Towards an integrated clinical framework for patient with shoulder pain

Background: Shoulder pain (SP) represents a common musculoskeletal condition that requires physical therapy care. Along the years, the usual evaluation strategies based on clinical tests and diagnostic imaging has been challenged. Clinical tests appear unable to clearly identify the structures that generated pain and interpretation of diagnostic imaging is still controversial. The current patho-anatomical diagnostic categories have demonstrated poor reliability and seem inadequate for the SP treatment. Objectives: The present paper aims to (1) describe the different proposals of clinical approach to SP currently available in the literature; to (2) integrate these proposals in a single framework in order to help the management of SP. Conclusion: The proposed clinical framework, based on a bio-psychosocial vision of health, integrates symptoms characteristics, pain mechanisms and expectations, preferences and psychosocial factors of patients that may guide physiotherapist to make a diagnostic triage and to choose the right treatment for the individual patient

Progression of motor subtypes in Huntington’s disease. a 6-year follow-up study

The objective of this study is to investigate the progression of predominantly choreatic and hypokinetic-rigid signs in Huntington's disease (HD) and their relationship with cognitive and general functioning over time. The motor signs in HD can be divided into predominantly choreatic and hypokinetic-rigid subtypes. It has been reported in cross-sectional studies that predominantly choreatic HD patients perform better on functional and cognitive assessments compared to predominantly hypokinetic-rigid HD patients. The course of these motor subtypes and their clinical profiles has not been investigated longitudinally. A total of 4135 subjects who participated in the European HD Network REGISTRY study were included and classified at baseline as either predominantly choreatic (n = 891), hypokinetic-rigid (n = 916), or mixed-motor (n = 2328), based on a previously used method. The maximum follow-up period was 6 years. The mixed-motor group was not included in the analyses. Linear mixed models were constructed to investigate changes in motor subtypes over time and their relationship with cognitive and functional decline. Over the 6-year follow-up period, the predominantly choreatic group showed a significant decrease in chorea, while hypokinetic-rigid symptoms slightly increased in the hypokinetic-rigid group. On the Total Functional Capacity, Stroop test, and Verbal fluency task the rate of change over time was significantly faster in the predominantly choreatic group, while on all other clinical assessments the decline was comparable for both groups. Our results suggest that choreatic symptoms decrease over time, whereas hypokinetic-rigid symptoms slightly increase in a large cohort of HD patients. Moreover, different motor subtypes can be related to different clinical profiles

Diagnostic Accuracy of Physical Tests and Imaging Techniques in Patients with Shoulder Impingement Syndrome

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Expression of the HMGI(Y) gene products in human neuroblastic tumours correlates with differentiation status

HMGI and HMGY are splicing variants of the HMGI(Y) gene and together with HMGI-C, belong to a family of DNA binding proteins involved in maintaining active chromatin conformation and in the regulation of gene transcription. The expression of the HMGI(Y) gene is maximal during embryonic development, declines in adult differentiated tissues and is reactivated in most transformed cells in vitro and in many human cancers in vivo. The HMGI(Y) genomic locus is frequently rearranged in mesenchymal tumours, suggesting a biological role for HMGI(Y) gene products in tumour biology. HMGIs are both target and modulators of retinoic acid activity. In fact, HMGI(Y) gene expression is differentially regulated by retinoic acid in retinoid-sensitive and -resistant neuroblastoma cells, while HMGI-C participates in conferring retinoic acid resistance in some neuroblastoma cells. In this paper we show that HMGI and HMGY isoforms are equally regulated by retinoic acid in neuroblastoma cell lines at both RNA and protein levels. More importantly our immunohistochemical analysis shows that, although HMGI(Y) is expressed in all neuroblastic tumours, consistently higher levels are observed in less differentiated neuroblastomas compared to more differentiated ganglioneuromas, indicating that HMGI(Y) expression should be evaluated as a potential diagnostic and prognostic marker in neuroblastic tumours. © 2000 Cancer Research Campaign http://www.bjcancer.co

Estimates of remote sensing retrieval errors by the GRASP algorithm: application to ground-based observations, concept and validation

