Prevalence, correlates and impact of pain and cramps in anti-MAG neuropathy:a multicentre European study

BACKGROUND AND PURPOSE: The frequency of pain and cramps is uncertain in anti-myelin associated glycoprotein antibody (anti-MAG) neuropathy. Whether these symptoms may affect function/quality of life is unknown. METHODS: A cross-sectional study of the prevalence, correlates and impact of pain, pain subtypes and cramps, their severity, frequency and anatomical distribution was performed for 55 clinically stable patients with anti-MAG neuropathy. RESULTS: Pain of any type was reported by 80% of subjects. The most common subtype was paraesthesiae and dysaesthesiae (70%). Cramps were reported by >60% of patients, with lower limb cramps in all and upper limb cramps in about 20%. Cramps affected daily activities in >30% of these subjects, sleep in 60%, ability to exercise in >30%. Total pain score correlated with several Short Form 36 health-related quality of life (SF-36 HR-QoL) measures (P < 0.05), with Inflammatory Rasch-built Overall Disability Scale (I-RODS) (P = 0.006) and 10-m timed walk (P = 0.019). An independent association was ascertained with I-RODS (P = 0.002). Different pain subtypes showed multiple associations with SF-36 HR-QoL measures and/or functional scales. Upper limb cramps had multiple SF-36 HR-QoL functional correlates, with an independent association with the Overall Neuropathy Limitation Score (ONLS) (P = 0.004). Cramp severity correlated with ONLS (P = 0.04) and I-RODS (P = 0.028) and inversely with level of physiotherapy input (P = 0.009). Cramp frequency was associated with tremor score (P = 0.004) and multiple SF-36 HR-QoL subsections. CONCLUSIONS: Neuropathic pain and cramps may affect function and quality of life in anti-MAG neuropathy. Optimizing treatments of these symptoms, including by adequate levels of physiotherapy, may be beneficial in affected patients and requires further research

Synthesis, characterization, and catalytic activity of sulfonated carbon-based catalysts derived from rubber tree leaves and pulp and paper mill waste

Sulfonated carbon-based catalysts derived from rubber tree leaves, and pulp and paper mill waste were synthesized and characterized. Three types of catalyst synthesized were sulfonated rubber tree leaves (S-RTL), pyrolysed sludge char (P-SC) and sulfonated sludge char (S-SC). Sulfonated rubber tree leaves (S-RTL) and sulfonated sludge char (S-SC) were prepared through pyrolysis followed by functionalization via sulfonation process whereas, P- SC was only pyrolyzed without sulfonation. The characterization results indicated sulfonic acids, hydroxyl, and carboxyl moieties were detected in S-RTL and S-SC, but no sulfonic acid was detected in P-SC. Total acidity test showed S-RTL had the highest value followed by S-SC and P-SC. The thermal stability of S-RTL and S-SC were up to 230oC as the loss was associated with the decomposition of sulfonic acid group, whereas, P-SC showed higher stability than the S-RTL and S-SC. Morphology analysis showed that S-RTL consisted of an amorphous carbon structure, and a crystalline structure for P-SC and S-SC. Furthermore, traces of metal components were also detected on all of the catalysts. The catalyst catalytic activity was tested through esterification of oleic acid with methanol. The results showed that the reaction using S-RTL catalyst produced the highest conversion (99.9%) followed by P-SC (88.4%) and lastly S-SC (82.7%). The synthesized catalysts showed high potential to be used in biodiesel production

Practice Inquiry: Clinical Uncertainty as a Focus for Small-Group Learning and Practice Improvement

PROBLEM: Many primary care physicians in nonacademic settings lack a collegial forum for engaging the clinical uncertainties inherent in their work. PROGRAM DESCRIPTION: “Practice Inquiry” is proposed as a set of small-group, practice-based learning and improvement (PBLI) methods designed to help clinicians better manage case-based clinical uncertainty. Clinicians meet regularly at their offices/clinics to present dilemma cases, share clinical experience, review evidence for blending with experience, and draw implications for practice improvement. From 2001 through 2005, Practice Inquiry was introduced to sites in the San Francisco Bay Area as a demonstration effort. Meeting rosters, case logs, a feedback survey, and meeting field notes documented implementation and provided data for a formative, qualitative evaluation. PROGRAM EVALUATION: Of the 30 sites approached, 14 held introductory meetings. As of summer 2006, 98 clinicians in 11 sites continue to hold regularly scheduled group meetings. Of the 118 patient cases presented in the seven oldest groups, clinician–patient relationship and treatment dilemmas were most common. Clinician feedback and meeting transcript data provided insights into how busy practitioners shared cases, developed trust, and learned new knowledge/skills for moving forward with patients. DISCUSSION: Ongoing clinician involvement suggests that Practice Inquiry is a feasible, acceptable, and potentially useful set of PBLI methods. Two of the Practice Inquiry’s group learning tasks received comparatively less focus: integrating research evidence with clinical experience and tracking dilemma case outcomes. Future work should focus on reducing the methodological limitations of a demonstration effort and examining factors affecting clinician participation. Set-aside work time for clinicians, or other equally potent incentives, will be necessary for the further elaboration of these PBLI methods aimed at managing uncertainty

The Advancement of Biomaterials in Regulating Stem Cell Fate.

