Showing papers by "Keele University published in 2007"

How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology

Abstract: Diastolic heart failure (DHF) currently accounts for more than 50% of all heart failure patients. DHF is also referred to as heart failure with normal left ventricular (LV) ejection fraction (HFNEF) to indicate that HFNEF could be a precursor of heart failure with reduced LVEF. Because of improved cardiac imaging and because of widespread clinical use of plasma levels of natriuretic peptides, diagnostic criteria for HFNEF needed to be updated. The diagnosis of HFNEF requires the following conditions to be satisfied: (i) signs or symptoms of heart failure; (ii) normal or mildly abnormal systolic LV function; (iii) evidence of diastolic LV dysfunction. Normal or mildly abnormal systolic LV function implies both an LVEF > 50% and an LV end-diastolic volume index (LVEDVI) 16 mmHg or mean pulmonary capillary wedge pressure >12 mmHg) or non-invasively by tissue Doppler (TD) (E/E' > 15). If TD yields an E/E' ratio suggestive of diastolic LV dysfunction (15 > E/E' > 8), additional non-invasive investigations are required for diagnostic evidence of diastolic LV dysfunction. These can consist of blood flow Doppler of mitral valve or pulmonary veins, echo measures of LV mass index or left atrial volume index, electrocardiographic evidence of atrial fibrillation, or plasma levels of natriuretic peptides. If plasma levels of natriuretic peptides are elevated, diagnostic evidence of diastolic LV dysfunction also requires additional non-invasive investigations such as TD, blood flow Doppler of mitral valve or pulmonary veins, echo measures of LV mass index or left atrial volume index, or electrocardiographic evidence of atrial fibrillation. A similar strategy with focus on a high negative predictive value of successive investigations is proposed for the exclusion of HFNEF in patients with breathlessness and no signs of congestion. The updated strategies for the diagnosis and exclusion of HFNEF are useful not only for individual patient management but also for patient recruitment in future clinical trials exploring therapies for HFNEF.

Palladium Complexes of N-Heterocyclic Carbenes as Catalysts for Cross-Coupling Reactions—A Synthetic Chemist's Perspective

Abstract: Palladium-catalyzed C-C and C-N bond-forming reactions are among the most versatile and powerful synthetic methods. For the last 15 years, N-heterocyclic carbenes (NHCs) have enjoyed increasing popularity as ligands in Pd-mediated cross-coupling and related transformations because of their superior performance compared to the more traditional tertiary phosphanes. The strong sigma-electron-donating ability of NHCs renders oxidative insertion even in challenging substrates facile, while their steric bulk and particular topology is responsible for fast reductive elimination. The strong Pd-NHC bonds contribute to the high stability of the active species, even at low ligand/Pd ratios and high temperatures. With a number of commercially available, stable, user-friendly, and powerful NHC-Pd precatalysts, the goal of a universal cross-coupling catalyst is within reach. This Review discusses the basics of Pd-NHC chemistry to understand the peculiarities of these catalysts and then gives a critical discussion on their application in C-C and C-N cross-coupling as well as carbopalladation reactions.

