Economic accountability in the context of local governance in the Philippines : a structural equation modelling approach

This study posits that by virtue of the enabling role of local governments, the economic development of their locality must be at the core of their public accountability, which is referred to here as “economic accountability”. Grounded on this idea of accountability, along with enabling theory and institutional theory, the study presents empirical evidence supportive of the argument that the enabling role of local governments, as manifested in a capacity to establish or adhere to formal institutional arrangements, has a direct impact on the entrepreneurial strategic posture and performance of local small and medium enterprises (SMEs) which are key players in local economic development.The results of the structural equation modelling support the view that institutional arrangements as manifestations of the enabling role of city governments are positively associated with an entrepreneurial strategic posture of local firms, which consequently improves the firms’ overall economic performance. Therefore, SME development in particular, and local economic development in general, should be part of the economic accountability of local governments in the Philippine context of local governance.

Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures : the Geelong Osteoporosis Study

In this population-based study, seasonal periodicity was seen with reduced serum vitamin D, increased serum PTH, and increased bone resorption in winter. This was associated with an increased proportion of falls resulting in fracture and an increased risk of wrist and hip fractures.

Introduction: In a population of women who reside in a temperate climate and do not generally receive dietary vitamin D supplementation, we investigated whether seasonal vitamin D insufficiency is associated with increased risk of fracture.

Materials and Methods: An observational, cross-sectional, population-based study set in southeastern Australia (latitude 38–39° S). Participants were drawn from a well-defined community of 27,203 women ≥55 years old: 287 randomly selected from electoral rolls, 1635 with incident fractures, and 1358 presenting to a university hospital with falls. The main outcome measures were annual periodicities of ultraviolet radiation, serum 25-hydroxyvitamin D [25(OH)D], serum parathyroid hormone (PTH), serum C-telopeptide (CTx), BMD, falls, and fractures.

Results: Cyclic variations in serum 25(OH)D lagged 1 month behind ultraviolet radiation, peaking in summer and dipping in winter (p < 0.001). Periodicity of serum PTH was the inverse of serum 25(OH)D, with a phase shift delay of 1 month (p = 0.004). Peak serum CTx lagged peak serum PTH by 1–2 months. In late winter, a greater proportion of falls resulted in fracture (p < 0.001). Seasonal periodicity in 439 hip and 307 wrist fractures also followed a simple harmonic model (p = 0.078 and 0.002, respectively), peaking 1.5–3 months after the trough in 25(OH)D.

Conclusions: A fall in 25(OH)D in winter is accompanied by increases in (1) PTH levels, (2) bone resorption, (3) the proportion of falls resulting in fracture, and (4) the frequency of hip and wrist fracture. Whether vitamin D supplementation in winter can reduce the population burden of fractures requires further investigation.

Segmentation of intentional human gestures for sports video annotation

We present results on the recognition of intentional human gestures for video annotation and retrieval. We define a gesture as a particular, repeatable, human movement having a predefined meaning. An obvious application of the work is in sports video annotation where umpire gestures indicate specific events. Our approach is to augment video with data obtained from accelerometers worn as wrist bands by one or more officials. We present the recognition performance using a Hidden Markov Model approach for gesture modeling with both isolated gestures and gestures segmented from a stream.

Hierarchical recognition of intentional human gestures for sports video annotation

We present a novel technique for the recognition of complex human gestures for video annotation using accelerometers and the hidden Markov model. Our extension to the standard hidden Markov model allows us to consider gestures at different levels of abstraction through a hierarchy of hidden states. Accelerometers in the form of wrist bands are attached to humans performing intentional gestures, such as umpires in sports. Video annotation is then performed by populating the video with time stamps indicating significant events, where a particular gesture occurs. The novelty of the technique lies in the development of a probabilistic hierarchical framework for complex gesture recognition and the use of accelerometers to extract gestures and significant events for video annotation.

Automatic labeling of sports video using umpire gesture recognition

We present results on an extension to our approach for automatic sports video annotation. Sports video is augmented with accelerometer data from wrist bands worn by umpires in the game. We solve the problem of automatic segmentation and robust gesture classification using a hierarchical hidden Markov model in conjunction with a filler model. The hierarchical model allows us to consider gestures at different levels of abstraction and the filler model allows us to handle extraneous umpire movements. Results are presented for labeling video for a game of Cricket.

