Relationship Between Proximal Articular Set Angle and Hallux Abducto Valgus

A study of radiographs from 50 males and 50 females was undertaken to determine whether a relationship existed between the proximal articular set angle and the hallux abductus angle. Gender differences in the relationship were also investigated. The normal range for the proximal articular set angle was –2.6° to 8.6°, with a mean of 5°. There was no significant difference in the mean values between males and females. A positive linear correlation between the proximal articular set angle and hallux abducto valgus deformity was found (R2 = 0.52), suggesting that an increased lateral tilt of the metatarsal head is one of the factors that lead to hallux abducto valgus deformity. The relationship between proximal articular set angle and hallux abducto valgus deformity was similar in males and females and did not account for the increased hallux deformity seen in females

Obfuscation for Cryptographic Purposes

An obfuscation of a function F should satisfy two requirements: firstly, using it should be possible to evaluate F; secondly, should not reveal anything about F that cannot be learnt from oracle access to F. Several definitions for obfuscation exist. However, most of them are either too weak for or incompatible with cryptographic applications, or have been shown impossible to achieve, or both. We give a new definition of obfuscation and argue for its reasonability and usefulness. In particular, we show that it is strong enough for cryptographic applications, yet we show that it has the potential for interesting positive results. We illustrat

Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia

Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP) with 15 preschool children from the facility’s on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose – the Myers Research Institute Engagement Scale (MRI-ES). These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented “lessons” to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed

Accurate exchange-correlation energies for the warm dense electron gas

Density matrix quantum Monte Carlo (DMQMC) is used to sample exact-on-average $N$-body density matrices for uniform electron gas systems of up to 10$^{124}$ matrix elements via a stochastic solution of the Bloch equation. The results of these calculations resolve a current debate over the accuracy of the data used to parametrize finite-temperature density functionals. Exchange-correlation energies calculated using the real-space restricted path-integral formalism and the $k$-space configuration path-integral formalism disagree by up to $\sim$$10$\% at certain reduced temperatures $T/T_F \le 0.5$ and densities $r_s \le 1$. Our calculations confirm the accuracy of the configuration path-integral Monte Carlo results available at high density and bridge the gap to lower densities, providing trustworthy data in the regime typical of planetary interiors and solids subject to laser irradiation. We demonstrate that DMQMC can calculate free energies directly and present exact free energies for $T/T_F \ge 1$ and $r_s \le 2$.Comment: Accepted version: added free energy data and restructured text. Now includes supplementary materia

A bayesian nonparametric model for white blood cells in patients with lower urinary tract symptoms

Lower Urinary Tract Symptoms (LUTS) affect a significant proportion of the population and often lead to a reduced quality of life. LUTS overlap across a wide variety of diseases, which makes the diagnostic process extremely complicated. In this work we focus on the relation between LUTS and Urinary Tract Infection (UTI). The latter is detected through the number of White Blood Cells (WBC) in a sample of urine: WBC≥ 1 indicates UTI and high levels may indicate complications. The objective of this work is to provide the clinicians with a tool for supporting the diagnostic process, deepening the available knowledge about LUTS and UTI. We analyze data recording both LUTS profile and WBC count for each patient. We propose to model the WBC using a random partition model in which we specify a prior distribution over the partition of the patients which includes the clustering information contained in the LUTS profile. Then, within each cluster, the WBC counts are assumed to be generated by a zero-inflated Poisson distribution. The results of the predictive distribution allows to identify the symptoms configuration most associated with the presence of UTI as well as with severe infections

Bayesian Autoregressive Frailty Models for Inference in Recurrent Events

We propose autoregressive Bayesian semi-parametric models for gap times between recurrent events. The aim is two-fold: inference on the effect of possibly time-varying covariates on the gap times and clustering of individuals based on the time trajectory of the recurrent event. Time-dependency between gap times is taken into account through the specification of an autoregressive component for the frailty parameters influencing the response at different times. The order of the autoregression may be assumed unknown and is an object of inference. We consider two alternative approaches to perform model selection under this scenario. Covariates may be easily included in the regression framework and censoring and missing data are easily accounted for. As the proposed methodologies lie within the class of Dirichlet process mixtures, posterior inference can be performed through efficient MCMC algorithms. We illustrate the approach through simulations and medical applications involving recurrent hospitalizations of cancer patients and successive urinary tract infections

Urothelial cells may indicate underlying bacteriuria in pregnancy at term: a comparative study

