Velocity Standard Deviation Research Articles

Experimental study of human thermal plumes in a small space via large-scale TR PIV system

In small occupied spaces such as vehicle cabins, in-depth information about human thermal plumes can be important for designing ventilation systems, especially in the case of displacement ventilation. In this study, large-scale time-resolved particle image velocimetry measurements were performed to reveal airflow characteristics of thermal plumes inside a small space with high temporal and spatial resolutions. The measured time-averaged velocity showed that the development of thermal plumes was limited by the small space, with maximum vertical velocity of 0.184 m/s above the head. The standard deviation of velocity and the turbulence intensity (TI) indicated high fluctuation characteristics, with TI of approximately 0.4 in the mainstream area. With these time-resolved data, the integral, Taylor and Kolmogorov scales were calculated, which provided recommended grid sizes and time steps for different numerical simulations. For investigation of instantaneous characteristics and vortex structures, three vortex identification parameters were compared. The vorticity index identified bulky attached and detached vortexes around the head; the Q-criterion revealed that the mainstream area was controlled mainly by deformation structures; and the λci criterion, which was the most effective means of identification, avoided the influences of deformation structures and focused only on the rotation structures with directions of rotation. Furthermore, multi-scaled characteristics of thermal plumes were revealed by proper orthogonal decomposition, and the period of ascending plumes was estimated as 5 s.

Instability in car-following behavior: new Nagel–Schreckenberg type cellular automata model

In the past few decades, numerical models were proposed to study car-following behavior, in order to resolve the controversy about the fundamental relation between speed and spacing under various traffic conditions. Jiang et al (2014 Plos one 9 e94351, 2015 Transp. Res. B 80 338–54) carried out a series of field experiments, revealing that the vehicle speed and its spacing span a 2D region in the speed-spacing plane and standard deviations of the velocities of cars fit to a concave curve. To describe this instability of car-following behavior, we proposed a new NaSch type model, in which a speed-dependent variable is introduced. The flow rate, spatiotemporal patterns and the velocity standard deviation can be in basic agreement with the experiment. Moreover, transitions of the traffic phases are reproduced and the fundamental relationship between flow rate, speed and density is presented.

Quasi-Experimental Determination of Turbulent Dispersion Parameters for Different Stability Conditions from a Tall Micrometeorological Tower

AbstractTurbulent wind data measured by sonic anemometers installed at various heights on a 140-m-tall micrometeorological tower located at a coastal site are used to obtain vertical profiles of the velocity standard deviations σi, Lagrangian decorrelation local time scales TLi, and eddy diffusivities Kα for distinct stability conditions. The novelty of the study lies in the use of turbulent data directly measured over the extension of the atmospheric surface layer at a coastal site for that purpose. Furthermore, the approach employs the Hilbert–Huang transform to determine the wind energy spectral peak frequencies. These are applied to the asymptotic spectral equation from Taylor statistical diffusion theory to obtain the turbulent dispersion parameters, which are shown to generally agree well with those provided by a classical autocorrelation approach. For neutral and stable situations the vertical profiles of momentum eddy diffusivities agree well with those derived from the spectral and autocorrelation method. Additionally, the turbulent integral time scales and eddy diffusivities determined by the method at a coastal location are found to overestimate those predicted from analytical expressions based on continental field observations. The turbulence parameters found are suitable to be employed in air pollution dispersion models.

Persistence of Sarcopenia After Pediatric Liver Transplantation Is Associated With Poorer Growth and Recurrent Hospital Admissions.

