Degree Of Weakness Research Articles

On the Weak Infinite Zero Structures and Relative Degrees for Linear Time-Delay Systems

On the Weak Infinite Zero Structures and Relative Degrees for Linear Time-Delay Systems

Clinical characteristics and impairment of activities of daily living among patients with myasthenia gravis with differing degrees of muscle weakness: a real-world study of patients in the US and five European countries

BackgroundReal-world data were employed to determine clinical characteristics of patients with myasthenia gravis (MG) with differing degrees of muscle weakness, as defined using the Myasthenia Gravis Foundation of America (MGFA) classification system.MethodsData were drawn from the Adelphi MG Disease Specific Programme (DSP)™, a multinational (United States, France, Germany, Italy, Spain, United Kingdom) survey completed by physicians and their patients with MG in 2020. The association between MGFA class and impairment in activities of daily living (ADL) was tested using linear regression adjusting for sex and Charlson Comorbidity Index. Bivariate comparisons were performed for each individual item. A range of other clinical characteristics were also explored according to MGFA class.ResultsAmong 1232 patients, those in MGFA class I had significantly lower ADL impairment versus class II or III/IV (adjusted for sex and Charlson Comorbidity Index) (p < 0.01). However, heterogeneity occurred within each MGFA class. Bulbar symptoms (impaired speech, difficulty swallowing, and/or difficulty chewing/choking on food) were reported in some class I patients (mild in 1.1–1.9% and moderate in 0.3–1.1% of patients) and class II patients (mild in 8.5–16.4%, moderate in 4.7–7.4%, and severe in 0.3–0.9% of patients), and shortness of breath was reported in some class I (mild in 0.5% of patients) and class II patients (mild in 9.8%, moderate in 4.8%, and severe in 0.3% of patients). Conversely, in 11.2–19.2% of class III/IV patients, bulbar symptoms and shortness of breath reported were only mild in severity. In line with this finding, despite significant correlations between MGFA class and several clinical characteristics, patients across every class were at risk of experiencing myasthenic crisis or hospitalization, experiencing comorbidities including anxiety and depression, and not being in remission.ConclusionsAlthough MGFA class correlates with greater ADL impairment and presence of other clinical characteristics, there is variability between patients in each class in terms of symptoms experienced, overall disease burden, and the precise nature of ADL impairment.

Cellular Profile of Subfornical Organ Insulin Receptors in Mice.

Brain insulin receptor signaling is strongly implicated in cardiovascular and metabolic physiological regulation. In particular, we recently demonstrated that insulin receptors within the subfornical organ (SFO) play a tonic role in cardiovascular and metabolic regulation in mice. The SFO is a forebrain sensory circumventricular organ that regulates cardiometabolic homeostasis due to its direct exposure to the circulation and thus its ability to sense circulating factors, such as insulin. Previous work has demonstrated broad distribution of insulin receptor-expressing cells throughout the entire SFO, indirectly indicating insulin receptor expression in multiple cell types. Based on this, we sought to determine the cellular phenotypes that express insulin receptors within the SFO by combining immunohistochemistry with genetically modified reporter mouse models. Interestingly, SFO neurons, including both excitatory and inhibitory types, were the dominant cell site for insulin receptor expression, although a weak degree of insulin receptor expression was also detected in astrocytes. Moreover, SFO angiotensin type 1a receptor neurons also expressed insulin receptors. Collectively, these anatomical findings indicate the existence of potentially complex cellular networks within the SFO through which insulin signaling can influence physiology and further point to the SFO as a possible brain site for crosstalk between angiotensin-II and insulin.

HADITS DHA’IF DAN HUKUM MENGAMALKANNYA

This study aims to analyze and review the use of dha’if (weak) hadith in Islamic law, considering the significant differences of opinion among scholars. Hadith is the second primary source of Islamic law after the Quran and plays a crucial role in explaining the Quran. However, dha’if hadith often becomes a subject of debate regarding its validity and application in Islamic jurisprudence. The majority of hadith scholars and jurists have differing views on the use of dha’if hadith, with some scholars completely prohibiting it and others allowing it under certain conditions.This research employs a qualitative approach with a descriptive-analytical method. Primary data includes dha’if hadiths found in major hadith collections, opinions of scholars on dha’if hadith, and statements from key figures in the fields of hadith and fiqh. Secondary data consists of supporting literature such as books, journals, scholarly articles, and writings of classical and contemporary scholars. Data collection techniques involve literature review and interviews with experts in hadith and fiqh.Data is analyzed using descriptive-analytical techniques, involving the categorization of hadith based on their degree of weakness, analysis of scholars' views on the use of dha’if hadith, and interpretation of data to construct a strong argument regarding the legal use of dha’if hadith. Data validation is conducted through source and method triangulation to ensure the accuracy and reliability of the research findings.

