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Valerie Sparkes,1 Gemma M Whatling,2,3 Paul Biggs,2,3 Nidal Khatib,2,3 Mohammad Al-Amri,1,3 David Williams,2,3 Rebecca Hemming,1,3 Martina Hagen,4 Ishaak Saleem,2,3 Ramesh Swaminathan,2,3 Cathy Holt2,3 1School of Healthcare Sciences, Biomechanics and Bioengineering Research Centre Versus Arthritis, College of Biomedical and Life Sciences, Cardiff University, Cardiff CF24 0AB, UK; 2School of Engineering, College of Physical Sciences and Engineering, Cardiff University, Cardiff CF24 3AA, UK; 3Arthritis Research UK Biomechanics and Bioengineering Centre, Cardiff University, Cardiff CF10 3AT, UK; 4Medical Affairs, Pain Relief Category, GSK Consumer Healthcare S.A., Nyon 1260, SwitzerlandCorrespondence: Valerie Sparkes Newport Road, Cardiff CF24 0AB UKTel +44 29 2068 7560Email sparkesv@cardiff.ac.ukObjective: To examine functional performance differences using kinematic and kinetic analysis between participants with and without knee osteoarthritis (OA) to determine which outcomes best characterize persons with and without knee OA.Methods: Participants with unilateral moderate knee OA (Kellgren–Lawrence grades 2 or 3) and controls without knee pain were matched for age, gender, and body mass index. Primary outcomes included temporal parameters, joint rotations and moments, and ground reaction forces assessed via 3D motion capture during walking and ascending/descending stairs. Secondary outcomes included timed functional activities (sit to stand; tying shoelaces), 48 hrs lower limb activity monitoring, and patient-reported outcome measures (Knee Injury and Osteoarthritis Outcome Score, Western Ontario and McMaster Universities Osteoarthritis Index, European Quality of Life–5 Dimensions).Results: Eight matched pairs were analyzed. Compared with controls, OA participants exhibited significant reductions in peak frontal hip and sagittal knee moments, and decreased peak anterior ground reaction force with the affected limb while walking. Ascending stairs, OA participants had slower speed, fewer strides per minute, longer cycle and stance times, and increased trunk range of motion (ROM) in assessments of both limbs; longer swing time and reduced ankle ROM in the affected limb; and increased knee frontal ROM in the unaffected limb. Descending stairs, OA participants had fewer strides per minute and decreased trunk transverse ROM in assessments of both limbs; increased knee frontal ROM in the affected limb; and longer strides, shorter stance and cycle times, increased trunk sagittal and decreased knee transverse ROMs in the unaffected limbs vs controls. Compared with controls, OA participants had slower walking cadence (120–130 vs 100–110 steps/min, respectively), took significantly longer on timed functional measures, and had significantly worse scores in patient-reported outcomes.Conclusion: Several objectives and patient-reported measures examined in this study could potentially be considered as outcomes in pharmacologic or physical therapy OA trials.Keywords: osteoarthritis, knee, 3D motion analysis, biomechanics, kinetics, gait

This article presents a study on the early prenatal diagnosis of aortopulmonary window (APW), a congenital heart defect. The study examined 10 cases and described the clinical outcomes and associated structural and genetic abnormalities. The researchers identified a new sonographic sign called the "red eye" in the main pulmonary artery, which was a key indicator of APW. The study found that APW can be detected as early as the first trimester, and early detection allows for genetic testing and the possibility of spontaneous resolution. The prevalence of APW may be higher than previously reported. [Extracted from the article]

Vast majority of active tuberculosis patients seeks treatment, do so promptly, still many patients spend a great deal of time and money “shopping for health” and too often they do not receive either accurate diagnosis or effective treatment, despite spending considerable resources. Objective: To find out the time taken to, for diagnosis of tuberculosis and to put patient on DOTS from the onset of symptoms and pattern of health seeking behavior of new pulmonary tuberculosis patients. A cross-sectional rapid assessment using qualitative (FGD) and quantitative (Interview) methods conducted at DOTS center of tertiary care hospital from rural Wardha. Participants: 53 pulmonary tuberculosis patients already on DOTS, in intensive phase. Main outcome measure: Delay in initiation of DOTS & health seeking behavior Results: Median total delay for starting DOTS was 111 days, (range: 10 to 321 days). Patient delay was more than provider delay. Patients delay was more in patients above 60 years, illiterate, per-capita income below 650 Rupees and HIV TB co-infection. Pattern of health seeking behavior was complex. Family physician was the preferred health care provider. Patient visited on an average four providers and spent around 1450 rupees (only direct cost) before DOTS begin. Time taken from the onset of symptoms and start of DOT is a cause of concern for the tuberculosis control program. Early case detection is important rather than mere achieving target of 70% new case detection. Program manager needs to implement locally relevant & focused strategies for early case detection to improve the treatment success, especially in rural area of India.

