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Background Low back pain (LBP) is a common and costly problem throughout the United States. To achieve a greater understanding of the occupational risk factors, the National Institute for Occupational Safety and Health (NIOSH) funded a low back health effects consortium, which performed several surveillance studies throughout the United States. This study combines data from the consortium research groups resulting in a data set with nearly 2000 workers in various regions of the country. The purpose of this paper is to examine prevalence and personal risk factors of low back health effects among these workers. Methods There were three common questions regarding history of low back health effects in the past 12 months including 1) have you had LBP lasting 7 days, 2) have you sought medical care for LBP, and 3) have you taken time off work due to LBP. The questionnaire included demographic questions. There were five data collections institutions or sites including NIOSH, Ohio State University, University of Wisconsin-Milwaukee, Texas A&M University, and University of Utah. Results The 12-month period prevalence of low back pain lasting 7 days, seeking medical care, and lost time due to LBP were 25, 14 and 10%, respectively. There were no statistically significant differences in gender, age or weight between cases and non-cases for any prevalence measure. The height of workers was significantly greater in the cases compared to non-cases for all three prevalence definitions. There were significant differences among the sites on the prevalence of seeking medical care for LBP and lost time due to LBP. The Ohio State University had significantly higher prevalence rates for seeking medical care and lost time due to LBP than University of Wisconsin, University of Utah, or Texas A&M University. Conclusion LBP, the least severe low back health effect studied, had the highest prevalence (25%) and lost time due to LBP, the most severe low back health effect studied, had the lowest prevalence (10%) among nearly 2000 US manual material handling workers. There was a significant site or regional influence in prevalence rates for seeking medical care and lost time due to LBP.

Abstract Background DSM265 is a selective inhibitor of Plasmodium dihydroorotate dehydrogenase that fully protected against controlled human malarial infection (CHMI) by direct venous inoculation of Plasmodium falciparum sporozoites when administered 1 day before challenge and provided partial protection when administered 7 days before challenge. Methods A double-blinded, randomized, placebo-controlled trial was performed to assess safety, tolerability, pharmacokinetics, and efficacy of 1 oral dose of 400 mg of DSM265 before CHMI. Three cohorts were studied, with DSM265 administered 3 or 7 days before direct venous inoculation of sporozoites or 7 days before 5 bites from infected mosquitoes. Results DSM265-related adverse events consisted of mild-to-moderate headache and gastrointestinal symptoms. DSM265 concentrations were consistent with pharmacokinetic models (mean area under the curve extrapolated to infinity, 1707 µg*h/mL). Placebo-treated participants became positive by quantitative reverse transcription–polymerase chain reaction (qRT-PCR) and were treated 7–10 days after CHMI. Among DSM265-treated subjects, 2 of 6 in each cohort were sterilely protected. DSM265-treated recipients had longer times to development of parasitemia than placebo-treated participants (P < .004). Conclusions This was the first CHMI study of a novel antimalarial compound to compare direct venous inoculation of sporozoites and mosquito bites. Times to qRT-PCR positivity and treatment were comparable for both routes. DSM265 given 3 or 7 days before CHMI was safe and well tolerated but sterilely protected only one third of participants. A controlled human malarial infection study was conducted to assess the efficacy of oral DSM265 against preerythrocytic Plasmodium falciparum sporozoite infection. Complete protection was achieved in 33% of volunteers who received DSM265 3 or 7 days before challenge.

Purpose The purpose of the study was to determine thresholds for low back kinematic measures for the amount of functional recovery necessary to reduce the risk of recurrent pain symptoms or lost time. Methods Low back kinematic ability measures were collected at baseline when the workers returned to work for full duty. The range of motion, velocity, and acceleration were collected using the lumbar motion monitor. Results Follow-up data was collected on 196 of the 206 workers. Workers with sagittal extension velocity of <40 deg./s at baseline were twice as likely to report recurrent low back pain symptoms. Workers with sagittal flexion velocity <34 deg./s were 3 times more likely to report lost time. Conclusions Kinematic functional performance measures may be used as recovery criteria in low back pain patients to minimize recurrence risk.

Low back pain (LBP) is the leading cause of disability worldwide. Unfortunately, there is no gold standard for objectively quantifying low back function. The clinical lumbar motion monitor (CLMM), a wearable technology, has been developed to provide an objective measure of low back function. The evaluation for the patient is like playing a video game with their back. For health care practitioners the CLMM provides three metrics including overall impairment, structural/muscular and test reliability (do we have good data). This study had two goals. 1) To evaluate the ease of use for the patients. 2) To evaluate how the health care practitioners were able to use the results. Sixty-six low back pain patients were evaluated in the study and 18 health care practitioners were interviewed after receiving CLMM results on their patients. The patients were given a survey immediately after evaluation completion. The practitioners participated in a phone survey after all patient evaluations were completed. Ninety-two percent of the patients either agreed or strongly agreed that the monitor was comfortable and 98% either agreed or strongly agreed that the instructions were clear. One hundred percent of the health care practitioners agreed the test reliability metric was informative and provided a new perspective to their clinical impression. Overall LBP patients were satisfied with the evaluation and health care practitioners thought the results added to their clinical impression. The CLMM technology provides an objective quantitative measure of low back function that may change the way health care practitioners treat LBP patients.

Purpose The purpose of this study was to assess low back functional health among a group of nurses with a history of low back pain symptoms in a university hospital using a direct measure of low back functional performance and compare to traditional low back disability and pain questionnaires. Methods Fifty-two nurses and patient care associates volunteered for the study. The clinical lumbar motion monitor (LMM) was used to directly measure low back functional performance. The participants performed a series of standard tasks involving trunk flexion and extension at different asymmetries. The LMM measures the motion signature of the participant (range of motion, velocity and acceleration) in all three planes of the body. The clinical LMM evaluation documented objective assessment of low back function normalized for age and gender. The Oswestry Disability Index (ODI) was used to evaluate self-reported disability and the McGill Pain Questionnaire visual analog scale assessed pain symptom. Results The average functional performance probability was 0.49 with a standard deviation of 0.29, indicating that on average the functional performance was impaired. The average ODI score was 13.4 with a standard deviation of 11.6. The correlation between the functional performance probability and ODI was 0.046 (not statistically significant). Conclusions The clinical LMM functional performance measure provides a direct measure of trunk function. The low correlation between the ODI and clinical LMM functional performance probability indicates that the direct functional performance measure adds another component to our understanding of low back health or impairment that traditional questionnaires lack.

Dry thunderstorms (those that occur without significant rainfall at the ground) are common in the interior western United States. Moisture drawn into the area from the Gulfs of Mexico and California is sufficient to form high-based thunderstorms. Rain often evaporates before reaching the ground, and cloud-to-ground lightning generated by these storms strikes dry fuels. Fire weather forecasters at the National Weather Service and the National Interagency Coordination Center try to anticipate days with widespread dry thunderstorms because they result in multiple fire ignitions, often in remote areas. The probability of the occurrence of dry thunderstorms that produce fire-igniting lightning strikes was found to be greater on days with high instability and a deficit of moisture at low levels of the atmosphere. Based on these upper-air variables, an algorithm was developed to estimate the potential of dry lightning (lightning that strikes the ground with little or no rainfall at the surface) when convective storms are expected. In the current study, this algorithm has been applied throughout the western United States, with modeled meteorological variables rather than the observed soundings that have previously been used, to develop a predictive scheme for estimating the risk of dry thunderstorms. Predictions of the risk of dry thunderstorms were generated from real-time forecasts using the fifth-generation Pennsylvania State University–National Center for Atmospheric Research Mesoscale Model (MM5) for the summers of 2004 and 2005. During that period, 240 large lightning-caused fires were ignited in the model domain. Of those fires, 40% occurred where the probability of dry lightning was predicted to be equal to or greater than 90% and 58% occurred where the probability was 75% or greater.

This paper examines the potential of regional environmental prediction by focusing on the local forecasting effort in the Pacific Northwest. A consortium of federal, state, and local agencies have funded the development and operation of a multifaceted numerical prediction system centered at the University of Washington that includes atmospheric, hydrologic, and air quality models, the collection of real-time regional weather data sources, and a number of realtime applications using both observations and model output. The manuscript reviews northwest modeling and data collection systems, describes the funding and management system established to support and guide the effort, provides some examples of regional real-time applications, and examines the national implications of regional environmental prediction.

Generalized linear mixed models (GLMM) were used to study the effect of vegetation cover, elevation, slope, and precipitation on the probability of ignition in the Blue Mountains, Oregon, and to estimate the probability of ignition occurrence at different locations in space and in time. Data on starting location of lightning-caused ignitions in the Blue Mountains between April 1986 and September 1993 constituted the base for the analysis. The study area was divided into a pixel-time array. For each pixel-time location we associated a value of 1 if at least one ignition occurred and 0 otherwise. Covariate information for each pixel was obtained using a geographic information system. The GLMMs were fitted in a Bayesian framework. Higher ignition probabilities were associated with the following cover types: subalpine herbaceous, alpine tundra, lodgepole pine (Pinus contorta Dougl. ex Loud.), whitebark pine (Pinus albicaulis Engelm.), Engelmann spruce (Picea engelmannii Parry ex Engelm.), subalpine fir (Abies lasiocarpa (Hook.) Nutt.), and grand fir (Abies grandis (Dougl.) Lindl.). Within each vegetation type, higher ignition probabilities occurred at lower elevations. Additionally, ignition probabilities are lower in the northern and southern extremes of the Blue Mountains. The GLMM procedure used here is suitable for analysing ignition occurrence in other forested regions where probabilities of ignition are highly variable because of a spatially complex biophysical environment.

Objectives: South Carolina mandates reporting of animal bites and manages distribution of biologics for rabies postexposure prophylaxis (PEP). Incidence and epidemiologic characteristics of potential human rabies exposures and preventive treatment in South Carolina from 1993 through 2002 were examined to help assess the burden of PEP in the state and determine if the incidence of rabies exposures has changed over time. Methods: Data on animal exposure investigations and PEP administration at the state and county level were examined, and the annual incidences of potential rabies exposures and human PEP courses were calculated. Results: The incidence of animal exposures for which investigations were initiated was 297.9 per 100,000 population per year, and the incidence of PEP was 10.6 per 100,000 population per year. At the county level, the incidence of PEP appeared inversely correlated with the population density. Most courses of PEP were administered following exposures to domestic species, although these animals accounted for only a small proportion of rabid animals in the state. The annual PEP incidence was similar throughout the study period, but it was markedly higher than estimates from 1981 (<5/100,000 population per year). Conclusions: The incidence of PEP in South Carolina is higher than previously thought, and these findings suggest that incidence extrapolations for other states and at the national level may be underestimated. An accurate estimation of the incidence of PEP and an understanding of rabies epidemiology is important at the state level to allow for better public health planning.