Dynamic forces acting on the lumbar spine during manual handling. Can they be estimated using electromyographic techniques alone?

STUDY DESIGN: Compressive loading of the lumbar spine was analyzed using electromyographic, movement analysis, and force-plate techniques. OBJECTIVES: To evaluate the inertial forces that cannot be detected by electromyographic techniques alone. SUMMARY OF BACKGROUND DATA: Links between back pain and manual labor have stimulated attempts to measure spine compressive loading. However, direct measurements of intradiscal pressure are too invasive, and force plates too cumbersome for use in the workplace. Electromyographic techniques are noninvasive and portable, but ignore certain inertial forces. METHODS: Eight men lifted boxes weighing 6.7 and 15.7 kg from the ground, while joint moments acting about L5-S1 were quantified 1) by using a linked-segment model to analyze data from Kistler force plates and a Vicon movement-analysis system, and 2) by measuring the electromyographic activity of the erector spinae muscles, correcting it for contraction speed and comparing it to moment generation during static contractions. The linked-segment model was used to calculate the "axial thrust," defined as the component of the L5-S1 reaction force that acts along the axis of the spine and that is unrelated to trunk muscle activity or static body weight. RESULTS: Peak extensor moments predicted by the two techniques were similar and equivalent to spinal compressive forces of 2.9-4.8 kN. The axial thrust "hidden" from the electromyographic technique was negligible during slow lifts, and remained below 4% of peak spinal compression even during fast heavy lifts. Peak axial thrust was proportional to the peak vertical ground reaction (R2 = 0.74). CONCLUSIONS: Electromyographic techniques can measure dynamic spinal loading, but additional force-plate data would improve accuracy slightly during lifts requiring a vigorous upward thrust from the legs

Synergistically enhance confined diffusion by continuum intersecting channels in zeolites

In separation and catalysis applications, adsorption and diffusion are normally considered mutually exclusive. That is, rapid diffusion is generally accompanied by weak adsorption and vice versa. In this work, we analyze the anomalous loading-dependent mechanism of p-xylene diffusion in a newly developed zeolite called SCM-15. The obtained results demonstrate that the unique system of “continuum intersecting channels” (i.e., channels made of fused cavities) plays a key role in the diffusion process for the molecule-selective pathways. At low pressure, the presence of strong adsorption sites and intersections that provide space for molecule rotation facilitates the diffusion of p-xylene along the Z direction. Upon increasing the molecular uptake, the adsorbates move faster along the X direction because of the effect of continuum intersections in reducing the diffusion barriers and thus maintaining the large diffusion coefficient of the diffusing compound. This mechanism synergistically improves the diffusion in zeolites with continuum intersecting channels.This work was supported by the National Natural Science Foundation of China (nos. 22032005, 21902180, 21802164, 21991092, 21991090, 22002174, and 91645112), the Natural Science Foundation of Hubei Province of China (2018CFA009), the Key Research Program of Frontier Sciences (CAS no. QYZDB-SSW-SLH026), Sinopec Corp. (417012-4), and the CAS Interdisciplinary Innovation Team (grant no. JCTD-2018-10). G.S. thanks the MICINN of Spain for funding through projects RTI2018-101784-B-I00, RTI2018-101033-B-I00, and SEV-2016-0683

Perspective-Taking and Perspective-Sharing in Pediatric Education: Exploring Connections Between Strategies of Medical Students and Patients' Caregivers

INTRODUCTION: In pediatric education, caregivers are increasingly involved to share their perspective. Yet, an in-depth understanding of the perspective-taking process between medical students and caregivers is lacking. This study explored: 1) Which strategies do medical students use to take a caregiver's perspective and which facilitators and constraints do they perceive? 2) Which strategies do caregivers use to share their perspective with students? and 3) How do students' perspective-taking strategies relate to caregivers' perspective-sharing strategies? METHODS: In an online lesson: two caregivers of pediatric patients, shared their story with 27 fourth-year Dutch medical students. After the session, students undertook an assignment where they individually reflected on how they took perspective. Students' reflections were collected via audio recordings. Caregivers were individually interviewed. Data were analyzed through thematic and cross-case analysis. RESULTS: Students used eight perspective-taking strategies, in various combinations. Students used inferential strategies, where they made inferences from available information, and cultivating strategies, where they attempted to elicit more information about the caregiver. Students perceived individual-, contextual- and caregiver-related facilitators and constraints for taking perspective. Caregivers shared their perspective by adopting multiple strategies to share their story and create a trusting learning environment. We visualized connections between students' perspective-taking strategies, facilitators/constraints, and caregivers' perspective-sharing strategies. DISCUSSION: By combining data from both perspective-takers (students) and perspective-sharers (caregivers), this study provides a foundation for future research to study perspective-taking between students and patients in an educational context. On a practical level, our findings provide tools for students, patients, and educators to enhance perspective-taking processes

Daily-life tele-monitoring of motor performance in stroke survivors

The objective of the EU project INTERACTION is to develop an unobtrusive and modular sensing system for objective monitoring of daily-life motor performance of stroke survivors. This will enable clinical professionals to advise their patients about their continued daily-life activity profile and home training, and evaluate and optimize rehabilitation programs.A modular textile-integrated sensing system was developed and performance and capacity measures were proposed and clinically tested in stroke subject.Telemonitoring facilities were developed and tested. In the last stage of the project, the system will be tested during daily-life