Hypermobility syndromes in paediatrics: progressions in assessment and management

Joint Hypermobility Syndrome (JHS) and Ehlers Danlos Syndrome-Hypermobility Type (EDS-HM) referred to collectively as Hypermobility Syndromes (HMS), are heritable disorders of connective tissue comprising symptomatic joint hypermobility predisposing to arthralgia, soft-tissue injury and joint instability which if not managed effectively result in ongoing cycles of disability. How HMS affects paediatric patients and how physiotherapists approach the condition in this population is unclear. The aim of this thesis was to address gaps in knowledge and practice and advance strategies in assessment and management of symptoms. Study 1 involved an original online survey of paediatric physiotherapists, gauging understanding of HMS in children, and investigating current trends in clinical practice regarding diagnosis, treatment and management, in a UK context. Findings highlighted the prevalence of musculoskeletal pain and injury in children, the unsuitability of current diagnostic tools for assessing children, the lack of a standardised approach to diagnosis in addition to preferences for exercise interventions. This needs analysis informed Study 2 which involved the design and implementation of a novel Physical Assessment Battery for Paediatric Hypermobility merging 4 existing tests: the Nine-Point Beighton Score, Revised Brighton Criteria, Paediatric Balance Scale and Paediatric Pain Questionnaire, to capture a more complete profile of symptoms in the functional and clinical assessment of children. Children with diagnoses of HMS were assigned to a clinical group (n=29), and age and gender matched children recruited as a control group (n=25) were tested. Distinct differences were revealed between groups in terms of functional balance, pain intensity and location and trends in physical activity, exercise and sport, in addition to significant correlations observed between hypermobility and both balance and pain intensity scores. Findings from Study 1 and Study 2 twinned with supplementary qualitative data, collectively confirm the need to validate a paediatric specific assessment tool, and design blended treatment and management strategies for children experiencing symptoms to increase quality of life and reduce disability

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for supersymmetry in events with one lepton and multiple jets in proton-proton collisions at root s=13 TeV

Peer reviewe

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead