Safe suprapancreatic lymph node dissection for gastric cancer with ectopic common hepatic artery.

Suprapancreatic lymph node dissection for patients with gastric cancer in whom the common hepatic artery is located neither at the suprapancreatic margin nor in front of the portal vein is a more difficult procedure than when the common hepatic artery is in a more typical position. There is an increased risk of injury to the vessels that need to be preserved and inadequate lymph node dissection. Measures that have been reported for use in this situation are preoperative diagnosis with three-dimensional computed tomography angiography, dissection using the portal vain as a guide, and safe exposure of the portal vein with dissection to preserve the nerves at the suprapancreatic margin and in front of the portal vein. We review the literature and report our experience with a patient whose common hepatic artery was not located in the suprapancreatic margin who safely underwent suprapancreatic lymph node dissection using these methods.

Preliminary study on the acute effects of hydrogen sulfide on Amphipoda (Lysianassoidea; Pseudorchomene sp. and Anonyx sp.) collected from deep-sea floors in the Sea of Japan.

To study the environmental impact of the assessment technologies for the development of shallow methane hydrate zones in the Sea of Japan, deep-sea amphipods (Pseudorchomene sp. and Anonyx sp.) were collected from a depth of approximately 1000 m and were tested for H2S toxicity. At 0.57 mg L-1 H2S, all specimens of Pseudorchomene sp. were dead after 96 h, whereas all individuals survived at 0.18 mg L-1. Moreover, Anonyx sp. had a survival rate of 17 % after 96 h at 0.24 mg L-1. A similar toxicity test was conducted with the coastal amphipod Merita sp., a detritivore, and all individuals died within 24 h at 0.15 mg L-1. These results suggested that compared with coastal detritivorous amphipods, deep-sea detritivorous amphipods, which also live near biomats with sediment H2S concentrations exceeding 10 mg L-1, showed a higher tolerance to H2S.

Visible-Light-Driven Silyl or Germyl Radical Generation via Si-C or Ge-C Bond Homolysis.

We report a simple, rapid, and selective protocol for visible-light-driven generation of silyl radicals through photoredox-induced Si-C bond homolysis. Irradiating 3-silyl-1,4-cyclohexadienes with blue light in the presence of a commercially available photocatalyst smoothly generated silyl radicals bearing various substituents within 1 h, and these radicals were trapped by a broad range of alkenes to afford products in good yields. This process is also available for efficient generation of germyl radicals.

Application of post-column reaction gas chromatography with a single reference gas for offshore air and gas seeped from the seafloor samples.

Ambient air commonly contains carbon dioxide at concentrations greater than 400 µmol mol-1 and methane at ~ 2000 nmol mol-1; non-methane hydrocarbons are also widespread in the atmosphere at much lower concentrations. For quantification of various carbon-containing compounds in typical analytical instrument, corresponding number of reference materials are required. Therefore, the development of a method that uses a single reference material applicable to air monitoring is desired. Here, we examined a post-column reaction system combined with a gas chromatograph equipped with a flame ionization detector (FID), which involves oxidation and reduction processes after separation. To determine various carbon-containing gases by post-column reaction gas chromatography with FID (GC-r-FID) using a single reference, it is necessary to confirm a good linearity of the response with carbon concentrations originating from various carbon-containing gases. When mixtures of carbon-containing gases at three different concentrations and the calibration curve of the FID response with the concentration converted into methane were used, a single linear calibration curve (correlation coefficient > 0.9999, 18 points) was obtained over four orders of magnitudes (to ~ 5000 µmol mol-1 as methane). The applicability of GC-r-FID was confirmed by determining carbon-containing gases in air and gas seeped from the seafloor samples. Because the results were comparable to those obtained by conventional GC-FID and GC-thermal conductivity detector, typically GC-r-FID with a single reference gas should be suitable for air monitoring.

Success rate of anterior shoulder dislocation reduction by emergency physicians: a retrospective cohort study.

