Pre-operative interventions (non-surgical and non-pharmacological) for patients with hip or knee osteoarthritis awaiting joint replacement surgery – a systematic review and meta-analysis

SummaryObjectiveTo determine if pre-operative interventions for hip and knee osteoarthritis provide benefit before and after joint replacement.MethodSystematic review with meta-analysis of randomised controlled trials (RCTs) of pre-operative interventions for people with hip or knee osteoarthritis awaiting joint replacement surgery.Standardised mean differences (SMD) were calculated for pain, musculoskeletal impairment, activity limitation, quality of life, and health service utilisation (length of stay and discharge destination). The GRADE approach was used to determine the quality of the evidence.ResultsTwenty-three RCTs involving 1461 participants awaiting hip or knee replacement surgery were identified. Meta-analysis provided moderate quality evidence that pre-operative exercise interventions for knee osteoarthritis reduced pain prior to knee replacement surgery (SMD (95% CI)=0.43 [0.13, 0.73]). None of the other meta-analyses investigating pre-operative interventions for knee osteoarthritis demonstrated any effect. Meta-analyses provided low to moderate quality evidence that exercise interventions for hip osteoarthritis reduced pain (SMD (95% CI)=0.52 [0.04, 1.01]) and improved activity (SMD (95% CI)=0.47 [0.11, 0.83]) prior to hip replacement surgery. Meta-analyses provided low quality evidence that exercise with education programs improved activity after hip replacement with reduced time to reach functional milestones during hospital stay (e.g., SMD (95% CI)=0.50 [0.10, 0.90] for first day walking).ConclusionLow to moderate evidence from mostly small RCTs demonstrated that pre-operative interventions, particularly exercise, reduce pain for patients with hip and knee osteoarthritis prior to joint replacement, and exercise with education programs may improve activity after hip replacement

Contrasting the effectiveness and efficiency of virtual reality and real environments in the treatment of acrophobia

Previous studies reported good results in using virtual reality for the treatment of acrophobia. Similarly this paper reports the use of a virtual environment for the treatment of acrophobia. In the study, 10 subjects were exposed to three sessions of simulated heights in a virtual reality (VR) system, and 5 others were exposed to a real environment. Both groups revealed significant progress in a range of anxiety, avoidance and behaviour measurements when confronted with virtual as well as real height circumstances. Despite VR participants experiencing considerably shorter treatment times than the real-world subjects, significant improvements were recorded on the Behavioural Avoidance Test, the Attitudes Toward Heights Questionnaire and the Acrophobia Questionnaire. These results are suggestive of a possible higher effectiveness and efficiency of VR in treating acrophobia

Scale of Patchiness Affects the Relation Between Forage Quality and Patch Choice by Cattle

We predicted and tested the effects of scale of heterogeneity on movements and selectivity of a large grazer in a controlled field experiment. We created random mosaics of short/high quality and tall/low quality grass patches in equal proportion at grid sizes of 2x2 m and 5x5 m. Subsequently, we monitored the foraging behavior of four steers in 16 20x40 m plots over 30-minute periods. As predicted, the animals selected the short patches both by walking in a nonrandom manner and by concentrating their grazing time. Selectivity was more pronounced in large patches than in small ones. In contrast, the number of bites per feeding station was not affected by patch size, suggesting that selection between and within feeding stations are essentially different processes. We conclude that selectivity is facilitated by large scale heterogeneity, particularly by enhancing discrimination between feeding stations and larger selection units

Ozonolysis of a-phellandrene - Part 2 : Compositional analysis of secondary organic aerosol highlights the role of stabilized Criegee intermediates

The molecular composition of secondary organic aerosol (SOA) generated from the ozonolysis of α-phellandrene is investigated for the first time using high pressure liquid chromatography coupled to high-resolution Quadrupole-Orbitrap tandem mass spectrometry. In total, 21 prominent products or isomeric product groups were identified using both positive and negative ionisation modes, with potential formation mechanisms discussed. The aerosol was found to be composed primarily of polyfunctional first- and second-generation species containing one or more carbonyl, acid, alcohol and hydroperoxide functionalities, with the products significantly more complex than those proposed from basic gas-phase chemistry in the companion paper (Mackenzie-Rae et al., 2017a). Mass spectra show a large number of dimeric products are also formed. Both direct scavenging evidence using formic acid, and indirect evidence from double bond equivalency factors, suggests the dominant oligomerisation mechanism is the bimolecular reaction of stabilised Criegee intermediates (SCIs) with non-radical ozonolysis products. Saturation vapour concentration estimates suggest monomeric species cannot explain the rapid nucleation burst of fresh aerosol observed in chamber experiments, hence dimeric species are believed to be responsible for new particle formation, with detected first- and second-generation products driving further particle growth in the system. Ultimately, identification of the major constituents and formation pathways of α-phellandrene SOA leads to a greater understanding of the atmospheric processes and implications of monoterpene emissions and SCIs, especially around Eucalypt forests regions where α-phellandrene is primarily emitted

