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SMA actuators are a group of lightweight actuators that offer advantages over conventional technology and allow for simple and compact solutions to the increasing demand for electrical actuation. In particular, an increasing number of SMA torsional actuator applications have been published recently due to their ability to supply rotational motion under load, resulting in advantages such as module simplification and the reduction of overall product weight. This paper presents the conceptual design, operating principle, experimental characterization and working performance of torsional actuators applicable in active rudder in aeronautics. The proposed application comprises a pair of SMA torsion springs, which bi-directionally actuate the actuator by Joule heating and natural cooling. The experimental results confirm the functionality of the torsion springs actuated device and show the rotation angle of the developed active rudder was about 30° at a heating current of 5 A. After the design and experiment, one of their chief drawbacks is their relatively slow operating speed in rudder positioning, but this can be improved by control strategy and small modifications to the actuator mechanism described in this work.
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BACKGROUND: Emotion regulation difficulties underlie several psychiatric conditions, and treatments that focus on improving emotion regulation can have an effect on a broad range of symptoms. However, participants' in-depth experiences of participating in emotion regulation treatments have not been much studied. In this qualitative study, we investigated participants' experiences of a joint emotion regulation group skills training in a child and adolescent psychiatric outpatient setting. METHODS: Twenty-one participants (10 adolescents and 11 parents) were interviewed about their experiences after they had participated in a seven-session transdiagnostic emotion regulation skills training for adolescents and parents. The aim of the skills training was to decrease emotion regulation difficulties, increase emotional awareness, reduce psychiatric symptoms, and enhance quality of life. The skills training consisted of psychoeducation about emotions and skills for regulating emotions. The interviews were transcribed and analysed using reflexive thematic analysis. RESULTS: The analysis resulted in three overarching themes: Parent - Child processes, Individual processes, and Group processes. The result showed that participants considered an improved parent-child relationship to be the main outcome. Increased knowledge, emotion regulation skills and behavioural change were conceptualised as both mechanisms of change and outcomes. The group format, and the fact that parents and adolescents participated together, were seen as facilitators. Furthermore, the participants experienced targeting emotions in skills training as meaningful and helpful. CONCLUSION: The results highlight the potential benefits of providing emotion regulation skills training for adolescents and parents together in a group format to improve the parent-child relationship and enable the opportunity to learn skills.
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Regulación Emocional , Humanos , Adolescente , Calidad de Vida , Padres/psicología , Emociones , Relaciones Padres-HijoRESUMEN
Linear optical quantum computing provides a desirable approach to quantum computing, with only a short list of required computational elements. The similarity between photons and phonons points to the interesting potential for linear mechanical quantum computing using phonons in place of photons. Although single-phonon sources and detectors have been demonstrated, a phononic beam splitter element remains an outstanding requirement. Here we demonstrate such an element, using two superconducting qubits to fully characterize a beam splitter with single phonons. We further use the beam splitter to demonstrate two-phonon interference, a requirement for two-qubit gates in linear computing. This advances a new solid-state system for implementing linear quantum computing, further providing straightforward conversion between itinerant phonons and superconducting qubits.
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Upper respiratory tract (URT) disorders are common in dogs but neither general nor breed-related epidemiological data are widely reported. This study´s aims were to describe the epidemiology of URT disorders in a Swedish population of dogs and to investigate whether brachycephalic breeds were overrepresented among high-risk breeds. A cohort of dogs insured by Agria Djurförsäkring in Sweden (2011-2014) was used to calculate overall and breed-specific incidence rate (IR), age at first URT diagnosis and relative risk (RR) for URT disorders. For breeds with high RR for URT disorders, co-morbidities throughout the dog's insurance period and age at death were investigated. The cohort included approximately 450,000 dogs. URT disorders had an overall IR of 50.56 (95% CI; 49.14-52.01) per 10,000 dog years at risk. Among 327 breeds, the English bulldog, Japanese chin, Pomeranian, Norwich terrier and pug had highest RR of URT disorders. Eight of 13 breeds with high RR for URT disorders were brachycephalic. The median age at first URT diagnosis was 6.00 years (interquartile range 2.59-9.78). French bulldogs with URT diagnoses had a significantly shorter life span (median = 3.61 years) than other breeds with URT diagnosis (median = 7.81 years). Dogs with high risk for URT disorders had more co-morbidities than average.
