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7 Early Signs of Gum Disease And Gingivitis, According To A Dentist – Women’s Health

Aug 28th, 2021
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When you're a kid, you fear cavities. When you're an adult? Well, clues for cavities are still on your radarbut early sigs of gum disease should be, too.

Youre likely familiar with the concept of gum disease from talking to your dentist, but if youve assumed its an older persons disease, youd be wrong. Gum disease can affect adults of all ages. Even the early signs and symptoms can cause significant discomfort.

Here, a dentist breaks down what to watch out for and how to reduce your risk.

Gum disease, also known as periodontal disease, is caused when plaque (bacteria) builds up between the gums and teeth, says Vera W. L. Tang, DDS, a clinical assistant professor of periodontology and implant dentistry at NYU College of Dentistry.

When the bacteria begin to grow and increase, the gums surrounding the tooth initially become inflamed, [causing] gingivitis, Dr. Tang explains. When left untreated, this inflammation can continue to invade and break down the bone supporting the teeth, causing whats known as periodontitis. This can cause gums to recede or even continue to cause tooth loss.

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According to Dr. Tang, there are a long list of factors that may contribute to early gum disease (gingivitis): diabetes, smoking, aging, genetic predisposition, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and the use of certain medications.

Research has [also] shown that gum disease may be associated with other systemic diseases, such as diabetes, heart disease, rheumatoid arthritis, low birth weight babies, respiratory diseases, osteoporosis, cancer, and Alzheimers disease, she says.

Gum disease isnt limited to older adults, either. According to data from the Centers for Disease Control and Prevention (CDC) on the prevalence of periodontal disease, about one out of two American adults over the age of 30 have periodontal disease.

In adults over the age of 65 years, the prevalence jumps to 70 percent, Dr. Tang says. People with a genetic predisposition, smokers and people with diabetes have a significantly higher risk.

Gum disease is often silent and signs and symptoms may not show up until much later, Dr. Tang says. Still, here's what to watch out for:

The good news is that youre not destined to get gum disease, though prevention is key, Dr. Tang says. Brush and floss your teeth to remove food debris and plaque trapped between your teeth and gums, especially along the gum line, she advises. Mouthwash can help reduce plaque and can remove remaining food particles that brushing and flossing may have missed.

Finally, ask your dentist how often you should make an appointment for a cleaning. While insurance often covers twice yearly cleanings, if you're particularly at risk for periodontal disease, have gingivitis, or have had either condition, your dentist may advise coming in more often. This schedule is important to stick with, as seeing your dentist will catch symptoms sooner (where they're not as severe and can be more easily addressed) a determine if youre dealing with a more serious issue.

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7 Early Signs of Gum Disease And Gingivitis, According To A Dentist - Women's Health



Latest Cats, Dogs, Pets Available For Adoption In Meyerland Area – Meyerland, TX Patch

Aug 28th, 2021
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Want to add a furry friend to your family? Look no further than these Meyerland animal shelters for a pet available for adoption. Many shelter animals are still looking for their forever home and facilities are still working to fulfill adoptions and place pets with families.

Millions of companion animals are taken in each year by rescue organizations nationwide, according to the American Society for the Prevention of Cruelty to Animals.

Of those, approximately 3.3 million are dogs and 3.2 million are cats. Shelters often look after other animals in search of a permanent home as well, including pigs, birds and even horses.

However, only around half of all shelter animals are adopted each year, ASPCA data shows. This means millions of animals some right here in the Meyerland area are still waiting for their forever homes.

Here at Patch, with a little help from our friends at Petfinder, we've rounded up this week's list of animals available for adoption near you. If you're a cat person, meet Dale, a Domestic Short Hair up for adoption. Or if dogs are more your thing, there are several great dogs available, too.

Click on any listing to learn more about a pet or to start the adoption process.

Editor's note: This list was automatically generated using data compiled by Petfinder. If you're a local shelter looking to see your adoptable pets appear on Patch, you'll need to list them through Petfinder. All readers are encouraged to report errors or other feedback to

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Latest Cats, Dogs, Pets Available For Adoption In Meyerland Area - Meyerland, TX Patch



The 25 Best Stress Relief Gifts of 2021 – Healthline

Aug 28th, 2021
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Our list of recommended products is based on a mixture of personal experience, high ratings of at least 4 or 5 stars, and best-selling items.

Weighted blankets can be a useful and cozy tool to add to your arsenal of de-stressing products. The blankets heaviness emulates deep pressure stimulation therapy, which can help relax the nervous system.

While there is a multitude of blankets on the market, Bearaby weighted blankets are by far some of the most stylish. Perfect as a couch or bed throw, the chunky knit blanket comes in six colors.

Another major perk of the Bearaby Tree Napper is its cooling effects. The blanket is made from eco-friendly eucalyptus fibers and Tencel Lyocell fabrics that can wick away moisture a necessary feature for hot sleepers.

The Tree Napper blanket comes in weights of 15, 20, and 25 pounds, and the brand recommends the blanket be roughly 10 percent of a persons body weight.

When stress creeps up on you, you might feel tension in your neck and shoulders. The Neckteck neck and back massager is a luxury that wont break the bank.

The device is a best-seller on Amazon and has amassed nearly 28,000 reviews. The shiatsu massager has eight nodes that knead deeply into the skin at three different speed options. Bonus: The massager is heated, which can help boost circulation and reduce stiffness.

Whether your loved one has a case of text neck or they just need to decompress, an on-demand massage is a gift that will be put to good use.

Nectars set of donut-themed bath bombs are a sweet (pun intended) gift for the bath lover in your life. The pastel color palette and whimsical shape make the set a playful touch for a bathroom counter. Nectars bath bomb formula includes kaolin clay, Epsom salt, and skin-nourishing almond oil. The colorful bath products are handmade in Las Vegas and use natural, vegan-friendly ingredients.

Hot baths have many health benefits like stress relief, reduced inflammation, and a better nights sleep. Of course, bath bombs are one way to make a healthy habit even more enticing for your loved one.

If youre shopping for someone who loves their weighted blanket, a weighted sleep mask sounds like a natural progression. The unique design of the Nodpod mask helps block out light and provides deep pressure, similar to a weighted blanket, on your eyes. Theres no strap or Velcro, so it wont be too tight or get stuck in your hair.

Many reviewers found that the Nodpod mask helped them calm down at night and get a restful sleep. Some verified buyers also claimed the sleep mask helped alleviate their headaches.

Aromatherapy has been a longtime natural treatment for stress, and a growing body of research continues to suggest its effectiveness. A 2017 study found that when using lavender essential oil on participants receiving a massage, those receiving the oil reported a 12 percent decrease in stress, while those only receiving a massage noticed just a 3.3 percent decrease.

The Vitruvi stone diffuser dilutes essential oils and disperses them into the air, filling the room with the aroma of your choice. The modern design is sleek and subtle, making it a great addition to a nightstand or countertop.

Opening a book helps readers enter a different world with new perspectives. Reading can help increase empathy, enhance your vocabulary, and even reduce stress. One 2019 study found that recreational reading helped reduce psychological distress in university students during the school year.

Book of the Month takes the guesswork out of picking a specific book to give. The membership, available in plans ranging from 3 to 12 months, ships a new book to the readers house each month. Readers can choose from five books that are vetted by the Book of the Month team, including some early releases for the VIP bookworm in your life.

The line of pendants from Cor has managed to make aromatherapy a wearable companion, and the minimalist style looks effortlessly cool and stylish.

However, these gold and silver pendants are more than just a fashion statement theyre also a covert stress relief tool. The pendant is a vessel for Cor Wicks, the brands essential oil blends that fit inside each pendant. The inserts come in various scents, including a Calm blend with lavender, chamomile, neroli, Rosalina, and linaloe berry.

Over the last year, everyones spending a lot more time inside. Give your night in an upgrade with the Calm Club Big Night In kit.

The curated box includes essentials for curling up on the couch like cozy wool socks, a soy wax candle, and a ceramic mug for your favorite hot beverage. For mindfulness, Calm Club also includes a wooden puzzle to help focus your thoughts. Of course, theres also a sleep mask for when its time to turn in for the night.

This care package is a great hint for workaholic friends who could use a little self-care.

DAVIDsTEA has more than 150 loose-leaf teas to choose from, which can feel overwhelming for shoppers. The sampler features 12 tea leaf blends designed to aid relaxation and sleep. Options include popular chamomile and rooibos, as well as blends like Halo Headache and Lavender Buttercream.

