Intra- and interspecies variation and population dynamics of Fasciola gigantica among ruminants in Sudan.

Fasciola gigantica is a widespread parasite that causes neglected disease in livestock worldwide. Its high transmissibility and dispersion are attributed to its ability to infect intermediate snail hosts and adapt to various mammalian definitive hosts. This study investigated the variation and population dynamics of F. gigantica in cattle, sheep, and goats from three states in Sudan. Mitochondrial cytochrome c oxidase subunit I (COI) and NADH dehydrogenase subunit 1 (ND1) genes were sequenced successfully to examine intra and interspecific differences. ND1 exhibited higher diversity than COI, with 15 haplotypes and 10 haplotypes, respectively. Both genes had high haplotype diversity but low nucleotide diversity, with 21 and 11 polymorphic sites for ND1 and COI, respectively. Mismatch distribution analysis and neutrality tests revealed that F. gigantica from different host species was in a state of population expansion. Maximum likelihood phylogenetic trees and median networks revealed that F. gigantica in Sudan and other African countries had host-specific and country-specific lineages for both genes. The study also indicated that F. gigantica-infected small ruminants were evolutionarily distant, suggesting deep and historical interspecies adaptation.

Combined Effects of Clime, Vegetation, Human-Related Land Use and Livestock on the Distribution of the Three Indigenous Species of Gazelle in Eritrea.

The status and habitat selection of the three species of gazelle indigenous to Eritrea, i.e., Nanger soemmerringii, Gazella dorcas and Eudorcas tilonura, are not well known. In this study, we analyzed the present distribution of the three species in the country in order to identify preferred habitats and assess the effect of human disturbance (land use for agricultural purposes and livestock) on species occurrence. These data represent baseline information for evidence-based strategies for conservation of the three species in Eritrea. Presence/absence data of the three species in each of the 67 administrative subregions (Sub Zoba) composing the country were collected using direct (field surveys) and indirect methods (questionnaires). For each sampling unit, we collected fifteen environmental variables, of which three are associated with climatic features, eight with vegetation structure and four with human disturbance (human-related land use and livestock). The occurrence probability of each species was modeled through Generalized Linear Models (GLM). The analyses showed that Dorcas gazelle occurred more frequently in warmer conditions and in a wide range of natural vegetation types. Heuglin's gazelle occurred in warmer regions with higher seasonality in both temperature and precipitation with a preference for closed woody and open grassland areas. In the case of Soemmerring's gazelle, the GLM with climatic variables predicted a preference for warmer conditions but with lower seasonality of temperature and precipitation. The species also seemed to prefer arid and semi-arid open vegetation. Human disturbance is the variable with the strongest, negative, effect on the species occurrence. Indeed, the occurrence probability of each species decreased with increasing livestock density and agricultural land use. Most of these gazelle occurred in unprotected areas, thus the human-related activities are undoubtedly the most important threat for the three species of gazelle in Eritrea. Therefore, the establishment of protected areas that preserve the potential optimal habitats for gazelle and reduce the impact of livestock ranching are essential to ensure a future for these gazelle in Eritrea.

Administration of tranexamic acid for victims of severe trauma within pre-hospital care ambulance services (PHCAS) in Malaysia

@#Introduction: Trauma is a Global threat and the 5th highest cause of all-cause mortality in Malaysia caused predominantly due to road traffic accidents. Majority of trauma victims are young adults aged between 21-40 years old. In Malaysia, 24 out of 100,000 population die annually due to trauma, rating us amongst the highest in South East Asia. These alarming figures justify aggressive preventive and mitigation strategies. The aim of this paper is to promote the implementation of evidence-based interventions that will reduce the rate of preventable death because of trauma. Tranexamic acid is one of the few interventions in the early management of severe trauma with level-one evidence. Tranexamic acid has been proven to reduce all causes of mortality and mortality due to bleeding. Evidence proves that it is most effective when administered early, particularly within the 1st hour of trauma. This proposed guideline is formulated based upon quality evidence from multicentre studies, clinical practices in other countries and consideration of the local demographic factors with the intent of enabling an easy and simple pathway to administer tranexamic acid early in the care of the severely injured. Conclusion: The guideline highlights select pre-hospital criteria’s and the methods for drug administration. The authors recognise that some variants may be present amongst certain institutions necessitating minor adaptations, nevertheless the core principles of advocating tranexamic acid early in the course of pre-hospital trauma should be adhered to.