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Craneosinostosis , Enfermedades de los Perros , Seguro , Enfermedades Respiratorias , Perros , Animales , Suecia/epidemiología , Enfermedades de los Perros/epidemiología , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/veterinaria , Craneosinostosis/epidemiología , Craneosinostosis/veterinaria , Sistema RespiratorioRESUMEN
This work presents an experimental study related to the mechanical performance of a special design spring fabricated with a superelastic shape memory alloy (SMA-SE). For the experimental testing, the spring was coupled in a rotor machine, aiming to attenuate the mechanical vibration when the system went through a natural frequency without any external power source. It was verified that the reduction in instabilities stemmed from the better distribution of vibration force in the proposed device, as well as the damping capacity of the spring material. These findings showed that the application of the M-Shape device of SMA-SE for three different cases could reduce vibration up to 23 dB when compared to the situations without, and with, 1.5 mm of preload. The M-Shape device was shown to be efficient in reducing the mechanical vibration in a rotor system. This was due to the damping capacity of the SMA-SE material, and because the application did not require any external source of energy to generate phase transformation.
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[This corrects the article DOI: 10.1007/s10680-020-09570-0.].
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BACKGROUND: Recovery of muscle function after peripheral nerve injury is often poor, and this can be attributed to muscle fiber atrophy and cell death. In the current study, we have investigated the effects of stromal vascular fraction (SVF) on muscle cell apoptosis and its potential to preserve muscle tissue following denervation. METHODS: Rat gastrocnemius muscle was denervated by sciatic nerve transection. At 2 and 4 weeks after injury, muscles were examined histologically and apoptosis was measured using TUNEL assay and PCR array for a range of apoptotic genes. Additionally, an in vitro TNF-α apoptosis model was established using SVF cells co-cultured indirectly with primary rat myoblasts. Annexin V and TUNEL were used together with Western blotting to investigate the signaling pathways. RESULTS: Denervated muscles showed significantly higher TUNEL reactivity at 2 and 4 weeks following nerve injury, and an increased expression of caspase family genes, mitochondria-related apoptotic genes, and tumor necrosis factor family genes. In cultured rat primary myoblasts, Annexin V labeling was significantly increased at 12 h after TNF-α treatment, and this was followed by a significant increase in TUNEL reactivity at 48 h. Western blotting showed that caspase-7 was activated/cleaved as well as the downstream substrate, poly (ADP-ribose) polymerase (PARP). Co-culture of myoblasts with SVF significantly reduced all these measures of apoptosis. Bax and Bcl-2 levels were not changed suggesting that the TNF-α-induced apoptosis occurred via mitochondria-independent pathways. The protective effect of SVF was also shown in vivo; injections of SVF cells into denervated muscle significantly improved the mean fiber area and diameter, as well as reduced the levels of TUNEL reactivity. CONCLUSIONS: This study provides new insights into how adipose tissue-derived cells might provide therapeutic benefits by preserving muscle tissue.
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Tejido Adiposo , Músculo Esquelético , Animales , Apoptosis , Etiquetado Corte-Fin in Situ , Ratas , Nervio CiáticoRESUMEN
During the 2010s, fertility rates fell across the Nordic region. The onset of these declines seems linked to the Great Recession of 2008-2009, but their continuation cannot easily be linked to subsequent economic change. The 1990s, too, brought episodes of economic crises to the Nordic region that were followed by different degrees of fertility decline. In this study, we provide an empirical overview of parity-, age- and education-specific fertility developments in the five Nordic countries in the wake of the economic recessions in 2008 and the early 1990s, respectively. We demonstrate a high degree of heterogeneity in fertility developments across countries after 1990, whereas after 2008, the trends are much more similar across the five countries. Likewise, the educational differences in birth hazards that characterized the developments after 1990 were much smaller in the initial years after 2008-2009. This reversal from heterogeneity to homogeneity in the fertility response to recessions calls for an expansion of theories on the cyclicality of fertility in relation to uncertainty and economic and social change. In our discussion, we consider the role of a set of factors that also incorporates the state, crisis management, and perceptions of economic and welfare uncertainty.
