Measurement of abdominal muscle thickness using ultrasound: A reliability study on patients with chronic nonspecific low back pain

Background and purpose: The purpose of this study was to assess the Within-day and Between-days reliability of abdominal muscles size measurement in patients with chronic non-specific low back pain (LBP) using ultrasound (US). Materials and methods: In this study, 15 patients with chronic non-specific LBP (20-50 years old) were recruited. The reliability of the abdominal muscle size (External and Internal oblique, and Transversus abdominis) was assessed in a relaxed and contraction state by a real time US. Two images were taken on the same day with an hour interval to assess the within day reliability and the third image was taken a week later to determine the between- days reliability. Results: Within-day and between-days reliability of abdominal muscles thickness measurements using US in patients with nonspecific chronic LBP in both rest and contraction state found to be high, ICC = 0.90 for within and ICC=0.85 for between-days of Transversus abdominis muscle in rest state and ICC= 0.82 and 0.86 in contraction state, respectively. For Internal oblique muscle, ICC=0.90 (82) and ICC=0.88 (88) were found for within-day and between-days in rest and contraction state, respectively. Within-day and between-days reliability at rest of ICC=0.86 (79) and in contraction state of ICC=0.79 (75) were demonstrated for External Oblique muscle. Conclusion: Results of the present study suggest US as a reliable method to evaluate the thickness of the abdominal muscles which could be used as a reliable tool in the assessment of patients and also in evaluating the effect of different therapeutic interventions. © 2015, Mazandaran University of Medical Sciences. All rights reserved

Circadian rest-activity rhythms predict cognitive function in early Parkinson's disease independently of sleep

BACKGROUND: Cognitive impairment is a common and debilitating symptom of Parkinson's disease (PD), and its etiology is likely multifactorial. One candidate mechanism is circadian disruption. Although there is evidence of circadian abnormalities in PD, no studies have directly assessed their association with cognitive impairment. OBJECTIVES: Investigate whether circadian rest-activity rhythm is associated with cognitive function in PD independently of sleep. METHODS: Thirty-five participants with PD wore wrist actigraph monitors and completed sleep diaries for 7 to 10 days, then underwent neuropsychological testing. Rest-activity rhythm was characterized using nonparametric circadian rhythm analysis of actigraphy data. Objective sleep parameters were also estimated using actigraphy data. Hierarchical regression models assessed the independent contributions of sleep and rest-activity rhythm to cognitive performance. RESULTS: Less stable day-to-day rest-activity rhythm was associated with poorer executive, visuospatial, and psychomotor functioning, but not with memory. Hierarchical regressions showed that interdaily stability's contribution to cognitive performance was independent of sleep's contributions. Whereas sleep contributed to executive function, but not psychomotor or visuospatial performance, rest-activity rhythm stability significantly contributed to variance in all three of these domains, uniquely accounting for 14.4% to 17.6% of their performance variance. CONCLUSIONS: Our findings indicate that circadian rest-activity rhythm is associated with cognitive impairment independently of sleep. This suggests the possible utility of rest-activity rhythm as a biomarker for circadian function in PD. Future research should explore interventions to stabilize behavioral rhythms in order to strengthen circadian function, which, in turn, may reduce cognitive impairment in PD.R00 HL102241 - NHLBI NIH HHS; R01 AG048108 - NIA NIH HHSAccepted manuscrip

Assessment of poststress left ventricular ejection fraction by gated SPECT: comparison with equilibrium radionuclide angiocardiography

