102 research outputs found
On some problems involving Hardy's function
Some problems involving the classical Hardy function are discussed. In particular we discuss the odd moments of
, the distribution of its positive and negative values and the primitive
of . Some analogous problems for the mean square of are
also discussed.Comment: 15 page
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Improving adherence to acute low back pain guideline recommendations with chiropractors and physiotherapists: the ALIGN cluster randomised controlled trial
Background
Acute low back pain is a common condition, has high burden, and there are evidence-to-practice gaps in the chiropractic and physiotherapy setting for imaging and giving advice to stay active. The aim of this cluster randomised trial was to estimate the effects of a theory- and evidence-based implementation intervention to increase chiropractors’ and physiotherapists’ adherence to a guideline for acute low back pain compared with the comparator (passive dissemination of the guideline). In particular, the primary aim of the intervention was to reduce inappropriate imaging referral and improve patient low back pain outcomes, and to determine whether this intervention was cost-effective.
Methods
Physiotherapy and chiropractic practices in the state of Victoria, Australia, comprising at least one practising clinician who provided care to patients with acute low back pain, were invited to participate. Patients attending these practices were included if they had acute non-specific low back pain (duration less than 3 months), were 18 years of age or older, and were able to understand and read English. Practices were randomly assigned either to a tailored, multi-faceted intervention based on the guideline (interactive educational symposium plus academic detailing) or passive dissemination of the guideline (comparator). A statistician independent of the study team undertook stratified randomisation using computer-generated random numbers; four strata were defined by professional group and the rural or metropolitan location of the practice. Investigators not involved in intervention delivery were blinded to allocation. Primary outcomes were X-ray referral self-reported by clinicians using a checklist and patient low back pain-specific disability (at 3 months).
Results
A total of 104 practices (43 chiropractors, 85 physiotherapists; 755 patients) were assigned to the intervention and 106 practices (45 chiropractors, 97 physiotherapists; 603 patients) to the comparator; 449 patients were available for the patient-level primary outcome. There was no important difference in the odds of patients being referred for X-ray (adjusted (Adj) OR: 1.40; 95% CI 0.51, 3.87; Adj risk difference (RD): 0.01; 95% CI − 0.02, 0.04) or patient low back pain-specific disability (Adj mean difference: 0.37; 95% CI − 0.48, 1.21, scale 0–24). The intervention did lead to improvement for some key secondary outcomes, including giving advice to stay active (Adj OR: 1.96; 95% CI 1.20, 3.22; Adj RD: 0.10; 95% CI 0.01, 0.19) and intending to adhere to the guideline recommendations (e.g. intention to refer for X-ray: Adj OR: 0.27; 95% CI 0.17, 0.44; intention to give advice to stay active: Adj OR: 2.37; 95% CI 1.51, 3.74).
Conclusions
Intervention group clinicians were more likely to give advice to stay active and to intend to adhere to the guideline recommendations about X-ray referral. The intervention did not change the primary study outcomes, with no important differences in X-ray referral and patient disability between groups, implying that hypothesised reductions in health service utilisation and/or productivity gains are unlikely to offset the direct costs of the intervention. We report these results with the caveat that we enrolled less patients into the trial than our determined sample size. We cannot recommend this intervention as a cost-effective use of resources
Reverse Monte Carlo modeling of amorphous silicon
An implementation of the Reverse Monte Carlo algorithm is presented for the
study of amorphous tetrahedral semiconductors. By taking into account a number
of constraints that describe the tetrahedral bonding geometry along with the
radial distribution function, we construct a model of amorphous silicon using
the reverse monte carlo technique. Starting from a completely random
configuration, we generate a model of amorphous silicon containing 500 atoms
closely reproducing the experimental static structure factor and bond angle
distribution and in improved agreement with electronic properties. Comparison
is made to existing Reverse Monte Carlo models, and the importance of suitable
constraints beside experimental data is stressed.Comment: 6 pages, 4 PostScript figure
Derivative moments for characteristic polynomials from the CUE
We calculate joint moments of the characteristic polynomial of a random
unitary matrix from the circular unitary ensemble and its derivative in the
case that the power in the moments is an odd positive integer. The calculations
are carried out for finite matrix size and in the limit as the size of the
matrices goes to infinity. The latter asymptotic calculation allows us to prove
a long-standing conjecture from random matrix theory.Comment: 31 pages, 3 figure
Sugar responses of human enterochromaffin cells depend on gut region, sex, and body mass
