ABSTRACT
OBJECTIVE: To assess the benefits and harms associated with biopsychosocial rehabilitation in patients with inflammatory arthritis and osteoarthritis (OA). METHODS: We performed a systematic review and meta-analysis. Data were collected through electronic searches of Cochrane CENTRAL, MEDLINE, Embase, PsycInfo, and CINAHL databases up to March 2019. Trials examining the effect of biopsychosocial rehabilitation in adults with inflammatory arthritis and/or OA were considered eligible, excluding rehabilitation adjunct to surgery. The primary outcome for benefit was pain and total withdrawals for harm. RESULTS: Of the 27 trials meeting the eligibility criteria, 22 trials (3,750 participants) reported sufficient data to be included in the quantitative synthesis. For patient-reported outcome measures, biopsychosocial rehabilitation was slightly superior to control for pain relief (standardized mean difference [SMD] -0.19 [95% confidence interval (95% CI) -0.31, -0.07]), had a small effect on patient global assessment score (SMD -0.13 [95% CI -0.26, -0.00]), with no apparent effect on health-related quality of life, fatigue, self-reported disability/physical function, mental well-being, and reduction in pain intensity ≥30%. Clinician-measured outcomes displayed a small effect on observed disability/physical function (SMD -0.34 [95% CI -0.57, -0.10]), a large effect on physician global assessment score (SMD -0.72 [95% CI -1.18, -0.26]), and no effect on inflammation. No difference in harms existed in terms of the number of withdrawals, adverse events, or serious adverse events. CONCLUSION: Biopsychosocial rehabilitation produces a significant but clinically small beneficial effect on patient-reported pain among patients with inflammatory arthritis and OA, with no difference in harm. Methodologic weaknesses were observed in the included trials, suggesting low-to-moderate confidence in the estimates of effect.
Subject(s)
Osteoarthritis , Quality of Life , Adult , Humans , Randomized Controlled Trials as Topic , Osteoarthritis/diagnosis , PainABSTRACT
Prediction of dry matter content in whole potatoes is a desired capability in the processing industry. Accurate prediction of dry matter content may greatly reduce waste quantities and improve utilization of the raw material through sorting, hence also reducing the processing cost. The following study demonstrates the use of a low resolution, high speed NIR interactance instrument combined with partial least square regression for prediction of dry matter content in whole unpeeled potatoes. Three different measuring configurations were investigated: (1) off-line measurements with contact between the potato and the light collection tube; (2) off-line measurements without contact between the potato and the light collection tube; and (3) on-line measurements of the potatoes. The offline contact measurements gave a prediction performance of R(2)=0.89 and RMSECV=1.19. Similar prediction performance were obtained from the off-line non-contact measurements (R(2)=0.89, RMSECV=1.23). Significantly better (p=0.038) prediction performance (R(2)=0.92, RMSECV=1.06) was obtained with the on-line measuring configuration, thus showing the possibilities of using the instrument for on-line measurements. In addition it was shown that the dry matter distribution across the individual tuber could be predicted by the model obtained.
Subject(s)
Food Handling , Solanum tuberosum/chemistry , Spectroscopy, Near-Infrared , Analytic Sample Preparation Methods , LightABSTRACT
AFM images were taken of the exterior surface of a single trabecula, extracted from a human femoral head removed during surgery for a hip fracture in an old women with former fractures. The images showed a dense structure of bundled collagen fibrils banded with 67 nm periodicity. Bundles were seen to run in parallel in layers confirming the collagen structure seen by other techniques. Single collagen fibrils were seen to cross the bundles, thus forming cross-links between neighboring bundles of collagen fibrils. Some of these crossing fibrils did not have the 67 nm band pattern and their dimensions were about half compared to the neighboring collagen fibrils. Very little mineral was found on the surface of the trabecula. An AFM image of a fracture plane was also displayed. The trabecula was extracted from a region close to the hip fracture. However, there were in this case no obvious features in the images that could be linked directly to osteoporosis, but altered collagen banding and collagen protrusions may alter mechanical competence. A path to extensive studies of the nanometer scale structure of bone was demonstrated.