Measurements of 21 cm Epoch of Reionization (EoR) structure are subject to systematics originating from both the analysis and the observation conditions. Using 2013 data from the Murchison Widefield ...Array (MWA), we show the importance of mitigating both sources of contamination. A direct comparison between results from Beardsley et al. and our updated analysis demonstrates new precision techniques, lowering analysis systematics by a factor of 2.8 in power. We then further lower systematics by excising observations contaminated by ultra-faint RFI, reducing by an additional factor of 3.8 in power for the zenith pointing. With this enhanced analysis precision and newly developed RFI mitigation, we calculate a noise-dominated upper limit on the EoR structure of Δ2 ≤ 3.9 × 103 mK2 at k = 0.20 h Mpc−1 and z = 7 using 21 hr of data, improving previous MWA limits by almost an order of magnitude.
Abstract Background Context In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of ...manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). Purpose To update findings of the Neck Pain Task Force examining the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of WAD or NAD. Study Design/Setting Systematic review and best evidence synthesis. Sample Randomized controlled trials (RCTs), cohort studies, case-control studies comparing manual therapies, passive physical modalities, or acupuncture to other interventions, placebo/sham, or no intervention. Outcome measures Self-rated or functional recovery, pain intensity, health-related quality of life, psychological outcomes, or adverse events. Methods We systematically searched five databases from 2000 to 2014. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. Studies with a low risk of bias were stratified by the intervention's stage of development (exploratory versus evaluation) and synthesized following best evidence synthesis principles. Funding was provided by the Ministry of Finance. Results We screened 8551 citations, 38 studies were relevant, and 22 had a low risk of bias. Evidence from seven exploratory studies suggests that: 1) for recent but not persistent NAD I-II: thoracic manipulation offers short-term benefits; 2) for persistent NAD I-II: technical parameters of cervical mobilization (e.g., direction or site of manual contact) do not impact outcomes, while one session of cervical manipulation is similar to Kinesiotaping; and 3) for NAD I-II: strain-counterstrain treatment is no better than placebo. Evidence from 15 evaluation studies suggests that: 1) for recent NAD I-II: cervical and thoracic manipulation provides no additional benefit to high-dose supervised exercises; Swedish/clinical massage adds benefit to self-care advice; 2) for persistent NAD I-II: home-based cupping massage has similar outcomes to home-based muscle relaxation; low-level laser therapy (LLLT) does not offer benefits; Western acupuncture provides similar outcomes to non-penetrating placebo electroacupuncture; needle acupuncture provides similar outcomes to sham-penetrating acupuncture; 3) for WAD I-II: needle electroacupuncture offers similar outcomes as simulated electroacupuncture; and 4) for recent NAD III: a semi-rigid cervical collar with rest and graded strengthening exercises lead to similar outcomes; LLLT does not offer benefits. Conclusions Our review adds new evidence to the Neck Pain Task Force and suggests that mobilization, manipulation, and clinical massage are effective interventions for the management of neck pain. It also suggests that electroacupuncture, strain-counterstrain, relaxation massage, and some passive physical modalities (heat, cold, diathermy, hydrotherapy, ultrasound) are not effective and should not be used to manage neck pain.
One-year outcomes in patients who have had COVID-19 and who received treatment in the intensive care unit (ICU) are unknown.
To assess the occurrence of physical, mental, and cognitive symptoms among ...patients with COVID-19 at 1 year after ICU treatment.
An exploratory prospective multicenter cohort study conducted in ICUs of 11 Dutch hospitals. Patients (N = 452) with COVID-19, aged 16 years and older, and alive after hospital discharge following admission to 1 of the 11 ICUs during the first COVID-19 surge (March 1, 2020, until July 1, 2020) were eligible for inclusion. Patients were followed up for 1 year, and the date of final follow-up was June 16, 2021.
Patients with COVID-19 who received ICU treatment and survived 1 year after ICU admission.
