The prevalence and incidence of musculoskeletal symptoms among hospital physicians: a systematic review

Physicians are exposed to a range of work-related risk factors that may result in occupational diseases. This systematic review aims at shedding light on the prevalence and incidence of musculoskeletal complaints among hospital physicians. A systematic literature search was performed in Pubmed and EMBASE (1990-2010), and methodological quality criteria were applied. A search was done for musculoskeletal complaints. Five medium-quality studies and three high-quality studies were included in this review. The definitions and assessment used in the studies for musculoskeletal complaints were different. In short, the frequently reported prevalence for hand and wrist pain was 8-33 and 0%, 17% for shoulder pain, and 9-28% for neck pain. Moreover, the annual prevalence of low back pain was between 33 and 68%. The limited number of studies makes it difficult to draw conclusions, and the results should be intepreted with care. In conclusion, musculoskeletal complaints may be work-related complaints in hospital physicians, which need future attentio

Association of oral health with body weight:a prospective study in community-dwelling older adults

Background: To prevent involuntary weight loss in older people, the knowledge about factors affecting body weight (BW) is essential. Therefore, we aimed to investigate the longitudinal associations of multiple oral health aspects with BW in community-dwelling older adults. Methods: This analysis is based on prospective data with a 10-year follow-up of 657 Dutch community-dwelling older adults (age 66.4 ± 5.8 years, 54% female) from the Longitudinal Aging Study Amsterdam. Participants’ characteristics, BW, and 12 oral health variables (teeth, dentures, nine oral problems, self-rated oral health) were assessed in 2005/07 and 2015/16. The association between oral health and BW was analyzed by mixed models and adjusted for demographic, socio-economic, smoking, health, and functional aspects considering data of both assessments. Results: Mean BW was 79.1 ± 13.3 kg at baseline (B) and 77.6 ± 13.8 kg at follow-up (FU). At baseline, 29.6% of the participants reported being edentulous (FU:34.4%) and 55.8% to wear dentures (FU:62.3%). Dental pain while chewing was the oral problem with the lowest (B:5.2%, FU:6.6%) and xerostomia with the highest prevalence at both examinations (B:24.3%, FU:30.0%). Most participants rated their oral status as healthy (B:65.2%, FU:66.9%). Neither edentulism and denture use nor oral problems showed a longitudinal association with BW. In contrast, self-rated oral health was associated with BW (b = 0.724, SE = 0.296, p = 0.015) after adjusting for multiple confounders. Conclusions: In community-dwelling older adults self-rated oral health may indicate changes in body weight in the long term. Therefore, this simple measure could serve to identify a risk for weight loss and to initiate oral interventions in clinical practice

Review of underground logistic systems in the Netherlands: an ex-post evaluation of barriers, enablers and spin-offs

Now, 10 years after the first plans, we analyse in this paper what has happened with Underground Logistic Systems (ULS). The major question in this paper is: Which barriers and enablers led to the failure of ULS and what ULS spin-offs can be found nowadays? Several factors can be classified as barriers or enablers. The main conclusions that can be drawn are that the opportunities for try-out were too limited; political support could have been gained on higher levels; the costs were too high, the catchment area was too limited; ULS in itself is a very promising system, but there was no one clear goal. In particular, the lack of a thorough and positive business model in combination with a lack of sufficient freight volumes almost immediately guaranteed the failure of the initiative. The spin-offs seem to have taken place in different directions: ranging from rather soft impacts (e.g. scientific knowledge) to more hard developments (adopting and developing transport and tunnelling technologies), and, although difficult to quantify, they are of great value

The association between muscle strength and activity limitations in patients with the hypermobility type of Ehlers–Danlos syndrome : the impact of proprioception

