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This manuscript presents practical recommendations for managing acute attacks and implementing preventive immunotherapies for neuromyelitis optica spectrum disorders (NMOSD), a rare autoimmune disease that causes severe inflammation in the central nervous system (CNS), primarily affecting the optic nerves, spinal cord, and brainstem. The pillars of NMOSD therapy are attack treatment and attack prevention to minimize the accrual of neurological disability. Aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) are a diagnostic marker of the disease and play a significant role in its pathogenicity. Recent advances in understanding NMOSD have led to the development of new therapies and the completion of randomized controlled trials. Four preventive immunotherapies have now been approved for AQP4-IgG-positive NMOSD in many regions of the world: eculizumab, ravulizumab - most recently-, inebilizumab, and satralizumab. These new drugs may potentially substitute rituximab and classical immunosuppressive therapies, which were as yet the mainstay of treatment for both, AQP4-IgG-positive and -negative NMOSD. Here, the Neuromyelitis Optica Study Group (NEMOS) provides an overview of the current state of knowledge on NMOSD treatments and offers statements and practical recommendations on the therapy management and use of all available immunotherapies for this disease. Unmet needs and AQP4-IgG-negative NMOSD are also discussed. The recommendations were developed using a Delphi-based consensus method among the core author group and at expert discussions at NEMOS meetings. [ABSTRACT FROM AUTHOR]

Purpose: Scapular dyskinesis is a common problem in athletes, especially overhead sports such as volleyball and basketball. The biomechanical and neurocognitive impairments are involved in the occurrence of the scapular dyskinesis. Based on previous studies about the whole-body vibration (WBV) effects on the athletes training, musculoskeletal injuries and neuromuscular responses, the current study focused on the investigation immediate effectiveness of WBV on neurocognitive parameters (reaction time and anticipatory skill) in overheads athletes with and without scapular dyskinesis. Methods: Thirty athletes with (n = 15) and without (n = 15) scapular dyskinesis participated in this interventional-observational study. The WBV applied with 30 Hz frequency and 5 mm amplitude in the modified push-up position in two groups. The scapular dyskinesis and neurocognitive parameters were recorded by the Caliper test and the Speed Anticipation Reaction Time (SART) system. Results: The Caliper measurement in three positions of arm significantly reduced after the WBV in the athletes with scapular dyskinesis (P < 0.005). The auditory complex choice reaction time significantly declined after the WBV between two groups (P = 0.042). Also, there was a correlation between the visual complex choice reaction time and 0 degree of abduction in both groups (P = 0.022). Conclusion: The WBV in the modified push-up position has immediately positive effects on neurologic and cognition skills in athletes with and without scapular dyskinesis. Based on these findings, WBV may have good potential for improved outcomes such as neurocognitive abilities and correction of scapular dyskinesia. [ABSTRACT FROM AUTHOR]

In this manuscript, a pyridyl containing porphyrin, C46H36N8O4 (denoted as Tris@NTPP) and its derived polyoxometalate-porphyrin hybrid, [C4H9)4N]3[C41H26N7NHCO(NH)C(OCH2)3MnMo6 O18(OCH2)3C(NH)CONHN7 H26C41] (denoted as NTPP@POM) in which two pyridyl containing porphyrin moieties hanged onto one Anderson polyoxometalate, have been successfully synthesized and thoroughly characterized. Fluorescence quenching was observed in NTPP@POM as compared with its precursor Tris@NTPP inferring the transfer of electron/energy from porphyrin moiety to POM moiety. NTPP@POM showed notably enhanced nonlinear absorption (β = 2.32 × 10–5 esu) than Tris@NTPP (β = 0.73 × 10–5 esu). These NLO responses were associated with fluorescence decay mechanism which oriented the singlet excited(*S) states and triplet excited(*T) states of Tris@NTPP and NTPP@POM. Life time decay studies revealed that NTPP@POM (τ2 = 5.32 ns) were stayed for shorter time in excited triplet state than Tris@NTPP (τ2 = 10 ns), implying shorter life time led towards higher NLO responses. [ABSTRACT FROM AUTHOR]

Edge-functionalization of graphene is emerging as a powerful chemical method for the construction of π-delocalized highly-planar graphene nanoconjugates that are not accessible through surface-supported syntheses. Herein, a graphene-porphyrin nanoconjugate via a robust pyrazine (pz) linkage has been obtained by condensing 2,3-diamino-5,10,15,20-tetraphenylporphyrin (DA-TPP) with ortho-quinone (o-quinone) moieties at edge sites of graphene oxide (GO). The as-prepared GO-pz-TPP exhibits an intense absorption extending from 375 to 900 nm and a high quenching yield (98%) of fluorescence, indicating a strong electronic coupling effect between GO and TPP units. GO-pz-TPP displays strong nonlinear optical (NLO) absorption and giant NLO coefficients with 800 and 1,030 nm fs laser, in sharp contrast to traditional graphene-porphyrin nanohybrids only NLO-active towards ns laser. Such a dramatic NLO performance towards femtosecond pulsed laser has not been achieved in any carbon-chromophores nanohybridized materials to date. This work validates the π-extended edge-functionalization strategy as a means to tune the NLO properties of graphene, thereby providing a new paradigm for the assembly of versatile optoelectronic materials. [ABSTRACT FROM AUTHOR]