Sarcopenia is prevalent in adults pre-liver transplantation (LTx) and post-LTx contributing to adverse outcomes. Little is known regarding the prevalence of sarcopenia in pediatric LTx recipients. This novel study examined sarcopenia prevalence and associations with post-LTx growth and healthcare utilization in pediatric LTx recipients. We prospectively assessed body composition at annual clinical appointments in children (0.5-17 years; n = 58) by Dual-energy-X-ray absorptiometry (absolute/regional/percent fat mass [FM], fat-free mass [FFM], skeletal muscle mass [SMM]). Sarcopenia was defined as SMM z scores ≤2. Additional variables measured included age, gender, PELD, immunosuppressive therapies (dose/type), weight, weight-z, height, height-z, serum aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, albumin, total/conjugated bilirubin, prothrombin time, international normalized ratio, albumin, creatinine clearance, urea and creatinine at LTx assessment, LTx and annual clinic appointments. Healthcare variables studied included rejection (number/type/severity), length of in-patient stay (total, intensive care unit [ICU], emergency, readmission) and ventilator dependency. Sarcopenia occurred in 41% (n = 17) at 7.6 (± 3.1) years; with a mean time post-LTx of 1.1 ± 1.9 (1-8) years. Female children ≤9.8 years had a higher sarcopenia prevalence than children >9.8 years (83.1% vs 17.1%; p = 0.004). Sarcopenia was associated with lower weight velocity standard deviation scores, lower weight-z/height-z scores at 2-10 years post LTx, increased hospitalization (total, ICU, emergency and readmission) and ventilator dependency (p < 0.05), but not to rejection and/or corticosteroid therapy (p > 0.05). This is the first study demonstrating persistent sarcopenia associated with poorer growth and recurrent hospitalization in children post-LTx.

Growth hormone treatment of Canadian children: results from the GeNeSIS phase IV prospective observational study.

Country-specific data on outcomes of treatment with recombinant human growth hormone are lacking. We present such data for children treated with growth hormone in Canada. We describe characteristics and outcomes of 850 children (mean age at baseline 8.5 yr) treated with growth hormone constituting the Canadian cohort of the multinational phase IV prospective observational Genetics and Neuroendocrinology of Short-stature International Study (GeNeSIS). The diagnosis associated with short stature was as determined by the investigator. Auxological data were evaluated yearly until near-adult height. Adverse events were assessed in all growth-hormone-treated patients. The diagnosis ascribed as the cause of short stature was growth hormone deficiency in 526 children (61.9%), predominantly organic rather than idiopathic, particularly congenital pituitary abnormalities and intracranial tumours. All diagnostic groups with sufficient patients for analysis had increased height velocity standard deviation score (SDS) and height SDS during growth hormone treatment. For patients who reached near-adult height (n = 293), the mean height SDS was within the normal range for about 80% of patients with organic growth hormone deficiency (n = 131) or idiopathic growth hormone deficiency (n = 50), 50% of patients with idiopathic short stature (n = 10) and 46% of patients with Turner syndrome (n = 79). Eleven deaths were reported, 7 in patients with organic growth hormone deficiency. Serious adverse events considered related to growth hormone treatment (n = 19) were isolated except for medulloblastoma recurrence (n = 2) and adenoidal hypertrophy (n = 2). Growth hormone treatment was effective and had a good safety profile in Canadian children. Growth hormone dosages were lower than in the US and global GeNeSIS cohorts, and a greater proportion of treated Canadian children had organic growth hormone deficiency. ClinicalTrials.gov, no. NCT01088412.

Quantification characteristics of digital spiral analysis for understanding the relationship among tremor and clinical measures in persons with multiple sclerosis