Purpose: The patients diagnosed with Ehlers-Danlos Syndrome Hypermobility Type (EDS-HT) are characterized by pain, proprioceptive inacuity, muscle weakness, potentially leading to activity limitations. In EDS-HT, a direct relationship between muscle strength, proprioception and activity limitations has never been studied. The objective of the study was to establish the association between muscle strength and activity limitations and the impact of proprioception on this association in EDS-HT patients. Methods: Twenty-four EDS-HT patients were compared with 24 controls. Activity limitations were quantified by Health Assessment Questionnaire (HAQ), Six-Minute Walk test (6MWT) and 30-s chair-rise test (30CRT). Muscle strength was quantified by handheld dynamometry. Proprioception was quantified by movement detection paradigm. In analyses, the association between muscle strength and activity limitations was controlled for proprioception and confounders. Results: Muscle strength was associated with 30CRT (r = 0.67, p = <0.001), 6MWT (r = 0.58, p = <0.001) and HAQ (r = 0.63, p = <0.001). Proprioception was associated with 30CRT (r = 0.55, p <0.001), 6MWT (r = 0.40, p = <0.05) and HAQ (r = 0.46, p < 0.05). Muscle strength was found to be associated with activity limitations, however, proprioceptive inacuity confounded this association. Conclusions: Muscle strength is associated with activity limitations in EDS-HT patients. Joint proprioception is of influence on this association and should be considered in the development of new treatment strategies for patients with EDS-HT. Implications for rehabilitation : Reducing activity limitations by enhancing muscle strength is frequently applied in the treatment of EDS-HT patients. Although evidence regarding treatment efficacy is scarce, the current paper confirms the rationality that muscle strength is an important factor in the occurrence of activity limitations in EDS-HT patients. Although muscle strength is the most dominant factor that is associated with activity limitations, this association is confounded by proprioception. In contrast to common belief proprioception was not directly associated with activity limitations but confounded this association. Controlling muscle strength on the bases of proprioceptive input may be more important for reducing activity limitations than just enhancing sheer muscle strength

Chemically versus thermally processed brown shrimp shells or Chinese mitten crab as a source of chitin, nutrients or salts and as microbial stimulant in soilless strawberry cultivation

Brown shrimp (Crangon crangon) shells and Chinese mitten crab (Efiocheir sinensis) were chemically demineralized and deproteinized (denoted as M1 to M4 for the shrimp shells and MS to M7 for the Chinese mitten crab), and shrimp shells were torrefied at 200 to 300 degrees C (denoted as R200, R255, R300), and were compared with a commercially available chitin source (denoted as reference chitin). Based on their chemical characteristics, a selection of chitin sources was tested for their N mineralization capacity. The N release was high for the chemically treated shrimp shells and Chinese mitten crab, but not for the Dandled shrimp shells with or without acid treatment, indicating that treatment at 200 et or higher resulted in low N availability. Interaction with nutrients was tested in a leaching experiment with limed peat for three thermally and two chemically processed shrimp shells and the reference chitin source. The K concentrations in the leachate for the chemically treated shrimp shells and the reference chitin were lower than for limed peat during fertigation. Irreversible K retention was observed for one source of chemically treated shrimp shells, and the reference chitin. The thermally treated shrimp shells had a significantly higher net release of P. Na and CI than the treatment without chitin source. Three shrimp shell based materials (M4, R200 and 8300) and the reference chitin were tested in a greenhouse trial with strawberry at a dose of 2 g/L limed peat. A very positive and significant effect on Borryris cinerea disease suppression in the leaves was found for the reference chitin, M4 and R200 compared to the unamended control. The disease suppression of the 3 chitin sources was linked with an increase of the microbial biomass in the limed peat with 24% to 28% due to chitin decomposition and a 9-44% higher N uptake in the plants

Phenological mismatch affects individual fitness and population growth in the winter moth

Climate change can severely impact species that depend on temporary resources by inducing phenological mismatches between consumer and resource seasonal timing. In the winter moth, warmer winters caused eggs to hatch before their food source, young oak leaves, became available. This phenological mismatch changed the selection on the temperature sensitivity of egg development rate. However, we know little about the fine-scale fitness consequences of phenological mismatch at the individual level and how this mismatch affects population dynamics in the winter moth. To determine the fitness consequences of mistimed egg hatching relative to timing of oak budburst, we quantified survival and pupation weight in a feeding experiment. We found that mismatch greatly increased mortality rates of freshly hatched caterpillars, as well as affecting caterpillar growth and development time. We then investigated whether these individual fitness consequences have population-level impacts by estimating the effect of phenological mismatch on population dynamics, using our long-term data (1994-2021) on relative winter moth population densities at four locations in The Netherlands. We found a significant effect of mismatch on population density with higher population growth rates in years with a smaller phenological mismatch. Our results indicate that climate change-induced phenological mismatch can incur severe individual fitness consequences that can impact population density in the wild.</p

