% of patients could be assigned correctly to high- and low-responders to treatment. Conclusion (i) Manipulation elicited significant and clinically relevant improvements and retention in self-reported levels of pain, discomfort and functionality for patients electing treatment for Morton’s neuroma; (ii) Exploratory multivariate modelling provided a significant prediction model for successful non-surgical treatment outcomes; (iii) Single measurements showed compromised precision amongst serial assessments of PTT

Gaining Insight into Determinants of Physical Activity using Bayesian Network Learning

Contains fulltext : 228326pre.pdf (preprint version ) (Open Access) Contains fulltext : 228326pub.pdf (publisher's version ) (Open Access)BNAIC/BeneLearn 202

Human and Artificial Intelligence

Although tremendous advances have been made in recent years, many real-world problems still cannot be solved by machines alone. Hence, the integration between Human Intelligence and Artificial Intelligence is needed. However, several challenges make this integration complex. The aim of this Special Issue was to provide a large and varied collection of high-level contributions presenting novel approaches and solutions to address the above issues. This Special Issue contains 14 papers (13 research papers and 1 review paper) that deal with various topics related to human–machine interactions and cooperation. Most of these works concern different aspects of recommender systems, which are among the most widespread decision support systems. The domains covered range from healthcare to movies and from biometrics to cultural heritage. However, there are also contributions on vocal assistants and smart interactive technologies. In summary, each paper included in this Special Issue represents a step towards a future with human–machine interactions and cooperation. We hope the readers enjoy reading these articles and may find inspiration for their research activities

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When considering advances in “smart” weapons it is clear that air-launched systems have adopted an integrated approach to meet rigorous requirements, whereas air-defence systems have not. The demands on sensors, state observation, missile guidance, and simulation for air-defence is the subject of this research. Historical reviews for each topic, justification of favoured techniques and algorithms are provided, using a nomenclature developed to unify these disciplines. Sensors selected for their enduring impact on future systems are described and simulation models provided. Complex internal systems are reduced to simpler models capable of replicating dominant features, particularly those that adversely effect state observers. Of the state observer architectures considered, a distributed system comprising ground based target and own-missile tracking, data up-link, and on-board missile measurement and track fusion is the natural choice for air-defence. An IMM is used to process radar measurements, combining the estimates from filters with different target dynamics. The remote missile state observer combines up-linked target tracks and missile plots with IMU and seeker data to provide optimal guidance information. The performance of traditional PN and CLOS missile guidance is the basis against which on-line trajectory optimisation is judged. Enhanced guidance laws are presented that demand more from the state observers, stressing the importance of time-to-go and transport delays in strap-down systems employing staring array technology. Algorithms for solving the guidance twopoint boundary value problems created from the missile state observer output using gradient projection in function space are presented. A simulation integrating these aspects was developed whose infrastructure, capable of supporting any dynamical model, is described in the air-defence context. MBDA have extended this work creating the Aircraft and Missile Integration Simulation (AMIS) for integrating different launchers and missiles. The maturity of the AMIS makes it a tool for developing pre-launch algorithms for modern air-launched missiles from modern military aircraft.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

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The contributions cover a wide range of methodologies and application areas for safety and reliability that contribute to safe societies in a changing world. These methodologies and applications include: - foundations of risk and reliability assessment and management - mathematical methods in reliability and safety - risk assessment - risk management - system reliability - uncertainty analysis - digitalization and big data - prognostics and system health management - occupational safety - accident and incident modeling - maintenance modeling and applications - simulation for safety and reliability analysis - dynamic risk and barrier management - organizational factors and safety culture - human factors and human reliability - resilience engineering - structural reliability - natural hazards - security - economic analysis in risk managemen

Proceedings XXI Congresso SIAMOC 2021

XXI Congresso Annuale della SIAMOC, modalità telematica il 30 settembre e il 1° ottobre 2021. Come da tradizione, il congresso vuole essere un’occasione di arricchimento e mutuo scambio, dal punto di vista scientifico e umano. Verranno toccati i temi classici dell’analisi del movimento, come lo sviluppo e l’applicazione di metodi per lo studio del movimento nel contesto clinico, e temi invece estremamente attuali, come la teleriabilitazione e il telemonitoraggio