The contributions of first nations ethnicity, income, and delays in surgery on mortality post-fracture : a population-based analysis

Summary We examined the independent contributions of First Nations ethnicity and lower income to post-fracture mortality. A similar relative increase in mortality associated with fracture appears to translate into a larger absolute increase in post-fracture mortality for First Nations compared to non-First Nations peoples. Lower income also predicted increased mortality post-fracture.

Introduction First Nations peoples have a greater risk of mortality than non-First Nations peoples. We examined the independent contributions of First Nations ethnicity and income to mortality post-fracture, and associations with time to surgery post-hip fracture.

Methods Non-traumatic fracture cases and fracture-free controls were identified from population-based administrative data repositories for Manitoba, Canada (aged ≥50 years). Populations were retrospectively matched for sex, age (within 5 years), First Nations ethnicity, and number of comorbidities. Differences in mortality post-fracture of hip, wrist, or spine, 1996–2004 (population 1, n = 63,081), and the hip, 1987–2002(Population 2, n = 41,211) were examined using Cox proportional hazards regression to model time to death. For hip fracture, logistic regression analyses were used to model the probability of death within 30 days and 1 year.

Results Population 1: First Nations ethnicity was associated with an increased mortality risk of 30–53 % for each fracture type. Lower income was associated with an increased mortality risk of 18–26 %. Population 2: lower income predicted mortality overall (odds ratio (OR) 1.15, 95 % confidence interval (CI) 1.07–1.23) and for hip fracture cases (OR 1.18, 95%CI 1.05–1.32), as did older age, male sex, diabetes, and >5 comorbidities (all p ≤ 0.01). Higher mortality was associated with pertrochanteric fracture (OR 1.14, 95 % CI 1.03–1.27), or surgery delay of 2–3 days (OR 1.34, 95 % CI 1.18–1.52) or ≥4 days (OR 2.35, 95 % CI 2.07–2.67).

Conclusion A larger absolute increase in mortality post-fracture was observed for First Nations compared to non-First Nations peoples. Lower income and surgery delay >2 days predicted mortality post-fracture. These data have implications regarding prioritization of healthcare to ensure targeted, timely care for First Nations peoples and/or individuals with lower income.

Design, development, and evaluation of a pinch-grasp haptic interface

Interaction with virtual or teleoperated environments requires contact with objects on a multipoint level. We describe the design of a pinch--grasp hand interface device for use as a grasping mechanism to complement haptic interfaces. To preserve a suitable level of transparency for human--computer interaction, this novel interface is designed for high-resolution contact forces, while centered around a lightweight structure. This functionality renders the device scalable and adaptable to a wide range of haptic interface structures and force level requirements. We present an optimal configuration for a pinch--grasp interface, which produces bidirectional forces to an operator's fingers and a rotational force to the wrist through a cable drive system. The device is characterized for use on a commercial haptic interface through demonstration of sustained peak performance and also workspace utilization. The dynamic performance of the pinch--grasp interface is experimentally determined, and the frequency response is identified to illustrate its contact force resolution.

Anodal tDCS applied during strength training enhances motor cortical plasticity

Purpose:
The objective of this study was to assess the effect of anodal transcranial direct current stimulation (a-tDCS) on voluntary dynamic strength and cortical plasticity when applied during a 3-wk strength training program for the wrist extensors.

Methods:
Thirty right-handed participants were randomly allocated to the tDCS, sham, or control group. The tDCS and sham group underwent 3 wk of heavy-load strength training of the right wrist extensors, with 20 min of a-tDCS (2 mA) or sham tDCS applied during training (double blinded). Outcome measures included voluntary dynamic wrist extension strength, muscle thickness, corticospinal excitability, short-interval intracortical inhibition (SICI), and silent period duration.

Results:
Maximal voluntary strength increased in both the tDCS and sham groups (14.89% and 11.17%, respectively, both P < 0.001). There was no difference in strength gain between the two groups (P = 0.229) and no change in muscle thickness (P = 0.15). The tDCS group demonstrated an increase in motor-evoked potential amplitude at 15%, 20%, and 25% above active motor threshold, which was accompanied by a decrease in SICI during 50% maximal voluntary isometric contraction and 20% maximal voluntary isometric contraction (all P < 0.05). Silent period decreased for both the tDCS and sham groups (P < 0.001).