Microwave irradiation-induced deterioration of rock mechanical properties and implications for mechanized hard rock excavation

In this study, a novel microwave-water cooling-assisted mechanical rock breakage method was proposed to address the issues of severe tool wear at elevated temperatures, poor rock microwave absorption, and excessive microwave energy consumption. The investigation object was sandstone, which was irradiated at 4 kW microwave power for 60 s, 180 s, 300 s, and 420 s, followed by air and water cooling. Subsequently, uniaxial compression, Brazilian tension, and fracture tests were conducted. The evolution of damage in sandstone was measured using active and passive nondestructive acoustic detection methods. The roughness of the fracture surfaces of the specimens was quantified using the box-counting method. The damage mechanisms of microwave heating and water cooling on sandstone were discussed from both macroscopic and microscopic perspectives. The experimental results demonstrated that as the duration of the microwave irradiation increased, the P-wave velocity, uniaxial compressive strength (UCS), elastic modulus (E), tensile strength, and fracture toughness of sandstone exhibited various degrees of weakness and were further weakened by water cooling. Furthermore, an increase in the microwave irradiation duration enhanced the damaging effect of water cooling. The P-wave velocity of the sandstone was proportional to the mechanical parameters. Microwave heating and water cooling weakened the brittleness of the sandstone to a certain extent. The fractal dimension of the fracture surface was correlated with the duration of microwave heating, and the water-cooling treatment resulted in a rougher fracture surface. An analysis of the instantaneous cutting rate revealed that water cooling can substantially enhance the efficiency of microwave-assisted rock breakage.

Lumbar Disc Herniation—the Significance of Symptom Duration for the Indication for Surgery.

Lumbar disc surgery is among the more common spinal procedures. In this paper, we report the current treatment recommendations for patients with symptomatic disc herniation. This review is based on pertinent publications retrieved by a selective literature search in PubMed using the terms [timing] AND [lumbar disc herniation], supplemented by other relevant articles and guidelines. Symptoms resolve in 60% to 80% of patients with herniated discs in 6-12 weeks, and in 80% to 90% over the long term (≥ 1 year). According to the guidelines, 6-12 weeks of conservative treatment are recommended in the absence of significant neu - rologic deficits. Early surgery is indicated in case of worsening pain or new onset of neurologic deficits. Lumbar disc herniation associated bladder or bowel dysfunction (cauda equina syndrome) is considered an absolute surgical emergency that requires immediate decompression (within 24 to 48 hours). Patients with severe motor deficits (MRC ≤ 3/5) benefit from early intervention and should be offered surgery within three days, if possible, for the best chance of recovery. The degree of weakness and the duration of symptoms have been identified as risk factors for incomplete recovery. Early surgery can be considered in patients with mild paresis (MRC 4/5) in case of functional impairment (e.g., quadriceps paresis). Longer symptom duration and lower motor scores are associated with worse outcome and a lower chance of neurologic recovery. The recovery rate for motor deficits ranges from 33% to 75%, depending on the timing and modality of treatment as well as the motor score.

Risk factors for preoperative neurological impairment in patients with spinal meningioma: A retrospective multicenter study