Laboratory rearing of Anopheles arabiensis: impact on genetic variability and implications for Sterile Insect Technique (SIT) based mosquito control in northern Sudan.

BACKGROUND: Mosquito colony populations often show significant changes in their population genetic make-up compared to the field populations that were used as founding source. Most of the changes that have been reported are indicators of depletion in the overall genetic diversity of the colony populations. The Sterile Insect Techniques programme of mosquito control that is underway in Northern Sudan uses sterilized males produced from a laboratory-maintained colony population. The genetic diversity of an advanced generation of this colony population was quantitatively assessed and compared to the field population from which the colony was derived. METHODS: Anopheles arabiensis mosquito samples from the 13th generation of the colony, and from the locality that was the source of the first generation of the colony, were genotyped at 11 microsatellite loci distributed throughout the species' genome. Standard population genetic analyses were carried out to quantify and compare their population genetic make-up and diversities. RESULTS: The colony samples showed significant reduction in the total number of alleles, the numbers of rare and private alleles, and the fractions of heterozygote individuals at all the loci. The pattern of change is consistent with the expected effect of the use of a small number of mosquitoes when the colony was established. Departure from Hardy-Weinberg equilibrium in the direction of homozygote excess was observed at some loci and attributed to the presence of null-alleles. CONCLUSIONS: This study highlights the need for broad sampling when initiating colony populations and for ongoing assessment of the population genetic make-up of colony populations. Previous assessments of survivorship, dispersive behaviour and swarm formation indicate that the inbreeding and reduced genetic variability reported in this study may not have had direct fitness consequences yet. However, noting the lessons learned in other SIT programmes about the impact of colonization on male sexual behaviour and longevity, as well as other inbreeding related adverse effects, a systematic investigation of these potential effects is recommended because they have direct impact on the ultimate success of the programme.

Progression and Natural History of Nonalcoholic Fatty Liver Disease in Adults.

Liver-related mortality is the third cause of death in patients with nonalcoholic fatty liver disease, but the long-term prognosis basically depends on the presence and severity of liver damage. Thus, life expectancy in patients with simple steatosis is not different from the general population, but liver-related mortality is significantly higher in patients with nonalcoholic steatohepatitis (NASH), particularly in those with advanced fibrosis. Progression of liver disease is observed in up to one-third of patients with NASH. The long-term hepatic prognosis mostly depends on the histologic stage at initial liver biopsy, but multiple risk factors may concur.

Reliability and validity of an adapted Arabic version of the Scoliosis Research Society-22r Questionnaire.

