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Background/Aim
This study aimed to establish the somatosensory profile of patients with lumbar radiculopathy at pre-and post-microdiscectomy and to explore any association between pre-surgical quantitative sensory test (QST) parameters and post-surgical clinical outcomes.
Methods
A standardized QST protocol was performed in 53 patients (mean age 38 ± 11 years, 26 females) with unilateral L5/S1 radiculopathy in the main pain area (MPA), affected dermatome and contralateral mirror sites and in age- and gender-,and body site-matched healthy controls. Repeat measures at 3 months included QST, the Oswestry Disability Index (ODI) and numerous other clinical measures; at 12 months, only clinical measures were repeated. A change <30% on the ODI was defined as ‘no clinically meaningful improvement’.
Results
Patients showed a significant loss of function in their symptomatic leg both in the dermatome (thermal, mechanical, vibration detection p < .002), and MPA (thermal, mechanical, vibration detection, mechanical pain threshold, mechanical pain sensitivity p < .041) and increased cold sensitivity in the MPA (p < .001). Pre-surgical altered QST parameters improved significantly post-surgery in the dermatome (p < .018) in the symptomatic leg and in the MPA (p < .010), except for thermal detection thresholds and cold sensitivity. Clinical outcomes improved at 3 and 12 months (p < .001). Seven patients demonstrated <30% change on the ODI at 12 months. Baseline loss of function in mechanical detection in the MPA was associated with <30% change on the ODI at 12 months (OR 2.63, 95% CI 1.09–6.37, p = .032).
Conclusion
Microdiscectomy resulted in improvements in affected somatosensory parameters and clinical outcomes. Pre-surgical mechanical detection thresholds may be predictive of clinical outcome.
Significance
This study documented quantitative sensory testing (QST) profiles in patients with lumbar radiculopathy in their main pain area (MPA) and dermatome pre- and post-microdiscectomy and explored associations between QST parameters and clinical outcome. Lumbar radiculopathy was associated with loss of function in modalities mediated by large and small sensory fibres. Microdiscectomy resulted in significant improvements in loss of function and clinical outcomes in 85% of our cohort. Pre-surgical mechanical detection thresholds in the MPA may be predictive of clinical outcome.
Purpose
Sedentary behaviour (SED) and low level of physical activity (PA) might be associated with the development or worsening of pain. Still, studies assessing physical behaviours by accelerometry in individuals with orofacial pain are limited. This study aims to assess whether women with temporomandibular disorders (TMD) present different patterns of physical behaviours in days with (DWP) or without pain (DWoP).
Methods
Twenty-nine out of forty-four women (mean age 29.21 sd 7.96) were diagnosed with TMD and monitored over seven days using a thigh-worn accelerometer. DWP was determined when subjects presented pain in one of the craniocervical regions (head, jaw and neck) with intensity of at least 3 in the numerical rating scale. To be considered a DWoP, the individual presented less than 3 points in the three regions. Daily time-use compositions were described in terms of SED in short (<30 min) and long (≥30 min) bouts, light PA (LPA), moderate-to-vigorous PA (MVPA), and time-in-bed. Isometric log-ratios (ilr) were calculated to express the ratio of time-in-bed to time spent awake, SED relative to LPA and MVPA, SED in short relative to long bouts, and LPA relative to MVPA. Differences between DWP and DWoP were examined using MANOVA, followed by univariate post-hoc tests of pairwise differences.
Results
During DWP, women with TMD spent more time in SED in short (239 min) and long bouts (419 min), less time in LPA (245 min), MVPA (68 min), and in bed (468 min) compared with DWoP (235, 378, 263, 70 and 493 min, respectively). The MANOVA showed that all sets of ilrs did not differ statistically (ηp2 = 0.19, p = 0.25). Still, the post-hoc tests showed a trend that time spent SED relative to LPA and MVPA was larger in DWP than in DWoP (Cohen’s d = 0.36, p = 0.05).
Conclusions
Women with TMD did not show different patterns of physical behaviours in DWP or DWoP. However, there is a trend of more sedentary behaviour and less physical activity in DWP compared to DWoP. Future studies should consider other pain intensity cut-offs, isolated pain locations, and larger sample sizes to confirm these results.