The main outcomes were self-reported occurrence of physical symptoms (frailty Clinical Frailty Scale score ≥5, fatigue Checklist Individual Strength-fatigue subscale score ≥27, physical problems), mental symptoms (anxiety Hospital Anxiety and Depression {HADS} subscale score ≥8, depression HADS subscale score ≥8, posttraumatic stress disorder mean Impact of Event Scale score ≥1.75), and cognitive symptoms (Cognitive Failure Questionnaire-14 score ≥43) 1 year after ICU treatment and measured with validated questionnaires.
Of the 452 eligible patients, 301 (66.8%) patients could be included, and 246 (81.5%) patients (mean SD age, 61.2 9.3 years; 176 men 71.5%; median ICU stay, 18 days IQR, 11 to 32) completed the 1-year follow-up questionnaires. At 1 year after ICU treatment for COVID-19, physical symptoms were reported by 182 of 245 patients (74.3% 95% CI, 68.3% to 79.6%), mental symptoms were reported by 64 of 244 patients (26.2% 95% CI, 20.8% to 32.2%), and cognitive symptoms were reported by 39 of 241 patients (16.2% 95% CI, 11.8% to 21.5%). The most frequently reported new physical problems were weakened condition (95/244 patients 38.9%), joint stiffness (64/243 patients 26.3%) joint pain (62/243 patients 25.5%), muscle weakness (60/242 patients 24.8%) and myalgia (52/244 patients 21.3%).
In this exploratory study of patients in 11 Dutch hospitals who survived 1 year following ICU treatment for COVID-19, physical, mental, or cognitive symptoms were frequently reported.
Purpose
Long-term mental outcomes in family members of coronavirus disease 2019 (COVID-19) intensive care unit (ICU) survivors are unknown. Therefore, we assessed the prevalence of mental health ...symptoms, including associated risk factors, and quality of life (QoL) in family members of COVID-19 ICU survivors 3 and 12 months post-ICU.
Methods
A prospective multicentre cohort study in ICUs of ten Dutch hospitals, including adult family members of COVID-19 ICU survivors admitted between March 1, and July 1, 2020. Symptom prevalence rates of anxiety, depression (Hospital Anxiety and Depression Scale) and Post-Traumatic Stress Disorder (Impact of Event Scale-6), and QoL (Short Form-12) before ICU admission (baseline), and after 3 and 12 months were measured. Additionally, associations between family and patient characteristics and mental health symptoms were calculated.
Results
A total of 166 out of 197 (84.3%) included family members completed the 12-month follow-up of whom 46.1% and 38.3% had mental health symptoms 3 and 12 months post-ICU, respectively; both higher compared to baseline (22.4%) (
p
< 0.001). The mental component summary score of the SF-12 was lower at 12-month follow-up compared with baseline mean difference mental component score: − 5.5 (95% confidence interval (CI) − 7.4 to − 3.6). Furthermore, 27.9% experienced work-related problems. Symptoms of anxiety (odds ratio (OR) 9.23; 95% CI 2.296–37.24;
p
= 0.002) and depression (OR 5.96; 95% CI 1.29–27.42;
p
= 0.02) prior to ICU admission were identified as risk factors for mental health symptoms after 12 months.
Conclusion
A considerable proportion of family members of COVID-19 survivors reported mental health symptoms 3 and 12 months after ICU admission, disrupting QoL and creating work-related problems.
Abstract Background context In 2008, the Neck Pain Task Force (NPTF) recommended exercise for the management of neck pain and whiplash-associated disorders (WAD). However, no evidence was available ...on the effectiveness of exercise for Grade III neck pain or WAD. Moreover, limited evidence was available to contrast the effectiveness of various types of exercises. Purpose To update the findings of the NPTF on the effectiveness of exercise for the management of neck pain and WAD grades I to III. Study design/setting Systematic review and best evidence synthesis. Sample Studies comparing the effectiveness of exercise to other conservative interventions or no intervention. Outcome measures Outcomes of interest included self-rated recovery, functional recovery, pain intensity, health-related quality of life, psychological outcomes, and/or adverse events. Methods We searched eight electronic databases from 2000 to 2013. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. The results of scientifically admissible studies were synthesized following best-evidence synthesis principles. Results We retrieved 4,761 articles, and 21 randomized controlled trials (RCTs) were critically appraised. Ten RCTs were scientifically admissible: nine investigated neck pain and one addressed WAD. For the management of recent neck pain Grade I/II, unsupervised range-of-motion exercises, nonsteroidal anti-inflammatory drugs and acetaminophen, or manual therapy lead to similar outcomes. For recent neck pain Grade III, supervised graded strengthening is more effective than advice but leads to similar short-term outcomes as a cervical collar. For persistent neck pain and WAD Grade I/II, supervised qigong and combined strengthening, range-of-motion, and flexibility exercises are more effective than wait list. Additionally, supervised Iyengar yoga is more effective than home exercise. Finally, supervised high-dose strengthening is not superior to home exercises or advice. Conclusions We found evidence that supervised qigong, Iyengar yoga, and combined programs including strengthening, range of motion, and flexibility are effective for the management of persistent neck pain. We did not find evidence that one supervised exercise program is superior to another. Overall, most studies reported small effect sizes suggesting that a small clinical effect can be expected with the use of exercise alone.