Aim: Emergency physicians (EPs) often treat anterior shoulder dislocation, but epidemiology of anterior shoulder dislocation in the emergency department of Japan remains unclear. In this study, we clarified the success rate of anterior shoulder reduction performed by EPs. Methods: This single-center cohort study included patients with anterior shoulder dislocation for whom the EP performed initial reduction. The period was from January 2006 to March 2021 and we used the electronic medical record data of the tertiary care hospital. Our primary outcome was the success rate of the shoulder reduction performed by EP. The secondary outcome was to compare the success of reduction with the failure of the reduction. Results: In total, 293 eligible patients were identified. Of these patients, 244 were included in this study. The success rate of the shoulder reduction performed by EP was 92.2% (225/244). EPs failed in successfully performing reduction in 19 (7.8%) cases of anterior shoulder dislocations. The failure group was older (P = 0.017), had a higher frequency of fall down in the mechanism of dislocation (P = 0.019), used intravenous analgesics more frequently (P = 0.004), used peripheral nerve blocks more frequently (P = 0.006), and had fewer patients who did not use drugs (P = 0.002). We could not perform statical adjustment because the sample size was small. Conclusion: The success rate of the shoulder reduction performed by EPs was 92.2%. Older age might be associated with failure of shoulder reduction.

Trunk muscle activation patterns during active hip abduction test during remission from recurrent low back pain: an observational study.

BACKGROUND: The active hip abduction test (AHAbd) is widely used to evaluate lumbopelvic stability, but the onset of trunk muscle activation during the test in individuals with recurrent low back pain (rLBP) has not been investigated so far. It is important to investigate the pattern of trunk muscle activation during the AHAbd test to provide insight into the interpretation of observation-based assessment results; this may help to create exercise therapy interventions, from a movement control perspective, for people seeking treatment for rLBP. The purpose of this study was to compare the timing of trunk muscle activation between individuals with and without rLBP and to assess potential differences. METHODS: Seventeen subjects in remission from rLBP and 17 subjects without rLBP were recruited. We performed surface electromyography of the transversus abdominis/internal abdominal oblique, external oblique, erector spinae, and gluteus medius muscles during the AHAbd test on both sides. The onset of trunk muscle activation was calculated relative to the prime mover gluteus medius. The independent-samples t- and Mann-Whitney U tests were used to compare the onset of trunk muscle activation between the two groups. RESULTS: The onset of transversus abdominis/internal abdominal oblique activation on the ipsilateral (right AHAbd: -3.0 ± 16.2 vs. 36.3 ± 20.0 msec, left AHAbd: -7.2 ± 18.6 vs. 29.6 ± 44.3 ms) and contralateral sides (right AHAbd: -11.5 ± 13.9 vs. 24.4 ± 32.3 ms, left AHAbd: -10.1 ± 12.5 vs. 23.3 ± 17.2 ms) and erector spinae on the contralateral side (right AHAbd: 76.1 ± 84.9 vs. 183.9 ± 114.6 ms, left AHAbd: 60.7 ± 70.5 vs. 133.9 ± 98.6 ms) occurred significantly later in individuals with rLBP than in individuals without rLBP (p < 0.01). During the left AHAbd test, the ipsilateral erector spinae was also activated significantly later in individuals with rLBP than in individuals without rLBP (71.1 ± 80.1 vs. 163.8 ± 120.1 ms, p < 0.05). No significant difference was observed in the onset of the external oblique activation on the right and left AHAbd tests (p > 0.05). CONCLUSIONS: Our results suggest that individuals with rLBP possess a trunk muscle activation pattern that is different from that of individuals without rLBP. These findings provide an insight into the underlying muscle activation patterns during the AHAbd test for people with rLBP and may support aggressive early intervention for neuromuscular control.

Blunt adrenal gland injury: The impact of extra-abdominal injury.