BackgroundPatients with spinal meningioma may present preoperatively with paralysis and sensory deficits. However, there is a paucity of detailed evaluations and a lack of consensus regarding imaging findings that are predictive of neurological symptoms in patients with spinal meningioma. MethodsHerein, a total of 55 patients who underwent surgical resection of spinal meningiomas in eight hospitals between 2011 and 2021 were enrolled. Patient characteristics, degree of muscle weakness, sensory disturbances, and the presence of bowel/bladder dysfunction (BBD) before surgical treatment were evaluated using medical records. Patients with American Spinal Injury Impairment Scale grades A-C and the presence of BBD were classified into the paralysis (+) group. Patients with sensory disturbances were assigned to the sensory disturbance (+) group. Based on magnetic resonance (MR) and computed tomography images, the tumor location was classified according to the spinal level and its attachment to the dura mater. To evaluate tumor size, the tumor occupation ratio (OR) was calculated using the area and distance measurement method in horizontal MR images, and the maximum length and area of the tumor in the sagittal plane were measured. ResultsOf all patients, 85 % were women. The mean age of patients at surgery was 69.7 years. Twenty-eight (51 %) and 41 (75 %) patients were classified into the paralysis (+) and sensory disturbance (+) groups, respectively. The average tumor length and area in the sagittal plane were 19.6 mm and 203 mm2, respectively; OR-area and diameters were 70.3 % and 72.3 %, respectively. In univariate analyses, tumor length and area in the sagittal plane were significant risk factors for paralysis. OR-diameter, symptom duration, and a low MIB-1 index correlated with sensory disturbances. Multivariate logistic regression analysis demonstrated that the area and length of the tumor in the sagittal plane were significantly correlated with paralysis, whereas the OR-diameter and symptom duration significantly correlated with sensory disturbances. The cut-off values for the area and length of the tumor in the sagittal plane to predict paralysis were 243 mm2 and 20.1 mm, respectively. ConclusionsPreoperative paralysis in patients with spinal meningiomas was significantly associated with sagittal tumor size than with high tumor occupancy in the horizontal plane. Sensory disturbances were associated with high occupancy in the horizontal plane. Patients with spinal meningiomas > 20 mm in length or 243 mm2 in area in the sagittal plane are at risk of developing paralysis and could be considered for surgery even in the absence of paralysis.

AI Literacy across Curriculum Design: Investigating College Instructor’s Perspectives

Artificial Intelligence (AI) is increasingly prevalent, permeating various aspects of and spreading across education. However, a comprehensive understanding of AI applications and how to define AI literacy is under-investigated. On this note, teaching and evaluating AI literacy necessitating educators to integrate it in course content. The implementation and utilization of AI are reshaping college students’ experiences mannerly. A limited efforts have been made to promote artificial intelligence (AI) literacy for individuals at academic institutions. This study aims to investigate college instructors’ perspectives towards AI integration in curriculum design at a higher education institution, Palestine technical university Kadoorie (PTUK). A mixed study approach is utilized with a pre-existing questionnaire containing 14 items in this study and 17 semi-structured interviews. The data were collected from nine different departments at PTUK. The target population consisted of college 176. The results revealed that college instructors are perceiving AI literacy at a weak degree in the curriculum. Three themes merged from qualitative data: positive perspectives, negative perspectives, and willingness of integration of AI literacy across the curriculum. Recommendations include: there is a necessity to incorporate AI literacy curriculum design and in higher education context in different disciplines.

P.064 A case of late onset Pompe Disease presenting in 6th decade

Background: Late onset Pompe disease (LOPD), rare autosomal recessive lysosomal storage disease, resulting from mutation in alpha glucosidase enzyme (GAA) can present even in 6th decade of life. Slowly progressive, subtle, limb girdle pattern of weakness (LGPW), with auxiliary features such as ptosis, enlarged tongue, axial rigidity, facial diplegia, variable degree of respiratory weakness is not uncommon. Hypertrophic and electrical cardiac abnormalities are well described in LOPD. Methods: We present a case of 67-year-old male presenting with proximal weakness, subtle ptosis, bilateral quadriceps and shoulder girdle atrophy, and left toe numbness. PMHx: CABG, NSTEMI. Statin use. FMHx: noncontributory. Results: EMG: L5 radiculopathy, with unexpected myopathic units in hip/pelvic/ shoulder girdle muscles with active denervation and muscle irritability. CK, CRP, SPEP, ANA, LFTs, HMG-CoA reductase: normal. GAA enzymatic activity=0.96µmol/L/hr (low), genetics: pathogenic variants in GAA gene: c.-32-13T&gt;G and c.1194+3G&gt;C. ECHO: severe diastolic dysfunction, restrictive left ventricular filling. PFTs: normal. Diagnosed with LOPD, started on therapy. Conclusions: LOPD remains a differential for LGPW especially in older patient population with history of cardiopulmonary features. Age-appropriate conconminant pathologies may confound the diagnostic process.Symptoms may preceed diagnosis for years.GAA enzymatic activity followed by genetic testing remains readily available and can confirm diagnosis, preventing delay of approved therapy.