Abstract Background context In 2008, the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders recommended patient education for the management of neck pain. ...However, the effectiveness of education interventions has recently been challenged. Purpose To update the findings of the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of structured patient education for the management of patients with whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). Study design/setting Systematic review of the literature and best-evidence synthesis. Patient sample Randomized controlled trials that compared structured patient education with other conservative interventions. Outcome measures Self-rated recovery, functional recovery (eg, disability, return to activities, work, or school), pain intensity, health-related quality of life, psychological outcomes such as depression or fear, or adverse effects. Methods We systematically searched eight electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, DARE, PubMed, and ICL) from 2000 to 2012. Randomized controlled trials, cohort studies, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized in evidence tables and synthesized following best-evidence synthesis principles. Results We retrieved 4,477 articles. Of those, nine were eligible for critical appraisal and six were scientifically admissible. Four admissible articles investigated patients with WAD and two targeted patients with NAD. All structured patient education interventions included advice on activation or exercises delivered orally combined with written information or as written information alone. Overall, as a therapeutic intervention, structured patient education was equal or less effective than other conservative treatments including massage, supervised exercise, and physiotherapy. However, structured patient education may provide small benefits when combined with physiotherapy. Either mode of delivery (ie, oral or written education) provides similar results in patients with recent WAD. Conclusions This review adds to the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders by defining more specifically the role of structured patient education in the management of WAD and NAD. Results suggest that structured patient education alone cannot be expected to yield large benefits in clinical effectiveness compared with other conservative interventions for patients with WAD or NAD. Moreover, structured patient education may be of benefit during the recovery of patients with WAD when used as an adjunct therapy to physiotherapy or emergency room care. These benefits are small and short lived.
Objective
The aim of the present study was to determine whether serum urate (sUA) concentration is positively associated with subclinical atherosclerosis, independent of body mass index (BMI), ...amongst generally healthy adults.
Design and setting
The CARDIA study followed 5115 Black and White individuals aged 18–30 years in 1985–1986 (year 0). Subclinical atherosclerosis comprised coronary artery calcified plaque (CAC; years 15, 20 and 25), and maximum common carotid intima–media thickness (IMT; year 20). sUA (years 0, 10, 15 and 20) was modelled as gender‐specific quartiles that were pooled. Discrete‐time hazard regressions and generalized linear regressions were used for analyses.
Results
Mean sUA concentration was lower in women than in men and increased with age. Adjusting for demographic and lifestyle factors, the highest versus lowest quartile of sUA at year 0 was associated with a 44% 95% confidence interval (CI) 20%, 73% greater risk of CAC progression from years 15 to 25 (Ptrend < 0.001), which was attenuated by adjustment for BMI at year 0 (Ptrend = 0.45). A stronger association was found between sUA at year 15 and CAC progression at year 20 or 25 (hazard ratio 2.07, 95% CI 1.66, 2.58 for the highest versus lowest sUA quartile Ptrend < 0.001), which was attenuated, but remained significant with additional adjustment for BMI at year 15 (Ptrend = 0.01). A greater increment in sUA concentration from year 0 to year 15, independent of change in BMI, was related to a higher risk of CAC progression (Ptrend < 0.001). Similar associations were found between sUA and IMT, but only in men.
