These results confirm the utility and applicability of the system. It is currently in redesign to improve accuracy and to render it compatible with on-line planning.

Background: Previous studies have not shown a correlation between knuckle cracking (KC) and hand osteoarthritis (OA). However, one study showed an inverse correlation between KC and metacarpophalangeal joint OA.Methods: We conducted a retrospective case-control study among persons aged 50 to 89 years who received a radiograph of the right hand during the last 5 years. Patients had radiographically proven hand OA, and controls did not. Participants indicated frequency, duration, and details of their KC behavior and known risk factors for hand OA.Results: The prevalence of KC among 215 respondents (135 patients, 80 controls) was 20%. When examined in aggregate, the prevalence of OA in any joint was similar among those who crack knuckles (18.1%) and those who do not (21.5%; P ‫؍‬ .548). When examined by joint type, KC was not a risk for OA in that joint. Total past duration (in years) and volume (daily frequency ؋ years) of KC of each joint type also was not significantly correlated with OA at the respective joint.Conclusions: A history of habitual KC-including the total duration and total cumulative exposuredoes not seem to be a risk factor for hand OA. (J Am Board Fam Med 2011;24:169 -174.)

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We prove the existence of the reflected diffusion on a complex of an arbitrary size for a large class of planar simple nested fractals. Such a process is obtained as a folding projection of the free Brownian motion from the unbounded fractal. We give sharp necessary geometric conditions on the fractal under which this projection can be well defined. They are illustrated by various specific examples. We first construct a proper version of the transition probability densities for reflected process and we prove that it is a continuous, bounded and symmetric function which satisfies the Chapman-Kolmogorov equations. These provide us with further regularity properties of the reflected process such us Markov, Feller and strong Feller property