BackgroundMultiple sclerosis (MS) is a degenerative neurological condition causing demyelination and neuronal loss. Tremor, a symptom of MS, is prevalent in 45.0–46.8% NARCOMS registrants. Although several tools to measure tremor exist, few outcomes are quantitative or regularly utilized clinically. New methodIntroduction of a novel adaptation of the digital spiral drawing to find a quick, sensitive, and clinically useful technique, to predict tremor in persons with MS (pwMS). Digital spiral measures included: Segment Rate (SEGRT), Standard Deviation (SD) of Radial Velocity (VSD-R), SD of Tangential Velocity (VSD-T), SD of Overall Velocity (VSD-O), Mean Drawing Velocity (MNV-O) and Mean Pen Pressure Acceleration (MNA-P). Digital spiral measures were compared with the manual Archimedes Spiral (AS) drawing and the following clinical measures: Finger-Nose Test (FNT), presence of visually observed intention tremor (VOT), Nine-Hole Peg Test (NHPT), and Box and Block Test (BBT). ResultsAll clinical measures utilized demonstrated significant relationships with all digital variables, except VSD-R. The forward-stepwise regression revealed BBT accounted for the most variance, followed by SEGRT.Comparison with Existing Methods: SEGRT is more sensitive in detecting VOT and better for quantifying tremor than AS. BBT and SEGRT are optimal predictive measures for tremor. ConclusionsSEGRT has stronger sensitivity and negative predictive value than AS in detecting VOT. All clinical measures (NHPT, FNT, BBT, and AS) were significantly associated with the digital variables (SEGRT, VSD-T, VSD-O, MNV-O, and MNA-P) except for VSD-R. After controlling for Patient Determined Disease Steps (PDDS), BBT and SEGRT are the best predictive measures for tremor.

Bathymetric Controls on Rotational Surfzone Currents

AbstractA multibeach Lagrangian data set was used to determine bathymetric controls on flow variability within the surfzone. Seven microtidal flow regimes were examined, six containing rip channels, under moderate shore normal waves. Three selected zones exemplified varying bathymetric control: (i) a alongshore uniform zone; (ii) a shallow rip channel at an oblique angle to shore normal; and (iii) a deep, shore‐normal rip channel. Bathymetric variables included alongshore nonuniformity (φ) and channel angle relative to shore normal (α). Low‐frequency flow (0.01 Hz) was described by velocity (U), velocity standard deviation (σU), angular deviation (σθ), and bias in direction of eddy rotation (ζbias). Observations of the exemplar zones indicated the following: (i) near‐zero mean flow with transient eddies within the alongshore uniform zone; (ii) low mean flow with high ζbias within the oblique channel; and (iii) strong mean flow with low ζbias in the deep channel. Bathymetry and flow variables were spatially averaged and linearly correlated, scaling for wave forcing. Normalized flow variables were found to be interdependent and were correlated with bathymetric variability, with [U ∝ φ], [(U/σU) ∝ φ], and [σθ ∝ − φ], all with (R2 ≥ 0.8). A correlation was determined between α and ζbias (R2 ≥ 0.7, increasing as zone width is decreased), with peak ζbias within oblique channels. Based on these results, a conceptual model is introduced to predict flow behavior for known bathymetry. Surfzone currents were found to span a dynamic continuum from transient eddies on alongshore uniform bathymetry, to channelized rip currents, forced by bathymetric three‐dimensionality and mediated by channel geometry.

Examining the diagnostic accuracy of static postural stability measures in differentiating among knee osteoarthritis patients with mild and moderate to severe radiographic signs

BackgroundClinicians need a reliable and accurate tools that can best identify and classify balance impairments between mild and moderate to severe grades of knee osteoarthritis (OA). Research questionThis study was designed to investigate the accuracy of postural measurements to discriminate between these two groups of knee OA. MethodsA total of 130 patients with knee OA based on the Kellgren-Lawrence (KL) grading scale were categorized into 65 patients with mild (a KL grade≤ 2) and 65 patient with moderate to severe (a KL grade≥3) radiographic sign. Static postural control was assessed on the force plate in three conditions of double leg stance with open (DO) and closed eyes (DC) and single leg stance with open eyes (SO). The accuracy for static postural control parameters was determined by calculation of sensitivity, specificity, area under the Receiver Operating Characteristic (ROC) curve (AUC) and likelihood ratios (LRs). ResultsOur results showed that standard deviation (SD) of velocity in anterior-posterior (AP) direction had the highest sensitivity and specificity in conditions of DO and DC, respectively. ROC curve analysis indicated that measures of mean and SD velocity in medio-lateral (ML) direction in conditions of DO and DC had acceptable levels of accuracy (AUC > 0.70) in discriminating between the two groups of knee OA patients. Also, based on LR results, SD of velocity in AP direction had the best ability for ruling in and ruling out moderate to severe grade of knee OA patients in conditions of DC and DO, respectively. SignificanceOur findings provide evidence for selection of mean velocity and SD of velocity in identifying and discriminating static postural performance in patients with mild and moderate to severe grades of knee OA.

