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.
News Article | December 1, 2016
Researchers of the Sarcoma research group of the Bellvitge Biomedical Research Institute (IDIBELL), led by Dr. Òscar Martínez-Tirado, have first described the methylation profile of Ewing's sarcoma (ES), a cancer of bone and soft tissues that mainly affects children and teenagers. Their analysis has unveiled the potential of the PTRF gene as a prognostic marker of the disease and as a possible future therapeutic target in conjunction with the new genomic editing tools available. "This is the first time that the methylation profile of Ewing's sarcoma has been described," explains Dr. Òscar Martínez-Tirado, lead author of the study. DNA methylation is a type of epigenetic modification capable of controlling gene expression, that is, it can activate or deactivate genes that enhance to or block characteristics and processes in individuals, including the development of tumors. Using bioinformatic tools, the research team looked for common elements that allowed them to relate the set of differentially hypomethylated or hypermethylated genes they found in the tumor samples. The researchers identified a group of 12 genes related to the structure of the cell membrane; Among them, the precursor of the protein PTRF particularly called their attention by its relation with the caveolae, small invaginations that are present in the membrane of some cells; the IDIBELL group has extensive experience in the study of these structures and their relationship with ES. The team correlated the presence of PTRF in samples from 67 patients. "Initially, we saw that those patients who express PTRF have a better survival, therefore, we could consider this protein as a potential marker of prognosis of the disease," concludes Martinez-Tirado. Normal cells with caveolae express both the PTRF protein and caveolin-1 (CAV1), another protein related to caveolae formation. In contrast, tumor cells in ES do not have caveolae, nor express PTRF. "This made us think about the possibility of exogenously reintroducing the precursor gene PTRF into the study cell lines", explains the researcher. "In those that also expressed CAV1, the reintroduction of PTRF triggered caveolae formation. For tumor cells, this modification of the structure is so stressful that it destroys them". In addition, researchers have shown that the formation of the caveolae in these cells activates a known cell death signaling pathway promoted by the p53 protein. Current epigenetic drugs are rather nonspecific, but new CRISPR genomic editing tools have the potential to be used to demethylate specific genes from a tumor cell in the future. "If we are able to specifically act on the PTRF promoter gene so that the protein is expressed at normal levels, we would induce cell death and therefore we would have a promising new personalized therapeutic option for ES." This has been a highly collaborative work, both at the research level, as researchers by two groups from IDIBELL's epigenetics and cancer biology program, Germans Trias Institute, Institute of biomedicine of Seville, University Hospital la Paz, Children's University Hospital Niño Jesús, San Juan de Dios Hospital, Vall d'Hebron University Hospital and Virgen del Rocío University Hospital have collaborated, as well as at a financial level level, given that the project is funded by the Carlos III Health Institute, the AECC and the Alba Pérez Foundation.
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.
Sileghem L.,Ghent University |
Bosteels D.,AECC |
May J.,AECC |
Favre C.,AECC |
Verhelst S.,Ghent University
Transportation Research Part D: Transport and Environment | Year: 2014
Several studies have shown that the type-approval data is not representative for real-world usage. Consequently, the emissions and fuel consumption of the vehicles are underestimated. Aiming at a more dynamic and worldwide harmonised test cycle, the new Worldwide Light-duty Test Cycle is being developed. To analyse the new cycle, we have studied emission results of a test programme of six vehicles on the test cycles WLTC (Worldwide Light-duty Test Cycle), NEDC (New European Driving Cycle) and CADC (Common Artemis Driving Cycle). This paper presents the results of that analysis using two different approaches. The analysis shows that the new driving cycle needs to exhibit realistic warm-up procedures to demonstrate that aftertreatment systems will operate effectively in real service; the first trip of the test cycle could have an important contribution to the total emissions depending on the length of the trip; and that there are some areas in the acceleration vs. vehicle speed map of the new WLTC that are not completely filled, especially between 70 and 110. km/h. For certain vehicles, this has a significant effect on total emissions when comparing this to the CADC. © 2014 Elsevier Ltd.
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.
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.
May J.,AECC |
Bosteels D.,AECC |
SAE International Journal of Engines | Year: 2014
From 1 September 2014 new car types in the EU must meet 'Euro 6' emissions requirements. The 'New European Driving Cycle' (NEDC) is currently the main test for this, but the European Commission intends to also introduce PEMS (Portable Emissions Measurement Systems)-based procedures to ensure that emissions are well controlled in real use. 'Random Cycles' have also been considered and remain a possible option for 'real world' particle number measurement. At the same time, the UN Working Party on Pollution and Energy (GRPE) has developed the new Worldwide harmonized Light vehicles Test Procedure (WLTP) that is expected to be adopted in the EU in the near future. To identify and understand the differences in emissions that may arise between these various methodologies, AECC has conducted some initial tests on two modern light-duty vehicles. Chassis dynamometer emissions tests were conducted over the NEDC, the Common Artemis suite of test cycles (CADC), the new Worldwide Light-duty Test Cycle (WLTC - the test cycle for 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. A Portable Emissions Measurement System (PEMS) was used to measure emissions during real driving over pre-selected routes. The test results show that there can be substantial differences for some pollutants measured as 'real driving emissions' (RDE) using PEMS equipment, compared to the test cycles. © 2014 SAE International.