Conscious shoppers may admire the sustainability efforts of DAVIDsTEA. The fair trade-certified brand is allied with the Ethical Tea Partnership, an organization with a mission to make the tea industry more sustainable and fairer for tea farmers, their families, and the environment.

When in doubt, candles are always a good idea. Tucked away in a Brooklyn factory, Apotheke has been hand-pouring candles and bar soap for a decade. Founder Chrissy Fichtl started concocting scents in her kitchen and selling at local flea markets until a West Elm debut put the brand on the map.

Apotheke candles are a minimalist and versatile choice to incorporate into any home, regardless of decor. The Hinoki Lavender candle comes in a chic frosted glass, but the design is the icing on the cake. The earthy scent blends notes of Hinoki cypress, lavender, lotus flower, and sandalwood a soothing fusion that can burn for up to around 70 hours.

Calm is an award-winning app that provides calming techniques, morning stretches, guided meditations, and sleep aids. The app is available for iOS and Android devices as well as desktops and has a 4.8-star average rating in Apples App Store. Among the many tools within the app, users can learn and meditate with the stars.

From meditating with professional basketball player LeBron James to taking a master class in creativity with Elizabeth Gilbert, the membership sprinkles celebrity-led content into the experience. Some sleep stories on the app are narrated by A-listers like Kate Winslet and Harry Styles. Yes, you can give the gift of falling asleep to the sound of Idris Elbas voice.

Plant-lined shelves and hanging pothos plants have taken over Instagram feeds and TikTok videos. With more time at home than ever, garden centers have been teeming with new customers and many reported a huge boom in 2020.

But plants are more than just a pretty thing to sit on the windowsill. Research finds plants are powerful tools to boost positivity and concentration. A 2020 study analyzing the impact of indoor plants in work environments concluded that plants decreased anxiety in employees in a Japanese office.

When buying for a plant newbie, aim for one where a green thumb wont be a prerequisite. The ZZ plant is a hardy piece of greenery that can survive in low light and requires minimal maintenance.

Small habits like keeping a journal can help reduce stress symptoms. The Press Pause journal is chock-full of writing prompts and questions that can help guide writers who are new to journaling. The 52-week journal also includes inspirational stories from writers who share their own journey with mindfulness.

Taking a small portion of the day to jot down goals, reflect on gratitude, and document memories can create a special memento to look back on in the future.

Author and mental health activist Moorea Seal is known for her line of journals that focus on subjects like bravery, togetherness, and happiness. Her book 52 Lists for Calm is teeming with thought-provoking prompts for each week of the year.

The prompts are separated into four sections: Present, Look Back, Move Forward, and Release. Seals journal features images and illustrations designed to spark serenity in users. She also incorporates mindfulness strategies, essays, and quotes meant to help those who are struggling with burnout.

Fine art photographer Gray Malin has traveled the world capturing beauty from a birds eye view. His aerial photos of candy-colored beach umbrellas and crystal blue waters have become his trademark.

Rather than lining the halls of a gallery, Malins work has evolved into a lifestyle brand. His photography is emblazoned on phone cases, coaster sets, postcards, and tote bags.

The artists two-sided puzzle features Hawaiis famed Waikiki Beach on one side and a verdant Kauai coastline on the other. Its the perfect calming tool for a friend who needs to step away from their screen and focus on the moment.

Heating pads can be used for injuries and pain, but their value doesnt have to end there. According to the American Psychological Association, muscle tension is almost a reflex reaction to stress. Chronic stress can make you feel constantly guarded, and when that tension hits the neck and shoulders, it can cause headaches.

Since heat can help loosen muscles, a heating pad can be a handy tool for stress relief. Put a unique spin on the traditional heating pad with this adorable sloth plushie, which can be microwaved or frozen to offer relief.

Are shower steamers the new bath bombs? These essential oil-infused shower steamers are one way to bring your hot showers to the next level. Break off a piece of the Miss Patisserie product and place it on the floor of the shower the scents blend with the hot steam and fill the shower with an aroma designed to soothe.

The package comes with six steamers with essential oils like juniper berry, lemongrass, lavender, eucalyptus, jasmine, and orange. The de-stressing steamers are also cruelty-free and vegan-friendly.

When shopping for a skin care devotee, eye gels can be a nice pick-me-up to add to a regimen. Patchology Moodpatch Chill Mode eye gels have a cooling effect that soothes.

The gels are infused with cannabis seed oil, which contains the anti-inflammatory gamma-linoleic acid to soothe the skin and purports to encourage cell turnover. The products allantoin and rhodiola extract help to calm redness while the reishi and snow mushroom extracts hydrate the under-eye area.

Similar to the time-honored method of using cut cucumbers on your eyes, the eye gels are cool to the touch. The eye gels can help depuff tired eyes in the morning or provide a little indulgence after a long day.

Getting adequate sleep is necessary for a healthy life. A general rule for adults is 7 to 9 hours of sleep, and sacrificing extra Zzzs can have a detrimental effect on wellness. Research shows that 21 percent of adults report feeling more stressed, while 37 percent find themselves feeling fatigued or tired because of stress.

With sleep being such an important part of life, the Hatch Restore can be a helpful aid for loved ones in need of some quality shut-eye. The Hatch Restore is a multi-use relaxation tool that features a sound machine, meditation app, and a sunrise alarm that simulates the morning sun. The device also includes a soft-glow reading light.

Celebrate your friend with a little bubbly no, not that kind. Neom Real Luxury Bath Foam from their Scent to De-Stress line is a fragranced formula that contains lavender, jasmine, and Brazilian rosewood. The effervescent foam also works to soften and soothe the skin with ingredients like coconut oil, aloe, and almond oil.

Neom sells branded gift bags and boxes that may come in handy for those sending gifts long-distance.

Much like adult coloring books, activities that require focus and distract from self-awareness can result in relaxation. Etsy has a stockpile of crafting kits that focus on everything from candle-making to pottery. Embroidery the skill of hand-sewing art onto fabric is a popular craft on Etsys marketplace, where more than 618,000 embroidery kits are available.

Fiber arts like sewing have been incorporated into art therapy programs and explored by researchers. The embroidery trend has also captured consumers: Google Trends shows a 2020 surge in embroidery-curious users searching for ways to start the craft. Etsy seller snugglymonkey has garnered more than 20,000 reviews and provides embroidery hoops, patterns, and supplies for crafters.

Any yogi knows that the best part of a yoga practice is Savasana (aka Corpse Pose). Using a yoga bolster can alleviate pressure on joints and deepen the stretches of certain poses. Bolsters are similar to a pillow but feature a firmer foam that provides lumbar support.

This AJNA yoga bolster is highly rated on Amazon. It has a 4.8-star average rating with more than 2,500 reviewers 88 percent of which gave the pillow 5 stars. As a yoga teacher Id absolutely recommend this bolster, says one Amazon reviewer.

Cozy weekends need their own uniform. Parachutes soft rib robe is made from 100% cotton terry cloth, a material that many reviewers call cuddly. While comfort is key, Parachutes clean design features ribbed lines and side-seam pockets.

Gray and white are two reliable color choices, but the robe is also available in a rustlike clay color like the one on Popsugars list of colors dominating 2021 runways.

In the reviews, 81 percent awarded it between 4 and 5 stars. Warning: You may be tempted to buy the Parachute robe for yourself. I loved this robe so much that in a matter of two days [I] bought one a day for other people. They love their robes too, writes a verified customer.

A flurry of vitamin brands has emerged on the market with an aesthetic of simple design and familiar fonts that have come to symbolize modern wellness. While stress-relieving supplements sound appealing, some brands can cost upwards of $60 for a months supply. Rae Wellness, founded in 2019, has supplements starting at $14.99. Its DeStress capsules have the same ingredients that aim to combat stress at a far more accessible price.

Studies conducted on ingredients like the Ayurvedic herb ashwagandha and Rhodiola rosea have shown some positive findings in stress reduction, though research is developing. The capsules also include L-tyrosine, an amino acid with some promising findings on its link to improved mental function.

Aveda Stress-Fix Composition Oil is an aromatic product that can be used as a body oil, scalp oil, or bath additive. The multiuse product blends certified organic lavender, lavandin, and clary sage scents into its formula. The compositions jojoba and sunflower oils also moisturize and work as antioxidants.

