Analysis of the third national health and nutrition examination survey (NHANES III) using expert ratings of job categories

Background Few epidemiologic studies have addressed the exposure–response relationships between work activities and symptomatic knee osteoarthritis (OA). This analysis used data from a national survey and ergonomists' ratings to address this issue. Methods Interview and knee X-ray data were obtained from the Third National Health and Nutrition Examination Survey. Occupational ratings were obtained using ergonomists. A weighted logistic regression was used. Results Among men, a significant exposure–response relationship was found between symptomatic knee OA and kneeling. In both genders, there was a significant trend in heavy lifting and severe symptomatic knee OA. Approximately 20.7% of knee OA can be attributed to kneeling >14% of the workday among men. Conclusions The significant exposure–response relationships suggest that modest reductions in certain occupational activities can reduce the burden of knee OA. The study was limited by unvalidated expert ratings. Research is needed to identify hazardous characteristics of work activities and to clarify exposure–response relationships. Am. J. Ind. Med. 51:37–46, 2008. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/57516/1/20512_ftp.pd

A Cross-Sectional Assessment of the ACGIH TLV for Hand Activity Level

The ACGIH Worldwide Threshold Limit Value (TLV) for hand activity “considers average hand activity level or “HAL” and peak hand force.” We report cross-sectional data that assess the validity of the TLV with respect to symptoms and selected upper extremity musculoskeletal disorders among workers. The prevalence of symptoms and specific disorders were examined among 908 workers from 7 different job sites in relation to the TLV. Worker exposures were categorized as above the TLV, above the TLV Action Limit but below the TLV, or below the TLV Action Limit. Symptoms in the distal upper extremities did not vary by TLV category. Tendonitis in the wrist/hands/fingers did not vary by TLV category, but elbow/forearm tendonitis was significantly associated with TLV category. All measures of carpal tunnel syndrome were associated with TLV category. In all instances, prevalence of symptoms and specific disorders were substantial in jobs that were below the TLV action limit, suggesting that even at “acceptable” levels of hand activity, many workers will still experience symptoms and/or upper extremity musculoskeletal disorders, which may be important in the rehabilitation and return to work of injured workers. Future analyses need to examine the incidence of symptoms and upper extremity musculoskeletal disorders prospectively among workers in relation to the TLV for hand activity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45015/1/10926_2005_Article_874.pd

7-Substituted 2-Nitro-5,6-dihydroimidazo[2,1-b][1,3]oxazines: Novel Antitubercular Agents Lead to a New Preclinical Candidate for Visceral Leishmaniasis.

Within a backup program for the clinical investigational agent pretomanid (PA-824), scaffold hopping from delamanid inspired the discovery of a novel class of potent antitubercular agents that unexpectedly possessed notable utility against the kinetoplastid disease visceral leishmaniasis (VL). Following the identification of delamanid analogue DNDI-VL-2098 as a VL preclinical candidate, this structurally related 7-substituted 2-nitro-5,6-dihydroimidazo[2,1-b][1,3]oxazine class was further explored, seeking efficacious backup compounds with improved solubility and safety. Commencing with a biphenyl lead, bioisosteres formed by replacing one phenyl by pyridine or pyrimidine showed improved solubility and potency, whereas more hydrophilic side chains reduced VL activity. In a Leishmania donovani mouse model, two racemic phenylpyridines (71 and 93) were superior, with the former providing >99% inhibition at 12.5 mg/kg (b.i.d., orally) in the Leishmania infantum hamster model. Overall, the 7R enantiomer of 71 (79) displayed more optimal efficacy, pharmacokinetics, and safety, leading to its selection as the preferred development candidate

Detecting Mutations in the Mycobacterium tuberculosis Pyrazinamidase Gene pncA to Improve Infection Control and Decrease Drug Resistance Rates in Human Immunodeficiency Virus Coinfection.

