Monitoring osteoarthritis: a cross-sectional survey in general practice

<b>Background</b> Despite being a highly prevalent chronic condition managed predominantly in primary care and unlike other chronic conditions, osteoarthritis (OA) care is delivered on an ad hoc basis rather than through routine structured review. Evidence suggests current levels of OA care are suboptimal, but little is known about what general practitioners' (GPs) consider important in OA care, and, thus, the scope to improve inconsistency or poor practice is, at present, limited.<p></p> <b>Objectives</b> We investigated GPs' views on and practice of monitoring OA. <p></p> <b>Methods</b> This was a cross-sectional postal survey of 2500 practicing UK GPs randomly selected from the Binley's database. Respondents were asked if monitoring OA patients was important and how monitoring should be undertaken.<p></p> <b>Results</b> Responses were received from 768 GPs of whom 70.8% were male and 89.5% were principals within their practices. Despite 55.4% (n = 405) indicating monitoring patients with OA was important and 78.3% (n = 596) considering GPs the appropriate professionals to monitor OA, only 15.2% (n = 114) did so routinely, and 45% (n = 337) did not monitor any OA patients at all. In total, 61.4% (n = 463) reported that patients should self-monitor. Respondents favored monitoring physical function, pain, and analgesia use over monitoring measures of BMI, self management plans, and exercise advice.<p></p> <b>Conclusions</b> The majority of respondents felt that monitoring OA was important, but this was not reflected in their reported current practice. Much of what they favored for monitoring was in line with published guidance, suggesting provision of suboptimal care does not result from lack of knowledge and interventions to improve OA care must address barriers to GPs engaging in optimal care provision

Genetic variation among lambs in peripheral IgE activity against the larval stages of <i>Teladorsagia circumcincta</i>

IgA and IgE activity against Teladorsagia circumcincta was investigated in a flock of Texel lambs following natural, mixed nematode infection among lambs. The distribution of IgA activity was similar to a gamma distribution whereas IgE activity was different. Box-Cox analysis demonstrated that X0.25 was a suitable transformation to normalise IgE responses. The transformed IgE activity was under moderate to strong genetic control. Nine different allergens were identified by proteomic analysis. Tropomyosin was selected for further analysis. IgE activity against tropomyosin was moderately heritable and associated with decreased egg counts and with reduced body weight at the time of sampling

Ground State Energy of the One-Dimensional Discrete Random Schr\"{o}dinger Operator with Bernoulli Potential

In this paper, we show the that the ground state energy of the one dimensional Discrete Random Schroedinger Operator with Bernoulli Potential is controlled asymptotically as the system size N goes to infinity by the random variable \ell_N, the length the longest consecutive sequence of sites on the lattice with potential equal to zero. Specifically, we will show that for almost every realization of the potential the ground state energy behaves asymptotically as $\frac{\pi^2}{\ell_N+1)^2}$ in the sense that the ratio of the quantities goes to one

The architecture of cancellous bone in the hindlimb of moa (Aves: Dinornithiformes), with implications for stance and gait

The extinct, flightless moa of New Zealand included some of the largest birds to have existed and possessed many distinguishing pelvic and hindlimb osteological features. These features may have influenced stance and gait in moa compared with extant birds. One means of assessing locomotor biomechanics, particularly for extinct species, is quantitative analysis of the architecture of cancellous bone, since this architecture is adapted to suit its mechanical environment with high sensitivity. This study investigated the three-dimensional architecture of cancellous bone in the femur, tibiotarsus and fibula of three moa species: Dinornis robustus, Pachyornis elephantopus and Megalapteryx didinus. Using computed tomographic X-ray scanning and previously developed fabric analysis techniques, the spatial variation in cancellous bone fabric patterns in moa was found to be largely comparable with that previously reported for extant birds, particularly large species. Moa hence likely used postures and kinematics similar to those employed by large extant bird species, but this interpretation is tentative on account of relatively small sample sizes. A point of major difference between moa and extant birds concerns the diaphyses; cancellous bone invades the medullary cavity in both groups, but the invasion is far more extensive in moa. Combined with previous assessments of cortical geometry, this further paints a picture of at least some moa species possessing very robust limb bones, for which a convincing explanation remains to be determine