Endoscopic evaluation of gastric mucosal alterations in patients with chronic heart failure II-III nyha functional class utilizing advanced endoscopic techniques

Objective: To assess the alterations of gastric mucosa, its pathomorphological and functional characteristics in patients with complete erosions suffering from chronic heart failure II-III NYHA functional class. Materials and Methods: 185 patients with complete erosions comprised the main group, while the control group consisted of 183 patients with incomplete erosions of the stomach. Patients in both groups had chronic heart failure II-III NYHA functional class. All patients underwent esophagogastroduodenoscopy with white light imaging (WLI), narrow-band imaging (NBI), and ZOOM modes, as well as biopsy sampling followed by pathomorphological examination, determination of Helicobacter pylori presence, and endoscopic pH-metry. The diagnosis of chronic heart failure was established based on anamnestic data and the results of instrumental and functional diagnostic methods, including electrocardiography (ECG), echocardiography, Holter monitoring of ECG, stress echocardiography, and coronary angiography. Results: The study utilized the classification of gastric erosive lesions by K. Toljamo (2012), according to which in the main group, mature erosions subtype Ia were detected in 83.8% of cases, while immature extensive erosions subtype Ib were found in 16.2%. In combination with haemorrhagic erosions (type III), complete erosions were detected in 12.6% of cases, while with incomplete erosions of type II, they were found in 11.4%. The combination of complete erosions with erosive prepyloric changes (type IV) was identified in 8.7%. In the control group, gastric erosive lesions were mainly represented by type III (41%) and type IV (38.8%). Based on the analysis of endoscopic changes in the gastric mucosa using WLI, NBI, and ZOOM modes, the most characteristic visual changes were identified for each type and subtype of erosive gastric mucosa alterations. In patients with chronic heart failure II-III NYHA functional class, gastritis was noted in 75.1% of cases in the main group and in 58.5% in the control group. Helicobacter pylori infection of weak degree was determined in 40.5% in the main group and 37.7% in the control group. Evaluation of endoscopic pH-metry showed predominantly hypochlorhydria in both groups - 70.8% in the main group and 48.6% in the control group. Conclusion: By comparing the macroscopic features of various gastric erosive lesions in WLI, NBI, and ZOOM modes according to the classification by K. Toljamo (2012), the most characteristic signs for each type and subtype were identified. High prevalence of gastritis was established among patients with chronic heart failure II-III NYHA functional class.

Oxoborates of the ludwigite group: Natural and mineral-like compounds as prospective materials

Research subject. Natural oxoborates of the ludwigite group, including azoproite, ludwigite, and vonsenite. Their empirical formulas based on five oxygen atoms have the following form: azoproite (Mg1.81Fe2+0.19)∑2.00(Fe3+0.36Ti0.26Mg0.26Al0.12)∑1.00 O2(BO3), ludwigite (Mg1.69Fe2+0.30Mn2+0.01)Σ2.00(Fe3+0.90Al0.07Mg0.02Sn0.01)Σ1.00O2(BO3) and vonsenite (Fe2+1.86Mg0.13)∑1.99 (Fe3+0.92Mn2+0.05Sn4+0.02Al0.02)∑1.01O2(BO3). Aim. To establish the relationship between the composition, crystal structure, and thermal behavior (293–1373 K) of the minerals. Materials and methods. Ludwigite was collected at the Iten’yurginskoe tin skarn deposit; vonsenite was collected at the Titovskoe magnesium-skarn boron deposit; azoproite was collected at magnesian skarns of the Tazheran alkaline massif. The methods of single crystal X-ray diffraction, energy dispersive X-ray spectroscopy, high-temperature X-ray diffraction, Mössbauer spectroscopy, and thermal analysis were used. Results. Low-charge cations (Fe2+, Fe2.5+, Mg2+) tend to occupy the M(1)–M(3) sites, and high-charge cations (Fe3+, Al3+, Ti4+, Sn4+) generally occupy the M(4) site. Azoproite is characterized by the highest melting temperature Tm &gt; 1650 K. Due to the low Fe2+ content, azoproite does not undergo solid-phase decomposition across the investigated temperature range. The melting point of ludwigite exceeds 1582 K, which is due to the high Mg content; as a result of the Fe2+ → Fe3+ oxidation, it gradually decomposes with the formation of hematite, warwickite, and magnetite. The temperatures of oxidation and solid-phase decomposition in the Fe2+-rich vonsenite are approximately 100 K lower than those in ludwigite. The melting point of vonsenite is 1571 K. All the minerals are characterized by a weak degree of thermal expansion anisotropy. The main contribution to the thermal expansion anisotropy is due to the preferred orientation of the [BO3]3– triangles. Conclusions. The thermal properties of the oxoborates depend on their chemical composition. It was established that Tm increases with an increase in the Mg and Ti4+ content, and decreases with an increase in the Fe2+ content. The Fe2+ → Fe3+ oxidation is observed when the FeO component in the minerals exceeds 10 wt %, which leads to the solid-phase decomposition starting at temperatures of about 500–600 K. The values of the 293KαV volume thermal expansion of ludwigite and azoproite are comparable, while the largest values were observed for vonsenite. This is associated with the largest average bond lengths, primarily those of &lt;Fe2+–O&gt;6.