Understanding the uncertainties in the retrieval of aerosol and surface properties is very important for an adequate characterization of the processes that occur in the atmosphere. However, the reliable characterization of the error budget of the retrieval products is a very challenging aspect that currently remains not fully resolved in most remote sensing approaches. The level of uncertainties for the majority of the remote sensing products relies mostly on post-processing validations and intercomparisons with other data, while the dynamic errors are rarely provided. Therefore, implementations of fundamental approaches for generating dynamic retrieval errors and the evaluation of their practical efficiency remains of high importance. This study describes and analyses the dynamic estimates of uncertainties in aerosol-retrieved properties by the GRASP (Generalized Retrieval of Atmosphere and Surface Properties) algorithm. The GRASP inversion algorithm, described by Dubovik et al. (2011, 2014, 2021), is designed based on the concept of statistical optimization and provides dynamic error estimates for all retrieved aerosol and surface properties. The approach takes into account the effect of both random and systematic uncertainties propagations. The algorithm provides error estimates both for directly retrieved parameters included in the retrieval state vector and for the characteristics derived from these parameters. For example, in the case of the aerosol properties, GRASP directly retrieves the size distribution and the refractive index that are used afterwards to provide phase function, scattering, extinction, single scattering albedo, etc. Moreover, the GRASP algorithm provides full covariance matrices, i.e. not only variances of the retrieval errors but also correlations coefficients of these errors. The analysis of the correlation matrix structure can be very useful for identifying less than obvious retrieval tendencies. This appears to be a useful approach for optimizing observation schemes and retrieval set-ups. In this study, we analyse the efficiency of the GRASP error estimation approach for applications to ground-based observations by a sun/sky photometer and lidar. Specifically, diverse aspects of the error generations and their evaluations are discussed and illustrated. The studies rely on a series of comprehensive sensitivity tests when simulated sun/sky photometer measurements and lidar data are perturbed by random and systematic errors and inverted. Then, the results of the retrievals and their error estimations are analysed and evaluated. The tests are conducted for different observations of diverse aerosol types, including biomass burning, urban, dust and their mixtures. The study considers observations of AErosol RObotic NETwork (AERONET) sun/sky photometer measurements at 440, 675, 870 and 1020 nm and multiwavelength elastic lidar measurements at 355, 532 and 1064 nm. The sun/sky photometer data are inverted alone or together with lidar data. The analysis shows overall successful retrievals and error estimations for different aerosol characteristics, including aerosol size distribution, complex refractive index, single scattering albedo, lidar ratios, aerosol vertical profiles, etc. Also, the main observed tendencies in the error dynamic agree with known retrieval experience. For example, the main accuracy limitations for retrievals of all aerosol types relate to the situations with low optical depth. Also, in situations with multicomponent aerosol mixtures, the reliable characterization of each component is possible only in limited situations, for example, from radiometric data obtained for low solar zenith angle observations or from a combination of radiometric and lidar data. At the same time, the total optical properties of aerosol mixtures are always retrieved satisfactorily. In addition, the study includes an analysis of the detailed structure of the correlation matrices for the retrieval errors in mono- and multicomponent aerosols. The conducted analysis of error correlation appears to be a useful approach for optimizing observation schemes and retrieval set-ups. The application of the approach to real data is provided.</p

Fatigue in laser shock peened open-hole thin aluminium specimens

An experimental study was performed in order to determine the influence of the sequence of operations on the effectiveness of Laser Shock Peening (LSP) treatment in increasing the fatigue performances of open-hole aluminium specimens. Residual stress measurements, fractographic analysis and FEM analysis were performed, indicating the presence of compressive residual stresses on the surface of the treated specimens and tensile residual stresses in the mid-section along the thickness of the specimens. Negative effects on fatigue lives were encountered on the specimens with the hole already present, while positive effect were observed in specimens in which the hole was drilled after LSP treatment. These results indicate that LSP can be a good solution for “in production” application, in which open holes are to be drilled after the LSP treatment. The application in which LSP is used “in service” on structures with pre-existing cut-outs, has proven to be impracticable in the investigated configuration

Tests of a tuner for a 325 MHz SRF spoke resonator

Fermilab is developing 325 MHz SRF spoke cavities for the proposed Project X. A compact fast/slow tuner has been developed for final tuning of the resonance frequency of the cavity after cooling down to operating temperature and to compensate microphonics and Lorentz force detuning [2]. The modified tuner design and results of 4.5K tests of the first prototype are presented. The performance of lever tuners for the SSR1 spoke resonator prototype has been measured during recent CW and pulsed tests in the Fermilab SCTF. The tuner met or exceeded all design goals and has been used to successfully: (1) Bring the cold cavity to the operating frequency; (2) Compensate for dynamic Lorentz force detuning; and (3) Compensate for frequency detuning of the cavity due to changes in the He bath pressure