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Canine atopic dermatitis (CAD) is an inflammatory and pruritic allergic skin disease with both genetic and environmental risk factors described. We performed mRNA sequencing of non-lesional axillary skin biopsies from nine German shepherd dogs. Obtained RNA sequences were mapped to the dog genome (CanFam3.1) and a high-quality skin transcriptome was generated with 23,510 expressed gene transcripts. Differentially expressed genes (DEGs) were defined by comparing three controls to five treated CAD cases. Using a leave-one-out analysis, we identified seven DEGs: five known to encode proteins with functions related to an activated immune system (CD209, CLEC4G, LOC102156842 (lipopolysaccharide-binding protein-like), LOC480601 (regakine-1-like), LOC479668 (haptoglobin-like)), one (OBP) encoding an odorant-binding protein potentially connected to rhinitis, and the last (LOC607095) encoding a novel long non-coding RNA. Furthermore, high mRNA expression of inflammatory genes was found in axillary skin from an untreated mild CAD case compared with healthy skin. In conclusion, we define genes with different expression patterns in CAD case skin helping us understand post-treatment atopic skin. Further studies in larger sample sets are warranted to confirm and to transfer these results into clinical practice.
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Dermatitis Atópica/veterinaria , Enfermedades de los Perros/genética , Regulación de la Expresión Génica/inmunología , Piel/inmunología , Animales , Dermatitis Atópica/genética , Dermatitis Atópica/inmunología , Enfermedades de los Perros/inmunología , Perros , Inflamación/genética , ARN Mensajero/genética , ARN Mensajero/metabolismo , TranscriptomaRESUMEN
AIM: To investigate the survival of Escherichia coli O157:H7 and Salmonella Typhimurium in cowpats on pasture in a temperate Nordic climate. METHODS AND RESULTS: The study consists of two parts, the first part using artificially created cowpats inoculated with E. coli O157:H7 and S. Typhimurium and the second part using cowpats from empty pastures on which cattle herds positive for E. coli O157:H7 had grazed 6 month previously. Artificial cowpats were created, placed in an outdoor field station in June, August and October, and sampled over 1 year. Escherichia coli O157:H7 and S. Typhimurium were analysed by standard culture methods. The results showed viable E. coli O157:H7 and S. Typhimurium in the sampled cowpats throughout the 365-day sample period for the June trial, 250 days for the August trial and 40-70 days for the October trial. In addition, 200 natural cowpats were sampled from eight pastures that had previously held E. coli O157:H7 positive cattle herds. Five positive E. coli O157:H7 isolates were obtained, all with the same multi-locus variable number tandem repeat analysis pattern as had been found on the pasture the previous grazing season. CONCLUSIONS: Escherichia coli O157:H7 and S. Typhimurium can survive in cowpats up to a year and persist throughout a winter season. Therefore, there is a possibility that cowpats can act as a reservoir and be a source of re-infection of Salmonella or E. coli O157:H7 in cattle between grazing seasons. SIGNIFICANCE AND IMPACT OF THE STUDY: The obtained results can provide valuable information for managing the risk posed by zoonotic pathogens originating from farm environments.
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Escherichia coli O157/fisiología , Salmonella typhimurium/fisiología , Animales , Bovinos , Escherichia coli O157/genética , Escherichia coli O157/aislamiento & purificación , Estiércol/microbiología , Viabilidad Microbiana , Repeticiones de Minisatélite , Salmonella typhimurium/aislamiento & purificaciónRESUMEN
Elevated non-esterified fatty acids (NEFAs) are associated with negative effects on bovine theca, granulosa and oviductal cells but the effects of NEFAs on bovine endometrial epithelial cells (bEECs) are not as well documented. The objective of this study was to define the effects of NEFAs on bEECs. Postprimary bEECs were treated with 150, 300 or 500µM of either palmitic acid (PA), stearic acid (SA) or oleic acid (OA) or a mixture of NEFAs (150µM of each FA) or 0.5% final concentration of vehicle ethanol (control). Viability and proliferation of bEECs exposed to 150µM of each NEFA or a mixture of NEFAs were unaffected. Increased lipid accumulation was found in all treated groups (P<0.01). In cells exposed to 500µM of each NEFA and 300µM PA decreased cell viability (P<0.001), proliferation (P<0.05) and increased apoptosis (P<0.05) were observed. Treatment with 500µM OA, PA and SA had the strongest effects on cell viability, proliferation and apoptosis (P<0.05). Treatment with PA and OA increased interleukin-6 (IL-6) concentrations (P<0.05), whereas only the highest concentration of PA, OA and SA stimulated IL-8 production (P<0.05). These results suggest that high concentrations of NEFAs may impair endometrial function with more or less pronounced effects depending on the type of NEFA and time of exposure.