New Results in Sasaki-Einstein Geometry

This article is a summary of some of the author's work on Sasaki-Einstein geometry. A rather general conjecture in string theory known as the AdS/CFT correspondence relates Sasaki-Einstein geometry, in low dimensions, to superconformal field theory; properties of the latter are therefore reflected in the former, and vice versa. Despite this physical motivation, many recent results are of independent geometrical interest, and are described here in purely mathematical terms: explicit constructions of infinite families of both quasi-regular and irregular Sasaki-Einstein metrics; toric Sasakian geometry; an extremal problem that determines the Reeb vector field for, and hence also the volume of, a Sasaki-Einstein manifold; and finally, obstructions to the existence of Sasaki-Einstein metrics. Some of these results also provide new insights into Kahler geometry, and in particular new obstructions to the existence of Kahler-Einstein metrics on Fano orbifolds.Comment: 31 pages, no figures. Invited contribution to the proceedings of the conference "Riemannian Topology: Geometric Structures on Manifolds"; minor typos corrected, reference added; published version; Riemannian Topology and Geometric Structures on Manifolds (Progress in Mathematics), Birkhauser (Nov 2008

Summer CO2 evasion from streams and rivers in the Kolyma River basin, north-east Siberia

Inland water systems are generally supersaturated in carbon dioxide (CO2) and are increasingly recognized as playing an important role in the global carbon cycle. The Arctic may be particularly important in this respect, given the abundance of inland waters and carbon contained in Arctic soils; however, a lack of trace gas measurements from small streams in the Arctic currently limits this understanding.We investigated the spatial variability of CO2 evasion during the summer low-flow period from streams and rivers in the northern portion of the Kolyma River basin in north-eastern Siberia. To this end, partial pressure of carbon dioxide (pCO2) and gas exchange velocities (k) were measured at a diverse set of streams and rivers to calculate CO2 evasion fluxes. We combined these CO2 evasion estimates with satellite remote sensing and geographic information system techniques to calculate total areal CO2 emissions. Our results show that small streams are substantial sources of atmospheric CO2 owing to high pCO2 and k, despite being a small portion of total inland water surface area. In contrast, large rivers were generally near equilibrium with atmospheric CO2. Extrapolating our findings across the Panteleikha-Ambolikha sub-watersheds demonstrated that small streams play a major role in CO2 evasion, accounting for 86% of the total summer CO2 emissions from inland waters within these two sub-watersheds. Further expansion of these regional CO2 emission estimates across time and space will be critical to accurately quantify and understand the role of Arctic streams and rivers in the global carbon budget

Stability of condensate in superconductors

According to the BCS theory the superconducting condensate develops in a single quantum mode and no Cooper pairs out of the condensate are assumed. Here we discuss a mechanism by which the successful mode inhibits condensation in neighboring modes and suppresses a creation of noncondensed Cooper pairs. It is shown that condensed and noncondensed Cooper pairs are separated by an energy gap which is smaller than the superconducting gap but large enough to prevent nucleation in all other modes and to eliminate effects of noncondensed Cooper pairs on properties of superconductors. Our result thus justifies basic assumptions of the BCS theory and confirms that the BCS condensate is stable with respect to two-particle excitations

Effect of simplicity and attractiveness on route selection for different journey types

This study investigated the effects of six attributes, associated with simplicity or attractiveness, on route preference for three pedestrian journey types (everyday, leisure and tourist). Using stated choice preference experiments with computer generated scenes, participants were asked to choose one of a pair of routes showing either two levels of the same attribute (experiment 1) or different attributes (experiment 2). Contrary to predictions, vegetation was the most influential for both everyday and leisure journeys, and land use ranked much lower than expected in both cases. Turns ranked higher than decision points for everyday journeys as predicted, but the positions of both were lowered by initially unranked attributes. As anticipated, points of interest were most important for tourist trips, with the initially unranked attributes having less influence. This is the first time so many attributes have been compared directly, providing new information about the importance of the attributes for different journeys. © 2014 Springer International Publishing

Multidimensional rasch models for partial credit scoring

Rasch models for partial-credit scoring are discussed and a multidimensional version of the model is formulated. A model may be specified in which consecutive item responses depend on an underlying latent trait. In the multidimensional partial-credit model, different responses may be explained by different latent traits. Data from van Kuyk’s (1988) size concept test and the Raven Progressive Matrices test were analyzed. Maximum likelihood estimation and goodness-of-fit testing are discussed and applied to these datasets. Goodness-of-fit statistics show that for both tests, multidimensional partial-credit models were more appropriate than the unidimensional partial-credit model. Index terms: X2 testing, exponential family model, multidimensional item response theory, multidimensional Rasch model, partial-credit models, Progressive Matrices test, Rasch model