Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial

Objective To determine the effectiveness of dynamic muscle training and relaxation training for chronic neck pain. Design Randomised controlled trial. Setting Five occupational healthcare centres, Tampere, Finland. Participants 393 female office workers (mean age 45 years) with chronic non-specific neck pain randomly assigned to 12 weeks of dynamic muscle training (n = 135) or relaxation training (n = 128), plus one week of reinforcement training six months after baseline; or ordinary activity (control group; n = 130). Main outcome measure Change in intensity of neck pain at three, six, and 12 months. Results No significant difference was found in neck pain between the groups at follow up. However, the range of motion for cervical rotation and lateral flexion increased more in the training groups than in the control group. Conclusions Dynamic muscle training and relaxation training do not lead to better improvements in neck pain compared with ordinary activity

Exposure to cobalt in the production of cobalt and cobalt compounds and its effect on the heart

Aims: To investigate whether exposure to cobalt in cobalt plants has any measurable effect on the cardiovascular system. Methods: Occupational, cross sectional study, using a self administered questionnaire, blood pressure measurement, electrocardiography, and laboratory tests in which 203 male workers with at least one year of exposure to cobalt and 94 unexposed controls participated. Echocardiography was performed on a subset of 122 most highly exposed cobalt workers, of which 109 were analysed, and on 60 controls, of which 57 were analysed. Analysis of covariance and a multiple regression analysis were used to evaluate the data. Results: Two of the echocardiography parameters measured were associated with cobalt exposure. In the higher exposure group the left ventricular isovolumic relaxation time (mean 53.3, 49.1, and 49.7 ms in the high exposure, low exposure, and control groups respectively) and the deceleration time of the velocity of the early rapid filling wave (mean 194.3, 180.5, and 171.7 ms for those in the high exposure, low exposure, and control groups respectively) were prolonged, indicating altered left ventricular relaxation and early filling. Conclusion: Cumulative exposure to cobalt was found to be associated with the results of Doppler echocardiography measurements, indicating altered diastole. This finding supports the hypothesis that cobalt accumulation in the myocardium could affect myocardial function. Whether this finding has clinical implications remains to be evaluated

The circumsolar solar energetic particle event on 2022 January 2022, particle spread within and outside a magnetic cloud

On 2022 January 20, the Energetic Particle Detector on board Solar Orbiter detected a solar energetic particle (SEP) event showing unusual sunward-directed fluxes. Near-Earth spacecraft separated by 17° in longitude from Solar Orbiter measured classic antisunward-directed fluxes. Parker Solar Probe and MAVEN, separated by 130° and 216° respectively from Solar Orbiter, observed the particle event as well, suggesting a widespread event of nearly 360° in the heliosphere. The SEP event was associated with an M5-class X-ray flare and a CME with a speed of 1400 km/s. The energetic particles reached 3 MeV and 100 MeV energies for electrons and protons, respectively. The aim of this study is to disentangle how the particles are able to spread throughout the heliosphere and how the local heliospheric conditions affect the acceleration and transport of the particles at different spacecraft locations. This work presents the observations and analyses that lead to a scenario in which the solar source injected energetic particles into the solar wind and within a preceding interplanetary coronal mass ejection (ICME) that was already present in the heliosphere at the time of the SEP event onset. In particular, Solar Orbiter measured the particles injected along the longest leg of an ICME still connected to the Sun at the time of the particle release

The 17 April 2021 widespread solar energetic particle event

Context. A solar eruption on 17 April 2021 produced a widespread Solar Energetic Particle (SEP) event that was observed by five longitudinally well-separated observers in the inner heliosphere at heliocentric distances of 0.42 to 1 au: BepiColombo, Parker Solar Probe, Solar Orbiter, STEREO A, and near-Earth spacecraft. The event produced relativistic electrons and protons. It was associated with a long-lasting solar hard X-ray flare and a medium fast Coronal Mass Ejection (CME) with a speed of 880 km/s driving a shock, an EUV wave as well as long-lasting radio burst activity showing four distinct type III burst. Methods. A multi-spacecraft analysis of remote-sensing and in-situ observations is applied to attribute the SEP observations at the different locations to the various potential source regions at the Sun. An ENLIL simulation is used to characterize the interplanetary state and its role for the energetic particle transport. The magnetic connection between each spacecraft and the Sun is determined. Based on a reconstruction of the coronal shock front we determine the times when the shock establishes magnetic connections with the different observers. Radio observations are used to characterize the directivity of the four main injection episodes, which are then employed in a 2D SEP transport simulation. Results. Timing analysis of the inferred SEP solar injection suggests different source processes being important for the electron and the proton event. Comparison among the characteristics and timing of the potential particle sources, such as the CME-driven shock or the flare, suggests a stronger shock contribution for the proton event and a more likely flare-related source of the electron event. Conclusions. We find that in this event an important ingredient for the wide SEP spread was the wide longitudinal range of about 110 degrees covered by distinct SEP injections