Biomechanical evaluation of the push-up exercise of the upper extremities from various starting points

The purpose of the present research was to evaluate the push-up exercise of the upper extremities in respect of biomechanics, to compare the muscle function, while changing the position of performance and to examine the torso's inclination during the exercise. The result is that the activation of the muscles, apart from the triceps brachii muscle, does not differentiate significantly in any of the positions. Moreover, the elevating the hands above the feet position is not recommended in protocols where the aim is to improve the muscle force because it displays the lowest mean value of vertical force and a low RFD. On the other hand, the standard push-up position is considered to be the most appropriate when the aim is to improve the triceps brachii muscle's force because it displays the highest RFD and the highest activation of this muscle. Finally, the correct body position during this exercise prevents from incorrect and damaging inclinations of the torso. © JPES

Personal experience with whole-body, low-dosage, digital X-ray scanning (LODOX-Statscan) in trauma

<p>Abstract</p> <p>Background</p> <p>Lodox-Statscan is a whole-body, skeletal and soft-tissue, low-dose X-ray scanner Anterior-posterior and lateral thoraco-abdominal studies are obtained in 3-5 minutes with only about one-third of the radiation required for conventional radiography. Since its approval by the Food and Drug Administration (FDA) in the USA, several trauma centers have incorporated this technology into their Advanced Trauma Life Support protocols. This review provides a brief overview of the system, and describes the authors' own experience with the system.</p> <p>Methods</p> <p>We performed a PubMed search to retrieve all references with 'Lodox' and 'Stat-scan' used as search terms. We furthermore used the google search engine to identify existing alternatives. To the best of our knowledge, this is the only FDA-approved device of its kind currently used in trauma.</p> <p>Results and Conclusion</p> <p>The intention of our review has been to sensitize the readership that such alternative devices exist. The key message is that low dosage full body radiography may be an alternative to conventional resuscitation room radiography which is usually a prelude to CT scanning (ATLS algorithm). The combination of both is radiation intensive and therefore we consider any reduction of radiation a success. But only the future will show whether LS will survive in the face of low-dose radiation CT scanners and magnetic resonance imaging devices that may eventually completely replace conventional radiography.</p

A new approach in blade shape adjustment in PBD-14 design mode

Thesis (S.M. and Nav.E.)--Massachusetts Institute of Technology, Dept. of Ocean Engineering, 2001.Includes bibliographical references (leaves 68-70).The purpose of this study is to develop a more efficient and robust algorithm for adjusting the blade shape as a part of a coupled lifting-surface design/analysis code for marine propulsors developed at MIT, known as PBD-14. The algorithm for adjusting the blade shape in the current version of PBD-14 works satisfactorily in most cases. However, with more complex schemes such as ducted propulsors and/or higher load distributions, the process has to be carefully monitored by the user and the blade surface can develop corrugations in the spanwise direction. A different approach investigated in this study is based on an idea of aligning the blade shape by tracing streamlines. In order to satisfy the kinematic boundary condition, the final blade shape has to exactly match the streamlines of the flow field in which the propeller blade operates. The algorithm that is developed traces streamlines by calculating the total velocity on a grid of points and then exactly fits the blade on this grid of points. Initial tests of this algorithm have demonstrated its robustness by producing accurate blade shapes both in uniform and in more complicated flow fields. Finally, propeller fabrication is investigated, and tolerance issues as well as propeller inspection methods, traditional and modem, are examined. A cost analysis is performed that investigates the economic impact of manufacturing an example propeller according to a certain tolerance system.by Aristomenis Chrisospathis.S.M.and Nav.E

Accidental Hypothermia in a Swiss Alpine Trauma Centre-Not an Alpine Problem.

BACKGROUND Research in accidental hypothermia focuses on trauma patients, patients exposed to cold environments or patients after drowning but rarely on hypothermia in combination with intoxications or on medical or neurological issues. The aim of this retrospective single-centre cohort study was to define the aetiologies, severity and relative incidences of accidental hypothermia, methods of measuring temperature and in-hospital mortality. METHODS The study included patients ≥18 years with a documented body temperature ≤35 °C who were admitted to the emergency department (ED) of the University Hospital in Bern between 2000 and 2019. RESULTS 439 cases were included, corresponding to 0.32 per 1000 ED visits. Median age was 55 years (IQR 39-70). A total of 167 patients (38.0%) were female. Furthermore, 63.3% of the patients suffered from mild, 24.8% from moderate and 11.9% from severe hypothermia. Exposure as a single cause for accidental hypothermia accounted for 12 cases. The majority were combinations of hypothermia with trauma (32.6%), medical conditions (34.2%), neurological conditions (5.2%), intoxications (20.3%) or drowning (12.0%). Overall mortality was 22.3% and depended on the underlying causes, severity of hypothermia, age and sex

