Reduction of radiation dose using 80 kV tube voltage: a feasible strategy?

Cardiolog

Usefulness and feasibility of comprehensive and less comprehensive vocational rehabilitation for patients with chronic musculoskeletal pain:perspectives from patients, professionals, and managers

Purpose: To explore the usefulness and feasibility of a comprehensive vocational rehabilitation (C-VR) program and less comprehensive (LC-VR) program for workers on sick leave due to chronic musculoskeletal pain, from the perspective of patients, professionals, and managers.Materials and methods: Semi-structured interviews were held with patients, professionals, and managers. Using topic lists, participants were questioned about barriers to and facilitators of the usefulness and feasibility of C-VR and LC-VR. Thirty interviews were conducted with thirteen patients (n = 6 C-VR, n = 7 LC-VR), eight professionals, and nine managers. All interviews were transcribed verbatim. Data were analyzed by systematic text condensation using inductive thematic analysis.Results: Three themes emerged for usefulness ("patient factors," "content," "dosage") and six themes emerged for feasibility ("satisfaction," "intention to continue use," "perceived appropriateness," "positive/negative effects on target participants," "factors affecting implementation ease or difficulty," "adaptations"). The patients reported that both programs were feasible and generally useful. The professionals preferred working with the C-VR, although they disliked the fixed and uniform character of the program. They also mentioned that this program is too extensive for some patients, and that the latter would probably benefit from the LC-VR program. Despite their positive intentions, the managers stated that due to the Dutch healthcare system, implementation of the LC-VR program would be financially unfeasible.Conclusions: The main conclusion of this study is that it is not useful to have one VR program for all patients with CMP and reduced work participation, and that flexible and tailored-based VR are warranted.Implications for rehabilitationBoth comprehensive and less comprehensive vocational rehabilitation are deemed useful for patients with chronic musculoskeletal pain and reduced work participation. Particular patient factors, for instance information uptake, discipline, willingness to change, duration of complaints, movement anxiety, obstructing thoughts, and willingness to return to work might guide the right program for the right patient.Both comprehensive and less comprehensive vocational rehabilitation are deemed feasible in practice. However, factors such as center logistic (schemes, rooms, professionals available) and country-specific healthcare insurance and sickness compensation systems should foster the implementation of less comprehensive programs

IVUS detects more coronary calcifications than MSCT; matter of both resolution and cross-sectional assessment?

Vascular Biology and Interventio

Salmonella in mengvoeders

In het kader van het veelomvattende salmonella-vraagstuk is het plan opgevat om alle mengvoeders te pelleteren. De monsters werden na pelleteren aangeboden en onderzocht op aanwezigheid van salmonella volgens de zogenaamde 'methode Cornelisse'. Doel hiervan is na te gaan of het pelleteerprocédé van mengvoeders voldoende effectief is om de aanwezigheid van salmonella in mengvoeders te reduceren

Adults with probable Developmental Coordination Disorder selectively process early visual, but not tactile information during action preparation. An electrophysiological study.

Developmental coordination disorder (DCD) is a neurodevelopmental condition affecting motor coordination in children and adults. Here, EEG signals elicited by visual and tactile stimuli were recorded while adult participants with and without probable DCD (pDCD) performed a motor task. The task cued reaching movements towards a location in visible peripersonal space as well as an area of unseen personal space. Event-related potentials elicited by visual and tactile stimuli revealed that visual processing was strongly affected by movement preparation in the pDCD group, even more than in controls. However, in contrast to the controls, tactile processing in unseen space was unaffected by movement preparation in the pDCD group. The selective use of sensory information from vision and proprioception is fundamental for the adaptive control of movements, and these findings suggest that this is impaired in DCD. Additionally, the pDCD group showed attenuated motor rhythms (beta: 13-30Hz) over sensorimotor regions following cues to prepare movements towards unseen personal space. The results reveal that individuals with pDCD exhibit differences in the neural mechanisms of spatial selection and action preparation compared to controls, which may underpin the sustained difficulties they experience. These findings provide new insights into the neural mechanisms potentially disrupted in this highly prevalent disorder

