Electromyographic Analysis of Shoulder Girdle Muscles during Common Internal Rotation Exercises

Background: High level throwing performance requires the development of effective muscle activation within shoulder girdle muscles particularly during forceful internal rotation (IR) motions. Study Design: Controlled Laboratory Descriptive Study Purpose: To investigate activation pattern of 16 shoulder girdle muscles/muscle sub-regions during three common shoulder IR exercises. Method: EMG was recorded in 30 healthy subjects from 16 shoulder girdle muscles/muscle sub-regions (surface electrode: anterior, middle and posterior deltoid, upper, middle and lower trapezius, serratus anterior, teres major, upper and lower latissimus dorsi, upper and lower pectoralis major; fine wire electrodes: supraspinatus, infraspinatus, subscapularis and rhomboid major) using a telemetric EMG system. Three IR exercises (standing IR at 0o and 90o of Abduction, and IR at Zero-Position) were studied. EMG amplitudes were normalized to EMGmax (EMG at maximal IR force in a standard position) and compared using one-way repeated-measures analysis of variance (ANOVA). Results: There were significant differences in muscles’ activation across IR exercises (p<0.05–p<0.001). Rotator cuff and deltoid muscles were highly activated during IR at 90° of Abduction. Latissimus dorsi exhibited markedly higher activation during IR at Zero-Position. While upper trapezius had the highest activation during IR at Zero-Position, middle and lower trapezius were activated at highest during IR at 90o of Abduction. The highest activation of serratus anterior and rhomboid major occurred in IR at Zero-Position and IR at 90o of Abduction, respectively. Conclusions: Studied exercises have the potential to effectively activate glenohumeral and scapular muscles involved in throwing motions. Results provide further evidence for developing rehabilitation, injury prevention, and training strategies

Characteristics of direct human impacts on the rivers Karun and Dez in lowland south-west Iran and their interactions with earth surface movements

Two of the primary external factors influencing the variability of major river systems, over river reach scales, are human activities and tectonics. Based on the rivers Karun and Dez in south-west Iran, this paper presents an analysis of the geomorphological responses of these major rivers to ancient human modifications and tectonics. Direct human modifications can be distinguished by both modern constructions and ancient remnants of former constructions that can leave a subtle legacy in a suite of river characteristics. For example, the ruins of major dams are characterised by a legacy of channel widening to 100's up to c. 1000 m within upstream zones that can stretch to channel distances of many kilometres upstream of former dam sites, whilst the legacy of major, ancient, anthropogenic river channel straightening can also be distinguished by very low channel sinuosities over long lengths of the river course. Tectonic movements in the region are mainly associated with young and emerging folds with NW–SE and N–S trends and with a long structural lineament oriented E–W. These earth surface movements can be shown to interact with both modern and ancient human impacts over similar timescales, with the types of modification and earth surface motion being distinguishable. This paper examines the geomorphological evidence and outlines the processes involved in the evolution of these interactions through time. The analysis shows how interactions between earth surface movements and major dams are slight, especially after ancient dam collapse. By contrast, interactions between earth surface movements and major anthropogenic river channel straightening are shown to be a key factor in the persistence of long, near-straight river courses. Additionally, it is suggested that artificial river development, with very limited river channel lateral migration, may promote incision across an active fold at unusually long distances from the fold “core” and may promote markedly increased sinuosity across a structural lineament

Pain, Functional Disability, Psychological Status, and Health-Related Quality of Life in Patients with Subacromial Impingement Syndrome

Background Subacromial impingement syndrome (SAIS) is the comments painful shoulder condition leading to considerable functional loss. Considering numerous existing conservative and surgical interventions for SAIS, the use of optimal patient-centred outcome measures is essential. Study assessed various generic and shoulder-specific outcome measures in patients and healthy controls to provide baseline data and facilitate the development of evidence-based interventions. Methods A total of 75 participants including 39 patients and 36 healthy controls were evaluated and compared by a battery of validated outcome tools: McGill Pain Questionnaire, Oxford Shoulder Score, Constant Murley Score, The Disability of the Arm, Shoulder and Hand, Upper Limb Function Index, Functional Impairment Test–Hand and Neck/Shoulder/Arm, Hospital Anxiety and Depression Scale, Short-Form Health Survey, and shoulder muscle strength. Results All selected measures showed significant differences in the pain experience, upper limb functional capacity, psychological status (anxiety and depression), and health-related quality of life between SAIS patients and healthy controls in both female and male participant groups (p<0.05 - p<0.001). Conclusion The use of an array of patient-centred upper limb regional/joint-specific pain and functional measures combined with psychological status and quality of life tools is recommended for the evidence-based assessment of intervention outcome in patients with SAIS

Dabigatran etexilate for thromboprophylaxis in over 5000 hip or knee replacement patients in a real-world clinical setting

BACKGROUND: Thromboprophylaxis is recommended for patients undergoing total hip or total knee replacement (THR, TKR). An international, open-label, prospective, observational, single-arm study in a routine clinical setting was performed to assess the safety and efficacy of dabigatran etexilate 220 mg once daily in patients undergoing THR or TKR, and in subgroups of patients with potentially increased risk of bleeding or venous thromboembolism (VTE). MATERIALS AND METHODS: Patients were ≥18 years and required to be eligible to receive dabigatran 220 mg once daily (first dose 110 mg 1–4 h after THR/TKR surgery) according to the European Summary of Product Characteristics. The primary safety and efficacy outcomes were incidence of major bleeding events (MBEs), and the composite incidence of symptomatic VTE events and all-cause mortality, respectively. RESULTS: In total, 5292 patients (median age 64 years) were enrolled and received dabigatran (2734 THR and 2558 TKR). Median drug exposure was 31 days (THR 34 days; TKR 27 days). Overall incidence of MBEs was 0.72 % (95 % confidence interval [CI] 0.51, 0.98), and this rate was comparable between types of surgery and was not significantly affected by protocol-defined risk factors. The overall incidence of symptomatic VTE and all-cause mortality was 1.04 % (95 % CI 0.78, 1.35); the only significant risk factor was history of VTE events (odds ratio 5.59; 95 % CI 2.53, 11.08). A post-hoc analysis showed that the incidence of MBEs in this observational study was similar to or lower than those reported in previous phase 3 trials. CONCLUSIONS: Results from this observational study of dabigatran etexilate administered to patients undergoing THR or TKR surgery are reassuring and supportive of those obtained in dabigatran phase 3 trials. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00846807. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12959-016-0082-4) contains supplementary material, which is available to authorized users

Planting a Standard: Proposing a Broad Reading of \u3cem\u3eIn re Elsner\u3c/em\u3e

This Note will show that one can read Elsner broadly to encompass both plant-type and widget-type inventions, and that applying Elsner to both plants and widgets is within the current statutory framework and case law. Such a reading would change the § 102 bar for inventions patentable under § 10i29 (hereinafter referred to as widgets ) as well as for plants. Part I of this Note argues that congressional sources require a flexible test-one that does not prejudice any objects under the Patent Act. Part II discusses the judicial interpretation of the Patent Act prior to Elsner in order to argue first, that past cases disfavor discrimination based on invention type and second, that courts have already applied a broad reading of Elsner to non-plant inventions. Part III shows that the move toward harmonization of U.S. laws with international standards is especially strong in intellectual property. As a result, Part III argues that courts should pay attention to international sources and harmonize U.S. laws with international standards. Such harmonization requires considering foreign sales as prior art for all inventions. Thus, courts should apply the Elsner\u27s possession test to plants and § 101 inventions, effectively removing the territorial boundary for sales that make inventions accessible to the U.S. public