Subgroup characteristics in care workers with low back pain: cluster analysis-based severity of central sensitivity syndromes and low back pain.

PURPOSE: This multicentre, collaborative, cross-sectional study aimed to explore the characteristics of subgroups based on central sensitivity syndromes (CSSs) and low back pain (LBP) severity. Furthermore, we investigated the relationship between the classified subgroups and work status among the care workers. PATIENTS AND METHODS: In 660 care workers, we assessed LBP intensity, pain duration, pain sites, CSS (using the central sensitization inventory-9), psychological factors (using the pain catastrophizing scale and pain self-efficacy questionnaire), and work status (interference, amount of assistance, frequency of assistance, and work environment). We used hierarchical clustering analysis to divide the participants into subgroups based on CSS and LBP severity. We further performed multiple comparison analyzes and adjusted the residuals (chi-square test) to reveal differences between clusters. RESULTS: Care workers with LBP were divided into four subgroups (Cluster 1: no CSS and mild LBP, Cluster 2: mild CSS and severe LBP, Cluster 3: mild CSS and mild LBP, Cluster 4: severe CSS and moderate LBP). Cluster 4 tended to have a higher number of pain sites, severe pain catastrophizing, and poor pain self-efficacy. In addition, Cluster 4 showed a higher frequency of assistance and an inadequate working environment and equipment. By contrast, Cluster 2 tended to have low pain self-efficacy. In addition, Cluster 2 experienced the highest work-related interference compared with any of the subgroups. CONCLUSION: Our findings suggested that the severe LBP and severe CSS subgroups had common and different characteristics concerning psychological factors and work status, including interference with work. Our results may help to improve the management of care workers with LBP.

Associations of Central Sensitization-Related Symptoms with Low Back Pain-Related Factors and Work Status in Caregivers.

Low back pain (LBP) is associated with psychological factors and central sensitization-related symptoms (CSSs). The relationship between CSSs, LBP-related factors, and work status in caregivers remain unclear. This multicentre, collaborative, cross-sectional study aimed to determine the association between CSS severity, LBP-related factors, and work status in caregivers with LBP. We measured LBP intensity, pain duration, pain sites, CSSs (using the Central Sensitization Inventory-9: CSI-9), psychological factors (using the Pain Catastrophizing and Pain Self-Efficacy scales), and work status (interference, amount of assistance, frequency of assistance, and work environment) in 660 caregivers. CSS severity was categorised as no (CSI-9:0−9), mild (CSI-9:10−19), or moderate/severe (CSI-9:20−36). We further performed multiple comparison analyses and adjusted the residual chi-square to reveal differences between CSS severity groups. Caregivers with more severe CSSs tended to exhibit worse LBP intensity (p < 0.01), widespread pain (p < 0.01), catastrophic thinking (p < 0.01), and pain self-efficacy (p < 0.01), and they also tended to experience work interference (p < 0.01). Caregivers without CSSs tended to receive a smaller amount of assistance with a lower frequency (p < 0.05). The number of participants with an adequate environment and equipment was significantly less in the moderate/severe CSS group (p < 0.01). Thus, our findings may suggest that CSS severity is associated with LBP intensity, widespread pain, psychological factors, and work status in caregivers.

Wettability Difference Induced Out-of-Plane Unidirectional Droplet Transport for Efficient Fog Harvesting.

Securing freshwater resources is a global issue for ensuring sustainable development. Fog harvesting is attracting great attention as a method to collect water without any energy input. Previous reports that were inspired by insects and plants have given insights such as the effectiveness of in-plane wettability and structural differences for droplet transport, which might enhance artificial water harvesting efficiency. However, further efforts to transfer droplets while maintaining performance are needed because droplet motion owing to these effects is limited to the in-plane direction. In this study, we report droplet transport between three-dimensional copper wire structures with nanostructured hydrophobic and superhydrophilic features. This mechanism enhanced the fog harvesting capability by more than 20% compared with the cumulative value of individual wires. In addition, the relationship between the droplet height and spacing of wires affected the performance. Our results show the importance of out-of-plane directional droplet transport from the wire surface assisted by differences in wire wettability, which minimizes limiting factors of fog harvesting including clogging and droplet shedding. Furthermore, the proposed arrangement reduces the overall system width compared with that of a two-dimensional arrangement while maintaining the amount of harvested water. These results provide a promising approach to designing large-scale and highly efficient fog harvesters.

Pitfalls in which otolaryngologists often are caught in the diagnosis and treatment of vertigo.

We have been clinically treating vertigo patients for the last 45 years. As is well-known, vertigo is not a simple otolaryngological disease. In fact, it is associated with various diseases in various clinical fields, including internal medicine, neurosurgery, and ophthalmology. As otolaryngologists, we have learned a few lessons from our experiences with patients having vertigo and in working with other otolaryngologists. Here, we discuss and share pitfalls in which otolaryngologists often are caught in diagnosing and treating vertigo.

Motion sickness: its pathophysiology and treatment.

The pathogenesis of motion sickness includes both inner-ear stimulation by body movement, especially a Coriolis-type stimulus, and optokinetic stimulation due to the shift of the surrounding visual fields. According to Kornhuber, Sakata and others, the vestibular cerebellum also participates in an important way. We conducted this study to elucidate the influence of the vestibular cerebellum on the development of motion sickness. We initially focused attention on the visual suppression test of Takemori et al. as a test for vestibular cerebellar function. We reported a modification of this test, described as postrotatoric nystagmus. We employed this test as a rotatoric visual suppression test using milder stimulus for patients complaining of motion sickness. The pathogenesis and treatment of motion sickness are also discussed.

Persistent continuous dizziness: pathophysiology and treatment.

Persistent blurred vision and oscillopsia have a negative impact on quality of life, and the burden of these symptoms is more severe than that of rotationally vertiginous attack. We doctors should take patients' pain as our own and treat them accordingly. However, because these cases are rather rare in daily clinical experience, in reality we tend to treat these patients as neurosis cases and send the patients home without providing adequate care. We conducted a retrospective study involving 182 recently treated clinical cases and found that "jumbling of objects," which is thought to be caused by bilateral peripheral vestibular lesions, was more often observed in patients with central vestibular lesions. We named this the pseudo-Dandy phenomenon. In this study, we discuss the pathophysiology and treatment of this pseudo-Dandy phenomenon.