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Supervivencia Celular/efectos de los fármacos , Citocinas/metabolismo , Endometrio/efectos de los fármacos , Células Epiteliales/efectos de los fármacos , Ácidos Grasos no Esterificados/farmacología , Lípidos , Animales , Apoptosis/efectos de los fármacos , Bovinos , Proliferación Celular/efectos de los fármacos , Endometrio/citología , Endometrio/metabolismo , Células Epiteliales/citología , Células Epiteliales/metabolismo , Femenino , Ácido Oléico/farmacología , Ácido Palmítico/farmacología , Ácidos Esteáricos/farmacologíaRESUMEN
This article was originally published under a CC BY-NC-ND 4.0 license, but has now been made available under a CC BY 4.0 license. The PDF and HTML versions of the paper have been modified accordingly.
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Glucocorticoid treatment, a major cause of drug-induced osteoporosis and fractures, is widely used to treat inflammatory conditions and diseases. By contrast, mechanical loading increases bone mass and decreases fracture risk. With these relationships in mind, we investigated whether mechanical loading interacts with GC treatment in bone. Three-month-old female C57BL/6 mice were treated with high-dose prednisolone (15â¯mg/60â¯dayâ¯pellets/mouse) or vehicle for two weeks. During the treatment, right tibiae were subjected to short periods of cyclic compressive loading three times weekly, while left tibiae were used as physiologically loaded controls. The bones were analyzed using peripheral quantitative computed tomography, histomorphometry, real-time PCR, three-point bending and Fourier transform infrared micro-spectroscopy. Loading alone increased trabecular volumetric bone mineral density (vBMD), cortical thickness, cortical area, osteoblast-associated gene expression, osteocyte- and osteoclast number, and bone strength. Prednisolone alone decreased cortical area and thickness and osteoblast-associated gene expression. Importantly, prednisolone treatment decreased the load-induced increase in trabecular vBMD by 57% (pâ¯<â¯0.001) and expression of osteoblast-associated genes, while completely abolishing the load-induced increase in cortical area, cortical thickness, number of osteocytes and osteoclasts, and bone strength. When combined, loading and prednisolone decreased the collagen content. In conclusion, high-dose prednisolone treatment strongly inhibits the loading-induced increase in trabecular BMD, and abolishes the loading-induced increase in cortical bone mass. This phenomenon could be due to prednisolone inhibition of osteoblast differentiation and function.
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Osteogénesis/efectos de los fármacos , Prednisolona/farmacología , Anabolizantes/farmacología , Animales , Hueso Esponjoso/efectos de los fármacos , Hueso Esponjoso/fisiología , Colágeno/metabolismo , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Ratones Endogámicos C57BL , Osteoblastos/citología , Osteoblastos/efectos de los fármacos , Osteoblastos/metabolismo , Osteoclastos/citología , Osteoclastos/efectos de los fármacos , Osteoclastos/metabolismo , Osteocitos/citología , Osteocitos/efectos de los fármacos , Osteocitos/metabolismo , Osteogénesis/genética , Soporte de Peso/fisiologíaRESUMEN
STUDY QUESTION: Have seasonal variations in births by factors related to maternal education, age, parity and re-partnering changed over a 72-year period? SUMMARY ANSWER: Seasonal variation in births has been reduced overall but also changed its pattern over the last seven decades. WHAT IS KNOWN ALREADY: The number of births varies markedly by season, but the causes of this variation are not fully understood. Seasonality of births is, in some populations, strongly influenced by sociodemographic factors. STUDY DESIGN SIZE DURATION: A longitudinal study design was used by analysing the seasonal variation in live births between 1940 and 2012, and relating it to mothers' sociodemographic characteristics at the time of childbirth (maternal education, age, parity and re-partnering). PARTICIPANTS/MATERIALS SETTING METHODS: Register data on 6 768 810 live births in Sweden between 1940 and 2012 were used. Information on biological parents are available for more than 95% of all births. Multinomial logistic regressions were used to calculate predicted probabilities of giving birth for each calendar month. MAIN RESULTS AND THE ROLE OF CHANCE: Between 1940 and 1999, Swedish birth rates showed the typical seasonal variation with high numbers of births during the spring, and low numbers of births during the last quarter of the year. However, during the 21st century, the seasonal variation in fertility declined so that only minor variation in birth rates between February and September now remains. Still, the pattern of low birth rates at the end of the year remains and has even become more pronounced from the 1980s onwards. The characteristic 'Christmas effect' that used to be visible in September has vanished over the last 30 years. The roles in seasonal variation of maternal education, the mother's age, parity and instances where the mother has re-partnered between subsequent births changed during the second half of the 20th century. From 1980s onwards, the decline in birth rates during the last quarter of the year became particularly pronounced among highly educated mothers. Over the 72 years studied, the seasonal variation among first-time mothers declined steadily and has almost disappeared at the end of the study period. Using data that cover ~180 000 births in each month, all meaningful results are statistically significant. LIMITATIONS REASONS FOR CAUTION: The study uses data