Conclusion
sUA may be an early biomarker for subclinical atherosclerosis in young adults; starting in early middle age, sUA predicts subclinical atherosclerosis independently of BMI.
Interferometric arrays seeking to measure the 21 cm signal from the epoch of reionization (EOR) must contend with overwhelmingly bright emission from foreground sources. Accurate recovery of the 21 ...cm signal will require precise calibration of the array, and several new avenues for calibration have been pursued in recent years, including methods using redundancy in the antenna configuration. The newly upgraded Phase II of Murchison Widefield Array (MWA) is the first interferometer that has large numbers of redundant baselines while retaining good instantaneous UV coverage. This array therefore provides a unique opportunity to compare redundant calibration with sky-model-based algorithms. In this paper, we present the first results from comparing both calibration approaches with MWA Phase II observations. For redundant calibration, we use the package OMNICAL and produce sky-based calibration solutions with the analysis package Fast Holographic Deconvolution (FHD). There are three principal results: (1) We report the success of OMNICAL on observations of ORBComm satellites, showing substantial agreement between redundant visibility measurements after calibration. (2) We directly compare OMNICAL calibration solutions with those from FHD and demonstrate that these two different calibration schemes give extremely similar results. (3) We explore improved calibration by combining OMNICAL and FHD. We evaluate these combined methods using power spectrum techniques developed for EOR analysis and find evidence for marginal improvements mitigating artifacts in the power spectrum. These results are likely limited by the signal-to-noise ratio in the 6 hr of data used, but they suggest future directions for combining these two calibration schemes.
Increasing evidence for an elaborate subglacial drainage network underneath modern Antarctic ice sheets suggests that basal meltwater has an important influence on ice stream flow. Swath bathymetry ...surveys from previously glaciated continental margins display morphological features indicative of subglacial meltwater flow in inner shelf areas of some paleo ice stream troughs. Over the last few years several expeditions to the eastern Amundsen Sea embayment (West Antarctica) have investigated the paleo ice streams that extended from the Pine Island and Thwaites glaciers. A compilation of high-resolution swath bathymetry data from inner Pine Island Bay reveals details of a rough seabed topography including several deep channels that connect a series of basins. This complex basin and channel network is indicative of meltwater flow beneath the paleo-Pine Island and Thwaites ice streams, along with substantial subglacial water inflow from the east. This meltwater could have enhanced ice flow over the rough bedrock topography. Meltwater features diminish with the onset of linear features north of the basins. Similar features have previously been observed in several other areas, including the Dotson-Getz Trough (western Amundsen Sea embayment) and Marguerite Bay (SW Antarctic Peninsula), suggesting that these features may be widespread around the Antarctic margin and that subglacial meltwater drainage played a major role in past ice-sheet dynamics.
Gamma-glutamyltransferase (GGT) is located on the external surface of most cells and mediates the uptake of gluthathione, an important component of intracellular antioxidant defenses. An increase in ...GGT concentration has been regarded as a marker of alcohol consumption or liver disease. However, more subtle gradations in GGT could be informative because its expression is enhanced by oxidative stress and it could be released by several conditions inducing cellular stress. Recently, serum GGT concentrations have been associated with many cardiovascular disease risk factors or components of the insulin resistance syndrome. We did a prospective study with the hypothesis that serum GGT is a predictor of incident diabetes.
A total of 4,088 healthy men working in a steel manufacturing company were examined in 1994 and 1998. Diabetes was defined as a serum fasting glucose concentration of more than 126 mg/dl or the use of diabetes medication.
There was a strong dose-response relation between serum GGT concentrations at baseline and the incidence of diabetes. In contrast to the 31% of men with GGT concentrations under 9 U/l, adjusted relative risks for incidence of diabetes for GGT concentrations 10-19, 20-29, 30-39, 40-49, and over 50 U/l were 8.0, 13.3, 12.6, 19.6 and 25.8, respectively. The associations of age and BMI with incident diabetes became stronger the higher the value of baseline serum GGT concentration.
This study suggests that an increase in GGT concentration within its physiological range is a sensitive and early biomarker for the development of diabetes.
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