Creatine kinase monitoring in sport medicine

Abstract: Areas of general agreement: Total creatine kinase (CK) levels depend on age, gender, race, muscle mass, physical activity and climatic condition. High levels of serum CK in apparently healthy subjects may be correlated with physical training status, as they depend on sarcomeric damage: strenuous exercise that damages skeletal muscle cells results in increased total serum CK. The highest postexercise serum enzyme activities are found after prolonged exercise such as ultradistance marathon running or weight-bearing exercises and downhill running, which include eccentric muscular contractions. Total serum CK activity is markedly elevated for 24 h after the exercise bout and, when patients rest, it gradually returns to basal levels. Persistently increased serum CK levels are occasionally encountered in healthy individuals and are also markedly increased in the pre-clinical stages of muscle diseases. Areas that are controversial: Some authors, studying subjects with high levels of CK at rest, observed that, years later, subjects developed muscle weakness and suggested that early myopathy may be asymptomatic. Others demonstrated that, in most of these patients, hyperCKemia probably does not imply disease. In many instances, the diagnosis is not formulated following routine examination with the patients at rest, as symptoms become manifest only after exercise. Some authors think that strength training seems to be safe for patients with myopathy, even though the evidence for routine exercise prescription is still insufficient. Others believe that, in these conditions, intense prolonged exercise may produce negative effects, as it does not induce the physiological muscle adaptations to physical training given the continuous loss of muscle proteins. Growing points: High CK serum levels in athletes following absolute rest and without any further predisposing factors should prompt a full diagnostic workup with special regards to signs of muscle weakness or other simple signs that, in both athletes and sedentary subjects, are not always promptly evident. These signs may indicate subclinical muscle disease, which training loads may evidence through the onset of profound fatigue. It is probably safe to counsel athletes with suspected myopathy to continue to undertake physical activity at a lower intensity, so as to prevent muscle damage from high intensity exercise and allow ample recovery to favour adequate recovery.

Interrater reliability of algometry in measuring pressure pain thresholds in healthy humans, using multiple raters

Abstract: Objective: To evaluate interrater reliability using 5 newly trained observers in the assessment of pressure pain threshold (PPT) using a fixed-angle algometer. Methods: The study design comprised 2 phases. Phase 1: 5 undergraduate physical therapists were trained in algometry at a predefined angle, at a rate of 5 Newtons (N)/s, to the first dorsal interosseous muscle. Each observer then underwent a competency test of the application speed. The aim was to achieve repeated applications at 5 N/s without visual feedback from the algometer. Phase 2: the 5 observers measured PPT of 13 healthy volunteers, at the first dorsal interosseous muscle. The sequence of observer measurements for each participant was randomized. Mean PPT values for each observer were analyzed using repeated measures analysis of variance, intraclass correlation coefficient (ICC2,1), and standard error of measurement, with 95% confidence intervals (CIs). Results: No significant differences between observers’ mean values were found (P = 0.094), suggesting no bias. The ICC was 0.91 (95% CI 0.82, 0.97). The standard error of measurement value was 6.27 N/cm 2 (95% CI 5.35, 7.59). Differences in PPT measurements of more than 17.39 N/cm 2 (1.77 kg/cm 2 ) are likely to exceed the magnitude of measurement error, and could be used to indicate true change. This margin of error is, however, somewhat larger than a previously proposed minimum clinically important difference in PPT of 14.71 N/cm 2 (1.5 kg/cm 2 ). Discussion: This study provides new evidence that trained observers can apply an algometer at a consistent rate and provide highly reliable measures of PPT in healthy humans, when PPT is calculated as the mean of 3 trials.

Epidemiology of insomnia: a longitudinal study in a UK population.

Abstract: Study objectives To investigate the incidence, persistence, and consequences of insomnia and their associations with psychological health and pain. Design A population based, longitudinal, cohort study using postal questionnaires at baseline and 12-month follow-up. Sleep problems in the past month were assessed using 4 questions: insomnia was defined as having at least 1 of the sleep problems "on most nights." Questions about psychological health, presence of pain at different sites, and demographic details were included in the questionnaire. Setting Five general practices in Staffordshire, UK. Participants The questionnaire was mailed to a random sample of 4885 adults aged 18 years and over registered with these practices. There were 2662 questionnaires returned. Results Of the responders, 2363 completed all 4 sleep questions at baseline: 870 (37%) had insomnia and 1493 (63%) did not have insomnia. Of those without insomnia at baseline, the incidence of insomnia at 12 months was 15%, and this was significantly associated with baseline anxiety, depression, and pain. Of those who did have insomnia at baseline, 69% had insomnia at 12-month follow-up; persistence of insomnia was significantly associated with older age. Insomnia at baseline was significantly associated with incidence of anxiety, depression, and widespread pain at 12-month follow-up. Conclusions Insomnia is common and often persistent. Older people appear more vulnerable to persistent symptoms. Our results provide evidence that the common problems of insomnia, pain, and psychological distress are intertwined and suggest that combined approaches to treatment may be needed to reduce the onset and persistence of these problems in the community.

