The ACGIH TLV for lifting: Estimated TLVs for torso asymmetry beyond 30 degrees

BACKGROUND

The American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Values (TLVs) for Lifting is a manual material handling (MMH) assessment method to identify weight limits that nearly all workers may be exposed to without developing work-related low back disorders (LBD). However, this assessment method only applies to lifting with the torso within 30° asymmetry of the sagittal plane.

OBJECTIVE

Estimate TLV weight limits while lifting with torso asymmetry greater than 30° beyond the sagittal plane.

METHODS

Lifting tasks were performed from various horizontal and vertical locations, at torso asymmetry angles of 0°, 15°, 30°, 45°, 60°, 75° and 90°, using ACGIH identified TLVs. Validated MMH assessment methods (NIOSH Lifting Equation, Ohio State University LBD Risk Model) were utilized to estimate TLVs at torso asymmetries greater than 30°.

RESULTS

The current ACGIH TLVs resulted in low- to moderate-risk risk levels for torso asymmetries from 0° to 30°, and the risk incrementally increased as torso asymmetry increased to 90°. With the intention to keep the risk levels to that found at 30° torso asymmetry, lower TLV weight limits in the vertical and horizontal zones investigated were estimated for torso asymmetries from 45° to 90°. The resulting adjusted TLVs were consistent with weight limits identified for similar lifting conditions from other assessment methods that account for torso asymmetry.

CONCLUSIONS

This research found current ACGIH-defined TLVs possess less than high-risk for LBD, and provided guidance to practitioners for reduced TLVs when torso asymmetry is greater than 30° from the sagittal plane.

Differences in Postoperative Atrial Fibrillation Incidence and Outcomes After Cardiac Surgery According to Assessment Method and Definition: A Systematic Review and Meta-Analysis

BACKGROUND

Postoperative atrial fibrillation (POAF) is the most frequent complication of cardiac surgery. Despite clinical and economic implications, ample variability in POAF assessment method and definition exist across studies. We performed a study-level meta-analysis to evaluate the influence of POAF assessment method and definition on its incidence and association with clinical outcomes.

METHODS AND RESULTS

A systematic literature search was conducted to identify studies comparing the outcomes of patients with and without POAF after cardiac surgery that also reported POAF assessment method. The primary outcome was POAF incidence. The secondary outcomes were in-hospital mortality, stroke, intensive care unit length of stay, and postoperative length of stay. Fifty-nine studies totaling 197 774 patients were included. POAF cumulative incidence was 26% (range: 7.3%-53.1%). There were no differences in POAF incidence among assessment methods (27%, [range: 7.3%-53.1%] for continuous telemetry, 27% [range: 7.9%-50%] for telemetry plus daily ECG, and 19% [range: 7.8%-42.4%] for daily ECG only; P>0.05 for all comparisons). No differences in in-hospital mortality, stroke, intensive care unit length of stay, and postoperative length of stay were found between assessment methods. No differences in POAF incidence or any other outcomes were found between POAF definitions. Continuous telemetry and telemetry plus daily ECG were associated with higher POAF incidence compared with daily ECG in studies including only patients undergoing isolated coronary artery bypass grafting.

CONCLUSIONS

POAF incidence after cardiac surgery remains high, and detection rates are variable among studies. POAF incidence and its association with adverse outcomes are not influenced by the assessment method and definition used, except in patients undergoing isolated coronary artery bypass grafting.

Assessing work speed using MODAPTS: A tool for occupational therapists

BACKGROUND

The importance to be able to work is recognised as one of the United Nation's Sustainable Development Goals. Occupational therapists working in vocational rehabilitation require cost effective, valid, and reliable tests that offer flexibility during the work evaluation process. The use of self-developed work samples standardized using Modular Arrangement of Predetermined Time Standards (MODAPTS) as an objective measure of work speed could meet this need.

OBJECTIVE

Evaluate the face, content, and criterion validity of MODAPTS work samples to assess work speed.

METHODS

We conducted a quantitative cross-sectional, descriptive study. Occupational therapists completed electronic surveys to evaluate face and content validity. We evaluated criterion validity during a multiphase process that involved a realist synthesis, online survey, and comparing MODAPTS to Methods Time Management (MTM) time standards using three work samples that measured work speed.

