A meta-analysis of acupuncture for chronic pain.

Results of 14 randomized controlled trials of acupuncture for chronic pain were pooled in a meta-analysis and analysed in three subgroups according to site of pain; and in two subgroups each according to type to trial, type of treatment, type of control, 'blindness' of participating agents, trial size, and type of journal in which results were published. While few individual trials had statistically significant results, pooled results of many subgroups attained statistical significance in favour of acupuncture. Various potential sources of bias, including problems with blindness, precluded a conclusive finding although most results apparently favoured acupuncture.

Innovative LIDAR 3D dynamic measurement system to estimate fruit-tree leaf area

In this work, a LIDAR-based 3D Dynamic Measurement System is presented and evaluated for the geometric characterization of tree crops. Using this measurement system, trees were scanned from two opposing sides to obtain two three-dimensional point clouds. After registration of the point clouds, a simple and easily obtainable parameter is the number of impacts received by the scanned vegetation. The work in this study is based on the hypothesis of the existence of a linear relationship between the number of impacts of the LIDAR sensor laser beam on the vegetation and the tree leaf area. Tests performed under laboratory conditions using an ornamental tree and, subsequently, in a pear tree orchard demonstrate the correct operation of the measurement system presented in this paper. The results from both the laboratory and field tests confirm the initial hypothesis and the 3D Dynamic Measurement System is validated in field operation. This opens the door to new lines of research centred on the geometric characterization of tree crops in the field of agriculture and, more specifically, in precision fruit growing.

Postmortem measurement of human chorionic gonadotropin in vitreous humor and bile.

Postmortem human chorionic gonadotrophin (HCG) blood assay can confirm postmortem diagnosis of pregnancy or document situations in which HCG levels are elevated. In some cases, however, blood sampling is not possible at autopsy. In this study, HCG was quantified by enzyme-linked fluorescent assay (ELFA) in the bile (n = 5), vitreous humor (n = 4), and postmortem blood (n = 4) of five pregnant women. There were no false negatives in the pregnant subjects (n = 5) or false positives in controls (n = 34), enabling this test to be recommended for routine use in forensic contexts in which the detection of elevated HCG levels could be of interest.

PTPN11 mutation manifesting as LEOPARD syndrome associated with hypertrophic plexi and neuropathic pain.

BACKGROUND: LEOPARD syndrome (LS) belongs to the family of neuro-cardio-facio-cutaneous syndromes, which include Neurofibromatosis-1 (NF1), Noonan syndrome, Costello Syndrome, cardio-facio-cutaneous syndrome, Noonan-like syndrome with loose anagen hair and Legius syndrome. These conditions are caused by mutations in genes encoding proteins involved in the RAS-MAPK cellular pathway. Clinical heterogeneity and phenotype overlaps across those different syndromes is already recognized. CASE PRESENTATION: We hereby report a heterozygous de novo mutation in the PTPN11 gene (c.1403C > T) manifesting with a clinical picture of LS during childhood, and later development of neuropathic pain with hypertrophic plexi, which are typically observed in NF1 but have not been reported in LS. CONCLUSION: LS caused by PTPN11 mutations may be associated with hypertrophic roots and plexi. Consequently, clinicians should be aware of the possible development of neuropathic pain and consider specific diagnostic work-up and management.

Expert clinical reasoning and pain assessment in mechanically ventilated patients: A descriptive study.

BACKGROUND: Pain assessment in mechanically ventilated patients is challenging, because nurses need to decode pain behaviour, interpret pain scores, and make appropriate decisions. This clinical reasoning process is inherent to advanced nursing practice, but is poorly understood. A better understanding of this process could contribute to improved pain assessment and management. OBJECTIVE: This study aimed to describe the indicators that influence expert nurses' clinical reasoning when assessing pain in critically ill nonverbal patients. METHODS: This descriptive observational study was conducted in the adult intensive care unit (ICU) of a tertiary referral hospital in Western Switzerland. A purposive sample of expert nurses, caring for nonverbal ventilated patients who received sedation and analgesia, were invited to participate in the study. Data were collected in "real life" using recorded think-aloud combined with direct non-participant observation and brief interviews. Data were analysed using deductive and inductive content analyses using a theoretical framework related to clinical reasoning and pain. RESULTS: Seven expert nurses with an average of 7.85 (±3.1) years of critical care experience participated in the study. The patients had respiratory distress (n=2), cardiac arrest (n=2), sub-arachnoid bleeding (n=1), and multi-trauma (n=2). A total of 1344 quotes in five categories were identified. Patients' physiological stability was the principal indicator for making decision in relation to pain management. Results also showed that it is a permanent challenge for nurses to discriminate situations requiring sedation from situations requiring analgesia. Expert nurses mainly used working knowledge and patterns to anticipate and prevent pain. CONCLUSIONS: Patient's clinical condition is important for making decision about pain in critically ill nonverbal patients. The concept of pain cannot be assessed in isolation and its assessment should take the patient's clinical stability and sedation into account. Further research is warranted to confirm these results.