Environmental citizenship: towards sustainable development

Abstract: It is assumed that changes in the behaviour of individuals, institutions and organizations are a prerequisite for sustainable development. This article broaches the question of how best to bring about such change. A distinction is drawn between changes in behaviour and changes in attitudes, and it is argued that attendance to the latter will lead to more secure and long-lasting changes in the former. Fiscal incentives, as a means of changing behaviour, are compared and contrasted with the ‘environmental citizenship’ route to attitude change, rooted in considerations of justice and injustice. Finally, the citizenship curriculum at high school level is considered as a way of promoting environmental or ecological citizenship. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment.

Cross versus Within-Company Cost Estimation Studies: A Systematic Review

Abstract: The objective of this paper is to determine under what circumstances individual organizations would be able to rely on cross-company-based estimation models. We performed a systematic review of studies that compared predictions from cross-company models with predictions from within-company models based on analysis of project data. Ten papers compared cross-company and within-company estimation models; however, only seven presented independent results. Of those seven, three found that cross-company models were not significantly different from within-company models, and four found that cross-company models were significantly worse than within-company models. Experimental procedures used by the studies differed making it impossible to undertake formal meta-analysis of the results. The main trend distinguishing study results was that studies with small within-company data sets (i.e., $20 projects) that used leave-one-out cross validation all found that the within-company model was significantly different (better) from the cross-company model. The results of this review are inconclusive. It is clear that some organizations would be ill-served by cross-company models whereas others would benefit. Further studies are needed, but they must be independent (i.e., based on different data bases or at least different single company data sets) and should address specific hypotheses concerning the conditions that would favor cross-company or within-company models. In addition, experimenters need to standardize their experimental procedures to enable formal meta-analysis, and recommendations are made in Section 3.

Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial.

Abstract: BackgroundRestoring the anatomical footprint may improve the healing and mechanical strength of repaired tendons. A double row of suture anchors increases the tendon-bone contact area, reconstituting a more anatomical configuration of the rotator cuff footprint.HypothesisThere is no difference in clinical and imaging outcome between single-row and double-row suture anchor technique repairs of rotator cuff tears.Study DesignRandomized controlled trial; Level of evidence, 1.MethodsThe authors recruited 60 patients. In 30 patients, rotator cuff repair was performed with a single-row suture anchor technique (group 1). In the other 30 patients, rotator cuff repair was performed with a double-row suture anchor technique (group 2).ResultsEight patients (4 in the single-row anchor repair group and 4 in the double-row anchor repair group) did not return at the final follow-up. At the 2-year follow-up, no statistically significant differences were seen with respect to the University of California, Los Angeles score...

The empirical metallicity dependence of the mass-loss rate of O- and early B-type stars

