Search results for: heel pain

Authors: P. Sanzo

Abstract:

Increased physical fitness participation has been paralleled by increasedoveruse injuries such as insertional Achilles tendinosis (AT). Treatment has provided inconsistentresults. The use of extracorporeal shockwave therapy (ECSWT) offers a new treatment consideration.The purpose of this study was to assess the effects of ECSWTon pain, function, range of motion (ROM), joint mobility and strength in patients with AT. Thirty subjects were treated with ECSWT and measures were takenbefore and three months after treatment. There was significant differences in visual analog scale (VAS) scores for pain at rest (p=0.002); after activity (p= 0.0001); overall improvement(p=0.0001); Lower Extremity Functional Scale (LEFS) scores (p=0.002); dorsiflexion range of motion (ROM) (p=0.0001); plantarflexion strength (p=0.025); talocrural joint anterior glide (p=0.046); and subtalar joint medial and lateral glide (p=0.025).ECSWT offers a new intervention that may limit the progression of the disorder and the long term healthcare costs associated with AT.

Keywords: Extracorporeal shockwave therapy, shockwave therapy, Achilles tendinosis, range of motion, strength, joint mobility

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Authors: M. Ramezani, Gh. Amin, E. Jalili

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In present study the effects of anti-inflammatory and antinociceptive of vitex hydro-alcoholic extract were evaluated on male mice. In inflammatory test mice were divided into 7 groups: first group was control. The second group, positive control group, received dexamethasone (15 mg/kg) and the other five groups received different doses of hydroalcohol extract of Vitex fruit (265, 365, 465, 565, and 665 mg/kg). The inflammation was caused by xylene-induced ear edema. Formalin test was used for evaluation of antinociceptive effect of extract. In this test, mice were divided into 7 groups: control, morphine (10mg/kg) as positive control group, and Vitex extract groups ((265, 365, 465, 565, and 665 mg/kg). All drugs were administered intrapritoneally, 30 min before each test. The data were analyzed using one-way ANOVA followed by Tukey-kramer multiple comparison test. Results have shown significant antiinflammatory effects of extract at all dosed as compared with control (P<0.05). In the first phase of formalin test (0-5 min) none doses of extract could inhibit acute pain, but in the second phase (15-30 min) chronic pain decreased at 265, 365, 465, and 565 mg/kg doses (P<0.05). The results of this research indicated that Vitex extract remarkably inhibited inflammation and second phase of nociception (inflammatory pain) and can be used for treatment of inflammatory diseases.

Keywords: Anti-inflammatory, Antinociceptive, Mice, Vitexagnus castus.

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Authors: Ji-il Park, Donghan Koo, Hyungtae Seo, Jihyuk Park, Heewon Park, Sukyung Park, Kyung-Soo Kim, and Soohyun Kim

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In the paper, the energetic features of the loaded gait are newly analyzed depending on the trunk flexion change. To investigate the loaded gait, walking experiments are performed for five subjects and, the ground reaction forces and kinematic data are measured. Based on these information, we compute the impulse, momentum and mechanical works done on the center of body mass, through the trunk flexion change. As a result, it is shown that the trunk flexion change does not affect the impulses and momentums during the step-to-step transition as well. However, the direction of the pre-collision momentum does change depending on the trunk flexion change, which is degenerated just after (or during) the collision period.

Keywords: Loaded gait, collision, impulse, gravity, heel strike, push-off, gait analysis.

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Authors: Toyoyuki Honjo, Takeshi Hayashi, Akinori Nagano, Zhi-Wei Luo

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For stable bipedal gait generation on the level floor, efficient restoring of mechanical energy lost by heel collision at the ground is necessary. Parametric excitation principle is one of the solutions. We dealt with the robot-s total center of mass as an inverted pendulum to consider the total dynamics of the robot. Parametrically excited walking requires the use of continuous target trajectory that is close to discontinuous optimal trajectory. In this paper, we proposed the new target trajectory based on a position in the walking direction. We surveyed relations between walking performance and the parameters that form the target trajectory via numerical simulations. As a result, it was found that our target trajectory has the similar characteristics of a parametrically excited inverted pendulum.

Keywords: Dynamic Bipedal Walking, Parametric Excitation, Target Trajectory Design.