Oculomotor Disturbances in Patients with Chronic Nonspecific Spinal Pain.

There is increasing evidence that the cerebellum has a role in pain processing. The present study investigates whether chronic pain patients, who are likely to have altered pain processing, exhibit signs of subtle cerebellar dysfunction. We used oculomotor tasks to assess dysfunction of the associated neuronal networks, including the cerebellum. Thirty patients with chronic nonspecific spinal pain and 30 age- and sex-matched controls were enrolled. Using a head-mounted eye tracker (EyeSeeCam), eye movements were quantified during predictable and unpredictable saccade and smooth pursuit tasks in the horizontal plane. The initial latency and the velocity variability of smooth pursuit were significantly increased in the chronic spinal pain patients compared with controls (initial latency: 198 ± 20 vs 185 ± 11 ms, P < 0.01; slow phase velocity standard deviation: 3.31 ± 1.02 vs 2.70 ± 0.83°/s, P < 0.05). Moreover, the latency of predictable saccades was prolonged in patients (rightward: 161 ± 20 vs 152 ± 12 ms, P < 0.05; leftward: 164 ± 22 vs 153 ± 18 ms, P = 0.05). Our results show that chronic spinal pain patients display subtle but significant oculomotor changes as compared with healthy controls. Considering the networks involved in the generation of saccades and smooth pursuit, the results would be consistent with a dysfunction of cerebellar regions, especially parts of the cerebellar hemispheres. Alternatively, they could also point toward a dysfunction in the frontal eye field and/or pontine oculomotor nuclei.

Main factor causing \u201cfaster-is-slower\u201d phenomenon during evacuation: rodent experiment and simulation

Understanding crowd flow at bottlenecks is important for preventing accidents in emergencies. In this research, a crowd evacuation passing through a narrow exit connected with guide-walls is analysed using the discrete element method based on physical and psychological modelling in parallel with empirical rodent research. Results of rodent experiment and simulation demonstrate the faster-is-slower (FIS) effect, which is a well-known phenomenon in pedestrian dynamics. As the angle of the guide-walls increases, agents rapidly evacuate the room even though they have low velocity. The increase in this angle causes agents to form lanes. It is validated that ordered agents evacuate expeditiously with relatively low velocity despite expectations to the contrary. The extracted experimental and simulation data strongly suggest that the agents’ standard deviation of velocity can be a key factor causing the FIS effect. It is found that the FIS effect can be eliminated by controlling the standard deviation.

Effective cues for accelerating young drivers’ time to transfer control following a period of conditional automation

ObjectiveDuring conditional automated driving, a transition from the automated driving suite to manual control requires the driver to take over control at a moment’s notice. Thus, it is critical that a driver be made situationally aware as quickly as possible in those conditions where he or she may not be paying full attention. Recent research suggests that specific cues about upcoming hazards (e.g., “crosswalk ahead”) can increase the drivers’ situation awareness during these safety-critical take-over situations when compared with a general cue (“take over control”). The current study examines whether this increased situation awareness which occurs as a result of more specific cues translates into improved hazard mitigation performance within the same limited time window. MethodFifty-seven drivers were randomly assigned to one of five between-subjects conditions (one control condition and four experimental auditory cue conditions) that varied in the specificity of information provided about an upcoming hazard. The four experimental conditions included a period of conditional automated driving where the driver was engaged in a driving-irrelevant task and looked away from the forward roadway prior to a take-over request. Drivers in the fifth condition had no cue and drove manually throughout. The same six simulator scenarios were used in all five conditions to evaluate how well the driver mitigated a hazard. The average velocity, standard deviation of velocity, and average absolute acceleration were recorded along with the glance behaviors of drivers. ResultsIn general, during the 4s prior to a latent hazard (following the alerting cues in the automated driving conditions), the more likely a driver was to glance towards a latent hazard, the more likely the driver was to reduce his or her speed. Moreover, analyses focusing solely on hazard mitigation behavior revealed patterns that mirrored the glance behavior results. Specifically, drivers that were presented with cues that described the environments in which hazards were likely to occur were more likely to demonstrate vehicle behaviors that were consistent with speed reductions (lower velocity, higher speed variability, and higher absolute acceleration) than were drivers who were presented general cues or cues about the identity of the upcoming hazards. ConclusionEven in as little as 4s prior to a potential hazard, cues that inform the driver of the environment in which the hazard is likely to occur increase the likelihood that the driver mitigates the crash compared with drivers who are provided general information or threat identity information.

