The association between back pain and trunk posture of workers in a special school for the severe handicaps

<p>Abstract</p> <p>Background</p> <p>The present study aims to determine the time spent in different static trunk postures during a typical working day of workers in a special school for the severe handicaps.</p> <p>Methods</p> <p>Eighteen workers with low back pain (LBP) and fifteen asymptomatic workers were recruited. A cross-sectional design was employed to study the time spent in different static trunk postures which was recorded by a biaxial accelerometer attached to the T₁₂level of the back of the subjects.</p> <p>Results</p> <p>The results of ANCOVA revealed that subjects with LBP spent significantly longer percentage of time in static trunk posture when compared to normal (p < 0.05). It was also shown that they spent significantly longer time in trunk flexion for more than 10° (p < 0.0125).</p> <p>Conclusion</p> <p>An innovative method has been developed for continuous tracking of spinal posture, and this has potential for widespread applications in the workplace. The findings of the present investigation suggest that teachers in special schools are at increased risk of getting LBP. In order to minimise such risk, frequent postural change and awareness of work posture are recommended.</p

Cost-Effectiveness of Dabigatran versus Genotype-Guided Management of Warfarin Therapy for Stroke Prevention in Patients with Atrial Fibrillation

BACKGROUND: Dabigatran is associated with lower rate of stroke comparing to warfarin when anticoagulation control is sub-optimal. Genotype-guided warfarin dosing and management may improve patient-time in target range (TTR) and therefore affect the cost-effectiveness of dabigatran compared with warfain. We examined the cost-effectiveness of dabigatran versus warfarin therapy with genotype-guided management in patients with atrial fibrillation (AF). METHODOLOGY/PRINCIPAL FINDINGS: A Markov model was designed to compare life-long economic and treatment outcomes of dabigatran (110 mg and 150 mg twice daily), warfarin usual anticoagulation care (usual AC) with mean TTR 64%, and genotype-guided anticoagulation care (genotype-guided AC) in a hypothetical cohort of AF patients aged 65 years old with CHADS(2) score 2. Model inputs were derived from literature. The genotype-guided AC was assumed to achieve TTR = 78.9%, adopting the reported TTR achieved by warfarin service with good anticoagulation control in literature. Outcome measure was incremental cost per quality-adjusted life-year (QALY) gained (ICER) from perspective of healthcare payers. In base-case analysis, dabigatran 150 mg gained higher QALYs than genotype-guided AC (10.065QALYs versus 9.554QALYs) at higher cost (USD92,684 versus USD85,627) with ICER = USD13,810. Dabigatran 110 mg and usual AC gained less QALYs but cost more than dabigatran 150 mg and genotype-guided AC, respectively. ICER of dabigatran 150 mg versus genotype-guided AC would be >USD50,000 (and genotype-guided AC would be most cost-effective) when TTR in genotype-guided AC was >77% and utility value of warfarin was the same or higher than that of dabigatran. CONCLUSIONS/SIGNIFICANCE: The likelihood of genotype-guided anticoagulation service to be accepted as cost-effective would increase if the quality of life on warfarin and dabigatran therapy are compatible and genotype-guided service achieves high TTR (>77%)

Blood Oxygen Level-Dependent (BOLD) MRI in Glomerular Disease

Renal hypoxia has recently been implicated as a key contributor and indicator of various glomerular diseases. As such, monitoring changes in renal oxygenation in these disorders may provide an early diagnostic advantage that could prevent potential adverse outcomes. Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI) is an emerging noninvasive technique for assessing renal oxygenation in glomerular disease. Although BOLD MRI has produced promising initial results for the use in certain renal pathologies, the use of BOLD imaging in glomerular diseases, including primary and secondary nephrotic and nephritic syndromes, is relatively unexplored. Early BOLD studies on primary nephrotic syndrome, nephrotic syndrome secondary to diabetes mellitus, and nephritic syndrome secondary to systemic lupus erythematosus have shown promising results to support its future clinical utility. In this review, we outline the advancements made in understanding the use of BOLD MRI for the assessment, diagnosis, and screening of these pathologies

