International Musculoskeletal Medicine | Year: 2014
Objective: To investigate the precision of acupuncture needle placement using two methods of guidance (termed assisted and guided).Method: A lamb shoulder in vitro study model was chosen. In the case of assisted acupuncture, the track the needle would take was visualized before subsequent blind needle placement. For guided acupuncture, the needle placement was seen in real-time. In total, 33 measurements of needle tip-target distance were performed for each of the two methods of acupuncture needle placement. Descriptive statistics were used to compare the precision of the two methods. Repeated measurements were analysed to investigate operator reliability using the intra-class correlation coefficient (ICC) statistic.Results: In terms of precision of needle placement, guided placement was more precise than assisted. Guided acupuncture (0.2 mm± 0.19 SD) was more precise than assisted (4.4 mm± 4.08 SD). Operator reliability of measurement of needle tip-target distance was good for both methods. Assisted method gave an ICC of 0.99, whereas the guided method was 0.90.Discussion: Precision of acupuncture placement is improved by diagnostic ultrasound guidance. The utilization of diagnostic ultrasound prior to needling in anatomically challenging areas may contribute to patient safety. The visualization of needle track anatomy may facilitate skill acquisition when training in acupuncture. © W. S. Maney & Son Ltd and the British Institute of Musculoskeletal Medicine 2014.
Field J.,Private Practice |
Chiropractic and Manual Therapies | Year: 2013
Background: Chronicity amongst musculoskeletal patients remains a considerable burden and predicting outcomes in these patients has proven difficult. Although a large number of studies have investigated a range of predictors of outcome few have looked at the practitioners' ability to discern those that improve from those most likely to fail to improve. This study aimed to investigate the ability of chiropractors to predict patient outcomes.Methods: Prediction and outcome data were collected from 440 consecutive patients with back, neck or shoulder pain accepted for chiropractic care within 5 linked private practices.Predictions by chiropractors were compared to patient outcomes as measured by Bournemouth Questionnaire (BQ) scores, pain NRS scores and patient global impression of change (PGIC) collected at 4 and 12 weeks following the initial consultation.Results: Overall, chiropractors appear unable to accurately predict poor outcomes in their patients particularly in the longer term. Although some conditions (neck) faired a little better in some cases with some trends in short term pain scores being associated with the clinicians prediction, this was marginal. Subgrouping by practitioners or duration did not improve the performance of these predictions. Conclusions: Chiropractors generally fail to reliably predict poor treatment outcome of patients at initial consultation. © 2013 Newell et al.; licensee BioMed Central Ltd.
Docherty S.,AECC |
BMC Research Notes | Year: 2010
Background. Perception of subjective visual vertical (SVV) and horizontal (SVH) has traditionally been measured by rotating a mechanical rod either with or without a frame present. The computerised rod and frame (CRAF) system has previously only been used to measure SVV. We have expanded the use of this system by testing its feasibility to measure SVH. This was done by comparing two groups of subjects (n = 103) randomly assigned to be tested for SVV or SVH. Findings. Preliminary results showed a higher than expected percentage of individuals with SVH errors < 0.5°. This was attributed to additional visual cues provided by the changing appearance of the rod as it approached the horizontal. A solution to this problem was sought by replacing the rod by two dots to mark its ends. In a second investigation 30 subjects were tested using both the "rod as line" and "rod as dots" presentation. Bland and Altman analysis showed no difference between the rod and dots presentations in the measurement of SVV, but confirmed a fixed error of -0.93°between rods and dots for SVH. Changing the rod from a line to dots in the computer system resulted in errors for both SVV and SVH that were comparable to previous studies using manual systems. Conclusions. The computerized rod and frame system may be improved by replacement of the line with two dots. This reduces clues provided to the subject by the appearance of the rod on the screen. © 2010 Docherty et al; licensee BioMed Central Ltd.
