EditorialMillennium development goal 5: situation analysis

No Abstract. East AfricanMedical Journaly Vol. 83(1) 2006: 1-

Acupuncture for frozen shoulder

This randomised controlled trial was undertaken to evaluate the effectiveness of acupuncture as a treatment for frozen shoulder. Thirty-five patients with a diagnosis of frozen shoulder were randomly allocated to an exercise group or an exercise plus acupuncture group and treated for a period of 6 weeks. Functional mobility, power, and pain were assessed by a blinded assessor using the Constant Shoulder Assessment, at baseline, 6 weeks and 20 weeks. Analysis was based on the intention-to-treat principle. Compared with the exercise group, the exercise plus acupuncture group experienced significantly greater improvement with treatment. Improvements in scores by 39.8% (standard deviation, 27.1) and 76.4% (55.0) were seen for the exercise and the exercise plus acupuncture groups, respectively at 6 weeks (P=0.048), and were sustained at the 20-week re-assessment (40.3% [26.7] and 77.2% [54.0], respectively; P=0.025). We conclude that the combination of acupuncture with shoulder exercise may offer effective treatment for frozen shoulder.published_or_final_versio

ELASTOGRAPHY CAN EFFECTIVELY DECREASE THE NUMBER OF FINE-NEEDLE ASPIRATION BIOPSIES IN PATIENTS WITH CALCIFIED THYROID NODULES

When calcification, frequently found in both benign and malignant nodules, is present in thyroid nodules, non-invasive differentiation with ultrasound becomes challenging. The goal of this study was to evaluate the utility of elastography in differentiating calcified thyroid nodules. Consecutive patients (165 patients with 196 nodules) referred for fine-needle aspiration who had undergone both ultrasound elastography and B-mode examinations were analyzed retrospectively. Calcification was present in 45 benign and 20 malignant nodules. On 65 calcified nodules, elastography had 95% sensitivity, 51.1% specificity, 46.3% positive predictive value and 95.8% negative predictive value in detecting malignancy. Twenty-three of 45 benign calcified nodules were correctly diagnosed with elastography compared with 4 of 45 by B-mode ultrasound. Although it is difficult to differentiate benign and malignant calcified thyroid nodules solely with B-mode ultrasound, elastography has the potential to reduce the number of fine-needle aspiration biopsies performed on calcified nodules. (C) 2014 World Federation for Ultrasound in Medicine & Biology.1188Ysciescopu

A novel 16-channel wireless system for electroencephalography measurements with dry spring-loaded sensors

Understanding brain function using electroencephalography (EEG) is an important issue for cerebral nervous system diseases, especially for epilepsy and Alzheimer's disease. Many EEG measurement systems are used reliably to study these diseases, but their bulky size and the use of wet sensors make them uncomfortable and inconvenient for users. To overcome the limitations of conventional EEG measurement systems, a wireless and wearable multichannel EEG measurement system is proposed in this paper. This system includes a wireless data acquisition device, dry spring-loaded sensors, and a sizeadjustable soft cap. We compared the performance of the proposed system using dry versus conventional wet sensors. A significant positive correlation between readings from wet and dry sensors was achieved, thus demonstrating the performance of the system. Moreover, four different features of EEG signals (i.e., normal, eye-blinking, closed-eyes, and teeth-clenching signals) were measured by 16 dry sensors to ensure that they could be detected in real-life cognitive neuroscience applications. Thus, we have shown that it is possible to reliably measure EEG signals using the proposed system. This paper presents novel insights into the field of cognitive neuroscience, showing the possibility of studying brain function under real-life conditions. © 2014 IEEE

New plasma surface-treated memory alloys: Towards a new generation of "smart" orthopaedic materials

