A simple model of complex cusp ion dispersions during intervals of northward interplanetary magnetic field

During northward IMF intervals, cusp ion energy-latitude dispersions observed by POLAR's TIMAS instrument often have two components. One dispersion decreases in energy with decreasing latitude. The second appears to split from the first and increases in energy as the equatorward edge of the cusp is approached. We present a simple model representing particle entry resulting from reconnection poleward of the cusp. We qualitatively show that split dispersions may arise on reconnected field lines which accelerate as they contract sunward into regions of lower magnetosheath flow velocity. The velocity filter effect produces the first dispersion by spreading particles entering near the reconnection site across a range of latitudes. The second, increasing energy dispersion, results from particles crossing the magnetopause at later times and lower latitudes. These particles are accelerated to higher energies due to the increased contraction speed of reconnected field lines at these latitudes

Is physiotherapy effective for patients with a chronic mid-body Achilles tendinopathy? A systematic review of non-surgical and non-pharmacological interventions

Objective: To assess the effectiveness of physiotherapy interventions (non-surgical and nonpharmacological) for a chronic mid-body Achilles tendinopathy. Materials and methods: A search of published and grey literature databases was undertaken (January 1999 to January 2011). Two reviewers independently assessed the studies for eligibility using a strict inclusion and exclusion criteria. All eligible articles were assessed critically using the PEDro score. Data on cohort characteristics, diagnostic criteria, treatment intervention, outcome measures, and results were extracted. A narrative research synthesis method was adopted since there were insufficient data to conduct a metaanalysis. Results: Two hundred and ninety studies were identified. Nine publications met the review inclusion criteria. Methodological quality was adequate for all nine studies; however, blinding was a limitation for most. Interventions investigated were; exercises (n= 2), low-level laser therapy (n = 1), low-energy shockwave treatment (SWT) (n= 3), air cast brace (n = 2), and insoles (n = 1). Some evidence exists for eccentric exercises in combination with SWT or laser. In contrast to other reviews, eccentric exercises alone were not found to be superior to other physiotherapy treatments. Conclusion: There is an insufficient evidence to determine which method of physiotherapy is most appropriate for a chronic mid-body Achilles tendinopathy. Further well-designed randomized controlled trials assessing physiotherapy interventions with specific diagnostic criteria and appropriate outcome tools are required to determine the efficacy of physiotherapy for the condition. © The Society of Orthopaedic Medicine and the British Institute of Musculoskeletal Medicine 2011

Intense pulsed light treatment of chronic mid-body Achilles tendinopathy: A double blind randomised placebo-controlled trial.

We conducted a randomised controlled trial to determine whether active intense pulsed light (IPL) is an effective treatment for patients with chronic mid-body Achilles tendinopathy. A total of 47 patients were randomly assigned to three weekly therapeutic or placebo IPL treatments. The primary outcome measure was the Victorian Institute of Sport Assessment - Achilles (VISA-A) score. Secondary outcomes were a visual analogue scale for pain (VAS) and the Lower Extremity Functional Scale (LEFS). Outcomes were recorded at baseline, six weeks and 12 weeks following treatment. Ultrasound assessment of the thickness of the tendon and neovascularisation were also recorded before and after treatment. There was no significant difference between the groups for any of the outcome scores or ultrasound measurements by 12 weeks, showing no measurable benefit from treatment with IPL in patients with Achilles tendinopathy

Stabilisation of the fractured fibula plays an important role in the treatment of pilon fractures: a retrospective comparison of fibular fixation methods

Ninety-eight pilon fractures associated with ipsilateral distal fibular fracture were included in this study. The pilon fractures were treated by open reduction and plating. The 98 fractures were divided into three groups based on the treatment method of fractured fibula. Group A was composed of 50 fibular fractures treated by open reduction and plate fixation. Group B was composed of 23 fibular fractures treated by open reduction and pin fixation. Group C was composed of 25 fibular fractures treated conservatively by closed reduction. The radiographs were reviewed for adequacy of fracture reduction and posttraumatic arthrosis. At the end of follow-up, the clinical outcomes were evaluated using a rating scale. The three groups were similar in respect to Ruedi type, open fracture grade, and demographics (all p values >0.25). Group A showed a decreasing trend of malunion and ankle arthrosis compared to group C (p = 0.091 and p = 0.099, respectively). Group A had a better clinical outcome than group C (p = 0.008). In addition, group A showed an increasing trend of satisfactory outcome compared to group B (p = 0.096). In conclusion, for pilon fractures associated with ipsilateral fibular fractures, stabilisation of the fractured fibula plays an important role in the decrease of distal tibial malunion and post-traumatic ankle arthrosis as well as improvement of clinical outcomes