Lasting effects of workplace strength training for neck/shoulder/arm pain among laboratory technicians:Natural experiment with 3-year follow-up

Objectives. This study investigated long-term effects and implementation processes of workplace strength training for musculoskeletal disorders. Methods. 333 and 140 laboratory technicians from private and public sector companies, respectively, replied to a 3-year follow-up questionnaire subsequent to a 1-year randomized controlled trial (RCT) with high-intensity strength training for prevention and treatment of neck, shoulder, and arm pain. Being a natural experiment, the two participating companies implemented and modified the initial training program in different ways during the subsequent 2 years after the RCT. Results. At 3-year follow-up the pain reduction in neck, shoulder, elbow, and wrist achieved during the first year was largely maintained at both companies. However, the private sector company was rated significantly better than the public sector company in (1) training adherence, (2) training culture, that is, relatively more employees trained at the workplace and with colleagues, (3) self-reported health changes, and (4) prevention of neck and wrist pain development among initially pain-free employees. Conclusions. This natural experiment shows that strength training can be implemented successfully at different companies during working hours on a long-term basis with lasting effects on pain in neck, shoulder, and arm

High levels of soluble VEGF receptor 1 early after trauma are associated with shock, sympathoadrenal activation, glycocalyx degradation and inflammation in severely injured patients: a prospective study

<p>Abstract</p> <p>Background</p> <p>The level of soluble vascular endothelial growth factor receptor 1 (sVEGFR1) is increased in sepsis and strongly associated with disease severity and mortality. Endothelial activation and damage contribute to both sepsis and trauma pathology. Therefore, this study measured sVEGFR1 levels in trauma patients upon hospital admission hypothesizing that sVEGFR1 would increase with higher injury severity and predict a poor outcome.</p> <p>Methods</p> <p>Prospective observational study of 80 trauma patients admitted to a Level I Trauma Centre. Data on demography, biochemistry, Injury Severity Score (ISS), transfusions and 30-day mortality were recorded and plasma/serum (sampled a median of 68 min (IQR 48-88) post-injury) was analyzed for sVEGFR1 and biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), tissue injury (histone-complexed DNA fragments, hcDNA), endothelial activation and damage (von Willebrand Factor Antigen, Angiopoietin-2, soluble endothelial protein C receptor, syndecan-1, soluble thrombomodulin (sTM)), coagulation activation/inhibition and fibrinolysis (prothrombinfragment 1 + 2, protein C, activated Protein C, tissue-type plasminogen activator, plasminogen activator inhibitor-1, D-dimer) and inflammation (interleukin-6). Spearman correlations and regression analyses to identify variables associated with sVEGFR1 and its predictive value.</p> <p>Results</p> <p>Circulating sVEGFR1 correlated with injury severity (ISS, rho = 0.46), shock (SBE, rho = -0.38; adrenaline, rho = 0.47), tissue injury (hcDNA, rho = 0.44) and inflammation (IL-6, rho = 0.54) (all p < 0.01) but by multivariate linear regression analysis only lower SBE and higher adrenaline and IL-6 were independent predictors of higher sVEGFR1. sVEGFR1 also correlated with biomarkers indicative of endothelial glycocalyx degradation (syndecan-1, rho = 0.67), endothelial cell damage (sTM, rho = 0.66) and activation (Ang-2, rho = 0.31) and hyperfibrinolysis (tPA, rho = 0.39; D-dimer, rho = 0.58) and with activated protein C (rho = 0.31) (all p < 0.01). High circulating sVEGFR1 correlated with high early and late transfusion requirements (number of packed red blood cells (RBC) at 1 h (rho = 0.27, p = 0.016), 6 h (rho = 0.27, p = 0.017) and 24 h (rho = 0.31, p = 0.004) but was not associated with mortality.</p> <p>Conclusions</p> <p>sVEGFR1 increased with increasing injury severity, shock and inflammation early after trauma but only sympathoadrenal activation, hypoperfusion, and inflammation were independent predictors of sVEGFR1 levels. sVEGFR1 correlated strongly with other biomarkers of endothelial activation and damage and with RBC transfusion requirements. Sympathoadrenal activation, shock and inflammation may be critical drivers of endothelial activation and damage early after trauma.</p

The Early Expansion of Cluster Cores

The observed properties of young star clusters, such as the core radius and luminosity profile, change rapidly during the early evolution of the clusters. Here we present observations of 6 young clusters in M51 where we derive their sizes using HST imaging and ages using deep Gemini-North spectroscopy. We find evidence for a rapid expansion of the cluster cores during the first 20 Myr of their evolution. We confirm this trend by including data from the literature of both Galactic and extra-galactic embedded and young clusters, and possible mechanisms (rapid gas removal, stellar evolutionary mass-loss, and internal dynamical heating) are discussed. We explore the implications of this result, focussing on the fact that clusters were more concentrated in the past, implying that their stellar densities were much higher and relaxation times correspondingly shorter. Thus, when estimating if a particular cluster is dynamically relaxed, (i.e. when determining if a cluster's mass segregation is due to primordial or dynamical processes), the current relaxation time is only an upper-limit, with the relaxation time likely being significantly shorter in the past.Comment: 9 pages, 5 figures, accepted MNRA

Strange metals and the AdS/CFT correspondence

I begin with a review of quantum impurity models in condensed matter physics, in which a localized spin degree of freedom is coupled to an interacting conformal field theory in d = 2 spatial dimensions. Their properties are similar to those of supersymmetric generalizations which can be solved by the AdS/CFT correspondence; the low energy limit of the latter models is described by a AdS2 geometry. Then I turn to Kondo lattice models, which can be described by a mean- field theory obtained by a mapping to a quantum impurity coupled to a self-consistent environment. Such a theory yields a 'fractionalized Fermi liquid' phase of conduction electrons coupled to a critical spin liquid state, and is an attractive mean-field theory of strange metals. The recent holographic description of strange metals with a AdS2 x R2 geometry is argued to be related to such mean-field solutions of Kondo lattice models.Comment: 19 pages, 4 figures; Plenary talk at Statphys24, Cairns, Australia, July 2010; (v2) added refs; (v3) more ref