Determination of the Functional Relationship Between Lumbar Lordosis and Pelvic Tilt

Americans are undergoing spinal fusion surgery (SFS) at an ever increasing rate; in 2008 over 400,000 Americans underwent SFS with a national cost of approximately $33.9 billion. During SFS it is difficult for the surgeon to properly align the spine’s s-shape, as viewed from the patient’s side. Abnormal alignment of the spine then alters the position of the pelvis and hip joints, which may impact the function and hip contact patterns. Several studies have shown that patients with spinal pathology, such as arthritis, often have a coexisting hip pathology or subsequently develop hip pathology, and it is estimated that 18% of individuals undergoing total hip arthroplasty (THA) have concurrently developed a lumbar spine disorder. If the THA patient then undergoes SFS, any abnormal alignment of the spine can then impact the function and survivorship of the THA. The goal of this study was to examine the influence of altered sagittal lumbar lordosis on sagittal pelvis kinematics during activities of daily living including gait, sit-to-stand, and standto-sit. We hypothesized that a subject would compensate an altered lumbar lordosis by manipulating their pelvic tilt and torso alignment to maintain a normal plumbline. To investigate this hypothesis 10 healthy subjects (6 female, 4 male), aged 18-35 years, with no back, spine, or lower extremity injuries or surgeries were evaluated during static stance, gait, sit-to-stand, and stand-to-sit. Subjects performed activities in a 3-D motion analysis lab, with and without the use of a hyper-tensioned clavicle strap. An EOS bi-planar x-ray system was used to validate marker placement, as well as spinal and pelvic changes induced by the hypertension clavicle strap. Each subject also underwent a standard physical therapy exam to determine any functional limitations or abnormalities. Subjects were then evaluated in a paired fashion. Changes in pelvic tilt and hip flexion were correlated to changes in lumbar lordosis, plumbline, and trunk-pelvic angle. When different groups were present, the statistical coincidence of each linear regression was tested. For each condition a Wilcoxon signed-rank test was used to determine if each of the aforementioned parameters significantly changed from normal. This study found that decreasing lumbar lordosis by (mean ± SD) 4 ± 2 deg during gait did not significantly alter pelvic tilt. However, subjects with clinically tight hamstrings responded significantly different to a hyper-tensioned clavicle strap. Similarly, -5 to 9 deg change in lumbar lordosis did not correlate with changes in pelvic tilt during sit-to-stand or stand-to-sit activities. Changes in plumbline were found to be the best predictor for changes in pelvic tilt at peak hip flexion during stand-to-sit and sit-to-stand activities, exhibiting a nearly 1:1 relationship

Current and Future Issues in the Development of Spinal Agents for the Management of Pain.

Targeting analgesic drugs for spinal delivery reflects the fact that while the conscious experience of pain is mediated supraspinally, input initiated by high intensity stimuli, tissue injury and/or nerve injury is encoded at the level of the spinal dorsal horn and this output informs the brain as to the peripheral environment. This encoding process is subject to strong upregulation resulting in hyperesthetic states and downregulation reducing the ongoing processing of nociceptive stimuli reversing the hyperesthesia and pain processing. The present review addresses the biology of spinal nociceptive processing as relevant to the effects of intrathecally-delivered drugs in altering pain processing following acute stimulation, tissue inflammation/injury and nerve injury. The review covers i) the major classes of spinal agents currently employed as intrathecal analgesics (opioid agonists, alpha 2 agonists; sodium channel blockers; calcium channel blockers; NMDA blockers; GABA A/B agonists; COX inhibitors; ii) ongoing developments in the pharmacology of spinal therapeutics focusing on less studied agents/targets (cholinesterase inhibition; Adenosine agonists; iii) novel intrathecal targeting methodologies including gene-based approaches (viral vectors, plasmids, interfering RNAs); antisense, and toxins (botulinum toxins; resniferatoxin, substance P Saporin); and iv) issues relevant to intrathecal drug delivery (neuraxial drug distribution), infusate delivery profile, drug dosing, formulation and principals involved in the preclinical evaluation of intrathecal drug safety

Concert recording 2014-12-06

[Track 01]. Sonata in E minor BWV 1034. Adagio ma non troppo ; [Track 02]. Allegro ; [Track 03]. Andante ; [Track 04]. Allegro / Johann Sebastian Bach -- [Track 05]. Sunstreams / Ian Clarke -- [Track 06]. Tango etude no. 4 / Astor Piazolla -- [Track 07]. Le tour de danse (part one). El canto del toreo ; [Track 08]. Baiao de Brazil ; [Track 09]. The Orient ; [Track 10]. Americana ; [Track 11]. An Irish gigue ; [Track 12]. El tango de Argentina / Anthony J. King

UNL’s Wiley Journal Downloads: 2014-2020

Because the field of librarianship has been examining its relationship to commercial academic publishers and their \u27Big Deal\u27 journal packages, the authors elected to examine one such package, Wiley\u27s. The authors\u27 hoped to determine whether the University of Nebraska-Lincoln\u27s usage was concentrated enough and consistent enough over a multi-year interval for download data to be useful in identifying journals for hypothetical individual subscriptions or for inclusion in a hypothetical smaller, UNL-specific package

