Ultrasound guided glenohumeral injections in adhesive capsulitis

Thesis (M.A.)--Boston UniversityObjective: The objective of this thesis was to assess outcomes of glenohumeral corticosteroid injections for adhesive capsulitis. Design: The thesis was composed of two parts. First, a systematic literature review was conducted on glenohumeral corticosteroid injections on shoulder outcomes for adhesive capsulitis. Second, an original prospective study was conducted to measure the effect of ultrasound-guided injections on pain and function for adhesive capsulitis patients. Setting: All injections for the prospective injection study were conducted at Brigham and Women’s Hospital in Boston, MA. Patients: Inclusion criteria were patients receiving an ultrasound guided injection for adhesive capsulitis. 67 patients were included, 59 patients were available at first follow up, and 40 patients were available at final follow up. Methods: The literature review was conducted using the online databases PubMed (1966-present), Embase (1947-present), Web of Science (1900– present), and the Cochrane Central Register of Controlled Trials. Study criteria were limited to clinical trials that evaluated the application of corticosteroid injections, both alone and in combination with other treatment modalities, specifically for the condition of adhesive capsulitis in the shoulder. Studies involving non-corticosteroid injections or injections for conditions not specific to adhesive capsulitis were excluded. Results were limited to papers in the English language. A data table summarizing pain, function, and range of motion outcomes of each treatment was produced. A percent change from baseline was calculated to facilitate comparisons. For the injection study, the first follow-up took place after an average of 2.0 months and patients' improvement in pain and range of motion were assessed. During a final follow-up after an average of 10.4 months, patients’ pain and shoulder function scores were assessed over telephone. [TRUNCATED

Numerical Models for Predicting the Fate of Ammonia Nitrogen for Biological Treatment Processes in Urbanized Rivers in China

Volume 1 • Issue 6 • 2012 found to remove over 70% of nutrients during restoration exercises. The growing technology, Biological Treatment Method (BTM) is not new to history but it is beginning to receive attention in river and wastewater treatment nowadays. The BTM has been successfully used in many countries worldwide including China for domestic and industrial wastewater treatment. For instance, the method has been used in urban streams in Shenzen, Rui'an and Wuxi of China. This method has been known to rapidly reduce the concentrations of effluent BOD and COD There is however lack of requisite mathematical algorithms to support the forecasting and monitoring of water quality variables under the BTM. Nutrient flux in urban rivers is very important for monitoring water quality. Nitrogen is one of these nutrients that promote cellular growth and thus eutrophication in water bodies. In wastewater, nitrogen has the capability to exist in different forms -ammonia, organic, nitrate and nitrite. In this particular case, the ammonia-nitrogen widely known to contribute towards eutrophication is considered. Mathematical algorithms are developed and tested to determine their predicative Keywords: Fate; Ammonia-nitrogen; Numerical models; Biological treatment method Introduction Developing economies face the challenge of poor surface water quality of water bodies. Environmental degradation coupled with industrial growth and infrastructural development further adds more challenge to water planners and managers in urban communities. China for instance, is undergoing water related challenges due to urban expansion and the rapid growing industrial activity. It is also partly because the transport of household and industrial wastewater from both point and non-point sources into rivers have increased their vulnerability and support for aquatic life Abstract One of the sustainable approaches towards polluted urbanized rivers restoration is the use of biological treatment method. The method has been successfully used in China since the past decade and has received growing recognition among university and government authorities. Field campaigns during biological treatment methods to measure water quality variables are expensive as in most water quality measurements. Therefore, the availability of mathematical models helps to provide a basis for forecasting and planning for such campaigns. Ammonia-nitrogen is a key variable supporting eutrophication of rivers. In this research, mathematical models were developed to describe the fate of ammonia-nitrogen given a set of water quality variables (i.e. transparency, water temperature, COD, DO, total nitrogen and total phosphorus). Selected six models were chosen based on adjusted R2, Akaike Information Criterion (AICc) and Bayesian Information Criterion (BIC). The selected models were tested with independent dataset. The results show that the prediction errors range from ±20% to ±36%. The errors found in this research are comparable to previous studies and are considered to be largely due to the large sampling and measurement errors usually encountered in water quality testing and measurements. The results in this research support on-going numerical modelling in wastewater treatment, water quality modelling and water resources planning and management

Passive mode-locked lasing by injecting a carbon nanotube-solution in the core of an optical fiber