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Authors: Paria Soleimani, Arezoo Neshati

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Myocardial infarction is one of the leading causes of death in the world. Some of these deaths occur even before the patient reaches the hospital. Myocardial infarction occurs as a result of impaired blood supply. Because the most of these deaths are due to coronary artery disease, hence the awareness of the warning signs of a heart attack is essential. Some heart attacks are sudden and intense, but most of them start slowly, with mild pain or discomfort, then early detection and successful treatment of these symptoms is vital to save them. Therefore, importance and usefulness of a system designing to assist physicians in early diagnosis of the acute heart attacks is obvious. The main purpose of this study would be to enable patients to become better informed about their condition and to encourage them to seek professional care at an earlier stage in the appropriate situations. For this purpose, the data were collected on 711 heart patients in Iran hospitals. 28 attributes of clinical factors can be reported by patients; were studied. Three logistic regression models were made on the basis of the 28 features to predict the risk of heart attacks. The best logistic regression model in terms of performance had a C-index of 0.955 and with an accuracy of 94.9%. The variables, severe chest pain, back pain, cold sweats, shortness of breath, nausea and vomiting, were selected as the main features.

Keywords: Coronary heart disease, acute heart attacks, prediction, logistic regression.

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Authors: Andrew Hwang

Abstract:

The average American worker sits for thirteen hours a day, often with poor posture and infrequent breaks, which can lead to health issues and back problems. The Smart Cushion was created to alert individuals of their poor postures, and may potentially alleviate back problems and correct poor posture. The Smart Cushion is a portable, rectangular, foam cushion, with five strategically placed pressure sensors, that utilizes an Arduino Uno circuit board and specifically designed software, allowing it to collect data from the five pressure sensors and store the data on an SD card. The data is then compiled into graphs and compared to controlled postures. Before volunteers sat on the cushion, their levels of back pain were recorded on a scale from 1-10. Data was recorded for an hour during sitting, and then a new, corrected posture was suggested. After using the suggested posture for an hour, the volunteers described their level of discomfort on a scale from 1-10. Different patterns of sitting postures were generated that were able to serve as early warnings of potential back problems. By using the Smart Cushion, the areas where different volunteers were applying the most pressure while sitting could be identified, and the sitting postures could be corrected. Further studies regarding the relationships between posture and specific regions of the body are necessary to better understand the origins of back pain; however, the Smart Cushion is sufficient for correcting sitting posture and preventing the development of additional back pain.

Keywords: Arduino Sketch Algorithm, biomedical technology, pressure sensors, Smart Cushion.

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Authors: A. Lubis, S. S. Pasulu, Z. Hikmah, A. Endaryanto, A. Harsono

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Infection by group A streptococci (GAS) can trigger an autoantibody that cause a poststreptococcal reactive arthritis (PSRA). Four patients with PSRA aged 10 years to 14 years old with the main complaint of joint pain for five days to 10 days after suffering a fever and sore throat. The joint pain was persistent, additive, and non migratory. All patients revealed an increase in erythrocyte sedimentation rate (ESR) and anti-streptolysin O (ASLO), but the chest x-ray, electrocardiography, and echocardiography were normal. Bone imaging showed no destruction on the affected joint. Jones Criteria were not fulfilled in all patients. Erythromycin and ibuprofen were given in all patients and an improvement was shown. Erythromycin was continued for one year and routine controls were conducted for cardiac evaluation. The prognosis of all the patients was good.

Keywords: Arthritis, group A streptococcus, autoantibody, Jones criteria.

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Authors: Mohammad Ali Lotfollahi-Yaghin, Hamid Ahmadi

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In the present paper, a set of parametric FE stress analyses is carried out for two-planar welded tubular DKT-joints under two different axial load cases. Analysis results are used to present general remarks on the effect of geometrical parameters on the stress concentration factors (SCFs) at the inner saddle, outer saddle, toe, and heel positions on the main (outer) brace. Then a new set of SCF parametric equations is developed through nonlinear regression analysis for the fatigue design of two-planar DKT-joints. An assessment study of these equations is conducted against the experimental data; and the satisfaction of the criteria regarding the acceptance of parametric equations is checked. Significant effort has been devoted by researchers to the study of SCFs in various uniplanar tubular connections. Nevertheless, for multi-planar joints covering the majority of practical applications, very few investigations have been reported due to the complexity and high cost involved.