Multivariate paired data analysis: multilevel PLSDA versus OPLSDA

Metabolomics data obtained from (human) nutritional intervention studies can have a rather complex structure that depends on the underlying experimental design. In this paper we discuss the complex structure in data caused by a cross-over designed experiment. In such a design, each subject in the study population acts as his or her own control and makes the data paired. For a single univariate response a paired t-test or repeated measures ANOVA can be used to test the differences between the paired observations. The same principle holds for multivariate data. In the current paper we compare a method that exploits the paired data structure in cross-over multivariate data (multilevel PLSDA) with a method that is often used by default but that ignores the paired structure (OPLSDA). The results from both methods have been evaluated in a small simulated example as well as in a genuine data set from a cross-over designed nutritional metabolomics study. It is shown that exploiting the paired data structure underlying the cross-over design considerably improves the power and the interpretability of the multivariate solution. Furthermore, the multilevel approach provides complementary information about (I) the diversity and abundance of the treatment effects within the different (subsets of) subjects across the study population, and (II) the intrinsic differences between these study subjects

White matter architecture in major depression with anxious distress symptoms

Background: Comorbid anxious distress is common in Major Depressive Disorder (MDD), and associated with significantly worse clinical course and treatment response. While DSM-5 recently introduced the Anxious Distress (AD) specifier as a potentially useful symptom-based subtyping scheme for MDD, its neurobiological underpinnings remain unclear. The current study hence uniquely probed whether MDD with co-occurring AD (MDD/AD+) relates to distinct perturbations in frontolimbic white matter (WM) pathways tentatively theorized in MDD/AD+ pathophysiology. Methods: Tract-based spatial statistics (TBSS) was therefore used to analyze diffusion tensor imaging data on WM microstructure, in MDD/AD+ patients (N = 20) relative to MDD patients without AD (MDD/AD-; N = 29) and healthy controls (HC; N = 39). Using TBSS, we probed fractional anisotropy and axial/radial/mean diffusivity as proxies for WM integrity. Categorical (between-groups) and dimensional (within-patients) analyses subsequently assessed how Anxious Distress in MDD impacts frontolimbic WM connectivity. Receiver-Operating Characteristics additionally assessed classification capabilities of between-groups WM effects. Results: Compared to MDD/AD- and HC participants, MDD/AD+ patients exhibited diminished integrity within the anterior thalamic radiation (ATR). Higher AD specifier scores within MDD patients additionally related to diminished integrity of the uncinate fasciculus and cingulum pathways. These effects were not confounded by key clinical (e.g., comorbid anxiety disorder) and sociodemographic (e.g., age/sex) factors, with altered ATR integrity moreover successfully classifying MDD/AD+ patients from MDD/AD- and HC participants (90% sensitivity vertical bar 73% specificity vertical bar 77% accuracy). Conclusions: These findings collectively link MDD/AD+ to distinct WM anomalies in frontolimbic tracts important to adaptive emotional functioning, and may as such provide relevant, yet preliminary, clues on MDD/AD+ pathophysiology

Physical capacity and walking ability after lower limb amputation: a systematic review

Objective: To review the influence of physical capacity on regaining walking ability and the development of walking ability after lower limb amputation. Design: A systematic search of literature was performed. The quality of all relevant studies was evaluated according to a checklist for statistical review of general papers. Subjects: Lower limb amputees. Main measures: Physical capacity (expressed by aerobic capacity, anaerobic capacity, muscle force, flexibility and balance) and walking ability (expressed by the walking velocity and symmetry). Results: A total of 48 studies that complied with the inclusion criteria were selected. From these studies there is strong evidence for deterioration of two aspects of physical capacity (muscle strength and balance) and of two aspects of walking ability (walking velocity and symmetry) after lower limb amputation. Strong evidence was found for a relation between balance and walking ability. Conclusion: Strong evidence was only found for a relation between balance and walking ability. Evidence about a relation between other elements of physical capacity and walking ability was insufficient. Training of physical capacity as well as walking ability during rehabilitation following lower limb amputation should not be discouraged since several parameters have been shown to be reduced after amputation, although their relation to regaining walking ability and to the development of walking ability remains unclear. © 2006 SAGE Publications

Generalized Boltzmann Equation for Lattice Gas Automata

In this paper, for the first time a theory is formulated that predicts velocity and spatial correlations between occupation numbers that occur in lattice gas automata violating semi-detailed balance. Starting from a coupled BBGKY hierarchy for the $n$-particle distribution functions, cluster expansion techniques are used to derive approximate kinetic equations. In zeroth approximation the standard nonlinear Boltzmann equation is obtained; the next approximation yields the ring kinetic equation, similar to that for hard sphere systems, describing the time evolution of pair correlations. As a quantitative test we calculate equal time correlation functions in equilibrium for two models that violate semi-detailed balance. One is a model of interacting random walkers on a line, the other one is a two-dimensional fluid type model on a triangular lattice. The numerical predictions agree very well with computer simulations.Comment: 31 pages LaTeX, 12 uuencoded tar-compressed Encapsulated PostScript figures (`psfig' macro), hardcopies available on request, 78kb + 52k