Quantum Revivals in a Periodically Driven Gravitational Cavity

Quantum revivals are investigated for the dynamics of an atom in a driven gravitational cavity. It is demonstrated that the external driving field influences the revival time significantly. Analytical expressions are presented which are based on second order perturbation theory and semiclassical secular theory. These analytical results explain the dependence of the revival time on the characteristic parameters of the problem quantitatively in a simple way. They are in excellent agreement with numerical results

The diet of powerful owls (Ninox strenua) and prey availability in a continuum of habitats from disturbed urban fringe to protected forest environments in south-eastern Australia

This study investigates the diet of six breeding pairs of powerful owls in the Yarra Valley Corridor in Victoria, Australia, and compares prey consumption with prey availability. The six sites represent a continuum of habitats, ranging from urban Melbourne, through the urban fringe interface to a more forested landscape. We found that powerful owls in the Yarra Valley Corridor are reliant almost exclusively on arboreal marsupial prey as their preferred diet, with 99% of their overall diet comprising four arboreal marsupial species. These four species (the common ringtail possum, common brushtail possum, sugar glider and greater glider) were also the most abundant species observed while spotlighting; however, their abundance varied along the continuum. There was a strong positive relationship with the presence of these species in the diet and their site-specific availability, indicating that the powerful owl is a generalist hunter, preying on the most available prey at a given site and in a given season. This study suggests that food resources are high in these disturbed urban fringe sites and it is unlikely that food availability in urban environments will limit the potential survival of urban powerful owls.<br /

Self-control in decision-making involves modulation of the vmPFC valuation system

Every day, individuals make dozens of choices between an alternative with higher overall value and a more tempting but ultimately inferior option. Optimal decision-making requires self-control. We propose two hypotheses about the neurobiology of self-control: (i) Goal-directed decisions have their basis in a common value signal encoded in ventromedial prefrontal cortex (vmPFC), and (ii) exercising self-control involves the modulation of this value signal by dorsolateral prefrontal cortex (DLPFC). We used functional magnetic resonance imaging to monitor brain activity while dieters engaged in real decisions about food consumption. Activity in vmPFC was correlated with goal values regardless of the amount of self-control. It incorporated both taste and health in self-controllers but only taste in non–self-controllers. Activity in DLPFC increased when subjects exercised self-control and correlated with activity in vmPFC

Quantum Revivals in Periodically Driven Systems close to nonlinear resonance

We calculate the quantum revival time for a wave-packet initially well localized in a one-dimensional potential in the presence of an external periodic modulating field. The dependence of the revival time on various parameters of the driven system is shown analytically. As an example of application of our approach, we compare the analytically obtained values of the revival time for various modulation strengths with the numerically computed ones in the case of a driven gravitational cavity. We show that they are in very good agreement.Comment: 14 pages, 1 figur

Dendritic Spine Shape Analysis: A Clustering Perspective

Functional properties of neurons are strongly coupled with their morphology. Changes in neuronal activity alter morphological characteristics of dendritic spines. First step towards understanding the structure-function relationship is to group spines into main spine classes reported in the literature. Shape analysis of dendritic spines can help neuroscientists understand the underlying relationships. Due to unavailability of reliable automated tools, this analysis is currently performed manually which is a time-intensive and subjective task. Several studies on spine shape classification have been reported in the literature, however, there is an on-going debate on whether distinct spine shape classes exist or whether spines should be modeled through a continuum of shape variations. Another challenge is the subjectivity and bias that is introduced due to the supervised nature of classification approaches. In this paper, we aim to address these issues by presenting a clustering perspective. In this context, clustering may serve both confirmation of known patterns and discovery of new ones. We perform cluster analysis on two-photon microscopic images of spines using morphological, shape, and appearance based features and gain insights into the spine shape analysis problem. We use histogram of oriented gradients (HOG), disjunctive normal shape models (DNSM), morphological features, and intensity profile based features for cluster analysis. We use x-means to perform cluster analysis that selects the number of clusters automatically using the Bayesian information criterion (BIC). For all features, this analysis produces 4 clusters and we observe the formation of at least one cluster consisting of spines which are difficult to be assigned to a known class. This observation supports the argument of intermediate shape types.Comment: Accepted for BioImageComputing workshop at ECCV 201