Favre C.,AECC |
Bosteels D.,AECC |
SAE Technical Papers | Year: 2013
AECC, the Association for Emissions Control by Catalyst, conducted a test program to compare the newly developed World-harmonized Light vehicles Test Cycle (WLTC) with the current European regulatory New European Drive Cycle (NEDC) and the cold-start Common Artemis Driving Cycle (CADC). Vehicle engines and aftertreatment technologies were selected to cover a wide range of future systems. Six European commercially available passenger cars were chosen: three Euro 5 Gasoline Direct Injection cars, two Euro 6 Diesel cars and a Euro 5 non-plug-in gasoline hybrid car. The hybrid car was tested with three different battery state of charge: nominal, minimum charge, and maximum charge. Investigations on the test temperature were also conducted by comparing emissions at 25°C and at -7°C. Regulated gaseous emissions (HC, CO, NOx) and particulate mass and particles number were measured, together with additional pollutants such as CH4, NO2 and ammonia. The study isolated cycle-to-cycle effects on emissions for each vehicle by normalizing the test mass in all tests to the draft WLTP (World-harmonized Light vehicles Test procedure) Global Technical Regulation (gtr). Because of the higher inertia used, emissions results obtained on the regulatory NEDC can deviate from type-approval emissions for each tested vehicle. Comparison of emissions results obtained on NEDC and WLTC tends to show that WLTP may bring more realistic CO2 emissions from the higher vehicle inertia included in the test procedure (closer to real mass of vehicle) but most likely not from its drive cycle pattern, even if it is more transient. Copyright © 2013 SAE International.
Andersson J.,Ricardo PLC |
de Vries S.,Ricardo PLC |
Heaney M.,Ricardo PLC |
Keenan M.,Ricardo PLC |
And 4 more authors.
SAE International Journal of Fuels and Lubricants | Year: 2014
The exhaust emissions of two Euro 6 diesel cars with different emissions control systems have been evaluated both on the road and over various chassis dynamometer test cycles. European emissions limits are currently set using the New European Driving Cycle (NEDC), but the European Commission is preparing additional test procedures to ensure that emissions are well controlled both in real-world use and over the legislative test cycle. The main focus of this work on ‘Real Driving Emissions’ (RDE) is on measurements using Portable Emissions Measurement Systems (PEMS) in truly representative, on-road, driving. A key focus of the test programme, undertaken as a collaboration between AECC (the Association for Emissions Control by Catalyst) and Ricardo UK, was therefore the use of PEMS systems to measure on-road emissions of both gaseous pollutants and particulate matter. This included measurement of particle number emissions with a new candidate system for this type of measurement. The results from this testing are compared with emissions measured over four different chassis dynamometer test cycles - the current legislative cycle (New European Driving Cycle, NEDC); the Common Artemis suite of test cycles (CADC) that is widely used in emissions modelling; the new Worldwide Light-duty Test Cycle (WLTC) defined by the UN Working Party on Pollution and Energy (GRPE) as part of the development of the Worldwide harmonised Light vehicles Test Procedure (WLTP); and a set of cycles produced by a Random Cycle Generator based on ‘short trip’ segments from the EU database used to construct WLTC. This Random Cycle (RC) approach was originally considered by the European Commission and Member States as an alternative to PEMS measurements, but remains an option for particle number measurement should PEMS instrumentation not be fully available by the time such measurements are required by legislation. The aim of this test programme was to evaluate the emissions performance of two different vehicles when using PEMS systems in real-life driving, and to identify and help understand the differences in emissions that may arise between the various test procedures. The test results show the differing vehicle emissions performances that may be encountered in real-driving for two vehicles that both meet the Euro 6 limits in Type-Approval laboratory testing. The results show that in some cases the on-road PEMS-measured emissions for complete test routes can exceed Type-Approval limits, and indicate that real-world conditions require more robust control strategies over those needed to satisfy existing legislation. Copyright © 2014 SAE International.