Upper back pain in postmenopausal women and associated physical characteristics

The physical characteristics of postmenopausal women that are associated with upper back pain are not well-understood. The aim of this cross-sectional study was to identify the physical characteristics associated with presence and severity of upper back pain in healthy postmenopausal women. Self-reported upper back pain presence (within the previous month) and severity (numerical rating scale) were examined against the physical characteristics: height; weight; body mass index; breast size; breast ptosis; upper back extensor muscle endurance (isometric chest raise test); head, shoulder and upper back posture (photogrammetry); thoracic extension mobility (photogrammetry); bone mineral density (dual-energy x-ray absorptiometry (DXA)); body composition (DXA); and thoracic kyphosis, thoracic osteoarthritis and thoracic vertebral fracture (all radiography). A multivariable logistic regression model, adjusted for age, was built using physical characteristics with a significant univariate association with upper back pain. Censored Tobit regression, adjusted for age, was used to examine each physical characteristic against upper back pain severity. Postmenopausal women (n = 119) with a mean (SD) age of 61.4 (7.0) years participated in the study. After adjusting for age, the physical characteristics independently associated with upper back pain were: height (OR: 0.50, 95% CI: 0.31–0.79); and upper back extensor muscle endurance (OR: 0.46, 95%CI: 0.28–0.75). This model explained 31% of the variance in upper back pain (p<0.001). After adjusting for age, being taller and having better upper back extensor muscle endurance were associated with lower odds for upper back pain. After adjusting for age, differences in upper back pain severity were explained by upper back extensor muscle endurance (p = <0.001) and lean mass (p = 0.01). Conclusion: As a modifiable physical characteristic of postmenopausal women with upper back pain, upper back extensor muscle endurance is worth considering clinically

Permafrost degradation and nitrogen cycling in Arctic rivers: Insights from stable nitrogen isotope studies

Abstract. Across the Arctic, vast areas of permafrost are being degraded by climate change, which has the potential to release substantial quantities of nutrients, including nitrogen into large Arctic rivers. These rivers heavily influence the biogeochemistry of the Arctic Ocean, so it is important to understand the potential changes to rivers from permafrost degradation. This study utilized dissolved nitrogen species (nitrate and dissolved organic nitrogen (DON)) along with nitrogen isotope values (δ15N-NO3- and δ15N-DON) of samples collected from permafrost sites in the Kolyma River and the six largest Arctic rivers. Large inputs of DON and nitrate with a unique isotopically heavy δ15N signature were documented in the Kolyma, suggesting the occurrence of denitrification and highly invigorated nitrogen cycling in the Yedoma permafrost thaw zones along the Kolyma. We show evidence for permafrost-derived DON being recycled to nitrate as it passes through the river, transferring the high 15N signature to nitrate. However, the potential to observe these thaw signals at the mouths of rivers depends on the spatial scale of thaw sites, permafrost degradation, and recycling mechanisms. In contrast with the Kolyma, with near 100 % continuous permafrost extent, the Ob River, draining large areas of discontinuous and sporadic permafrost, shows large seasonal changes in both nitrate and DON isotopic signatures. During winter months, water percolating through peat soils records isotopically heavy denitrification signals in contrast with the lighter summer values when surface flow dominates. This early year denitrification signal was present to a degree in the Kolyma, but the ability to relate seasonal nitrogen signals across Arctic Rivers to permafrost degradation could not be shown with this study. Other large rivers in the Arctic show different seasonal nitrogen trends. Based on nitrogen isotope values, the vast majority of nitrogen fluxes in the Arctic rivers is from fresh DON sourced from surface runoff through organic-rich topsoil and not from permafrost degradation. However, with future permafrost thaw, other Arctic rivers may begin to show nitrogen trends similar to the Ob. Our study demonstrates that nitrogen inputs from permafrost thaw can be identified through nitrogen isotopes, but only on small spatial scales. Overall, nitrogen isotopes show potential for revealing integrated catchment wide nitrogen cycling processes. </jats:p

Salmonella and Campylobacter spp. in Northern Elephant Seals, California

Campylobacter and Salmonella spp. prevalence and antimicrobial drug sensitivity were determined in northern elephant seals that had not entered the water and seals that were stranded on the California coast. Stranded seals had a higher prevalence of pathogenic bacteria, possibly from terrestrial sources, which were more likely to be resistant

Identifying stakeholders and collaborating with communities

Working with communities, including local and Indigenous communities, is fundamental to most successful conservation practice. Key elements include determining the appropriate level of engagement, identifying the key stakeholders, identifying appropriate means of collaborating with different stakeholders, creating and maintaining trust, and collaborating to deliver the objectives

The effectiveness of schemes that refine referrals between primary and secondary care - the UK experience with glaucoma referrals: the Health Innovation & Education Cluster (HIEC) Glaucoma Pathways Project

