On-chip visible-to-infrared supercontinuum generation with more than 495 THz spectral bandwidth

We report ultra-broadband supercontinuum generation in high-confinement Si3N4 integrated optical waveguides. The spectrum extends through the visible (from 470 nm) to the infrared spectral range (2130 nm) comprising a spectral bandwidth wider than 495 THz, which is the widest supercontinuum spectrum generated on a chi

Optimierungsansätze motorischer fMRT-Paradigmen zur selektiven Darstellung primärmotorischer Kortexareale

Ziel dieser Arbeit waren Optimierungsansätze motorischer fMRT-Paradigmen, um selektiv das primärmotorische Areal detektieren zu können, insbesondere bei Patienten die keine kontralaterale Bewegung ausführen können. fMRT-Studien wurden an 24 Probanden in einem 1,5 Tesla MRT durchgeführt, eine Aktivierung erfolgte durch Finger-tapping, die prozentuale Aktivierung der einzelnen motorischen Corteaxareale wurde statistisch für die ipsi- und kontralateralen Areale ausgewertet. Die Untersuchung der Vorstellung einer Fingerbewegung und eine Messreihe mit sehr kurzen Messzeiten (Short-TR) schlossen sich an. „Rechts gegen Links“ war das beste Paradigma zur Lokalisation des SM1. Wenn eine einseitige Bewegung nicht möglich ist, kann das Paradigma „Bewegung gegen Ruhe“ eingesetzt werden, das kontralaterale SM1 erscheint jedoch signifikant geringer aktiviert als bei „Rechts gegen Links“. Die Hinzunahme der „Vorstellung einer Bewegung“ als Vergleichsparadigma brachte keine signifikante Besserung

Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis

Background: There is increasing interest in the role of �self-management� interventions to support the management of long-term conditions in health service settings. Self-management may include patient education, support for decision-making, self-monitoring and psychological and social support. Self-management support has potential to improve the efficiency of health services by reducing other forms of utilisation (such as primary care or hospital use), but a shift to self-management may lead to negative outcomes, such as patients who feel more anxious about their health, are less able to cope, or who receive worse quality of care, all of which may impact on their health and quality of life. We sought to determine which models of self-management support are associated with significant reductions in health services utilisation without compromising outcomes among patients with long-term conditions. Methods: We used systematic review with meta-analysis. We included randomised controlled trials in patients with long-term conditions which included self-management support interventions and reported measures of service utilisation or costs, as well as measures of health outcomes (standardized disease specific quality of life, generic quality of life, or depression/anxiety).We searched multiple databases (CENTRAL, CINAHL, Econlit, EMBASE, HEED, MEDLINE, NHS EED and PsycINFO) and the reference lists of published reviews. We calculated effects sizes for both outcomes and costs, and presented the results in permutation plots, as well as conventional meta-analyses. Results: We included 184 studies. Self-management support was associated with small but significant improvements in health outcomes, with the best evidence of effectiveness in patients with diabetic, respiratory, cardiovascular and mental health conditions. Only a minority of self-management support interventions reported reductions in health care utilisation in association with decrements in health. Evidence for reductions in utilisation associated with self-management support was strongest in respiratory and cardiovascular problems. Studies at higher risk of bias were more likely to report benefits. Conclusions: Self-management support interventions can reduce health service utilization without compromising patient health outcomes, although effects were generally small, and the evidence was strongest in respiratory and cardiovascular disorders. Further work is needed to determine which components of self-management support are most effective

Diagnostic accuracy of patient interview items and clinical tests for cervical radiculopathy.

ObjectiveTo determine the diagnostic accuracy of patient interview items and clinical tests to diagnose cervical radiculopathy.DesignA prospective diagnostic accuracy study.ParticipantsConsecutive patients (N=134) with a suspicion of cervical radiculopathy were included. A medical specialist made the diagnosis of cervical radiculopathy based on the patient's clinical presentation and corresponding Magnetic Resonance Imaging findings. Participants completed a list of patient interview items and the clinical tests were performed by a physiotherapist.Main outcome measuresDiagnostic accuracy was determined in terms of sensitivity, specificity, and positive (+LR) and negative likelihood ratios (-LR). Sensitivity and specificity values ≥0.80 were considered high. We considered +LR≥5 and -LR≤0.20 moderate, and +LR≥10 and -LR≤0.10 high.ResultsThe history items 'arm pain worse than neck pain', 'provocation of symptoms when ironing', 'reduction of symptoms by walking with your hand in your pocket', the Spurling test and the presence of reduced reflexes showed high specificity and are therefore useful to increase the probability of cervical radiculopathy when positive. The presence of 'paraesthesia' and 'paraesthesia and/or numbness' showed high sensitivity, indicating that the absence of these patient interview items decreases the probability of cervical radiculopathy. Although most of these items had potentially relevant likelihood ratios, none showed moderate or high likelihood ratios.ConclusionsSeveral patient interview items, the Spurling test and reduced reflexes are useful to assist in the diagnosis of cervical radiculopathy. Because there is no gold standard for cervical radiculopathy, caution is required to not over-interpret diagnostic accuracy values

Conversations about the elections on Twitter: Towards a structural understanding of Twitter’s relation with the political and the media field

This study uses network analysis to examine Twitter’s level of autonomy from external influences, being the political and the media field. The conceptual framework builds upon Bourdieu’s field theory, appropriated on social media as mediated social spaces. The study investigates conversation patterns on Twitter between political, media and citizen agents during election times in Belgium. Through the comparison of conversational practices with the positions users hold as political, media or citizen agents, we understand how the former is related to the latter. The analysis of conversation patterns (based on replies and mentions) shows a decentralized and loosely knit network, in which primarily citizen agents are present. Nonetheless, the prominence of citizens in the debate, mentions or replies to political and media agents are significantly higher, placing them more centrally in the network. In addition, politicians and media actors are closely connected within the network, and reciprocal communication of these established agents is significantly lower compared to citizen agents. We understand different aspects of autonomy related to the presence, positions and practices of the agents on Twitter and their relative positions as politicians, media or citizens. To conclude, we discuss the promises of Bourdieu’s relational sociology and the limitations of our study. The approach proposed here is an attempt to integrate existing work and evolve towards a systematic understanding of the interrelations between political, media and citizen agents in a networked media environment

A randomized, double-blind, placebo-controlled trial of coenzyme Q10 in Huntington disease

Objective: To test the hypothesis that chronic treatment of early-stage Huntington disease (HD) with high-dose coenzyme Q10 (CoQ) will slow the progressive functional decline of HD. Methods: We performed a multicenter randomized, double-blind, placebo-controlled trial. Patients with early-stage HD (n = 609) were enrolled at 48 sites in the United States, Canada, and Australia from 2008 to 2012. Patients were randomized to receive either CoQ 2,400 mg/d or matching placebo, then followed for 60 months. The primary outcome variable was the change from baseline to month 60 in Total Functional Capacity score (for patients who survived) combined with time to death (for patients who died) analyzed using a joint-rank analysis approach. Results: An interim analysis for futility revealed a conditional power of <5% for the primary analysis, prompting premature conclusion in July 2014. No statistically significant differences were seen between treatment groups for the primary or secondary outcome measures. CoQ was generally safe and well-tolerated throughout the study. Conclusions: These data do not justify use of CoQ as a treatment to slow functional decline in HD