We report the electronic absorption spectroscopy of 7,7,8,8-tetracyanoquinodimethane (TCNQ) and its fluorinated derivatives (F2TCNQ and F4TCNQ), well-known electron-accepting molecules in common organic solvents (toluene, chlorobenzene, acetonitrile, and ethanol) under controlled exposure to air (O2) and UV light. All compounds (FxTCNQ (x = 0, 2, 4)) were stable in a neutral state (FxTCNQ0) in toluene and chlorobenzene, even under both O2 and UV light. On the other hand, in EtOH, the formation of FxTCNQ·− was monitored upon controlled exposure to O2 or UV light. Especially in air-equilibrated ethanol upon the UV-illumination, efficient α,α-dicyano-p-toluoylcyanide anion (DCTC−) and its fluorinated derivatives were generated evinced by the absorption peak near 480 nm, whereas the reaction was shut off by removing O2 or blocking UV light, thereby keeping FxTCNQ·− stable. However, even in deaerated ethanol, upon the UV-illumination, the anion formation of TCNQ and its fluorinated derivatives (FxTCNQ·−, x = 0, 2, 4) was inevitable, showing the stability of FxTCNQ0 depends on the choice of solvent. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the effects of electromyography (EMG) biofeedback on scapular positions and muscle activities during scapular-focused exercises in oral cancer patients with accessory nerve dysfunction.Methods: Twenty-four participants were randomly allocated to the motor-control with biofeedback group (N = 12) or the motor-control group (N = 12) immediately after neck dissection. Each group performed scapular-focused exercises with conscious control of scapular orientation for 3 months. EMG biofeedback of upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT) was provided in the motor-control with biofeedback group. Scapular symmetry measured by modified lateral scapular slide test; shoulder pain; active range of motion (AROM) of shoulder abduction; upper extremity function; maximal isometric muscle strength of UT, MT, and LT; and muscle activities during arm elevation/lowering in the scapular plane were evaluated at baseline and the end of the intervention.Results: After the 3-month intervention, only the motor-control with biofeedback group showed improving scapular symmetry. Although both groups did not show significant improvement in shoulder pain, increased AROM of shoulder abduction and muscle strength of the UT and MT were observed in both groups. In addition, only the motor-control with biofeedback group had improved LT muscle strength, upper extremity function, and reduced UT and MT muscle activations during arm elevation/lowering.Conclusions: Early interventions for scapular control training significantly improved shoulder mobility and trapezius muscle strength. Furthermore, by adding EMG biofeedback to motor-control training, oral cancer patients demonstrated greater effectiveness in stabilizing scapular position, muscle efficiency, and upper extremity function than motor-control training alone.Trial Registration: Institutional Review Board: This study was approved by the Chang Gung Medical Foundation Institutional Review Board (Approval No: 201901788A3. Approval Date: 2 January, 2020).Clinical Trial Registration: This trial was registered at ClinicalTrials.gov (ClinicalTrials.gov ID: NCT04476004. Initial released Date: 16 July, 2020). [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of online-supervised versus workplace corrective exercises on neck–shoulder pain (NSP), sick leave, posture, workability, and muscular activity among office workers with the upper crossed syndrome (UCS). Methods: We performed a parallel-group randomized control trial at Shahid Beheshti University, Tehran, Iran, assigning 36 office workers to online-supervised, workplace, and control groups (mean (SD) age 38.91 ± 3.87, 38.58 ± 7.34, 37.00 ± 8.12). Inclusion criteria were alignment alteration (forward head (≥ 45°), rounding shoulder (≥ 52°), rounding back (≥ 42°), and pain intensity ≥ 3 in neck and shoulder. The two intervention groups performed 8-week exercise program, while the control group continued usual activities. Primary (NSP and sick leave) and secondary outcomes [postural angles, workability, and muscular activity were measured by VAS, outcome evaluation questionnaire (OEQ), photogrammetry, workability index, and EMG, respectively, at the baseline and an 8-week follow-up]. Results: ANCOVA results revealed improvements for the online-supervised group versus control for NSP (P = 0.007), postural angles (P = 0.000, P = 0.001, P = 0.005), workability (P = 0.048, P = 0.042), and upper trapezius activation (P = 0.024, P = 0.016), respectively. Using paired t tests, both intervention groups improved from baseline to follow-up for NSP (P = 0.000, P = 0.002), forward head posture (P = 0.000, P = 0.000), round shoulders (P = 0.001, P = 0.031), and round back (P = 0.034, P = 0.008), respectively. Related parameters of workability (P = 0.041, P = 0.038), upper trapezius (P = 0.005, P = 0.005, P = 0.022), and serratus anterior (P = 0.020, P = 0.015) changed only in the online-supervised group. Conclusion: Online-supervised corrective exercise seems to improve a range of parameters related to work performance. These findings are highly applicable in light of the ongoing COVID pandemic; many workers have to work from home. [ABSTRACT FROM AUTHOR]

