EFFECTS OF A HIP ORTHOSIS ON LUMBOPELVIC COORDINATION IN INDIVIDUALS WITH AND WITHOUT LOW BACK PAIN

Individuals with low back pain (LBP) demonstrate an abnormal lumbopelvic coordination compared to back-healthy individuals. This abnormal coordination presents itself as a reduction in lumbar contribution and an increase in pelvic contribution to trunk motion. This study investigated the ability of a hip orthosis to correct such an abnormal lumbo-pelvic coordination by restricting pelvic rotation and, as a result, increasing lumbar contributions. The effects of the hip orthosis on the magnitude and timing characteristics of lumbopelvic coordination were investigated in 20 patients with LBP and 20 asymptomatic controls. The orthosis significantly increased lumbar contributions by 11%, 5.42%, 4.84%, and 4.89% during forward bending, lateral bending to the left, and axial twisting to the left and right, respectively, and increased the amount of lumbar dominant motion during forward bending and return. Orthosis-induced changes in magnitude and timing aspects of lumbo-pelvic coordination were smaller in patients with LBP; likely because our relatively young patient group had smaller unrestricted pelvic rotations compared to asymptomatic individuals. However, the hip orthosis was capable of causing the expected changes in magnitude and timing aspects of lumbo-pelvic coordination in individuals with relatively large pelvic contributions to trunk motion; therefore, application of a hip orthosis may provide a method of correcting abnormal lumbopelvic coordination, particularly among patients with LBP who demonstrate large pelvic rotations, that warrants further investigation

Reasons for adopting different capacity levels in the denominator of overhead rates: a research note

There has been criticism of the use of budgeted capacity as the denominator of overhead rates. Prior questionnaire-based research has analysed which type of capacity is used in the denominator of overhead rates, but it has not assessed why these capacity levels are used. This paper uses grounded theory techniques to analyse 50 interviews with British management accountants about why a particular capacity level is used to determine the denominator of overhead rates. The results reveal that budgeted capacity is used because the calculation of the denominator is regarded as part of the budgeting process. Practical capacity and normal capacity are used to ensure that products are not under or overcosted

Changes in Lumbo-Pelvic Coordination of Individuals with and without Low Back Pain when Wearing a Hip Orthosis

Individuals with low back pain demonstrate an abnormal lumbo-pelvic coordination compared to back-healthy individuals. This abnormal coordination presents itself as a reduction in lumbar contributions and an increase in pelvic rotations during a trunk forward bending and backward return task. This study investigated the ability of a hip orthosis in correcting such an abnormal lumbo-pelvic coordination by restricting pelvic rotation and, hence increasing lumbar contributions. The effects of the hip orthosis on the lumbo-pelvic coordination were investigated in 20 low back pain patients and 20 asymptomatic controls. The orthosis reduced pelvic rotation by 12.7° and increased lumbar contributions by 11%. Contrary to our expectation, orthosis-induced changes in lumbo-pelvic coordination were smaller in patients; most likely because our relatively young patient group had smaller unrestricted pelvic rotations compared to asymptomatic individuals. Considering the observed capability of a hip orthosis in causing the expected changes in lumbo-pelvic coordination when there is a relatively large pelvic contribution to trunk motion, application of a hip orthosis may provide a promising method of correcting abnormal lumbo-pelvic coordination, particularly among patients who demonstrate larger pelvic rotation, that warrants further investigation

Реформування системи влади в Україні: децентралізація та дерегуляція

20 березня 2009 року в м. Борисполі (Київська область) відбувся круглий стіл на тему: «Реформування системи влади в Україні: децентралізація та дерегуляція» за участю лідерів місцевих громад Київської, Житомирської, Чернігівської областей. Захід провів Інститут трансформації суспільства (Київ) у співпраці з Бориспільською міською радою в рамках проекту «Розвиток громадського управління в Україні: децентралізація та дерегуляція», що підтримується Посольством Королівства Нідерланди в Україні

Experimental approaches for 100 TeV gamma-ray astronomy

The high energy end of gamma-ray source spectra might provide important clues regarding the nature of the processes involved in gamma-ray emission. Several galactic sources with hard emission spectra extending up to more than 30TeV have already been reported. Measurements around 100TeV and above should be an important goal for the next generation of high energy gamma-ray astronomy experiments. Here we present several techniques providing the required exposure (100 km^2.h). We focus our study on three Imaging Atmospheric Cherenkov Technique (IACT) based approaches: low elevation observations, large field of view telescopes, and large telescope arrays. We comment on the advantages and disadvantages of each approach and report simulation based estimates of their energy ranges and sensitivities.Comment: 3 pages 1 figure. Proceedings of TeV particle astrophysics 2, Madison, August 2006. http://www.icecube.wisc.edu/TeV/presentations/colin_poster.pd

In search of the ideal periosteal flap for bone non-union: the chimeric fibula-periosteal flap