Assessment of Pain Severity and Grip Strength as the Most Accurate Predictors of the Outcome of Treatment of Distal Radial Fractures.

Distal radial fractures are common injuries, accounting for approximately 25% of fractures in the paediatric population and up to 18% of all fractures in the elderly age group. Assessment of treatment outcomes of these fractures includes objective measurements of wrist joint range of motion and grip strength as well as subjective parameters such as the intensity of perceived pain, hand function and quality of life. The recent years have ushered in a trend towards using several outcome measures for a more comprehensive evaluation of the results of the treatment. The objective of this study was to investigate whether the assessment of pain severity and grip strength is sufficiently accurate for correct assessment of the outcome of the treatment of distal radial fractures. One hundred and two patients, 79 women (77%) and 23 men (23%), at a mean age of 54 years with distal radial fractures were treated operatively. Treatment outcomes were assessed at 3 and 6 months by measurements of intensity of pain (according to a numerical rating scale, NRS), grip strength (with a dynamometer) and hand function with the DASH questionnaire. The results of these measurements were compared in order to investigate the strength of the possible correlation between variables. An analysis of the correlation between the variables of interest at 3 and 6 months' assessment showed statistically significant correlations (Spearman rank test, R=0,26-0,41; p&lt;0,01). The NRS correlated negatively with grip strength (less pain - greater strength) and positively with DASH scores (less pain - better hand function). The correlation between grip strength and the DASH was the strongest (Spearman rank test R=0,61; p&lt;0,001, showing that greater power of the hand indicated better function, whereas weaker grip indicated worse function. 1. The severity of pain and the degree of weakness of the hand show (independently of each other) a very good correlation with the comprehensive assessment of hand function using the DASH questionnaire. 2. It follows that pain severity and hand weakness are sufficient to reliably assess the outcome of the treatment of a distal radius fracture.

Features of Hemodynamics of Retinal Vessels in Hypermetropic and Myopic Defoci during Treatment with Orthokeratological Lenses

Conduct a study of the hemodynamics of retinal vessels in eyes with myopia with hypermetropic and myopic defocuses: 60 eyes (30 patients) with mild myopia and 100 eyes (50 patients) with moderate myopia were examined. The average age of the patients was 12.0±0.38 years. The average degree of myopia was — (−) 2.2±0.25 D with a mild degree; (−) 4.7±0.22 D at average; The control group consisted of 40 eyes (20 patients) with emmetropia, average age -13.0±0.27 years. Along with generally accepted research methods, the following were carried out: autorefractometry, ophthalmometry, biometry, keratotopography, binocular ophthalmoscopy, OST of the optic disc and macula, OST-A with calimetry, ultrasound of the vessels of the central nervous system and central veins. All patients were fitted with orthokeratological lenses of reverse geometry Moonlens from Sky Optix, with repeated examinations after 1-3-6-12-24 months. With a weak degree of myopia, a narrowing of the caliber of the vessels of the central nervous system was revealed to 71.0±0.60 µm in 14.8% with hypermetropic defocus, with the absence of narrowing of these vessels with myopic defocus. With an average degree of myopia, narrowing of the vessels of the central nervous system to 66.1±0.60 μm was detected in 55% (55 eyes) with hypermetropic defocus, versus 35.8% (36 eyes) with the caliber of the vessels of the central nervous system — 68.6±0.57 μm (P &lt;0.05). Along with this, in patients with an average degree of myopia, a narrowing of the vessels of the central vein with hypermetropic defocus was found to 93.1±0.59 μm in 72.7% (73 eyes), versus 56.4% (56 eyes) with myopic defocus. In both groups, normalization of LBF in the central vascular system to 5.8±0.59 cm/sec and 5.3±0.63 cm/sec with myopic defocus was revealed, and LBF in the central vein to 15.3±0.64 cm/sec. sec with average degree of myopia (P &lt;0.05). In both groups, an increase in the resistivity coefficient (RI) was found to 0.85±0.54 (P &lt;0.01). Conducted studies of OCT-A with calimetry of the vessels of the central nervous system and central nervous system in moderate myopia revealed a significant decrease in the frequency of vasoconstriction in myopic defocus. When examining vessels using ultrasound, a significant normalization of LBF in the central nervous system and central veins was revealed, with myopic defocus with mild and moderate myopia during treatment with orthokeratological lenses. Accordingly, the state of eye hemodynamics may be one of the factors in the effectiveness of treating myopia with orthokeratological lenses.