RESULTS

MODAPTS had good face validity for measuring work speed. We also confirmed the content and criterion validity of codes used to analyse basic movement and handling of smaller and larger articles as well as other body actions.

CONCLUSION

MODAPTS demonstrated adequate face, content and criterion validity of tasks involving basic movements, handling of articles and other body actions.

Evaluation Methodology for Inclusive Schools Environments. A Comparative Analysis Towards Goals and Strategies for Urban Design

The paper deals with the issue of social inclusion in the scholastic environment where children begin to learn the set of rules that manage social life. The design of the spaces impact on people and becomes crucial to address a community behavioural change in terms of social inclusion. In line with Universal Design strategy, the paper presents a method developed for evaluating the degree of inclusion of primary schools' spaces, which consists of the definition of an evaluation matrix. The matrix makes possible to analyse quantitative-qualitative characteristics for each school and compare them objectively. It asses the level of accessibility and inclusion of the schools through four main categories (Outdoor space, Orientation, Movement, Spatial quality) and related criteria and indicators. The reliability of the evaluation matrix has been verified through its application in seven case studies (Italian and EU), and the analysis of one of them is described in the results. The present study proposes a basis to introduce a method able to support designing educational spaces that satisfy the needs of a wide range of users according to Universal Design strategy.

Curricular Considerations for Preparing Student Pharmacists to Prescribe Hormonal Contraception

In 2014, the pharmacist's role in the United States expanded to include prescribing hormonal contraception, and this practice is currently addressed by policy in 14 states and the District of Columbia. Training and education requirements for this expanded scope of practice vary between states and are changing rapidly. The objective of this review is to examine how student pharmacists are taught to provide contraceptive care, specifically for prescribing ongoing hormonal contraception and emergency contraception, and to identify potential gaps in the United States pharmacy curricula related to contraception. Despite steady adoption into community pharmacy practice, there is sparse literature assessing educational methods used to teach contraceptive care. This review offers recommendations to promote consistent and comprehensive student pharmacist education in providing contraceptive care across institutions, regardless of state policy status.

[Discussion on the ecological theory and assessment methods of ecosystem quality and its evolution]

Ecological civilization construction and ecological environment governance are basic tasks of state gover-nance in China. China has clearly put forward the goal of improving ecosystem quality and stability. However, there are no consensus on the scientific concept of ecosystem quality and the assessment methods of ecosystem quality evolution, which has puzzled the academic community. Based on the summarization of the scientific concept of ecosystem quality and its evolution, we discussed the concept of ecosystem quality and its ecological theory basis by referencing the concept of production quality, quality management and quality assessment of material production. The scientific connotation of ecosystem quality and its evolution was discussed from the perspectives of ecosystem natural attribute-social attribute-economic attribute and the relationships between them, the cascade relations of ecosystem component-structure-process-function-service-efficacy, the feedback of factor-system-environment, and the logic relation of state ecosystem fluctuation-quantity variation-quality alternation. We proposed perspectives and approaches of multi-objective assessment of ecosystem quality alternation from the aspects of natural resource environment system, typical ecosystem, regional macro-ecosystem, and ecological engineering efficacy.

Fatigue Life Assessment of Welded Joints by Combined Measurements Using DIC and XRD

The existing methods of assessing the fatigue life of welded joints fail to consider local strain ranges and mean stress at the weld toe. The present work proposes a novel approach to assessing the fatigue life of welded joints by conducting measurements with digital image correlation (DIC) and X-ray diffraction (XRD) in combination. Local strain ranges at the weld toe of gusset welded joints were measured by DIC. Hammer peening was conducted on the welded joints to introduce different initial stresses. The influence of mean stress was investigated by considering initial residual stress measured by XRD and a perfect plastic material model. The fatigue experiment was carried out on specimens with and without hammer peening. The results showed that hammer peening could offset adverse welding deformation effectively, and introduce significant residual compressive stress. The fatigue failure life increased by more than 15 times due to hammer peening. The fatigue initiation life assessed by the proposed method was close to that based on nominal stress, indicating that the proposed method is reliable for predicting the fatigue initiation life of welded joints.

