MRI changes in psoriatic dactylitisextent of pathology, relationship to tenderness and correlation with clinical indices

Objectives. To quantify the extent of inflammation in psoriatic dactylitis and to examine the relationship between clinical and magnetic resonance imaging (MRI) data in both tender and non-tender dactylitis. Methods. Seventeen patients with psoriatic dactylitis underwent clinical assessment for 6 months after change of treatment, usually to methotrexate. Measures of dactylitis included the Leeds Dactylitis Index, the assessment tool used in the Infliximab in Psoriatic Arthritis Clinical Trial (IMPACT), a simple count of tender dactlylitic digits and a count of all dactylitic digits, both tender and non-tender. MRI scans of the affected hand or foot were performed before and after treatment using a 1.5T Siemens scanner pre- and post-contrast. Results. All patients improved clinically, as did their respective dactylitis scores and MRI images. The findings on MRI in both dactylitic and non-dactylitic digits were profound and widespread. The difference between tender and non-tender dactylitis was quantitative rather than qualitative. Synovitis and soft-tissue oedema were the most frequent abnormalities being present in 69 of tender dactylitic digits but bone oedema and flexor tenosynovitis were also frequently seen. Soft-tissue oedema was circumferential and enhancing and not limited to association with the flexor or extensor tendons. None of the clinical indices of dactylitis showed a close relationship to the extent of MRI abnormalities. Conclusions. MRI images demonstrate widespread abnormalities in digits of people with psoriatic arthritis. Tender dactylitic digits have more abnormalities than other digits but the relationship between clinical and MRI scores is not strong

Adolescents' and parents' views of Child and Adolescent Mental Health Services (CAMHS) in Ireland

Aim: To explore adolescents’ and parents’ experiences of CAMHS in relation to accessibility, approachability, and appropriateness. Methods: Using a descriptive qualitative design, a combination of focus group and single interviews were conducted with adolescents (n=15) and parents (n=32) from three mental health clinics. Data were transcribed verbatim and analysed using thematic analysis. Results: Accessing mental health services was a challenging experience due to knowledge deficit, lack of information and limited availability of specialist services. Participants desired more information, involvement in decision-making, single and shared consultations, flexible scheduling of appointments, continuity with clinicians, school support and parent support groups. Participants seem to be generally satisfied, however adolescents felt less involved in decision making than they would have liked. Frequent staff changes was problematic as it disrupted continuity of care and hindered the formation of a trusting relationship. Implications for practice: Parents and adolescents expressed similar views of the positive and negative aspects of mental health services. Their need for more information-sharing and involvement in decision-making underline the importance of collaborative practice. Clinician continuity contributed to trusting therapeutic relationships and was valued. These are key principles that with attention, could lead to quality service provision for adolescents and families

The construction of an instrument for the evaluation of student teachers.

Thesis (Ed.M.)--Boston Universit

Does Corporate Performance Improve After Mergers?

We examine the post-acquisition operating performance of merged firms using a sample of the 50 largest mergers between U.S. public industrial firms completed in the period 1979 to 1983. The results indicate that merged firms have significant improvement in asset productivity relative to their industries after the merger, leading to higher post-merger operating cash flow returns. Sample firms maintain their capital expenditure and R&D rates relative to their industries after the merger, indicating that merged firms do not reduce their long-term investments. There is a strong positive relation between postmerger increases in operating cash flows and abnormal stock returns at merger announcements, indicating that expectations of economic improvements underlie the equity revaluations of the merging firms.

The fatigue behavior of materials for the supersonic transport

Crack propagation behavior, residual static strength, and base fatigue strength of supersonic transport skin materia

Acoustic characterization of crack damage evolution in sandstone deformed under conventional and true triaxial loading

We thank the Associate Editor, Michelle Cooke, and the reviewers, Ze'ev Reches and Yves Guéguen, for useful comments which helped to improve the manuscript. We thank J.G. Van Munster for providing access to the true triaxial apparatus at KSEPL and for technical support during the experimental program. We thank R. Pricci for assistance with technical drawings of the apparatus. This work was partly funded by NERC award NE/N002938/1 and by a NERC Doctoral Studentship, which we gratefully acknowledge. Supporting data are included in a supporting information file; any additional data may be obtained from J.B. (e-mail: [email protected]).Peer reviewedPublisher PD

Non-perturbative renormalization of the KPZ growth dynamics

We introduce a non-perturbative renormalization approach which identifies stable fixed points in any dimension for the Kardar-Parisi-Zhang dynamics of rough surfaces. The usual limitations of real space methods to deal with anisotropic (self-affine) scaling are overcome with an indirect functional renormalization. The roughness exponent $\alpha$ is computed for dimensions $d=1$ to 8 and it results to be in very good agreement with the available simulations. No evidence is found for an upper critical dimension. We discuss how the present approach can be extended to other self-affine problems.Comment: 4 pages, 2 figures. To appear in Phys. Rev. Let

Upper critical dimension, dynamic exponent and scaling functions in the mode-coupling theory for the Kardar-Parisi-Zhang equation

We study the mode-coupling approximation for the KPZ equation in the strong coupling regime. By constructing an ansatz consistent with the asymptotic forms of the correlation and response functions we determine the upper critical dimension d_c=4, and the expansion z=2-(d-4)/4+O((4-d)^2) around d_c. We find the exact z=3/2 value in d=1, and estimate the values 1.62, 1.78 for z, in d=2,3. The result d_c=4 and the expansion around d_c are very robust and can be derived just from a mild assumption on the relative scale on which the response and correlation functions vary as z approaches 2.Comment: RevTex, 4 page