Keywords: Offshore jacket structure, Parametric equation, Stress concentration factor (SCF), Two-planar tubular KT-joint

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Authors: Tahir Majeed, Michael Handschuh, René Meier

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Rheumatoid Arthritis patients have swelling and pain in joints of the hand. The regions where the patient feels pain also show increased body temperature. Thermal cameras can be used to detect the rise in temperature of the affected regions. To monitor the progression of Rheumatoid Arthritis, patients must visit the clinic regularly for scanning and examination. After scanning and evaluation, the dosage of the medicine is regulated accordingly. To monitor the disease progression over time, the correlation of the images between different visits must be established. It has been observed that the thermal measurements do not remain the same over time, even within a single scanning, when low-cost thermal cameras are used. In some situations, temperatures can vary as much as 2◦C within the same scanning sequence. In this paper, it has been shown that although the absolute temperature varies over time, the relative difference between different regions remains similar. Results have been computed over four scanning sequences and are presented.

Keywords: Relative thermal difference, rheumatoid arthritis, thermal imaging, thermal sensors.

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Authors: Enas Elsayed Abutaleb, Mohamed Taher Eldesoky, Shahenda Abd El Rasol

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Background: Muscle Energy Techniques (MET) have been widely used by manual therapists over the past years, but still limited research validated its use and there was limited evidence to substantiate the theories used to explain its effects. Objective: To investigate the effect of Muscle Energy Technique (MET) on anterior pelvic tilt in patients with lumbar spondylosis. Design: Randomized controlled trial. Subjects: Thirty patients with anterior pelvic tilt from both sexes were involved, aged between 35 to 50 years old and they were divided into MET and control groups with 15 patients in each. Methods: All patients received 3sessions/week for 4 weeks where the study group received MET, Ultrasound and Infrared, and the control group received U.S and I.R only. Pelvic angle was measured by palpation meter, pain severity by the visual analogue scale and functional disabilities by the Oswestry disability index. Results: Both groups showed significant improvement in all measured variables. The MET group was significantly better than the control group in pelvic angle, pain severity, and functional disability as p-value were (0.001, 0.0001, 0.0001) respectively. Conclusion and implication: the study group fulfilled greater improvement in all measured variables than the control group which implies that application of MET in combination with U.S and I.R were more effective in improving pelvic tilting angle, pain severity and functional disabilities than using electrotherapy only.

Keywords: Anterior pelvic tilt, lumbar spondylosis, muscle energy technique exercise, palpation meter.

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Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

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Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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Authors: Abeer A. Abdelhamed

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Background: Diabetic sensorimotor polyneuropathy (DSP) is one of the most common microvascular complications of type 2 diabetes. Loss of sensation is thought to contribute to a lack of static and dynamic stability and increased risk of falling. Purpose: The purpose of this study was to compare the effects of low-level laser (LLL) and monochromatic near-infrared photo energy (MIRE) on pain, cutaneous sensation, static stability, and index of lower limb blood flow in diabetic patients with peripheral neuropathy. Methods: Forty diabetic patients with peripheral neuropathy were recruited for participation in this study. They were divided into two groups: The MIRE group, which contained 20 patients, and the LLL group, which contained 20 patients. All patients who participated in the study had been subjected to various physical assessment procedures, including pain, cutaneous sensation, Doppler flow meter, and static stability assessments. The baseline measurements were followed by treatment sessions that were conducted twice a week for six successive weeks. Results: The statistical analysis of the data revealed significant improvement of pain in both groups, with significant improvement in cutaneous sensation and static balance in the MIRE group compared to the LLL group; on the other hand, the results showed no significant differences in lower limb blood flow between the groups. Conclusion: LLL and MIRE can improve painful symptoms in patients with diabetic neuropathy. On the other hand, MIRE is also useful in improving cutaneous sensation and static stability in patients with diabetic neuropathy.

Keywords: Diabetic neuropathy, Doppler flow meter, –Lowlevel laser, Monochromatic near-infrared photo energy.