from one Nordic country only, making it difficult to draw conclusions that may hold for other countries. WIDER IMPLICATIONS OF THE FINDINGS: The typical seasonal variation reported for Sweden between 1940 and 1999, with high numbers of births during the spring and low numbers of births during the last quarter of the year, is in line with results from most other European countries during the same time period. However, the significant decline in seasonal variation in the early 21st century is a novel development. The study underlines that in a society with low fertility and efficient birth control, active choices and behaviours associated with an individual's sociodemographic characteristics tend to matter more for the seasonal timing of childbearing than environmental factors related to the physiological ability to reproduce and cultural-behavioural factors related to the frequency of intercourse. STUDY FUNDING/COMPETING INTERESTS: The study was funded by the Swedish Research Council (Vetenskapsrådet) via the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM): Stockholm University SIMSAM Node for Demographic Research (grant registration number 340-2013-5164). The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER: Not applicable.
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OBJECTIVE: The aim of this study was to gain insights related to positive experiences reported by adults with tinnitus living in the United Kingdom. DESIGN: A cross-sectional survey design was used in a sample of adults with tinnitus who were interested in undertaking an Internet-based intervention for tinnitus. SETTING: The study was UK wide and data collection was online. PARTICIPANTS: Participants consisted of 240 adults (137 males, 103 females), with an average age of 48.16 years and average tinnitus duration of 11.52 years (SD: 11.88). MAIN OUTCOME MEASURES: Tinnitus severity was measured by means of the Tinnitus Functional Index. To evaluate the secondary effects of tinnitus, the Insomnia Severity Index, the Hearing Handicap Inventory for Adults-Screening Version and the Cognitive Failures Questionnaires were administered. Positive experiences related to tinnitus were explored using an open-ended question format. RESULTS: Around a third of participants (32.5%) reported positive experiences associated with tinnitus. The number of positive responses ranged from one to eight responses per participant, although there were fewer participants with more than one positive response. The predominant themes concerned for (i) coping; (ii) personal development; (iii) support, and to a lesser extent (iv) outlook. Younger participants, those with a lower hearing disability and those with fewer cognitive failures were more likely to report positive experiences associated with having tinnitus. CONCLUSIONS: This study has identified that personal development and a positive outlook are possible despite experiencing tinnitus. Ways to facilitate positive experiences related to tinnitus should be promoted, as these may reduce the negative consequences associated with tinnitus. The most prevalent positive theme was the ability to cope with tinnitus. Positive experiences were also drawn from having clinical and other support networks. This highlights the importance of providing tinnitus interventions that can assist people in coping with tinnitus, particularly to those less likely to relate tinnitus to any positive experiences. Those most likely to be helped include those who are older with greater cognitive difficulties and a greater hearing disability.
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Terapia Cognitivo-Conductual , Internet , Acúfeno/terapia , Adaptación Psicológica , Adulto , Estudios Transversales , Femenino , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Motivación , Encuestas y Cuestionarios , Acúfeno/psicología , Reino UnidoRESUMEN
Loading increases bone mass and strength in a site-specific manner; however, possible effects of loading on bone matrix composition have not been evaluated. Site-specific structural and material properties of mouse bone were analyzed on the macro- and micro/molecular scale in the presence and absence of axial loading. The response of bone to load is heterogeneous, adapting at molecular, micro-, and macro-levels. INTRODUCTION: Osteoporosis is a degenerative disease resulting in reduced bone mineral density, structure, and strength. The overall aim was to explore the hypothesis that changes in loading environment result in site-specific adaptations at molecular/micro- and macro-scale in mouse bone. METHODS: Right tibiae of adult mice were subjected to well-defined cyclic axial loading for 2 weeks; left tibiae were used as physiologically loaded controls. The bones were analyzed with µCT (structure), reference point indentation (material properties), Raman spectroscopy (chemical), and small-angle X-ray scattering (mineral crystallization and structure). RESULTS: The cranial and caudal sites of tibiae are structurally and biochemically different within control bones. In response to loading, cranial and caudal sites increase in cortical thickness with reduced mineralization (-14 and -3%, p < 0.01, respectively) and crystallinity (-1.4 and -0.3%, p < 0.05, respectively). Along the length of the loaded bones, collagen content becomes more heterogeneous on the caudal site and the mineral/collagen increases distally at both sites. CONCLUSION: Bone structure and composition are heterogeneous, finely tuned, adaptive, and site-specifically responsive at the micro-scale to maintain optimal function. Manipulation of this heterogeneity may affect bone strength, relative to specific applied loads.
