Evaluation of the Chinese version of the disability of the arm, shoulder and hand (DASH-HKPWH): cross-cultural adaptation process, internal consistency and reliability study

Abstract
The Disability of the Arm, Shoulder and Hand (DASH) was translated into Chinese by a physiotherapy team of the Prince of Wales Hospital, Hong Kong (DASH-HKPWH).

Objectives
This study evaluated the cross-cultural adaptation process, face validity, internal consistency and reliability of the DASH-HKPWH.

Method
Language officers and medical professionals from different fields were invited to translate and evaluate the face validity of the DASH-HKPWH. 88 patients were recruited to complete two DASH questionnaires on two occasions 1-2 weeks apart.

Results
Some adjustments were made to the translations based on the cultural and linguistic practice in Hong Kong. The face validity was satisfactory with a mean endorsement score of 3.2. The difference between the mean of DASH scores was not significant (t = −0.35, p = 0.73). The ICC (1,1) and Cronbach's alpha for the 30-item Disability/Symptom of the DASH-HKPWH was 0.77 and 0.94, respectively.

Conclusion
The translation was valid and reliable and acceptably equivalent to the original version. The questionnaire is suitable for measuring changes experienced by patients with any upper extremity disorders.

Construct validity of the Chinese version of the disability of the arm, shoulder and hand questionnaire (DASH-HKPWH)

The study evaluated the construct validity of the Chinese Hong Kong version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). Three hundred and thirty four patients with a broad range of upper extremity disorders were recruited into the study. Each completed DASH-HKPWH and SF-36 forms and their pain intensity (numeric pain rating scale) and grip strength were also measured. The mean DASH-HKPWH score was 40 (SD = 20). Principal component factor analysis identified a single factor, which accounted for 47% of the total variance. Pearson correlation was applied to assess convergent and divergent validity of the DASH-HKPWH by comparison with the above-mentioned subjective and objective measurements. Our findings were comparable to the DASH of other languages

Corticospinal adaptations and strength maintenance in the immobilized arm following 3 weeks unilateral strength training

Cross-education strength training has being shown to retain strength and muscle thickness in the immobilized contralateral limb. Corticospinal mechanisms have been proposed to underpin this phenomenon; however, no transcranial magnetic stimulation (TMS) data has yet been presented. This study used TMS to measure corticospinal responses following 3 weeks of unilateral arm training on the contralateral, immobilize arm. Participants (n = 28) were randomly divided into either immobilized strength training (Immob + train) immobilized no training (Immob) or control. Participants in the immobilized groups had their nondominant arm rested in a sling, 15 h/day for 3 weeks. The Immob + train group completed unilateral arm curl strength training, while the Immob and control groups did not undertake training. All participants were tested for corticospinal excitability, strength, and muscle thickness of both arms. Immobilization resulted in a group x time significant reduction in strength, muscle thickness and corticospinal excitability for the untrained limb of the Immob group. Conversely, no significant change in strength, muscle thickness, or corticospinal excitability occurred in the untrained limb of the Immob + train group. These results provide the first evidence of corticospinal mechanisms, assessed by TMS, underpinning the use of unilateral strength training to retain strength and muscle thickness following immobilization of the contralateral limb.

Parallel manipulators with a rotation-symmetric arm system

Parallel manipulators with a rotation-symmetric arm system possess all the typical advantages of parallel robots, such as high acceleration and high-accuracy positioning. Contrary to the majority of proposed parallel manipulators, the rotation-symmetric arm system leads to a large workspace in relation to the footprint of the manipulator. This paper focuses on a subclass of these manipulators with additional favorable qualities, including low inertia and high eigenfrequencies. These qualities are achieved using only 5-DOF lower arm links and by mounting all actuators on the nonmoving base column of the manipulator. The common feature of all previously proposed manipulators in this subclass is identified and several novel 3-DOF and 4-DOF members are introduced.

Kinematic analysis and workspace determination of hexarot-a novel 6-DOF parallel manipulator with a rotation-symmetric arm system

Parallel mechanisms possess several advantages such as the possibilities for high acceleration and high accuracy positioning of the end effector. However, most of the proposed parallel manipulators suffer from a limited workspace. In this paper, a novel 6-DOF parallel manipulator with coaxial actuated arms is introduced. Since parallel mechanisms have more workspace limitations compared to that of serial mechanisms, determination of the workspace in parallel manipulators is of the utmost importance. For finding position, angular velocity, and acceleration, in this paper, inverse and forward kinematics of the mechanism are studied and after presenting the workspace limitations, workspace analysis of the hexarot manipulator is performed by using MATLAB software. Next, using the obtained cloud of points from simulation, the overall borders of the workspace are illustrated. Finally, it is shown that this manipulator has the important benefits of combining a large positional workspace in relation to its footprint with a sizable range of platform rotations.

Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS).

We investigated change in health-related quality of life due to fracture in Australian adults aged over 50 years. Fractures reduce quality of life with the loss sustained at least over 12 months. At a population level, the loss was equivalent to 65 days in full health per fracture.

