The paper summarises current knowledge on ganglia of the wrist including the views of patients and doctors. The efficacy of available treatment options are discussed. Summary points are derived from ...the available knowledge with a referral protocol from primary care.
Evidence of the effectiveness of the WHO-recommended design of longer individualized regimens for multidrug- or rifampicin-resistant TB (MDR/RR-TB) is limited.
To report end-of-treatment outcomes for ...MDR/RR-TB patients from a 2015-2018 multi-country cohort that received a regimen consistent with current 2022 WHO updated recommendations and describe the complexities of comparing regimens.
We analyzed a subset of participants from the endTB Observational Study who initiated a longer MDR/RR-TB regimen that was consistent with subsequent 2022 WHO guidance on regimen design for longer treatments. We excluded individuals who received an injectable agent or who received fewer than four likely effective drugs.
Of the 759 participants analyzed, 607 (80.0%, 95% CI 77.0-82.7) experienced successful end-of-treatment outcomes. The frequency of success was high across groups, whether stratified on number of Group A drugs or fluoroquinolone resistance, and ranged from 72.1% to 90.0%. Regimens were highly variable regarding composition and the duration of individual drugs.
Longer, all-oral, individualized regimens that were consistent with 2022 WHO guidance on regimen design had high frequencies of treatment success. Heterogeneous regimen compositions and drug durations precluded meaningful comparisons. Future research should examine which combinations of drugs maximize safety/tolerability and effectiveness.
The efficacy of extracorporeal shock-wave therapy for tennis elbow was investigated using a single fractionated dosage in a randomised, double-blind study. Outcomes were assessed using the ...Disabilities of Arm, Shoulder and Hand questionnaire, measurements of grip strength, levels of pain, analgesic usage and the rate of progression to surgery. Informed consent was obtained before patients were randomised to either the treatment or placebo group. In the final assessment, 74 patients (31 men and 43 women) with a mean age of 43.4 years (35 to 71), were included. None of the outcome measures showed a statistically significant difference between the treatment and control groups (p > 0.05). All patients improved significantly over time, regardless of treatment. Our study showed no evidence that extracorporeal shock-wave therapy for tennis elbow is better than placebo.
Near‐Earth asteroid (101955) Bennu is an active asteroid experiencing mass loss in the form of ejection events emitting up to hundreds of millimeter‐ to centimeter‐scale particles. The close ...proximity of the Origins, Spectral Interpretations, Resource Identification, and Security–Regolith Explorer spacecraft enabled monitoring of particles for a 10‐month period encompassing Bennu's perihelion and aphelion. We found 18 multiparticle ejection events, with masses ranging from near zero to hundreds of grams (or thousands with uncertainties) and translational kinetic energies ranging from near zero to tens of millijoules (or hundreds with uncertainties). We estimate that Bennu ejects ~104 g per orbit. The largest event took place on 6 January 2019 and consisted of ~200 particles. The observed mass and translational kinetic energy of the event were between 459 and 528 g and 62 and 77 mJ, respectively. Hundreds of particles not associated with the multiparticle ejections were also observed. Photometry of the best‐observed particles, measured at phase angles between ~70° and 120°, was used to derive a linear phase coefficient of 0.013 ± 0.005 magnitudes per degree of phase angle. Ground‐based data back to 1999 show no evidence of past activity for Bennu; however, the currently observed activity is orders of magnitude lower than observed at other active asteroids and too low be observed remotely. There appears to be a gentle decrease in activity with distance from the Sun, suggestive of ejection processes such as meteoroid impacts and thermal fracturing, although observational bias may be a factor.