A Study on SPICE Modeling of Non-Resonant Plasmonic Terahertz Detector

Department Of Electrical EngineeringThe terahertz (sub-millimeter wave) is the frequency resource, ranging from 100 GHz ~ 10 THz band, located in the middle region of the infrared and millimeter waves in the electromagnetic spectrum. Terahertz waves has unique physical characteristics, which is transparency of radio waves and straightness of light waves, simultaneously. The terahertz wave is applied to the basic science, such as device, spectroscopy, and imaging technology. And also adjust in the applied science, such as biomedical engineering, security, environment, information and communication. Which importance already verified. In the new shape of future market is expected to be formed broadly. For this application, operating in the THz frequency detecting device essential. Recently, Current elements operating in terahertz are present, such as compound semiconductor (???-???HBT, HEMT). But, there are disadvantage to use as a high price. Therefore, research have been made of silicon based THz detector in many research groups. Silicon-based nano-technology utilizes a plasma wave transistor technology. Which is using the space-time change of the channel charge density. That causes plasma wave oscillation in the MOSFET (Metal oxide semiconductor field effect transistor) channel and this effect available MOSET operating terahertz regime beyond MOSFET cut-off frequency. So, PWT (plasma wave transistor) is available terahertz detection and oscillation. For integrated possible post processing circuit development in these of terahertz applications system, silicon based PWT compact model is essential thing. For this compact model for spice simulation beyond cut-off frequency, we consider charge time variance model which is NQS (non-quasi-static) model, not quasi-static model. For NQS model two kinds of model exist, first is RC ladder model. That is seral connect MOSFET get rid of parasitic elements. And these complex circuit making the equivalent circuit model, it called New Elmore model. For post processing circuit simulation, fast simulation speed is essential, RC ladder model has a disadvantage (for simulating each segment). In this thesis we using New Elmore model based on Non-resonant plasmonic THz detector modeling, And verified physical validity of our NQS model using the our TCAD model based on Quasi-plasma 2DEG. And we propose fast and accurate compact modelingope

Radiology AI Deployment and Assessment Rubric (RADAR) to bring value-based AI into radiological practice

Objective: To provide a comprehensive framework for value assessment of artificial intelligence (AI) in radiology. Methods: This paper presents the RADAR framework, which has been adapted from Fryback and Thornbury’s imaging efficacy framework to facilitate the valuation of radiology AI from conception to local implementation. Local efficacy has been newly introduced to underscore the importance of appraising an AI technology within its local environment. Furthermore, the RADAR framework is illustrated through a myriad of study designs that help assess value. Results: RADAR presents a seven-level hierarchy, providing radiologists, researchers, and policymakers with a structured approach to the comprehensive assessment of value in radiology AI. RADAR is designed to be dynamic and meet the different valuation needs throughout the AI’s lifecycle. Initial phases like technical and diagnostic efficacy (RADAR-1 and RADAR-2) are assessed pre-clinical deployment via in silico clinical trials and cross-sectional studies. Subsequent stages, spanning from diagnostic thinking to patient outcome efficacy (RADAR-3 to RADAR-5), require clinical integration and are explored via randomized controlled trials and cohort studies. Cost-effectiveness efficacy (RADAR-6) takes a societal perspective on financial feasibility, addressed via health-economic evaluations. The final level, RADAR-7, determines how prior valuations translate locally, evaluated through budget impact analysis, multi-criteria decision analyses, and prospective monitoring.Conclusion: The RADAR framework offers a comprehensive framework for valuing radiology AI. Its layered, hierarchical structure, combined with a focus on local relevance, aligns RADAR seamlessly with the principles of value-based radiology. Critical relevance statement: The RADAR framework advances artificial intelligence in radiology by delineating a much-needed framework for comprehensive valuation. </p

Femoral Neck Design Does Not Impact Revision Risk After Primary Total Hip Arthroplasty Using a Dual Mobility Cup

Background: The use of dual mobility (DM) cups has increased quickly. It is hypothesized that femoral neck taper geometry may be involved in the risk of prosthetic impingement and DM cup revision. We aim to (1) explore the reasons for revision of DM cups or head/liners and (2) explore whether certain femoral neck characteristics are associated with a higher risk of revision of DM cups. Methods: Primary total hip arthroplasties with a DM cup registered in the Dutch Arthroplasty Register between 2007 and 2021 were identified (n = 7603). Competing risk survival analyses were performed, with acetabular component and head/liner revision as the primary endpoint. Reasons for revision were categorized in cup-/liner-related revisions (dislocation, liner wear, acetabular loosening). Femoral neck characteristics were studied to assess whether there is an association between femoral neck design and the risk of DM cup/liner revision. Multivariable Cox proportional hazard analyses were performed. Results: The 5- and 10-year crude cumulative incidence of DM cup or head/liner revision for dislocation, wear, and acetabular loosening was 0.5% (CI 0.4-0.8) and 1.9% (CI 1.3-2.8), respectively. After adjusting for confounders, we found no association between the examined femoral neck characteristics (alloy used, neck geometry, CCD angle, and surface roughness) and the risk for revision for dislocation, wear, and acetabular loosening. Conclusions: The risk of DM cup or head/liner revision for dislocation, wear, and acetabular loosening was low. We found no evidence that there is an association between femoral neck design and the risk of cup or head/liner revision.</p