Abstract: We present a comprehensive study of the observational dependence of the mass-loss rate in stationary stellar winds of hot massive stars on the metal content of their atmospheres. The metal content of stars in the Magellanic Clouds is discussed, and a critical assessment is given of state-of-the-art mass-loss determinations of OB stars in these two satellite systems and the Milky-Way. Assuming a powerlaw dependence of mass loss on metal content, u M ∝ Z m , and adopting a theoretical relation between the terminal flow velocity and metal content, v∞ ∝ Z 0.13 (Leitherer et al. 1992, ApJ, 401, 596), we find m = 0.83 ± 0.16 for non-clumped outflows from an analysis of the wind momentum luminosity relation (WLR) for stars more luminous than 10 5.2 L� . Within the errors, this result is in agreement with the prediction m = 0.69 ± 0.10 by Vink et al. (2001, A&A, 369, 574). Absolute empirical values for the mass loss, based on Hα and ultraviolet (UV) wind lines, are found to be a factor of two higher than predictions in this high luminosity regime. If this difference is attributed to inhomogeneities in the wind, and this clumping does not impact the predictions, this would imply that luminous O and early-B stars have clumping factors in their Hα and UV line forming regions of about a factor of four. For lower luminosity stars, the winds are so weak that their strengths can generally no longer be derived from optical spectral lines (essentially Hα) and one must currently rely on the analysis of UV lines. We confirm that in this low-luminosity domain the observed Galactic WLR is found to be much steeper than expected from theory (although the specific sample is rather small), leading to a discrepancy between UV mass-loss rates and the predictions by a factor 100 at luminosities of L ∼ 10 4.75 L� , the origin of which is unknown. We emphasize that even if the current mass-loss rates of hot luminous stars would turn out to be overestimated as a result of wind clumping, but the degree of clumping would be rather independent of metallicity, the scalings derived in this study are expected to remain correct.

Efficient identification of exoplanetary transit candidates from SuperWASP light curves

Abstract: Transiting extrasolar planets constitute only a small fraction of the range of stellar systems found to display periodic, shallow dimmings in wide-field surveys employing small-aperture A camera arrays. Here we present an efficient selection strategy for follow-up observations, derived from analysis of the light curves of a sample of 67 SuperWASP targets that passed the selection tests we used in earlier papers, but which have subsequently been identified either as planet hosts or as astrophysical false positives. We determine the system parameters using Markov-chain Monte Carlo analysis of the SuperWASP light curves. We use a constrained optimization of X 2 combined with a Bayesian prior based on the main-sequence mass and radius expected from the Two Micron All Sky Survey J - H colour. The Bayesian nature of the analysis allows us to quantify both the departure of the host star from the main-sequence mass-radius relation and the probability that the companion radius is less than 1.5 Jupiter radii. When augmented by direct fight-curve analyses that detect binaries with unequal primary and secondary eclipses, and objects with aperture blends that are resolved by SuperWASP, we find that only 13 of the original 67 stars, including the three known planets in the sample, would qualify for follow-up. This suggests that planet discovery 'hit rates' better than one-in-five should be achievable. In addition, the stellar binaries that qualify are likely to have astrophysically interesting stellar or substellar secondaries.

Eccentric Loading, Shock-Wave Treatment, or a Wait-and-See Policy for Tendinopathy of the Main Body of Tendo Achillis A Randomized Controlled Trial

Abstract: BackgroundFew randomized controlled trials compare different methods of management in chronic tendinopathy of the main body of tendo Achillis.PurposeTo compare the effectiveness of 3 management strategies—group 1, eccentric loading; group 2, repetitive low-energy shock-wave therapy (SWT); and group 3, wait and see—in patients with chronic tendinopathy of the main body of tendo Achillis.Study DesignRandomized controlled trial; Level of evidence, 1.MethodsSeventy-five patients with a chronic recalcitrant (>6 months) noninsertional Achilles tendinopathy were enrolled in a randomized controlled study. All patients had received unsuccessful management for >3 months, including at least (1) peritendinous local injections, (2) nonsteroidal anti-inflammatory drugs, and (3) physiotherapy. A computerized random-number generator was used to draw up an allocation schedule. Analysis was on intention-to-treat basis.ResultsAt 4 months from baseline, the Victorian Institute of Sport Assessment (VISA)-A score increased in ...

Prognostic factors for musculoskeletal pain in primary care: a systematic review.