Growth hormone therapy for people with thalassaemia.

Thalassaemia is a recessively-inherited blood disorder that leads to anaemia of varying severity. In those affected by the more severe forms, regular blood transfusions are required which may lead to iron overload. Accumulated iron from blood transfusions may be deposited in vital organs including the heart, liver and endocrine organs such as the pituitary glands which can affect growth hormone production. Growth hormone deficiency is one of the factors that can lead to short stature, a common complication in people with thalassaemia. Growth hormone replacement therapy has been used in children with thalassaemia who have short stature and growth hormone deficiency. To assess the benefits and safety of growth hormone therapy in people with thalassaemia. We searched the Cochrane Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We also searched the reference lists of relevant articles, reviews and clinical trial registries. Our database and trial registry searches are current to 10 August 2017 and 08 August 2017, respectively. Randomised and quasi-randomised controlled trials comparing the use of growth hormone therapy to placebo or standard care in people with thalassaemia of any type or severity. Two authors independently selected trials for inclusion. Data extraction and assessment of risk of bias were also conducted independently by two authors. The quality of the evidence was assessed using GRADE criteria. One parallel trial conducted in Turkey was included. The trial recruited 20 children with homozygous beta thalassaemia who had short stature; 10 children received growth hormone therapy administered subcutaneously on a daily basis at a dose of 0.7 IU/kg per week and 10 children received standard care. The overall risk of bias in this trial was low except for the selection criteria and attrition bias which were unclear. The quality of the evidence for all major outcomes was moderate, the main concern was imprecision of the estimates due to the small sample size leading to wide confidence intervals. Final height (cm) (the review's pre-specified primary outcome) and change in height were not assessed in the included trial. The trial reported no clear difference between groups in height standard deviation (SD) score after one year, mean difference (MD) -0.09 (95% confidence interval (CI) -0.33 to 0.15 (moderate quality evidence). However, modest improvements appeared to be observed in the following key outcomes in children receiving growth hormone therapy compared to control (moderate quality evidence): change between baseline and final visit in height SD score, MD 0.26 (95% CI 0.13 to 0.39); height velocity, MD 2.28 cm/year (95% CI 1.76 to 2.80); height velocity SD score, MD 3.31 (95% CI 2.43 to 4.19); and change in height velocity SD score between baseline and final visit, MD 3.41 (95% CI 2.45 to 4.37). No adverse effects of treatment were reported in either group; however, while there was no clear difference between groups in the oral glucose tolerance test at one year, fasting blood glucose was significantly higher in the growth hormone therapy group compared to control, although both results were still within the normal range, MD 6.67 mg/dL (95% CI 2.66 to 10.68). There were no data beyond the one-year trial period. A small single trial contributed evidence of moderate quality that the use of growth hormone for a year may improve height velocity of children with thalassaemia although height SD score in the treatment group was similar to the control group. There are no randomised controlled trials in adults or trials that address the use of growth hormone therapy over a longer period and assess its effect on final height and quality of life. The optimal dosage of growth hormone and the ideal time to start this therapy remain uncertain. Large well-designed randomised controlled trials over a longer period with sufficient duration of follow up are needed.