This paper is devoted to the study of a mathematical model of atherosclerosis in one-dimensional geometry with a free boundary. The motion of the boundary is attributable to the concentration of cells in the intima and their interaction in the subendothelial space in addition to their influx through the boundary. A mathematical model that describes the main inflammatory processes in atherosclerosis is proposed, then, by considering some simplifications, a reduced model is obtained. Using a change of variables, the reduced model is converted to a fixed boundary model with space- and time-dependent coefficients and nonlinear terms. We study the existence of solution for the fixed boundary model starting with a model with linear terms then by applying the fixed point theorem. The wave solution is as well investigated along with numerical simulations. Then, we return to the reduced model, prove the existence of solution and present numerical results. Finally, we generalize the results to the complete model initially proposed. [ABSTRACT FROM AUTHOR]

In this paper, we consider a steady state multi-anticipative traffic model and we provide necessarily and sufficient conditions for the existence of traveling solutions. In our work, the word "traveling" means that the distance between two consecutive vehicles travels continuously between two different states. As application to our result, we show that taking a strictly concave optimal velocity, we can construct a traveling solution such that the distance between two vehicles decreases. The existence, uniqueness and the study of the asymptotic behavior of such solutions is done at the level of the Hamilton-Jacobi equation. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a chronic disease which involves the build up of cholesterol and fatty deposits within the inner lining of the artery. It is associated with a progressive thickening and hardening of the arterial wall that result in narrowing of the vessel lumen and restriction of blood flow to vital organs. These events may cause heart attack or stroke, the commonest causes of death worldwide. In this paper we study the early stages of atherosclerosis via a mathematical model of partial differential equations of reaction-diffusion type. The model includes several key species and identifies endothelial hyperpermeability, believed to be a precursor on the onset of atherosclerosis. For simplicity, we reduce the system to a monotone system and provide a biological interpretation for the stability analysis according to endothelial functionality. We investigate as well the existence of solutions of traveling waves type along with numerical simulations. The obtained results are in good agreement with current biological knowledge. Likewise, they confirm and generalize results of mathematical models previously performed in literature. Then, we study the non monotone reduced model and prove the existence of perturbed solutions and perturbed waves, particularly in the bistable case. Finally, we extend the study by considering the complete model proposed initially, perform numerical simulations and provide more specific results. We study the consistency between the reduced and complete model analysis for a certain range of parameters, we elaborate bifurcation diagrams showing the evolution of inflammation upon endothelial permeability and LDL accumulation and we consider the effect of anti-inflammatory process on the system behavior. In this model, the regulation of atherosclerosis progression is mediated by anti-inflammatory responses that, up to certain extent, lead to plaque regression. [ABSTRACT FROM AUTHOR]

Dengue hemorrhagic fever (DHF) is a common syndrome of dengue viral infection but complications such as sub-capsular splenic hematoma leading to capsular rupture in dengue are rare. We report a case of a young male who presented with fever, breathlessness, and acute abdomen. His CT of the abdomen revealed subcapsular splenic hematoma measuring 16.7 cm × 13.0 cm × 11 cm. His laboratory parameters were suggestive of anemia, thrombocytopenia, acute kidney injury, coagulopathy, and hepatopathy because of which instead of splenectomy, splenic artery embolization with ultrasound-guided splenic hemorrhage drainage was performed for his management as his clinical condition deteriorated. This case report sensitizes newer modalities of treatment of subcapsular splenic hematoma with splenic arterial embolization.

In this paper, we consider the blood flow in a stenosed artery. We give an analytical study of the equations for a non-Newtonian fluid modeling the blood for which the behavior is obeying to Carreau’s law. The case we treat is different than classic cases where the total pressure is in the natural boundary conditions. For this, we use the Faedo–Galerkin method to prove the existence of a weak solution for the fluid problem. Then we use a coupled approach between the fluid equations and the solid model of the arterial wall and the atheromatous plaque. A special attention is paid to the effects of the wall motion on the local fluid displacement, on the stresses, and on strains in the diseased arterial wall. These relevant quantities are analyzed extensively through numerical results. [ABSTRACT FROM PUBLISHER]

This report demonstrates that using interferon gamma release assays to screen for latent tuberculosis infection in female commercial sex workers in an outreach sexual health clinic is feasible and acceptable. Routine interferon gamma release assay use successfully identified high numbers of latent tuberculosis infection. Innovative approaches to treatment and follow up were required to improve treatment adherence in this group. Direct observation of therapy within the sexual health clinic was also feasible. Successful follow up was dependent on the support of outreach workers, interpreters and tuberculosis nurses. [ABSTRACT FROM AUTHOR]