Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review

Background: Osteoarthritis and subsequent total hip arthroplasty (THA) lead to damages to hip joint mechanoceptors, which in turns lead to impairments in proprioception. One of the abilities mainly affected by an altered joint proprioception is balance. The aim of this work was to investigate the balance and proprioception impairments, current assessment tools, and rehabilitation training after THA. Methods: A systematic literature revision was conducted on PubMed, Web of Science and Cochrane databases. Articles reporting balance and proprioception impairments, current assessment tools, or rehabilitation interventions were included. Methodological quality was assessed using the Downs and Black checklist. A total of 41 articles were included, 33 discussing balance and proprioception assessment, and 8 dealing with training. Data related to type of surgical approach, type and timing of assessment protocols, assessment instrumentation, and type, volume and duration of the rehabilitation training were extracted from each study. Results: Thirty-one studies were of high quality, 2 of moderate quality and 8 of low-quality. Literature review showed an improvement in balance following THA in comparison with the pre-operative performance, although balance abnormalities persist up to 5 years after surgery, with THA patients showing an increased risk for falls. Balance training is effective in all the rehabilitation phases if specifically structured for balance enhancement and consistent in training volume. It remains unclear which assessments are more appropriate for the different rehabilitation phases, and if differences exist between the different surgical procedures used for THA. Only two studies assessed proprioception. Conclusion: Balance and proprioception show impairments up to 5 years after THA, increasing the risk of falls. However, patients with THA may benefit of an adequate balance training. Further research is needed to investigate the gaps in balance and proprioception assessment and training following THA surgery

Rice grain cadmium concentrations in the global supply-chain

One of cadmium’s major exposure routes to humans is through rice consumption. The concentrations of cadmium in the global polished (white), market rice supply-chain were assessed in 2270 samples, purchased from retailers across 32 countries, encompassing 6 continents. It was found on a global basis that East Africa had the lowest cadmium with a median for both Malawi and Tanzania at 4.9 μg/kg, an order of magnitude lower than the highest country, China with a median at 69.3 μg/kg. The Americas were typically low in cadmium, but the Indian sub-continent was universally elevated. In particular certain regions of Bangladesh had high cadmium, that when combined with the high daily consumption rate of rice of that country, leads to high cadmium exposures. Concentrations of cadmium were compared to the European Standard for polished rice of 200 μg/kg and 5% of the global supply-chain exceeded this threshold. For the stricter standard of 40 μg/kg for processed infant foods, for which rice can comprise up to 100% by composition (such as rice porridges, puffed rice cereal and cakes), 25% of rice would not be suitable for making pure rice baby foods. Given that rice is also elevated in inorganic arsenic, the only region of the world where both inorganic arsenic and cadmium were low in grain was East Africa

The effectiveness of computerized clinical guidelines in the process of care: a systematic review

<p>Abstract</p> <p>Background</p> <p>Clinical practice guidelines have been developed aiming to improve the quality of care. The implementation of the computerized clinical guidelines (CCG) has been supported by the development of computerized clinical decision support systems.</p> <p>This systematic review assesses the impact of CCG on the process of care compared with non-computerized clinical guidelines.</p> <p>Methods</p> <p>Specific features of CCG were studied through an extensive search of scientific literature, querying electronic databases: Pubmed/Medline, Embase and Cochrane Controlled Trials Register. A multivariable logistic regression was carried out to evaluate the association of CCG's features with positive effect on the process of care.</p> <p>Results</p> <p>Forty-five articles were selected. The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.</p> <p>Conclusions</p> <p>From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.</p

Time domain reflectometry-measuring dielectric permittivity to detect soil non-acqeous phase liquids contamination-decontamination processes

Contamination of soils with non-aqueous phase liquids (NAPL) constitutes a serious geo-environmental problem, given the toxicity level and high mobility of these organic compounds. To develop effective decontamination methods, characterisation and identification of contaminated soils are needed. The objective of this work is to explore the potential of dielectric permittivity measurements to detect the presence of NAPLs in soils. The dielectric permittivity was measured by Time Domain Reflectometry method (TDR) in soil samples with either different volumetric content of water (θw) and NAPL (θNAPL) or at different stages during immiscible displacement test carried out with two different flushing solutions. A mixing model proposed by Francisca and Montoro, was calibrated to estimate the volume fraction of contaminant present in soil. Obtained results, showed that soil contamination with NAPL and the monitoring of immiscible fluid displacement, during soil remediation processes, can be clearly identified from dielectric measurements. © 2013, Copyright A. Comegna et al