A perk of this Aveda oil is its ability to multitask, making it more than just a one-trick pony of a present. It can be used from head to toe, acting as a pre-shampoo scalp massage oil or a nourishing foot rub for calloused feet. The Aveda website also suggests adding a few drops of oil into the bathtub for a full-body soak.

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What Jameis Winston as starter means for Saints’ offense, fantasy and Taysom Hill – ESPN

Aug 28th, 2021
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METAIRIE, La. -- In the end, the choice became clear for coach Sean Payton, who named Jameis Winston as the New Orleans Saints' starting quarterback Friday.

Although the battle was close for a while, the 27-year-old Winston arguably offered more upside than the 31-year-old Taysom Hill -- and definitely made a stronger closing argument with his dynamic display Monday night.

Still, the Saints' decision hardly means all questions have been eliminated as they head into a season without Drew Brees for the first time in 16 years.

Here's a look at four questions that stand out most:

It didn't take long to see the element Winston brings to Payton's offense. His first of two deep touchdown passes to receiver Marquez Callaway on Monday traveled 53.3 yards in the air according to NFL Next Gen Stats -- the longest of any Saints TD since 2016.

When asked if Callaway was his first read, Winston's face lit up.

"Absolutely," Winston said. "As soon as I saw the safety cut [toward a shallow receiver], I'm letting it go. I don't like missing those opportunities."

We saw several similar throws from Winston throughout training camp, and we also saw Payton design a 56-yard TD pass from Winston on a trick play in the playoffs last season.

Conversely, we didn't see many of those throws in Brees' later years. In 2020, the Saints threw 29 passes that traveled 20-plus yards beyond the line of scrimmage, according to ESPN Stats & Information -- fewer than any team since 2014.

2 Related

Obviously there is more to playing quarterback than arm strength. Brees is Exhibit A. But that doesn't mean Payton isn't excited to add some old tricks back into his playbook from when Brees was routinely throwing for 5,000-plus yards per season.

Almost every time Payton has been asked about Winston over the past two years, he has mentioned his "arm talent" and his leadership as two traits that stand out most. Several Saints receivers have also expressed excitement with knowing Winston might let it loose down the field even if they aren't the first read.

Winston didn't actually rely that much on deep balls during five years with the Tampa Bay Buccaneers. According to ESPN Stats & Info, he ranked 16th, 15th, eighth and 14th in the NFL in percentage of passes thrown 20-plus yards from 2015 to 2018. But he ranked second in 2019 at 16% while leading the league with 5,109 passing yards in his first year with aggressive offensive coach Bruce Arians. Of course, Winston also infamously became the first QB to throw at least 30 TD passes and 30 interceptions in that same season.

Therein lies the rub. Winston threw 88 interceptions and lost 23 fumbles in 70 games with the Bucs. The Saints need to make sure he stays on the right side of that risk-reward formula.

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So far, Winston has said and done the right things -- starting with his decision to join the Saints last year to get a "Harvard education in quarterback school" under Payton, Brees and offensive coordinator Pete Carmichael Jr.

Winston said the No. 1 thing he learned from Brees was focusing on making the right decision instead of trying to force big results. And you can count his total number of interceptions on one hand through four weeks of camp, while he has made a habit of checking down to safer throws (he did have a slightly underthrown deep ball picked in the first preseason game, though it bounced out of receiver Lil'Jordan Humphrey's hands).

"Sean Payton told us, 'Jameis will not play the same way he played in Tampa Bay, I assure you of that. I will not allow him to, and our system will not allow him to,'" said ESPN analyst Louis Riddick, who had a pregame chat with Payton as part of the Monday Night Football broadcast.

"The reason why you should be optimistic is simply because, one, Jameis is a good quarterback," Riddick said. "He always has been. He just needed to be better as far as his decision-making is concerned. And that's not always just about him. That may also be a function of the offenses he has played in. The other reason to be optimistic is that he is in a tried-and-true and productive system that has been proven to work."

This is obviously a disappointment for the fifth-year pro, who has always stressed that his goal is to become a starting quarterback, despite his eagerness to help the team in so many other ways as a RB/TE/WR/kick returner/special teams coverage ace.

From California to New Hampshire, 43 states (and D.C.) have produced NFL quarterbacks. Take a deep dive into the data to see who's the best, worst and everything in between. Story See which NFL QBs come from your state

Hill went all-in to achieve his goal this offseason, gearing his workouts and practice reps solely toward playing QB. Listed at 6-foot-2, 221 pounds, Hill bulked up a bit in past years to take on some of those extra duties. This year he said he slimmed down to 215 to gain flexibility because "if I'm not going to be blocking defensive ends and backers and safeties and stuff, then I didn't need to carry the extra weight."

Still, it's hard to imagine Hill won't gamely step back into a similar role. Maybe the Saints won't ask him to do as much blocking or special teams work. But they will almost certainly keep designing packages for him as a read-option QB, runner and pass-catcher after he has racked up 613 rushing yards, 332 receiving yards and 16 touchdowns over the past two seasons.

That versatility is a big reason the Saints signed Hill to a two-year, $21 million deal as a restricted free agent in 2020. And you could argue that role is more important than ever since the Saints lost Brees, wide receiver Emmanuel Sanders and tight ends Jared Cook and Josh Hill this offseason -- and top WR Michael Thomas is currently out because of an ankle injury.

As for the future, Hill will be an unrestricted free agent in 2022 and may have to decide whether to keep pursuing QB opportunities elsewhere or potentially embrace his "slash" role on a more permanent basis.

Winston's emergence didn't shake things up much in ESPN's fantasy football rankings. Mike Clay, who produces ESPN's projections, said he already had Winston making 12 starts -- and only bumped that up to 14 because of the risk of a potential QB switch at some point. Clay only moved Winston up to QB 24.

"He can prove to be a fantasy steal," Clay said. "But at the same time, his pass-catchers remain a question mark and he's going to lose occasional snaps to Hill."

Winston's value increased more with analysts Matthew Berry and Field Yates, since both thought Payton might go with Hill to start the season. But neither was ready to make Winston a top-15 QB since he doesn't add much fantasy value through rushing yardage -- and since he could cede snaps to Hill in certain packages.

However, everyone agrees Winston enhances the value of New Orleans' pass-catchers -- especially running back Alvin Kamara, who is safer as the consensus No. 3 overall pick. And Callaway has soared into the top 50 among receivers after his breakout summer.

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What Jameis Winston as starter means for Saints' offense, fantasy and Taysom Hill - ESPN



Phlebitis: Definition, symptoms, treatment, and more – Medical News Today

Aug 28th, 2021
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Phlebitis is the name for the inflammation of a vein. A vein can inflame if a blood clot is inside it or if something damages the veins walls. Symptoms of phlebitis can include painful lumps beneath the skin and flushing or darkening of the skin.

Phlebitis most commonly occurs in the lower leg. But it may also affect surface veins in the arms, penis, or breasts.

If a blood clot is causing the inflammation, then the condition is called thrombophlebitis.

Thrombophlebitis primarily affects people between 2550 years old, with the average age being around 40 years old. Males are three times more likely than females to experience thrombophlebitis.

In this article, we examine the types and causes of phlebitis. We also look at the potential treatments and possible complications.

There are two main types of phlebitis, known as superficial phlebitis and deep vein thrombosis (DVT).

If a person has superficial phlebitis, the inflamed veins are near to the skins surface. Healthcare professionals may treat this condition, but they do not consider it to be serious. This condition often goes away once the inflammation goes down.

If a blood clot is present, doctors will refer to this as superficial vein thrombosis (SVT).

If a person has DVT, they tend to have inflammation in the larger veins located deeper in the body, usually in the legs.

Blood clots can often cause DVT, which can be severe. These blood clots can break away and travel through the vein into the lungs, which may cause a pulmonary embolism (PE).

A person should contact a doctor if they think they have DVT.

The following are symptoms of superficial phlebitis and deep vein phlebitis.

Symptoms of superficial phlebitis include:

Deep vein phlebitis may occur without the presence of any symptoms. But sometimes, the following symptoms do occur:

The leading two causes of phlebitis are a blood clot inside the vein or damage to the veins walls.

A persons veins may receive damage in several ways. These include:

There is a wide range of factors that can cause a person to develop blood clots. These include:

Some people can treat phlebitis at home with advice from their doctor, but others will need medical treatment.

A person may wish to treat their inflammation with anti-inflammatory drugs such as aspirin or ibuprofen (Advil). But if a doctor prescribes an anticoagulant blood-thinning medicine, a person should avoid taking anti-inflammatory medications unless a doctor advises them to do so.