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Authors: J. Preetha, S. Selvarajan

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When neck pain is associated with pain, numbness, or weakness in the arm, shoulder, or hand, further investigation is needed as these are symptoms indicating pressure on one or more nerve roots. Evaluation necessitates a neurologic examination and imaging using an MRI/CT scan. A degenerating disc loses some thickness and is less flexible, causing inter-vertebrae space to narrow. A radiologist diagnoses an Intervertebral Disc Degeneration (IDD) by localizing every inter-vertebral disc and identifying the pathology in a disc based on its geometry and appearance. Accurate localizing is necessary to diagnose IDD pathology. But, the underlying image signal is ambiguous: a disc’s intensity overlaps the spinal nerve fibres. Even the structure changes from case to case, with possible spinal column bending (scoliosis). The inter-vertebral disc pathology’s quantitative assessment needs accurate localization of the cervical region discs. In this work, the efficacy of multilevel set segmentation model, to segment cervical discs is investigated. The segmented images are annotated using a simple distance matrix.

Keywords: Intervertebral Disc Degeneration (IDD), Cervical Disc Localization, multilevel set segmentation.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: Cancer, complementary and alternative medicine, ozone therapy, palliative care, PEMF Therapy.

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Authors: Sung Ho Ha, Seong Hyeon Joo, Eun Kyung Kwon

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Until recently, researchers have developed various tools and methodologies for effective clinical decision-making. Among those decisions, chest pain diseases have been one of important diagnostic issues especially in an emergency department. To improve the ability of physicians in diagnosis, many researchers have developed diagnosis intelligence by using machine learning and data mining. However, most of the conventional methodologies have been generally based on a single classifier for disease classification and prediction, which shows moderate performance. This study utilizes an ensemble strategy to combine multiple different classifiers to help physicians diagnose chest pain diseases more accurately than ever. Specifically the ensemble strategy is applied by using the integration of decision trees, neural networks, and support vector machines. The ensemble models are applied to real-world emergency data. This study shows that the performance of the ensemble models is superior to each of single classifiers.

Keywords: Diagnosis intelligence, ensemble approach, data mining, emergency department

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Authors: T. Qasim, M. Obeidat, S. Al-Sharairi

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The objective of this study is to investigate the effect of the excessive use of smartphones. Smartphones have enormous effects on the human body in that some musculoskeletal disorders (MSDs) and health problems might evolve. These days, there is a wide use of the smartphones among all age groups of society, thus, the focus on smartphone effects on human behavior and health, especially on the young and elderly people, becomes a crucial issue. This study was conducted in Jordan on smartphone users for different genders and ages, by conducting a survey to collect data related to the symptoms and MSDs that are resulted from the excessive use of smartphones. A total of 357 responses were used in the analysis. The main related symptoms were numbness, fingers pain, and pain in arm, all linked to age and gender for comparative reasons. A statistical analysis was performed to find the effects of extensive usage of a smartphone for long periods of time on the human body. Results show that the significant variables were the vision problems and the time spent when using the smartphone that cause vision problems. Other variables including age of user and ear problems due to the use of the headsets were found to be a border line significant.

Keywords: Smartphone, age group, musculoskeletal disorders (MSDs), health problems.

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Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: Patient education, post-operative pain, patient satisfaction, post-operative outcome.

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Authors: Tanwarat Kajsongkram, Saowalux Rotamporn, Sirinat Limbunruang, Sirinan Thubthimthed

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High Performance Liquid Chromatography (HPLC) method was developed and validated for simultaneous estimation of 6-Gingerol(6G) and 6-Shogaol(6S) in joint pain relief gel containing ginger extract. The chromatographic separation was achieved by using C18 column, 150 x 4.6mm i.d., 5μ Luna, mobile phase containing acetonitrile and water (gradient elution). The flow rate was 1.0 ml/min and the absorbance was monitored at 282 nm. The proposed method was validated in terms of the analytical parameters such as specificity, accuracy, precision, linearity, range, limit of detection (LOD), limit of quantification (LOQ), and determined based on the International Conference on Harmonization (ICH) guidelines. The linearity ranges of 6G and 6S were obtained over 20- 60 and 6-18 μg/ml respectively. Good linearity was observed over the above-mentioned range with linear regression equation Y= 11016x- 23778 for 6G and Y = 19276x-19604 for 6S (x is concentration of analytes in μg/ml and Y is peak area). The value of correlation coefficient was found to be 0.9994 for both markers. The limit of detection (LOD) and limit of quantification (LOQ) for 6G were 0.8567 and 2.8555 μg/ml and for 6S were 0.3672 and 1.2238 μg/ml respectively. The recovery range for 6G and 6S were found to be 91.57 to 102.36 % and 84.73 to 92.85 % for all three spiked levels. The RSD values from repeated extractions for 6G and 6S were 3.43 and 3.09% respectively. The validation of developed method on precision, accuracy, specificity, linearity, and range were also performed with well-accepted results.