Abstract: Background Estimating the future course of musculoskeletal pain is an important consideration in the primary care consultation for patients and healthcare professionals. Studies of prognostic indicators tend to have been viewed in relation to each site separately, however, an alternative view is that some prognostic indicators may be common across different sites of musculoskeletal pain. Aim To identify generic prognostic indicators for patients with musculoskeletal pain in primary care. Design of study Systematic review. Setting Observational cohort studies in primary care. Method MEDLINE, EMBASE, PsychINFO and CINAHL electronic databases were searched from inception to April 2006. Inclusion criteria were that the study was a primary care-based cohort, published in English and contained information on prognostic indicators for musculoskeletal conditions. Results Forty-five studies were included. Eleven factors, assessed at baseline, were found to be associated with poor outcome at follow up for at least two different regional pain complaints: higher pain severity at baseline, longer pain duration, multiple-site pain, previous pain episodes, anxiety and/or depression, higher somatic perceptions and/or distress, adverse coping strategies, low social support, older age, higher baseline disability, and greater movement restriction. Conclusion Despite substantial heterogeneity in the design and analysis of original studies, this review has identified potential generic prognostic indicators that may be useful when assessing any regional musculoskeletal pain complaint. However, Its unclear whether these indicators, used alone, or in combination, can correctly estimate the likely course of individual patients9 problems. Further research is needed, particularly in peripheral joint pain and using assessment methods feasible for routine practice.

Reviewing the literature on interactive whiteboards

Abstract: The aims of this article are to review the existing literature on the introduction and use of interactive whiteboards (IWBs) in schools and to summarise the key issues arising from this analysis in order to provide a context for the articles which follow in this special issue of Learning, Media and Technology. The article reviews the evidence about the initial adoption of the technology in classrooms, the existing empirical evidence of its impact on teaching and learning in schools as well as presenting an analysis of some of the underlying theoretical and conceptual issues.

Aus der Sicht des Synthetikers: Palladiumkomplexe N-heterocyclischer Carbene als Katalysatoren für Kreuzkupplungen

Abstract: Palladiumkatalysierte C-C- und C-N-Kupplungen zahlen zu den vielseitigsten und leistungsfahigsten Syntheseverfahren. Seit 15 Jahren erfreuen sich die N-heterocyclischen Carbene (NHCs) wachsender Beliebtheit als Liganden fur palladiumvermittelte Kreuzkupplungen und ahnliche Methoden. Sie sind in vielerlei Hinsicht den ublichen tertiaren Phosphanen uberlegen. Weil NHCs stark σ-elektronenschiebend sind, konnen sie auch anspruchsvolle Substrate zu oxidativen Insertionen bewegen. Andererseits fuhren ihre Sperrigkeit und ihre besondere Topologie zu einer raschen reduktiven Eliminierung. Schlieslich tragen die starken Pd-NHC-Bindungen zur hohen Stabilitat der aktiven Spezies bei – auch bei niedrigen Ligand/Pd-Verhaltnissen und hohen Temperaturen. Wenn erst stabile, anwenderfreundliche und leistungsstarke NHC-Pd-Prakatalysatoren kommerziell verfugbar sind, liegt das Ziel eines universellen Kreuzkupplungskatalysators in greifbarer Nahe. Dieser Aufsatz beschreibt zunachst die chemischen Grundlagen zu den NHC-Pd-Komplexen, um ihre Besonderheiten kennenzulernen. Anschliesend folgt eine umfassende Diskussion zur Anwendung dieser Katalysatoren in C-C- und C-N-Kreuzkupplungen sowie in der Carbopalladierung.

The temporal responses of protein synthesis, gene expression and cell signalling in human quadriceps muscle and patellar tendon to disuse.