If phlebitis is present in a persons leg, raising the leg may help reduce swelling. A person could also speak with their doctor about using a compression stocking, which may help reduce swelling.

A doctor may treat deep vein phlebitis with an anticoagulant. These are blood-thinning medications that help prevent blood from clotting.

If a blood clot is present, a doctor may decide that the person should undergo a thrombectomy. A thrombectomy is a surgical procedure that aims to remove a blood clot from a blood vessel.

A surgeon inserts a wire and a catheter into a blood vessel during this procedure, commonly in the groin. They then advance the wire through the blood vessel until they reach the blood clot.

Once they reach the blood clot, a surgeon will use one of several methods to remove it. They may use:

A doctor may also use an inferior vena cava filter. This small device sits in the vena cava, which is a large vein in the body.

This device does not stop blood clots from forming, but allows blood to flow while stopping the clots from moving into the lungs. This device can help prevent a PE from taking place.

A doctor may diagnose phlebitis using a basic examination and knowledge of a persons symptoms. Often, they will not perform any specific tests.

But they may use an ultrasound, a CT scan, or an MRI scan to see if a blood clot is present.

If a person does have a blood clot, a doctor may carry out a blood test to look for certain blood clotting disorders, such as thrombophilia.

DVT is a significant complication of phlebitis. DVT is the presence of a blood clot in the veins, typically in the leg.

Blood clots in the vein can cause phlebitis. The blood clot may move from the vein and travel through the bloodstream to the lungs. Here, it can block the pulmonary artery, resulting in a PE.

Blood clots are a common cause of phlebitis. Many factors can increase a persons chances of developing blood clots, such as:

A person can help prevent blood clots in several ways. These include:

If a person has to sit for long periods, such as when traveling for longer than 4 hours, they could try getting up and walking around every 23 hours and wearing loose-fitting clothing.

They may also wish to exercise their legs while sitting down by:

Learn about Medicare and compression stockings here.

Superficial phlebitis often goes away without treatment or any lasting effects.

Deep vein phlebitis can be more severe and requires treatment by a doctor. If a blood clot is causing deep vein phlebitis and the person has DVT, this can be life threatening.

According to the Centers for Disease Control and Prevention (CDC), one-third to one-half of people with DVT will develop long-term complications in the affected limb, such as:

The CDC also states that around one-third of people with DVT will have a reoccurrence within 10 years.

If a person experiences any symptoms of phlebitis, they should contact a doctor. A doctor can determine whether a person has superficial phlebitis or more severe deep vein phlebitis.

If the person has deep vein phlebitis, healthcare professionals will provide treatment immediately.

Phlebitis sometimes displays similar symptoms to another condition called cellulitis.

Phlebitis results from blood clots or damaged veins, and cellulitis is due to a bacterial infection.

Cellulitis affects the deeper layers of the skin and the fat and soft tissue that lies underneath.

Symptoms of cellulitis can resemble phlebitis, such as:

A person with cellulitis may also have skin that looks pitted, similar to orange peel, and may develop blisters on the skin. Some people also develop a fever and chills.

A person can develop cellulitis in various parts of the body. But it is most common on the legs and feet.

As cellulitis is a bacterial infection, doctors treat it with antibiotics.

Phlebitis is the name for the inflammation of a vein. Two causes of phlebitis are blood clots and damage to the veins wall.

Superficial phlebitis and deep vein phlebitis are the two main types of phlebitis. Superficial phlebitis affects veins that are near to the skins surface. Deep vein phlebitis affects veins located deeper in the body.

Symptoms of phlebitis include painful lumps beneath the skin and redness of the skin.

Healthcare professionals do not consider superficial phlebitis to be serious. But deep vein phlebitis can be severe if a blood clot is present, because the blood clot may travel through the bloodstream and cause a PE.

Doctors can treat phlebitis with anticoagulants. They may also wish to carry out a thrombectomy, which is a surgical procedure to remove a blood clot from a vein.

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Phlebitis: Definition, symptoms, treatment, and more - Medical News Today



ACL Tear: Know about this common knee injury – The Indian Express

Aug 28th, 2021
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ACL (anterior cruciate ligament injury) is one of the main stabiliser ligaments of the knee joint. Injury or tear of the ACL is one of the most common injuries of the knee.

It can occur at any age or in any sport, but generally seen in young people playing sports that involve pivoting of the knee like soccer, basketball, hockey and skiing, when sudden stops or changes in direction occur during jumping and landing. It is also a common injury in contact sports such as kabaddi, wrestling and American football, said Dr Shubhang Aggarwal, Orthopedic and Joint Replacement Surgeon, NHS Hospital, Jalandhar.

Besides sportsmen, the injury can also happen to anyone while doing common activities like jumping across a puddle or if you miss the last step of the stairs in a rush or just simply climbing a stool.

Once torn, an ACL can never repair itself. 40 per cent of people can manage their sedentary life with occasional sports without surgery but if someone wants to run/jog, play even weekend sports regularly or they experience feeling of instability and sense of discomfort then surgery is recommended to protect the knee from repeated damage and future arthritis, the expert added.

What happens?

The pop sound of ACL rupture may not be heard in every fresh injury case and we have to look for other common symptoms like:

1- Pain: If you have a minor injury, you may not feel pain. You may feel sore along your knees joint line. Some people have trouble standing or putting pressure on the hurt leg.2- Swelling: This is most likely to happen in the first 24 hours. You can reduce swelling by putting ice on your knee and elevating (raising) your leg on a stool or 2 pillows.3- Trouble walking: You may not be able to put pressure on your hurt knee to walk, climb stairs and walk on uneven ground. Some people find that the knee joint feels loose than it should be.4- Less range of motion. After you damage your ACL, its very likely that you wont be able to bend and flex your knee like you normally would.

Symptoms in a chronic case: Instability is the most common symptom in an ACL deficient knee in which patient feels that his/her knee will buckle in certain movements/positions of knee especially while playing sports, he added.

What is it?

Ligaments are strong bands of tissue that connect one bone to another. The ACL is one of two ligaments inside the knee that cross in the centre and stop the undue movement of your thighbone (femur) on your shinbone (tibia). When injured, it puts stress on the knee.

Who is at risk?

1- Females possibly due to differences in anatomy, muscle strength and hormonal influences2- Participating in certain sports, such as soccer, kabaddi, basketball, gymnastics, skiing and wrestling.3- Poor conditioning of muscles that can actually protect against violent movements.4- Wearing footwear that doesnt fit properly5- Using poorly maintained sports equipment or wrong techniques.6- Playing on artificial turf surfaces

How is it diagnosed?

-Detailed history: Your doctor will want to hear exactly how you injured your knee. They will look at both knees to see if the sore one looks different.-Clinical examination: Your doctor may ask you to lie on your back and bend your hips and/or your knees at certain angles. Theyll then place their hands on different parts of your leg and gently shift the leg around. If any of your bones move in a way that isnt normal, that could be a sign that your ACL is damaged.-X-ray: Soft tissues like the ACL dont appear on X-rays, but your doctor may want to rule out broken bones.-MRI: This exam can show both soft tissue and bone. If you have a damaged ACL, it shows up on the scan.


Arthroscopy: This literally means to look within the joint. During this exam, an orthopedic surgeon makes a small 4mm keyhole into your skin. He inserts a camera attached on a pencil-sized tool that contains a lighting system and lens (arthroscope) into the joint. The camera projects a magnified image of the joint onto a large screen. Your doctor can see what type of injury you have and repair as needed, he explained.


Treatment depends on how badly youve been hurt.

First is first aid: If your injury is minor, you just put ice on your knee, elevate your leg, and stay off your foot for a while. You can reduce swelling by wrapping a crepe bandage around your knee. Crutches/walkers can help you to keep weight off your knee.

Medication: Analgesics and anti-inflammatory drugs help to reduce swelling and pain. Rarely for intense pain and swelling, you may have to get the blood aspirated and get an injection into your knee with a steroid.

Knee brace: Some people with a damaged ACL can get by wearing a brace on their knee when they run or play sports. It provides extra support.

Physical therapy: You may need this a few days a week to get your knee back in working order. During your sessions, youll do exercises to strengthen the muscles around your knee and help you regain a full range of motion. You may be asked to exercise on your own.