The effect of myofascial techniques on the electrical activity of the neck muscles

Introduction. Research by foreign scientists often present the results of studies of the effects of specific osteopathic techniques on the body. Myofascial techniques are dynamic low-amplitude techniques in which the myofascial complex of tissues is rhythmically stretched in areas where their mobility is limited. In one study of paravertebral muscles using surface electromyography (sEMG) before and after myofascial techniques, a statistically significant (p&lt;0,05) decrease in their electrical activity was obtained. No publications devoted to the study of the effect of myofascial techniques on the electrical activity of the neck muscles were found.The aim is to study the effect of myofascial techniques on the electrical activity of the neck muscles in individuals with increased tone of these muscles.Materials and methods. A prospective study was conducted in the Department of Osteopathy of Mechnikov North-West State Medical University in which 30 apparently healthy volunteers who did not present active complaints, aged from 23 to 35 years, took part, with a median of 25 years. Inclusion criteria were palpation-determined increased tone of the sternocleidomastoid and upper trapezius muscles. Non-inclusion criteria were the presence of diseases and/or conditions that are an absolute contraindication to osteopathic correction, a history of neck injuries; taking medications that affect muscle tone at the time of the study; neuromuscular diseases. At the beginning of the study, all volunteers underwent palpation of the upper trapezius and sternocleidomastoid muscles on both sides. The degree of increase in muscle tone was assessed in points: 1 — weak; 2 — medium; 3 — strong; 0 — normal tone. Next, they underwent myofascial mobilization techniques: longitudinal and unilateral lateral mobilization of the soft tissues of the neck, separate mobilization of the sternocleidomastoid muscles. Before, immediately after, and three days after the session, muscle tone was recorded using surface electromyography (sEMG), which was performed on a wireless monitoring complex for electrophysiological signals «Kolibri» (OOO NMF «Neurotech», Russia). At rest, the average and maximum amplitude of electrical activity of the sternocleidomastoid and upper trapezius muscles was measured. The recording was made synchronously from the right and left sides of the body.Results. The sEMG indices of muscles with different tone based on the results of subjective assessment were statistically highly significant (p=0,0001). Moreover, according to the A(avg) indicator, the range diagrams either did not intersect or intersected only slightly. The electrical activity of the sternocleidomastoid muscles after myofascial mobilization techniques decreased statistically significantly and remained at the same level for 3 days (p=0,01). Such dynamics were observed in both the average and maximum amplitude of electrical activity. The amplitude of electrical activity of the right sternocleidomastoid muscle was slightly greater than that of the left (all subjects were right-handed), but these differences did not reach statistical significance (p&gt;0,05). After treatment, there was a trend towards a decrease in the asymmetry of electrical activity between the left and right sternocleidomastoid muscles, both middle and maximum, but these changes were not statistically significant (p&gt;0,05). The electrical activity of the upper part of the right trapezius muscle decreased statistically significantly after treatment and remained at this level for 3 days (p=0,01). The left trapezius muscle was excluded from the study due to technical reasons.Conclusion. The study showed that osteopaths (who are completing residency training in osteopathy) palpably distinguish between normal muscle tone and its increase in weak and moderate degrees. One session of myofascial mobilization techniques leads to a decrease in the tone of the sternocleidomastoid muscles and the upper part of the right trapezius muscle according to sEMG. Such changes occur immediately after the session and then persist for at least three days in young people with increased tone of these muscles. Surface electromyography can be used to objectively record and measure the results of specific osteopathic techniques. This is important for increasing the evidence of clinical research in osteopathy.