In this paper, we propose a saturable absorber (SA) device consisting on an in-fiber micro-slot inscribed by femtosecond laser micro fabrication, filled by a dispersion of Carbon Nanotubes (CNT). Due to the flexibility of the fabrication method, efficient and simple integration of the mode-locking device directly into the optical fiber is achieved. Furthermore, the fabrication process offers a high level of control over the dimensions and location of the micro-slots. We apply this fabrication flexibility to extend the interaction length between the CNT and the propagating optical field along the optical fiber, hence enhancing the nonlinearity of the device. Furthermore, the method allows the fabrication of devices that operate by either a direct field interaction (when the central peak of the propagating optical mode passes through the nonlinear media) or an evanescent field interaction (only a fraction of the optical mode interacts with the CNT). In this paper, several devices with different interaction lengths and interaction regimes are investigated. Self-starting passively modelocked laser operation with an enhanced nonlinear interaction is observed using CNT-based SAs in both interaction regimes. This method constitutes a simple and suitable approach to integrate the CNT into the optical system as well as enhancing the optical nonlinearity of CNT-based photonic devices

Microspinning: Local Surface Mixing via Rotation of Magnetic Microparticles for Efficient Small-Volume Bioassays

The need for high-throughput screening has led to the miniaturization of the reaction volume of the chamber in bioassays. As the reactor gets smaller, surface tension dominates the gravitational or inertial force, and mixing efficiency decreases in small-scale reactions. Because passive mixing by simple diffusion in tens of microliter-scale volumes takes a long time, active mixing is needed. Here, we report an efficient micromixing method using magnetically rotating microparticles with patterned magnetization induced by magnetic nanoparticle chains. Because the microparticles have magnetization patterning due to fabrication with magnetic nanoparticle chains, the microparticles can rotate along the external rotating magnetic field, causing micromixing. We validated the reaction efficiency by comparing this micromixing method with other mixing methods such as simple diffusion and the use of a rocking shaker at various working volumes. This method has the potential to be widely utilized in suspension assay technology as an efficient mixing strategy

Walking For Health: A Community Education and Physical Activity Initiative

Background/Introduction: Vermont was ranked the nation’s healthiest state, according to 2007 America’s Health Rankings. However obesity, currently the second most common cause of death among VT adults, is becoming so common it may replace cigarette smoking as the number one risk factor for death. In fact obesity affects 21% of adults in VT, most commonly low income adults. Obesity is a risk factor for high cholesterol, high blood pressure, heart diseases, and diabetes. Diet quality and physical activity are important factors in preventing obesity. 42% of Vermont adults are below the recommended level of physical activity. Greater knowledge about nutrition correlates with improved diet quality and greater physical activity. A successful educational strategy on physical activity and nutrition promotes group activities and adapts for cultural relevance.https://scholarworks.uvm.edu/comphp_gallery/1013/thumbnail.jp

Genetic variants in the calcium signaling pathway genes are associated with cutaneous melanoma-specific survival

Remodeling or deregulation of the calcium signaling pathway is a relevant hallmark of cancer including cutaneous melanoma (CM). In this study, using data from a published genome-wide association study (GWAS) from The University of Texas M.D. Anderson Cancer Center, we assessed the role of 41,377 common single-nucleotide polymorphisms (SNPs) of 167 calcium signaling pathway genes in CM survival. We used another GWAS from Harvard University as the validation dataset. In the single-locus analysis, 1830 SNPs were found to be significantly associated with CM-specific survival (CMSS; P ≤ 0.050 and false-positive report probability ≤ 0.2), of which 9 SNPs were validated in the Harvard study (P ≤ 0.050). Among these, three independent SNPs (i.e. PDE1A rs6750552 T>C, ITPR1 rs6785564 A>G and RYR3 rs2596191 C>A) had a predictive role in CMSS, with a meta-analysis-derived hazards ratio of 1.52 (95% confidence interval = 1.19–1.94, P = 7.21 × 10−4), 0.49 (0.33–0.73, 3.94 × 10−4) and 0.67 (0.53–0.86, 0.0017), respectively. Patients with an increasing number of protective genotypes had remarkably improved CMSS. Additional expression quantitative trait loci analysis showed that these genotypes were also significantly associated with mRNA expression levels of the genes. Taken together, these results may help us to identify prospective biomarkers in the calcium signaling pathway for CM prognosis

One-Step Generation of a Drug-Releasing Hydrogel Microarray-On-A-Chip for Large-Scale Sequential Drug Combination Screening