STUDY DESIGN: Cross-sectional validation and reliability assessment study of Arabic version of Scoliosis Research Society-22 (SRS-22r) Questionnaire. OBJECTIVE: To develop and validate the Arabic version of the SRS-22r questionnaire. SUMMARY OF BACKGROUND DATA: The diagnosis and treatment of adolescent idiopathic scoliosis may influence patient quality of life. SRS-22r is an internationally validated questionnaire used to assess function/activity, pain, self-image, and mental health of patients with scoliosis. It has been translated into several languages but not into Arabic language. Therefore, a valid health-related quality-of-life outcome questionnaire for patients with spinal deformity is still lacking in Arabic language. METHODS: The English version of SRS-22r questionnaire was translated, back-translated, and culturally adapted to Arabic language. Then, 81 patients with idiopathic adolescent scoliosis were allocated randomly into either the reliability testing group (group 1) or the validity testing group (group 2). Group 1 patients completed Arabic version of SRS-22r questionnaire twice with 1-week interval in-between. Cronbach α and intraclass correlation coefficient were measured to determine internal consistency and temporal reliability. Group 2 patients completed the Arabic version of SRS-22r questionnaire and the previously validated Arabic version of 36-Item Short Form Health Survey (Short Form-36) questionnaire concurrently, and Pearson correlation coefficient was obtained to assess validity. RESULTS: Content analysis, internal consistency reliability, test/retest reproducibility (intraclass correlation coefficient range: 0.82-0.90), and test of concurrent validity showed satisfactory results. Function/activity and satisfaction with management domains had a lower Cronbach α (0.58 and 0.44, respectively, vs. 0.71-0.85 range for others). Self-image/appearance and satisfaction with management had a lower correlation with domains of the 36-Item Short Form Health Survey. CONCLUSION: An Arabic version of the SRS-22r questionnaire has been developed and validated. This questionnaire will aid health care workers and researchers in evaluation of patient perception of the deformity, satisfaction with treatment, and quality of life in Arabic-speaking populations. LEVEL OF EVIDENCE: 3.

Best Practices in Intraoperative Neuromonitoring in Spine Deformity Surgery: Development of an Intraoperative Checklist to Optimize Response.

STUDY DESIGN: Consensus-based creation of a checklist and guideline. OBJECTIVE: To develop a consensus-based checklist to guide surgeon responses to intraoperative neuromonitoring (IONM) changes in patients with a stable spine and to develop a consensus-based best practice guideline for IONM practice in the United States. SUMMARY OF BACKGROUND DATA: Studies show that checklists enhance surgical team responses to crisis situations and improve patient outcomes. Currently, no widely accepted guidelines exist for the response to IONM changes in spine deformity surgery. METHODS: After a literature review of risk factors and recommendations for responding to IONM changes, 4 surveys were administered to 21 experienced spine surgeons and 1 neurologist experienced in IONM. Areas of equipoise were identified and the nominal group process was used to determine items to be included in the checklist. The authors reevaluated and modified the checklist at 3 face-to-face meetings over 12 months, including a period of clinical validation using a modified Delphi process. The group was also surveyed on current IONM practices at their institutions. This information and existing IONM position statements were used to create the IONM best practice guideline. RESULTS: Consensus was reached for the creation of 5 checklist headings containing 26 items to consider in the response to IONM changes. Consensus was reached on 5 statements for inclusion in the best practice guideline; the final guideline promotes a team approach and makes recommendations aimed at decreasing variability in neuromonitoring practices. CONCLUSIONS: The final products represent the consensus of a group of expert spine surgeons. The checklist includes the most important and high-yield items to consider when responding to IONM changes in patients with a stable spine, whereas the IONM guideline represents the group consensus on items that should be considered best practice among IONM teams with the appropriate resources.

Use and outcomes of wound drain in spinal fusion for adolescent idiopathic scoliosis.

STUDY DESIGN: A multicenter retrospective analysis. OBJECTIVE: To evaluate outcomes of closed-suction wound drainage after posterior spinal fusion with instrumentation for adolescent idiopathic scoliosis and to identify surgeon patterns of drain use in this cohort. SUMMARY OF BACKGROUND DATA: There is little evidence on the use of drains in spinal surgery, particularly for repair of adolescent idiopathic scoliosis. Studies on hip and knee arthroplasty suggest no advantage to draining. There are few published reports on surgeon technique and rationale for drain use in spinal surgery. METHODS: Patients were divided into drain and no drain cohorts and followed for 2 years. Primary outcome was complication rate. A separate survey was conducted from surgeons in the Spinal Deformity Study Group to evaluate drain practice patterns. RESULTS: There were 324 drained and 176 undrained patients. Complication rate did not differ between the drain and no drain cohorts in any of the 4 categories (wound infection, neural injury, other infection, and other complication) at any time (all P > 0.1). More drained patients received postoperative transfusions compared with those without a drain (43% vs. 22%, P < 0.001). Of the 50 surgeons in the group, 36 used drains. Half of these did so out of habit. Surgeons tended to place deep drains with bulb suction, without drain manipulation. Half removed drains on the basis of output, whereas half removed them after 1 to 3 days. CONCLUSION: More patients tended to receive wound drains than not receive wound drains. Drains did not impact complication rate and drained patients received more blood product. There are no universal criteria for draining and practice patterns vary widely.