Bubbling AdS and droplet descriptions of BPS geometries in IIB supergravity

This paper focuses on supergravity duals of BPS states in N=4 super Yang-Mills. In order to describe these duals, we begin with a sequence of breathing mode reductions of IIB supergravity: first on S^3, then S^3 x S^1, and finally on S^3 x S^1 x CP^1. We then follow with a complete supersymmetry analysis, yielding 1/8, 1/4 and 1/2 BPS configurations, respectively (where in the last step we take the Hopf fibration of S^3). The 1/8 BPS geometries, which have an S^3 isometry and are time-fibered over a six-dimensional base, are determined by solving a non-linear equation for the Kahler metric on the base. Similarly, the 1/4 BPS configurations have an S^3 x S^1 isometry and a four-dimensional base, whose Kahler metric obeys another non-linear, Monge-Ampere type equation. Despite the non-linearity of the problem, we develop a universal bubbling AdS description of these geometries by focusing on the boundary conditions which ensure their regularity. In the 1/8 BPS case, we find that the S^3 cycle shrinks to zero size on a five-dimensional locus inside the six-dimensional base. Enforcing regularity of the full solution requires that the interior of a smooth, generally disconnected five-dimensional surface be removed from the base. The AdS_5 x S^5 ground state corresponds to excising the interior of an S^5, while the 1/8 BPS excitations correspond to deformations (including topology change) of the S^5 and/or the excision of additional droplets from the base. In the case of 1/4 BPS configurations, by enforcing regularity conditions, we identify three-dimensional surfaces inside the four-dimensional base which separate the regions where the S^3 shrinks to zero size from those where the S^1 shrinks.Comment: 94 pages, 6 figures, latex, typos corrected, references added, one new Appendi

Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms

Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number of minor and moderate injuries has reached crisis proportions, especially in the United Kingdom. Numerous efforts have been made to explore the complex causes because it is becoming more and more important to provide adequate healthcare within tight budgets. Optimisation of patient pathways in the emergency department is therefore an important factor

Improving prehospital trauma management for skiers and snowboarders - need for on-slope triage?

Background Injuries from skiing and snowboarding became a major challenge for emergency care providers in Switzerland. In the alpine setting, early assessment of injury and health status is essential for the initiation of adequate means of care and transport. Nevertheless, validated standardized protocols for on-slope triage are missing. This article can assist in understanding the characteristics of injured winter sportsmen and exigencies for future on-slope triage protocols. Methods Six-year review of trauma cases in a tertiary trauma centre. Consecutive inclusion of all injured skiers and snowboarders aged >15 (total sample) years with predefined, severe injury to the head, spine, chest, pelvis or abdomen (study sample) presenting at or being transferred to the study hospital. Descriptive analysis of age, gender and injury pattern. Results Amongst 729 subjects (total sample) injured from skiing or snowboarding, 401 (55%, 54% of skiers and 58% of snowboarders) suffered from isolated limb injury. Amongst the remaining 328 subjects (study sample), the majority (78%) presented with monotrauma. In the study sample, injury to the head (52%) and spine (43%) was more frequent than injury to the chest (21%), pelvis (8%), and abdomen (5%). The three most frequent injury combinations were head/spine (10% of study sample), head/thorax (9%), and spine/thorax (6%). Fisher's exact test demonstrated an association for injury combinations of head/thorax (p < 0.001), head/abdomen (p = 0.019), and thorax/abdomen (p < 0.001). Conclusion The data presented and the findings from previous investigations indicate the need for development of dedicated on-slope triage protocols. Future research must address the validity and practicality of diagnostic on-slope tests for rapid decision making by both professional and lay first responders. Thus, large-scale and detailed injury surveillance is the future research priority

Visually estimated ejection fraction by two dimensional and triplane echocardiography is closely correlated with quantitative ejection fraction by real-time three dimensional echocardiography

<p>Abstract</p> <p>Background</p> <p>Visual assessment of left ventricular ejection fraction (LVEF) is often used in clinical routine despite general recommendations to use quantitative biplane Simpsons (BPS) measurements. Even thou quantitative methods are well validated and from many reasons preferable, the feasibility of visual assessment (eyeballing) is superior. There is to date only sparse data comparing visual EF assessment in comparison to quantitative methods available. The aim of this study was to compare visual EF assessment by two-dimensional echocardiography (2DE) and triplane echocardiography (TPE) using quantitative real-time three-dimensional echocardiography (RT3DE) as the reference method.</p> <p>Methods</p> <p>Thirty patients were enrolled in the study. Eyeballing EF was assessed using apical 4-and 2 chamber views and TP mode by two experienced readers blinded to all clinical data. The measurements were compared to quantitative RT3DE.</p> <p>Results</p> <p>There were an excellent correlation between eyeballing EF by 2D and TP vs 3DE (r = 0.91 and 0.95 respectively) without any significant bias (-0.5 ± 3.7% and -0.2 ± 2.9% respectively). Intraobserver variability was 3.8% for eyeballing 2DE, 3.2% for eyeballing TP and 2.3% for quantitative 3D-EF. Interobserver variability was 7.5% for eyeballing 2D and 8.4% for eyeballing TP.</p> <p>Conclusion</p> <p>Visual estimation of LVEF both using 2D and TP by an experienced reader correlates well with quantitative EF determined by RT3DE. There is an apparent trend towards a smaller variability using TP in comparison to 2D, this was however not statistically significant.</p

Partial tetraplegic syndrome as a complication of a mobilizing/manipulating procedure of the cervical spine in a man with Forestier's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Even if performed by qualified physical therapists, spinal manipulation and mobilization can cause adverse events. This holds true particularly for the cervical spine. In light of the substantial risks, the benefits of cervical spine manipulation may be outweighed by the possibility of further injury.</p> <p>Case presentation</p> <p>We present the case of a 56-year-old Caucasian man with Forestier's disease who went to see a physiotherapist to relieve his aching neck while on a holiday trip. Following the procedure, he was transferred to a local hospital with a partial tetraplegic syndrome due to a cervical 6/7 luxation fracture. Reportedly, the physiotherapist took neither a detailed history, nor adequate diagnostic measures.</p> <p>Conclusions</p> <p>This case highlights the potentially dangerous complications associated with cervical spine mobilization/manipulation. If guidelines concerning cervical spine mobilization and manipulation practices had been followed, this adverse event could have been avoided.</p