BACKGROUND: Blunt adrenal gland injuries are considered uncommon. Moreover, the factors associated with the mechanisms of the injury following blunt trauma are unclear. In this study, we determined the factors associated with blunt adrenal gland injury (BAGI). MATERIALS AND METHODS: A total of 315 patients with blunt abdominal trauma were admitted to our institution during a 12-year period. After excluding 26 patients who were under 18 years old and 27 patients who were in cardiopulmonary arrest on arrival, 262 eligible patients were retrospectively reviewed. Patient characteristics, mechanism of injury, intervention, and associated organ injuries were compared between those with and without BAGI. RESULTS: Blunt adrenal gland injury was identified in 38 of 262 patients (14.5%). The right side was the predominant site of injury (68%). There were no differences in vital sign, in-hospital mortality, intervention, and concomitant abdominal organ injuries between those with and without adrenal gland injury. Patients with BAGI had a higher frequency of fall and motorcycle collision as mechanisms of injury. In addition, patients with BAGI had a higher injury severity score and a higher frequency of concomitant severe head, chest, and pelvic injuries. CONCLUSION: The results of the present study suggest that the deceleration injury leading to concomitant head, chest, or pelvic injuries with blunt abdominal trauma may be associated with the mechanism of BAGI. LEVEL OF EVIDENCE: Prognostic study, level IV.

Transverse Transport in Two-Dimensional Relativistic Systems with Nontrivial Spin Textures.

Using multiple scattering theory, we show that the generally accepted expression of transverse resistivity in magnetic systems that host skyrmions, given by the linear superposition of the ordinary, the anomalous, and the topological Hall effect, is incomplete and must be amended by an additional term, the "noncollinear" Hall effect (NHE). Its angular form is determined by the magnetic texture, the spin-orbit field of the electrons, and the underlying crystal structure, allowing us to disentangle the NHE from the various other Hall contributions. Its magnitude is proportional to the spin-orbit interaction strength. The NHE is an essential term required for decoding two- and three-dimensional spin textures from transport experiments.

Absence of calvarial fracture could predict the need for tracheostomy in traumatic brain injury.

AIM: Tracheostomy is a common procedure for intubated patients with traumatic brain injury (TBI) in the intensive care unit (ICU) but optimal timing and the predictors of tracheostomy are still unclear. The aim of our study was to explore whether the traumatic variables of head injury predict the need for tracheostomy in intubated TBI patients. METHODS: A single-center, retrospective observational study including a series of TBI patients admitted to Fukui Prefectural Hospital from April 1, 2004 to March 31, 2020 was carried out. Our primary outcome was tracheostomy. Patients with TBI who were intubated and admitted into the ICU within 24 h after injury were enrolled. Exclusion criteria were age less than 18 years, pregnancy, mortality within 24 h, post-cardiac arrest syndrome, and patients for whom life-sustaining interventions were withheld. Radiologic images were also reviewed and the morphology of the head injury was categorized. RESULTS: Seventy-six patients were included. Forty-six patients (60.5%) underwent tracheostomy and 30 patients (39.5%) were successfully extubated. Calvarial fracture (odds ratio [OR] 0.34; 95% confidence interval [CI], 0.13-0.88; P = 0.03), Injury Severity Score (OR 1.07; 95% CI, 1.00-1.15; P = 0.04), and Glasgow Comas Scale score (OR 0.84; 95% CI, 0.73-0.96) were statistically significant in the univariable analysis. Multivariate logistic regression identified calvarial fracture as an independent predictor for tracheostomy. The model involving calvarial fracture, Injury Severity Score ≥16, and Glasgow Coma Scale score ≤8 showed the area under the receiver operating characteristic curve for the model was 0.737 (95% CI, 0.629-0.846). CONCLUSIONS: The absence of calvarial fracture could predict the necessity for tracheostomy in intubated TBI patients when combined with other factors. Further prospective randomized trials are necessary to confirm the findings.

Long-term ocean acidification trends in coastal waters around Japan.

This study examines long-term ocean pH data to evaluate ocean acidification (OA) trends at two coastal research institutions located on the Sea of Japan and the Pacific Ocean. These laboratories are located away from the influences of large rivers and major industrial activity. Measurements were performed daily for the past 30 years (1980s-2010s). The average annual ocean pH for both sites showed generally negative trends. These trends were - 0.0032 and - 0.0068 year-1 (p < 0.001) at the Sea of Japan and Pacific Ocean sites, respectively. The trends were superimposed onto approximately 10-year oscillations, which appear to synchronize with the ocean current periodicity. At the Sea of Japan site, the ocean pH in the summer was higher, and the rate of OA was higher than during other seasons. Our results suggest that seasonality and ocean currents influence OA in the coastal areas of open oceans and can affect the coastal regions of marginal seas.

The dual pocket binding novel tankyrase inhibitor K-476 enhances the efficacy of immune checkpoint inhibitor by attracting CD8+ T cells to tumors.

The Wnt/ß-catenin pathway, which is associated with disease progression, is activated in many cancers. Tankyrase (TNKS) has received attention as a target molecule for Wnt/ß-catenin pathway inhibition. We identified K-476, a novel TNKS inhibitor, a dual pocket binder that binds to both the nicotinamide and ADP-ribose pockets. In a human colon cancer cell line, K-476 specifically and potently inhibited TNKS and led to stabilization of the Axin protein, resulting in Wnt/ß-catenin pathway suppression. Aberrant Wnt/ß-catenin pathway activation was recently reported as a possible mechanism of ineffectiveness in immune checkpoint inhibitor (ICI) treatment. Because the Wnt/ß-catenin pathway activation causes dendritic cell inactivation and suppresses chemokine production, resulting in a paucity of CD8+ T cells in tumor tissue, which is an important effector of ICIs. Thus, TNKS inhibitors may enhance the efficacy of ICIs. To examine whether K-476 enhances the antitumor effect of anti-PD-L1 antibodies, K-476 was administered orally with an anti-PD-L1 antibody to melanoma-bearing C57BL/6J mice. Although K-476 was ineffective as a monotherapy, it significantly enhanced the antitumor effect in combination with anti-PD-L1 antibody. In mice, intra-tumor infiltration of CD8+ T cells was increased by combination treatment. K-476 upregulated the chemokine expression (e.g., Ccl3 and Ccl4), which attracted CD8+ T cells. This was considered to contribute to the increased CD8+ T cells in the tumor microenvironment. Furthermore, while the potential gastrointestinal toxicity of TNKS inhibitors has been reported, it was not observed at effective doses. Thus, K-476 could be an attractive therapeutic option to enhance the efficacy of ICIs.

Immediate changes in trunk muscle activation patterns during a lifting task following an abdominal drawing-in exercise in subjects with recurrent low back pain.

BACKGROUND: The abdominal drawing-in exercise could help improve delayed transversus abdominis (TrA) activation during limb movement in subjects with recurrent low back pain (rLBP). However, little is known about whether the same effect is observed during lifting tasks in subjects with rLBP. OBJECTIVE: This study aimed to clarify whether a single session of abdominal drawing-in exercise could correct the altered trunk muscle activation patterns during a lifting task in subjects with rLBP. METHODS: Fifteen subjects with rLBP performed lifting tasks before and immediately after three sets of 10 repetitions of isolated TrA voluntary contractions. The time of onset and activation amplitude during the lifting tasks were measured by surface electromyography (EMG) and compared between the trials before and immediately after exercise. RESULTS: During lifting, the onset of internal abdominal oblique/TrA (IO/TrA) and multifidus activation occurred earlier, the EMG amplitude of IO/TrA increased, and the EMG amplitude of erector spinae and multifidus decreased, compared with the pre-exercise data. CONCLUSIONS: These results suggest a possibility that the abdominal drawing-in exercise might be effective in improving the muscle recruitment pattern in people with rLBP.