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Purpose of Review: Scapulothoracic dyskinesis (SD) occurs when there is a noticeable disruption in typical position and motion of the scapula, which can result in debilitating pain. The purpose of this review is to describe the current knowledge regarding the diagnosis and management of scapulothoracic dyskinesis by providing an evidence-based overview of clinical exams and treatment modalities available for orthopedic surgeons and provide insight into which treatment modalities require further investigation. Recent Findings: SD is highly prevalent in athletes, particularly those participating in overhead activities (e.g., baseball, tennis, and swimming) and can coexist with several shoulder pathologies. A holistic approach in the diagnosis of SD has been supported in the literature; however, it is important to recognize that diagnosis is currently limited to the absence of a quantitative SD clinical assessment. The main goal of the treatment of SD is to regain proper scapular positioning and dynamics. The standard of care for the management of SD is conservative interventions aimed at optimizing scapular kinematics. Surgical intervention is only considered in the presence of concomitant pathology requiring surgery. Summary: Due to the complexity of coordinated movement of the shoulder girdle, recent literature has begun to move away from the use of traditional orthopedic tests, in favor of a more system-based approach for the diagnosis of SD. We present a concise review of clinical exams and treatment modalities available for orthopedic surgeons in the management of SD. [ABSTRACT FROM AUTHOR]

This paper covers the entire lifetime of an underground coal mine, including the start-up of the mining operations and the period after the closure and sealing of the underground workings. Measurements of the vertical surface movement are presented for three neighbouring mines in the Belgian Campine coal basin, where the longwall mining method was applied. First, the monitoring of the initial phase showed that the impact of the first panel was smaller than the impacts of the following two neighbouring panels. When the second panel was mined, a change in the induced surface tilt was observed in the immediate proximity of the panels. Second, data for a transect with a length of about 2.5 km were presented, covering a total time of 54 years, of which the first 31 years were during the active life of the mine. Average subsidence rates of up to − 0.3 m/year were observed. After the mine was closed and the pumping facilities were stopped, the average uplift rate was situated mostly between 4 and 16 mm/year, but a value of 141 mm/year also was measured. Thirty years after closure, the upward movements are still occurring. Third, the phase of uplift is analyzed in more detail over a full north–south transect. A clear narrow maximum was observed for the uplift, corresponding to a total vertical movement of 0.2 m over approximately an 18-year period. All these phases are relevant, for example when analysing damage to buildings and infrastructure. Damage becomes visible when the cumulative movement and loading exceed critical limits and not necessarily when the largest rate of movement is observed, for example. [ABSTRACT FROM AUTHOR]

Purpose of Review: This article aims to provide a comprehensive understanding of the evaluation, diagnosis, and management of scapular dyskinesis and its impact on the kinetic chain in tennis athletes. Recent Findings: Optimal glenohumeral biomechanics are intimately associated with proper scapular motion and function. The tennis serve requires the scapula to act as a force transducer in the kinetic chain to convert potential energy generated in the lower extremities to kinetic energy in the upper extremity. Any aberration within this complex kinetic chain will result in force uncoupling and increases the potential for injury through compensatory mechanisms. Specifically, scapular dyskinesis has been associated with an increased risk of shoulder pain of up to 43% in overhead athletes. These pathologies include rotator cuff disease, subacromial and posterior impingement, labral injuries, and SLAP tears. Although the direct causality of these injuries remains controversial, multiple kinematic studies have demonstrated altered scapular positioning increasing the predilection for soft tissue pathology. Summary: The diagnosis of scapular dyskinesis is predicated upon a thorough history, physical examination, and observational analysis of key nodes in the kinetic chain during tennis activity. Conservative management remains the mainstay of treatment and consists of a graduated physical therapy regimen. Although shoulder pain in the overhead athletes is often multifactorial, early recognition and treatment of scapular dyskinesis generally carry a favorable prognosis and result in improved patient outcomes. [ABSTRACT FROM AUTHOR]

