Bladelet Polish: a lithic analysis of Spracklen (33GR1585), an upland Hopewell campsite

This thesis builds upon recent investigations at Spracklen (33GR1585), a small upland site in Greene County, Ohio. The presence of non-local cherts, bladelets, and bladelet cores indicates a Middle Woodland Ohio Hopewell occupation. Raw material sourcing, debitage analyses, and a use-wear analysis uncovered that Spracklen functioned as a logistical hunting campsite. Its people utilized bladelets for butchery and hide-working processes. This information provides new insights into Hopewellian life in the uplands and its place within Hopewell community organization

Variation in the spatial distribution of erector spinae activity during a lumbar endurance task in people with low back pain

© 2019 Anatomical Society This study aimed to investigate the spatial distribution and redistribution of lumbar erector spinae (ES) activity during a lumbar extension endurance task in pain-free participants and how this is modified in people with low back pain (LBP). High density surface electromyography (HDEMG) was recorded using 13 × 5 electrode grids placed over the lumbar ES in 13 LBP and 13 control participants while completing an Ito test to task failure. The root mean square of the HDEMG signals was computed, a topographical map of the EMG amplitude generated and the centre of the activity (centroid) determined throughout the task. The centroid of the EMG amplitude map was systematically more cranial (F = 6.09, P = 0.022) for the LBP participants compared with the control subjects. Regression analysis showed that the extent of redistribution of ES activity was associated with longer endurance. These results show that LBP participants utilised a different motor strategy to perform the endurance task, characterised by greater activation of more cranial regions of the ES and less redistribution of ES activity throughout the task. This study provides new insight into the functional activation of the lumbar ES and how it is modified when people have pain

B-type natriuretic peptide-guided treatment for heart failure

Background Heart failure is a condition in which the heart does not pump enough blood to meet all the needs of the body. Symptoms of heart failure include breathlessness, fatigue and fluid retention. Outcomes for patients with heart failure are highly variable; however on average, these patients have a poor prognosis. Prognosis can be improved with early diagnosis and appropriate use of medical treatment, use of devices and transplantation. Patients with heart failure are high users of healthcare resources, not only due to drug and device treatments, but due to high costs of hospitalisation care. B‐type natriuretic peptide levels are already used as biomarkers for diagnosis and prognosis of heart failure, but could offer to clinicians a possible tool to guide drug treatment. This could optimise drug management in heart failure patients whilst allaying concerns over potential side effects due to drug intolerance. Objectives To assess whether treatment guided by serial BNP or NT‐proBNP (collectively referred to as NP) monitoring improves outcomes compared with treatment guided by clinical assessment alone. Search methods Searches were conducted up to 15 March 2016 in the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library; MEDLINE (OVID), Embase (OVID), the Database of Abstracts of Reviews of Effects (DARE) and the NHS Economic Evaluation Database in the Cochrane Library. Searches were also conducted in the Science Citation Index Expanded, the Conference Proceedings Citation Index on Web of Science (Thomson Reuters), World Health Organization International Clinical Trials Registry and ClinicalTrials.gov. We applied no date or language restrictions. Selection criteria We included randomised controlled trials of NP‐guided treatment of heart failure versus treatment guided by clinical assessment alone with no restriction on follow‐up. Adults treated for heart failure, in both in‐hospital and out‐of‐hospital settings, and trials reporting a clinical outcome were included. Data collection and analysis Two review authors independently selected studies for inclusion, extracted data and evaluated risk of bias. Risk ratios (RR) were calculated for dichotomous data, and pooled mean differences (MD) (with 95% confidence intervals (CI)) were calculated for continuous data. We contacted trial authors to obtain missing data. Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, we assessed the quality of the evidence and GRADE profiler (GRADEPRO) was used to import data from Review Manager to create a 'Summary of findings' table. Main results We included 18 randomised controlled trials with 3660 participants (range of mean age: 57 to 80 years) comparing NP‐guided treatment with clinical assessment alone. The evidence for all‐cause mortality using NP‐guided treatment showed uncertainty (RR 0.87, 95% CI 0.76 to 1.01; patients = 3169; studies = 15; low quality of the evidence), and for heart failure mortality (RR 0.84, 95% CI 0.54 to 1.30; patients = 853; studies = 6; low quality of evidence). The evidence suggested heart failure admission was reduced by NP‐guided treatment (38% versus 26%, RR 0.70, 95% CI 0.61 to 0.80; patients = 1928; studies = 10; low quality of evidence), but the evidence showed uncertainty for all‐cause admission (57% versus 53%, RR 0.93, 95% CI 0.84 to 1.03; patients = 1142; studies = 6; low quality of evidence). Six studies reported on adverse events, however the results could not be pooled (patients = 1144; low quality of evidence). Only four studies provided cost of treatment results, three of these studies reported a lower cost for NP‐guided treatment, whilst one reported a higher cost (results were not pooled; patients = 931, low quality of evidence). The evidence showed uncertainty for quality of life data (MD ‐0.03, 95% CI ‐1.18 to 1.13; patients = 1812; studies = 8; very low quality of evidence). We completed a 'Risk of bias' assessment for all studies. The impact of risk of bias from lack of blinding of outcome assessment and high attrition levels was examined by restricting analyses to only low 'Risk of bias' studies. Authors' conclusions In patients with heart failure low‐quality evidence showed a reduction in heart failure admission with NP‐guided treatment while low‐quality evidence showed uncertainty in the effect of NP‐guided treatment for all‐cause mortality, heart failure mortality, and all‐cause admission. Uncertainty in the effect was further shown by very low‐quality evidence for patient's quality of life. The evidence for adverse events and cost of treatment was low quality and we were unable to pool results.</p

Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

Background and purpose A retrocalcaneal bursitis is caused by repetitive impingement of the bursa between the Achilles tendon and the posterosuperior calcaneus. The bursa is situated in the posteroinferior corner of Kager's triangle (retrocalcaneal recess), which is a radiolucency with sharp borders on the lateral radiograph of the ankle. If there is inflammation, the fluid-filled bursa is less radiolucent, making it difficult to delineate the retrocalcaneal recess. We assessed whether the radiographic appearance of the retrocalcaneal recess on plain digital (filmless) radiographs could be used in the diagnosis of a retrocalcaneal bursitis. Methods Whether or not there was obliteration of the retrocalcaneal recess (yes/no) on 74 digital weight-bearing lateral radiographs of the ankle was independently assessed by 2 observers. The radiographs were from 24 patients (25 heels) with retrocalcaneal bursitis (confirmed on endoscopic calcaneoplasty); the control group consisted of 50 patients (59 heels). Results The sensitivity of the test was 83% for observer 1 and 79% for observer 2. Specificity was 100% and 98%, respectively. The kappa value of the interobserver reliability test was 0.86. For observer 1, intraobserver reliability was 0.96 and for observer 2 it was 0.92. Interpretation On digital weight-bearing lateral radiographs of a retrocalcaneal bursitis, the retrocalcaneal recess has a typical appearanc

Use of DOE-2 to Evaluate Evaporative Cooling in Texas Correctional Facilities

This study investigates the feasibility of using direct and indirect evaporative cooling systems for correctional facilities in two different Texas climatic regions with the DOE-2.1E hourly energy simulation program. The analysis is based on adding user defined functions to the DOE-2 SYSTEMS subprogram to simulate direct and indirect evaporative cooling configurations. The DOE-2 program was run with two weather tapes, one for Kingsville, Texas and one for Abilene, Texas during April, July, and October to resemble neutral, summer and winter weather conditions. The results showed that direct evaporative cooling is applicable in April for Abilene and October for Kingsville. The indirect evaporative cooling is feasible in July for Abilene and April for Kingsville

Possibility between earthquake and explosion seismogram differentiation by discrete stochastic non-Markov processes and local Hurst exponent analysis

The basic purpose of the paper is to draw the attention of researchers to new possibilities of differentiation of similar signals having different nature. One of examples of such kind of signals is presented by seismograms containing recordings of earthquakes (EQ's) and technogenic explosions (TE's). We propose here a discrete stochastic model for possible solution of a problem of strong EQ's forecasting and differentiation of TE's from the weak EQ's. Theoretical analysis is performed by two independent methods: with the use of statistical theory of discrete non-Markov stochastic processes (Phys. Rev. E62,6178 (2000)) and the local Hurst exponent. Time recordings of seismic signals of the first four dynamic orthogonal collective variables, six various plane of phase portrait of four dimensional phase space of orthogonal variables and the local Hurst exponent have been calculated for the dynamic analysis of the earth states. The approaches, permitting to obtain an algorithm of strong EQ's forecasting and to differentiate TE's from weak EQ's, have been developed.Comment: REVTEX +12 ps and jpg figures. Accepted for publication in Phys. Rev. E, December 200

The effect of berry-based food interventions on markers of cardiovascular and metabolic health: A systematic review of randomized controlled trials

Scope: Epidemiological evidence, animal, and in vitro studies suggest that berry consumption may ameliorate markers of cardiovascular disease (CVD). The aim of this systematic review is to evaluate findings from berry-based randomized controlled trials (RCTs) to establish the effects of berry consumption on markers of cardiovascular and metabolic health. Methods and results: PubMed and Web of Science are searched for RCTs investigating berry consumption on CVD risk outcomes in adults. A total of 23 studies (which includes 1168 participants) out of 1384 records meet the inclusion criteria. Of these 23 studies, 17 RCTs are of high quality, where 12 RCTs (71%) report beneficial effects of berry consumption on CVD risk markers. Overall, 4/11 RCTs that observe a reduction in systolic and/or diastolic blood pressure (BP); 3/7 RCTs report favorable effects on endothelial function, 2/3 RCTs report improvements in arterial stiffness, 7/17 studies observe benefits in blood lipids, and 3/6 studies report improvements in glycemic profile. Conclusion: Our evaluation of the literature indicates that more than two-thirds of high-quality trials have reported beneficial effects of berry consumption on markers of CVD risk. This systematic review contributes moderate to strong evidence for the inclusion of berries as part of a cardioprotective diet