Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review

Background The rehabilitation of knee osteoarthritis often includes electrotherapeutic modalities as well as advice and exercise. One commonly used modality is pulsed electromagnetic field therapy (PEMF). PEMF uses electro magnetically generated fields to promote tissue repair and healing rates. Its equivocal benefit over placebo treatment has been previously suggested however recently a number of randomised controlled trials have been published that have allowed a systematic review to be conducted. Methods A systematic review of the literature from 1966 to 2005 was undertaken. Relevant computerised bibliographic databases were searched and papers reviewed independently by two reviewers for quality using validated criteria for assessment. The key outcomes of pain and functional disability were analysed with weighted and standardised mean differences being calculated. Results Five randomised controlled trials comparing PEMF with placebo were identified. The weighted mean differences of the five papers for improvement in pain and function, were small and their 95% confidence intervals included the null. Conclusion This systematic review provides further evidence that PEMF has little value in the management of knee osteoarthritis. There appears to be clear evidence for the recommendation that PEMF does not significantly reduce the pain of knee osteoarthritis

Real time 100 Gbit/s electrical Nyquist WDM transmitter

We demonstrate the use of passive electrical filters to produce high quality spectrally-shaped 29 Gbaud WDM signals with a 20 dB bandwidth of 32 GHz, a roll-off of 4.8 dB/GHz and a required OSNR of 12.1 dB

Intrinsic alignments of the extended radio continuum emission of galaxies in the EAGLE simulations

We present measurements of the intrinsic alignments (IAs) of the star-forming gas of galaxies in the EAGLE simulations. Radio continuum imaging of this gas enables cosmic shear measurements complementary to optical surveys. We measure the orientation of star-forming gas with respect to the direction to, and orientation of, neighbouring galaxies. Star-forming gas exhibits a preferentially radial orientation-direction alignment that is a decreasing function of galaxy pair separation, but remains significant to $\gtrsim 1$ Mpc at $z=0$. The alignment is qualitatively similar to that exhibited by the stars, but is weaker at fixed separation. Pairs of galaxies hosted by more massive subhaloes exhibit stronger alignment at fixed separation, but the strong alignment of close pairs is dominated by ${\sim}L^\star$ galaxies and their satellites. At fixed comoving separation, the radial alignment is stronger at higher redshift. The orientation-orientation alignment is consistent with random at all separations, despite subhaloes exhibiting preferential parallel minor axis alignment. The weaker IA of star-forming gas than for stars stems from the former's tendency to be less well aligned with the dark matter structure of galaxies than the latter, and implies that the systematic uncertainty due to IA may be less severe in radio continuum weak lensing surveys than in optical counterparts. Alignment models equating the orientation of star-forming gas discs to that of stellar discs or the DM structure of host subhaloes will therefore overestimate the impact of IAs on radio continuum cosmic shear measurements

Improving the use of research evidence in guideline development: introduction

In 2005 the World Health Organisation (WHO) asked its Advisory Committee on Health Research (ACHR) for advice on ways in which WHO can improve the use of research evidence in the development of recommendations, including guidelines and policies. The ACHR established the Subcommittee on the Use of Research Evidence (SURE) to collect background documentation and consult widely among WHO staff, international experts and end users of WHO recommendations to inform its advice to WHO. We have prepared a series of reviews of methods that are used in the development of guidelines as part of this background documentation. We describe here the background and methods of these reviews, which are being published in Health Research Policy and Systems together with this introduction

Generation Scotland: Donor DNA Databank; A control DNA resource

<p>Abstract</p> <p>Background</p> <p>Many medical disorders of public health importance are complex diseases caused by multiple genetic, environmental and lifestyle factors. Recent technological advances have made it possible to analyse the genetic variants that predispose to complex diseases. Reliable detection of these variants requires genome-wide association studies in sufficiently large numbers of cases and controls. This approach is often hampered by difficulties in collecting appropriate control samples. The Generation Scotland: Donor DNA Databank (GS:3D) aims to help solve this problem by providing a resource of control DNA and plasma samples accessible for research.</p> <p>Methods</p> <p>GS:3D participants were recruited from volunteer blood donors attending Scottish National Blood Transfusion Service (SNBTS) clinics across Scotland. All participants gave full written consent for GS:3D to take spare blood from their normal donation. Participants also supplied demographic data by completing a short questionnaire.</p> <p>Results</p> <p>Over five thousand complete sets of samples, data and consent forms were collected. DNA and plasma were extracted and stored. The data and samples were unlinked from their original SNBTS identifier number. The plasma, DNA and demographic data are available for research. New data obtained from analysis of the resource will be fed back to GS:3D and will be made available to other researchers as appropriate.</p> <p>Conclusions</p> <p>Recruitment of blood donors is an efficient and cost-effective way of collecting thousands of control samples. Because the collection is large, subsets of controls can be selected, based on age range, gender, and ethnic or geographic origin. The GS:3D resource should reduce time and expense for investigators who would otherwise have had to recruit their own controls.</p

The fully connected N-dimensional skeleton: probing the evolution of the cosmic web