A molecular survey on cystic echinococcosis in Sinnar area, Blue Nile state (Sudan).

BACKGROUND: Cystic echinococcosis (CE) is a zoonosis caused by the cestodes of the Echinococcus species. Its life cycle involves dogs and other canids as definitive hosts for the intestinal tapeworm, as well as domestic and wild ungulates as intermediate hosts for the tissue-invading metacestode (larval) stage. The disease has a special impact on disadvantaged pastoralist communities and is listed now among the three top priority neglected tropical disease (NTD). Therefore, CE is a neglected disease even in high endemicity regions. This study aimed at investigation of the prevalence of CE in different animals slaughtered for food consumption in Sinnar area, Blue Nile states in Sudan. METHODS: A survey of CE in livestock was conducted from April 2009 to March 2011 in Sinnar area, Blue Nile state in Sudan. Location, parasitological status and fertility conditions were determined. In addition, 120 hydatid cysts (30 from camels, 62 from cattle and 28 from sheep) were examined by polymerase chain reaction (PCR) and mitochondrial gene sequencing for the genetic allocation of Echinococcus strains or species RESULTS: The prevalence of CE was 29.7% (30/101) in camels, 2.7% (62/2310) in cattle and 0.6% (26/4378) in sheep. It was shown that infection rates increased with age in camels, cattle and sheep. In camels, 67% (20/30) of the infected animals were aged between 2 - 5 years whereas 58% (36/62) of the infected cattle were > 5 years. In sheep, the prevalence rate was distributed equally between animals ranging 2 - 5 years and > 5 years. Even though multiple cysts were found in some animals, the average number of cysts per animal was close to 1 in all examined species. Lungs were found to be the predilection sites for the parasite in both camels and cattle, while most of the cysts found in sheep were located in the liver. About 63.4% of cysts encountered in camels were considered as large (5 - 7 cm), whereas those in cattle and sheep were medium (2 - 4 cm) and small (< 2 cm) respectively. The highest fertility rate was found in camel cysts with 85.4% (35/41) followed by cattle (50.0%, 32/64) and sheep (39.0%, 11/28). All examined cysts belonged to Echinococcus canadensis G6, which was confirmed to be the overwhelmingly predominant species in that area. CONCLUSION: The epidemiological situation in Sinnar area, Blue Nile state is characterized by intense transmission of Echinococcus canadensis G6, thereby closely resembling the situation in most other regions of Sudan.

Rapid inexpensive assay method for verapamil by spectrophotometric sequential injection analysis.

Sequential injection analysis (SIA) technique with a miniaturized fibre optic spectrophotometry was exploited to optimize and validate a new method for the assay of verapamil in pharmaceutical formulations. The reduction of acidified permanganate by verapamil was spectrophotometrically detected at 546 nm. The 2(3) full-factorial design was adopted for screening the effect of conditions controlling the proposed method, and accordingly for the purpose of optimization. The remarkable advantages of the method are high rapidity (sample frequency was 10.6 samples/h), saving in reagents and sample (total consumed volume was 190 µl) and better safety for the environment (total waste production volume was 2140 µl). Additionally, the method was selective in the presence of excipients usually found in tablet and injection formulations. The average of recovery in synthetic samples as well as dosage forms was 98.8-103.0%. The obtained results were realized by the British Pharmacopoeia method and comparable results were obtained.