Surgery is done when all else fails and is called Arthroscopic ACL reconstruction in which surgeon will remove the damaged ACL stump through a keyhole and replace it with a graft sometimes made from the core of your hamstring muscle or a fibre tape.

This is usually a daycare surgery and after surgery with proper rehabilitation ie Proprioceptive and strengthening exercises, patients can resume brisk walk in six weeks and jog in three months. Active contact sports again within six months. With modern surgical techniques and fixation methods available, ACL surgery for sportsmen especially has proven to be a highly successful procedure, he said.

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ACL Tear: Know about this common knee injury - The Indian Express



Body-powered variable impedance: An approach to augmenting humans with a passive device by reshaping lifting posture – Science

Aug 28th, 2021
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The movement patterns appropriate for exercise and manual labor do not always correspond to what people instinctively choose for better comfort. Without expert guidance, people can even increase the risk of injury by choosing a comfortable posture rather than the appropriate one, notably when lifting objects. Even in situations where squatting is accepted as a desirable lifting strategy, people tend to choose the more comfortable strategy of stooping or semisquatting. The common approach to correcting lifting posture, immobilizing vulnerable joints via fixation, is insufficient for preventing back injuries sustained from repetitive lifting. Instead, when lifting small but heavy objects, the entire kinetic chain should cooperate to achieve a series of squat-lifting patterns. Inspired by the observation that force fields affect the coordination of voluntary human motion, we devised a passive exosuit embedded with a body-powered variable-impedance mechanism. The exosuit adds impedance to the human joints according to how far the wearers movement is from the squat-lifting trajectories so that it hinders stooping but facilitates squatting. In an experiment that entailed lifting a small 10-kg box, 10 first-time users changed their voluntary lifting motion closer to squatting on average. Simulation results based on recorded kinematic and kinetic data showed that this postural change reduced the compression force, shear force, and moment on the lumbosacral joint. Our work demonstrates the potential of using an exosuit to help people move in a desirable manner without requiring a complicated, bulky mechanical system.

Manual work, sports, exercise, and everyday activities involve motor tasks that can lead to injury if not performed in a proper way. Tasks that involve lifting have a particularly high rate of causing musculoskeletal injury (1, 2). Contrary to the common belief that taking a stooping posture at lifting causes spinal injuries, the relationship between posture and injury has not been clarified (35). However, at least, researchers in the field of biomechanics have found that the magnitude of back compression force (BCF) during the lift process can vary depending on the various settings, such as wearers posture and object size and shape (68). Kingma et al. (9) compared different lifting techniques in various object conditions and showed that squatting reduces BCF more effectively than stooping when lifting an object small enough to pass between the legs. However, when the object is large, squatting may cause higher BCF than other lifting techniques, such as stooping, kneeling, and weight lifters technique (9, 10). The U.S. National Institute of Occupational Safety and Health (NIOSH) recommends that manual workers should use context-appropriate lifting techniques to avoid injury (11): (i) If the object is small, a worker should keep the back straight and keep the target object close to the body by widening the knees laterally and flexing them as much as possible (i.e., squat to lift); (ii) if the object is large, a worker should place one knee on the floor and lift the object using the kneeling technique. In environments where small or specially shaped objects are handled close to the bodysuch as some industrial settings (12), gyms (13), and rehabilitation centers (14)squat technique is accepted as a desirable lifting strategy.

However, people tend to choose comfortable lifting behaviors, such as stooping and semisquatting, when there is no specific instruction or training. It has been consistently argued that human movement patterns are planned by an innate optimization algorithm that takes into account certain cost functions, although any universal cost has never been clearly revealed; the cost may include such dynamic variables as muscle activation level (15, 16), energy expenditure (1719), torque change (20), and jerk (21). Perceptual costs and constraints also play a role (22, 23). In motor tasks, including lifting, choosing a desirable movement often counters the instinct of humans, which prefers comfortable movements. In some industrial settings, economic costs are expended on adjusting the layout of the worksite or training the target group to control their lifting behavior (24). However, the low efficacy of the training, pointed out in some studies (2527), calls for interventions that can directly and immediately induce people to lift items with more desired form.

To date, motion correction strategies have been mostly focused on static methods such as fixing or hindering the use of vulnerable joints (28). For example, some workers wear back belts that compress the trunk in radial direction to stabilize the spine. However, the usefulness of the back belt in correcting workers lifting behavior or preventing injuries has been questioned by several studies (2830). Todays evolved version of the back belt corresponds to a back-assistive wearable robot. These devices attach actuators (3133) or springs (3437) with a large moment arm to the torso to reduce muscle stress and spine compression during lifting. However, modifying users lifting motion pattern has deviated from their main concerns. To ensure that people use a particular desirable motion pattern for a movement, simply interfering or assisting certain single joint is not sufficient. Instead, proper coordination of all joints in the involved kinetic chain is required.

Our focus in this study is on finding a way to induce people to voluntarily adopt a specific posture to lift objects by artificially changing the force field surrounding the body. The properly designed force field can intervene in the dynamic motion pattern generated by all joints in the kinetic chain to induce any desired movement. Several studies have found that artificially changing the force field of a persons workspace changes their voluntary movement patterns (3840). Robotic systems have used this principle to provide movement training for patients with neurological disorders. These robots use impedance-based control to create a force field in which a restoring force is applied when the users movements deviate from the desired trajectory (4145). However, many of these robots are large and heavy because they require motors to generate the restorative forces, making them difficult to use in daily life and the workplace.

The force field that people feel in their movements is not only determined by externally actuated force but also influenced by intrinsic musculoskeletal structures. When those structures are damaged by disease or injury, people are often able to adapt them into atypical movement patterns. For example, people with hereditary myopathies in which proximal weakness is a dominant feature exhibit waddling gait patterns because the calf muscles compensate for weakened hip flexors and lumbar hyperlordosis due to weak trunk muscles (46, 47). This suggests that artificially placing tendons on a persons body to interfere with or limit joint movement can be a way to form a force field.

Our proposed solution for a lightweight wearable device that can facilitate specific motion incorporates the artificial bi-articular tendon, which is inspired by natural examples of muscles that cross two joints at once. Placing an artificial tendon across two joints couples the angles of the joints such that when one joint rotates, the tendon becomes taut and pulls the other joint, causing it to rotate. If one joint is fixed, then the tendon also restricts rotation of the other joint. Such artificial bi-articular tendons are applied to body-powered devices that allow a person to use one or more healthy joints to control a disabled one (48, 49). They have also been used in robotic exosuits that use a single motor to assist movement in multiple joints (50, 51). However, what would happen if a devices bi-articular tendon crossed two healthy joints? Because the tendon path is simultaneously affected by the angle of the two joints, the tendon may become taut or loose depending on the position of both joints. As a result, the person wearing the device experiences different levels of resistance in different joint chain postures.

An important factor in determining the performance of a wearable tendon system is its impedance. If tendon impedance is too high, then it causes discomfort that hinders movement, especially during dynamic motion, but if the impedance is too low, then it is difficult to limit movement to a desired range. A clutch system could be used to implement a device that can vary impedance with motion (52). However, if mostly soft materials could be used to passively change the impedance, then a new type of wearable device would be possible that could be incorporated as part of a garment.

In this study, we present an artificial tendon morphology that can design a desired force field on a wearable device without requiring a power source (Movie 1). The new tendon morphology can be incorporated into a passive full-body exosuit that uses the wearers movements to vary the impedance that the suit places on target joints. This idea is inspired by human musculoskeletal anatomy, which allows the impedance of joints to be adjusted for different environments (53, 54). Among various motor tasks, we first pay attention to lifting, which frequently results in injuries when performed with undesirable form (1, 2), and among various lifting patterns, we focus on squatting, which is considered as the desirable form in various sites (1214). To create a force field that hinders stooping to lift but facilitates squatting, we devised and installed bi-articular tendons that cross behind the wearers back, hip, and knee joints. The tendons are pulled when the back and hip are flexed and released when the knees are flexed (Fig. 1 and figs. S15 to S17).

Individual wearing exosuit and holding a box photographed from the front (A) and the back (B). (C) Stooping to pick up the object. (D) Squatting to pick up the object.