Objectives: A comparison of glaucoma referral refinement schemes (GRRS) in the UK during a time period of considerable change in national policy and guidance. Design: Retrospective multisite review. Setting: The outcomes of clinical examinations by optometrists with a specialist interest in glaucoma (OSIs) were compared with optometrists with no specialist interest in glaucoma (non-OSIs). Data from Huntingdon and Nottingham assessed non-OSI findings, while Manchester and Gloucestershire reviewed OSI findings. Participants: 1086 patients. 434 patients were from Huntingdon, 179 from Manchester, 204 from Gloucestershire and 269 from Nottingham. Results: The first-visit discharge rate (FVDR) for all time periods for OSIs was 14.1% compared with 36.1% from non-OSIs (difference 22%, CI 16.9% to 26.7%; p<0.001). The FVDR increased after the April 2009 National Institute for Health and Clinical Excellence (NICE) glaucoma guidelines compared with pre-NICE, which was particularly evident when pre-NICE was compared with the current practice time period (OSIs 6.2–17.2%, difference 11%, CI −24.7% to 4.3%; p=0.18, non-OSIs 29.2–43.9%, difference 14.7%, CI −27.8% to −0.30%; p=0.03). Elevated intraocular pressure (IOP) was the commonest reason for referral for OSIs and non-OSIs, 28.7% and 36.1%, respectively, of total referrals. The proportion of referrals for elevated IOP increased from 10.9% pre-NICE to 28.0% post-NICE for OSIs, and from 19% to 45.1% for non-OSIs. Conclusions: In terms of ‘demand management’, OSIs can reduce FVDR of patients reviewed in secondary care; however, in terms of ‘patient safety’ this study also shows that overemphasis on IOP as a criterion for referral is having an adverse effect on both the non-OSIs and indeed the OSIs ability to detect glaucomatous optic nerve features. It is recommended that referral letters from non-OSIs be stratified for risk, directing high-risk patients straight to secondary care, and low-risk patients to OSIs

Mutation profiling in South African patients with Cornelia de Lange syndrome phenotype

DATA AVAILABILITY STATEMENT : The variants described here were submitted to ClinVar and can be viewed under Organization ID 508172 or the ClinVar IDs recorded in Table 1. Data available on reasonable request from the corresponding author.BACKGROUND : Cornelia de Lange Syndrome (CdLS) presents with a variable multi-systemic phenotype and pathogenic variants have been identified in five main genes. This condition has been understudied in African populations with little phenotypic and molecular information available. METHODS AND RESULTS : We present a cohort of 14 patients with clinical features suggestive of CdLS. Clinical phenotyping was carried out and cases were classified according to the international consensus criteria. According to this criteria, nine patients had classical CdLS, one had non-classical CdLS and four presented with a phenotype that suggested molecular testing for CdLS. Each patient underwent mutation profiling using a targeted next generation sequencing panel of 18 genes comprising known and suspected CdLS causal genes. Of the 14 patients tested, pathogenic and likely pathogenic variants were identified in nine: eight variants in the NIPBL gene and one in the STAG1 gene. CONCLUSIONS : We present the first molecular data for a cohort of South African patients with CdLS. Eight of the nine variants identified were in the NIPBL gene, the most commonly involved gene in cases of CdLS. This is also the first report of a patient of African ancestry presenting with STAG1-related CdLS.The National Research Foundation and the South African Medical Research Council.http://www.wileyonlinelibrary.com/journal/mgg3hj2024BiochemistryGeneticsMicrobiology and Plant PathologySDG-03:Good heatlh and well-bein

Applied utility and the auto-ethnographic short story: persuasions for, and illustrations of, writing critical social science

In some quarters it is argued that, narrative researchers might be classified as being either storyanalysts or storytellers. They go on to suggest that one feature of storytellers is that they undertake a form of analysis as the process of writing unfolds. With these sentiments in mind, in the present paper, we consider how auto-ethnographical accounts of traumatic and challenging life events might, through the analysis contained within, demonstrate value within the realm of applied pedagogy. In making our case we embrace and adapt the literary genre of storytelling, more specifically, the short story. The story presented here, ‘Travel Writer’, offers an opaque, multicontextualised and lifelong view of career transition. The present paper, in more general terms, considers the capacity of auto-ethnography and, more specifically, the short storied version of it, to engender critical reader engagement, to encourage personal reflection in others, and to act as a point of stimulus for the enactment of applied debate through the lens of critical social science. With regards to the assumptions of critical social science, the final discussion also considers how the auto-ethnographic text, as a pedagogic tool, might help others to contest and challenge the meta-narratives that, we argue, risk stagnating established thinking

Poet: Product-oriented Video Captioner for E-commerce

In e-commerce, a growing number of user-generated videos are used for product promotion. How to generate video descriptions that narrate the user-preferred product characteristics depicted in the video is vital for successful promoting. Traditional video captioning methods, which focus on routinely describing what exists and happens in a video, are not amenable for product-oriented video captioning. To address this problem, we propose a product-oriented video captioner framework, abbreviated as Poet. Poet firstly represents the videos as product-oriented spatial-temporal graphs. Then, based on the aspects of the video-associated product, we perform knowledge-enhanced spatial-temporal inference on those graphs for capturing the dynamic change of fine-grained product-part characteristics. The knowledge leveraging module in Poet differs from the traditional design by performing knowledge filtering and dynamic memory modeling. We show that Poet achieves consistent performance improvement over previous methods concerning generation quality, product aspects capturing, and lexical diversity. Experiments are performed on two product-oriented video captioning datasets, buyer-generated fashion video dataset (BFVD) and fan-generated fashion video dataset (FFVD), collected from Mobile Taobao. We will release the desensitized datasets to promote further investigations on both video captioning and general video analysis problems.Comment: 10 pages, 3 figures, to appear in ACM MM 2020 proceeding