The plasma membrane is a lipid bilayer of < 10 nm width that separates intra- and extra-cellular environments and serves as the site of cell-cell communication, as well as communication between cells and the extracellular environment. As such, biophysical phenomena at and around the plasma membrane play key roles in determining cellular physiology and pathophysiology. Thus, the selective visualization and characterization of the plasma membrane are crucial aspects of research in wide areas of biology and medicine. However, the specific characterization of the plasma membrane has been a challenge using conventional imaging techniques, which are unable to effectively distinguish between signals arising from the plasma membrane and those from intracellular lipid structures. In this regard, interface-specific second harmonic generation (SHG) and sum-frequency generation (SFG) imaging demonstrate great potential. When combined with exogenous SHG/SFG active dyes, SHG/SFG can specifically highlight the plasma membrane as the most prominent interface associated with cells. Furthermore, SHG/SFG imaging can be readily extended to multimodal multiphoton microscopy with simultaneous occurrence of other multiphoton phenomena, including multiphoton excitation and coherent Raman scattering, which shed light on the biophysical properties of the plasma membrane from different perspectives. Here, we review traditional and current applications, as well as the prospects of long-known but unexplored SHG/SFG imaging techniques in biophysics, with special focus on their use in the biophysical characterization of the plasma membrane. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the effects of scapular taping on scapular kinematics by three-dimensional electromagnetic system during shoulder elevation in facioscapulohumeral muscular dystrophy patients. A total of 11 patients with facioscapulohumeral muscular dystrophy were included in the study. Scapular anterior-posterior tilt, upward-downward rotation, and internal-external rotations were evaluated using the three-dimensional electromagnetic system during the elevation of the upper limbs in the scapular plane before and after kinesio taping. For maximum humerothoracic elevation, there were no differences between the patients before and after taping on both dominant (p = 0.72) and non-dominant sides (p = 0.64). For scapular internal rotation, upward rotation, and posterior tilt, there were no differences between patients before and after taping during humerothoracic elevation on both dominant and non-dominant sides (p > 0.05). These results showed us that the excessive and abnormal movements of the scapula observed during the humeral elevation in facioscapulohumeral muscular dystrophy patients cannot be supported with flexible methods like kinesio taping. Therefore, we recommend to evaluate the scapula position by applying flexible and rigid taping to the patients who can reach over 90o in humerothoracic elevation in future studies. [ABSTRACT FROM AUTHOR]

Myasthenia gravis is a well-treatable disease, in which a prompt diagnosis and an adequate management can achieve satisfactory control of symptoms in the great majority of patients. Improved knowledge of the disease pathogenesis has led to recognition of patient subgroups, according to associated antibodies, age at onset and thymus pathology, and to a more personalized treatment. When myasthenia gravis is suspected on clinical grounds, diagnostic confirmation relies mainly on the detection of specific antibodies. Neurophysiological studies and, to a lesser extent, clinical response to cholinesterase inhibitors support the diagnosis in seronegative patients. In these cases, the differentiation from congenital myasthenia can be challenging. Treatment planning must consider weakness extension and severity, disease subtype, thymus pathology, together with patient characteristics and comorbidities. Since most subjects with myasthenia gravis require long-term immunosuppressive therapy, surveillance of expected and potential adverse events is critical. For patients refractory to conventional immunosuppression, the use of biologic agents is highly promising. These recommendations are addressed to non-experts on neuromuscular transmission disorders. The diagnostic procedures and therapeutic approaches hereafter described are largely accessible in Italy. [ABSTRACT FROM AUTHOR]

Background: Lower trapezius transfer can restore external rotation in brachial plexus palsies. In some cuff tear arthropathies, there is lack of active external rotation with a preservation of forward elevation. We evaluated the clinical outcomes of a lower trapezius transfer extended with a semitendinosus tendon and fixed to the insertion of the infraspinatus via arthroscopy.Methods: Between 2013 and 2016, we operated on 14 patients (8 men, 6 women; mean age of 62 years, range: 50-70) to reconstruct irreparable posterosuperior rotator cuff tear. A vertical incision of 6 cm following the medial border of the spine was made to harvest the lower trapezius in extension with the semitendinosus tendon. The extension band of the lower trapezius was fixed laterally via arthroscopy on the great tuberosity at the level of the insertion of the infraspinatus. The proximal stump of this extension band was then fixed medially into the muscle of the lower trapezius with the arm in maximum external rotation. Outcomes were evaluated with the Constant-Murley score, simple shoulder test (SST), and subjective shoulder value (SSV).Results: Over a mean follow-up of 24 months (range: 12-36 months), the gain in external rotation with the arm at the side was 24° and 40° in 90° of abduction. The Constant-Murley score improved from 35 to 60 points, the SST from 3.5 to 7.5, the SSV from 30 to 60%, and the pain decreased from 7 to 2 (visual analogue scale, 0-10). Both the lag sign and hornblower sign were negative after this transfer. There were two cases of hematomas, and one was revised because of infection.Conclusion: Lower trapezius transfer is a therapeutic option for irreparable posterosuperior cuff tears with a lack of active external rotation and a good subscapularis. Patients can expect improvements in pain and in active external rotation without any loss of active anterior elevation. [ABSTRACT FROM AUTHOR]

Purpose of Review: Swimmer’s shoulder is the term used to describe the problem of shoulder pain in swimmers. Originally described as supraspinatus tendon impingement under the coracoacromial arch, it is now understood that several different pathologies can cause shoulder pain in competitive swimmers, including subacromial impingement syndrome, overuse and subsequent muscle fatigue, scapular dyskinesis, and laxity and instability.Recent Findings: Swimmers may develop increased shoulder laxity over time due to repetitive use. Such excessive laxity can decrease passive shoulder stability and lead to rotator cuff muscle overload, fatigue, and subsequent injury in order to properly control the translation of the humeral head. Generalized laxity can be present up to 62% of swimmers, while a moderate degree of multi-directional instability can be present in the majority. Laxity in swimmers can be due to a combination of underlying inherent anatomical factors as well as from repetitive overhead activity.Summary: The role of excessive laxity and muscle imbalance are crucial in the swimmer’s shoulder and should be well understood since they are the primary target of the training and rehabilitation program. [ABSTRACT FROM AUTHOR]

