Reliability and validity of arm volume measurements for assessment of lymphedema

Background and Purpose. Arm lymphedema following breast cancer In this study, we assessed the surgery is a continuing problem. reliability and validity of circumferential measurements and water displacement for measuring upper-limb volume. Subjects. Participants included subjects who had had breast cancer surgery, including axillary dissection-19 with and 22 without a diagnosis of arm lymphedema-and 25 control subjects. Methods. Two raters measured each subject by using circumferential tape measurements at specified distances from the fingertips and in relation to anatornic landmarks and by using water displacement. Interrater reliability was calculated by analysis of variance and multilevel modeling. Volumes from circumferential measurements were compared with those from water displacement by use of means and correlation coefficients, respectively. The standard error of measurement, minimum detectable change (MDC), and limits of agreement (LOA) for volumes also were calculated. Results. Arm volumes obtained with these methods had high reliability. Compared with volumes from water displacement, volumes from circumferential measurements had high validity, although these volumes were slightly larger. Expected differences between subjects with and without clinical lymphedema following breast cancer were found. The MDC of volumes or the error associated with a single measure for data based oil anatomic landmarks was lower than that based oil distance from fingertips. The mean LOA with water displacement were lower for data based on anatomic landmarks than for data based on distance from fingertips. Discussion and Conclusion. Volumes calculated from anatomic landmarks are reliable, valid, and more accurate than those obtained from circumferential measurements based on distance from fingertips.

Synthesis and aggregation behavior of four-arm star amphiphilic block copolymers in water

We report the first synthesis of amphiphilic four-arm star diblock copolymers consisting of styrene (STY) and acrylic acid (AA) made using reversible addition-fragmentation chain transfer (RAFT; Z group approach with no star-star coupling). The polymerization proceeded in an ideal living manner. The size of the poly(AA(132)-STYm)(4) stars in DMF were small and close to 7 nm, suggesting no star aggregation. Slow addition of water (pH = 6.8) to this mixture resulted in aggregates of 15 stars per micelle with core-shell morphology. Calculations showed that the polyAA blocks were slightly extended with a shell thickness of 15 nm. Treatment of these micelles with piperidine to cleave the block arms from the core resulted in little or no change on micelle size or morphology, but the polyAA shell thickness was close to 29 nm (33 nm is the maximum at full extension) suggesting a release of entropy when the arms are detached from the core molecule. In this work we showed through the use of star amphiphilic polymers that the micelle size, aggregation number, and morphology could be controlled.

Validation of the Action Research Arm Test using item response theory in patients after stroke

Objective: To validate the unidimensionality of the Action Research Arm Test (ARAT) using Mokken analysis and to examine whether scores of the ARAT can be transformed into interval scores using Rasch analysis. Subjects and methods: A total of 351 patients with stroke were recruited from 5 rehabilitation departments located in 4 regions of Taiwan. The 19-item ARAT was administered to all the subjects by a physical therapist. The data were analysed using item response theory by non-parametric Mokken analysis followed by Rasch analysis. Results: The results supported a unidimensional scale of the 19-item ARAT by Mokken analysis, with the scalability coefficient H = 0.95. Except for the item pinch ball bearing 3rd finger and thumb'', the remaining 18 items have a consistently hierarchical order along the upper extremity function's continuum. In contrast, the Rasch analysis, with a stepwise deletion of misfit items, showed that only 4 items (grasp ball'', grasp block 5 cm(3)'', grasp block 2.5 cm(3)'', and grip tube 1 cm(3)'') fit the Rasch rating scale model's expectations. Conclusion: Our findings indicated that the 19-item ARAT constituted a unidimensional construct measuring upper extremity function in stroke patients. However, the results did not support the premise that the raw sum scores of the ARAT can be transformed into interval Rasch scores. Thus, the raw sum scores of the ARAT can provide information only about order of patients on their upper extremity functional abilities, but not represent each patient's exact functioning.

Postural activity of the pelvic floor muscles is delayed during rapid arm movements in women with stress urinary incontinence

The aim of this study was to determine whether postural activity of the pelvic floor (PF) and abdominal muscles differs between continent and incontinent women during rapid arm movements that present a postural challenge to the trunk. A further aim was to study the effect of bladder filling. Electromyographic activity (EMG) of the PF, abdominal, erector spinae (ES), and deltoid muscles was recorded with surface electrodes. During rapid shoulder flexion and extension, PF EMG increased before that of the deltoid in continent women, but after the deltoid in incontinent women (p= 0.002). In many incontinent women, PF EMG decreased before the postural activation. Although delayed, postural PF EMG amplitude was greater in women with incontinence ( p= 0.010). In both groups, PF EMG decreased and abdominal and ES EMG increased when the bladder was moderately full. These findings would be expected to have negative consequences for continence and lumbopelvic stability in women with incontinence.

Debate : arm's- length bodies and alternative models of service delivery

This article reflects on the UK coalition government’s ‘alternative models’ agenda, specifically in terms of the adoption of new models of service delivery by arm’s-length bodies (ALBs). It provides an overview of the alternative models agenda and discusses barriers to implementation. These include practical challenges involved in the set up of alternative models, the role of sponsor departments, and the effective communication of best practice. Finally, the article highlights some issues for further discussion.

