Rehabilitation of shoulder impingement syndrome and rotator cuff injuries: an evidence-based review

Rehabilitation of the patient with glenohumeral impingement requires a complete understanding of the structures involved and the underlying mechanism creating the impingement response. A detailed clinical examination and comprehensive treatment programme including specific interventions to address pain, scapular dysfunction and rotator cuff weakness are recommended. The inclusion of objective testing to quantify range of motion and both muscular strength and balance in addition to the manual orthopaedic clinical tests allows clinicians to design evidence-based rehabilitation programmes as well as measure progression and patient improvement

On the Hierarchical Preconditioning of the PMCHWT Integral Equation on Simply and Multiply Connected Geometries

We present a hierarchical basis preconditioning strategy for the Poggio-Miller-Chang-Harrington-Wu-Tsai (PMCHWT) integral equation considering both simply and multiply connected geometries.To this end, we first consider the direct application of hierarchical basis preconditioners, developed for the Electric Field Integral Equation (EFIE), to the PMCHWT. It is notably found that, whereas for the EFIE a diagonal preconditioner can be used for obtaining the hierarchical basis scaling factors, this strategy is catastrophic in the case of the PMCHWT since it leads to a severly ill-conditioned PMCHWT system in the case of multiply connected geometries. We then proceed to a theoretical analysis of the effect of hierarchical bases on the PMCHWT operator for which we obtain the correct scaling factors and a provably effective preconditioner for both low frequencies and mesh refinements. Numerical results will corroborate the theory and show the effectiveness of our approach

The m−m-dissimilarity map and representation theory of SLmSL_m

We give another proof that $m$-dissimilarity vectors of weighted trees are points on the tropical Grassmanian, as conjectured by Cools, and proved by Giraldo in response to a question of Sturmfels and Pachter. We accomplish this by relating $m$-dissimilarity vectors to the representation theory of $SL_m.$Comment: 11 pages, 8 figure

A multi-exon deletion within WWOX is associated with a 46,XY disorder of sex development

Disorders of sex development (DSD) are congenital conditions where chromosomal, gonad or genital development is atypical. In a significant proportion of 46,XY DSD cases it is not possible to identify a causative mutation, making genetic counseling difficult and potentially hindering optimal treatment. Here, we describe the analysis of a 46,XY DSD patient that presented at birth with ambiguous genitalia. Histological analysis of the surgically removed gonads showed bilateral undifferentiated gonadal tissue and immature testis, both containing malignant germ cells. We screened genomic DNA from this patient for deletions and duplications using an Illumina whole-genome SNP microarray. This analysis revealed a heterozygous deletion within the WWOX gene on chromosome 16, removing exons 6-8. Analysis of parental DNA showed that the deletion was inherited from the mother. cDNA analysis confirmed that the deletion maintained the reading frame, with exon 5 being spliced directly onto exon 9. This deletion is the first description of a germline rearrangement affecting the coding sequence of WWOX in humans. Previously described Wwox knockout mouse models showed gonadal abnormalities, supporting a role for WWOX in human gonad development

Traffic flow on realistic road networks with adaptive traffic lights

We present a model of traffic flow on generic urban road networks based on cellular automata. We apply this model to an existing road network in the Australian city of Melbourne, using empirical data as input. For comparison, we also apply this model to a square-grid network using hypothetical input data. On both networks we compare the effects of non-adaptive vs adaptive traffic lights, in which instantaneous traffic state information feeds back into the traffic signal schedule. We observe that not only do adaptive traffic lights result in better averages of network observables, they also lead to significantly smaller fluctuations in these observables. We furthermore compare two different systems of adaptive traffic signals, one which is informed by the traffic state on both upstream and downstream links, and one which is informed by upstream links only. We find that, in general, both the mean and the fluctuation of the travel time are smallest when using the joint upstream-downstream control strategy.Comment: 41 pages, pdflate

Tryptophan depletion disinhibits punishment but not reward prediction: implications for resilience

Item does not contain fulltextRATIONALE: We have previously shown that tryptophan depletion enhances punishment but not reward prediction (Cools et al. in Neuropsychopharmacology 33:2291-2299, 2008b). This provided evidence for a valence-specific role of serotonin (which declines under depleted tryptophan) in aversive processing. Recent theoretical (Dayan and Huys in PLoS Comput Biol 4:e4, 2008) and experimental (Crockett et al. in J Neurosci 29:11993-11999, 2009) approaches have, however, further specified this role by showing that serotonin is critical for punishment-induced inhibition. OBJECTIVES: We sought to examine the role of serotonin in punishment-induced inhibition. We also examined the impact of induced mood on this effect to assess whether effects of tryptophan depletion on affective inhibition are moderated by mood. METHODS: Healthy females consumed a balanced amino acid mixture with (N = 20) or without (N = 21) the serotonin precursor tryptophan. Each subject completed either negative or neutral mood induction. All subjects completed the reward and punishment reversal learning task adopted in the previous study. RESULTS: We demonstrate a punishment prediction impairment in individuals who consumed tryptophan which was absent in individuals who were depleted of tryptophan. This effect was impervious to mood state. CONCLUSIONS: Our results suggest that serotonin promotes the inhibition of responses to punishing outcomes. This may lead to reduced punishment prediction accuracy in the presence of tryptophan and may contribute to resilience to affective disorders. Reduction of serotonin via tryptophan depletion then removes this inhibition. As such, we highlight a mechanism by which reduced serotonin can contribute to disorders of impulsivity and compulsivity as well as disorders of emotion.1 januari 201

Dopamine precursor depletion improves punishment prediction during reversal learning in healthy females but not males

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