Keywords: Ginger, 6-gingerol, HPLC, 6-shogaol.

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Authors: S. Rawangwong, J. Chatthong, W. Boonchouytan

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The objective of the research was to study of foot anthropometry of children aged 7-12 years in the South of Thailand Thirty-three dimensions were measured on 305 male and 295 female subjects with 3 age ranges (7-12 years old). The instrumentation consists of four types of anthropometer, digital vernier caliper, digital height gauge and measuring tape. The mean values and standard deviations of average age, height, and weight of the male subjects were 9.52(±1.70) years, 137.80(±11.55) cm, and 37.57(±11.65) kg. Female average age, height, and weight subjects were 9.53(±1.70) years, 137.88(±11.55) cm, and 34.90(±11.57) kg respectively. The comparison of the 33 comparison measured anthropometric. Between male and female subjects were sexual differences in size on women in almost all areas of significance (p<0.05). The comparison of size and proportion elementary school students 11-12 years old men in Southern of Thailand with Thai boys aged 11-12 years of industrial standards at stage 4 year A.D. 2000-2001 Number nine ratio. Concluded that students male in Southern of Thailand has a size different from the proportions of research Industrial Standards. Ministry of Industry, Phase 4, when every year from A.D. 2000-2001 ratio was significantly (p<0.05).All of the feet studied were classified into 4 categories according to the ratios of diagonal foot breadth to the maximum foot length and heel breadth to the foot breadth. They were short but thick, small but long, small, and large. The numbers of the males feet classified in these categories were 86, 64, 40, and 115 persons or 28.20, 20.98, 13.11, and 37.70% respectively. For the female feet, the same values were 46, 59, 81, and 109 persons or 15.59, 20.00, 27.46, and 36.95% respectively.

Keywords: Ergonomics, foot anthropometry, male and female, primary school children

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Authors: Tasneem Halawani, Yamen Khateeb

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With customers’ ever-increasing expectations for fast services provisioning for all their business needs, information technology (IT) organizations, as business partners, have to cope with this demanding environment and deliver their services in the most effective and efficient way. The purpose of this paper is to identify optimization and automation opportunities for the top requested IT services in a heterogenic digital environment and widely spread customer base. In collaboration with systems, processes, and subject matter experts (SMEs), the processes in scope were approached by analyzing four-year related historical data, identifying and surveying stakeholders, modeling the as-is processes, and studying systems integration/automation capabilities. This effort resulted in identifying several pain areas, including standardization, unnecessary customer and IT involvement, manual steps, systems integration, and performance measurement. These pain areas were addressed by standardizing the top five requested IT services, eliminating/automating 43 steps, and utilizing a single platform for end-to-end process execution. In conclusion, the optimization of IT service request processes in a heterogenic digital environment and widely spread customer base is challenging, yet achievable without compromising the service quality and customers’ added value. Further studies can focus on measuring the value of the eliminated/automated process steps to quantify the enhancement impact. Moreover, a similar approach can be utilized to optimize other IT service requests, with a focus on business criticality.

Keywords: Automation, customer value, heterogenic, integration, IT services, optimization, processes.

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Authors: Eman A. Embaby, Amira A. A. Abdallah

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Background: Occupational standing is associated with low back pain (LBP) development. Yet, trunk and gluteus-medius muscles’ fatigability has not been extensively studied during occupational standing. This study examined and correlated the rectus abdominus (RA), erector-spinae (ES), external oblique (EO), and gluteus-medius (GM) muscles’ fatigability on both sides while standing in a confined area for 30min Methods: Median frequency EMG data were collected from 15 female clinical instructors with chronic LBP (group A) and 15 asymptomatic controls (group B) (mean age 29.53±2.4 vs 29.07±2.4years, weight 63.6±7 vs 60±7.8kg, and height 162.73±4 vs 162.8±6cm respectively) using a spectrum analysis program. Data were collected in the first and last 5min of the standing task. Results: Using Mixed three-way ANOVA, group A showed significantly (p<0.05) lower frequencies for the right and left ES, and right GM in the last 5min and significantly higher frequencies for the left RA in the first and last 5min than group B. In addition, the left ES and right EO, ES and GM in group B showed significantly higher frequencies and the left ES in group A showed significantly lower frequencies in the last 5min compared with the first. Moreover, the right RA showed significantly higher frequencies than the left in the last 5min in group B. Finally, there were significant (p<0.05) correlations among the median frequencies of the tested four muscles on the same side and between both sides in both groups. Discussion/Conclusions: Clinical instructors with LBP are more liable to have higher trunk and gluteus-medius muscle fatigue than asymptomatic individuals. Thus, endurance training for these muscles should be included in the rehabilitation of such patients.