This paper describes the corrosion resistance, surface mechanical properties, cyto-compatibility, and in-vivo performance of plasma-treated and untreated NiTi samples. Nickel-titanium discs containing 50.8% Ni were treated by nitrogen and carbon plasma immersion ion implantation (PIII). After nitrogen plasma treatment, a layer of stable titanium nitride is formed on the NiTi surface. Titanium carbide is also found at the surface after carbon plasma implantation. Compared to the untreated samples, the corrosion resistances of the plasma PIII samples are better by a factor of five and the surface hardness and elastic modulus are better by a factor of two. The concentration of Ni leached into the simulated body fluids from the untreated samples is 30 ppm, whereas that from the plasma-treated PIII are undetectable. Although there is no significant difference in the ability of cells to grow on either surface, bone formation is found to be better on the nitrogen and carbon PIII sample surfaces at post-operation 2 weeks. All these improvements can be attributed to the formation of titanium nitride and titanium carbide on the surface. © 2007 Elsevier B.V. All rights reserved.postprin

Rare Earth Element Adsorption to Clay Minerals: Mechanistic Insights and Implications for Recovery from Secondary Sources

\ua9 2024 American Chemical Society.The energy transition will have significant mineral demands and there is growing interest in recovering critical metals, including rare earth elements (REE), from secondary sources in aqueous and sedimentary environments. However, the role of clays in REE transport and deposition in these settings remains understudied. This work investigated REE adsorption to the clay minerals illite and kaolinite through pH adsorption experiments and extended X-ray absorption fine structure (EXAFS). Clay type, pH, and ionic strength (IS) affected adsorption, with decreased adsorption under acidic pH and elevated IS. Illite had a higher adsorption capacity than kaolinite; however, >95% adsorption was achieved at pH ∼7.5 regardless of IS or clay. These results were used to develop a surface complexation model with the derived binding constants used to predict REE speciation in the presence of competing sorbents. This demonstrated that clays become increasingly important as pH increases, and EXAFS modeling showed that REE can exist as both inner- and outer-sphere complexes. Together, this indicated that clays can be an important control on the transport and enrichment of REE in sedimentary systems. These findings can be applied to identify settings to target for resource extraction or to predict REE transport and fate as a contaminant

Quality control for next-generation liquefaction case histories

The Next-Generation Liquefaction (NGL) database is an open-source, global database of liquefaction and non-ground failure case-histories. The database is part of a multi-year research effort with the main goal of developing improved procedures to evaluate liquefaction susceptibility, triggering, and consequences. In NGL, a case-history is defined as the intersection of three components: (1) a site, (2) an earthquake event, and (3) post-earthquake observations. The NGL database hosts case-histories used to develop existing liquefaction models, as well as new data derived from recent earthquakes such as the 2010-2011 Canterbury earthquake sequence, the 2011 Tohoku-Oki earthquake, and the 2012 Emilia earthquake. The database also hosts lateral spread case-histories, and a substantial number of liquefaction sites characterized by the presence of co-located recording stations. All of the data present in the NGL database are reviewed by the NGL Database Working Group. The NGL formal vetting process is described for an example case-history

The effect of Tai Chi Chuan in reducing falls among elderly people: design of a randomized clinical trial in the Netherlands [ISRCTN98840266]

BACKGROUND: Falls are a significant public health problem. Thirty to fifty percent of the elderly of 65 years and older fall each year. Falls are the most common type of accident in this age group and can result in fractures and subsequent disabilities, increased fear of falling, social isolation, decreased mobility, and even an increased mortality. Several forms of exercise have been associated with a reduced risk of falling and with a wide range of physiological as well as psychosocial health benefits. Tai Chi Chuan seems to be the most promising form of exercise in the elderly, but the evidence is still controversial. In this article the design of a randomized clinical trial is presented. The trial evaluates the effect of Tai Chi Chuan on fall prevention and physical and psychological function in older adults. METHODS/DESIGN: 270 people of seventy years and older living at home will be identified in the files of the participating general practitioners. People will be asked to participate when meeting the following inclusion criteria: have experienced a fall in the preceding year or suffer from two of the following risk factors: disturbed balance, mobility problems, dizziness, or the use of benzodiazepines or diuretics. People will be randomly allocated to either the Tai Chi Chuan group (13 weeks, twice a week) or the no treatment control group. The primary outcome measure is the number of new falls, measured with a diary. The secondary outcome measures are balance, fear of falling, blood pressure, heart rate, lung function parameters, physical activity, functional status, quality of life, mental health, use of walking devices, medication, use of health care services, adjustments to the house, severity of fall incidents and subsequent injuries. Process parameters will be measured to evaluate the Tai Chi Chuan intervention. A cost-effectiveness analysis will be carried out alongside the evaluation of the clinical results. Follow-up measurements will be collected at 3, 6 and 12 months after randomization. DISCUSSION: As far as we know this is the first trial in Europe considering Tai Chi Chuan and fall prevention. This project will answer a pragmatic research question regarding the efficacy of Tai Chi Chuan regarding fall reduction