Use of the heat dissipation method for sap flow measurement in citrus nursery trees1

Sap flow could be used as physiological parameter to assist irrigation of screen house citrus nursery trees by continuous water consumption estimation. Herein we report a first set of results indicating the potential use of the heat dissipation method for sap flow measurement in containerized citrus nursery trees. 'Valencia' sweet orange [Citrus sinensis (L.) Osbeck] budded on 'Rangpur' lime (Citrus limonia Osbeck) was evaluated for 30 days during summer. Heat dissipation probes and thermocouple sensors were constructed with low-cost and easily available materials in order to improve accessibility of the method. Sap flow showed high correlation to air temperature inside the screen house. However, errors due to natural thermal gradient and plant tissue injuries affected measurement precision. Transpiration estimated by sap flow measurement was four times higher than gravimetric measurement. Improved micro-probes, adequate method calibration, and non-toxic insulating materials should be further investigated.

Paper Surface Image Processing for Roughness Quality Measurement

Diplomityössä on käsitelty paperin pinnankarkeuden mittausta, joka on keskeisimpiä ongelmia paperimateriaalien tutkimuksessa. Paperiteollisuudessa käytettävät mittausmenetelmät sisältävät monia haittapuolia kuten esimerkiksi epätarkkuus ja yhteensopimattomuus sileiden papereiden mittauksissa, sekä suuret vaatimukset laboratorio-olosuhteille ja menetelmien hitaus. Työssä on tutkittu optiseen sirontaan perustuvia menetelmiä pinnankarkeuden määrittämisessä. Konenäköä ja kuvan-käsittelytekniikoita tutkittiin karkeilla paperipinnoilla. Tutkimuksessa käytetyt algoritmit on tehty Matlab® ohjelmalle. Saadut tulokset osoittavat mahdollisuuden pinnankarkeuden mittaamiseen kuvauksen avulla. Parhaimman tuloksen perinteisen ja kuvausmenetelmän välillä antoi fraktaaliulottuvuuteen perustuva menetelmä.

The measurement of ice velocity, mass balance and thinning-rate on Johnsons Glacier, Livingston Island, South Shetland Islands, Antarctica

A network of twenty stakes was set up on Johnsons Glacier in order to determine its dynamics. During the austral summers from 1994-95 to 1997-98, we estimated surface velocities, mass balances and ice thickness variations. Horizontal velocity increased dow nstream from 1 m a- 1 near the ice divides to 40 m a- 1 near the ice terminus. The accumulation zone showed low accumulation rates (maximum of 0,6 m a- 1 (ice)), whereas in the lower part of the glacier, ablation rates were 4,3 m a- 1 (ice). Over the 3-year study period, both in the accumulation and ablation zones, we detected a reduction in the ice surface level ranging from 2 to 10 m from the annual ve rt ical velocities and ice-thinning data, the mass balance was obtained and compared with the mass balance field values, resulting in similar estimates. Flux values were calculated using cross-section data and horizontal velocities, and compared with the results obtained by means of mass balance and ice thinning data using the continuity equation. The two methods gave similar results.

The role of causal links in performance measurement models

Abstract Purpose: Several well-known managerial accounting performance measurement models rely on causal assumptions. Whilst users of the models express satisfaction and link them with improved organizational performance, academic research, of the realworld applications, shows few reliable statistical associations. This paper provides a discussion on the"problematic" of causality in a performance measurement setting. Design/methodology/approach: This is a conceptual study based on an analysis and synthesis of the literature from managerial accounting, organizational theory, strategic management and social scientific causal modelling. Findings: The analysis indicates that dynamic, complex and uncertain environments may challenge any reliance upon valid causal models. Due to cognitive limitations and judgmental biases, managers may fail to trace correct cause-and-effect understanding of the value creation in their organizations. However, even lacking this validity, causal models can support strategic learning and perform as organizational guides if they are able to mobilize managerial action. Research limitations/implications: Future research should highlight the characteristics necessary for elaboration of convincing and appealing causal models and the social process of their construction. Practical implications: Managers of organizations using causal models should be clear on the purposes of their particular models and their limitations. In particular, difficulties are observed in specifying detailed cause and effect relations and their potential for communicating and directing attention. They should therefore construct their models to suit the particular purpose envisaged. Originality/value: This paper provides an interdisciplinary and holistic view on the issue of causality in managerial accounting models.