Swyer-James-McLeod's syndrome and pneumothorax on same side: delay in chest drain removal despite full expansion.

Swyer-James-McLeod's syndrome (SJMS) occurs as a result of childhood recurrent respiratory infections. As this condition presents with few symptoms, if any, it may pass unnoticed until adulthood. The authors are presenting a case of a 17-year-old male admitted with spontaneous pneumothorax. Even though his lung expanded, his chest x-rays still mimicked a pneumothorax. Chest CT pulmonary angiogram was needed to confirm the diagnosis of unilateral SJMS. Diagnostic difficulty arose because both conditions were on the same side.

Microbial modification of host long-distance dispersal capacity.

BACKGROUND: Dispersal plays a key role in shaping biological and ecological processes such as the distribution of spatially-structured populations or the pace and scale of invasion. Here we have studied the relationship between long-distance dispersal behaviour of a pest-controlling money spider, Erigone atra, and the distribution of maternally acquired endosymbionts within the wider meta-population. This spider persists in heterogeneous environments because of its ability to recolonise areas through active long-distance airborne dispersal using silk as a sail, in a process termed 'ballooning'. RESULTS: We show that there is spatial heterogeneity in the prevalence of two maternally acquired endosymbiont infections within the wider E. atra meta-population and we demonstrate through several independent approaches a link between the presence of one of these endosymbionts, Rickettsia, and the tendency for long-distance movement. CONCLUSION: This novel finding that particular endosymbionts can influence host dispersal is of broad importance given the extremely widespread occurrence of similar bacteria within arthropod communities. A bacterial phenotype that limits dispersal has the potential not only to reduce gene flow and thus contribute to degrees of reproductive isolation within species, but also to influence species distribution and thus overall community composition.

Spectrophotometric methods for the determination of cefprozil in bulk and dosage form.

Two simple spectrophotometric methods were developed for the determination of cefprozil in pure bulk and in tablets forms. The first is a colorimetric method based on the coupling of cefprozil, after being hydrolyzed by sodium hydroxide (0.1N), with ascorbic acid as a chromogen (method A). It has been established that cefprozil reacts with ascorbic acid to form a 1:1 water soluble colored product with maximum absorbance (λmax) at 408 nm and molar absorptivity of 7.2 × 10(3)L mol(-1) cm(-1). The second method (Method B) utilizes a direct reaction between cefprozil and sodium hydroxide (1N). A colored product with λmax at 486 nm and molar absorptivity of 7.4 × 10(3) L mol(-1) cm(-1) is formed after heating cefprozil with sodium hydroxide (1N). The absorbance-concentration plot was rectilinear over the range 5-25 µg/ml in both methods with correlation coefficient values not less than 0.999. The detection limits (L.O.D.) were 0.96 µg/ml and 0.93 µg/ml for method A and method B respectively. The methods were validated using the USP liquid chromatography method for cefprozil assay. The results obtained by the USP liquid chromatography method for the tablets dosage form were statistically compared with those of the developed methods and evaluated at 95% confidence limits.

Comparison of the lowest instrumented, stable, and lower end vertebrae in "single overhang" thoracic adolescent idiopathic scoliosis: anterior versus posterior spinal fusion.