Validating precision estimates in horizontal wind measurements from a Doppler lidar

Abstract. Results from a recent field campaign are used to assess the accuracy of wind speed and direction precision estimates produced by a Doppler lidar wind retrieval algorithm. The algorithm, which is based on the traditional velocity-azimuth-display (VAD) technique, estimates the wind speed and direction measurement precision using standard error propagation techniques, assuming the input data (i.e., radial velocities) to be contaminated by random, zero-mean, errors. For this study, the lidar was configured to execute an 8-beam plan-position-indicator (PPI) scan once every 12 min during the 6-week deployment period. Several wind retrieval trials were conducted using different schemes for estimating the precision in the radial velocity measurements. The resulting wind speed and direction precision estimates were compared to differences in wind speed and direction between the VAD algorithm and sonic anemometer measurements taken on a nearby 300 m tower.All trials produced qualitatively similar wind fields with negligible bias but substantially different wind speed and direction precision fields. The most accurate wind speed and direction precisions were obtained when the radial velocity precision was determined by direct calculation of radial velocity standard deviation along each pointing direction and range gate of the PPI scan. By contrast, when the instrumental measurement precision is assumed to be the only contribution to the radial velocity precision, the retrievals resulted in wind speed and direction precisions that were biased far too low and were poor indicators of data quality.

Numerical Analysis of a Compressor Type of Dehumidifier: (I) Fluid Flow

A three-dimensional simulation of a compressor dehumidifier was conducted by applying a porous model for condenser and evaporator, and a moving reference frame for the fan. A physical model was simulated for the unit cell of the actual shape of a fin-tube, and the parameters of viscous resistance and initial resistance were obtained. With these values, the porous model showed close agreement with the physical model within a reasonable computation time. A uniform flow across the evaporator and the condenser is desirable for high performance of the dehumidifier. Surface averaged velocity, standard deviation of velocity, and uniformity were chosen as indicators of the design object. A case study showed that two factors, (i) reducing the space between the evaporator and the condenser and (ii) introducing a cover to reduce the by-passing air flow, have the strongest influence on the air distribution in this dehumidifier.

A RCT comparing lumbosacral orthosis to routine physical therapy on postural stability in patients with chronic low back pain.

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain. However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute to chronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacral orthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain. Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapy clinic of the School of Rehabilitation Sciences. Patients with nonspecific chronic low back pain aged 20 to 55 years were randomly allocated to the intervention and control groups. Both groups received 8 sessions of physical therapy twice weekly for 4 weeks. The intervention group received nonextensible LSO in addition to routine physical therapy. Pain intensity, functional disability, fear of movement/ (re)injury, and postural stability in 3 levels of postural difficulty were measured before and after 4 weeks of intervention. A 2×2×3 mixed model of analysis of variance (ANOVA) was used to determine the main and interactive effects of the 3 factors including group, time, and postural difficulty conditions for each variable of postural stability. Results: The LSO and control groups displayed significant improvement in postural stability at the most difficult postural task conditions (P-value for 95% area ellipse was 0.003; and for phase plane, the mean total velocity and standard deviation of velocity was <0.001). Both groups exhibited a decrease in pain intensity, Oswestry Disability Index, and Tampa Scale of Kinesiophobia after 4 weeks of intervention. A significant difference between groups was found only for functional disability, with greater improvement in the orthosis group (t = 3.60, P<0.001). Conclusion: Both routine physical therapy and LSO significantly improved clinical and postural stability outcomes immediately after 4 weeks of intervention. The orthosis group did not display superior outcomes, except for functional disability.

Effects of pomegranate extract in supplementing gonadotropin-releasing hormone therapy on idiopathic central precocious puberty in Chinese girls: a randomized, placebo-controlled, double-blind clinical trial.