Time domain reflectometry-measuring dielectric permittivity to detect soil non-acqeous phase liquids contamination-decontamination processes

Contamination of soils with non-aqueous phase liquids (NAPL) constitutes a serious geo-environmental problem, given the toxicity level and high mobility of these organic compounds. To develop effective decontamination methods, characterisation and identification of contaminated soils are needed. The objective of this work is to explore the potential of dielectric permittivity measurements to detect the presence of NAPLs in soils. The dielectric permittivity was measured by Time Domain Reflectometry method (TDR) in soil samples with either different volumetric content of water (w) and NAPL (NAPL) or at different stages during immiscible displacement test carried out with two different flushing solutions. A mixing model proposed by Francisca and Montoro, was calibrated to estimate the volume fraction of contaminant present in soil. Obtained results, showed that soil contamination with NAPL and the monitoring of immiscible fluid displacement, during soil remediation processes, can be clearly identified from dielectric measurements

Non-Cooperative Bistatic Sonar for Underwater Environmental Monitoring: a Model-based Approach

In this contribution we consider the simplified bi-static case in which the source waveform is known, and in particular is a chirp signal of known duration and bandwidth. The unknown source position is estimated by exploiting the multi-path structure of the received signal, in particular by extracting the acoustic channel impulse response at the receiver (through matched-filter and automated envelope peak extraction) and matching it with the one predicted by a ray-tracing model [4]. Environmental parameters (bathymetry, sound speed profile) are assumed known. Not having knowledge of the emission time of the source signal, the impulse response matching is based on computing the difference in time between the first and the subsequent arrivals. Source position estimation is obtained by minimizing a measure of discrepancy between the measured and the predicted time-difference sequences as a function of source depth and range from the receiver

Mini review: Nesfatin-1: Role as possible new anti-obesity treatment

In this article, we review on the current concepts about Nesfatin-1 as a new anti-obesity treatment and evaluate the existing issues in the context of this knowledge and the available literature. The intent is to enable clinicians to know Nesfatin-1 as a new anti-obesity treatment and make rational decisions based on this perspective as possible clinical application. Future research should seek to clarify whether Nesfatin-1 would be beneficial in the management of obesity

In vivo bioavailability and in vitro toxicological evaluation of the new butyric acid releaser N-(1-carbamoyl-2-phenyl-ethyl) butyramide

A large body of evidence suggests that supplementation of butyric acid exerts beneficial intestinal and extra-intestinal effects. Unfortunately, unpleasant sensorial properties and unfavourable physico-chemical properties strongly limit its use in food supplements and foods for medicinal purposes. N-(1-carbamoyl-2-phenyl-ethyl) butyramide (FBA) is a new butyric acid releaser in solid form with neutral sensorial properties. The aim of this investigation is to provide preliminary information on its pharmacokinetic and toxicological properties through the study of a) in vivo bioavailability of FBA administered by oral gavage to male and female Swiss CD1 mice in comparison with sodium butyrate, b) the influence of digestion on FBA stability through an in vitro simulated oro-gastro-duodenal digestion process, and c) in vitro toxicological profile by means of the Ames Test and Micronucleus Test. The results reveal that FBA is a good butyric acid releaser, being able to increase butyrate serum concentration in a dose and time dependent manner in both male and female mice with a pharmacokinetic profile similar to that obtained from sodium butyrate as such. These data are confirmed by investigating the influence of digestion on FBA, which undergoes extensive hydrolysis following oro-gastro-duodenal digestion, especially in duodenal conditions, with a residual concentration of less than 10% of the initial FBA concentration. Finally, in the Ames and Micronucleus Tests, FBA does not show any in vitro genotoxicity as it is non mutagenic in the Ames Test and results to be unable to induce chromosome breaks in the Micronucleus Test. In conclusion, FBA is a new butyric acid releaser that can overcome the disadvantages of butyric acid while maintaining the same pharmacokinetic properties and safety profile, as shown by the results of the preliminary in vitro toxicological studies performed in this investigation