Inter-rater reliability of data elements from a prototype of the Paul Coverdell National Acute Stroke Registry

<p>Abstract</p> <p>Background</p> <p>The Paul Coverdell National Acute Stroke Registry (PCNASR) is a U.S. based national registry designed to monitor and improve the quality of acute stroke care delivered by hospitals. The registry monitors care through specific performance measures, the accuracy of which depends in part on the reliability of the individual data elements used to construct them. This study describes the inter-rater reliability of data elements collected in Michigan's state-based prototype of the PCNASR.</p> <p>Methods</p> <p>Over a 6-month period, 15 hospitals participating in the Michigan PCNASR prototype submitted data on 2566 acute stroke admissions. Trained hospital staff prospectively identified acute stroke admissions, abstracted chart information, and submitted data to the registry. At each hospital 8 randomly selected cases were re-abstracted by an experienced research nurse. Inter-rater reliability was estimated by the kappa statistic for nominal variables, and intraclass correlation coefficient (ICC) for ordinal and continuous variables. Factors that can negatively impact the kappa statistic (i.e., trait prevalence and rater bias) were also evaluated.</p> <p>Results</p> <p>A total of 104 charts were available for re-abstraction. Excellent reliability (kappa or ICC > 0.75) was observed for many registry variables including age, gender, black race, hemorrhagic stroke, discharge medications, and modified Rankin Score. Agreement was at least moderate (i.e., 0.75 > kappa ≥; 0.40) for ischemic stroke, TIA, white race, non-ambulance arrival, hospital transfer and direct admit. However, several variables had poor reliability (kappa < 0.40) including stroke onset time, stroke team consultation, time of initial brain imaging, and discharge destination. There were marked systematic differences between hospital abstractors and the audit abstractor (i.e., rater bias) for many of the data elements recorded in the emergency department.</p> <p>Conclusion</p> <p>The excellent reliability of many of the data elements supports the use of the PCNASR to monitor and improve care. However, the poor reliability for several variables, particularly time-related events in the emergency department, indicates the need for concerted efforts to improve the quality of data collection. Specific recommendations include improvements to data definitions, abstractor training, and the development of ED-based real-time data collection systems.</p

Imaging-guided chest biopsies: techniques and clinical results

Background This article aims to comprehensively describe indications, contraindications, technical aspects, diagnostic accuracy and complications of percutaneous lung biopsy. Methods Imaging-guided biopsy currently represents one of the predominant methods for obtaining tissue specimens in patients with lung nodules; in many cases treatment protocols are based on histological information; thus, biopsy is frequently performed, when technically feasible, or in case other techniques (such as bronchoscopy with lavage) are inconclusive. Results Although a coaxial system is suitable in any case, two categories of needles can be used: fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB), with the latter demonstrated to have a slightly higher overall sensitivity, specificity and accuracy. Conclusion Percutaneous lung biopsy is a safe procedure even though a few complications are possible: pneumothorax, pulmonary haemorrhage and haemoptysis are common complications, while air embolism and seeding are rare, but potentially fatal complications