Delegation in hard times:the financial management of arm's length bodies in the UK

This paper explores the effectiveness of financial management tools in regulating the use of resources by arm’s length bodies (ALBs) in a period of fiscal stress. The paper presents research undertaken into the implementation of a new financial management tool for ALBs in the UK since the 2008 financial crisis. Drawing on conflict ambiguity theory, the paper shows how the effectiveness of such tools is affected by deep-rooted tensions implicit within arm’s length governance. This gives rise to micro-level conflict over the means of achieving fiscal regulation, underpinned by macro-level ambiguity over the logic of governance pursued by the government.

High frequency inverter topologies integrated with the coupled inductor bridge arm

A new topology of the high frequency alternating current (HFAC) inverter bridge arm is proposed which comprises a coupled inductor, a switching device and an active clamp circuit. Based on it, new single-phase and threephase inverters are proposed and their operating states are analysed along with the traditional H-bridge inverter. Multiphase and multi-level isolated inverters are also developed using the HFAC bridge arm. Furthermore, based on the proposed HFAC, a front-end DC-DC converter is also developed for photovoltaic systems to demonstrate the application of the proposed HFAC converter. Simulation and experimental results from prototype converters are carried out to validate the proposed topologies which can be utilised widely in high frequency power conversion applications such as induction heating and wireless power transfer.

Biological factors affecting sea survival of Atlantic salmon Salmo salar L., in Western Arm Brook and an analysis of selection by the commercial fishery of nearby St. Barbe Bay, Newfoundland

The problems faced by scientists in charge of managing Atlantic salmon (Salmo salar) stocks are : i) how to maintain spawning runs consisting of repeat spawners and large multi-sea-winter (MSW) adults in the face of selective homewater and distant commercial fisheries and , ii) how to more accurately predict returns of adults. Using data from scales collected from maiden Atlantic salmon grilse from two locations on the Northern Peninsula of Newfoundland, St. Barbe Bay and Western Arm Brook, their length at smolting was back calculated. These data were then used to examine whether the St. Barbe commercial fishery is selective for salmon of particular smolt age and/or size. Analysis indicated that come commercial fishery selected larger, but not necessarily older adults that those escaping to Western Arm Brook over the period of this study, 1978-1987. It was determined that less than average size smolts survived better than above average size smolts. Slection for repeat spawners, large MSW salmon, and larger grilse has meant reductions in the proportions of these adults in the spawning runs on Western Arm Brook. This may impact the Western Arm Brook salmon stock by increasing the population instability. Sea survival was significantly correlated with selection by the commercial fishery. Characteristics of adults in Western Arm Brook during the period of study (1978-1987) did not help in explaining yearly variation in sea survival. The characteristics of smolts, however, when subjected to multiple regression analysis explained 57.2 percent of the yearly variation in sea survival.

A ROS-based Workspace Control and Trajectory Planner for a seven degrees of freedom Robotic arm

In this Bachelor Thesis I want to provide readers with tools and scripts for the control of a 7DOF manipulator, backed up by some theory of Robotics and Computer Science, in order to better contextualize the work done. In practice, we will see most common software, and developing environments, used to cope with our task: these include ROS, along with visual simulation by VREP and RVIZ, and an almost "stand-alone" ROS extension called MoveIt!, a very complete programming interface for trajectory planning and obstacle avoidance. As we will better appreciate and understand in the introduction chapter, the capability of detecting collision objects through a camera sensor, and re-plan to the desired end-effector pose, are not enough. In fact, this work is implemented in a more complex system, where recognition of particular objects is needed. Through a package of ROS and customized scripts, a detailed procedure will be provided on how to distinguish a particular object, retrieve its reference frame with respect to a known one, and then allow navigation to that target. Together with technical details, the aim is also to report working scripts and a specific appendix (A) you can refer to, if desiring to put things together.

Evaluación del rendimiento de un planificador de tareas sobre una plataforma heterogénea ARM+DSP de Texas Instruments

El presente trabajo estudia la viabilidad a la hora de aplicar un modelo de programación basado en la extracción de paralelismo a nivel de tareas sobre distintas arquitecturas heterogéneas basadas en un procesador multinúcleo de propósito general acelerado con uno o más aceleradores hardware. Se ha implementado una aplicación completa cuyo objetivo es la detección de bordes en una imagen (implementando el Algoritmo de Canny), y se ha evaluado en detalle su rendimiento sobre distintos tipos de arquitecturas, incluyendo CPUs multinúcleo de última generación, sistemas multi-GPU y una arquitectura objetivo basada en procesadores ARM Cortex-A15 acelerados mediante un DSP C66x de la compañía Texas Instruments. Los resultados experimentales demuestran la viabilidad de este tipo de implementación también para arquitecturas heterogéneas novedosas como esta última, e ilustran la facilidad de programación que introduce este tipo de modelos de programación sobre arquitecturas de propósito específico.

Data feedback and behavioural change intervention to improve primary care prescribing safety (EFIPPS) : multicentre, three arm, cluster-randomised controlled trial

Funding and trial registration: Scottish Government Chief Scientist Office grant CZH/3/17. ClinicalTrials.gov registration NCT01602705.