A bio-psycho-social exercise program (RÜCKGEWINN) for chronic low back pain in rehabilitation aftercare - Study protocol for a randomised controlled trial

Background  

There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours). Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent.     

Microstructural Assessment of a Multiple-Intermetallic-Strengthened Aluminum Alloy Produced from Gas-Atomized Powder by Hot Extrusion and Friction Extrusion

An aluminum (Al) matrix with various transition metal (TM) additions is an effective alloying approach for developing high-specific-strength materials for use at elevated temperatures. Conventional fabrication processes such as casting or fusion-related methods are not capable of producing Al–TM alloys in bulk form. Solid phase processing techniques, such as extrusion, have been shown to maintain the microstructure of Al–TM alloys. In this study, extrusions are fabricated from gas-atomized aluminum powders (≈100–400 µm) that contain 12.4 wt % TM additives and an Al-based matrix reinforced by various Al–Fe–Cr–Ti intermetallic compounds (IMCs). Two different extrusion techniques, conventional hot extrusion and friction extrusion, are compared using fabricating rods. During extrusion, the strengthening IMC phases were extensively refined as a result of severe plastic deformation. Furthermore, the quasicrystal approximant IMC phase (70.4 wt % Al, 20.4 wt % Fe, 8.7 wt % Cr, 0.6 wt % Ti) observed in the powder precursor is replaced by new IMC phases such as Al_3.2Fe and Al₄₅Cr₇-type IMCs. The Al₃Ti-type IMC phase is partially dissolved into the Al matrix during extrusion. The combination of linear and rotational shear in the friction extrusion process caused severe deformation in the powders, which allowed for a higher extrusion ratio, eliminated linear voids, and resulted in higher ductility while maintaining strength comparable to that resulting from hot extrusion. Results from equilibrium thermodynamic calculations show that the strengthening IMC phases are stable at elevated temperatures (up to ≈ 600 °C), thus enhancing the high-temperature strength of the extrudates.     

Diabetes induced testicular dysfunction amelioration by ethyl acetate fraction of hydromethanolic extract of root of Musa paradisiaca L. in streptozotocin-induced diabetic rat

ObjectiveTo investigate the diabetic therapeutic potentiality and antioxidative efficacy of ethyl acetate fraction of hydro-methanol (40:60) extract of root of Musa paradisiaca Lam. (Musaceae) in streptozotocin-induced diabetic rat.MethodsStreptozotocin-induced diabetic state was confirmed by decreased serum insulin level and carbohydrate metabolomics i.e. increased fasting blood glucose level, glycated hemoglobin level and diminished glycogen contents in liver and skeletal muscle. Reproductive homeostasis alteration in diabetes was evaluated by reproductive organo-somatic indices, sperm count, motility and histological analysis of testicular seminiferous tubule along with levels of serum testosterone, testicular cholesterol and seminal vesicular fructose assessment. Oxidative stress in primary and accessory sex organs, and in sperm pellet was assessed by measuring antioxidant enzyme activities along with quantification of free radicals products. Testicular pro-apoptotic Bax-α mRNA expression pattern was studied semi-quantitatively by PCR technique. Reverse phase HPLC fingerprinting was performed using methanol and acetonitrile as mobile phase.ResultsOral administration of ethyl acetate fraction at a dose of 20 mg/0.5 mL of distilled water/100 gm body weight twice daily to the diabetic rats for 28 days significantly recovered organo-somatic indices, protected reproductive activities, corrected oxidative stress markers and pro-apoptotic mRNA expression pattern, which were deviated in diabetes mellitus from control level without any type of toxicity. HPLC fingerprinting shows five completely resolved peaks at γ max 254 nm and 342 nm.ConclusionsIt has a promising antihyperglycaemic and antioxidative activity for curing diabetes induced reproductive disorders in streptozotocin-induced diabetic rat.     

Age-related differences in cranial sexual dimorphism in contemporary Europe

International Journal of Legal Medicine - Biomechanical load and hormonal levels tended to change just like the soft and skeletal tissue of the elderly with age. Although aging in both sexes shared...     

Complete lymph node dissection or observation in melanoma patients with multiple positive sentinel lymph nodes: A single‐center retrospective analysis

Although the role of sentinel lymph node biopsy (SLNB) as a prognostic factor is well established, its consequences for therapy are controversial. The aim of this study was to analyze if complete lymph node dissection (CLND) in patients with more than one positive sentinel lymph node (SLN) significantly improves melanoma‐specific survival (MSS) and progression‐free survival (PFS). Medical records of patients who underwent SLNB between 2001 and 2016 at the University Hospital of Cologne were reviewed, and patients with positive SLN were identified. Patient and tumor characteristics, patterns of recurrence, progression‐free and melanoma‐specific survival were analyzed. Seventy‐eight patients with multiple positive and 197 patients with one positive SLN were included in this study. Patients with multiple positive SLN had significantly more positive non‐SLN compared with patients with only one positive SLN (26.9% vs 8.6%, P = 0.01). However, in the subgroup of patients with multiple positive SLN, CLND did not significantly improve MSS (mean MSS 95 vs 75 months, P = 0.5) and PFS (mean PFS 59 vs 68 months P = 0.167). CLND did not result in a significant improvement in PFS and MSS in patients with multiple positive SLN.