Keywords: EMG, Fatigability, Gluteus-medius, LBP, Standing, Trunk.

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Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

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Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: Advanced palliative aquatics care, magnetic field therapy, medical device, research design.

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Authors: D. Farsi, Gh. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

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Background and aim: It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FT versus fentanyl-midazolam (FM) in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods: In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccessful rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: Procedural Sedation and Analgesia, Thiopental, Fentanyl, Midazolam, Orthopedic Procedure, Emergency Department, Pain.

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Authors: Leena Korpinen, Rauno Pääkkönen, Fabriziomaria Gobba

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This paper is based on a large questionnaire study. The paper presents how all participants and subgroups (upper- and lower-level white-collar workers) answered the question, “Have you had an ache, pain, or numbness, which you associate with desktop computer use, in the different body parts during the last 12 months?’ 14.6% of participants (19.4% of women and 8.2% of men) reported that they had often or very often physical symptoms in the neck. Even if our results cannot prove a causal relation of symptoms with computer use, show that workers believe that computer use can influence their wellbeing: this is important when devising treatment modalities to decrease these physical symptoms.

Keywords: Ergonomics, work, computer, symptoms.

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Authors: Mohamed M. Ragab, Neveen A. Abdel Raoof, Reham H. Diab

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Background: Delayed onset muscle soreness (DOMS) is the most common symptom when ordinary individuals and athletes are exposed to unaccustomed physical activity, especially eccentric contraction which impairs athletic performance, ordinary people work ability and physical functioning. Multitudes of methods have been investigated to reduce DOMS. One of the valuable methods to control DOMS is repeated bout effect (RBE) as a prophylactic method. Purpose: To compare the repeated bout effect of submaximal eccentric with maximal isometric contraction on induced DOMS. Methods: Sixty normal male volunteers were assigned randomly into three equal groups: Group A (first study group): 20 subjects received submaximal eccentric contraction on non-dominant elbow flexors as a prophylactic exercise. Group B (second study group): 20 subjects received maximal isometric contraction on nondominant elbow flexors as a prophylactic exercise. Group C (control group): 20 subjects did not receive any prophylactic exercises. Maximal isometric peak torque of elbow flexors and patient related elbow evaluation (PREE) scale were measured for each subject 3 times before, immediately after, and 48 hours after induction of DOMS. Results: Post-hoc test for maximal isometric peak torque and PREE scale immediately and 48 hours after induction of DOMS revealed that group (A) and group (B) resulted in significant decrease in maximal isometric strength loss and elbow pain and disability rather than control group (C), but submaximal eccentric group (A) was more effective than maximal isometric group (B) as it showed more rapid recovery of functional strength and less degrees of elbow pain and disability. Conclusion: Both submaximal eccentric contraction and maximal isometric contraction were effective in prevention of DOMS but submaximal eccentric contraction produced a greater protective effect against muscle damage induced by maximal eccentric exercise performed 2 days later.

Keywords: Delayed onset muscle soreness, maximal isometric peak torque, patient related elbow evaluation scale, repeated bout effect.

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Authors: S. Zamir

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The modern era has brought with it significant organizational changes. These changes have not bypassed the academic world, and along with the old academic bonds that include a world of knowledge and ethics, academic faculty members are required more than ever not only to survive in the academic world, but also to thrive and flourish and position themselves as modern and opinionated academicians. Based upon the writings of organizational consultants, the article suggests a 10 X C model for cultivating an academic backbone, as well as emphasizing its input to the professional growth of university and college academics: Competence, Calculations of pain & gain, Character, Commitment, Communication, Curiosity, Coping, Courage, Collaboration and Celebration.

Keywords: Academic career, academicians, higher education, the 10xC Model.