Plain Language Summary
We measured the brightness of pebble‐sized particles in the vicinity of near‐Earth asteroid Bennu to better understand their physical characteristics and the events that launched them from Bennu's surface. Our measurements spanned 10 months, encompassing Bennu's closest and farthest distances from the Sun, so that we could assess how the level of ejection activity changes with solar distance. We observed 18 multiparticle ejection events containing anywhere from a few to 200+ particles. Individual particles ranged from millimeters to centimeters in diameter. The energy of the events and a possible decrease in activity with larger distances from the Sun suggest that meteoroid impacts, fracturing of surface boulders due to solar heating, or both may be responsible for ejecting the particles. We estimate that Bennu releases ~10,000 g of material over one orbit or 1.2 years. Although mass loss has been remotely observed for other asteroids, the comparatively low level of particle ejection activity at Bennu was only observable thanks to the close proximity of the Origins, Spectral Interpretations, Resource Identification, and Security–Regolith Explorer spacecraft.
Key Points
Asteroid (101955) Bennu is active from perihelion through aphelion with a possible decrease in activity further from the Sun
Bennu's activity is less than that detected by telescope for other active asteroids and is only observable up close
The particles' shallow phase functions resemble those of similarly sized individual rocks rather than those of ensemble asteroid surfaces
In this paper, in a linear formulation, the stability problem of a closed cylindrical shell under the influence of an inhomogeneous temperature field and a supersonic gas stream flowing around the ...shell is considered. The stability conditions for the unperturbed state of the aero-thermo-elastic system under consideration are obtained. It was shown for different boundary conditions that by the combined action of the temperature field and the flowing stream, the stability process can be controlled and the critical flutter velocity can be substantially changed using the temperature field. The following most significant results were obtained: 1) in the case of a homogeneous temperature field, if the edges of the shell freely move in the longitudinal direction: a) a constant temperature field practically does not affect the value of the critical velocity νcr; b) the critical velocity function νcr, depending on the number of circumferential waves n, has a minimum point; 2) in the case of a homogeneous temperature field, if the edges of the shell are fixed: a) for negative values of T0, the lower the temperature, the wider the stability region; b) for positive values of T0 up to a certain temperature value the stability region narrows, after which, with increasing temperature it expands; c) starting from a certain temperature value T0* for all T0>T0* the system is unstable for any 0 < ν < ν*, and with increasing speed (ν > ν*) the system becomes stable, and the larger the radius of the shell, the smaller this value T0*; 3) in the case of a temperature field inhomogeneous over the thickness of the shell, if the edges of the shell move freely in the longitudinal direction: a) when Θ > 0 the critical velocity increases significantly and the minimum point of the function νcr(n) moves towards the lower values of n; b) when Θ < 0 the opposite is observed; 4) in the case of a temperature field inhomogeneous over thickness of the shell, if the edges of the shell are fixed: a) the stability region expands with increasing |Θ|; b) for a fixed value of the gradient Θ, an increase in the radius of the shell R leads to an expansion of the stability region; 5) fixing the edges of the shell leads to a significant increase in the value of the critical velocity of the flowing stream.
Active pharmacovigilance (PV) is recommended for TB programmes, notably for multidrug-resistant TB (MDR-TB) patients treated with new drugs. Launched with the support of UNITAID in April 2015, endTB ...(Expand New Drug markets for TB) facilitated treatment with bedaquiline (BDQ) and/or delamanid of >2600 patients in 17 countries, and contributed to the creation of a central PV unit (PVU).
To explain the endTB PVU process by describing the serious adverse events (SAEs) experienced by patients who received BDQ-containing regimens.
The overall PV strategy was in line with the 'advanced´ WHO active TB drug safety monitoring and management (aDSM) system. All adverse events (AEs) of clinical significance were followed up; the PVU focused on signal detection from SAEs.
Between 1 April 2015 and 31 March 2019, the PVU received and assessed 626 SAEs experienced by 417 BDQ patients. A board of MDR-TB/PV experts reviewed unexpected and possibly drug-related SAEs to detect safety signals. The experts communicated on clusters of risks factors, notably polypharmacy and off-label drug use, encouraging a patient-centred approach of care. Organising advanced PV in routine care is possible but demanding. It is reasonable to expect local/national programmes to focus on clinical management, and to limit reporting to aDSM systems to key data, such as the SAEs.
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