Long-Term Effects of Specific Stabilizing Exercises for First-Episode Low Back Pain

Study Design. A randomized clinical trial with 1-year and 3-year telephone questionnaire follow-ups. Objective. To report a specific exercise intervention’s long-term effects on recurrence rates in acute, first-episode low back pain patients. Summary of Background Data. The pain and disability associated with an initial episode of acute low back pain (LBP) is known to resolve spontaneously in the short-term in the majority of cases. However, the recurrence rate is high, and recurrent disabling episodes remain one of the most costly problems in LBP. A deficit in the multifidus muscle has been identified in acute LBP patients, and does not resolve spontaneously on resolution of painful symptoms and resumption of normal activity. Any relation between this deficit and recurrence rate was investigated in the long-term. Methods. Thirty-nine patients with acute, first-episode LBP were medically managed and randomly allocated to either a control group or specific exercise group. Medical management included advice and use of medications. Intervention consisted of exercises aimed at rehabilitating the multifidus in cocontraction with the transversus abdominis muscle. One year and three years after treatment, telephone questionnaires were conducted with patients. Results. Questionnaire results revealed that patients from the specific exercise group experienced fewer recurrences of LBP than patients from the control group. One year after treatment, specific exercise group recurrence was 30%, and control group recurrence was 84% (P , 0.001). Two to three years after treatment, specific exercise group recurrence was 35%, and control group recurrence was 75% (P , 0.01). Conclusion. Long-term results suggest that specific exercise therapy in addition to medical management and resumption of normal activity may be more effective in reducing low back pain recurrences than medical management and normal activity alone. [Key Words: multifidus, low back pain, rehabilitation]

Desarrollo sustentable de geoestructuras compuestas por suelo loéssico compactado mejorado con agregado de materiales estabilizantes. Sustainable development of compacted loess soil geo-structures with addition of stabilizing materials.

Los suelos estabilizados mediante compactación, permiten obtener materiales con ventajas ténicas y economicas en diferentes tipos de obras de ingeniería. Ejemplos de su uso se tiene en bases viales de autopistas, rutas o calles urbanas, pistas de aterrizaje, barreras de contención para enterramientos sanitarios o lagunas de estabilización, apoyos de plateas para fundación de edificios, losas industriales, entre otras aplicaciones. Las fallas en este tipo de construcciones pueden resultar en catástrofes ambientales, sociales y elevadas pérdidas económicas, por lo que resulta de gran importancia optimizar el diseño e incrementar la seguridad de este tipo de construcciones. Las obras con estas características involucran grandes volúmenes y/o superficies que requieren controles sistemáticos durante su desarrollo, a los fines de garantizar el cumplimiento de las propiedades de los materiales establecidos en la etapa de diseño. De esta forma, es necesario contar con ensayos de campo sencillos, confiables y eficientes que permitan identificar propiedades físicas, mecánicas e hidráulicas. Las geoestructuras generadas mediante la compactación del suelo próximo al sector de construcción pueden funcionar adecuadamente, con reducidos costos de material y transporte. Su estabilización puede ejecutarse en forma natural, o con la incorporación de agregados minerales como bentonita, cal o cemento. Estas incorporaciones mejoran las propiedades hidráulicas y mecánicas del material, optimizando el comportamiento requerido para la obra. Para establecer la forma en la que estos minerales modifican el comportamiento del suelo local compactado deben realizarse investigaciones especiales con los materiales involucrados. En el ámbito internacional existen numerosas investigaciones sobre comportamiento de suelos compactados, no obstante, si bien aportan antecedentes para la planificación de estudios locales, sus resultados no pueden trasladarse de manera directa. Las características propias del suelo local constituye la principal variable debido a la diversidad en las propiedades geotécnicas de cada Región. Esta investigación, se focaliza en el empleo de suelos limosos de la formación loéssica de la zona central de Argentina. Los suelos de la llanura cordobesa poseen comportamientos particulares, los cuales son contemplados en los diseños presentados como resutado de las investigaciones internacionales. Esta particularidad se relaciona con su inestabilidad, lo que los clasifica como suelos colapsables. Los resultados obtenidos en este trabajo podrán ser extendidos a una gran superficie de la Provincia de Córdoba y a la Región Pampeana en general, a los fines de establecer recomendaciones de diseño y construcción para la confección de Pliegos de Especificaciones Técnicas de diferentes tipos de obras públicas y privadas. El estudio contempla la ejecución de un plan experimental a escala de laboratorio y campo. Los materiales corresponden a suelo limosos puros, y diferentes agregados tales como bentonita, cal y cemento. Se planifican ensayos para evaluar el desempeño del material, a partir de la confección de muestras preparadas con diferentes condiciones de compactación (energía, humedad y método), y en forma de mezcla con los distintos tipos de agregados. Se realizarán ensayos de permeabilidad en celdas de pared rígida y flexible, junto a ensayos mecánicos de compresión confinada, simple y triaxial. Para el trabajo experimental de campo se prevé la ejecución de terraplenes de prueba instrumentados con tensiómetros e infiltrómetros para evaluar el comportamiento hidraúlico en el tiempo, junto con ensayos de penetración y plato de carga para la caracterización mecánica. En forma conjunta se propone el desarrollo de modelos numéricos de caracterización hidromecánica. Stabilized soils by compaction, produce materials technical and economic advantages in different types of engineering works. For example, road bases in highways, roads or city streets, containment barriers for sanitary landfill or stabilization ponds, foundation support of building, industrial flat, and other applications. Failures can result in environmental catastrophes, social, and economic loss, so it is important to optimize the design and increase the safety of such buildings. These works involve large surfaces that require systematic tests during construction, so it is necessary to have simple field tests, reliable and efficient to identify physical, mechanical and hydraulic properties. The geo-structures generated by local soil compaction have reduced material and transportation costs. Stabilization can be naturally, or with the addition of mineral aggregates as bentonite, lime and cement. These additions improve the hydraulic and mechanical properties of the material. So, special investigations should be conducted with the materials involved. There are many international studies on compacted soils behavior but their results can not be transferred directly due to the particularities of regional soils. For this research silty soils of central Argentina are the main focus. The soils of Córdoba plains are instability, so are classified as collapsible soils. The results obtained in this work may be extended to a large area of the Province of Cordoba and the Pampas region in general, in order to establish design and construction recommendations. The study includes laboratory and field tests. The materials are pure silty soil, and different aggregates such as bentonite, lime and cement. Tests are planned to evaluate the performance. Laboratory includes rigid and flexible wall cells, confined, triaxial and simple compression tests. For field experimental instrumented embankments will be constructed. A numerical hydromechanical model will be developed.