Purpose of Review Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries. Recent Findings Conservative management of rotator cuff injuries continues to be the "gold standard" in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness. Summary Rotator cuff injuries can range from contusions and tendinopathy to full-thickness tears. A comprehensive evaluation is needed to determine the extent of injury and appropriate plan of care. Management strategies can range from rehabilitation to operative intervention and are guided by the size of the tear, time of season, sport, performance limitations, and presence of concomitant pathology. [ABSTRACT FROM AUTHOR]

Sustainability indicators are well recognized for their potential to assess and monitor sustainable development of agricultural systems. A large number of indicators are proposed in various sustainability assessment frameworks, which raises concerns regarding the validity of approaches, usefulness and trust in such frameworks. Selecting indicators requires transparent and well-defined procedures to ensure the relevance and validity of sustainability assessments. The objective of this study, therefore, was to determine whether experts agree on which criteria are most important in the selection of indicators and indicator sets for robust sustainability assessments. Two groups of experts (Temperate Agriculture Research Network and New Zealand Sustainability Dashboard) were asked to rank the relative importance of eleven criteria for selecting individual indicators and of nine criteria for balancing a collective set of indicators. Both ranking surveys reveal a startling lack of consensus amongst experts about how best to measure agricultural sustainability and call for a radical rethink about how complementary approaches to sustainability assessments are used alongside each other to ensure a plurality of views and maximum collaboration and trust amongst stakeholders. To improve the transparency, relevance and robustness of sustainable assessments, the context of the sustainability assessment, including prioritizations of selection criteria for indicator selection, must be accounted for. A collaborative design process will enhance the acceptance of diverse values and prioritizations embedded in sustainability assessments. The process by which indicators and sustainability frameworks are established may be a much more important determinant of their success than the final shape of the assessment tools. Such an emphasis on process would make assessments more transparent, transformative and enduring. [ABSTRACT FROM AUTHOR]

Purpose: In order to provide science-based guidelines for injury prevention or return to play, regular measurement of isometric and eccentric internal (IR) and external (ER) rotator strength is warranted in overhead athletes. However, up to date, no normative database exists regarding these values, when measured with a hand-held dynamometer. Therefore, the purpose of the study was to provide a normative database on isometric and eccentric rotator cuff (RC) strength values in a sample of overhead athletes, and to discuss gender, age and sports differences.Methods: A HHD was used to measure RC strength in 201 overhead athletes between 18 and 50 years old from three different sports disciplines: tennis, volleyball and handball. Isometric as well as eccentric strength was measured in different shoulder positions. Outcome variables of interest were isometric ER and IR strength, eccentric ER strength, and intermuscular strength ratios ER/IR.Results: Our results show significant side, gender and sports discipline differences in the isometric and eccentric RC strength. However, when normalized to body weight, gender differences often are absent. In general, strength differences are in favour of the dominant side, the male athletes and handball. Intermuscular ER/IR ratios showed gender, sports, and side differences.Conclusion: This normative database is necessary to help the clinician in the evaluation of RC strength in healthy and injured overhead athletes. In view of the preventive screening and return-to-play decisions in overhead athletes, normalization to body weight and calculating intermuscular ratios are key points in this evaluation.Level Of Evidence: Diagnostic study, Level III. [ABSTRACT FROM AUTHOR]

Copyright of Obere Extremitat is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To give an overview of current knowledge and guidelines with respect to evidence-based rehabilitation of athletes with glenohumeral instability.Methods: This narrative review combines scientific evidence with clinical guidelines based on the current literature to highlight the different components of the rehabilitation of glenohumeral instability.Results: Depending on the specific characteristics of the instability pattern, the severity, recurrence, and direction, the therapeutic approach may be adapted to the needs and demands of the athlete. In general, attention should go to (1) restoration of rotator cuff strength and inter-muscular balance, focusing on the eccentric capacity of the external rotators, (2) normalization of rotational range of motion with special attention to the internal rotation ROM, (3) optimization of the flexibility and muscle performance of the scapular muscles, and (4) gradually increasing the functional sport-specific load on the shoulder girdle. The functional kinetic chain should be implemented throughout all stages of the rehabilitation program. Return to play should be based on subjective assessment as well as objective measurements of ROM, strength, and function.Conclusions: This paper summarizes evidence-based guidelines for treatment of glenohumeral instability. These guidelines may assist the clinician in the prevention and rehabilitation of the overhead athlete.Level Of Evidence: Expert opinion, Level V. [ABSTRACT FROM AUTHOR]