The key to the variable impedance of our design is allowing the tendons to slide laterally and change their angle. We achieved this by placing an orthogonal rubber band at the midpoint of two strands of nonparallel, bi-articular tendons connecting the hip and knees to create an A-shaped tendon structure (Fig. 2, A and B). When there is an angle difference between the upper cable and the lower cable (state angle), the cables tend to align by stretching the rubber band when the tendon is tight (Fig. 2C). When the state angle is large, the rubber band can be stretched easily under even small tension, which means the impedance of the bi-articular tendons becomes small (Fig. 2D). In contrast, when the state angle is small, the impedance of the bi-articular tendons becomes large (movie S5).

(A) Arrangement of the tendons that create body-powered variable impedance in the exosuit. (B) A-shaped tendon structure. (C) Dependence of the tendon force on the state angle. The bottom points of the lower cables are fixed to the ground; the top of the upper cable is being manually pulled. (D) Tensile profile of the A-shaped tendon structure during deformation. (E) State angle during stooping. (F) Representative concept for explaining the deformation of the A-shaped tendon structure during stooping. (G) State angle during squatting. (H) Representative concept for explaining the deformation of the A-shaped tendon structure during squatting. (I) Dependence of the tendon force and impedance on lifting strategy. During stooping, tendon impedance increases because of the decreased state angle, which leads to a rapid increase in tension (red line). During squatting, tendon impedance decreases because of the increased state angle, which leads to a slow increase in tension (blue line). When the posture begins to change from squatting to stooping, the impedance pattern changes immediately to one that interferes with stooping (yellow line).

To minimize stooping, which involves flexion of the back and hip joints (Fig. 2E), we anchored the upper cables to the shoulders and routed their paths vertically down the back and hip joints. When the wearer stoops, the upper cables are pulled upward as the back and hip joints flex, decreasing the state angle (Fig. 2F). Because squatting involves flexion of the knee joints and abduction of the hip joints (Fig. 2G), we anchored the lower cables to the feet and routed them vertically upward behind the knees. When the wearer squats, hip abduction moves the lower cables in a lateral direction and knee flexion elongates them, increasing the state angle (Fig. 2H). As a result, high impedance is created when the wearer stoops to lift and low impedance is created when the wearer squats to lift (Fig. 2I and movie S2). Therefore the force field, designed through body-powered variable impedance, gives freedom of movement within the squatting posture range but hinders movement the farther the wearers posture strays from squatting. This approach allows wearers to voluntarily select any motion pattern that is within the squatting posture range. Strategies for designing different types of trajectory-oriented force fields with body-powered variable impedance are introduced in the Supplementary Materials (figs. S3 and S4).

The design of the exosuit also allows for kneeling so that the wearer can lift large objects with relatively smaller BCF than when taking a squat (fig. S13). The left and right tendons of the suit are connected to each other through a ring-shaped pulley on the centerline of the body. This design makes the tendon slide horizontally without yielding noticeable resistance when the wearers legs cross each other. This allows wearers to comfortably perform not only kneeling but also many other movements, including walking and climbing stairs (movie S1).

We modeled the exosuit and examined the force and energy profile produced by the tendons in each posture of the wearer (Supplementary Materials). We also compared the results with actual measurements. The tension of the bi-articular tendon gradually increased as the lifting motion approached stooping and gradually decreased as it approached squatting in both the model and the measurements (Fig. 3, A to C, and movie S2). On the other hand, the potential energy stored in the hip rubber band is relatively large in the squatting posture range compared with the stooping posture range (Fig. 3, D to F, and movie S2). This result shows that the functionality of the exosuit can vary according to the wearers movement pattern; it works as a spring during squatting and as a brake (or strut) during stooping (54). The exosuit model also shows the torque and impedance applied to the joints during various postures. The torque applied to the hip and knee joints increased as the lifting posture deviated from the squatting trajectory, which hindered stooping (Fig. 4, A to C). The additive joint impedance to the hip and knee joint also increased as the lifting posture approached the stooping trajectory (Fig. 4, D and E).

(Movie S2) (A) Force on the back cables estimated by the model. See Fig. 4A for the location of the lumbopelvic angle. (B and C) Force on the back cables measured by the experiments. (D) Energy stored in the hip rubber band estimated by the model. This plot is based on the assumption that no participants made a motion in which the back extension force exceeded 200 N, a supposition that the experiment confirmed. (E and F) Energy stored in the hip rubber band measured in the experiment.

(A) Angle parameters used for analysis. (B) Additive extension torque to the hip joint. (C) Additive flexion torque to the knee joint. The rubber band that traverses the kneecap (see fig. S2) changes the direction of the knee torque to extension in the squatting motion. (D) Additive impedance to the hip joint, resisting hip flexion. (E) Additive impedance to the knee joint, resisting knee extension.

We performed experiments to assess the feasibility of the proposed suit design. Ten first-time users were recruited for a squat-lifting test and a free-lifting test. Each test was performed in with-suit and no-suit conditions. In the squat-lifting test, we measured the effect of wearing the suit on metabolic rate during squatting. The metabolic rate of 9 of 10 participants decreased, by an average of 5.26 2.4% (n = 10; mean SEM; paired t test, P = 0.073; Fig. 5). Although the reduction in the metabolic rate was not statistically significant, the results show that the exosuit does not impose an energy penalty for squatting. On the contrary, the suit slightly decreased metabolic rate during squatting despite the suits weight (850 g). The mechanical design, which enables the hip and knee rubber bands to absorb elastic energy only during the lowering motion of squatting, seems to contribute to this positive effect (Fig. 3, D to F).

(A) Metabolic rate for each participant. Each letter on the x axis of the graph corresponds to each individual participant. (B) Average metabolic rate for the total participant group (N = 10; mean SEM).

In the free-lifting test, we measured the effect of the suit on the participants voluntary lifting patterns. Lifting motion patterns were compared using the lifting postural index (LPI) (55)LPI=kneeankle+hip+lumbar vertebra(1)where ankle is the ankle plantar flexion angle, hip is the hip flexion angle, knee is the knee flexion angle, and lumbar vertebra is the flexion angle of the lumbar vertebra from the normal standing position. The lower the LPI, the closer the persons posture is to the stooping posture. A fully stooped posture and a fully squatting posture typically correspond to an LPI of 0.11 and 0.8, respectively. The suit increased LPI by 34.9% with statistical significance (N = 10; paired t test, P = 0.033, SMD = 0.79, 1 = 0.61; Fig. 6B). This increase in LPI was observed for 9 of 10 participants.

(A) LPI for each participant (mean SD). Each letter on the x axis of the graph corresponds to each individual participant. Results are ordered from left to right on the basis of participants LPI in the no-suit condition. (B) Average LPI for the total participant group (N = 10; mean SEM). (C) Average maximum trunk incline angle for the total participant group (N = 10; mean SEM). (D) Average maximum spine flexion angle for the total participant group (N = 10; mean SEM). (E) Average maximum lumbopelvic flexion angle for the total participant group (N = 10; mean SEM). (F) Average maximum knee flexion angle for the total participant group (N = 10; mean SEM). *P < 0.05.

We also analyzed the range of motion of four major joints that are closely related to the lifting posture: trunk incline, spine flexion, lumbopelvic flexion, and knee flexion angle (Fig. 6, C to F; figs. S7 to S9; and tables S2 to S5). The results show that the participants changed their kinetic chain posture into a form that made the additive joint impedance by the exosuit smaller.

We additionally assessed the efficacy of the suit on the spinal loads with inverse analysis. We estimated the BCF on the L5-S1 spine of participants during the free-lifting test using musculoskeletal simulation software (OpenSim; SimTK; fig. S10). The peak BCF was decreased by 2.2 0.94% with statistical significance (N = 10; mean SEM; paired t test, P = 0.046, SMD = 0.74, 1 = 0.55; Fig. 7B). This decrease in BCF was observed for 8 of 10 participants.

(A) Peak BCF for each participant (mean SD). Each letter on the x axis of the graph corresponds to each individual participant. (B) Average BCF for the total participant group (N = 10; mean SEM). *P < 0.05.

By additional analysis, we found that the suit force itself does not make a statistically significant effect on BCF, and the change in the voluntary lifting pattern of the participants is the major factor of the reduction in BCF (Supplementary Materials; fig. S12).

To sum up, the suit successfully changed wearers free-lifting posture closer to the squatting form immediately, and most of the wearers were able to perform squat lifting with less energy consumption and reduced BCF.

Humans have, for many centuries, sought to artificially create a better body by donning garments and harnesses that passively assist movement. Today, this involves developing state-of-the-art wearable robots, but simple passive devices still remain relatively popular (56, 57). In this study, we developed a body-powered variable impedance technique that can be embedded in a garment. The proposed mechanism does not forcibly determine the wearers body position. Instead, it changes the force field to make undesirable motions difficult and desirable motions easy, thereby inducing the wearer to voluntarily choose desirable ones.