BACKGROUND: Urinary tract infection is common in pregnancy. Urine is sampled from by mid-stream collection (MSU). If epithelial cells are detected, contamination by vulvo-vagial skin and skin bacteria is assumed. Outside pregnancy, catheter specimen urine (CSU) is considered less susceptible to contamination. We compared MSU and CSU methods in term pregnancy to test these assumptions. METHODS: Healthy pregnant women at term gestation (n = 32, median gestation 38 + 6 weeks, IQR 37 + 6–39 + 2) undergoing elective caesarean section provided a MSU and CSU for paired comparison that were each analysed for bacterial growth and bladder distress by fresh microscopy, sediment culture and immunofluorescent staining. Participants completed a detailed questionnaire on lower urinary tract symptoms. Epithelial cells found in urine were tested for urothelial origin by immunofluorescent staining of Uroplakin III (UP3), a urothelial cell surface glycoprotein. Urothelial cells with closely associated bacteria, or “clue cells”, were also counted. Wilcoxons signed rank test was used for paired analysis. RESULTS: Women reported multiple lower urinary tract symptoms (median 3, IQR 0–8). MSU had higher white blood cell counts (median 67 vs 46, z = 2.75, p = 0.005) and epithelial cell counts (median 41 vs 22, z = 2.57, p = 0.009) on fresh microscopy. The proportion of UP3+ cells was not different (0.920 vs 0.935, z = 0.08, p = 0.95), however MSU had a higher proportion of clue cells (0.978 vs 0.772, z = 3.17, p = 0.001). MSU had more bacterial growth on sediment culture compared to CSU specimens (median 8088 total cfu/ml vs 0, z = 4.86, p = 0.001). Despite this, routine laboratory cultures reported a negative screening culture for 40.6% of MSU specimens. CONCLUSION: Our findings have implications for the correct interpretation of MSU findings in term pregnancy. We observed that MSU samples had greater bacterial growth and variety when compared to CSU samples. The majority of epithelial cells in both MSU and CSU samples were urothelial in origin, implying no difference in contamination. MSU samples had a higher proportion of clue cells to UP3+ cells, indicating a greater sensitivity to bacterial invasion. Urinary epithelial cells should not be disregarded as contamination, instead alerting us to underlying bacterial activity

Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs

Background: The UK health service, nursing homes and public spend around £94 million per year on incontinence pads (absorbent products) to contain urine and/or faeces, but the research base for making informed choices between different product designs is very weak.Objectives: The aim of this trial was to compare the performance and cost-effectiveness of the key absorbent product designs to provide a more solid basis for guiding selection and purchase.A further aim was to carry out the first stage in the development of a quality of life instrument for measuring the impact of absorbent product use on users' lives.Design: The work involved three clinical trials focusing on the three biggest market sectors. Each trial had a similar crossover design in which each participant tested all products within their group in random order.Settings, participants and methods: In Trial 1, 85 women with light urinary incontinence living in the community tested three products from each of the four design categories available (total of 12 test products): disposable inserts (pads); menstrual pads; washable pants with integral pad; and washable inserts. In Trial 2a, 85 moderate/heavily incontinent adults (urinary or urinary/faecal) living in the community (49 men and 36 women) tested three (or two) products from each of the five design categories available (total of 14 test products): disposable inserts (with mesh pants); disposable diapers (nappies); disposable pull-ups (similar to toddlers' trainer pants); disposable T-shaped diapers (nappies with waist-band); and washable diapers. All products were provided in a daytime and a (mostly more absorbent) night-time variant. In these first two trials, the test products were selected on the basis of data from pilot studies. In Trial 2b, 100 moderate/heavily incontinent adults (urinary or urinary/faecal) living in 10 nursing homes (27 men and 73 women) evaluated one product from each of the four disposable design categories from Trial 2a. Products were selected on the basis of product performance in Trial 2a and, again, daytime and night-time variants were provided. The first phase of work to develop a quality of life tool for measuring the impact of using different pad designs was carried out by interviewing participants from Trials 1 and 2a.Outcome measures: Product performance was characterised using validated questionnaires, which asked the participants (in Trials 1 and 2a) or carers (all participants in Trial 2b, except for the few who could report for themselves) to evaluate various aspects of pad performance (leakage, ease of putting on, discreetness, etc.) using a five-point scale (very good–very poor) at the end of the week (or 2 weeks for Trial 2b) of product testing. In addition, participants/carers were asked to save individual used pads in bags for weighing and to indicate the severity of any leakage from them on a three-point scale (none, a little, a lot). These data were used to determine differences in leakage performance. Numbers of laundry items and pads used were recorded to estimate costs, and skin health changes were recorded by the participant or by the researchers (Trial 2b). At the end of testing, participants were interviewed and ranked their preferences (with and without costs), stated the acceptability of each design (highly acceptable–totally unacceptable) and recorded their overall opinion on a visual analogue scale (VAS) of 0–100 points (worst design–best design). This VAS score was used with product costs to estimate cost-effectiveness. In addition, a timed pad changing exercise was conducted with 10 women from Trial 2b to determine any differences between product designs.Results: Results presented are for statistically and clinically significant findings.<br/

A prospective observational study of urinary cytokines and inflammatory response in patients with Overactive Bladder Syndrome

Background Contemporary studies have discredited the methods used to exclude urinary tract infection (UTI) when treating overactive bladder (OAB). Thus we must revisit the OAB phenotype to check that UTI has not been overlooked. Aims To examine the differences in urinary cytokines IL6 and lactoferrin in OAB patients compared to controls, with references to microscopy of urine and enhanced quantitative urine culture. Methods A blinded, prospective cohort study with normal controls using six repeated measures, achieved two-monthly, over 12 months. Results The differences between patients and controls in urine IL6 (F = 49.0, p < .001) and lactoferrin (F = 228.5, p < .001) were significant and of a magnitude to have clinical implications. These differences were for lactoferrin correlated to symptoms (9.3, p = .003); for both to pyuria (IL6 F = 66.2, p < .001, Lactoferrin F = 73.9, p < .001); and for IL6 microbial abundance (F = 5.1, p = .024). The pathological markers had been missed by urinary dipsticks and routine MSU culture. Conclusion The OAB phenotype may encompass patients with UTI that is being overlooked because of the failure of standard screening methods