Purpose: Long-term use of unfavorable postures, congenital deformations and degenerative processes associated with aging or disease may generate an increased thoracic curvature resulting in pain and disability. We wanted to examine whether a slouched postural alignment with increased thoracic kyphosis changes the shoulder kinematics and muscle activity in upper trapezius (UT), lower trapezius (LT) and serratus anterior (SA) during arm elevation. The aim was to determine if a slouched posture influences range of motion, muscle activation patterns, maximal muscle activity and the total muscle work required when performing arm elevations.Method: Twelve male subjects (23.3 ± 1.5 years) performed maximum arm elevations in upright and slouched postures. A combined 3D movement and EMG system recorded arm movements and spine curvature simultaneously with EMG activity in the UT, LT and SA.Results: Slouched posture affected the biomechanical conditions by significantly decreasing maximum arm elevation by ~15° (p < 0.001) and decreasing arm movement velocity by ~8 % during movements upwards (p < 0.001) and downwards (p = 0.034). The peak muscle activity increased in all muscles: UT (p = 0.034, +32.3 %), LT (p = 0.001, +48.6 %) and SA (p = 0.007, +20.9 %). The total muscle work increased significantly in the slouched posture during movements upwards: UT (p = 0.003, +36.6 %), LT (p < 0.001, +89.0 %), SA (p = 0.002, +19.4 %) and downwards: UT (p = 0.012, +29.8 %) and LT (p < 0.001, +122.5 %).Conclusion: An increased thoracic kyphosis was found associated with marked increased physical costs when performing arm movements. Hence, patients suffering from neck-shoulder pain and disability should be investigated and treated for defective thoracic curvature issues. [ABSTRACT FROM AUTHOR]

Purpose: Scapular dyskinesis has been related to acromioclavicular injuries. A rehabilitation protocol has been studied in order to treat scapular dyskinesis, but it has not yet been evaluated. This rehabilitation programme was adopted to improve the shoulder function, thereby improving the scapular dyskinesis in patients with chronic acromioclavicular dislocation. Method: Twenty-four patients diagnosed with chronic type III acromioclavicular dislocation and scapular dyskinesis that have already been conservatively treated were enrolled in the rehabilitation protocol and analysed. Fourteen of these patients had a Scapular Inferior Coracoid dysKinesis (SICK) Syndrome. The adopted rehabilitation protocol consisted of 12 strengthening and stretching exercises of the scapulae. The final follow-ups were performed after 6 weeks, 6 months and 12 months using clinical measurements of scapular position and clinical evaluation of the scapular motion. In order to evaluate the SICK scapula syndrome, we used the SICK Scapula Rating Scale. The shoulder function was evaluated with a Constant Score and a Subjective Shoulder Value. Results: After 12 months, the follow-up concluded that the scapular dyskinesis was no longer present in 18/23 patients (78.2 %). SICK scapula syndrome was observed in 4/8 patients with a scapular malposition. The Scapula Rating Scale score in 4 patients with SICK scapula was 7.5 points. After 12 months of rehabilitation, the mean Constant Score and Subjective Shoulder Value grew up to 85 points. Conclusion: The scapular dyskinesis and SICK syndrome secondary to chronic type III AC dislocation can be treated with the proposed rehabilitation protocol resulting in positive improvements of the shoulder function within 6 weeks; however, patients that do not respond to the rehabilitation programme will not improve with extended rehabilitation time. It is important to advise patients of the specific exercises for the prevention/treatment of scapular dyskinesis in the rehabilitation programme after AC joint dislocation. Level of evidence: IV. [ABSTRACT FROM AUTHOR]

Biological membranes with cubic symmetry are a hallmark of virus-infected or diseased cells. The mechanisms of formation and specific cellular functions of cubic membranes, however, are unclear. The best-documented cubic membrane formation occurs in the free-living giant amoeba Chaos carolinense. In that system, mitochondrial inner membranes undergo a reversible structural change from tubular to cubic membrane organization upon starvation of the organism. As a prerequisite to further analyze the structural and functional features of cubic membranes, we adapted protocols for the isolation of mitochondria from starved amoeba and have identified buffer conditions that preserve cubic membrane morphology in vitro. The requirement for high concentration of ion-chelating agents in the isolation media supports the importance of a balanced ion milieu in establishing and maintaining cubic membranes in vivo. [ABSTRACT FROM AUTHOR]

Pyrimidinophanes are macrocycles consisting of pyrimidine moieties bridged to each other with alkyl spacers. Most of the known pyrimidinophanes originate from pyrimidinic nucleobase uracil and its 5(6)-substituted derivatives. Diverse macrocyclic compounds with pyrimidine moieties have appeared during the last two decades, and in this review the synthesis and properties of the pyrimidinophanes studied have been described. [ABSTRACT FROM AUTHOR]