Hospital infection control measures are crucial to tuberculosis (TB) control strategies within settings caring for human immunodeficiency virus (HIV)-positive patients, as these patients are at heightened risk of developing TB. Pyrazinamide (PZA) is a potent drug that effectively sterilizes persistent Mycobacterium tuberculosis bacilli. However, PZA resistance associated with mutations in the nicotinamidase/pyrazinamidase coding gene, pncA, is increasing. A total of 794 patient isolates obtained from four sites in Lima, Peru, underwent spoligotyping and drug resistance testing. In one of these sites, the HIV unit of Hospital Dos de Mayo (HDM), an isolation ward for HIV/TB coinfected patients opened during the study as an infection control intervention: circulating genotypes and drug resistance pre- and postintervention were compared. All other sites cared for HIV-negative outpatients: genotypes and drug resistance rates from these sites were compared with those from HDM. HDM patients showed high concordance between multidrug resistance, PZA resistance according to the Wayne method, the two most common genotypes (spoligotype international type [SIT] 42 of the Latino American-Mediterranean (LAM)-9 clade and SIT 53 of the T1 clade), and the two most common pncA mutations (G145A and A403C). These associations were absent among community isolates. The infection control intervention was associated with 58-92% reductions in TB caused by SIT 42 or SIT 53 genotypes (odds ratio [OR] = 0.420, P = 0.003); multidrug-resistant TB (OR = 0.349, P < 0.001); and PZA-resistant TB (OR = 0.076, P < 0.001). In conclusion, pncA mutation typing, with resistance testing and spoligotyping, was useful in identifying a nosocomial TB outbreak and demonstrating its resolution after implementation of infection control measures

Photoelasticity of crystalline and amorphous silica from first principles

Based on density-functional perturbation theory we have computed from first principles the photoelastic tensor of few crystalline phases of silica at normal conditions and high pressure (quartz, $\alpha$-cristobalite, $\beta$-cristobalite) and of models of amorphous silica (containig up to 162 atoms), obtained by quenching from the melt in combined classical and Car-Parrinello molecular dynamics simulations. The computational framework has also been checked on the photoelastic tensor of crystalline silicon and MgO as prototypes of covalent and ionic systems. The agreement with available experimental data is good. A phenomenological model suitable to describe the photoelastic properties of different silica polymorphs is devised by fitting on the ab-initio data.Comment: ten figure

Rings and rigidity transitions in network glasses

Three elastic phases of covalent networks, (I) floppy, (II) isostatically rigid and (III) stressed-rigid have now been identified in glasses at specific degrees of cross-linking (or chemical composition) both in theory and experiments. Here we use size-increasing cluster combinatorics and constraint counting algorithms to study analytically possible consequences of self-organization. In the presence of small rings that can be locally I, II or III, we obtain two transitions instead of the previously reported single percolative transition at the mean coordination number $\bar r=2.4$, one from a floppy to an isostatic rigid phase, and a second one from an isostatic to a stressed rigid phase. The width of the intermediate phase $~ \bar r$ and the order of the phase transitions depend on the nature of medium range order (relative ring fractions). We compare the results to the Group IV chalcogenides, such as Ge-Se and Si-Se, for which evidence of an intermediate phase has been obtained, and for which estimates of ring fractions can be made from structures of high T crystalline phases.Comment: 29 pages, revtex, 7 eps figure

Predictors of Upper Extremity Discomfort: A Longitudinal Study of Industrial and Clerical Workers

Upper extremity discomfort associated with work activity is common with a prevalence of over 50% in many settings. This study followed a cohort of 501 active workers for an average of 5.4 years. Cases were defined as workers who were asymptomatic or had a low discomfort score of 1 or 2 at baseline testing and went on to report a discomfort score of 4 or above on a 10-point visual analog scale. This change is considered clinically significant. Controls had a low baseline discomfort score and continued to have a low discomfort rating throughout the study. The risk factors found to have the highest predictive value for identifying a person who is likely to develop a significant upper extremity discomfort rating included age over 40, a BMI over 28, a complaint of baseline discomfort, the severity of the baseline discomfort rating and a job that had a high hand activity level (based upon hand repetition and force). The risk profile identified both ergonomic and personal health factors as risks and both factors may be amenable to prevention strategies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45012/1/10926_2005_Article_871.pd

No association between chronic musculoskeletal complaints and Val158Met polymorphism in the Catechol-O-methyltransferase gene. The HUNT study

BACKGROUND: The Catechol-O-methyltransferase (COMT) gene contains a functional polymorphism, Val158Met, that has been found to influence human pain perception. In one study fibromyalgia was less likely among those with Val/Val genotype. METHODS: In the 1995–97 Nord-Trøndelag Health Study (HUNT), the association between Val/Met polymorphism at the COMT gene and chronic musculoskeletal complaints (MSCs) was evaluated in a random sample of 3017 individuals. RESULTS: The distribution of the COMT Val158Met genotypes and alleles were similar between controls and the twelve different chronic MSCs groups. Even when the Met/Met and Val/Met genotypes were pooled, the distribution of the Val/Val genotype and other genotypes were similar between controls and the chronic MSCs groups. CONCLUSION: In this population-based study, no significant association was found between Val/Met polymorphism at the COMT gene and chronic MSCs