PURPOSE: We compared left ventricular (LV) ejection fraction obtained by gated SPECT with that obtained by equilibrium radionuclide angiocardiography in a large cohort of patients. METHODS: Within 1 week, 514 subjects with suspected or known coronary artery disease underwent same-day stress-rest (99m)Tc-sestamibi gated SPECT and radionuclide angiocardiography. For both studies, data were acquired 30 min after completion of exercise and after 3 h rest. RESULTS: In the overall study population, a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.82, p<0.0001) and after stress (r=0.83, p<0.0001). In Bland-Altman analysis, the mean differences in ejection fraction (radionuclide angiocardiography minus gated SPECT) were -0.6% at rest and 1.7% after stress. In subjects with normal perfusion (n=362), a good correlation between ejection fraction measured by gated SPECT and by radionuclide angiocardiography was observed at rest (r=0.72, p<0.0001) and after stress (r=0.70, p<0.0001) and the mean differences in ejection fraction were -0.9% at rest and 1.4% after stress. Also in patients with abnormal perfusion (n=152), a good correlation between the two techniques was observed both at rest (r=0.89, p<0.0001) and after stress (r=0.90, p<0.0001) and the mean differences in ejection fraction were 0.1% at rest and 2.5% after stress. CONCLUSION: In a large study population, a good agreement was observed in the evaluation of LV ejection fraction between gated SPECT and radionuclide angiocardiography. However, in patients with perfusion abnormalities, a slight underestimation in poststress LV ejection fraction was observed using gated SPECT as compared to equilibrium radionuclide angiocardiography

The Whalesong

To build or not to build: Juneau debates linking to the rest of the world -- Textbook Mafia? Prices increased 62 percent since 1994 -- Campus calendar -- Board of Regents announce new technology certificates -- UAS receives a high grade as a regional university -- Finding illiteracy in school parking -- Capitalism's constitutional contradiction -- Juneau colliding with a space station -- New shop opens to connect community to art of knitting -- An article on human language -- Loss of American pride worries advice seeker -- Do you know St. Patrick? -- St Urho's Day or a beer day

Changes in lower extremity muscle function after 56 days of bed rest

Preservation of muscle function, known to decline in microgravity and simulation (bed rest), is important for successful spaceflight missions. Hence, there is great interest in developing interventions to prevent musclefunction loss. In this study, 20 males underwent 56 days of bed rest. Ten volunteers were randomized to do resistive vibration exercise (RVE). The other 10 served as controls. RVE consisted of muscle contractions against resistance and concurrent whole-body vibration. Main outcome parameters were maximal isometric plantar-flexion force (IPFF), electromyography (EMG)/force ratio, as well as jumping power and height. Measurements were obtained before and after bed rest, including a morning and evening assessment on the first day of recovery from bed rest. IPFF (-17.1%), jumping peak power (-24.1%), and height (-28.5%) declined (P < 0.05) in the control group. There was a trend to EMG/force ratio decrease (-20%; P < 0.051). RVE preserved IPFF and mitigated the decline of countermovement jump performance (peak power -12.2%; height -14.2%). In both groups, IPFF was reduced between the two measurements of the first day of reambulation. This study indicates that bed rest and countermeasure exercises differentially affect the various functions of skeletal muscle. Moreover, the time course during recovery needs to be considered more thoroughly in future studies, as IPFF declined not only with bed rest but also within the first day of reambulation. RVE was effective in maintaining IPFF but only mitigated the decline in jumping performance. More research is needed to develop countermeasures that maintain muscle strength as well as other muscle functions including power

Epigenetic regulation of Mash1 expression

Mash1 is a proneural gene important for specifying the neural fate. The Mash1 locus undergoes specific epigenetic changes in ES cells following neural induction. These include the loss of repressive H3K27 trimethylation and acquisition of H3K9 acetylation at the promoter, switch to an early replication timing and repositioning of the locus away from the nuclear periphery. Here I examine the relationship between nuclear localization and gene expression during neural differentiation and the role of the neuronal repressor REST in silencing Mash1 expression in ES cells. Following neural induction of ES cells, I observed that relocation of the Mash1 locus occurs from day 4-6 whereas overt expression begins at day 6. Mash1 expression was unaffected by REST removal in ES cells as well as the locus localization at the nuclear periphery. In contrast bona fide REST target genes were upregulated in REST -/- cells. Interestingly, among REST targets, loci that were more derepressed upon REST removal showed an interior location (Sthatmin, Synaptophysin), while those more resistant to REST withdrawal, showed a peripheral location (BDNF, Calbidin, Complexin). To ask whether the insulator protein CTCF together with the cohesin complex might be involved in regulating Mash1 in ES cells, I performed ChIP analysis of CTCF and cohesin binding across the Mash1 locus in ES cells and used RNAi to deplete CTCF and cohesin expression. A slight increase in the transcription of Mash1 was seen in cells upon Rad21 knock down, although it was not possible to exclude this was a consequence of delayed cell cycle progression. Finally ES cell lines that carried a Mash1 transgene were created as a tool to look at whether activation of Mash1 can affect the epigenetic properties of neighbouring genes

