The relative timing of trunk muscle activation is retained in response to unanticipated postural-perturbations during acute low back pain

The purpose of this study was to assess the activation of the erector spinae (ES) and external oblique (EO) in response to unanticipated, bi-directional postural perturbations before and after the induction of acute low back pain (LBP) in healthy individuals. An experimental session consisted of a baseline, control, and an acute LBP condition. For the control and acute LBP condition, isotonic or hypertonic saline (HS), respectively, was injected into the right ES muscle. In each condition, participants stood on a moveable platform during which 32 randomized postural perturbations (8 repetitions of 4 perturbation types: 8 cm anterior slides, 8 cm posterior slides, 10° anterior tilts, and 10° posterior tilts) with varying inter-perturbation time intervals were performed over a period of 4–5 min. Bilateral surface electromyography (EMG) was recorded from the ES and EO in addition to subjective pain records. During the acute LBP condition: (1) the onset time of the ES and EO was delayed for the forward and backward sliding perturbations (P < 0.05); (2) EMG amplitude was reduced bilaterally for all perturbations (P < 0.05); (3) the order of activation and interval between the onset times of the ES and EO were unaltered and (4) ES, but not EO, activity was adjusted to account for the directional differences between the perturbations. This study revealed that re-establishment of posture and balance was a result of the individuals’ ability to rapidly modulate ES with respect to EO activity and that the bi-directional postural responses, although shifted in time and amplitude, retained temporal features in the presence of acute LBP

Limited access to hepatitis B/C treatment among vulnerable risk populations

Background: To investigate access to treatment for chronic hepatitis B/C among six vulnerable patient/population groups at-risk of infection: undocumented migrants, asylum seekers, people without health insurance, people with state insurance, people who inject drugs (PWID) and people abusing alcohol. Methods: An online survey among experts in gastroenterology, hepatology and infectious diseases in 2012 in six EU countries: Germany, Hungary, Italy, the Netherlands, Spain and the UK. A four-point ordinal scale measured access to treatment (no, some, significant or complete restriction). Results: From 235 recipients, 64 responses were received (27%). Differences in access between and within countries were reported for all groups except people with state insurance. Most professionals, other than in Spain and Hungary, reported no or few restrictions for PWID. Significant/complete treatment restriction was reported for all groups by the majority in Hungary and Spain, while Italian respondents reported no/few restrictions. Significant/complete restriction was reported for undocumented migrants and people without health insurance in the UK and Spain. Opinion about undocumented migrants in Germany and the Netherlands was divergent. Conclusions: Although effective chronic hepatitis B/C treatment exists, limited access among vulnerable patient populations was seen in all study countries. Discordance of opinion about restrictions within countries is seen, especially for groups for whom the health care system determines treatment access, such as undocumented migrants, asylum seekers and people without health insurance. This suggests low awareness, or lack, of entitlement guidance among clinicians. Expanding treatment access among risk groups will contribute to reducing chronic viral hepatitis-associated avoidable morbidity and mortality

Comparison between the degree of motor unit short-term synchronization and recurrence quantification analysis of the surface EMG in two human muscles

n/

Experience in the application of IEC/TR 61000-3-6 to harmonic allocation in transmission systems

Technical report IEC/TR 61000-3-6 is widely used as a guide to harmonic management in HV and MV networks, assisting in coordination of harmonic levels between utility and customer. In 2001, Australia and New Zealand adopted the harmonic standard AS/NZS 61000.3.6, which closely follows the above IEC technical report. As a result, transmission utilities and connected loads are required by government regulations to abide by the harmonic allocations set by the standard. The technical report contains some useful general principles which can be applied to the harmonic management of power systems. However, unexpected difficulties can be found when attempts are made to apply them to large power systems. The formal procedure recommended by the standard for calculation of harmonic emission levels limits the voltage at the point of connection. There can be situations where the highest harmonic voltages are remote from the PCC. This can be accounted for by taking into account interactions between each injecting load and all other busbars in one single step. This leads to the development of a harmonic allocation constant , which will apply to the entire transmission network, as a measure of the ability of the network to absorb harmonics without violating a set planning limit. At present, the allocation procedure given in the standard implies consideration of only a single network operation scenario. However, substantial variations have been identified in the harmonic behaviour of transmission networks, including harmonic absorption capacity, with changes in generator commitment and switching configuration. The proposed approach accounts for variations by taking data from multiple network scenarios. For the specification of an easily-measurable harmonic current emission level - rather than a harmonic voltage level - for a particular customer, the network harmonic impedance is necessary. This quantity can vary substantially at the one busbar in a transmission network. The application of a standardised hth harmonic impedance is proposed which is based on the fundamental frequency fault level at the PCC. IEC/TR 61000-3-6 gives no guidance as to methods of treating harmonic resonances in transmission systems. Resonances will occur in any transmission system with sufficient line lengths, and will impose substantial constraints on harmonic allocation if computer calculations are accepted without modification. It is unclear if these resonances are of practical importance, and it is proposed that resonance amplifications be limited to allow useful allocations until their importance has been established by field results