Modified Tumor Budding as a Better Predictor of Lymph Node Metastasis in Early Gastric Cancer: Possible Real-World Applications

Simple Summary

To obtain the optimal treatment effect of endoscopic resection (ER) in early gastric carcinoma (EGC), a well-established indication for post-ER surgery is needed. In addition, accurate prediction of lymph node metastasis (LNM) is necessary to achieve this goal. Here, we present modified tumor budding (mTB), which excludes signet ring cells from conventional tumor budding (TB) as a novel predictor for LNM. Conventional TB and mTB were the most predictive independent factors for LNM. Furthermore, mTB was superior to TB in predicting LNM (p = 0.0004–0.0008). In conclusion, mTB significantly enhanced the predictive power of LNM, which could be a novel indicator for determining post-ER surgery.

Abstract

Endoscopic resection (ER) is a minimally invasive treatment for early gastric cancer (EGC) with a low risk of lymph node metastasis (LNM). Recently, tumor budding (TB) has emerged as a potential predictor of LNM in EGC. We assessed the clinical significance of modified TB (mTB) that excludes the signet ring cell component and compared several TB assessment methods. Two hundred and eighty-nine patients with EGC at Uijeongbu St. Mary’s Hospital from 2010 to 2021 were enrolled. In univariate analysis, age, size, depth of invasion, tumor type, histologic type, Lauren classification, lymphatic invasion, venous invasion, poorly differentiated carcinoma (“not otherwise specified” predominant), and TB were significantly associated with LNM. Multivariate regression analysis showed that mTB (difference area under the curve [dAUC] = 0.085 and 0.087) was superior to TB (dAUC = 0.054 and 0.057) in predicting LNM. In addition, total TB counts on representative slide sections (dAUC = 0.087 and 0.057) in assessing TB and mTB and the ITBCC method (dAUC = 0.085) in mTB were superior to the presence or absence method (dAUC = 0.042 and 0.029). The mTB significantly increases LNM prediction ability, which can provide important information for patients with EGC.

Three-Dimensional Urethral Profilometry-A Global Urethral Pressure Assessment Method

Background: To present a new method of urethral pressure examination, and to evaluate diagnostic capabilities of three-dimensional profilometry, as an alternative to classical urethral profile (UPP). Using five channel catheters and dedicated software, a global urethral pressure image is obtained. The method eliminates the main limitation of classical urethral profilometry, where the catheter orientation determines the pressure picture limited to only one point in the urethral circumference; we observed up to 50% differences in pressure measures depending on the point of urethral circumference where the measurement was taken. Methods: This is a preliminary study containing a method presentation and analysis of the use in varied clinical cases of either healthy patients or patients with lower urinary tract symptoms (LUTS). The article includes a technique and equipment description and a full evaluation of selected cases, including three-dimensional urethral pressure distribution graphics. Results and Conclusions: Three-dimensional profilometry compared to the classical technique is comparable regarding the time, cost, technical difficulty and patient discomfort. At the same time, we obtained much more data on the urethral pressure and its distribution. The results are easy to interpret due to the 3D movable graphics created automatically by the dedicated software.

A method identifying key optimisation points for aircraft seat comfort

Seating is the overriding factor influencing aircraft cabin comfort. To efficiently enhance seat comfort, this paper proposes a method to identify key optimisation points for seat comfort. Seat discomfort indicators are recognised based on a comparison of perceived performance with expectation. Confirmatory factor analysis is used to explore the latent variables of discomfort indicators, and a structural model was used to analyse correlations between latent variables. Finally, the most important latent variable influencing seat comfort was clarified. Analysis results of survey data from narrow-body aircraft show that seat discomfort indicators centre on the physical performance of the seat and include four latent variables: support performance, personal space, contact surface features, and safety and stability. Support performance determines body posture while travelling and is the overriding latent variable influencing seat comfort. This research establishes aircraft seat discomfort indicators, latent variables formed through the mutual linkage of discomfort indicators, and the structural relations between latent variables. The results can assist in the formulation of comfort optimisation procedures for aircraft seats. Practitioner summary: A method identifying the key points of aircraft seat comfort optimisation was proposed, which includes three steps: recognising discomfort indicators, exploring the relationship between discomfort indicators, and confirming the most important variable influencing seat comfort. Results provide guidance for aircraft seat optimisation. Abbreviations: SEM: structural equation modelling; EFA: exploratory factor analysis; CFA: confirmatory factor analysis; PA-OV: path analysis with observed variables; CR: construct reliability; AVE: average variance extracted; CMIN: likelihood-ratio chi-square; DF: degrees of freedom; GFI: goodness-of -fit index; AGFI: adjusted goodness-of -fit index; RMSEA: root mean square error of approximation; NNFI: non-normed fit index; RFI: relative fit index; CFI: comparative fit index; CN: critical N.