Central precocious puberty (CPP) without organic abnormality is called idiopathic CPP (ICPP). The objective of this trial was to evaluate the effects of pomegranate extract in supplementing gonadotropin-releasing hormone (GnRH) analog therapy on ICPP-affected girls in the Chinese population. 286 girls, diagnosed with ICPP were initially enrolled into this trial, and among them 225 eligible patients were randomized to receive a combinational GnRH analog treatment supplemented with either a placebo or pomegranate extract on a daily basis for a period of 3 months. Their demographics, secondary sexual characteristics and hormone profiles were analyzed at baseline and end of trial. After 3 months of treatment, demographic profiles including bone age, growth velocity and height standard deviation score for bone age, and secondary sexual characteristics including uterus and ovary volume, as well as serum hormone profiles including estradiol, peak luteinizing hormone and insulin-like growth factor 1 were all significantly improved in girls receiving a combinational treatment of both GnRH analog and pomegranate extract. Daily consumption of pomegranate extract was able to supplement and improve the treatment outcomes of the GnRH analog therapy for ICPP in Chinese girls.

Balance evaluation in haemophilic preadolescent patients using Nintendo Wii Balance Board®.

Alterations in the musculoskeletal system, especially in the lower limbs, limit physical activity and affect balance and walking. Postural impairments in haemophilic preteens could increase the risk of bleeding events and deteriorate the physical condition, promoting the progression of haemophilic arthropathy. This study aims to evaluate static postural balance in haemophilic children, assessed by means of the Wii Balance Board® (WBB). Nineteen children with haemophilia and 19 without haemophilia aged 9-10 years, have participated in this study. Postural balance was assessed by performing four tests, each one lasting 15 s: bipodal eyes open (BEO), bipodal eyes closed (BEC), monopodal dominant leg (MD) and monopodal non-dominant leg (MND). Two balance indices, standard deviation of amplitude (SDA) and standard deviation of velocity (SDV) were calculated in the anterior-posterior (AP) and medial-lateral (ML) directions. Index values were higher in haemophilic group and the differences were statistically significant (P < 0.05) in only six (SDAAP in BEO, BEC and MD conditions, SDAML in BEO, SDVAP in BEO and SDVML in MND condition) of 16 parameters analysed. Tests performed indicate a poorer static postural balance in the haemophilic cohort compared to the control group. Accordingly, physiotherapy programmes, physical activity and sports should be designed to improve the postural balance with the aim of preventing joint deterioration and improving quality of life.

Between-leg differences in challenging single-limb balance performance one year following anterior cruciate ligament reconstruction

Following anterior cruciate ligament (ACL) rupture, reconstructive surgery (ALCR) is often performed to mechanically stabilise the knee, however functional deficits often persist long after surgery. Impaired single-limb standing balance has been observed in the ACLR limb compared to healthy individuals. However, it remains inconclusive as to whether these same balance deficits exist between the injured and contralateral uninjured limbs, during challenging balance tasks, and at a time when patients are permitted to return to sport. 100 adults who had undergone a primary hamstring-tendon ACLR 12 months previously (68 male; median[IQR] age: 28.1[14.1] years) performed tests of single-limb standing with the knee in a functional position of 20–30° flexion, with their eyes closed, over 20s (Nintendo Wii Balance Board). Two repetitions were performed on the ACLR and uninjured limb. Measures of postural control included centre of pressure (CoP) path velocity, anterior-posterior and mediolateral range and standard deviation, and were averaged across the two trials. Wilcoxon signed-rank tests showed no significant between-leg differences in single-limb balance for any of the CoP measures of interest (all P values>0.686). Further, multiple linear regression analyses showed no significant associations between concomitant meniscectomy or chondral lesions noted at the time of ACLR and measures of single-limb balance on the ACLR limb one year later (all P values>0.213). In the context of prior research, these findings suggest bilateral balance deficits may exist prior to ACL injury, or appear post ACL-injury or ACLR. Treatment of balance deficits should therefore consider both limbs after ACLR.