Nocebo effects in the treatment of major depression: results from an individual study participant-level meta-analysis of the placebo arm of duloxetine clinical trials

BACKGROUND: The nocebo effect, when a harmless substance creates harmful effects in a person who takes it, is a clinically salient yet seldom studied phenomenon that may be associated with poorer treatment outcomes, perceived adverse events, and treatment discontinuation. The covert presence of nocebo responders in clinical trials may contribute to outcome variance in both placebo and active treatment arms for important primary and secondary endpoints. Nocebo effects are thought to be driven by expectancy and conditioning. METHOD: This study analyzed pooled clinical trial data in the placebo arms of controlled trials of antidepressant medications to investigate variables associated with the emergence of adverse outcomes in placebo-treated participants (N = 2,457). Specifically, we examined treatment-emergent adverse events (TEAEs) and discontinuation in placebo-treated individuals. Trials were commenced between 1993 and 2010 as studies of duloxetine versus active comparator and/or placebo. RESULTS: TEAEs were reported by 1,569 placebo-treated participants (63.9%), with 115 (4.7%) discontinuing from the studies due to TEAEs and 274 (11.2%) showing worsening of Hamilton Depression Rating Scale total score during placebo treatment. There was specifically no evidence to support the expectancy hypothesis, that reported TEAEs were influenced by adverse effects described in the clinical trials participant information and consent forms, or the conditioning hypothesis, that reported TEAEs would be influenced by adverse effect profiles of previous antidepressant medications used by these study participants. There was some evidence to suggest that people who had previously used complementary medications were more likely to report TEAEs. Variables specific to individual studies were the strongest predictors of TEAEs. DISCUSSION: In this study, TEAEs were very common among placebo-treated clinical trial participants. Unexpectedly, there was no evidence to associate TEAEs with adverse clinical outcomes, nor were the conditioning or expectancy hypotheses supported by these data. CONCLUSIONS: The nocebo effect is a common, covert, and poorly understood driver of clinical outcomes that requires further investigation.

Compressão de imagem e vídeo com controlador ARM

Este trabalho foi desenvolvido num estágio na empresa ABS GmbH sucursal em Portugal, e teve como foco a compressão de imagem e vídeo com os padrões JPEG e H.264, respetivamente. Foi utilizada a plataforma LeopardBoard DM368, com um controlador ARM9. A análise do desempenho de compressão de ambos os padrões foi realizada através de programas em linguagem C, para execução no processador DM368. O programa para compressão de imagem recebe como parâmetros de entrada o nome e a resolução da imagem a comprimir, e comprime-a com 10 níveis de quantização diferentes. Os resultados mostram que é possível obter uma velocidade de compressão até 73 fps (frames per second) para a resolução 1280x720, e que imagens de boa qualidade podem ser obtidas com rácios de compressão até cerca de 22:1. No programa para compressão de vídeo, o codificador está configurado de acordo com as recomendações para as seguintes aplicações: videoconferência, videovigilância, armazenamento e broadcasting/streaming. As configurações em cada processo de codificação, o nome do ficheiro, o número de frames e a resolução do mesmo representam os parâmetros de entrada. Para a resolução 1280x720, foram obtidas velocidades de compressão até cerca de 68 fps, enquanto para a resolução 1920x1088 esse valor foi cerca de 30 fps. Foi ainda desenvolvida uma aplicação com capacidades para capturar imagens ou vídeos, aplicar processamento de imagem, compressão, armazenamento e transmissão para uma saída DVI (Digital Visual Interface). O processamento de imagem em software permite melhorar dinamicamente as imagens, e a taxa média de captura, compressão e armazenamento é cerca de 5 fps para a resolução 1280x720, adequando-se à captura de imagens individuais. Sem processamento em software, a taxa sobe para cerca de 23 fps para a resolução 1280x720, sendo cerca de 28 fps para a resolução 1280x1088, o que é favorável à captura de vídeo.

X-ARM: um modelo de representação de artefatos de software

A great challenge of the Component Based Development is the creation of mechanisms to facilitate the finding of reusable assets that fulfill the requirements of a particular system under development. In this sense, some component repositories have been proposed in order to answer such a need. However, repositories need to represent the asset characteristics that can be taken into account by the consumers when choosing the more adequate assets for their needs. In such a context, the literature presents some models proposed to describe the asset characteristics, such as identification, classification, non-functional requirements, usage and deployment information and component interfaces. Nevertheless, the set of characteristics represented by those models is insufficient to describe information used before, during and after the asset acquisition. This information refers to negotiation, certification, change history, adopted development process, events, exceptions and so on. In order to overcome this gap, this work proposes an XML-based model to represent several characteristics, of different asset types, that may be employed in the component-based development. Besides representing metadata used by consumers, useful for asset discovering, acquisition and usage, this model, called X-ARM, also focus on helping asset developers activities. Since the proposed model represents an expressive amount of information, this work also presents a tool called X-Packager, developed with the goal of helping asset description with X-ARM