Large-scale screening of sequential drug combinations, wherein the dynamic rewiring of intracellular pathways leads to promising therapeutic effects and improvements in quality of life, is essential for personalized medicine to ensure realistic cost and time requirements and less sample consumption. However, the large-scale screening requires expensive and complicated liquid handling systems for automation and therefore lowers the accessibility to clinicians or biologists, limiting the full potential of sequential drug combinations in clinical applications and academic investigations. Here, a miniaturized platform for high-throughput combinatorial drug screening that is "pipetting-free" and scalable for the screening of sequential drug combinations is presented. The platform uses parallel and bottom-up formation of a heterogeneous drug-releasing hydrogel microarray by self-assembly of drug-laden hydrogel microparticles. This approach eliminates the need for liquid handling systems and time-consuming operation in high-throughput large-scale screening. In addition, the serial replacement of the drug-releasing microarray-on-a-chip facilitates different drug exchange in each and every microwell in a simple and highly parallel manner, supporting scalable implementation of multistep combinatorial screening. The proposed strategy can be applied to various forms of combinatorial drug screening with limited amounts of samples and resources, which will broaden the use of the large-scale screening for precision medicine

CD123-Engager T Cells as a Novel Immunotherapeutic for Acute Myeloid Leukemia

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Outcomes of Ultrasound-guided Glen Humeral Corticosteroid Injections in Adhesive Capsulitis

Aims To assess short and longer-term outcomes of ultrasound-guided glenohumeral corticosteroid injections for adhesive capsulitis. Study Design A mixed prospective and retrospective study design Place and Duration of Study Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Department of Orthopaedic Surgery, Brigham and Women’s Hospital, between June 2011 and July 2012. Methodology Using medical records, we first retrospectively identified patients who had received ultrasound-guided injections of lidocaine and triamcinolone for adhesive capsulitis We then assessed short-term follow-up outcomes (within 3 months of procedure) using medical record review and phone interviews. Longer-term follow-up (at least 3 months from the procedure) outcomes were determined by mailings and phone calls. Average and worst shoulder pain scores were measured on a visual analog scale. Shoulder ROM was measured in forward flexion, isolated abduction, and external rotation. Results: Patients presented an average of 5.1 (SD=4.1) months after onset of symptoms. Within three months of the injection, 55.9% (95% CI: 39.2%, 72.6%) of patients reported greater than 75% pain relief and 44.1% (95% CI: 27.4%, 60.8%) of patients reported greater than 75% ROM improvement. The percentage of patients who improved increased with increased duration of follow-up. At short-term follow-up (mean=2.1 months, SD=2.7), average pain decreased from 5.6 (SD=2.2) to 3.0 (SD=1.8) (p ≤ .001) and worst pain decreased from 7.8 (SD=1.2) to 4.3 (SD=3.2) (p ≤ .001). At longer-term follow-up (mean =10.4 months, SD=3.7), average pain decreased to 1.9 (SD=1.9) (p ≤ .001) and worst pain decreased to 2.9 (SD=2.3) (p ≤ .001). Conclusion: A majority of patients had significant pain reduction and functional improvement after an ultrasound guided glenohumeral corticosteroid injection for adhesive capsulitis. Our patients experience the majority of their pain and functional relief within the first three months after an ultrasound-guided corticosteroid injection with continued increase in relief in the longer-term

Ectopic A-lattice seams destabilize microtubules

Natural microtubules typically include one A-lattice seam within an otherwise helically symmetric B-lattice tube. It is currently unclear how A-lattice seams influence microtubule dynamic instability. Here we find that including extra A-lattice seams in GMPCPP microtubules, structural analogues of the GTP caps of dynamic microtubules, destabilizes them, enhancing their median shrinkage rate by >20-fold. Dynamic microtubules nucleated by seeds containing extra A-lattice seams have growth rates similar to microtubules nucleated by B-lattice seeds, yet have increased catastrophe frequencies at both ends. Furthermore, binding B-lattice GDP microtubules to a rigor kinesin surface stabilizes them against shrinkage, whereas microtubules with extra A-lattice seams are stabilized only slightly. Our data suggest that introducing extra A-lattice seams into dynamic microtubules destabilizes them by destabilizing their GTP caps. On this basis, we propose that the single A-lattice seam of natural B-lattice MTs may act as a trigger point, and potentially a regulation point, for catastrophe