Predicting Perceived Age: Both Language Ability and Appearance are Important

When interacting with robots in a situated spoken dialogue setting, human dialogue partners tend to assign anthropomorphic and social characteristics to those robots. In this paper, we explore the age and educational level that human dialogue partners assign to three different robotic systems, including an un-embodied spoken dialogue system. We found that how a robot speaks is as important to human perceptions as the way the robot looks. Using the data from our experiment, we derived prosodic, emotional, and linguistic features from the participants to train and evaluate a classifier that predicts perceived intelligence, age, and education level

Wiley Journal Package: UNL Download Activity by Subject

Because the field of librarianship has been reconsidering its relationship to commercial academic publishers and their \u27Big Deal\u27 journal packages, the authors decided to review the University of Nebraska-Lincoln\u27s usage of Wiley\u27s package. In this report, the authors looked into whether UNL\u27s downloads by subject were such that subscribing to a number of hypothetical smaller, subject-specific packages, rather than to the entire Wiley package, might be a viable strategy

Using Music to LearnGeomorphology:An UndergraduateExperience

As an alternative to traditional upper-level physical geography pedagogy (labs, quizzes, tests, papers, and occasional field exercises), this article outlines and analyzes a 10-week large-group research endeavor conceived and executed by undergraduates where they explored aspects of project construction, methods, analyses, and group dynamics. These experiences are then critiqued from both instructor- and student-based perspectives. We suggest that pedagogies linking physical geography and traditional humanities disciplines should not be overlooked, especially in physical geography-based courses, as they can expose students to high-level thinking skills such as: not limiting research projects to quantitative observations in a natural setting; implementing a student-friendly medium; putting into practice the (sometimes dryly-delivered) geomorphologic content. Additionally, we note that fostering humanities-science inquiry can enhance students’ overall learning, while encompassing an upper-division class’ primary focus of providing meaningful (to them) research experiences and generate crucial connections when applying knowledge to higher-level professional and academic research

Emergency Department Pain Management Following Implementation of a Geriatric Hip Fracture Program

Introduction: Over 300,000 patients in the United States sustain low-trauma fragility hip fractures annually. Multidisciplinary geriatric fracture programs (GFP) including early, multimodal pain management reduce morbidity and mortality. Our overall goal was to determine the effects of a GFP on the emergency department (ED) pain management of geriatric fragility hip fractures. Methods: We performed a retrospective study including patients age ≥65 years with fragility hip fractures two years before and two years after the implementation of the GFP. Outcomes were time to (any) first analgesic, use of acetaminophen and fascia iliaca compartment block (FICB) in the ED, and amount of opioid medication administered in the first 24 hours. We used permutation tests to evaluate differences in ED pain management following GFP implementation. Results: We studied 131 patients in the pre-GFP period and 177 patients in the post-GFP period. In the post-GFP period, more patients received FICB (6% vs. 60%; difference 54%, 95% confidence interval [CI] 45–63%; p<0.001) and acetaminophen (10% vs. 51%; difference 41%, 95% CI 32–51%; p<0.001) in the ED. Patients in the post-GFP period also had a shorter time to first analgesic (103 vs. 93 minutes; p=0.04) and received fewer morphine equivalents in the first 24 hours (15mg vs. 10mg, p<0.001) than patients in the pre-GFP period. Conclusion: Implementation of a GFP was associated with improved ED pain management for geriatric patients with fragility hip fractures. Future studies should evaluate the effects of these changes in pain management on longer-term outcomes

Multimessenger Approaches to Supermassive Black Hole Binary Detection and Parameter Estimation II: Optimal Strategies for a Pulsar Timing Array

Pulsar timing arrays (PTAs) are Galactic-scale gravitational wave (GW) detectors consisting of precisely-timed pulsars distributed across the sky. Within the decade, PTAs are expected to detect the nanohertz GWs emitted by close-separation supermassive black hole binaries (SMBHBs), thereby opening up the low frequency end of the GW spectrum for science. Individual SMBHBs which power active galactic nuclei are also promising multi-messenger sources; they may be identified via theoretically predicted electromagnetic (EM) signatures and be followed up by PTAs for GW observations. In this work, we study the detection and parameter estimation prospects of a PTA which targets EM-selected SMBHBs. Adopting a simulated Galactic millisecond pulsar population, we envisage three different pulsar timing campaigns which observe three mock sources at different sky locations. We find that an all-sky PTA which times the best pulsars is an optimal and feasible approach to observe EM-selected SMBHBs and measure their source parameters to high precision (i.e., comparable to or better than conventional EM measurements). We discuss the implications of our findings in the context of the future PTA experiment with the planned Deep Synoptic Array-2000 and the multi-messenger studies of SMBHBs such as the well-known binary candidate OJ 287.Comment: 14 pages, 6 figures, 3 tables; ApJ accepted; data will be available with the ApJ publicatio