Stem cells are well-known to have prominent roles in tissue engineering applications. Embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) can differentiate into every cell type in the body while adult stem cells such as mesenchymal stem cells (MSCs) can be isolated from various sources. Nevertheless, an utmost limitation in harnessing stem cells for tissue engineering is the supply of cells. The advances in biomaterial technology allows the establishment of ex vivo expansion systems to overcome this bottleneck. The progress of various scaffold fabrication could direct stem cell fate decisions including cell proliferation and differentiation into specific lineages in vitro. Stem cell biology and biomaterial technology promote synergistic effect on stem cell-based regenerative therapies. Therefore, understanding the interaction of stem cell and biomaterials would allow the designation of new biomaterials for future clinical therapeutic applications for tissue regeneration. This review focuses mainly on the advances of natural and synthetic biomaterials in regulating stem cell fate decisions. We have also briefly discussed how biological and biophysical properties of biomaterials including wettability, chemical functionality, biodegradability and stiffness play their roles

Effect of Relative Intensity Noise in Optical Transmission Systems Employing Wavelength Conversion Based on XPM and MZI

The overall intensity noise spectrum due to laser relative intensity noise (RIN) and interferometric conversion of laser phase noise after passing through wavelength conversion (WC) based on cross-phase modulation (XPM) and Mach-Zehnder interferometer (MZI) is modeled along with the resulting noise at the direct-detection receiver It is found that the effect of the laser-induced noise at the receiver is negligible when the MZI operated at quadrature and has a free spectral range (FSR) > 0.01 GHz. Only when FSR < 0.01 GHz is a power penalty induced that increases with decreasing laser current bias, j(0) (0.8 dB, j(0) = 2; 1.7 dB, j(0) = 1.5; 5.2 dB, j(0) = 1.1)

A technique to improve optical time division multiplexing - wavelength division multiplexing performance

Optical time division multiplexing - wavelength division multiplexing (OTDM-WDM), intensity modulation (IM) systems employing optical amplification and dispersion management (DM) are analyzed with and without the introduction of an optical narrowband bandpass filter placed right after optical time demultiplexing. The use of the filter was found to improve the performance of the demultiplexed channels by reducing amplitude jitter while possessing high intersymbol interference (ISI) tolerance. The OTDM-WDM link shows good performance up to 2000 km with the OTDM filter providing a Q gain of 0.7-1.1 dB. The optimal input power reduces for longer distances due to increased significance of nonlinear effects. A 900 km link showed good performance for spectral efficiencies as low as 0.52 bits/s/Hz, though the Q gain provided by the OTDM filter reduces as channel spacing decreases

Evaluation of the analytical performance of a portable ion-selective electrode meter for measuring whole-blood, plasma, milk, abomasal-fluid, and urine sodium concentrations in cattle

A portable ion-selective electrode (ISE) meter (LAQUAtwin B-722; Horiba Instruments Inc., Irvine, CA) is available for measuring the sodium ion concentration ([Na]) in biological fluids. The objective of this study was to characterize the analytical performance of the ISE meter in measuring [Na] in whole-blood, plasma, milk, abomasal fluid, and urine samples from cattle. Method comparison studies were performed using whole-blood and plasma samples from 106 sick calves and 11 sick cows admitted to a veterinary teaching hospital, 80 milk and 206 urine samples from 16 lactating Holstein-Friesian cows with experimentally induced free water, electrolyte, and acid-base imbalances, and 67 abomasal fluid samples from 7 healthy male Holstein-Friesian calves fed fresh milk with or without an oral electrolyte solution. Deming regression and Bland-Altman plots were used to determine the accuracy of the meter against reference methods. The meter used in direct mode on undiluted samples measured whole-blood [Na] 9.7 mmol/L (7.3%) lower than a direct ISE reference method and plasma [Na] 16.7 mmol/L (12.7%) lower than an indirect ISE reference method. The meter run in direct mode measured milk [Na] 3.1 mmol/L lower and abomasal fluid [Na] 9.0% lower than indirect ISE reference methods. The meter run in indirect mode on diluted samples accurately measured urine [Na] compared with an indirect ISE reference method. We conclude that, after adjustment for the bias determined from Bland-Altman plots, the LAQUAtwin ISE meter provides a clinically useful and low-cost cow-side instrument for measuring [Na] in whole blood, plasma, milk, and abomasal fluid

Palmprint verification with moments

Palmprint verification is an approach for verifying a palmprint input by matching the input to the claimed identity template stored in a database. If the dissimilarity measure between the input and the claimed template is below the predefined threshold value, the palmprint input is verified possessing same identity as the claimed identity template. This paper introduces an experimental evaluation of the effectiveness of utilizing three well known orthogonal moments, namely Zernike moments, pseudo Zernike moments and Legendre moments, in the application of palmprint verification. Moments are the most commonly used technique in character feature extraction. The idea of implementing orthogonal moments as palmprint feature extractors is prompted by the fact that principal features of both character and palmprint are based on line structure. These orthogonal moments are able to define statistical and geometrical features containing line structure information about palmprint. An experimental study about verification rate of the palmprint authentication system using these three orthogonal moments as feature descriptors has been discussed here. Experimental results show that the performance of the system is dependent on the moment order as well as the type of moments. The orthogonal property of these moments is able to characterize independent features of the palmprint image and thus have minimum information redundancy in a moment set. Pseudo Zernike moments of order of 15 has the best performance among all the moments. Its verification rate is 95.75%, which also represents the overall performance of this palmprint verification system