15 δ N signals in plant and soil material integrate over a number of biogeochemical processes
related to nitrogen (N) and therefore provide information on net effects of multiple
processes on N dynamics. In general little is known in many grassland restoration projects
on soil–plant N dynamics in relation to the restoration treatments. In particular, 15 δ N signals
may be a useful tool to assess whether abiotic restoration treatments have produced the
desired result. In this study we used the range of abiotic and biotic conditions provided
by a restoration experiment to assess to whether the restoration treatments and/or plant
functional identity and legume neighborhood affected plant 15 δ N signals. The restoration
treatments consisted of hay transfer and topsoil removal, thus representing increasing
restoration effort, from no restoration measures, through biotic manipulation to major
abiotic manipulation. We measured 15 δ N and %N in six different plant species (two nonlegumes and four legumes) across the restoration treatments. We found that restoration
treatments were clearly reflected in 15 δ N of the non-legume species, with very depleted
15 δ N associated with low soil N, and our results suggest this may be linked to uptake of
ammonium (rather than nitrate). The two non-legume species differed considerably in their
15 δ N signals, which may be related to the two species forming different kinds of mycorrhizal
symbioses. Plant 15 δ N signals could clearly separate legumes from non-legumes, but our
results did not allow for an assessment of legume neighborhood effects on non-legume
15 δ N signals. We discuss our results in the light of what the 15 δ N signals may be telling
us about plant–soil N dynamics and their potential value as an indicator for N dynamics in
restoration.
Injection of slurry or digestate below maize seeds is a relatively new technique developed to improve nitrogen use efficiency. However, this practice has the major drawback of increasing nitrous oxide (N2O) emissions. The application of a nitrification inhibitor (NI) is an effective method to reduce these emissions. To evaluate the effect of the NI 3,4‐dimethypyrazole phosphate (DMPP) on N2O emissions and the stabilization of ammonium, a two‐factorial soil‐column experiment was conducted. PVC pipes (20 cm diameter and 30 cm length) were used as incubation vessels for the soil‐columns. The trial consisted of four treatments in a randomized block design with four replications: slurry injection, slurry injection + DMPP, digestate injection, and digestate injection + DMPP. During the 47‐day incubation period, N2O fluxes were measured twice a week and cumulated by linear interpolation of the gas‐fluxes of consecutive measurement dates. After completion of the gas flux measurement, concentration of ammonium and nitrate within the soil‐columns was determined. DMPP delayed the conversion of ammonium within the manure injection zone significantly. This effect was considerably more pronounced in treatment digestate + NI than in treatment slurry + NI. Regarding the cumulated N2O emissions, no difference between slurry and digestate treatments was determined. DMPP reduced the release of N2O significantly. Transferring the results into practice, the use of DMPP is a promising way to reduce greenhouse gas emissions and nitrate leaching, following the injection of slurry or digestate.
Easy and inexpensive methods for measuring ammonia emissions in multi-plot field trials allow the comparison of several treatments with liquid manure application. One approach that might be suitable under these conditions is the dynamic tube method (DTM). Applying the DTM, a mobile chamber system is placed on the soil surface, and the air volume within is exchanged at a constant rate for approx. 90 s. with an automated pump. This procedure is assumed to achieve an equilibrium ammonia concentration within the system. Subsequently, a measurement is performed using an ammonia-sensitive detector tube. Ammonia fluxes are calculated based on an empirical model that also takes into account the background ammonia concentration measured on unfertilized control plots. Between measurements on different plots, the chamber system is flushed with ambient air and cleaned with paper towels to minimize contamination with ammonia. The aim of this study was to determine important prerequisites and boundary conditions for the application of the DTM.
We conducted a laboratory experiment to test if the ammonia concentration remains stable while performing a measurement. Furthermore, we investigated the cleaning procedure and the effect of potential ammonia carryover on cumulated emissions under field conditions following liquid manure application. The laboratory experiment indicated that the premeasurement phase to ensure a constant ammonia concentration is not sufficient. The concentration only stabilized after performing more than 100 pump strokes, with 20 pump strokes (lasting approximately 90 s) being the recommendation.
However, the duration of performing a measurement can vary substantially, and linear conversion accounts for those differences, so a stable concentration is mandatory. Further experiments showed that the cleaning procedure is not sufficient under field conditions. Thirty minutes after performing measurements on high emitting plots, which resulted in an ammonia concentration of approx.
10 ppm in the chamber, we detected a residual concentration of 2 ppm. This contamination may affect measurements on plots with liquid manure application as well as on untreated control plots. In a field experiment with trailing hose application of liquid manure, we subsequently demonstrated that the calculation of cumulative ammonia emissions can vary by a factor of three, depending on the degree of chamber system contamination when measuring control plots. When the ammoni background values were determined by an uncontaminated chamber system that was used to measure only control plots, cumulative ammonia emissions were approximately 9 kg NH3-N ha1.
However, when ammonia background values were determined using the contaminated chamber system that was also used to measure on plots with liquid manure application, the calculation of cumulative ammonia losses indicated approximately 3 kg NH3-N ha1. Based on these results, it can be concluded that a new empirical DTM calibration is needed for multi-plot field experiments with high-emitting treatments.
Purpose
This paper aims to investigate the strategic consequences of manufacturing location decisions, with a focus on understanding the link between collocating manufacturing with other value chain activities, via reshoring or retaining and organizational agility.
Design/methodology/approach
The paper uses qualitative data from 115 interviews with executives from UK high value manufacturing companies to explore the recent phenomenon of reshoring and the strategic effects of manufacturing location.
Findings
The location of manufacturing is operationally and strategically important for multinational companies. The spatial dispersion of manufacturing is determined by firm-specific and external factors, both of which are subject to constant change. The analysis shows that concentrating on manufacturing in their home countries enables firms to increase organizational agility and stimulate innovation. Better integration with and more extensive collaboration between related value chain activities, such as research and development, sales and marketing, leads to higher flexibility, speed and responsiveness to customer requirements. However, under certain conditions, firms also continue to benefit from the known advantages of offshoring.
Originality/value
This research sheds light on possible strategic downsides of global value chains, characterized by dispersed activities and intermitted processes. The results provide evidence that retaining manufacturing or bringing back manufacturing operations to a company’s home country can increase organizational flexibility, speed, adaptability, innovativeness and responsiveness to customer requirements. As these capabilities are critical for long-term survival, especially in dynamic environments, firms need to review their global factory configurations and determine whether the short-term advantages of foreign locations continue to justify offshoring practices.
Usability is a core construct of website evaluation and inherently defined as interactive. Yet, when analysing first impressions of websites, expected usability, i.e., before use, is of interest. Here we investigate to what extend ratings of expected usability are related to (a) experienced usability, i.e., ratings after use, and (b) objective usability measures, i.e., task performance. Furthermore, we try to elucidate how ratings of expected usability are correlated to aesthetic judgments. In an experiment, 57 participants submitted expected usability ratings after the presentation of website screenshots in three viewing-time conditions (50, 500, and 10,000 ms) and after an interactive task (experienced usability). Additionally, objective usability measures (task completion and duration) and subjective aesthetics evaluations were recorded for each website. The results at both the group and individual level show that expected usability ratings are not significantly related either to experienced usability or objective usability measures. Instead, they are highly correlated with aesthetics ratings. Taken together, our results highlight the need for interaction in empirical website usability testing, even when exploring very early usability impressions. In our study, user ratings of expected usability were no valid proxy neither for objective usability nor for experienced website usability.
Informatics competencies of the health care workforce must meet the requirements of inter-professional process and outcome oriented provision of care. In order to help nursing education transform accordingly, the TIGER Initiative deployed an international survey, with participation from 21 countries, to evaluate and prioritise a broad list of core competencies for nurses in five domains: 1) nursing management, 2) information technology (IT) management in nursing, 3) interprofessional coordination of care, 4) quality management, and 5) clinical nursing. Informatics core competencies were found highly important for all domains. In addition, this project compiled eight national cases studies from Austria, Finland, Germany, Ireland, New Zealand, the Philippines, Portugal, and Switzerland that reflected the country specific perspective. These findings will lead us to an international framework of informatics recommendations.
Background
Against the background of a steadily increasing degree of digitalization in health care, a professional information management (IM) is required to successfully plan, implement, and evaluate information technology (IT). At its core, IM has to ensure a high quality of health data and health information systems to support patient care.
Objectives
The goal of the present study was to define what constitutes professional IM as a construct as well as to propose a reliable and valid measurement instrument.
Methods
To develop and validate the construct of professionalism of information management (PIM) and itsmeasurement, a stepwise approach followed an established procedure from information systems and behavioral research. The procedure included an analysis of the pertaining literature and expert rounds on the construct and the
instrument, two consecutive and comprehensive surveys at the national and international level, exploratory and confirmatory factor analyses as well as reliability and validity testing.
Results
Professionalism of information management was developed as a construct consisting of the three dimensions of strategic, tactical, and operational IMas well as of the regularity and cyclical phases of IM procedures as the two elements of professionalism.
The PIM instrument operationalized the construct providing items that incorporated IM procedures along the three dimensions and cyclical phases. These procedures had to be evaluated against their degree of regularity in the instrument. The instrument proved to be reliable and valid in two consecutive measurement phases
and across three countries.
Conclusion
It can be concluded that professionalism of information management is a meaningful construct that can be operationalized in a scientifically rigorous manner. Both science and practice can benefit from these developments in terms of improved self-assessment, benchmarking capabilities, and eventually, obtaining a better understanding of health IT maturity.