39 research outputs found
Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis
Background
Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy.
Methods
We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance.
Results
We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography.
Conclusion
Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data
A digitally-augmented ground space with timed visual cues for facilitating forearm crutches’ mobility
Persuasive technologies for physical rehabilitation have been pro posed in a number of different health interventions such as post-stroke gait
rehabilitation. We propose a new persuasive system, called Augmented Crut ches, aimed at helping people to walk with crutches. People with injuries, or
with any sort of mobility problem typically use assistive devices such as crut ches, walkers or canes in order to be able to walk more independently. However,
walking with crutches is a learning skill that needs continuous repetition and
constant attention to detail in order to walk correctly with them and without
suffering negative consequences, such as falls or injuries. In close collaboration
with therapists, we identify the main issues that patients face when walking with
crutches. These vary from person to person, but the most common and hardest
challenges are the position and coordination of the crutches. Augmented Crut ches studies human behavior aspects in these situations and augments the
ground space around the user with digital visual cues where timing is the most
important factor, without the need for a constant therapist providing manual
help. This is performed through a mini-projector connected to a smartphone,
worn by the user in a portable, lightweight manner. Our system helps people to
learn how to walk using crutches with increased self-confidence and motivation.
Additionally, our work identifies timing, controllability and awareness as the
key design dimensions for the successful creation of persuasive, interactive
experiences for learning how to walk with crutches.info:eu-repo/semantics/publishedVersio
Optimisation of pH of cadmium chloride post-growth-treatment in processing CDS/CDTE based thin film solar cells
The role of Chlorine-based activation in the production of high quality CdS/CdTe photovoltaic have been well discussed and explored with an overlook of the effect of Cadmium chloride (CdCl2) post-growth treatment acidity on the property of the fabricated devices. This work focuses on the optimisation of CdCl2 post-growth treatment pH as it affects both the material and fabricated device properties of all-electrodeposited multilayer glass/FTO/n-CdS/n-CdTe/p-CdTe configuration. CdCl2 treatments with acidity ranging from pH1 to pH4 were explored. The properties of the ensued CdTe layer were explored using optical, morphological, compositional structural and electrical property analysis, while, the effect on fabricated multilayer glass/FTO/n-CdS/n-CdTe/p-CdTe configuration were also explored using both I-V and C-V measurements. Highest improvements in the optical, morphological, compositional and structural were observed at pH2 CdCl2 post-growth treatment with an improvement in absorption edge, grain size, crystallinity and crystallite size. Conductivity type conversions from n-CdTe to p-CdTe, increase in pin-hole density and collapse of the absorption edge were observed after pH1 CdCl2 treatment. The highest fabricated solar cell efficiency of 13% was achieved using pH2 CdCl2 treatment as compared to other pH values explored
Technical and Comparative Aspects of Brain Glycogen Metabolism.
It has been known for over 50 years that brain has significant glycogen stores, but the physiological function of this energy reserve remains uncertain. This uncertainty stems in part from several technical challenges inherent in the study of brain glycogen metabolism, and may also stem from some conceptual limitations. Factors presenting technical challenges include low glycogen content in brain, non-homogenous labeling of glycogen by radiotracers, rapid glycogenolysis during postmortem tissue handling, and effects of the stress response on brain glycogen turnover. Here, we briefly review aspects of glycogen structure and metabolism that bear on these technical challenges, and discuss ways these can be overcome. We also highlight physiological aspects of glycogen metabolism that limit the conditions under which glycogen metabolism can be useful or advantageous over glucose metabolism. Comparisons with glycogen metabolism in skeletal muscle provide an additional perspective on potential functions of glycogen in brain
An overview of the statistical methods reported by studies using the Canadian community health survey
Advances, challenges and future directions for stem cell therapy in amyotrophic lateral sclerosis
Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition where loss of motor neurons within the brain and spinal cord leads to muscle atrophy, weakness, paralysis and ultimately death within 3–5 years from onset of symptoms. The specific molecular mechanisms underlying the disease pathology are not fully understood and neuroprotective treatment options are minimally effective.
In recent years, stem cell transplantation as a new therapy for ALS patients has been extensively investigated, becoming an intense and debated field of study. In several preclinical studies using the SOD1G93A mouse model of ALS, stem cells were demonstrated to be neuroprotective, effectively delayed disease onset and extended survival. Despite substantial improvements in stem cell technology and promising results in preclinical studies, several questions still remain unanswered, such as the identification of the most suitable and beneficial cell source, cell dose, route of delivery and therapeutic mechanisms. This review will cover publications in this field and comprehensively discuss advances, challenges and future direction regarding the therapeutic potential of stem cells in ALS, with a focus on mesenchymal stem cells. In summary, given their high proliferation activity, immunomodulation, multi-differentiation potential, and the capacity to secrete neuroprotective factors, adult mesenchymal stem cells represent a promising candidate for clinical translation. However, technical hurdles such as optimal dose, differentiation state, route of administration, and the underlying potential therapeutic mechanisms still need to be assessed
ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures
CD14+CD16+ monocytes are the main target of Zika virus infection in peripheral blood mononuclear cells in a paediatric study in Nicaragua
The recent Zika pandemic in the Americas is linked to congenital birth defects and Guillain-Barré syndrome. White blood cells (WBCs) play an important role in host immune responses early in arboviral infection. Infected WBCs can also function as 'Trojan horses' and carry viruses into immune-sheltered spaces, including the placenta, testes and brain. Therefore, defining which WBCs are permissive to Zika virus (ZIKV) is critical. Here, we analyse ZIKV infectivity of peripheral blood mononuclear cells (PBMCs) in vitro and from Nicaraguan Zika patients and show CD14+CD16+ monocytes are the main target of infection, with ZIKV replication detected in some dendritic cells. The frequency of CD14+ monocytes was significantly decreased, while the CD14+CD16+ monocyte population was significantly expanded during ZIKV infection compared to uninfected controls. Viral RNA was detected in PBMCs from all patients, but in serum from only a subset, suggesting PBMCs may be a reservoir for ZIKV. In Zika patients, the frequency of infected cells was lower but the percentage of infected CD14+CD16+ monocytes was significantly higher compared to dengue cases. The gene expression profile in monocytes isolated from ZIKV- and dengue virus-infected patients was comparable, except for significant differences in interferon-γ, CXCL12, XCL1, interleukin-6 and interleukin-10 levels. Thus, our study provides a detailed picture of the innate immune profile of ZIKV infection and highlights the important role of monocytes, and CD14+CD16+ monocytes in particular