Abstract: We hypothesized that rates of myofibrillar and patellar tendon collagen synthesis would fall over time during disuse, the changes being accompanied in muscle by decreases in focal adhesion kinase (FAK) phosphorylation and in gene expression for proteolytic enzymes. We studied nine men (22 +/- 4 years, BMI 24 +/- 3 kg m(-2) (means +/- s.d.) who underwent unilateral lower leg suspension for 23 days; five were studied between 0 and 10 days and four between 10 and 21 days. Muscle and tendon biopsies were taken in the postabsorptive state at days 0, 10 and 21 for measurement of protein synthesis, gene expression and protein phosphorylation. Muscle cross-sectional area decreased by 5.2% at 14 days and 10.0% (both P < 0.001), at 23 days, i.e. 0.5% day(-1), whereas tendon dimensions were constant. Rates of myofibrillar protein synthesis fell (P < 0.01) from 0.047% h(-1) at day 0 to 0.022% h(-1) at 10 days without further changes. Tendon collagen synthetic rates also fell (P < 0.01), from 0.052 to 0.023% h(-1) at 10 days and then to 0.010% h(-1) at 21 days. FAK phosphorylation decreased 30% (P < 0.01) at 10 days. No changes occurred in the amounts/phosphorylation of PKB-P70s6k-mTOR pathway components. Expression of mRNA for MuRF-1 increased approximately 3-fold at 10 days without changes in MAFbx or tripeptidyl peptidase II mRNA, but all decreased between 10 and 21 days. Thus, both myofibrillar and tendon protein synthetic rates show progressive decreases during 21 days of disuse; in muscle, this is accompanied by decreased phosphorylation of FAK, with no marked increases in genes for proteolytic enzymes.

The challenge of breath analysis for clinical diagnosis and therapeutic monitoring

Abstract: The potential of breath analysis for clinical diagnosis and the strengths and weaknesses of the analytical methods used are discussed. Special attention is given to selected ion flow tube mass spectrometry, SIFT-MS, using which on-line real-time analyses of single breath exhalations can be carried out. Illustrative data on the concentration distributions of several breath metabolites amongst the healthy population are presented and their relations to disease when elevated above the normal are alluded to.

Social Reproduction and the Constitution of a Gendered Political Economy

Abstract: This review essay outlines and compares several recent contributions in feminist political economy with particular emphasis on the renaissance of the concept of social reproduction.1 Most definitio...

Patient reporting of suspected adverse drug reactions: a review of published literature and international experience

Abstract: Aims To synthesize data from published studies and international experience to identify evidence of potential benefits and drawbacks of direct patient reporting of suspected adverse drug reactions (ADRs) by patients.

WASP-1b and WASP-2b: Two new transiting exoplanets detected with SuperWASP and SOPHIE

Abstract: We have detected low-amplitude radial-velocity variations in two stars, USNO-B1.0 1219‐ 0005465 (GSC 02265‐00107 = WASP‐1) and USNO-B1.0 0964‐0543604 (GSC 00522‐ 01199 = WASP‐2). Both stars were identified as being likely host stars of transiting exoplanets in the 2004 SuperWASP wide-field transit survey. Using the newly commissioned radial-velocity spectrograph SOPHIE at the Observatoire de Haute-Provence, we found that both objects exhibit reflex orbital radial-velocity variations with amplitudes characteristic of planetary-mass companions and in-phase with the photometric orbits. Line-bisector studies rule out faint blended binaries as the cause of either the radial-velocity variations or the transits. We perform preliminary spectral analyses of the host stars, which together with their radialvelocity variations and fits to the transit light curves yield estimates of the planetary masses and radii. WASP-1b and WASP-2b have orbital periods of 2.52 and 2.15 d, respectively. Given mass estimates for their F7V and K1V primaries, we derive planet masses 0.80‐0.98 and 0.81‐ 0.95 times that of Jupiter, respectively. WASP-1b appears to have an inflated radius of at least 1.33 RJup, whereas WASP-2b has a radius in the range 0.65‐1.26 RJup.

Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: a systematic review.