Oxidative stress tolerance and antioxidant capacity of lactic acid bacteria as probiotic: a systematic review

Lactic acid bacteria (LAB) are the most frequently used probiotics in fermented foods and beverages and as food supplements for humans or animals, owing to their multiple beneficial features, which appear to be partially associated with their antioxidant properties. LAB can help improve food quality and flavor and prevent numerous disorders caused by oxidation in the host. In this review, we discuss the oxidative stress tolerance, the antioxidant capacity related herewith, and the underlying mechanisms and signaling pathways in probiotic LAB. In addition, we discuss appropriate methods used to evaluate the antioxidant capacity of probiotic LAB. The aim of the present review is to provide an overview of the current state of the research associated with the oxidative stress tolerance and antioxidant capacity of LAB.

The Submental Nasal Appearance Scale for the Assessment of Repaired Unilateral Complete Cleft Lip: A Validation Study

Objective:

To reassess reliability and validity of the Submental Nasal Appearance Scale (SNAS) compared to the preliminary pilot study, for assessment of patient photographs with repaired unilateral cleft lip and palate (UCLP). When utilizing the SNAS, 3 nasal features (1. nasal outline; 2. alar base position; 3. nostril axis) must be graded according to symmetry between the cleft and noncleft side using a 5-point scale with reference photographs for each feature. The mean score calculated from the graded features reflects the overall degree of nasal symmetry, which is considered an important goal when repairing UCLP.

Design:

Fifty patient photographs were selected and cropped, displaying the submental view. Six raters assessed these photographs using the SNAS and a separate 5-point scale to assess the overall submental appearance. Interrater reliability was determined for both methods and correlation was calculated between these as an indication of construct validity.

Setting:

Amsterdam UMC, location VUmc, Amsterdam, The Netherlands.

Patients:

Six- to 9-year-old patients with repaired UCLP.

Results:

Interrater reliability of 0.73 and 0.48 was found for the SNAS and overall appearance assessment, respectively, while in the pilot study values of 0.79 and 0.69 were found. Correlation of 0.59 and 0.74 was found in the current and pilot study, respectively, between the SNAS and overall appearance assessment.

Conclusions:

The SNAS is a reliable tool to assess nasal symmetry from the submental perspective. Reliability of the SNAS is higher compared to grading overall appearance, but validity of the SNAS was less well supported.

Confirmation of a Two-Factor Solution to the Questionnaire of Cognitive and Affective Empathy in a French Population of Patients With Schizophrenia Spectrum Disorders

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a tool for self-assessing the cognitive and emotional components of empathy. A study showed that a two-factor model fits the data of patients with schizophrenia, whereas other reports on healthy subjects have suggested a five-factor decomposition. We aimed to replicate the model of Horan et al. in a French population with schizophrenia spectrum disorders (i.e., schizophrenia and schizoaffective disorders) participating in the EVACO Study (NCT02901015). In total, 133 patients were assessed with the QCAE, the Positive and Negative Symptom Scale (PANSS), the Personal and Social Performance Scale (PSP), and the Self rating Quality of Life Scale (S-QoL). The two-factor model demonstrated an adequate fit with the data, comparable to that reported by Horan et al. Males scored higher on the Affective subscore than females. After correction for multiple tests, psychopathology (PANSS) and functioning (PSP) did not correlate significantly with the QCAE subscores. However, quality of life (S-QoL) correlated positively with the Emotional Contagion subscore. Thus, the variability of empathetic disposition in schizophrenia may be considered through the cognitive versus affective dichotomy and properly investigated with the QCAE. The results support further investigation of the relationship between QCAE scores and subjective outcome measurements, such as quality of life, and emphasize the importance of cross-cultural comparisons.