Although grazing of dairy cows is an integral part of dairy farming in many European countries, farmers today more often choose for zero-grazing systems, where cows are housed throughout the year. Some studies already compared grazing and zero-grazing systems for specific issues such as labor efficiency, environmental impact, or animal welfare. In our study, we perform a more integrated evaluation, considering relevant ecological, economic, and social aspects. This allows for a balanced and more complete comparison of the sustainability performance of the two production methods. We evaluated ten intensive grazing and ten zero-grazing specialized Flemish dairy farms on the use of nutrients and energy, productivity and profitability, labor input, and animal welfare. In addition, we put special effort in formulating useful management advice for farmers. Therefore, we combined a detailed analysis of the sustainability indicators with an intensive interaction and discussion with farmers and farm advisors. Results show that, on average, the zero-grazing farms performed significantly worse from an ecological and economic point of view. This fact is explained mainly due to a less efficient use of concentrates and byproducts. Social sustainability performance did not differ significantly between the two groups. As a result, the integrated sustainability performance was significantly lower for the zero-grazing group. This finding shows that a further shift from intensive grazing to zero-grazing can move dairy farming in Flanders further away from sustainability. An important advice to improve the ecological and economic performance of zero-grazing farms is to optimize cows' rations to include more forages and optimize forage production and use. More detailed site- and case-specific management advice for farmers of both groups was provided during a discussion meeting. We consider this an essential additional step to any sustainability evaluation, since progress can only be made when monitoring results are translated into practical measures. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the influence of iodine concentration on diagnostic efficacy in multi-detector-row computed tomography (MDCT) angiography of the abdominal aorta and abdominal arteries.Methods: IRB approval and informed consent were obtained. In this double-blind trial, patients were randomised to undergo MDCT angiography of the abdominal arteries during administration of iobitridol (350 mgI/ml) or iomeprol (400 mgI/ml). Each centre applied its own technique for delivery of contrast medium, regardless of iodine concentration. Diagnostic efficacy, image quality, visualisation of the arterial wall and arterial enhancement were evaluated. A total of 153 patients received iobitridol and 154 received iomeprol.Results: The ability to reach a diagnosis was "satisfactory" to "totally satisfactory" in 152 (99.3%) and 153 (99.4%) patients respectively. Image quality was rated as being "good" to "excellent" in 94.7 and 94.8% segments respectively. Similar results were observed for image quality of arterial walls (84.3 vs. 83.2%). The mean relative changes in arterial enhancement between baseline and arterial phase images showed no statistically significant differences.Conclusion: This study demonstrated the non-inferiority of the 350 versus 400 mgI/ml iodine concentration, in terms of diagnostic efficacy, in abdominal MDCT angiography. It also confirmed the high robustness and reliability of this technique across multi-national practices. [ABSTRACT FROM AUTHOR]

This paper examines the observational evidence for the detection of gravity modes in δ Scuti stars, which are p-mode pulsators. Low-order gravity modes have also been found in at least one star (FG Vir). Some reports of gravity modes may be due to systematic errors in the absolute magnitude calibrations for slowly rotating stars. Furthermore, many detected low frequencies are not high-order gravity modes, but linear combinations, fi -fj , of the main pulsation modes. Other low frequencies are caused by a close binary companion leading to tidal deformation as well as tidally excited gravity modes. [ABSTRACT FROM AUTHOR]

In this review we present the current status of line-profile-variation studies of β Cep stars. Such studies have been performed for 26 bright members of this class of pulsating stars in the past 25 years. We describe all these currently available data and summarize the interpretations based on them in terms of the excited pulsation modes. We emphasize that line-profile variations offer a much more detailed picture of the pulsational behaviour of pulsating stars compared to ground-based photometric data. The latter, however, remain necessary to unravel the often complex frequency pattern and to achieve unambiguous mode identification for multiperiodic β Cep stars and also to derive the pulsational properties of the faint members of the class. We highlight the statistical properties of the sample of 26 stars for which accurate spectroscopic studies are available and point out some future prospects. [ABSTRACT FROM AUTHOR]

We conducted a qualitative evaluation of a semi-structured, client-led support group that addressed drug use recovery issues and was assisted by a psychologi cal consultant. Seven regular group members and their counselors were interviewed about the effect of the assisted self-help group on drug use and the clients' quality of life, and these interviews were content analyzed. In addition, the psychological consultant made group process observations for each session of the first three months. Clients reported group strengths as: Feeling supported and understood, being able to speak freely without fear of staff reprisals, obtaining information/feedback, improved mood, and decreased drug use. With the provision of professional support and guidance, this group shows promise as an adjunct to standard outpatient drug abuse treatment by allowing for some degree of client independence and extending the scarce resource of professional counseling. [ABSTRACT FROM AUTHOR]

Presents a qualitative evaluation of an assisted client-led support group that addresses drug use recovery issues. Effect of the assisted self-help group on drug use and the clients' quality of life; Group strengths reported by clients; Identification of group components important to the group members and counselors.

