The effectiveness of different aerobic exercises to improve pain intensity and disability in chronic low back pain patients: a systematic review.

Background: Physical activity, including aerobic exercise, is highly recommended for chronic low back pain (CLBP) patients to improve pain intensity and functional disability. Objectives: To assess the effectiveness of different aerobic exercises to reduce pain intensity and functional disability in patients with CLBP. Methods: A computer-aided search was performed to find Randomised Controlled Trials (RCTs) that evaluated the effectiveness of different aerobic exercises in CLBP. Articles published between January 2007 to December 2020 were included in the review. Quality assessment using the PEDro scale, extraction of relevant information, and evaluation of outcomes were done by two reviewers independently. Results: A total of 17 studies were included that involved 1146 participants. Outcomes suggested that aerobic exercise combined with other interventions was more effective than aerobic exercise alone. Aerobic exercise with higher frequency (≥ 5 days/week) and longer duration (≥ 12 weeks) were effective to gain clinically significant (≥ 30%) improvements. Environment and using pedometer did not seem to influence the outcomes. Conclusions: Pain intensity and functional disability in CLBP patients can be minimized by prescribing aerobic exercise. However, to get better improvements, aerobic exercise should be done in combination with other interventions and at optimum frequency and duration. Further studies should emphasize examining the optimal doses and duration of different aerobic exercises.

Smart Self-Sensing Composite: Piezoelectric and Magnetostrictive FEA Modeling and Experimental Characterization Using Wireless Detection Systems.

This research work focuses on the development of a piezoelectric magnetostrictive smart composite with advanced sensing capability. The composite piezoelectric property is achieved from the dispersion of single-walled carbon nanotubes (SWCNTs) and the magnetostrictive property from Terfenol-D nanoparticles. Finite element analysis (FEA) is used to examine the feasibility of modelling the piezoelectric (change in electric field) and magnetostrictive (change in magnetic field) self-sensing responses in the presence of applied stress. The numerical work was coupled with a series of mechanical tests to characterize the piezoelectric response, magnetostriction response and mechanical strength. Tensile tests of the composite samples manufactured as is (virgin), samples with SWCNTs, samples with Terfenol-D nanoparticles and samples with both SWCNTs and Terfenol-D nanoparticles were conducted. It was observed that an increase in volume fraction of Terfenol-d nanoparticles increases the change in magnetization, therefore increasing voltage response up to the point of saturation. The optimum change in amplitude was observed with 0.35% volume fraction of Terfenol-D nanoparticles. A constant ratio of SWCNTs was maintained, and maximum change in electrical resistance was at 7.4%. Fracture toughness for the samples with all nanoparticles was explored, and the results showed improved resistance to crack propagation.

Correlation between valvular interstitial cell morphology and phenotypes: A novel way to detect activation.

Valvular interstitial cells (VICs) constitute the major cell population in heart valves. Quiescent fibroblastic VICs are seen in adult healthy valves. They become activated myofibroblastic VICs during development, in diseased valves and in vitro. 2D substrate stiffness within a 5-15 kPa range along with high passage numbers promote VIC activation in vitro. In this study, we characterize VIC quiescence and activation across a 1-21 kPa range of substrate stiffness and passages. We define a cell morphology characterization system for VICs as they transform. We hypothesize that VICs show distinct morphological characteristics in different activation states and the morphology distribution varies with substrate stiffness and passage number. Four VIC morphologies - tailed, spindle, rhomboid and triangle - account for the majority of VIC in this study. Using α-smooth muscle actin (α-SMA), non-muscle myosin heavy chain B (SMemb) and transforming growth factor ß (TGF-ß) as activation markers for validation, we developed a system where we categorize morphology distribution of VIC cultures, to be potentially used as a non-destructive detection method of activation state. We also show that this system can be used to force stiffness-induced deactivation. The reversibility in VIC activation has important implications in in vitro research and tissue engineering.

Enigma of recurrent strokes with literature review.

Metastatic tumors are the most common tumors affecting the heart. Primary tumors are rare, with myxomas being the most common of the primary cardiac tumors. The incidence of primary cardiac tumors is 0.02%, about 200 cases has been reported in 1 million autopsies. Most of primary cardiac tumors have been detected incidentally on diagnostic modalities: computed tomography (CT), cardiac magnetic resonance imaging (MRI), or echocardiography. Majority of primary-origin cardiac tumors are benign, of which the most common type of primary tumor is cardiac myxoma. Fibroelastoma is a rare benign tumor and the 2nd most common cause of primary cardiac tumors. In the past fibroelastoma has been detected on autopsy findings. With the development of more advanced imaging modalities fibroelastoma is more frequently detected as a cause of stroke, myocardial infarction (MI), angina episodes, and systemic embolization. Echocardiogram is the best diagnostic modality to diagnose primary cardiac tumors although transthoracic echocardiogram (TTE) can miss primary cardiac tumors; transesophageal echocardiography (TEE) has been more labeled more accurate in the diagnosis of primary cardiac tumors. We present here a case of a 21-year-old male with the history of multiple strokes secondary to cardiac papillary fibroelastoma (CPF).