STUDY DESIGN: A retrospective multicenter study. OBJECTIVE: To investigate the relationship between the lowest instrumented, stable, and lower end vertebrae in patients with "single overhang" thoracic (main thoracic) curves treated with anterior or posterior spinal fusion. SUMMARY OF BACKGROUND DATA: Previous studies have shown "saving" fusion levels with anterior spinal fusion, as opposed to posterior spinal fusion; however, to our knowledge, none of these studies evaluated the relative position to the lower end vertebra to compare study groups accurately. For clarification, "single overhang" includes Lenke 1A and 1B curves. For these thoracic curves, the lumbar curve does not cross the midline. MATERIALS AND METHODS: A retrospective multicenter study of adolescent idiopathic scoliosis was performed to identify specifically patients with "single overhang" thoracic (Lenke 1A and 1B) curves with more than a 2-year follow-up. To analyze relative fusion levels, the differences were computed as follows: (1) the difference between the vertebra position for the stable vertebra of the main thoracic (MT) curve and the lowest instrumented vertebra, as noted on postoperative radiographs, or [equation: see text] (2) the difference between the vertebra position for the lower end vertebra of the main thoracic (MT) curve and the lowest instrumented vertebra, as noted on postoperative radiographs, or [equation: see text]. RESULTS: A total of 298 "single overhang" thoracic curves (148 Lenke 1A, 150 Lenke 1B) were identified, of which 293 had either an anterior spinal fusion or posterior spinal fusion; 5 patients underwent a combined anterior-posterior spinal fusion. Anterior spinal fusion was performed in 70 patients (23.9%) and posterior spinal fusion in 223 (76.1%). While comparing the lowest instrumented vertebra to the stable vertebra with anterior spinal fusion, the lowest instrumented vertebra was identified either at the level of the stable vertebra or above in 97% of 1A/B curves (P < 0.001). Using posterior spinal fusion techniques, the lowest instrumented vertebra was identified either at the stable vertebra or above in 65% of the 1A/B curves (P < 0.05). CONCLUSIONS: These data confirm that anterior spinal fusion techniques result in a mean shorter fusion of 1.5 vertebral segments/patient when compared to posterior spinal fusion techniques with respect to the position of the lowest instrumented and stable vertebrae for "single overhang" thoracic (Lenke 1A/B) curves. However, because this is a retrospective multicenter study over 10 years, it represents various posterior spinal fusion techniques that do not include all pedicle screw constructs.

Anodic polarographic determination of josamycin in formulations and spiked human urine.

The anodic polarographic behaviour of josamycin (a macrolide antibiotic) has been studied using direct current (DC(t)) polarography and differential pulse polarography (DPP). In Britton-Robinson buffers (BRb) josamycin exhibited well-defined anodic polarographic waves in the pH range 2-8. In BRb of pH 6, the diffusion-current constant was 1.62 microA mmol(-1) (n = 6). The current-concentration plots are rectilinear over the range 10-50 and 5-40 microg/ml using the DC(t) and DPP modes, respectively, with a detection limit of 4.83 x 10(-6) M adopting the DPP mode. The method was applied to commercial tablets adopting both DC(t) and DPP modes, the recoveries % were 99.13 +/- 2.22 (n = 10) and 99.82 +/- 1.82 (n = 7), respectively. The method was further extended to the in vitro determination of josamycin in human urine, the recovery % (n = 6) was 100.06 +/- 2.84. The number of electrons involved in the electrode process could be accomplished and a proposal of electrode reaction was presented.

Kinetic spectrophotometric determination of josamycin in formulations and spiked human plasma using 3-methylbenzothiazolin-2-one hydrazone/Fe+3 system.

A simple kinetic spectrophotometric method was developed for the determination of josamycin in its dosage forms and spiked human plasma. The method is based on reaction of the drug with 3-methylbenzothiazolin-2-one hydrazone/ferric chloride system for a fixed time of 20 min at 70 degrees C and measuring the produced color at 665 nm. The absorbance-concentration plot is rectilinear over the range of 5.0-30.0 microg/mL with detection limit of 1.0 microg/mL (1.2 x 10(-6) M). The determination of josamycin by the fixed concentration and the rate-constant methods is also feasible with the calibration equations obtained, but the fixed-time method proved to be more applicable. The procedure was successfully applied to commercial tablets. The results obtained were favorably compared with those given by reference methods. The method was further extended to the in vitro determination of josamycin in spiked human plasma. The recovery (n = 8) was 100.76 +/- 3.43%. The stoichiometry of the reaction between the drug and the reagent was studied by adopting the limiting logarithmic method, and a proposal of the reaction pathway was presented.