Posteroanterior Segmental Displacement of the Lumbar Spine: Assessment Using Ultrasound in Asymptomatic Men.

OBJECTIVE: This study aimed to assess posteroanterior (PA) segmental displacement of the lumbar spine using ultrasound (US). METHODS: Eight asymptomatic male participants (20.1 ± 0.4 years) were included in this study. The relative depth between the tip of the L4 and L3 spinous processes from the US probe (mm) was measured using US in the following 7 conditions, which were without PA force, applying PA force of 9.8 newton (N), 19.6 N, 29.4 N, 39.2 N, 49.0 N, and 58.8 N to both sides of the L4 costal processes. The measurements were repeated twice within a day. The intraclass correlation coefficient, standard error of measurement (SEM), and minimal detectable change (MDC) were calculated. A repeated-measures analysis of variance was also used to determine the influence of PA force on the relative depth. RESULTS: The intraclass correlation coefficients for the intrarater reliability of the 7 conditions were 0.95 (SEM: 0.43 mm, MDC: 1.19 mm), 0.93 (SEM: 0.45 mm, MDC: 1.25 mm), 0.93 (SEM: 0.47 mm, MDC: 1.30 mm), 0.95 (SEM: 0.37 mm, MDC: 1.02 mm), 0.95 (SEM: 0.40 mm, MDC: 1.10 mm), 0.96 (SEM: 0.38 mm, MDC: 1.04 mm), and 0.95 (SEM: 0.42 mm, MDC: 1.15 mm), respectively. The intrarater reliability of the relative depth using US was reliable. There was no significant change in the relative depth among the 7 conditions (F = 0.88, P = .41). Incrementally greater PA force was not related to greater intersegmental translation. CONCLUSION: Our US method could not detect PA segmental displacement of the lumbar spine.

Spin-dependent transient current in transistor-like nanostructures.

Transient current in transistor-like nanostructures has been studied by a model of a few electrons confined in a one-dimensional effective potential consisting of three quantum wells, 'source', 'gate', and 'drain'. The time-dependent Schrödinger equation for the electrons has been integrated relying on the symplectic integrator method and the transient current has been calculated as the flux of the probability density of electrons absorbed by the complex absorbing potential placed at the far edge of the drain region. The electrons are initially placed in the source domain as their lowest-energy state for a given spin multiplicity and the source-drain current has been calculated for different gate potential heights. The current for different spin configurations has shown strong emission at different values of the gate potential, suggesting use of the studied nanostructures for extracting current with a specific spin configuration from spin-unpolarized normal current. Dependence of the current emission on electron correlation has also been studied by changing the size of the source domain. The current has shown appreciable differences for different spin configurations for the medium and strong confinement regimes, while these differences become smaller for smaller confinement and tend to diminish in the weak limit of confinement. This observed trend has been rationalized on the basis of the formation of the Wigner lattice states.

Detection of Gas Drifting Near the Ground by Drone Hovering Over: Using Airflow Generated by Two Connected Quadcopters.

This paper describes the utilization of the downwashes of multicopters for gas-sensing applications. Multirotor drones are an attractive platform for sensing applications. Their high maneuverability enables swift scanning of a target area with onboard sensors. When equipped with a gas sensor and used for gas-sensing applications, however, the strong downwash produced by the rotors poses a problem. When a multicopter is hovering at a low altitude, gas puffs leaked from a gas source on the ground are all blown away. Here, we propose to use two multicopters connected by a rod or a string and place a gas sensor at the midpoint of the rod/string. The downwash generated by each multicopter spreads radially after it impinges on the ground. When two multicopters are connected, the airflows spreading radially along the ground from the two multicopters impinge at the center and are deflected in the upward direction. Gas puffs wafting near the ground surface between the two multicopters are carried by this upward airflow to the gas sensor. Experimental results are presented to show the soundness of the proposed method. The connected quadcopters hovering over an ethanol gas source was able to detect the gas even with a moderate cross-flow.