The stabilizing effects of the acquired immunity on the schistosomiasis transmission modeling - the sensitivity Analysis

A mathematical model is proposed to analyze the effects of acquired immunity on the transmission of schistosomiasis in the human host. From this model the prevalence curve dependent on four parameters can be obtained. These parameters were estimated fitting the data by the maximum likelihood method. The model showed a good retrieving capacity of real data from two endemic areas of schistosomiasis: Touros, Brazil (Schistosoma mansoni) and Misungwi, Tanzania (S. haematobium). Also, the average worm burden per person and the dispersion of parasite per person in the community can be obtained from the model. In this paper, the stabilizing effects of the acquired immunity assumption in the model are assessed in terms of the epidemiological variables as follows. Regarded to the prevalence curve, we calculate the confidence interval, and related to the average worm burden and the worm dispersion in the community, the sensitivity analysis (the range of the variation) of both variables with respect to their parameters is performed.

Vasopressin-inducible ubiquitin-specific protease 10 increases ENaC cell surface expression by deubiquitylating and stabilizing sorting nexin 3

Adjustment of Na+ balance in extracellular fluids is achieved by regulated Na+ transport involving the amiloride-sensitive epithelial Na+ channel (ENaC) in the distal nephron. In this context, ENaC is controlled by a number of hormones, including vasopressin, which promotes rapid translocation of water and Na+ channels to the plasma membrane and long-term effects on transcription of vasopressin-induced and -reduced transcripts. We have identified a mRNA encoding the deubiquitylating enzyme ubiquitin-specific protease 10 (Usp10), whose expression is increased by vasopressin at both the mRNA and the protein level. Coexpression of Usp10 in ENaC-transfected HEK-293 cells causes a more than fivefold increase in amiloride-sensitive Na+ currents, as measured by whole cell patch clamping. This is accompanied by a three- to fourfold increase in surface expression of alpha- and gamma-ENaC, as shown by cell surface biotinylation experiments. Although ENaC is well known to be regulated by its direct ubiquitylation, Usp10 does not affect the ubiquitylation level of ENaC, suggesting an indirect effect. A two-hybrid screen identified sorting nexin 3 (SNX3) as a novel substrate of Usp10. We show that it is a ubiquitylated protein that is degraded by the proteasome; interaction with Usp10 leads to its deubiquitylation and stabilization. When coexpressed with ENaC, SNX3 increases the channel's cell surface expression, similarly to Usp10. In mCCD(cl1) cells, vasopressin increases SNX3 protein but not mRNA, supporting the idea that the vasopressin-induced Usp10 deubiquitylates and stabilizes endogenous SNX3 and consequently promotes cell surface expression of ENaC

Nuclear scaffold proteins are differently sensitive to stabilizing treatment by heat or Cu++.