Abstract: Purpose: Magnetic resonance imaging (MRI) is of great aid in the diagnosis of knee lesions. Most diagnostic studies comparing MRI and arthroscopy have shown good diagnostic performance in detecting lesions of the menisci and cruciate ligaments. Nevertheless, arthroscopy has remained the reference standard for the diagnosis of internal derangements of the knee, against which alternative diagnostic modalities should be compared. Methods: We took arthroscopy to be the ‘gold standard’, and we undertook a systematic review of MRI and arthroscopy in the diagnosis of internal derangements of the knee. We used Coleman scoring methodology to identify scientifically sound articles in a reproducible format. Results: MRI is highly accurate in diagnosing meniscal and anterior cruciate ligament (ACL) tears. It is the most appropriate screening tool before therapeutic arthroscopy. It is preferable to diagnostic arthroscopy in most patients because it avoids the surgical risks of arthroscopy. The results of MRI differ for medial and lateral meniscus and ACL, with only 85% accuracy.

Strongly self-absorbing C*-algebras

Abstract: Say that a separable, unital C*-algebra V ? C is strongly self absorbing if there exists an isomorphism V such that lx> ai>e approximately unitarily equivalent *-homomorphisms. We study this class of algebras, which includes the Cuntz algebras ?2, Ooo, the UHF algebras of infinite type, the Jiang-Su algebra Z and tensor products of ?00 with UHF algebras of infinite type. Given a strongly self-absorbing C*-algebra V we characterise when a separable C*-algebra absorbs V tensorially (i.e., is P-stable), and prove closure properties for the class of separable Testable C* algebras. Finally, we compute the possible If-groups and prove a number of classification results which suggest that the examples listed above are the only strongly self-absorbing C*-algebras.

Acupuncture treatment for chronic knee pain: a systematic review

Abstract: and study validity was assessed using a modification of a previously published instrument. Results. Thirteen RCTs were included, of which eight used adequate acupuncture and provided WOMAC outcomes, so were combined in meta-analyses. Six of these had validity scores of more than 50%. Combining five studies in 1334 patients, acupuncture was superior to sham acupuncture for both pain (weighted mean difference in WOMAC pain subscale score ¼ 2.0, 95% CI 0.57–3.40) and for WOMAC function subscale (4.32, 0.60–8.05). The differences were still significant at long-term follow-up. Acupuncture was also significantly superior to no additional intervention. There were insufficient studies to compare acupuncture with other sham or active interventions. Conclusions. Acupuncture that meets criteria for adequate treatment is significantly superior to sham acupuncture and to no additional intervention in improving pain and function in patients with chronic knee pain. Due to the heterogeneity in the results, however, further research is required to confirm these findings and provide more information on long-term effects.

The Spitzer survey of the small magellanic cloud : S3MC imaging and photometry in the mid-and far-infrared wave bands

Abstract: We present the initial results from the Spitzer Survey of the Small Magellanic Cloud (S^3MC), which imaged the star-forming body of the SMC in all seven MIPS and IRAC wave bands. We find that the F_8/F_(24) ratio (an estimate of PAH abundance) has large spatial variations and takes a wide range of values that are unrelated to metallicity but anticorrelated with 24 μm brightness and F_(24)/F_(70) ratio. This suggests that photodestruction is primarily responsible for the low abundance of PAHs observed in star-forming low-metallicity galaxies. We use the S3MC images to compile a photometric catalog of ~400,000 mid- and far-infrared point sources in the SMC. The sources detected at the longest wavelengths fall into four main categories: (1) bright 5.8 μm sources with very faint optical counterparts and very red mid-infrared colors ([5.8] - [8.0] > 1.2), which we identify as YSOs; (2) bright mid-infrared sources with mildly red colors (0.16 ≾ [5.8] - [8.0] < 0.6), identified as carbon stars; (3) bright mid-infrared sources with neutral colors and bright optical counterparts, corresponding to oxygen-rich evolved stars; and (4) unreddened early B stars (B3-O9) with a large 24 μm excess. This excess is reminiscent of debris disks and is detected in only a small fraction of these stars (≾5%). The majority of the brightest infrared point sources in the SMC fall into groups 1-3. We use this photometric information to produce a catalog of 282 bright YSOs in the SMC with a very low level of contamination (~7%).