A method to compute the full hierarchy of the critical subsets of a density field is presented. It is based on a watershed technique and uses a probability propagation scheme to improve the quality of the segmentation by circumventing the discreteness of the sampling. It can be applied within spaces of arbitrary dimensions and geometry. This recursive segmentation of space yields, for a $d$-dimensional space, a $d-1$ succession of $n$-dimensional subspaces that fully characterize the topology of the density field. The final 1D manifold of the hierarchy is the fully connected network of the primary critical lines of the field : the skeleton. It corresponds to the subset of lines linking maxima to saddle points, and provides a definition of the filaments that compose the cosmic web as a precise physical object, which makes it possible to compute any of its properties such as its length, curvature, connectivity etc... When the skeleton extraction is applied to initial conditions of cosmological N-body simulations and their present day non linear counterparts, it is shown that the time evolution of the cosmic web, as traced by the skeleton, is well accounted for by the Zel'dovich approximation. Comparing this skeleton to the initial skeleton undergoing the Zel'dovich mapping shows that two effects are competing during the formation of the cosmic web: a general dilation of the larger filaments that is captured by a simple deformation of the skeleton of the initial conditions on the one hand, and the shrinking, fusion and disappearance of the more numerous smaller filaments on the other hand. Other applications of the N dimensional skeleton and its peak patch hierarchy are discussed.Comment: Accepted for publication in MNRA

Gene variants influencing measures of inflammation or predisposing to autoimmune and inflammatory diseases are not associated with the risk of type 2 diabetes.

AIMS/HYPOTHESIS: There are strong associations between measures of inflammation and type 2 diabetes, but the causal directions of these associations are not known. We tested the hypothesis that common gene variants known to alter circulating levels of inflammatory proteins, or known to alter autoimmune-related disease risk, influence type 2 diabetes risk. METHODS: We selected 46 variants: (1) eight variants known to alter circulating levels of inflammatory proteins, including those in the IL18, IL1RN, IL6R, MIF, PAI1 (also known as SERPINE1) and CRP genes; and (2) 38 variants known to predispose to autoimmune diseases, including type 1 diabetes. We tested the associations of these variants with type 2 diabetes using a meta-analysis of 4,107 cases and 5,187 controls from the Wellcome Trust Case Control Consortium, the Diabetes Genetics Initiative, and the Finland-United States Investigation of NIDDM studies. We followed up associated variants (p < 0.01) in a further set of 3,125 cases and 3,596 controls from the UK. RESULTS: We found no evidence that inflammatory or autoimmune disease variants are associated with type 2 diabetes (at p <or= 0.01). The OR observed between the variant altering IL-18 levels, rs2250417, and type 2 diabetes (OR 1.00 [95% CI 0.99-1.03]), is much lower than that expected given (1) the effect of the variant on IL-18 levels (0.28 SDs per allele); and (2) estimates, based on other studies, of the correlation between IL-18 levels and type 2 diabetes risk (approximate OR 1.15 [95% CI 1.09-1.21] per 0.28 SD increase in IL-18 levels). CONCLUSIONS/INTERPRETATION: Our study provided no evidence that variants known to alter measures of inflammation, autoimmune or inflammatory disease risk, including type 1 diabetes, alter type 2 diabetes risk

The Burden of Selected Chronic Non-Communicable Diseases and Their Risk Factors in Malawi: Nationwide STEPS Survey

BACKGROUND: Chronic non-communicable diseases (NCDs) are becoming significant causes of morbidity and mortality, particularly in sub-Saharan African countries, although local, high-quality data to inform evidence-based policies are lacking. OBJECTIVES: To determine the magnitude of NCDs and their risk factors in Malawi. METHODS: Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25-64 years. Socio-demographic and behaviour risk factors were collected in Step 1. Physical anthropometric measurements and blood pressure were documented in Step 2. Blood cholesterol and fasting blood glucose were measured in Step 3. RESULTS AND CONCLUSION: A total of 5,206 adults (67% females) were surveyed. Tobacco smoking, alcohol drinking and raised blood pressure (BP) were more frequent in males than females, 25% vs 3%, 30% vs 4% and 37% vs 29%. Overweight, physical inactivity and raised cholesterol were more common in females than males, 28% vs 16%, 13% vs 6% and 11% vs 6%. Tobacco smoking was more common in rural than urban areas 11% vs 7%, and overweight and physical inactivity more common in urban than rural areas 39% vs 22% and 24% vs 9%, all with p<0.05. Overall (both sexes) prevalence of tobacco smoking, alcohol consumption, overweight and physical inactivity was 14%, 17%, 22%, 10% and prevalence of raised BP, fasting blood sugar and cholesterol was 33%, 6% and 9% respectively. These data could be useful in the formulation and advocacy of NCD policy and action plan in Malawi

Direct-to-consumer genetic testing: where and how does genetic counseling fit?

Direct-to-consumer genetic testing for disease ranges from well-validated diagnostic and predictive tests to ‘research’ results conferring increased risks. While being targeted at public curious about their health, they are also marketed for use in reproductive decision-making or management of disease. By virtue of being ‘direct-to-consumer’ much of this testing bypasses traditional healthcare systems. We argue that direct-to-consumer genetic testing companies should make genetic counseling available, pre- as well as post-test. While we do not advocate that mandatory genetic counseling should gate-keep access to direct-to-consumer genetic testing, if the testing process has the potential to cause psychological distress, then companies have a responsibility to provide support and should not rely on traditional healthcare systems to pick up the pieces