Performance Measurement as Part of Management

To achieve success in a constantly changing environment and with ever-increasing competition, companies must develop their operations continuously. To do this, they must have a clear vision of what they want to be in the future. This vision can be attained through careful planning and strategising. One method of transforming a strategy and vision into an everyday tool used by employees is the use of a balanced performance measurement system. The importance of performance measurement in the implementation of companies' visions and strategies has grown substantially in the last ten years. Measures are derived from the company's critical success factors and from many different perspectives. There are three time dimensions: past, present and future. Many such performance measurement systems have been created since the 1990s. This is a case study whose main objective is to provide a recommendation for how the case company could make use of performance measurement to support strategic management. To answer this question, the study uses literature-based research and empirical research at the case company's premises. The theoretical part of the study consists of two sections: introducing the Balanced Scorecard and discussing how it supports strategic management and change management. The empirical part of this study determines the company's present performance measurement situation through interviews in the company. The study resulted in a recommendation to the company to start developing the Balanced Scorecard system. By setting up this kind process, the company would be able to change its focus more towards the future, beginning to implement a more process-based organisation and getting its employees to work together towards common goals.

Measurement of a Structured Backflow in an Open Small Channel Induced by Surface-Tension Gradients

We present experiments in which the laterally confined flow of a surfactant film driven by controlled surface tension gradients causes the subtended liquid layer to self-organize into an inner upstream microduct surrounded by the downstream flow. The anomalous interfacial flow profiles and the concomitant backflow are a result of the feedback between two-dimensional and three-dimensional microfluidics realized during flow in open microchannels. Bulk and surface particle image velocimetry data combined with an interfacial hydrodynamics model explain the dependence of the observed phenomena on channel geometry.

Measurement of the air permeability profile on SC paper machine

Tämän diplomityön tarkoituksena oli asentaa ja kehittää UPM-Kymmene Rauman tehtaiden PK2:lle luotettava ja toimiva ilmanläpäisyprofiilin mittaus. Työn tarkoituksena oli myös kartoittaa tietoja ilmanläpäisyprofiiliin vaikuttavista seikoista sekä mahdollisuuksista säätää ilmanläpäisyprofiilia. Lisäksi työn tavoitteena oli löytää toimiva menetelmä verrata online mitattua ilmanläpäisyprofiilia laboratoriossa mitattuun ilmanläpäisyprofiiliin online mittauksen luotettavuuden näkökulmasta. Työn aikana selvitettiin myös ilmanläpäisyprofiilin mittauksen mahdollisuutta superkalanteroidusta SC paperista. Työn kirjallisessa osassa käsiteltiin paperin huokoisuutta ja ilmanläpäisyä, huokoisuustasoon ja huokoisuus profiiliin vaikuttavia tekijöitä, ilmanläpäisevyyden merkitystä SC paperin valmistukselle ja SC paperin painettavuudelle sekä ilmanläpäisevyyden laboratorio- sekä online mittausta. Kirjallisessa osassa käsiteltiin myös Honeywellin uutta Poros ilmanläpäisysensoria. Työn kokeellisessa osassa tutkittiin ilmanläpäisyprofiilimittauksen luotettavuutta CD ja MD suunnassa sekä laboratorio- ja online-mittausten välisiä eroavaisuuksia ennen PK2 uusintaa. PK2 uusinnan jälkeen kokeellisessa osassa keskityttiin luotettavuuden varmentamiseen CD ja MD suunnassa sekä kartoittamaan tekijöitä, jotka aiheuttivat pieniä tasoeroja mittausten välillä. Mittaukset todettiin luotettaviksi ja niiden pohjalta suoritettiin mitattujen online profiilien välisiä vertailuja. Ilmanläpäisyprofiililla todettiin olevan positiivinen korrelaatio neliömassaprofiilin ja kosteusprofiilin kanssa sekä negatiivinen korrelaatio tuhkaprofiilin kanssa. PK2 uusinnan yhteydessä tehtiin koeajoja, jotka liittyivät laadunoptimointiin viira- ja puristinosalla. Koeajoissa tutkittujen asioiden lisäksi tutkittiin muutettujen parametrien vaikutusta ilmanläpäisyprofiiliin. Höyrylaatikon vaikutusta ilmanläpäisyprofiiliin tutkittiin säätöjen virityksen yhteydessä.