Kinetic spectrophotometric determination of the macrolide antibiotic josamycin in formulations.

A simple kinetic spectrophotometric method was developed for the determination of josamycin in its dosage forms. The method is based on oxidation of the drug with alkaline potassium permanganate at room temperature for a fixed time of 20 min and measuring the produced green color at 611 nm. The absorbance-concentration plot is rectilinear over the range of 2-10 microg/mL (2.4 x 10(6)-1.2 x 10(-5)M) with minimum detectability of 1.0 microg/mL (1.2 x 10(-6)M). The determination of josamycin by fixed concentration and the rate-constant methods is also feasible with the calibration equations obtained, but the fixed-time method proved to be more applicable. The procedure was applied successfully to commercial tablets, and statistical analysis showed that the results compared favorably with those obtained by reference methods. The effect of sensitizers and surfactants on the performance of the proposed method was also studied. A proposal of the reaction pathway was presented.

Prothrombin activation in eastern tiger snake bite.

AIMS: To perform ex vivo studies in eastern tiger snake envenomation which define the haemostatic events associated with prothrombin activation. METHOD: Serial studies were performed on plasma from six individuals with evidence of eastern tiger snake envenomation. These analyses were particularly directed to fibrinogen levels, F1 + 2, TAT and evidence of fibrinolysis. RESULTS: There was a substantial rise in F1 + 2 and thrombin-antithrombin (TAT) complexes in all cases, even with minimal evenomation. In some cases the molar ratio of F1 + 2 and TAT was reduced from the relationship normally seen in vitro and ex vivo in clinical thrombosis. There was a dramatic fall in factor V and VIII levels which occurred 4-6 hours before the decline in prothrombin and AT3. This related in time to a fall in alpha2AP and plasminogen. Protein C levels also declined dramatically but many hours after presentation. CONCLUSIONS: F1 + 2 and TAT are sensitive markers of tiger snake evenomation. In some patients with massive prothrombin activation, the common mechanism for TAT clearance may be altered or overwhelmed. Conversely, the renal clearance of the smaller F1 + 2 may be enhanced. In the absence of thrombocytopaenia, which is a very sensitive marker of DIC, the fall in labile factors with tiger snake envenomation is significantly contributed to by proteolytic digestion of clotting factors.

A reliable and accurate method for measuring orthosis wearing time.

STUDY DESIGN: Compliance monitor measurement of orthosis wearing time during laboratory climate tests and normal volunteer subject tests were compared to normal diaries. OBJECTIVE: To develop and test the accuracy and reliability of a device designed to measure spinal orthosis wearing time. SUMMARY OF BACKGROUND DATA: Orthosis wearing time is an important factor in orthotic treatment for spine disorders. A reliable and objective method for measuring orthosis wearing time currently is lacking. METHODS: Four pressure switches and a data logger embedded in each thoracolumbosacral orthosis recorded orthosis wearing time. Orthoses were assumed to be worn when at least two switches were "on." Laboratory climate tests and normal volunteer tests were conducted to assess the ability of the compliance monitor to measure orthosis wearing time. A manual wearing-event diary was kept during all the tests. The length of each wearing-time interval, the daily wearing time, and the cumulative wearing time were calculated from data recorded by the compliance monitor and the manual diaries. RESULTS: A linear regression was performed on all orthosis wearing-time intervals as recorded by the compliance monitor and by the manual diaries. Climate chamber tests yielded 121 sensor trigger-event intervals (R2 = 0.998; slope = 1.003; P < 0.0001). Normal subject testing yielded 72 orthosis wearing-time intervals (R2 = 0.998; slope = 0.998; P < 0.0001). CONCLUSION: As indicated by the regression analyses, the compliance monitor accurately quantified the orthosis wearing-time intervals during the laboratory climate tests and the tests with normal volunteers.