Stage of chronicity and treatment response in patients with musculoskeletal injuries and concurrent symptoms of depression

Abstract The present study examined the relation between stage of chronicity and treatment response in patients with work-related musculoskeletal conditions and concurrent depressive symptoms. Also of interest was the role of reductions in pain severity, catastrophic thinking and fear of movement/re-injury as mediators of the relation between chronicity and treatment response. A sample of 80 individuals (38 women, 42 men) with a disabling musculoskeletal pain condition and concurrent depressive symptoms participated in the research. Individuals with work absence of less than 6 months (range 12-26 weeks) were classified as early chronic (N = 40), and individuals with work absence greater than 6 months (range 27-52 weeks) were classified as chronic. Both groups were matched on sex, age (±2 years) and severity of depressive symptoms. All participants were enrolled in a 10-week community-based disability management intervention. The early chronic group showed significantly greater reduction in depressive symptoms, and pain symptoms, than the chronic group. Regression analyses revealed that pain reduction, but not catastrophic thinking or fear of movement/ re-injury, mediated the relation between chronicity and improvement in depressive symptoms. The results highlight the importance of early detection and treatment of depressive symptoms, given that treatment response decreases over time. The results also suggest that reductions in depressive symptoms might be a precondition to the effective reduction of pain symptoms in this population. Discussion addresses the factors that might contribute to treatment resistance as the period of disability extends over time.

A computer program for the generalized chi-square analysis of categorical data using weighted least squares (GENCAT)

GENCAT is a computer program which implements an extremely general methodology for the analysis of multivariate categorical data. This approach essentially involves the construction of test statistics for hypotheses involving functions of the observed proportions which are directed at the relationships under investigation and the estimation of corresponding model parameters via weighted least squares computations. Any compounded function of the observed proportions which can be formulated as a sequence of the following transformations of the data vector -- linear, logarithmic, exponential, or the addition of a vector of constants -- can be analyzed within this general framework. This algorithm produces minimum modified chi-square statistics which are obtained by partitioning the sums of squares as in ANOVA. The input data can be either: (a) frequencies from a multidimensional contingency table; (b) a vector of functions with its estimated covariance matrix; and (c) raw data in the form of integer-valued variables associated with each subject. The input format is completely flexible for the data as well as for the matrices.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/21627/1/0000006.pd

Walk well:a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

Background - Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design - This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion - Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities

Durability design of reinforced concrete structures: a comparison of the use of durability indexes in the deemed-to-satisfy approach and the full-probabilistic approach

Abstract: To show the application of the chloride conductivity index test in service life prediction (SLP) using both the deemed-to-satisfy and probabilistic approaches to performance-based durability design. It is desirable to adopt a performance-based approach with respect to durability design of reinforced concrete (RC) structures. This is based on the perception that the durability of RC is achieved when the limiting value from an established test method is met. In South Africa, the durability index (DI) approach has been developed, which permits performance-based specifications for durability of RC. This approach involves the application of a test method together with a SLP model. This integrated approach links material properties directly with the expected service life of RC structures and environmental conditions. Two DIs are relevant to degradation processes in RC: the chloride conductivity index which is related to chloride ingress, and the oxygen permeability index related to carbonation. The study presented here focuses on the application of the chloride conductivity index as the main input parameter of a SLP model concerned with chloride-induced reinforcement corrosion. The methodology and output of the SLP model as applied in the deemed-to-satisfy approach are compared with those of the probabilistic approach. Both approaches are exemplified using a concrete pier cast in situ in a marine environment. The performance-based durability specifications from the deemed-to-satisfy approach are found to be more conservative compared to those of the probabilistic approach

Integration of ancient DNA with transdisciplinary dataset finds strong support for Inca resettlement in the south Peruvian coast

Ancient DNA (aDNA) analysis provides a powerful means of investigating human migration, social organization, and a plethora of other crucial questions about humanity’s past. Recently, specialists have suggested that the ideal research design involving aDNA would include multiple independent lines of evidence. In this paper, we adopt a transdisciplinary approach integrating aDNA with archaeological, biogeochemical, and historical data to investigate six individuals found in two cemeteries that date to the Late Horizon (1400 to 1532 CE) and Colonial (1532 to 1825 CE) periods in the Chincha Valley of southern Peru. Genomic analyses indicate that these individuals are genetically most similar to ancient and present-day populations from the north Peruvian coast located several hundred kilometers away. These genomic data are consistent with 16th century written records as well as ceramic, textile, and isotopic data. These results provide some of the strongest evidence yet of state-sponsored resettlement in the pre-Colonial Andes. This study highlights the power of transdisciplinary research designs when using aDNA data and sets a methodological standard for investigating ancient mobility in complex societies