Conclusion:
The application of a-tDCS in combination with strength training of the wrist extensors in a healthy population did not provide additional benefit for voluntary dynamic strength gains when compared with standard strength training. However, strength training with a-tDCS appears to differentially modulate cortical plasticity via increases in corticospinal excitability and decreases in SICI, which did not occur following strength training alone

Different current intensities of anodal transcranial direct current stimulation do not differentially modulate motor cortex plasticity

Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22–45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessation of anodal tDCS. Cortical excitability increased, whilst SICI was reduced at all time points following anodal tDCS. Interestingly, there were no differences between the three intensities of anodal tDCS on modulating cortical excitability or SICI. These results suggest that the aftereffect of anodal tDCS on facilitating cortical excitability is due to the modulation of synaptic mechanisms associated with long-term potentiation and is not influenced by different tDCS intensities.

That tender discipline: spacing, structured nothingness & kumbhaka

In the discussion that follows here, I will attempt what I have decided to call an onto-poetic reading of the yogic practice of kumbhaka. I choose the double-barrelled nomination 'onto-poetic' since I would like to use my experience of kumbhaka both to think of certain current ontological paradigms and implications, and also to allow myself the flexibility and discipline that I associate with the poetic register. I will draw on three particular thinkers, namely Alain Badiou, Jacques Derrida and Luce Irigaray. Badiou makes very explicit metaontological claims that, I believe, have something to contribute to a reading of kumbhaka. Derrida, for his part, has written extensively about phonologocentrism and its inherent links with speech and breath in the history of phallocentric metaphysics. Irigaray, finally, demonstrates a way to think unity, breath and praxis so as to bring these conceptual strands together in a kind of elegant, but urgent, agency.
What can the very practice of kumbhaka help me to think? And how can such thinking impact on what happens when I practice pranayama that involves kumbhaka? Kumbhaka can be situated as a practice within the broader discipline of Yogic pranayama. Yoga, as it often encountered in this historical moment in the so-called West, can appear to emphasize physical posture (which are certainly as aspect of its breadth). Yoga, however, as a technology of existential and ontological inquiry, has often, throughout its long and meandering history, made use of the manipulation of, and abstinence from, breath. I will begin by cursorily outlining the place of pranayama itself within the yogic canon of practice. Then, I will go on to explain specifically the technology of kumbhaka, before embarking on my onto-poetic discussion.

Trunk postures and upper-body muscle activation during physically demanding wildfire suppression tasks

This study examined the trunk postures and upper-body muscle activations during four physically demanding wildfire suppression tasks. Bilateral, wireless surface electromyography was recorded from the trapezius and erector spinae muscles of nine experienced, wildfire fighters. Synchronised video captured two retroreflective markers to allow for quantification of two-dimensional sagittal trunk flexion. In all tasks, significantly longer time was spent in the mild and severe trunk flexion (p ≤ 0.002) compared to the time spent in a neutral posture. Mean and peak muscle activation in all tasks exceeded previously established safe limits. These activation levels also significantly increased through the performance of each task (p < 0.001). The results suggest that the wildfire suppression tasks analysed impose significant musculoskeletal demand on firefighters. Fire agencies should consider developing interventions to reduce the exposure of their personnel to these potentially injurious musculoskeletal demands.

Patient comfort in the intensive care unit : a multicentre, binational point prevalence study of analgesia, sedation and delirium management

Objective: To measure the prevalence of assessment and management practices for analgesia, sedation and delirium in patients in Australian and New Zealand intensive care units.
Materials and Methods: We developed survey items from a modified Delphi panel and included them in a binational, point prevalence study. We used a standard case report form to capture retrospective patient data on management of analgesia, sedation and delirium at the end of a 4-hour period on the study day. Other data were collected during independent assessment of patient status and medication requirements.
Results: Data were collected on 569 patients in 41 ICUs. Pain assessment was documented in the 4 hours before study observation in 46% of patients. Of 319 assessable patients, 16% had moderate pain and 6% had severe pain. Routine sedation assessment using a scale was recorded in 63% of intubated and ventilated patients. When assessed, 38% were alert and calm, or drowsy and rousable, 22% were lightly to moderately sedated, 31% were deeply sedated (66% of these had a documented indication), and 9% were agitated or restless. Sedatives were titrated to a target level in 42% of patients. Routine assessment of delirium occurred in 3%, and at study assessment 9% had delirium. Wrist or arm restraints were used for 7% of patients.
Conclusions: Only two-thirds of sedated patients had their sedation levels formally assessed, half had pain assessed and very few had formal assessment of delirium. Our description of current practices, and other observational data, may help in planning further research in this area.