Gut-derived serotonin (5-HT) is released from enterochromaffin (EC) cells in response to nutrient cues, and acts to slow gastric emptying and modulate gastric motility. Rodent studies also evidence a role for gut-derived 5-HT in the control of hepatic glucose production, lipolysis and thermogenesis, and in mediating diet-induced obesity. EC cell number and 5-HT content is increased in the small intestine of obese rodents and human, however, it is unknown whether EC cells respond directly to glucose in humans, and whether their capacity to release 5-HT is perturbed in obesity. We therefore investigated 5-HT release from human duodenal and colonic EC cells in response to glucose, sucrose, fructose and α-glucoside (αMG) in relation to body mass index (BMI). EC cells released 5-HT only in response to 100 and 300 mM glucose (duodenum) and 300 mM glucose (colon), independently of osmolarity. Duodenal, but not colonic, EC cells also released 5-HT in response to sucrose and αMG, but did not respond to fructose. 5-HT content was similar in all EC cells in males, and colonic EC cells in females, but 3 to 4-fold higher in duodenal EC cells from overweight females (p < 0.05 compared to lean, obese). Glucose-evoked 5-HT release was 3-fold higher in the duodenum of overweight females (p < 0.05, compared to obese), but absent here in overweight males. Our data demonstrate that primary human EC cells respond directly to dietary glucose cues, with regional differences in selectivity for other sugars. Augmented glucose-evoked 5-HT release from duodenal EC is a feature of overweight females, and may be an early determinant of obesity.Amanda L. Lumsden, Alyce M. Martin, Emily W. Sun, Gudrun Schober, Nicole J. Isaacs, Nektaria Pezos, David A. Wattchow, Dayan de Fontgalland, Philippa Rabbitt, Paul Hollington, Luigi Sposato, Steven L. Due, Christopher K. Rayner, Nam Q. Nguyen, Alice P. Liou, V. Margaret Jackson, Richard L. Young, and Damien J. Keatin
Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines
Previously undiagnosed anaemia is common in elective orthopaedic surgical patients and is associated with increased likelihood of blood transfusion and increased perioperative morbidity and mortality. A standardized approach for the detection, evaluation, and management of anaemia in this setting has been identified as an unmet medical need. A multidisciplinary panel of physicians was convened by the Network for Advancement of Transfusion Alternatives (NATA) with the aim of developing practice guidelines for the detection, evaluation, and management of preoperative anaemia in elective orthopaedic surgery. A systematic literature review and critical evaluation of the evidence was performed, and recommendations were formulated according to the method proposed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical patients have a haemoglobin (Hb) level determination 28 days before the scheduled surgical procedure if possible (Grade 1C). We suggest that the patient's target Hb before elective surgery be within the normal range, according to the World Health Organization criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease (Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia should be viewed as a serious and treatable medical condition, rather than simply an abnormal laboratory value. Implementation of anaemia management in the elective orthopaedic surgery setting will improve patient outcomes
Chromosomal localization of 15 ion channel genes
Several human Mendelian diseases, including the long-QT syndrome, malignant hyperthermia, and episodic ataxia/myokymia syndrome, have recently been demonstrated to be due to mutations in ion channel genes. Systematic mapping of ion channel genes may therefore reveal candidates for other heritable disorders. In this study, the GenBank and dbEST databases were used to identify members of several ion channel families (voltage-gated calcium and sodium cardiac chloride, and all classes of potassium channels). Genes and ESTs without prior map localization were identified based on GDB and OWL database information and 15 genes and ESTs were selected for mapping. Of these 15, only the serotonin receptor 5HT3R had been previously mapped to a chromosome. A somatic cell hybrid panel (SCH) was screened with an STS from each gene and, if necessary, the results verified by a second SCH panel. For three ESTs, rodent derived PCR products of the same size as the human STS precluded SCH mapping. For these three, human Pl clones were isolated and the genomic location was determined by metaphase FISH. These genes and ESTs can now be further evaluated as candidate genes for inherited cardiac, neuromuscular, and psychiatric disorders mapped to these chromosomes. Furthermore, the ESTs developed in this study can be used to isolate genomic clones, enabling the determination of each transcript's genomic structure and physical map location. This approach may also be applicable to other gene families and may aid in the identification of candidate genes for groups of related heritable disorders.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45548/1/11188_2006_Article_BF02369898.pd
Reduced SLIT2 is associated with increased cell proliferation and arsenic trioxide resistance in acute promyelocytic Leukemia
The SLIT-ROBO axis plays an important role in normal stem-cell biology, with possible
repercussions on cancer stem cell emergence. Although the Promyelocytic Leukemia (PML) protein
can regulate SLIT2 expression in the central nervous system, little is known about SLIT2 in acute
promyelocytic leukemia. Hence, we aimed to investigate the levels of SLIT2 in acute promyelocytic
leukemia (APL) and assess its biological activity in vitro and in vivo. Our analysis indicated that
blasts with SLIT2high transcript levels were associated with cell cycle arrest, while SLIT2low APL
blasts displayed a more stem-cell like phenotype. In a retrospective analysis using a cohort of
patients treated with all-trans retinoic acid (ATRA) and anthracyclines, high SLIT2 expression was
correlated with reduced leukocyte count (p = 0.024), and independently associated with improved
overall survival (hazard ratio: 0.94; 95% confidence interval: 0.92–0.97; p < 0.001). Functionally,
SLIT2-knockdown in primary APL blasts and cell lines led to increased cell proliferation and resistance
to arsenic trioxide induced apoptosis. Finally, in vivo transplant of Slit2-silenced primary APL blasts
promoted increased leukocyte count (p = 0.001) and decreased overall survival (p = 0.002) compared
with the control. In summary, our data highlight the tumor suppressive function of SLIT2 in APL and
its deteriorating effects on disease progression when downregulated
Macrosocial determinants of population health in the context of globalization
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55738/1/florey_globalization_2007.pd
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