The exosuit can be used as an assistive device to train people to lift small-sized but heavy objects by squatting. The 10 participants had no experience of lifting objects while wearing the suit before the experiment; the efficacy of the suit, which was evaluated by the experimental results, suggest that the suit induces fast motor adaptation of the wearers, resulting in the immediate reshaping of the lifting posture. Furthermore, 5 of the 10 participants did not have any weight training experience (table S1); the function of the suit is valid even for novices who lack lifting training. This immediate efficacy of the exosuit in reshaping the voluntary lifting posture may be useful in various sites, including some industrial settings (12), gyms (13), and rehabilitation centers (14), where the squat technique is recommended, particularly for untrained employees.

One limitation of the exosuit design is that it constrains forward-leaning motion and possibly interferes with movements not related to lifting objects, such as leaning forward to grasp objects. This may make the exosuit uncomfortable to wear for long periods of time. To alleviate this problem, we designed a mode control module that lets people electronically or manually adjust the exosuits range of motion of the spine and hip flexion to permit freer movement (fig. S14 and movie S3).

Impedance is one of the factors that influence human behavior, but its efficacy may differ from person to person without elaborated customization. In our experiment, each of the 10 participants showed a different degree of postural change, and one outlier changed his posture closer to stooping after wearing the suit. As a result, the statistical power decreased below 0.8. Therefore, the statistically significant change in LPI and BCF should only be accepted as a demonstration of the feasibility. As a future work, further experiments with customized exosuit parameters and the resulting impedance will contribute to establishing a more effective strategy for controlling human behavior through the body-powered variable impedance.

Although the estimated BCF reduction was not substantial, we speculate that the actual effect of the suit could be more than the calculated effect if the anatomy of the spine is taken into consideration. When the spine is straight, the facet joints share about 20% of the spinal load, reducing the load on the discs (58, 59). Therefore, for participants who decreased spine flexion after wearing the suit, the reduction in the actual stress transmitted to the disc is likely more than the reduction in the peak BCF.

There were several additional limitations of the evaluation of the device performance. First, the kind and amount of the information that can be collected during the lifting motion in the experiment were limited. Because the cables in the exosuit closely contacts with the body and slides on the wearers body surface, a conventional load cell attached to the suit would cause substantial discomfort when the wearer performs lifting. Likewise, a surface electromyography sensor attached to the wearers muscle would cause interference with the exosuit. Any design change to circumvent this discomfort or interference would degrade the performance or the compactness of the suit. Second, the effect of muscle co-contraction or detailed anatomy of the spine was not considered in the simulation. Furthermore, to the best of our knowledge, no currently available tool for inverse analysis provides a reliable way to assess the effect of soft wearable devices that continuously change the cable path like the exosuit used in this study. In future work, it is necessary to evaluate the effect of the exosuit more accurately when more advanced sensors or analysis tools become available.

Unfortunately, humans often choose to perform motor tasks in a way that is comfortable in the short term but might be harmful in the long term. Because the deleterious effects of undesired motion, such as spinal disc degeneration, develop slowly, people do not receive stimuli from them in time to adopt less harmful motor patterns (6062). On the other hand, people immediately change their movements to reduce unpleasant stimuli such as mechanical or psychological stress, pain, fatigue, or discomfort. Body-powered variable impedance can provide the missing immediate feedback about undesired motions by generating the stimulus of impedance change in response to the undesired motion, resulting in immediate sensation of mechanical resistance and discomfort. By artificially giving a high priority to any appropriate posture, this process can induce the wearer to voluntarily choose the desired movement pattern. The proposed approach will facilitate the development of wearable devices that can alter motor patterns via a deliberately designed force field without a power source.

Ten healthy male adults (N = 10; age, 25.4 2.4 years; weight, 74 7 kg; height, 175.9 2.4 cm; mean SD; table S1) participated in the experiment. All participants were people who had no experience of wearing the exosuit (participants A, C, D, E, F, G, I, and J) or who had worn the suit for less than 5 min before the experiment (participants B and H). Participants B and H had simply moved their limbs with the suit to check the suit size but had not performed any actions related to the experimental protocol before the experiment. One additional participant participated in the experiment but was excluded from the analysis because the suit did not fit his body. All experimental procedures were approved by the Institutional Review Board of Seoul National University. Participants were informed about the experiment and provided written consent before participation.

Each participant was given 5 min of warm-up time to get used to the suit and try out lifting with it. All participants conducted a squat-lifting test and then a free-lifting test (fig. S5A). In each test, the order of the no-suit and with-suit conditions was randomly assigned for each participant. In each test, participants repeatedly lifted and lowered a 10-kg box with handles at a constant rate of 10 lifts/min for 6 min, from a 200-mm-high shelf to standing height. The size of the box was 450 mm by 290 mm by 150 mm. Each test condition was separated by a 20-min break. A force plate (FP6090-15-2000, Bertec, Columbus, OH, USA) recorded the ground reaction force (GRF) during the entire experiment. We developed a timer program that provided visual and auditory stimuli to help participants lift the box at a constant speed of 10 lifts/min. Each cycle of the lifting task was 6 s long: 2 s each for lifting and lowering and 1 s of waiting time in the fully lowered and standing postures (fig. S5B). In the squat-lifting test, participants were instructed to lift the box 60 times with a squatting movement. No detailed instruction on how to squat was provided. Instead, participants were instructed to follow the guidelines in the NIOSH manual (11). Metabolic gas data were collected with a portable respiratory gas analyzer (K5, COSMED, Italy). In the free-lifting test, participants were instructed to lift the box 60 times using any movements that they liked except for asymmetric motions, such as twisting and lateral bending, which could severely hinder evaluation of the LPI. Joint positions were recorded with motion-tracking cameras (Oqus500, Qualisys, Sweden; fig. S6). Additional tests were performed on two participants to measure tendon force from back cable and hip rubber band in various lifting postures with self-selected speed. Tension on the cables was measured by load cells (333FDX, Ktoyo, South Korea).

One limitation is that we did not randomize the order of the squat-lifting test and the free-lifting test; we intended to minimize any possible effect of fatigue during the metabolic cost measurement performed in the squat-lifting test. In future work, the efficacy of the exosuit can be evaluated more systematically either by assigning multiple sets of tests to participants in random order or by assigning only a single set to a single participant after recruiting sufficient participants.

Adopting the concept of LPI from a previous study (55), we quantitatively assessed how close the participants posture was to a squatting or stooped posture. The representative posture index per lift cycle was specified as the LPI at the point when trunk inclination reached its maximum. All 60 LPI readings collected over the entire 6-min lifting test were used for the analysis.

The OpenSim (SimTK, Stanford, CA; simulation platform was used for estimating the compression force, shear force, and moment on the L5-S1 spine. A full-body lumbar spine (FBLS) model was used for the simulation (fig. S10) (63). We increased the range of motion of the hips, lumbar, knees, elbows, and arms of the FBLS model following a recommendation of previous research (64). Marker position data (fig. S6), GRF data, and a 10-kg vertical load on the hands were specified in OpenSim. Because our experiment was performed on a single large force plate, we assumed that the measured GRF was symmetrically applied to both feet. To simulate holding a 10-kg box in the hands, we set the condition that an external load of 5 kg would be applied to each hand. We followed the simulation procedure used in previous studies (64, 65). Scale model, inverse kinematics, inverse dynamics, static optimization, and joint reaction analyses were performed sequentially. A second-order Butterworth low-pass filter at a cut-off frequency of 6 Hz was applied during the static optimization. Muscle forces were calculated using the sum of the square of 324 musculotendon actuator (including 224 trunk muscle fascicles) forces as the cost function. The peak compression force, shear force, and moment for each cycle were selected as representative results (Fig. 7, fig. S11, and tables S7 to S9). All 60 spinal load readings collected over the 6-min lifting test were used for the analysis.

A portable respiratory gas analyzer was used to measure metabolic rate (K5, COSMED, Italy) during the 6-min squat-lifting cycles. Average oxygen consumption and carbon dioxide production data over the last minute of the 6-min squat-lifting cycles were used for analysis. Energy expenditure was calculated using software supported by COSMED (66), referring to existing methods (67).