Point-of-care procalcitonin may predict the need for surgical treatment in patients with small bowel obstruction.

BACKGROUND: The early identification of patients with small bowel obstruction who require surgical treatment could potentially lead to improved patient outcomes. We evaluated the efficacy of point-of-care procalcitonin for predicting surgical treatment among patients with small bowel obstruction. METHODS: This was a prospective observational study. We measured serum procalcitonin levels in patients who presented to the emergency department and were diagnosed with small bowel obstruction from April 1, 2018 through March 31, 2019. Patients were grouped into two groups: the elevated procalcitonin and normal procalcitonin groups. Our primary outcome was surgical treatment. RESULTS: A total of 53 patients with small bowel obstruction were included in the study, and 11 patients (20.8%) were treated operatively. Baseline characteristics were similar, except for age, between the elevated procalcitonin (≥0.12 ng/ml) and normal procalcitonin groups. The elevated procalcitonin level was significantly correlated with surgical treatment and hospital length of stay (p < 0.05). The sensitivity, specificity, and positive likelihood of procalcitonin for the former were 45.5%, 85.7%, and 5.0 respectively. CONCLUSION: The patients with small bowel obstruction who had elevated procalcitonin levels on presentation showed significantly higher rate of surgical treatment than those who had normal procalcitonin levels. Point-of-care procalcitonin might predict the need for surgical treatment in patients with small bowel obstruction and could be used as an additional diagnostic test. Further studies with more patients are needed to investigate the predictive value of point-of-care procalcitonin for surgical treatment.

Correlation between peak expiratory flow and abdominal muscle activity in elderly women while holding maximum expiration and performing the side bridge exercise.

INTRODUCTION: Expiratory flow is important to minimize the risk of infection by expelling foreign substances from the lungs. Abdominal muscle activities primarily produce expiratory flow. However, data on the association of abdominal muscle activity during expiratory effort and abdominal exercise posture with expiratory flow rate is limited. This study aimed to assess the correlation between expiratory flow and abdominal muscle activity while holding maximum expiration and performing the side bridge exercise in elderly women. METHODS: Rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscle activity was measured using electromyography in 14 elderly women (82.8 ±â€¯6.7 years), who could walk independently while performing 2 tasks: holding their breath after maximum expiration in the crook-lying position (maximum expiration), and performing the side bridge exercise on their knees without breathing instruction (side bridge). Peak expiratory flow (PEF) was obtained using a peak flow meter. Correlations between PEF and the abdominal muscle activity were determined using the Spearman rank correlation coefficient. RESULTS: The correlation coefficients between PEF and RA, EO, and IO activity while holding maximum expiration were 0.407 (p = 0.149), -0.345 (p = 0.227), and 0.732 (p = 0.003), respectively. The correlation coefficients between PEF and RA, EO, and IO activity while performing the side bridge exercise were -0.297 (p = 0.303), -0.552 (p = 0.041), and 0.147 (p = 0.615), respectively. CONCLUSIONS: Higher IO activity while holding maximum expiration or lower EO activity while performing the side bridge exercise was related to higher PEF. Thus, maximum expiration and abdominal exercise might be effective in the improvement or prevention of the decrease of expiratory flow.

Active Chemical Sampling Using Jet Discharge Inspired by Crayfish: CFD Simulations of the Flow Fields Generated by the Jet Discharge Device.

Here, we report on computational fluid dynamics (CFD) simulations conducted to develop a chemical sample collection device inspired by crayfish. The sensitivity of chemical sensors can be improved when used with a sniffing device. By collecting fluid samples from the surroundings, all solute species are also collected for the sensor. Crayfish generate jet-like water currents for this purpose. Compared to simply sucking water, food smells dissolved in the surrounding water can be more efficiently collected using the inflow induced by the jet discharge because of the smaller decay of the inflow velocity with the distance. Moreover, the angular range of water sample collection can be adjusted by changing the directions of the jet discharge. In our previous work, a chemical sample collection device that mimics the jet discharge of crayfish has been proposed. Here, we report CFD simulations of the flow fields generated by the device. By carefully configuring the simulation setups, we have obtained simulation results in which the angular ranges of the chemical sample collection in real experiments is well reproduced. Although there are still some discrepancies between the simulation and experimental results, such simulations will facilitate the process of designing such devices.