Permeability and conductivity of platelet-reinforced membranes and composites

We present large scale simulations of the diffusion constant $D$ of a random composite consisting of aligned platelets with aspect ratio $a/b>>1$ in a matrix (with diffusion constant $D_0$) and find that $D/D_0 = 1/(1+ c_1 x + c_2 x^2)$, where $x= a v_f/b$ and $v_f$ is the platelet volume fraction. We demonstrate that for large aspect ratio platelets the pair term ($x^2$) dominates suggesting large property enhancements for these materials. However a small amount of face-to-face ordering of the platelets markedly degrades the efficiency of platelet reinforcement.Comment: RevTeX, 5 pages, 4 figures, submitted to PR

Cervical musculoskeletal impairments and pressure pain sensitivity in office workers with headache

Background: Office workers are specifically vulnerable to headache conditions. Neck pain is reported by almost 80% of patients with headaches. Associations between currently recommended tests to examine cervical musculoskeletal impairments, pressure pain sensitivity and self-reported variables in headache, are unknown. The aim of this study is to evaluate whether cervical musculoskeletal impairments and pressure pain sensitivity are associated with self-reported headache variables in office workers. Methods: This study reports a cross-sectional analysis using baseline data of a randomized controlled trial. Office workers with headache were included in this analysis. Multivariate associations, controlled for age, sex and neck pain, between cervical musculoskeletal variables (strength, endurance, range of motion, movement control) and pressure pain threshold (PPT) over the neck and self-reported headache variables, such as frequency, intensity, and the Headache-Impact-Test-6, were examined. Results: Eighty-eight office workers with a 4-week headache frequency of 4.8 (±5.1) days, a moderate average headache intensity (4.5 ± 2.1 on the NRS), and “some impact” (mean score: 53.7 ± 7.9) on the headache-impact-test-6, were included. Range of motion and PPT tested over the upper cervical spine were found to be most consistently associated with any headache variable. An adjusted R2 of 0.26 was found to explain headache intensity and the score on the Headache-Impact-Test-6 by several cervical musculoskeletal and PPT variables. Discussion: Cervical musculoskeletal impairments can explain, irrespective of coexisting neck pain, only little variability of the presence of headache in office workers. Neck pain is likely a symptom of the headache condition, and not a separate entity

Influence of pain location and hand dominance on scapular kinematics and EMG activities: an exploratory study

<p>Abstract</p> <p>Background</p> <p>Assessment of three-dimensional kinematics and electromyography (EMG) activities is common in patients with chronic neck pain. However, the effect of hand dominance and neck pain location on the measurement of movement and EMG characteristics is still unclear. Therefore, the purpose of this study was to investigate the effect of neck pain location and arm dominance on the scapular kinematics and muscle EMG activities in patients with chronic neck pain.</p> <p>Methods</p> <p>Thirty subjects (10 males, 20 females; mean age (sd): 38 (11.9) years) with chronic neck pain for more than 3 months were recruited. The scapular kinematics and EMG activity of the upper trapezius and sternocleidomastoid muscles were measured during the bilateral arm elevation task. The three-way repeated measures ANOVA was used to examine the effect of neck pain location and hand dominance on the measurement of kinematics and EMG muscle activities.</p> <p>Results</p> <p>The movement of scapular posterior tilt was significantly influenced by arm dominance (P = 0.001) and by the interaction of arm dominance and elevation angle (P = 0.002). The movement of scapular upward/downward rotation was affected by the interaction of arm dominance and elevation angle (P = 0.02). The location of pain did not show any significant influence on the scapular movement and muscle activities.</p> <p>Conclusions</p> <p>Hand dominance could have an influence on the scapular kinematics, which should be taken into consideration when describing and comparing neuromuscular characteristics in individuals with chronic neck pain.</p

La colección de vertebrados del Museo de Historia Natural Víctor Baca Aguinaga de la Universidad Nacional Pedro Ruiz Gallo (Lambayeque, Perú)

Se presenta el Catálogo de la Colección de Vertebrados expuesta en el Museo de Historia Natural Víctor Baca Aguinaga de la Universidad Nacional Pedro Ruiz Gallo (Lambayeque, Perú). La mayor parte de la colección de ámbito regional; proviene de la Colección del ingeniero Víctor Baca Aguinaga, quien dono su colección y es base de lo expuesto en el museo. Se exponen los ejemplares de especies de la región Lambayeque. Se proporciona información taxonómica y Atlas alfabético del material biológico.Palabras clave: museo, ciencias naturales, catálogo, colecciones, vertebrados

Cost-effectiveness analysis of recombinant human follicle-stimulating hormone alfa(r-hFSH) and urinary highly purified menopausal gonadotropin (hMG) based on data from a large German registry

This was a retrospective real-world evidence analysis of the costs per live birth for reference recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG-HP), based on data from a German in vitro fertilization registry (RecDate). Pregnancy and live birth rates from the RecDate real-world evidence study over three complete assisted reproductive technology (ART) cycles using the same gonadotropin drug were used as clinical inputs. Costs related to ART treatment and to drugs were obtained from public sources. Treatment with r-hFSH-alfa resulted in higher adjusted cumulative live birth rates versus hMG-HP after one (25.3% vs. 22.3%), two (30.9% vs. 27.5%), and three (31.9% vs. 28.6%) ART cycles. Costs per live birth were lower with r-hFSH-alfa versus hMG-HP after one (\u20ac17,938 vs. \u20ac20,054), two (\u20ac18,251 vs. \u20ac20,437), and three (\u20ac18,473 vs. \u20ac20,680) ART cycles. r-hFSH-alfa was found to be a cost-effective strategy compared with hMG-HP over three cycles