Vascularized periosteal flaps may increase union rates in recalcitrant long bone non-union. The fibula-periosteal chimeric flap utilizes periosteum raised on an independent periosteal vessel. This allows the periosteum to be inset freely around the osteotomy site, thereby facilitating bone consolidation. Patients and Methods: 10 patients underwent fibula-periosteal chimeric flaps (2016 – 2022) at Canniesburn Plastic Surgery Unit, UK. Preceding non-union 18.6 months, with bone gap 7.5 cm. Patients underwent pre-operative CT angiography to identify periosteal branches. A case-control approach was used. Patients acted as their own controls with one osteotomy covered by the chimeric periosteal flap and one without, although in two patients both osteotomies were covered by a long periosteal flap. Results: A chimeric periosteal flap was used in 12 of 20 osteotomy sites. Periosteal flap osteotomies had a primary union rate of 100% (11/11) versus those without 28.6% (2/7) (p=0.0025). Union occurred in the chimeric periosteal flaps at 8.5 months versus 16.75 in the control group (p=0.023). 1 case excluded from primary analysis due to recurrent mycetoma. Number needed to treat = 2, indicating that 2 patients would require a chimeric periosteal flap to avoid one non-union. Survival curves with hazards ratio 4.1, equating to 4 times higher chance of union with periosteal flaps (log rank p=0.0016). Conclusions: The chimeric fibula-periosteal flap may increase consolidation rates in difficult cases of recalcitrant non-union. This elegant modification of the fibula flap uses periosteum that is normally discarded, and adds to accumulating data supporting the use of vascularised periosteal flaps in non-union

The relation between acute changes in the systemic inflammatory response and circulating thiamine and magnesium concentrations after elective knee arthroplasty

Thiamine diphosphate (TDP) and magnesium are co-factors for key enzymes in human intermediary metabolism. However, their role in the systemic inflammatory response (SIR) is not clear. Therefore, the aim of the present study was to examine the relation between acute changes in the SIR and thiamine and magnesium dependent enzyme activity in patients undergoing elective knee arthroplasty (a standard reproducible surgical injury in apparently healthy individuals). Patients (n = 35) who underwent elective total knee arthroplasty had venous blood samples collected pre- and post-operatively for 3 days, for measurement of whole blood TDP, serum and erythrocyte magnesium, erythrocyte transketolase activity (ETKA), lactate dehydrogenase (LDH), glucose and lactate concentrations. Pre-operatively, TDP concentrations, erythrocyte magnesium concentrations, ETKA and plasma glucose were within normal limits for all patients. In contrast, 5 patients (14%) had low serum magnesium concentrations (< 0.75 mmol/L). On post-operative day1, both TDP concentrations (p < 0.001) and basal ETKA (p < 0.05) increased and serum magnesium concentrations decreased (p < 0.001). Erythrocyte magnesium concentrations correlated with serum magnesium concentrations (rs = 0.338, p < 0.05) and remained constant during SIR. Post-operatively 14 patients (40%) had low serum magnesium concentrations. On day1 serum magnesium concentrations were directly associated with LDH (p < 0.05), WCC (p < 0.05) and neutrophils (p < 0.01). Whole blood TDP and basal ETKA increased while serum magnesium concentrations decreased, indicating increased requirement for thiamine and magnesium dependent enzyme activity during SIR. Therefore, thiamine and magnesium represent potentially modifiable therapeutic targets that may modulate the host inflammatory response. Erythrocyte magnesium concentrations are likely to be reliable measures of status, whereas serum magnesium concentrations and whole blood TDP may not. ClinicalTrials.gov: NCT03554668

Insufficiencies in sensory systems reweighting is associated with walking impairment severity in chronic stroke: an observational cohort study

BackgroundWalking and balance impairment are common sequelae of stroke and significantly impact functional independence, morbidity, and mortality. Adequate postural stability is needed for walking, which requires sufficient integration of sensory information between the visual, somatosensory, and vestibular centers. “Sensory reweighting” describes the normal physiologic response needed to maintain postural stability in the absence of sufficient visual or somatosensory information and is believed to play a critical role in preserving postural stability after stroke. However, the extent to which sensory reweighting successfully maintains postural stability in the chronic stages of stroke and its potential impact on walking function remains understudied.MethodsIn this cross-sectional study, fifty-eight community-dwelling ambulatory chronic stroke survivors underwent baseline postural stability testing during quiet stance using the modified Clinical test of Sensory Interaction in Balance (mCTSIB) and assessment of spatiotemporal gait parameters.ResultsSeventy-six percent (45/58) of participants showed sufficient sensory reweighting with visual and somatosensory deprivation for maintaining postural stability, albeit with greater postural sway velocity indices than normative data. In contrast, survivors with insufficient reweighting demonstrated markedly slower overground walking speeds, greater spatiotemporal asymmetry, and limited acceleration potential.ConclusionAdequate sensory system reweighting is essential for chronic stroke survivors’ postural stability and walking independence. Greater emphasis should be placed on rehabilitation strategies incorporating multisensory system integration testing and strengthening as part of walking rehabilitation protocols. Given its potential impact on outcomes, walking rehabilitation trials may benefit from incorporating formal postural stability testing in design and group stratification

The Grail of original meaning : uses of the past in American constitutional theory

Originalist jurisprudence, which enjoins a faithful adherence to the values enshrined in the late eighteenth-century Constitution, has become a prominent feature of contemporary American conservatism. Recovering the original meaning of the Constitution is far from straightforward, and raises major issues of historical interpretation. How far do the assumed historical underpinnings of originalist interpretation mesh with the findings of academic historians? To what extent has the conservative invocation of the Founding Fathers obscured a lost American Enlightenment? Nor is ‘tradition’ in American Constitutional law an unproblematic matter. How far does a desire to restore the original meaning of the Constitution ignore the role of ‘stare decisis’ (precedent) in America's common law heritage? It transpires, moreover, that the various schemes of historical interpretation in American Constitutional jurisprudence do not map easily onto a simple liberal–conservative divide.PostprintPeer reviewe