Affordable Net Zero Housing and Transportation Solutions

Today the built environment expends 43% of US energy. In the past ten years the science community has begun to tackle this issue with research on the concept of net zero buildings, or buildings that combine energy efficiency and on-site renewable energy production to use no net energy from off-site sources (Dannenberg, 2007). This policy brief explores some of the issues related to net zero construction, as well as variation in state policy approaches that support a net zero construction approach. Current issues affecting net zero are the lack of definitional clarity, the broad range of policies needed to construct net zero housing, and the cost of implementation

Next nearest neighbour Ising models on random graphs

This paper develops results for the next nearest neighbour Ising model on random graphs. Besides being an essential ingredient in classic models for frustrated systems, second neighbour interactions interactions arise naturally in several applications such as the colour diversity problem and graphical games. We demonstrate ensembles of random graphs, including regular connectivity graphs, that have a periodic variation of free energy, with either the ratio of nearest to next nearest couplings, or the mean number of nearest neighbours. When the coupling ratio is integer paramagnetic phases can be found at zero temperature. This is shown to be related to the locked or unlocked nature of the interactions. For anti-ferromagnetic couplings, spin glass phases are demonstrated at low temperature. The interaction structure is formulated as a factor graph, the solution on a tree is developed. The replica symmetric and energetic one-step replica symmetry breaking solution is developed using the cavity method. We calculate within these frameworks the phase diagram and demonstrate the existence of dynamical transitions at zero temperature for cases of anti-ferromagnetic coupling on regular and inhomogeneous random graphs.Comment: 55 pages, 15 figures, version 2 with minor revisions, to be published J. Stat. Mec

Recognition of carbohydrate by major histocompatibility complex class I-restricted, glycopeptide-specific cytotoxic T lymphocytes

6 pages, 5 figures.-- PMID: 8046349 [PubMed].-- PMCID: PMC2191607.Cytotoxic T cells (CTL) recognize short peptide epitopes presented by class I glycoproteins encoded by the major histocompatibility complex (MHC). It is not yet known whether peptides containing posttranslationally modified amino acids can also be recognized by CTL. To address this issue, we have studied the immunogenicity and recognition of a glycopeptide carrying an O-linked N-acetylglucosamine (GlcNAc) monosaccharide-substituted serine residue. This posttranslational modification is catalyzed by a recently described cytosolic glycosyltransferase. We show that glycosylation does not affect peptide binding to MHC class I and that glycopeptides can elicit a strong CTL response that is glycopeptide specific. Furthermore, glycopeptide recognition by cytotoxic T cells is dependent on the chemical structure of the glycan as well as its position within the peptide.We wish to thank Dr. Elena Sadovnikova and Dr. Hans J. Stanss (Imperial Cancer Research Foundation, London, UK) for their valuable help with raising antipeptide CTLs; and Professor Jens Chr. Jensenius (University of Aarbus, Denmark) for helpful discussions. J. S. Haurum is a Carlsberg-Wellcome Travelling Research Fellow, G. Asequell is an EC Fellow, and A. C. Lellouch is supported by a United States Public Health Service National Research Service Award F32 GM- 15811. This work was supported by the Carlsberg Foundation, the Wellcome trust, the Beckett Foundation, and Statens Sundhedsvidenskabelige Forskningsr~d, Denmark.Peer reviewe

Index Patient and SARS Outbreak in Hong Kong

During the global outbreak of severe acute respiratory syndrome (SARS) in 2003, treatment was empiric. We report the case history of the index patient in a hospital outbreak of SARS in Hong Kong. The patient recovered after conventional antimicrobial therapy. Further studies are needed to address treatment of SARS, which has high attack and death rates