Оценка промышленной газоносности Ямальской и Гыданской нефтегазоносной области

In accordance with the strategic planning documents of the Russian gas industry, the development of the Yamal and Gydan oil and gas bearing regions is one of the priority tasks, as they are associated with the formation of a strategic reserve of gas resources and the creation of new gas production centers. The article analyses the spatial distribution of natural gas reserves in the oil and gas bearing areas of the Arctic region and concludes that the distribution of free gas resources is uneven both by section and by area. Some oil and gas bearing areas are characterized by a weak degree of geological and geophysical study. Depletion of the base fields in the Pur-Taz and Nadym-Pur oil and gas bearing areas raises the question of shifting the raw material base of the gas industry to the hard-to-reach areas of Yamal and Gydan, including the waters of the Kara Sea, the Ob, Taz and Gydan Bays. The paper provides a quantitative assessment of the level of commercial gas content of the Yamal and Gydan oil and gas bearing areas, including in the context of oil and gas bearing regions. It was determined that based on the technology of field development, processing and transportation scheme when assessing the prospects of development and options for monetization of gas resources, a zone of pipeline transport and a zone of liquefied natural gas are distinguished. Taking into account the current economic conjuncture of Arctic natural gas reserves development, it is reasonable and promising at this point in time to expand the resource base by developing satellite fields in Yamal and Gydan oil and gas bearing regions, which already have developed production, processing, transport and social infrastructure, as well as through additional exploration of discovered and developed fields and deposits.

The high price of green energy: Adjustments in general equilibrium

&lt;p style="text-align:justify"&gt;&lt;span style="font-size:16px"&gt;&lt;span style="font-family:Times New Roman,Times,serif"&gt;&lt;span dir="ltr" lang="EN-US"&gt;&lt;span style="color:black"&gt;The high price of energy due to green energy policy will cause adjustments across the US economy predicted in the present general equilibrium model that includes energy Btu input with capital and labor to produce manufactures and services.&amp;nbsp; This same model in trade theory examines the effects of a tariff on an imported factor of production such as a natural resource or capital.&amp;nbsp; Corresponding error correction estimates of the reduced form equations of the model in annual 1970-2018 data prove robust and suggest model modifications.&amp;nbsp; A parametric approach to noncompetitive pricing based on unit cost diminishing with output brings the model much closer to the estimates.&amp;nbsp; Manufactures are revealed to have a higher degree of noncompetitive pricing than services.&amp;nbsp; Assuming constant elasticity of substitution production, a weak degree is revealed to provide the best fit to the error correction estimates.&amp;nbsp; The high price of green energy will cause an inelastic decrease in energy input resulting in increased energy revenue.&amp;nbsp; Outputs of both sectors fall, more in manufactures due to its energy intensity.&amp;nbsp; The capital return and wage also fall given the weak substitution of capital and labor relative to the price of energy.&amp;nbsp; The wage rises slightly in the model but falls considerably in the error correction estimate.&amp;nbsp; The only clear winner is energy input with increased revenue.&amp;nbsp; The government owns a large share of hydrocarbon reserves and will benefit from a higher price of energy.&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;

A clinical review of hand manifestations of cervical myelopathy, cervical radiculopathy, radial, ulnar, and median nerve neuropathies.

Cervical spondylotic myelopathy (CSM) is defined as compression of the spinal cord in the neck, resulting in problems with fine motor skills, hand numbness, pain or stiffness of the neck, and difficulty walking due to loss of balance. Brachial plexus (BP) neuropathies arise due to compression to any distal branches arising from C5-T1, whereas cervical radiculopathy involves compression at the nerve root in the neck. Such conditions can present with variable degrees of musculoskeletal pain, weakness, sensory changes, and reflex changes. The pronounced convergence in symptomatic manifestation within these conditions can pose a formidable challenge to clinicians, particularly in primary care. Thus, the primary objective of this paper is to enhance clarity and distinction among these pathological conditions. This objective is pursued through comprehensive delineation of the dermatomal and myotomal distributions characteristic of each condition. Furthermore, a meticulous examination is undertaken to elucidate physical indicators and maneuvers that exhibit a notably high sensitivity in detecting these conditions. Accurate diagnosis and treatment of each nerve pathology is important as long-term spinal cord compression and its roots may result in permanent disability and severely impact one's quality of life. As such, this systematic review serves as a guide that aids clinicians in differentiating the aforementioned conditions based on anatomy, physical exam findings, and imaging studies. Furthermore, this study aims to outline common peripheral nerve neuropathies in the upper extremities and ways to mitigate these pathologies using the least to most invasive treatment modalities.

