Shoulder posture and median nerve sliding

Background: Patients with upper limb pain often have a slumped sitting position and poorshoulder posture. Pain could be due to poor posture causing mechanical changes (stretch; localpressure) that in turn affect the function of major limb nerves (e.g. median nerve). This studyexamines (1) whether the individual components of slumped sitting (forward head position, trunkflexion and shoulder protraction) cause median nerve stretch and (2) whether shoulderprotraction restricts normal nerve movements.Methods: Longitudinal nerve movement was measured using frame-by-frame cross-correlationanalysis from high frequency ultrasound images during individual components of slumped sitting.The effects of protraction on nerve movement through the shoulder region were investigated byexamining nerve movement in the arm in response to contralateral neck side flexion.Results: Neither moving the head forward or trunk flexion caused significant movement of themedian nerve. In contrast, 4.3 mm of movement, adding 0.7% strain, occurred in the forearm duringshoulder protraction. A delay in movement at the start of protraction and straightening of thenerve trunk provided evidence of unloading with the shoulder flexed and elbow extended and thescapulothoracic joint in neutral. There was a 60% reduction in nerve movement in the arm duringcontralateral neck side flexion when the shoulder was protracted compared to scapulothoracicneutral.Conclusion: Slumped sitting is unlikely to increase nerve strain sufficient to cause changes tonerve function. However, shoulder protraction may place the median nerve at risk of injury, sincenerve movement is reduced through the shoulder region when the shoulder is protracted andother joints are moved. Both altered nerve dynamics in response to moving other joints and localchanges to blood supply may adversely affect nerve function and increase the risk of developingupper quadrant pain

A universal relationship between magnetization and local structure changes below the ferromagnetic transition in La_{1-x}Ca_xMnO_3; evidence for magnetic dimers

We present extensive X-ray Absorption Fine Structure (XAFS) measurements on La_{1-x}Ca_xMnO_3 as a function of B-field (to 11T) and Ca concentration, x (21-45%). These results reveal local structure changes (associated with polaron formation) that depend only on the magnetization for a given sample, irrespective of whether the magnetization is achieved through a decrease in temperature or an applied magnetic field. Furthermore, the relationship between local structure and magnetization depends on the hole doping. A model is proposed in which a filamentary magnetization initially develops via the aggregation of pairs of Mn atoms involving a hole and an electron site. These pairs have little distortion and it is likely that they pre-form at temperatures above T_c.Comment: 5 pages, 5 figures (1 with 2 parts) -- v2. new data added (updated figures); discussion expande

Gynaecological surveillance in high risk women

Increasing availability of genetic testing and falling costs of the tests suggests that growing numbers of unaffected women will be identified worldwide who are at increased risk of gynaecological malignancies. The challenge in those identified is to prevent and detect the disease early without causing significant harm. Currently surgery remains the cornerstone of management. Most women undergoing surgery do not report a significant deterioration of their physical and mental health-related quality of life (1). However the resulting premature menopause is associated with decrease in sexual functioning and vasomotor symptoms even in women on hormone replacement therapy (HRT)(2)(3). As a result there is a continued effort to develop effective screening strategies for high risk women

The effects of a dietary supplement of fresh oranges on the oral health of children

Indiana University-Purdue University Indianapolis (IUPUI)The effects of additional citrus fruit in the diet on the periodontium have been a debated subject for some time. This study attempted to measure the effects of eating three additional oranges per day by 123 children ages six through twenty years and an equal number of controls over a 23-week period. To measure any changes that might take place, the following were evaluated clinically, and the decayed, missing and filled surfaces were also evaluated radiographically: 1. gingival status 2. plaque formation 3. D.M.F.S. and d.m.f.s. 4. white spots Results after the 23 week test period showed that the gingival scores increased significantly in both groups (increased inflammation). The plaque formation score also increased in both groups, but only the non-orange eaters' score increased significantly over their original score and over the orange eaters' score. The decayed, missing, and filled surfaces and white spots did not change significantly in either group. Therefore with this study sample over the 23-week test period, the additional oranges in the diet had limited measurable effect on the hard and soft tissues of the oral cavity

Observation of ferromagnetism above 900 K in Cr-GaN and Cr-AlN

We report the observation of ferromagnetism at over 900K in Cr-GaN and Cr-AlN thin films. The saturation magnetization moments in our best films of Cr-GaN and Cr-AlN at low temperatures are 0.42 and 0.6 u_B/Cr atom, respectively, indicating that 14% and 20%, of the Cr atoms, respectively, are magnetically active. While Cr-AlN is highly resistive, Cr-GaN exhibits thermally activated conduction that follows the exponential law expected for variable range hopping between localized states. Hall measurements on a Cr-GaN sample indicate a mobility of 0.06 cm^2/V.s, which falls in the range characteristic of hopping conduction, and a free carrier density (1.4E20/cm^3), which is similar in magnitude to the measured magnetically-active Cr concentration (4.9E19/cm^3). A large negative magnetoresistance is attributed to scattering from loose spins associated with non-ferromagnetic impurities. The results indicate that ferromagnetism in Cr-GaN and Cr-AlN can be attributed to the double exchange mechanism as a result of hopping between near-midgap substitutional Cr impurity bands.Comment: 14 pages, 4 figures, submitted to AP

Intensive simulation versus control in the assessment of time to skill competency and confidence of medical students to assess and manage cardiovascular and respiratory conditions—a pseudo-randomised trial

Background: The Clinical Placement Enhancement Program (CPEP) is a simulation course for medical students learning the core topics of cardiovascular and respiratory medicine, incorporating patient safety and professionalism teaching and based on adult learning principles and proven educational theory. The aims of this study are to assess whether the CPEP delivered at the beginning of a clinical rotation would result in competency outcomes that are at least equivalent to those achieved through a standard 6-week programme and whether this programme would increase student confidence levels in assessing and managing patients with cardiovascular and respiratory conditions. Methods: This was a pseudo-randomised control trial between two groups of medical students from one clinical school. The intervention group participated in CPEP, a 4-day immersive simulation course, in the first week of their cardiac and respiratory medicine clinical rotation. The control group participants attended the normal programme of the 6-week cardiovascular and respiratory medicine clinical rotation. The programme and student competence was assessed using Observed Structured Clinical Examinations (OSCEs) and self-reported confidence surveys. Results: There was no significant difference in OSCE scoring between the intervention group (examined in week one of their clinical rotation following CPEP) and the control group (examined at the end of their full clinical rotation). Students exposed to CPEP started their clinical rotation with confidence levels similar to those reported by the control group at the end of their rotation. Confidence levels of CPEP students were higher at the end of the rotation compared to those of the control group. Conclusions: Based on OSCE results, immersion into a 4-day simulation-based teaching programme at the start of a clinical rotation resulted in skill competency levels that were equivalent to those obtained after a full clinical rotation of 6 weeks. CPEP improved students' confidence levels in the assessment and management of patients presenting with cardiovascular and respiratory conditions. Simulation utilised in courses such as CPEP has the potential to enhance the overall learning experience in medical school clinical rotations