Joint US/USSR study: Comparison of effects of horizontal and head-down bed rest

An account is given of the results of the first joint U.S./U.S.S.R. bed rest study. The study was accomplished in two parts: A soviet part (May to June 1979) and an American part (July to August 1979). Both studies were conducted under identical conditions and provided a basis for comparison of physiologic reactions and standardizing procedures and methods. Each experiment consisted of three periods: 14 days of pre-bed rest control, 7 days of bed rest, and a 10 to 14 day recovery period. Ten males participated in each study, with five subjects experiencing horizontal bed rest and five subjects a -6 deg head-down body position. Biochemical and hormonal measurements were made of blood and urine, with particular attention to electrolyte metabolism and kidney function; cardio-pulmonary changes at rest and exercise; influence of Lower Body Negative Pressure (LBNP); and incremental exercise using a bicyle ergometer while supine and sitting. Expected moderate changes were noted to occur for various physiologic parameters. Clinical evidence pointed to the fact that head-down bed rest when compared to horizontal conditions more closely matched the conditions seen after manned spaceflight. For the most part, statistically significant differences between the two body positions were not observed

Downsizing of acute inpatient beds associated with private finance initiative: Scotland's case study

OBJECTIVES: To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotland. DESIGN: Comparison of projected and actual trends in acute bed capacity and inpatient and day case admissions in the first five years (1995-6 to 2000-1) of Lothian Health Board's integrated healthcare plan. Population study of trends in bed rate, hospital activity, length of stay, and throughput in Lothian hospitals compared with the rest of Scotland from 1990-1 to 2000-1. MAIN OUTCOME MEASURES: Staffed bed rates, admission rates, mean lengths of stay, occupancy, and throughput in four adult acute specialty groups in 1990-1, 1995-6, and 2000-1. RESULTS: By 2000-1, rates for inpatient admission in all acute, medical, surgical, and intensive therapy specialties in Lothian hospitals were respectively 20%, 6%, 28%, and 38% below those in the rest of Scotland. Day case rates in all acute and acute surgical specialties were 13% and 33% lower. The proportion of delayed discharges in staffed acute and post-acute NHS beds in Lothian hospitals exceeded the Scottish average (15% and 12% respectively; P&#60;0.001). CONCLUSION: The planning targets and increase in clinical activity in acute specialties in Lothian hospitals associated with PFI had not been achieved by 2000-1. The effect on clinical activity has been a steeper decline in the number of acute beds and rates of admission in Lothian hospitals compared with the rest of Scotland between 1995-6 and 2000-1

Has world poverty really fallen during the 1990s?

We evaluate the claim that world consumption poverty has fallen during the 1990s in light of alternative assumptions about the extent of initial poverty and the rate of subsequent poverty reduction in China, India, and the rest of the developing world. We assess the extent of poverty using two indicators: the aggregate poverty headcount and the poverty headcount ratio, and consider two international poverty lines that are widely used ($1.08/day and$2.15/day 1993 PPP). We find that under some of the assumptions considered, world poverty has risen. We conclude that, because of uncertainties in relation to the extent and trend of poverty in China, India, and the rest of the developing world, world poverty may or may not have increased. The extent of the increase or decrease in world poverty is critically dependent on the assumptions made. Our conclusions suggest the importance of improving the quality of global poverty statistics.world poverty, sensitivity analysis, China, India