Changes in filtration and capacitance properties of highly porous reservoir in underground gas storage: CT-based and geomechanical modeling

The paper presents the results of comprehensive studies of filtration and capacitance properties of highly porous reservoir rocks of the aquifer of an underground gas storage facility. The geomechanical part of the research included studying the dependence of rock permeability on the stress-strain state in the vicinity of the wells, and physical modeling of the implementation of the method of increasing the permeability of the wellbore zone - the method of directional unloading of the reservoir. The digital part of the research included computed tomography (CT)-based computer analysis of the internal structure, pore space characteristics, and filtration properties before and after the tests. According to the results of physical modeling of deformation and filtration processes, it is found that the permeability of rocks before fracture depends on the stress-strain state insignificantly, and this influence is reversible. However, when downhole pressure reaches 7-8 MPa, macrocracks in the rock begin to grow, accompanied by irreversible permeability increase. Porosity, geodesic tortuosity and permeability values were obtained based on digital studies and numerical modeling. A weak degree of transversal anisotropy of the filtration properties of rocks was detected. Based on the analysis of pore size distribution, pressure field and flow velocities, high homogeneity and connectivity of the rock pore space is shown. The absence of pronounced changes in pore space characteristics and pore permeability after non-uniform triaxial loading rocks was shown. On the basis of geometrical analysis of pore space, the reasons for weak permeability anisotropy were identified. The filtration-capacitance properties obtained from the digital analysis showed very good agreement with the results of field and laboratory measurements. The physical modeling has confirmed the efficiency of application of the directional unloading method for the reservoir under study. The necessary parameters of its application were calculated: bottomhole geometry, stage of operation, stresses and pressure drawdown value.

Diverse Cardiac Phenotype of Becker Muscular Dystrophy: Under-Recognized Subclinical Cardiomyopathy Due to Partial Dystrophin Deficiency in a Contemporary Era.

Becker muscular dystrophy (BMD) is an X-linked recessive disorder responsible for mild skeletal muscle involvement and variable degree of cardiomyopathy. The characteristics of cardiac phenotype of BMD in childhood remain elusive. Clinical manifestations, genotype, serum biomarkers, and echocardiogram were retrospectively reviewed in BMD patients. Cardiac phenotype was classified into acute progressive (AP), chronic persistent (CP), and latent (L) groups based upon symptoms and echocardiographic findings. Twenty-five BMD patients were studied over 9.5 ± 2.5years. Sixteen patients presented initially with variable degree of muscle weakness whereas 9 were asymptomatic. Three patients developed medically refractory heart failure by age 18 with progressive dilated cardiomyopathy (DCM) (AP). Six patients developed mild to moderate left ventricular (LV) systolic dysfunction with LV dilatation but remained asymptomatic (CP). Although 16 patients continued to show normal LV function (L), they demonstrated variable degrees of skeletal muscle involvement. The AP groups presented with significantly larger LV size and LV mass index (LVMI) at the initial encounter than groups CP or L, suggesting early myocardial remodeling predicts rapid disease progression. None presented with atrophic myocardial phenotype commonly observed in Duchenne muscular dystrophy (DMD). Wide availability of genetic testing has changed the scope of clinical presentation of BMD. Cardiomyopathy in BMD presents with a diverse clinical spectrum with variable progression of DCM where larger LV dimension and mass at the time of diagnosis may predict the progressiveness of cardiomyopathy.

African agency in ICT infrastructure provider choice: Navigating access to foreign finance and technology

After nearly three decades of “ICT for development”, the rollout of ICT backbone infrastructure remains challenging throughout Africa. African states do not only depend on the technology of foreign companies but must also seek external finance to pay for it. This dual dependency puts African governments in a vulnerable position, leading us to inquire: to what extent does the dual dependency on foreign finance and technology affect African agency in ICT infrastructure provider choice? The paper proposes a model that distinguishes between the agency of higher and lower income countries. Elaborating on the latter, the model assumes that the source of foreign ICT-related finance (i.e., China, World Bank, both, internal) determines whether the recipient state can exercise a weak, medium, or strong degree of agency in its ICT infrastructure provider choice. The paper further argues that the link between foreign finance and degree of agency is shaped by the digital development agenda of the donor. For instance, the model predicts that countries which predominantly received Chinese ICT finance possess weak agency when choosing an ICT infrastructure provider because China's digital development agenda ties the provision of finance to hiring a Chinese contractor. By examining the ICT-related financial inflows and geographical distribution of network equipment providers in African states, the paper shows that the source of finance affects the degree of agency and, subsequently, the choice of ICT infrastructure provider. However, the analysis also suggests a divide in African agency along former colonial lines. In fact, the model holds only for countries without colonial ties to France whereas former French colonies all contracted Huawei, regardless of ICT finance flows.