A comprehensive validation of very early rule-out strategies for non-ST-segment elevation myocardial infarction in emergency departments: protocol for a multicentre prospective cohort study.

INTRODUCTION: Recent advances in troponin sensitivity enabled early and accurate judgement of ruling-out myocardial infarction, especially non-ST elevation myocardial infarction (NSTEMI) in emergency departments (EDs) with development of various prediction-rules and high-sensitive-troponin-based strategies (hs-troponin). Reliance on clinical impression, however, is still common, and it remains unknown which of these strategies is superior. Therefore, our objective in this prospective cohort study is to comprehensively validate the diagnostic accuracy of clinical impression-based strategies, prediction-rules and hs-troponin-based strategies for ruling-out NSTEMIs. METHODS AND ANALYSIS: In total, 1500 consecutive adult patients with symptoms suggestive of acute coronary syndrome will be prospectively recruited from five EDs in two tertiary-level, two secondary-level community hospitals and one university hospital in Japan. The study has begun in July 2018, and recruitment period will be about 1 year. A board-certified emergency physician will complete standardised case report forms, and independently perform a clinical impression-based risk estimation of NSTEMI. Index strategies to be compared will include the clinical impression-based strategy; prediction rules and hs-troponin-based strategies for the following types of troponin (Roche Elecsys hs-troponin T; Abbott ARCHITECT hs-troponin I; Siemens ADVIA Centaur hs-troponin I; Siemens ADVIA Centaur sensitive-troponin I). The reference standard will be the composite of type 1 MI and cardiac death within 30 days after admission to the ED. Outcome measures will be negative predictive value, sensitivity and effectiveness, defined as the proportion of patients categorised as low risk for NSTEMI. We will also evaluate inter-rater reliability of the clinical impression-based risk estimation. ETHICS AND DISSEMINATION: The study is approved by the Ethics Committees of the Kyoto University Graduate School and Faculty of Medicine and of the five hospitals where we will recruit patients. We will disseminate the study results through conference presentations and peer-reviewed journals.

Effect of pelvic belt on the perception of difficulty and muscle activity during active straight leg raising test in pain-free subjects.

A pelvic belt decreases patient-reported perception of difficulty during the active straight leg raising (ASLR) test in individuals with pelvic girdle pain. However, the influence of a pelvic belt on the perception of difficulty during ASLR was not investigated in pain-free subjects. Therefore, this influence excluding the impact of pain is not clear. This paper aimed to clarify the effect of a pelvic belt on the perception of difficulty and muscle activity during ASLR performance in the subjective heavier side leg in pain-free subjects. Twenty pain-free female subjects participated. ASLR using the subjective heavier side leg was performed under two conditions: without and with a pelvic belt. Muscle activation of the external oblique, internal oblique, rectus abdominis, rectus femoris, and biceps femoris was measured during ASLR using a surface electromyograph. Difference in perceived difficulty in performing ASLR with and without a belt was assessed. In total, 80% of subjects had decreased perception of difficulty using a pelvic belt during ASLR. For ASLR performed with a pelvic belt, muscle activity significantly decreased in the contralateral rectus abdominis, ipsilateral external oblique, and bilateral internal oblique (P<0.05), while it significantly increased in the contralateral biceps femoris (P<0.05). There were no significant differences in muscle activity of the ipsilateral rectus abdominis, contralateral external oblique, and ipsilateral rectus femoris between the two conditions (P>0.05). In conclusion, using a pelvic belt can decrease the perception of difficulty during ASLR, and the pelvic belt may improve impairment of load transfer between the trunk and pelvis.