Long-term safety and efficacy of Omnitrope®, a somatropin biosimilar, in children requiring growth hormone treatment: Italian interim analysis of the PATRO Children study.

BackgroundPATRO Children is an ongoing observational, longitudinal, non-interventional, global post-marketing surveillance study, which is investigating the long-term safety and effectiveness of Omnitrope®, a somatropin biosimilar to Genotropin®, in children with growth disturbances. The primary endpoint of PATRO Children is long-term safety and the secondary endpoint is effectiveness, which is assessed by analysing auxological data such as height (HSDS) and height velocity (HVSDS) standard deviation scores. Here, we report the data from the Italian interim analysis of PATRO Children data up to August 2015.MethodsPATRO Children is enrolling children who are diagnosed with conditions of short stature requiring GH treatment and are receiving Omnitrope®. Adverse events (AEs) are assessed in all Omnitrope®-treated patients. Height is evaluated yearly to near-adult (final) height, and is herein reported as HSDS; height velocity is also assessed and reported as a standard deviation score (HVSDS).ResultsUp to August 2015, a total of 186 patients (mean age 10.2 years, 57.5 % males) were enrolled :156 [84 %] had growth hormone deficiency, 12 [6.5 %] were born small for gestational age, seven [3.8 %] had Prader-Willi syndrome, one [0.5 %] had Turner syndrome and one [0.5 %] had chronic renal insufficiency; seven [3.8 %] patients had other indication profiles. The mean treatment duration with Omnitrope® was 28.1 ± 19.1 months. AEs were reported in 35.6 % of patients and included headache, pyrexia, arthralgia, abdominal pain, leg and/or arm pain and increased blood creatine phosphokinase. Two serious AEs in two patients were thought to be drug-related; one patient experienced a minimal increase in a known residual craniopharyngioma, and another a gait disturbance with worsening of walking difficulties. Similar to investigational studies, Omnitrope® treatment was associated with improvements in both HSDS and HVSDS.ConclusionsOmnitrope® appears to be well tolerated and effective for the treatment of a wide range of paediatric indications, which is consistent with the outcomes from controlled clinical trials. These results need to be interpreted with caution until the data from the global PATRO Children study are available.

Growth and Adult Height in Patients with Crohn's Disease Treated with Anti-Tumor Necrosis Factor α Antibodies.

Inflammation contributes to growth failure associated with inflammatory bowel diseases. Anti-TNFα therapy induces sustained remission and short-term improvements in height velocity and/or height standard deviation score (H-SDS) patients with Crohn’s disease. The purpose of this study was to evaluate growth and adult height in patients with Crohn’s disease taking maintenance infliximab or adalimumab therapy.This university-hospital based retrospective study included 61 patients, with a median follow-up of 2.6 years (2.0; 3.3). 38 patients (62%) reached their adult height. H-SDS was collected at diagnosis and together with disease activity markers (Harvey-Bradshaw Index, albumin, and C-reactive protein) at treatment initiation (baseline), and follow-up completion. Wilcoxon’s signed-rank test was chosen for comparisons. Median H-SDS decreased from diagnosis to baseline (-0.08 [-0.73; +0.77] to -0.94 [-1.44; +0.11], p<0.0001) and then increased to follow-up completion (-0.63 [-1.08; 0.49], p = 0.003 versus baseline), concomitantly with an improvement in disease activity. Median adult H-SDS was within the normal range (-0.72 [-1.25; +0.42]) but did not differ from baseline H-SDS and was significantly lower than the target H-SDS (-0.09 [-0.67; +0.42], p = 0.01). Only 2 (6%) males had adult heights significantly below their target heights (10.5 and -13.5 cm [-1.75 and -2.25 SD]). In conclusion, anti-tumor necrosis factor α (TNF) therapy prevented loss of height without fully restoring the genetic growth potential in this group of patients with CD. Earlier treatment initiation might improve growth outcomes in these patients.