Cross-cultural adaptation of the VISA-A questionnaire, an index of clinical severity for patients with Achilles tendinopathy, with reliability, validity and structure evaluations

BACKGROUND: Achilles tendinopathy is considered to be one of the most common overuse injuries in elite and recreational athletes and the recommended treatment varies. One factor that has been stressed in the literature is the lack of standardized outcome measures that can be used in all countries. One such standardized outcome measure is the Victorian Institute of Sports Assessment – Achilles (VISA-A) questionnaire, which is designed to evaluate the clinical severity for patients with Achilles tendinopathy. The purpose of this study was to cross-culturally adapt the VISA-A questionnaire to Swedish, and to perform reliability, validity and structure evaluations. METHODS: Cross-cultural adaptation was performed in several steps including translations, synthesis of translations, back translations, expert committee review and pre-testing. The final Swedish version, the VISA-A Swedish version (VISA-A-S) was tested for reliability on healthy individuals (n = 15), and patients (n = 22). Tests for internal consistency, validity and structure were performed on 51 patients. RESULTS: The VISA-A-S had good reliability for patients (r = 0.89, ICC = 0.89) and healthy individuals (r = 0.89–0.99, ICC = 0.88–0.99). The internal consistency was 0.77 (Cronbach's alpha). The mean [95% confidence interval] VISA-A-S score in the 51 patients (50 [44–56]) was significantly lower than in the healthy individuals (96 [94–99]). The VISA-A-S score correlated significantly (Spearman's r = -0.68) with another tendon grading system. Criterion validity was considered good when comparing the scores of the Swedish version with the English version in both healthy individuals and patients. The factor analysis gave the factors pain/symptoms and physical activity CONCLUSION: The VISA-A-S questionnaire is a reliable and valid instrument and comparable to the original version. It measures two factors: pain/symptoms and physical activity, and can be used in both research and the clinical setting

Pre-Flight Calibration of the Mars 2020 Rover Mastcam Zoom (Mastcam-Z) Multispectral, Stereoscopic Imager

The NASA Perseverance rover Mast Camera Zoom (Mastcam-Z) system is a pair of zoomable, focusable, multi-spectral, and color charge-coupled device (CCD) cameras mounted on top of a 1.7 m Remote Sensing Mast, along with associated electronics and two calibration targets. The cameras contain identical optical assemblies that can range in focal length from 26 mm (25.5∘×19.1∘ FOV) to 110 mm (6.2∘×4.2∘ FOV) and will acquire data at pixel scales of 148-540 μm at a range of 2 m and 7.4-27 cm at 1 km. The cameras are mounted on the rover’s mast with a stereo baseline of 24.3±0.1 cm and a toe-in angle of 1.17±0.03∘ (per camera). Each camera uses a Kodak KAI-2020 CCD with 1600×1200 active pixels and an 8 position filter wheel that contains an IR-cutoff filter for color imaging through the detectors’ Bayer-pattern filters, a neutral density (ND) solar filter for imaging the sun, and 6 narrow-band geology filters (16 total filters). An associated Digital Electronics Assembly provides command data interfaces to the rover, 11-to-8 bit companding, and JPEG compression capabilities. Herein, we describe pre-flight calibration of the Mastcam-Z instrument and characterize its radiometric and geometric behavior. Between April 26thth and May 9thth, 2019, ∼45,000 images were acquired during stand-alone calibration at Malin Space Science Systems (MSSS) in San Diego, CA. Additional data were acquired during Assembly Test and Launch Operations (ATLO) at the Jet Propulsion Laboratory and Kennedy Space Center. Results of the radiometric calibration validate a 5% absolute radiometric accuracy when using camera state parameters investigated during testing. When observing using camera state parameters not interrogated during calibration (e.g., non-canonical zoom positions), we conservatively estimate the absolute uncertainty to be 0.2 design requirement. We discuss lessons learned from calibration and suggest tactical strategies that will optimize the quality of science data acquired during operation at Mars. While most results matched expectations, some surprises were discovered, such as a strong wavelength and temperature dependence on the radiometric coefficients and a scene-dependent dynamic component to the zero-exposure bias frames. Calibration results and derived accuracies were validated using a Geoboard target consisting of well-characterized geologic samples

Understanding acute ankle ligamentous sprain injury in sports

This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms). The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception. Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury