Dizziness and unsteadiness following whiplash injury: Characteristic features and relationship with cervical joint position error

Dizziness and/or unsteadiness are common symptoms of chronic whiplash-associated disorders. This study aimed to report the characteristics of these symptoms and determine whether there was any relationship to cervical joint position error. Joint position error, the accuracy to return to the natural head posture following extension and rotation, was measured in 102 subjects with persistent whiplash-associated disorder and 44 control subjects. Whiplash subjects completed a neck pain index and answered questions about the characteristics of dizziness. The results indicated that subjects with whiplash-associated disorders had significantly greater joint position errors than control subjects. Within the whiplash group, those with dizziness had greater joint position errors than those without dizziness following rotation (rotation (R) 4.5degrees (0.3) vs 2.9degrees (0.4); rotation (L) 3.9degrees (0.3) vs 2.8degrees (0.4) respectively) and a higher neck pain index (55.3% (1.4) vs 43.1% (1.8)). Characteristics of the dizziness were consistent for those reported for a cervical cause but no characteristics could predict the magnitude of joint position error. Cervical mechanoreceptor dysfunction is a likely cause of dizziness in whiplash-associated disorder.

Presentation and mechanisms of concussion in professional Rugby League football

The present study prospectively recorded the circumstances, incidence, mechanisms, injury detection and presentation of concussion in Rugby League. Forty-three consecutive concussions were recorded over three competitive seasons in 175 professional Rugby League players. Data showed (i) the incidence of concussion ranged from 5.9 to 9.8 injuries/1000 player hours across grades - except when age-group players were mismatched (18.4); (ii) 'head-high tackles' accounted for a significant number of concussions; (iii) concussion rarely involved a loss of consciousness with the most common indicators of concussion being amnesia, headache and unsteadiness, with the mechanism of injury often missed; and (iv) concussion often occurs concurrently with other injuries. Concussion (including repeated episodes) is a common injury in Rugby League. Systematic mental status questioning is warranted whenever concussion is suspected. Coaches, trainers and players need more education in the recognition and management of concussion. Stricter penalties for illegal 'head-high' tackling are strongly recommended.

The Smiling Project: development of a new program for gait and balance training

Introduction: The SMILING project, a multicentric project fundedby the European Union, aims to develop a new gait and balance trainingprogram to prevent falls in older persons. The program includes the"SMILING shoe", an innovative device that generates mechanical perturbationwhile walking by changing the soles' inclination. Induced perturbationschallenge subjects' balance and force them to react to avoidfalls. By training specifically the complex motor reactions used to maintainbalance when walking on irregular ground, the program will improvesubjects' ability to react in situation of unsteadiness and reduce theirrisk of falling. Methods: The program will be evaluated in a multicentric,cross-over randomized controlled trial. Overall, 112 subjects (aged≥65 years, ≥1 falls, POMA score 22-26/28) will be enrolled. Subjectswill be randomised in 2 groups: group A begin the training with active"SMILING shoes", group B with inactive dummy shoes. After 4 weeksof training, group A and B will exchange the shoes. Supervised trainingsessions (30 minutes twice a week for 8 weeks) include walkingtasks of progressive difficulties.To avoid a learning effect, "SMILINGshoes" perturbations will be generated in a non-linear and chaotic way.Gait performance, fear of falling, and acceptability of the program willbe assessed. Conclusion: The SMILING program is an innovative interventionfor falls prevention in older persons based on gait and balancetraining using chaotic perturbations. Because of the easy use of the"SMILING shoes", this program could be used in various settings, suchas geriatric clinics or at home.

Insights into the Design and Characteristics of the Sedimentation Process at Multi-Barrel Culverts in Iowa, TR-596, 2010

The present study is an integral part of a broader study focused on the design and implementation of self-cleaning culverts, i.e., configurations that prevent the formation of sediment deposits after culvert construction or cleaning. Sediment deposition at culverts is influenced by many factors, including the size and characteristics of material of which the channel is composed, the hydraulic characteristics generated under different hydrology events, the culvert geometry design, channel transition design, and the vegetation around the channel. The multitude of combinations produced by this set of variables makes the investigation of practical situations a complex undertaking. In addition to the considerations above, the field and analytical observations have revealed flow complexities affecting the flow and sediment transport through culverts that further increase the dimensions of the investigation. The flow complexities investigated in this study entail: flow non-uniformity in the areas of transition to and from the culvert, flow unsteadiness due to the flood wave propagation through the channel, and the asynchronous correlation between the flow and sediment hydrographs resulting from storm events. To date, the literature contains no systematic studies on sediment transport through multi-box culverts or investigations on the adverse effects of sediment deposition at culverts. Moreover, there is limited knowledge about the non-uniform, unsteady sediment transport in channels of variable geometry. Furthermore, there are few readily useable (inexpensive and practical) numerical models that can reliably simulate flow and sediment transport in such complex situations. Given the current state of knowledge, the main goal of the present study is to investigate the above flow complexities in order to provide the needed insights for a series of ongoing culvert studies. The research was phased so that field observations were conducted first to understand the culvert behavior in Iowa landscape. Modeling through complementary hydraulic model and numerical experiments was subsequently carried out to gain the practical knowledge for the development of the self-cleaning culvert designs.

Oliotietokannan muuttaminen relaatiotietokannaksi

Diplomityön tavoitteena oli parantaa oliotietokantaan perustuvan mökkivarausjärjestelmän pitkiä vasteaikoja ja epävakaata toimintaa sekä luoda tietokantaperusta uusille toiminnoille. Ratkaisua etsittiin korvaamalla oliotietokanta relaatiotietokannalla. Diplomityö on osa koko varausjärjestelmän uusintaa. Työn teoreettinen osuus käsittelee sekä olio- että relaatiotietokannan rakennetta ja oliomallin muuttamista relaatiomalliksi. Käytännön osassa esitellään relaatiotietokannan luominen vaiheittain ja kerrotaan tietojen siirron periaatteesta. Relaatiotietokannan havaittiin olevan vakaampi ja tehokkaampi vasteajoiltaan. Samoin sen vaatima levytilan ja muistin määrä oli pienempi kuin oliotietokannalla. Lisäksi siihen todettiin uusien järjestelmien liittämisen olevan yksinkertaisempaa.

Large-eddy simulation of wind flows over complex terrains for wind energy applications

Wind energy has obtained outstanding expectations due to risks of global warming and nuclear energy production plant accidents. Nowadays, wind farms are often constructed in areas of complex terrain. A potential wind farm location must have the site thoroughly surveyed and the wind climatology analyzed before installing any hardware. Therefore, modeling of Atmospheric Boundary Layer (ABL) flows over complex terrains containing, e.g. hills, forest, and lakes is of great interest in wind energy applications, as it can help in locating and optimizing the wind farms. Numerical modeling of wind flows using Computational Fluid Dynamics (CFD) has become a popular technique during the last few decades. Due to the inherent flow variability and large-scale unsteadiness typical in ABL flows in general and especially over complex terrains, the flow can be difficult to be predicted accurately enough by using the Reynolds-Averaged Navier-Stokes equations (RANS). Large- Eddy Simulation (LES) resolves the largest and thus most important turbulent eddies and models only the small-scale motions which are more universal than the large eddies and thus easier to model. Therefore, LES is expected to be more suitable for this kind of simulations although it is computationally more expensive than the RANS approach. With the fast development of computers and open-source CFD software during the recent years, the application of LES toward atmospheric flow is becoming increasingly common nowadays. The aim of the work is to simulate atmospheric flows over realistic and complex terrains by means of LES. Evaluation of potential in-land wind park locations will be the main application for these simulations. Development of the LES methodology to simulate the atmospheric flows over realistic terrains is reported in the thesis. The work also aims at validating the LES methodology at a real scale. In the thesis, LES are carried out for flow problems ranging from basic channel flows to real atmospheric flows over one of the most recent real-life complex terrain problems, the Bolund hill. All the simulations reported in the thesis are carried out using a new OpenFOAM® -based LES solver. The solver uses the 4th order time-accurate Runge-Kutta scheme and a fractional step method. Moreover, development of the LES methodology includes special attention to two boundary conditions: the upstream (inflow) and wall boundary conditions. The upstream boundary condition is generated by using the so-called recycling technique, in which the instantaneous flow properties are sampled on aplane downstream of the inlet and mapped back to the inlet at each time step. This technique develops the upstream boundary-layer flow together with the inflow turbulence without using any precursor simulation and thus within a single computational domain. The roughness of the terrain surface is modeled by implementing a new wall function into OpenFOAM® during the thesis work. Both, the recycling method and the newly implemented wall function, are validated for the channel flows at relatively high Reynolds number before applying them to the atmospheric flow applications. After validating the LES model over simple flows, the simulations are carried out for atmospheric boundary-layer flows over two types of hills: first, two-dimensional wind-tunnel hill profiles and second, the Bolund hill located in Roskilde Fjord, Denmark. For the twodimensional wind-tunnel hills, the study focuses on the overall flow behavior as a function of the hill slope. Moreover, the simulations are repeated using another wall function suitable for smooth surfaces, which already existed in OpenFOAM® , in order to study the sensitivity of the flow to the surface roughness in ABL flows. The simulated results obtained using the two wall functions are compared against the wind-tunnel measurements. It is shown that LES using the implemented wall function produces overall satisfactory results on the turbulent flow over the two-dimensional hills. The prediction of the flow separation and reattachment-length for the steeper hill is closer to the measurements than the other numerical studies reported in the past for the same hill geometry. The field measurement campaign performed over the Bolund hill provides the most recent field-experiment dataset for the mean flow and the turbulence properties. A number of research groups have simulated the wind flows over the Bolund hill. Due to the challenging features of the hill such as the almost vertical hill slope, it is considered as an ideal experimental test case for validating micro-scale CFD models for wind energy applications. In this work, the simulated results obtained for two wind directions are compared against the field measurements. It is shown that the present LES can reproduce the complex turbulent wind flow structures over a complicated terrain such as the Bolund hill. Especially, the present LES results show the best prediction of the turbulent kinetic energy with an average error of 24.1%, which is a 43% smaller than any other model results reported in the past for the Bolund case. Finally, the validated LES methodology is demonstrated to simulate the wind flow over the existing Muukko wind farm located in South-Eastern Finland. The simulation is carried out only for one wind direction and the results on the instantaneous and time-averaged wind speeds are briefly reported. The demonstration case is followed by discussions on the practical aspects of LES for the wind resource assessment over a realistic inland wind farm.

On the steadiness of separating meandering currents

The existence of inertial steady currents that separate from a coast and meander afterward is investigated. By integrating the zonal momentum equation over a suitable area, it is shown that retroflecting currents cannot be steady in a reduced gravity or in a barotropic model of the ocean. Even friction cannot negate this conclusion. Previous literature on this subject, notably the discrepancy between several articles by Nof and Pichevin on the unsteadiness of retroflecting currents and steady solutions presented in other papers, is critically discussed. For more general separating current systems, a local analysis of the zonal momentum balance shows that given a coastal current with a specific zonal momentum structure, an inertial, steady, separating current is unlikely, and the only analytical solution provided in the literature is shown to be inconsistent. In a basin-wide view of these separating current systems, a scaling analysis reveals that steady separation is impossible when the interior flow is nondissipative (e.g., linear Sverdrup-like). These findings point to the possibility that a large part of the variability in the world’s oceans is due to the separation process rather than to instability of a free jet.

Indícios da cultura docente revelados em um contexto online no processo da formação de professores de matemática

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mapeamento geológico-geontécnico de trecho da estrada vicinal na Serra de Itaqueri, Charqueada (SP)

Geological-geotechnical problems affecting escarps as well as embankment and fill slopes of roads and motorways may generate different types of unsteadiness, which are mainly arisen from the deficient knowledge about the physical environment. This results in unsuitable engineering projects and inadequate executions, which can be worsened by an occasional inappropriate maintenance of the construction. A geologically-geotechnically characterization of escarps and slopes is crucial in order to prevent these problems. This work deals with a geological-geotechnical study of 1:10.000 scale mapping in a stretch of a local road (CHQ-40) at the Serra de Itaqueri, Charqueada town, State of São Paulo. The stretch is known by several physical problems as erosion and mass movement. The methods of study were based on an integrative analysis of the diverse elements of the physical environment by using aerial photographs - to obtain the physiographic compartmentalization of terrain units - as well as field work - to accomplish the evaluation of the units by employing sketch lists. To achieve this, we selected several techniques in order to identify and classify different types of existing problems as erosion, landslide in embankments and fill slopes, rockfall, block rolling, among others. We also included the analysis of soil horizon, thickness and composition. The geological-geotechnical mapping resulted in six units: 1- Sandstones in cuesta’s backhill; 2 – Basalts in cuesta’s front; 3- Sandstones in cuesta’s front; 4 – Talus and colluvial deposits at cuesta’s foothill; 5- Sandstones of the Piramboia Formation in hillside; and 6 – Colluvial soil in the hill top. A characterization of the geological-geotechnical units is detailed, coupled to the cartographic material. Other cartographic products elaborated for this study included 1:10.000 maps of hypsometry, slope and curvature

Effect of chlorzoxazone in patients with downbeat nystagmus: A pilot trial

Objective: Downbeat nystagmus (DBN) is the most frequent form of acquired persisting fixation nystagmus with different symptoms such as unsteadiness of gait, postural instability, and blurred vision with reduced visual acuity (VA) and oscillopsia. However, different symptomatic therapeutic principles are required, such as 3,4-diaminopyridine and 4-aminopyridine, that effectively suppress DBN. Chlorzoxazone (CHZ) is a nonselective activator of small conductance calcium-activated potassium (SK) channels that modifies the activity of cerebellar Purkinje cells. We evaluated the effects of this agent on DBN in an observational proof-of-concept pilot study. Methods: Ten patients received CHZ 500 mg 3 times a day for 1 or 2 weeks. Slow-phase velocity of DBN, VA, postural sway, and the drug's side effects were evaluated. Recordings were conducted at baseline, 90 minutes after first administration, and after 1 or 2 weeks. Results: Mean slow-phase velocity significantly decreased from a baseline of 2.74°/s ± 2.00 to 2.29°/s ± 2.12 (mean ± SD) 90 minutes after first administration and to 2.04°/s ± 2.24 (p < 0.001; post hoc both p = 0.024) after long-term treatment. VA significantly increased and postural sway in posturography showed a tendency to decrease on medication. Fifty percent of patients did not report any side effects. The most common reported side effect was abdominal discomfort and dizziness. Conclusions: The treatment with the SK-channel activator CHZ is a potentially new therapeutic agent for the symptomatic treatment of DBN. Classification of evidence: This study provides Class IV evidence that CHZ 500 mg 3 times a day may improve eye movements and visual fixation in patients with DBN.

An unusual stroke-like clinical presentation of Creutzfeldt-Jakob disease: acute vestibular syndrome

INTRODUCTION Vertigo and dizziness are common neurological symptoms in general practice. Most patients have benign peripheral vestibular disorders, but some have dangerous central causes. Recent research has shown that bedside oculomotor examinations accurately discriminate central from peripheral lesions in those with new, acute, continuous vertigo/dizziness with nausea/vomiting, gait unsteadiness, and nystagmus, known as the acute vestibular syndrome. CASE REPORT A 56-year-old man presented to the emergency department with acute vestibular syndrome for 1 week. The patient had no focal neurological symptoms or signs. The presence of direction-fixed, horizontal nystagmus suppressed by visual fixation without vertical ocular misalignment (skew deviation) was consistent with an acute peripheral vestibulopathy, but bilaterally normal vestibuloocular reflexes, confirmed by quantitative horizontal head impulse testing, strongly indicated a central localization. Because of a long delay in care, the patient left the emergency department without treatment. He returned 1 week later with progressive gait disturbance, limb ataxia, myoclonus, and new cognitive deficits. His subsequent course included a rapid neurological decline culminating in home hospice placement and death within 1 month. Magnetic resonance imaging revealed restricted diffusion involving the basal ganglia and cerebral cortex. Spinal fluid 14-3-3 protein was elevated. The rapidly progressive clinical course with dementia, ataxia, and myoclonus plus corroborative neuroimaging and spinal fluid findings confirmed a clinicoradiographic diagnosis of Creutzfeldt-Jacob disease. CONCLUSIONS To our knowledge, this is the first report of an initial presentation of Creutzfeldt-Jacob disease closely mimicking vestibular neuritis, expanding the known clinical spectrum of prion disease presentations. Despite the initial absence of neurological signs, the central lesion location was differentiated from a benign peripheral vestibulopathy at the first visit using simple bedside vestibular tests. Familiarity with these tests could help providers prevent initial misdiagnosis of important central disorders in patients presenting vertigo or dizziness.

(Table 3) Sedimentation rates of stage 1 and last glacial maximum from different Holes during cruises of RRS Discovery in 1984-1985 and 1987-1988, and RRS James Clark Ross in 1992-1993

Within the Scotia Sea, the axis of the Antarctic Circumpolar Current (ACC) is geographically confined, and sediments therefore contain a record of palaeo-flow speed uncomplicated by ACC axis migration. We outline Holocene and Last Glacial Maximum (LGM) current-controlled sedimentation using data from 3.5-kHz profiles, cores and current meter moorings. Geophysical surveys show areas of erosion and deposition controlled by Neogene basement topography. Deposition occurs in mounded sediment drifts or flatter areas, where 500-1000 m of sediment overlies acoustic basement. 3.5-kHz profiles show parallel, continuous sub-bottom reflectors with highest sedimentation rates in the centre of the drifts, and reflectors converging towards marginal zones of non-deposition. Locally, on the flanks of continental blocks (e.g. South Georgia), downslope processes are dominant. The absence of mudwaves on the sediment drifts may result from the unsteadiness of ACC flow. A core transect from the ACC axis south to the boundary with the Weddell Gyre shows a southward decrease in biogenic content, controlled by the Polar Front and the spring sea-ice edge. Both these features lay farther north at LGM. The cores have been dated by relative abundance of the radiolarian Cycladophora davisiana, and by changes in the biogenic Ba content, a palaeoproductivity indicator. Sedimentation rates range from 3 to 17 cm/ka. The grain size of Holocene sediments shows a coarsening trend from south to north, consistent with strongest bottom-current flow near the ACC axis, though interpretation is complicated by the presence of biogenic grains. Year-long current meter records indicate mean speeds from 7 cm/s in the south to 12 cm/s in the north, with benthic storm frequency increasing northwards. LGM sediments are predominantly terrigenous and show a clearer northward-coarsening trend, with well-sorted silts in the northern Scotia Sea. Assuming a constant terrigenous source, this implies stronger ACC flow at the LGM, contrasting with weaker Weddell Gyre flow deduced from earlier work.

El conflicto de los españoles ante el proceso de emancipación : Los casos del Río de La Plata y México en los albores del siglo XIX

Las guerras de independencia en Latinoamérica y el consecuente proceso de construcción de la nación, representaron para los españoles una inestabilidad manifestada, en diversos grados de intensidad, en los países emergentes. La intención de este trabajo es presentar, a manera de contraste, las medidas que los gobiernos de dos territorios disímbolos, más no extraños, como son México y el Río de la Plata, adoptaron en contra de los peninsulares para legitimarse. Las posturas de ambos gobiernos reflejan las relaciones y afrentas que cada país guardaba con sus otrora conquistadores y los niveles de dependencia hacia la comunidad ibérica que hacían inoperables, en muchos de los casos, la intención de agraviar sus privilegios. Por tanto se pretende mostrar las vicisitudes, los paralelismos y las discrepancias que estos países presentan en sus disposiciones frente a los españoles.

El conflicto de los españoles ante el proceso de emancipación : Los casos del Río de La Plata y México en los albores del siglo XIX

Las guerras de independencia en Latinoamérica y el consecuente proceso de construcción de la nación, representaron para los españoles una inestabilidad manifestada, en diversos grados de intensidad, en los países emergentes. La intención de este trabajo es presentar, a manera de contraste, las medidas que los gobiernos de dos territorios disímbolos, más no extraños, como son México y el Río de la Plata, adoptaron en contra de los peninsulares para legitimarse. Las posturas de ambos gobiernos reflejan las relaciones y afrentas que cada país guardaba con sus otrora conquistadores y los niveles de dependencia hacia la comunidad ibérica que hacían inoperables, en muchos de los casos, la intención de agraviar sus privilegios. Por tanto se pretende mostrar las vicisitudes, los paralelismos y las discrepancias que estos países presentan en sus disposiciones frente a los españoles.

El conflicto de los españoles ante el proceso de emancipación : Los casos del Río de La Plata y México en los albores del siglo XIX

Las guerras de independencia en Latinoamérica y el consecuente proceso de construcción de la nación, representaron para los españoles una inestabilidad manifestada, en diversos grados de intensidad, en los países emergentes. La intención de este trabajo es presentar, a manera de contraste, las medidas que los gobiernos de dos territorios disímbolos, más no extraños, como son México y el Río de la Plata, adoptaron en contra de los peninsulares para legitimarse. Las posturas de ambos gobiernos reflejan las relaciones y afrentas que cada país guardaba con sus otrora conquistadores y los niveles de dependencia hacia la comunidad ibérica que hacían inoperables, en muchos de los casos, la intención de agraviar sus privilegios. Por tanto se pretende mostrar las vicisitudes, los paralelismos y las discrepancias que estos países presentan en sus disposiciones frente a los españoles.