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Authors: X.N. Chen, J.P. Wang, D. Jiang

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There were many studies on how to alleviate breast discomfort by reducing breast motion, in which nipple motion was used to represent breast motion. However, this assumption had not been experimentally validated. The aim of this paper was to experimentally validate if nipple can be used as a good indicator of breast. Seven participants (average of 24.4 years old) were recruited to walk and run on the treadmill at 5km h-1 and 10km h-1 respectively. Six markers were pasted on their bodies to collect motion data of different parts of breasts. The results of Friedman test combined with the relationship among the five markers on the same breast revealed that nipple could be used as a good indicator of breast. Wilcoxon test showed that there was no significant (P<0.05) between left and right nipple-s motion, so left nipple and right nipple could both be used to represent breast motion.

Keywords: Bra, breast motion, breast pain, nipple.

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Authors: Reinaldo Biscaro, Luciano R. Ferreira, Leonardo C. Biscaro, Raphael C. Biscaro, Isabela S. Vasconcelos, Laura C. R. Ferreira, Cristiano M. Galhardi, Erica P. Baciuk

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Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15^th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.

Keywords: Work-related accidents, cross-sectional study, shoulder lesions, labor lawsuits.

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Authors: Padmanabhan Balasubramanian, Karthik Anantha

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Structural representation and technology mapping of a Boolean function is an important problem in the design of nonregenerative digital logic circuits (also called combinational logic circuits). Library aware function manipulation offers a solution to this problem. Compact multi-level representation of binary networks, based on simple circuit structures, such as AND-Inverter Graphs (AIG) [1] [5], NAND Graphs, OR-Inverter Graphs (OIG), AND-OR Graphs (AOG), AND-OR-Inverter Graphs (AOIG), AND-XORInverter Graphs, Reduced Boolean Circuits [8] does exist in literature. In this work, we discuss a novel and efficient graph realization for combinational logic circuits, represented using a NAND-NOR-Inverter Graph (NNIG), which is composed of only two-input NAND (NAND2), NOR (NOR2) and inverter (INV) cells. The networks are constructed on the basis of irredundant disjunctive and conjunctive normal forms, after factoring, comprising terms with minimum support. Construction of a NNIG for a non-regenerative function in normal form would be straightforward, whereas for the complementary phase, it would be developed by considering a virtual instance of the function. However, the choice of best NNIG for a given function would be based upon literal count, cell count and DAG node count of the implementation at the technology independent stage. In case of a tie, the final decision would be made after extracting the physical design parameters. We have considered AIG representation for reduced disjunctive normal form and the best of OIG/AOG/AOIG for the minimized conjunctive normal forms. This is necessitated due to the nature of certain functions, such as Achilles- heel functions. NNIGs are found to exhibit 3.97% lesser node count compared to AIGs and OIG/AOG/AOIGs; consume 23.74% and 10.79% lesser library cells than AIGs and OIG/AOG/AOIGs for the various samples considered. We compare the power efficiency and delay improvement achieved by optimal NNIGs over minimal AIGs and OIG/AOG/AOIGs for various case studies. In comparison with functionally equivalent, irredundant and compact AIGs, NNIGs report mean savings in power and delay of 43.71% and 25.85% respectively, after technology mapping with a 0.35 micron TSMC CMOS process. For a comparison with OIG/AOG/AOIGs, NNIGs demonstrate average savings in power and delay by 47.51% and 24.83%. With respect to device count needed for implementation with static CMOS logic style, NNIGs utilize 37.85% and 33.95% lesser transistors than their AIG and OIG/AOG/AOIG counterparts.

Keywords: AND-Inverter Graph, OR-Inverter Graph, DirectedAcyclic Graph, Low power design, Delay optimization.

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Authors: Tian Hai, Yang Shengsheng, Jr., Wang Yi

Abstract:

Based on an analysis of the mechanism of degradation of optical characteristics of the ZnO-pigmented white paint by electron irradiation, a model of single molecular color centers is built. An equation that explains the relationship between the changes of variation of the ZnO-pigmented white paint-s spectrum absorptance and electron fluence is derived. The uncertain parameters in the equation can be calculated using the curve fitting by experimental data. The result indicates that the model can be applied to predict the degradation of optical characteristics of ZnO-pigmented white paint by electron radiation.

Keywords: ZnO-pigmented white pain, effects of electron radiation, optical characteristics degradation, prediction model.

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