The overall therapeutic equivalence of a fluorochlorohydrocarbon (FCH)-free glyceryl trinitrate (GTN) pump spray with a low ethanol content (TL) was investigated relative to an FCH-containing GTN spray (Nitrolingual; R), in terms of: (1) pharmacokinetic bioavailability, (2) pharmacodynamic responses as assessed by digital plethysmography (DPG), and (3) clinical perception upon application. Pharmacokinetically, the time courses of the plasma concentrations of GTN and its dinitrate metabolites, 1,2- and 1,3-GDN, subsequent to the sublingual administration of 0.8 mg GTN showed somewhat lower bioavailability of GTN and its metabolites than to the reference. Pharmacodynamically, the changes in the DPG signals after the application of 0.8 mg GTN with TL were biostatistically euivalent with R (estimated ratio TL/R for the maximum decrease of the ratio between the systolic a wave and c incisure: 0.98; 90% CI: 0.84-1.14; and for the average decrease of the c: a ratio: 0.97; 90% CI: 0.80-1.16). The time of occurrence of the maximum effect of TL was not significantly different from that of R (estimated difference TL-R: -2.25 min; 95% CI:-9.5 min to 2 min). In contrast, after the administration of an FCH-free GTN spray with a higher ethanol content (TH, active control), the effect had a slightly earlier onset (TH-R:-6 min, 95% CI: -9.5 to -2 min) and there was a higher average response (TH/R: 1.12: 90% CI: 0.95 to 1.34). However, TH was consistently judged to cause an extremely unpleasant burning sensation in the mouth and thus was perceived as distinctly different from R. In contrast, TL was well tolerated and could not be distinguished from R. Therefore only TL met the criteria of overall therapeutic equivalence to R. [ABSTRACT FROM AUTHOR]

Sixteen healthy male subjects were investigated on four occasions when they received either placebo, 10 mg isosorbide dinitrate (ISDN), or 2.5 or 10 mg pirsidomine, a novel NO-donating drug. A constant-rate iv. infusion of a subsystemic dose (average 42 ng·min, SD 20.5) of noradrenaline in a dorsal hand vein was begun 1 h before drug treatment. It did not cause systemic changes but reduced the venous hand vein diameter by about 50%. This venoconstrictor response was approximately halved by 10 mg ISDN. Pirsidomine, in contrast, did not affect the in situ venoconstrictor responses to noradrenaline. ISDN and pirsidomine reduced systemic resting blood pressure. ISDN and 10 mg pirsidomine were approximately equipotent in reducing systolic blood pressure, both in terms of the duration and the extent of the effect (maximum average reduction of ISDN -6.7, 95% CI -10.3 to -3.0; and 10 mg pirsidomine -7.6, 95% CI -11.3 to -4.0 mmHg, respectively); 2.5 mg pirsidomine was less effective (-4.1, 95% CI -7.8 to -0.5). ISDN and 10 mg pirsidomine were also similarly effective in reducing diastolic blood pressure (ISDN -8.4 mmHg, 95% CI -10.5 to -6.2; 10 mg pirsidomine -6.0 mmHg, 95% CI -8.2 to -3.9; 2.5 mg pirsidomine -2.8 mmHg, 95% CI -5.0 to -0.6) but the effects of ISDN were longer lasting. Although similar with regard to their putative mechanism(s) of action and likely arterial/arteriolar effects, pirsidomine and ISDN seem to affect the venous vascular bed in distinctly different ways. [ABSTRACT FROM AUTHOR]

Immuno-enzyme histochemical investigations on the bovine hypothalamus showed that the infundibular nucleus contains neurons that produce either neurophysin I or a neurophysin I-like substance. Fine processes of these neurons run in the direction of the median eminence. The possibility that these processes could be the origin of the 'neurophysin I-oxytocin' containing nerve fibres of the external region of the median eminence is discussed. [ABSTRACT FROM AUTHOR]

Upper crossed syndrome (UCS) refers to the altered muscle activations and movement patterns in scapulae along with some abnormal alignment in the upper quarter, which may contribute to the dysfunction of the cervicothoracic and glenohumeral joints. The present study aimed to investigate the effectiveness of a comprehensive corrective exercise program (CCEP) and subsequent detraining on alignment, muscle activation, and movement pattern in men with the UCS. This randomized controlled trial included 24 men. The intervention group conducted CCEP (8 weeks), followed by four weeks of detraining and the control group maintained normal daily activities. Electromyography of selected muscles, scapular dyskinesis test, head, shoulder, and thoracic spine angle were measured at baseline, post-test, and follow-up. There were significant differences for Group x time interaction and also for within-group from pre-test to post-test and follow-up in all outcomes. Also, significant differences were observed in three outcomes at post-test and follow-up between the CCEP and control group in favor of the CCEP. In Conclusion, the present study demonstrates that the CCEP for individuals with UCS is feasible and effective, improving muscle activation imbalance, movement patterns, and alignment. Importantly, these improvements were maintained after four weeks of detraining, suggesting lasting neuromuscular re-training adaptations. [ABSTRACT FROM AUTHOR]

Immuno-enzyme histochemical investigations showed the presence, in the external region of the bovine eminence, of neurophysin I-and neurophysin II-containing fine nerve fibres. [ABSTRACT FROM AUTHOR]