The distribution of three nuclear scaffold proteins (of which one is a component of a particular class of nuclear bodies) has been studied in intact K562 human erythroleukemia cells, isolated nuclei, and nuclear scaffolds. Nuclear scaffolds were obtained by extraction with the ionic detergent lithium diidosalicylate (LIS), using nuclei prepared in the absence of divalent cations (metal-depleted nuclei) and stabilized either by a brief heat exposure (20 min at 37C or 42C) or by Cu++ ions at 0C. Proteins were visualized by in situ immunocytochemistry and confocal microscopy. Only a 160-kD nuclear scaffold protein was unaffected by all the stabilization procedures performed on isolated nuclei. However, LIS extraction and scaffold preparation procedures markedly modified the distribution of the polypeptide seen in intact cells, unless stabilization had been performed by Cu++. In isolated nuclei, only Cu++ treatment preserved the original distribution of the two other antigens (M(r), 125 and 126 kD), whereas in heat-stabilized nuclei we detected dramatic changes. In nuclear scaffolds reacted with antibodies to 125 and 126-kD proteins, the fluorescent pattern was always disarranged regardless of the stabilization procedure. These results, obtained with nuclei prepared in the absence of Mg+2 ions, indicate that heat treatment per se can induce changes in the distribution of nuclear proteins, at variance with previous suggestions. Nevertheless, each of the proteins we have studied behaves in a different way, possibly because of its specific association with the nuclear scaffold.

Control Structures for Stabilizing Degrading Stream Channels Pottawattamie County, HR-236, 1987

Stream degradation due to steep stream gradients and large deposits of loess soil is a serious problem in western Iowa. One solution to this problem is to construct grade stabilization structures at critical points along the length of the stream. Iowa Highway Research Board project HR-236, "Pottawattamie County Evaluation of Control Structures for Stabilizing Degrading Stream Channels", was initiated in order to study the effectiveness of such structures in preventing stream degradation. This report describes the construction and 4-year performance of a gabion drop structure constructed along Keg Creek during the winter of 1982-83.

Evaluation of Asphalt Stabilizing Additives, HR-542, 1994

Efforts are constantly being put forth by researchers, highway related industries and product suppliers to improve the life and performance of asphalt pavements. As a result of those efforts, a variety of asphalt modifiers have been developed and evaluated in experimental sections over the years. Evaluations of the polymer asphalt modifiers have been done and results were usually compared with conventional sections within each respective project. The research presented in this report is also a comparison of asphalt modifiers with each other as well as a comparison of a modifier with its respective conventional section, when they exist. Several of the modifiers showed some improvements in performance while others did not.

Evaluation of Control Structures for Stabilizing Degrading Stream Channels in Western Iowa, Phases II and III, HR-208A, 1985

Since the turn of the century, tributaries to the Missouri River in western Iowa have entrenched their channels to as much as six times their original depth. This channel degradation is accompanied by widening as the channel side slopes become unstable and landslides occur. The deepening and widening of these streams have endangered about 25% of the highway bridges in 13 counties [Lohnes et al. 1980]. Grade stabilization structures have been recommended as the most effective remedial measure for stream degradation [Brice et al., 1978]. In western Iowa, within the last seven years, reinforced concrete grade stabilization structures have cost between $300,000 and $1,200,000. Recognizing that the high cost of these structures may be prohibitive in many situations, the Iowa Department of Transportation (Iowa DOT) sponsored a study at Iowa State University (ISU) to find low-cost alternative structures. This was Phase I of the stream degradation study. Analytical and laboratory work led to the conclusion that alternative construction materials such as gabions and soil-cement might result in more economical structures [Lohnes et al. 1980]. The ISU study also recommended that six experimental structures be built and their performance evaluated. Phase II involved the design of the demonstration structures, and Phase III included monitoring and evaluating their performance.

Alternate Methods of Stabilizing Degrading Stream Channels in Western Iowa, Phase I, HR-208, 1980

Since the beginning of channel straightening at the turn of the century, the streams of western Iowa have degraded 1.5 to 5 times their original depth. This vertical degradation is often accompanied by increases in channel widths of 2 to 4 times the original widths. The deepening and widening of these streams has jeopardized the structural safety of many bridges by undercutting footings or pile caps, exposing considerable length of piling, and removing soil beneath and adjacent to abutments. Various types of flume and drop structures have been introduced in an effort to partially or totally stabilize these channels, protecting or replacing bridge structures. Although there has always been a need for economical grade stabilization structures to stop stream channel degradation and protect highway bridges and culverts, the problem is especially critical at the present time due to rapidly increasing construction costs and decreasing revenues. Benefits derived from stabilization extend beyond the transportation sector to the agricultural sector, and increased public interest and attention is needed.

Ash2 acts as an Ecdysone Receptor coactivator by stabilizing the histone methyltransferase Trr.

The molting hormone ecdysone triggers chromatin changes via histone modifica- tions that are important for gene regulation. On hormone activation, the ecdysone receptor (EcR) binds to the SET domain-containing histone H3 methyltransferase trithorax-related protein (Trr). Methylation of histone H3 at lysine 4 (H3K4me), which is associated with tran- scriptional activation, requires several cofactors, including Ash2. We find that ash2 mutants have severe defects in pupariation and metamorphosis due to a lack of activation of ecdy- sone-responsive genes. This transcriptional defect is caused by the absence of the H3K4me3 marks set by Trr in these genes. We present evidence that Ash2 interacts with Trr and is re- quired for its stabilization. Thus we propose that Ash2 functions together with Trr as an ecdysone receptor coactivator.

Waste plastic as a stabilizing additive in Stone Mastic Asphalt

The present study investigates the benefits of stabilizing the stone mastic asphalt (SMA) mixture in flexible pavement with shredded waste plastic. Conventional (without plastic) and the stabilized SMA mixtures were subjected to performance tests including Marshall Stability, tensile strength and compressive strength tests. Triaxial tests were also conducted with varying percentage bitumen by weight of mineral aggregate (6% to 8%) and by varying percentage plastic by weight of mix (6% to 12% with an increment of 1%). Plastic content of 10% by weight of bitumen is recommended for the improvement of the performance of Stone Mastic Asphalt mixtures. 10% plastic content gives an increase in the stability, split tensile strength and compressive strength of about 64%, 18% and 75% respectively compared to the conventional SMA mix. Triaxial test results show a 44% increase in cohesion and 3% decrease in angle of shearing resistance showing an increase in the shear strength. The drain down value decreases with an increase in plastic content and the value is only 0.09 % at 10% plastic content and proves to be an effective stabilizing additive in SMA mixtures

Stabilizing swarm intelligence search via positive feedback resource allocation

A novel Swarm Intelligence method for best-fit search, Stochastic Diffusion Search, is presented capable of rapid location of the optimal solution in the search space. Population based search mechanisms employed by Swarm Intelligence methods can suffer lack of convergence resulting in ill defined stopping criteria and loss of the best solution. Conversely, as a result of its resource allocation mechanism, the solutions SDS discovers enjoy excellent stability.

Fragment-Based QSAR and Molecular Modeling Studies on a Series of Discodermolide Analogs as Microtubule-Stabilizing Anticancer Agents

Inhibition of microtubule function is an attractive rational approach to anticancer therapy. Although taxanes are the most prominent among the microtubule-stabilizers, their clinical toxicity, poor pharmacokinetic properties, and resistance have stimulated the search for new antitumor agents having the same mechanism of action. Discodermolide is an example of nontaxane natural product that has the same mechanism of action, demonstrating superior antitumor efficacy and therapeutic index. The extraordinary chemical and biological properties have qualified discodermolide as a lead structure for the design of novel anticancer agents with optimized therapeutic properties. In the present work, we have employed a specialized fragment-based method to develop robust quantitative structure - activity relationship models for a series of synthetic discodermolide analogs. The generated molecular recognition patterns were combined with three-dimensional molecular modeling studies as a fundamental step on the path to understanding the molecular basis of drug-receptor interactions within this important series of potent antitumoral agents.

Stabilizing Nonstationary Electrochemical Time Series

Electrochemical systems are ideal working-horses for studying oscillatory dynamics. Experimentally obtained time series, however, are usually associated with a spontaneous drift in some uncontrollable parameter that triggers transitions among different oscillatory patterns, despite the fact that all controllable parameters are kept constant. Herein we present an empirical method to stabilize experimental potential time series. The method consists of applying a negative galvanodynamic sweep to compensate the spontaneous drift and was tested for the oscillatory electro-oxidation of methanol on platinum. For a wide range of applied currents, the base system presents spontaneous transitions from quasi-harmonic to mixed mode oscillations. Temporal patterns were stabilized by galvanodynamic sweeps at different rates. The procedure resulted in a considerable increase in the number of oscillatory cycles from 5 to 20 times, depending on the specific temporal pattern. The spontaneous drift has been associated with uncompensated oscillations, in which the coverage of some adsorbed species are not reestablished after one cycle; i.e., there is a net accumulation and/or depletion of adsorbed species during oscillations. We interpreted the rate of the galvanodynamic sweep in terms of the time scales of the poisoning processes that underlies the uncompensated oscillations and thus the spontaneous slow drift.