Current body composition measurement techniques

PURPOSE OF REVIEW

The current article reviews the most innovative and precise, available methods for quantification of in-vivo human body composition.

RECENT FINDINGS

Body composition measurement methods are continuously being perfected. Ongoing efforts involve multisegmental and multifrequency bioelectrical impedance analysis, quantitative magnetic resonance for total body water, fat, and lean tissue measurements, imaging to further define ectopic fat depots. Available techniques allow for the measurement of fat, fat-free mass, bone mineral content, total body water, extracellular water, total adipose tissue and its subdepots (visceral, subcutaneous, and intermuscular), skeletal muscle, select organs, and ectopic fat depots.

SUMMARY

There is an ongoing need for methods that yield information on metabolic and biological functions. Based on the wide range of measurable properties, analytical methods and known body composition models, clinicians, and scientists can quantify a number of body components and with longitudinal assessment, can track changes in health and disease with implications for understanding efficacy of nutritional and clinical interventions, diagnosis, prevention, and treatment in clinical settings. With the greater need to understand precursors of health risk beginning prior to conception, a gap exists in appropriate in-vivo measurement methods with application beginning during gestation, that is, fetal development.

Objective Assessment of Technical Skills in Otorhinolaryngology-Head and Neck Surgery Residents: A Systematic Review

Objectives The primary goal is the indexation of validated methods used to assess surgical competency in otorhinolaryngology-head and neck surgery (ORL-HNS) residents. Secondary goals include assessment of the reliability and validity of these tools, as well as the documentation of specific procedures in ORL-HNS involved. Data Sources MEDBASE, OVID, Medline, CINAHL, and EBM, as well as the printed references, available through the Université de Montréal library. Review Methods The PRISMA method was used to review digital and printed databases. Publications were reviewed by 2 independent reviewers, and selected articles were fully analyzed to classify evaluation methods and categorize them by procedure and subspecialty of ORL-HNS involved. Reliability and validity were assessed and scored for each assessment tool. Results Through the review of 30 studies, 5 evaluation methods were described and validated to assess the surgical competency of ORL-HNS residents. The evaluation method most often described was the combined Global Rating Scale and Task-Specific Checklist tool. Reliability and validity for this tool were overall high; however, considerable data were unavailable. Eleven distinctive surgical procedures were studied, encompassing many subspecialties of ORL-HNS: facial plastics, general ear-nose-throat, laryngology, otology, pediatrics, and rhinology. Conclusions Although assessment tools have been developed for an array of surgical procedures, involving most ORL-HNS subspecialties, the use of combined checklists has been repeatedly validated in the literature and shown to be easily applicable in practice. It has been applied to many ORL-HNS procedures but not in oncologic surgery to date.

ESMI: a macrophyte index for assessing the ecological status of lakes

The paper introduces the Ecological State Macrophyte Index (ESMI), a method compliant with the Water Framework Directive (2000/60/EC) for assessing the ecological status of lakes based on macrophytes. A description of the elaboration of macrophyte metrics, relevant reference conditions and a classification system for two types of high-alkalinity lowland lakes (stratified and polymictic), and a customised field survey procedure based on belt transects are presented. The ESMI evaluates two aspects of macrophyte community: taxonomic composition (index of evenness J) and abundance (colonisation index Z), which are combined into one multimetric. ESMI values range from 0 to 1, where 1 denotes pristine conditions and 0, highly degraded habitats. The high/good class boundary (H/G) was set at the first quartile of ESMI values of reference lakes. For the other classes, boundaries were set by dividing the range of ESMI values between the H/G boundary and the minimum value recorded in the dataset in a logarithmic scale into four. The ESMI correlated best with water transparency (Pearson's R = 0.62 in stratified lakes and 0.79 in polymictic ones), whereas the correlations with phosphorus and nitrogen concentrations were somewhat weaker (R = -0.48 to -0.57). Based on the results of international intercalibration, the original class boundaries were modified (merged for stratified and polymictic lakes, the good/moderate boundary tightened to approximately 20%), to make ESMI-based assessment results comparable with the outcomes of other European methods.