Anodal-tDCS applied during unilateral strength training increases strength and corticospinal excitability in the untrained homologous muscle

Evidence suggests that the cross-transfer of strength following unilateral training may be modulated by increased corticospinal excitability of the ipsilateral primary motor cortex, due to cross-activation. Anodal-tDCS (a-tDCS) has been shown to acutely increase corticospinal excitability and motor performance, which may enhance this process. Therefore, we sought to examine changes in neural activation and strength of the untrained limb following the application of a-tDCS during a single unilateral strength training session. Ten participants underwent three conditions in a randomized, double-blinded crossover design: (1) strength training + a-tDCS, (2) strength training + sham-tDCS and (3) a-tDCS alone. a-tDCS was applied for 20 min at 2 mA over the right motor cortex. Unilateral strength training of the right wrist involved 4 × 6 wrist extensions at 70 % of maximum. Outcome measures included maximal voluntary strength, corticospinal excitability, short-interval intracortical inhibition, and cross-activation. We observed a significant increase in strength of the untrained wrist (5.27 %), a decrease in short-interval intracortical inhibition (−13.49 %), and an increase in cross-activation (15.71 %) when strength training was performed with a-tDCS, but not following strength training with sham-tDCS, or tDCS alone. Corticospinal excitability of the untrained wrist increased significantly following both strength training with a-tDCS (17.29 %), and a-tDCS alone (15.15 %), but not following strength training with sham-tDCS. These findings suggest that a single session of a-tDCS combined with unilateral strength training of the right limb increases maximal strength and cross-activation to the contralateral untrained limb.

Effects of vitamin D supplementation on neuroplasticity in older adults: a double-blinded, placebo-controlled randomised trial

Summary - Vitamin D can improve muscle function and reduce falls, but whether it can strengthen neural connections within the brain and nervous system is not known. This 10-week randomised controlled trial indicates that treatment with 2,000 IU/day vitamin D3 does not significantly alter neuroplasticity relative to placebo in older adults.
Introduction - The purpose of this study was to examine the effects of vitamin D supplementation on neuroplasticity, serum brain-derived neurotrophic factor (BDNF) and muscle strength and function in older adults.
Methods - This was a 10-week double-blinded, placebo-controlled randomised trial in which 26 older adults with 25-hydroxyvitamin D [25OHD] concentrations 25–60 nmol/L were randomised to 2,000 IU/day vitamin D3 or matched placebo. Single- and paired-pulse transcranial magnetic stimulation applied over the motor cortex was used to assess changes in motor-evoked potentials (MEPs) and short-interval intracortical inhibition (SICI), as measures of corticospinal excitability and inhibition respectively, by recording electromyography (EMG) responses to stimulation from the wrist extensors. Changes in muscle strength, stair climbing power, gait (timed-up-and-go), dynamic balance (four square step test), serum 25(OH)D and BDNF concentrations were also measured.
Results - After 10 weeks, mean 25(OH)D levels increased from 46 to 81 nmol/L in the vitamin D group with no change in the placebo group. The vitamin D group experienced a significant 8–11 % increase in muscle strength and a reduction in cortical excitability (MEP amplitude) and SICI relative to baseline (all P < 0.05), but these changes were not significantly different from placebo. There was no effect of vitamin D on muscle power, function or BDNF.
Conclusions - Daily supplementation with 2,000 IU vitamin D3 for 10 weeks had no significant effect on neuroplasticity compared to placebo, but the finding that vitamin D treatment alone was associated with a decrease in corticospinal excitability and intracortical inhibition warrants further investigation as this suggests that it may improve the efficacy of neural transmission within the corticospinal pathway.