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Adaptación Fisiológica/fisiología , Tibia/fisiología , Soporte de Peso/fisiología , Animales , Calcificación Fisiológica/fisiología , Colágeno/análisis , Fuerza Compresiva/fisiología , Femenino , Ratones Endogámicos C57BL , Espectrometría Raman/métodos , Tibia/química , Tibia/diagnóstico por imagen , Microtomografía por Rayos X/métodosRESUMEN
BACKGROUND: Autoimmune disease is one of the leading causes of morbidity and mortality worldwide. In Addison's disease, the adrenal glands are targeted by destructive autoimmunity. Despite being the most common cause of primary adrenal failure, little is known about its aetiology. METHODS: To understand the genetic background of Addison's disease, we utilized the extensively characterized patients of the Swedish Addison Registry. We developed an extended exome capture array comprising a selected set of 1853 genes and their potential regulatory elements, for the purpose of sequencing 479 patients with Addison's disease and 1394 controls. RESULTS: We identified BACH2 (rs62408233-A, OR = 2.01 (1.71-2.37), P = 1.66 × 10-15 , MAF 0.46/0.29 in cases/controls) as a novel gene associated with Addison's disease development. We also confirmed the previously known associations with the HLA complex. CONCLUSION: Whilst BACH2 has been previously reported to associate with organ-specific autoimmune diseases co-inherited with Addison's disease, we have identified BACH2 as a major risk locus in Addison's disease, independent of concomitant autoimmune diseases. Our results may enable future research towards preventive disease treatment.
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Enfermedad de Addison/genética , Factores de Transcripción con Cremalleras de Leucina de Carácter Básico/genética , Exoma/genética , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Haplotipos , Antígenos de Histocompatibilidad Clase II/genética , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Análisis de Secuencia , Adulto JovenRESUMEN
In recent years, the plantaris tendon has been implicated in the development of chronic painful mid-portion Achilles tendinopathy. In some cases, a thickened plantaris tendon is closely associated with the Achilles tendon, and surgical excision of the plantaris tendon has been reported to be curative in patients who have not derived benefit following conservative treatment and surgical interventions. The aim of this review is to outline the basic aspects of, and the recent research findings, related to the plantaris tendon, covering anatomical and clinical studies including those dealing with histology, imaging and treatment. Cite this article: Bone Joint J 2016;98-B:1312-19.
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Tendón Calcáneo/anatomía & histología , Diagnóstico por Imagen/métodos , Procedimientos Ortopédicos/métodos , Tendinopatía , Humanos , Tendinopatía/diagnóstico , Tendinopatía/fisiopatología , Tendinopatía/terapiaRESUMEN
BACKGROUND: Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach. METHOD: Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data. RESULTS: A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29-0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit-risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration. CONCLUSIONS: Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.
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Trastorno Depresivo Mayor/terapia , Internet , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Autocuidado/efectos adversos , Humanos , Autocuidado/métodosRESUMEN
Low-dimensional magnetic heterostructures are a key element of spintronics, where magnetic interactions between different materials often define the functionality of devices. Although some interlayer exchange coupling mechanisms are by now well established, the possibility of direct exchange coupling via proximity-induced magnetization through non-magnetic layers is typically ignored due to the presumed short range of such proximity effects. Here we show that magnetic order can be induced throughout a 40-nm-thick amorphous paramagnetic layer through proximity to ferromagnets, mediating both exchange-spring magnet behaviour and exchange bias. Furthermore, Monte Carlo simulations show that nearest-neighbour magnetic interactions fall short in describing the observed effects and long-range magnetic interactions are needed to capture the extent of the induced magnetization. The results highlight the importance of considering the range of interactions in low-dimensional heterostructures and how magnetic proximity effects can be used to obtain new functionality.