A polynomial surface fitting (poly23) was performed using MATLAB (MathWorks, Natick, MA, USA) to express the force and energy data obtained in the experiment in the form of a continuous curved surface.

The data were statistically analyzed in MATLAB (MathWorks, MA, USA). We used a paired t test to compare data from the no-suit and with-suit conditions. The level of statistical significance was set at P < 0.05. Statistical powers for LPI and BCF results were analyzed using G*Power software (F. Faul, Christian-Albrechts-Universitt Kiel, Kiel, Germany) (68).

C. Hamrick, Engineering controlsWhat works and what does not, in Interventions, Controls, and Applications in Occupational Ergonomics, W. S. Marras, W. Karwowski, Eds. (CRC Press, 2014), vol. 2, chap. 5.

H. Hara, Y. Sankai, Development of HAL for lumbar support, in SCIS & ISIS (Japan Society for Fuzzy Theory and Intelligent Informatics, 2010), pp. 416421.

Y. Muramatsu, H. Umehara, H. Kobayashi, Improvement and quantitative performance estimation of the back support muscle suit, in Proceedings of 2013 35th Annual International Conference of the IEEE Engineering in Medical and Biology Society (EMBC) (IEEE, 2013), pp. 28442849.

M. Wehner, D. Rempel, H. Kazerooni, Lower extremity exoskeleton reduces back forces in lifting, in Proceedings of the ASME 2009 Dynamic Systems and Control Conference (ASME, 2009), pp. 961968.

Acknowledgments: We thank J.-R. Song for help with fabricating the suit. Funding: This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korean Government (MSIT) (NRF-2016R1A5A1938472) and by the Industrial Technology Innovation Program (no. 20007058; Development of safe and comfortable human augmentation hybrid robot suit) funded by the Ministry of Trade, Industry and Energy (MOTIE, Korea). Author contributions: S.-S.Y. and K.-J.C. proposed the research. S.-S.Y. designed and built the passive exosuit with body-powered variable impedance. K.-J.C. articulated the main idea of the study. S.-S.Y. and J.A. designed the experiment and conducted the data analysis. S.-S.Y. conducted experimental work and modeling. J.A. provided neuroscientific information related to humans. K.K. provided medical information related to humans. S.-S.Y., J.A., K.K., and K.-J.C. wrote the paper. Competing interests: S.-S.Y. and K.-J.C. are inventors on Korea patent (KR. 10-2197331 and PCT/KR2019/014441) and U.S. patent (U.S. 17/295,762), which have been submitted by SNU R&DB Foundation. The other authors declare that they have no competing interests. Data and materials availability: All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials.

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Body-powered variable impedance: An approach to augmenting humans with a passive device by reshaping lifting posture - Science



Mark Boucher and the alternative history of South Africa’s champion side – ESPNcricinfo

Aug 28th, 2021
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His testimony, and those of others at the social justice hearings, has shed light on historic systemic failures in South African cricket

"You wanna get out now because I think you might be averaging single figures on this tour," before a pause, and some mocking magnanimity: "I'll walk you to the changing room as well."

He then asked Taibu whether his average was 9 or 10 before deciding "maybe 9.5 so we'll give you 10".

The substance itself was not offensive, but the idea that sledging that Zimbabwe side served any useful purpose was very Cobra Kai. Taibu was leading a desperately weakened Zimbabwe, about to slide to a second three-day innings defeat. Moreover, Boucher was part of a South Africa side that, at that point, was not nearly as good as it thought it was. It was no contest, was never going to be, and here was Boucher sticking it into men defeated long before they stepped on to the field. Say what you want about karma, but Taibu and Boucher retired from Tests on the same day and Taibu ended with a batting average 0.01 higher than Boucher's (30.31 to 30.30).

People change, some not as much as we'd like, others not as little as we'd assume, but it is this old Boucher - or at least the whiff of him - that has been felt through Cricket South Africa's Social Justice and Nation-Building (SJN) hearings in recent weeks.

Those hearings have primarily been a cleanse, a release of a lot that has felt pent up in South African cricket. Inadvertently and in some instances, they may become a kind of reckoning. It is entirely fitting not only that Dumisa Ntsebeza, the ombudsman presiding over it, began by quoting James Baldwin - "Not everything that is faced can be changed but nothing can be changed until it is faced" - but that he was one of those who presided over South Africa's Truth and Reconciliation Commission after the fall of apartheid.

Times change. Conversations about racism now are of a different nature - and necessarily so - than as recently as a decade ago. More enlightened for one. More divisive for another, though in being staunchly, proactively anti-racist it's always worth remembering racists are not here as part of some debating society. But for all the change, for all the retrospective reassessments of racist behaviour, there could never have been a time when it was okay for a team to sing that song. Least of all a team representing South Africa, in the post-apartheid era.

Think of the skewed dynamic here: power as a function of a society with a racist past and racism as a function of power. Adams is in this team of predominantly white players and naturally he wants to fit in because it is a team and he so badly wants to feel a part of it that it wasn't until his wife (then his girlfriend) pointed out to him that it was not right that he twigged it.

Boucher admitted he sang along. He apologised for it and has offered to meet players who felt excluded to mend those relationships. There is something to Boucher's claim that the players were nave and ill-equipped to deal with the environment they were in post-apartheid; today, nearly two decades on, it seems a gross dereliction of duty that CSA didn't, as Boucher claims, conduct any awareness training, or culture workshops for players coming into the environment. Post-apartheid wasn't just going to happen by itself. But at the time, sensitivity training, diversity and inclusion were not part of widespread public conversations.

The fatalist counter to this is that if players need training workshops to learn not to sing those songs, or to not use offensive terminology about South Africans of Indian heritage in front of Prince (whose wife is of Indian origin) or Goolam Rajah, the team's long-time, much respected manager, then no amount of training will ever really be enough.

Boucher acknowledging his role in that era's culture does not absolve him. It is the first step: of how many and towards what is not clear in specific detail, but in broad outline, towards a better, more equal and transparent space.

Those songs weren't sung alone, and neither was Boucher the only one because of whom players felt discriminated against. Other names have cropped up during the hearings, many of them integral contributors to that great South Africa side. The legacy of that team is undergoing a revision as we speak, although maybe the optimistic way to see it is as a necessary correction. These hearings are the alternative history of that side, the alternative history of South African cricket as a whole, post-apartheid.

Or, in the far more eloquent words of Zondo, from his testimony: "Privilege often makes equality seem like oppression. For equality to come into place, people need to strip themselves of privilege so they can see other people's experiences."

Osman Samiuddin is a senior editor at ESPNcricinfo

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Mark Boucher and the alternative history of South Africa's champion side - ESPNcricinfo



When the world treats you differently after weight loss – WHYY

Aug 14th, 2021
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This story is from The Pulse, a weekly health and science podcast.

Subscribe onApple Podcasts,Spotifyorwherever you get your podcasts.

Much of how people experience the world is determined by their appearance, particularly how the rest of society perceives and treats them. So, what happens if someones appearance changes dramatically in just a few months?

For people who undergo bariatric surgery and experience significant weight loss, navigating those social shifts can be difficult.

Rachel Goldman, a psychologist in New York City and a clinical assistant professor in the Department of Psychiatry at NYU School of Medicine, has been helping patients before and after bariatric surgery for more than a decade.

Most people can only imagine how others would treat them if their appearance changed, but theyll never really know how other people would treat them if they were taller or prettier or thinner. Goldmans patients do.

We try to prepare people as much as we can. But I dont think people fully understand what the changes are until theyre living it, she said. Oftentimes, before surgery, Ill get clients saying to me, Yeah, sure, OK. Thats not going to happen to me.

But for many, the change is startling. After surgery, suddenly, her patients say, they get more attention, according to Goldman. They report that they feel seen in a way they had not before, as if they had been invisible before their surgery. Strangers talk to them. People hold doors for them or help them with their luggage on an airplane. It can also mean navigating a host of new social situations, like flirting and dating.

There is this weight bias and negative attitudes towards individuals in a larger body, said Goldman. And after people lose a significant amount of weight, they really do start experiencing this. People are kinder and nicer. And its like theyre no longer invisible.

The change can be swift. Goldmans patients might see their appearance change drastically in just a few months. Patients may lose up to 60% of their excess weight in just the first six months after their weight loss surgery, and 77% of their excess weight within the first year post-surgery, according to the American Society for Metabolic and Bariatric Surgery.

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When the world treats you differently after weight loss - WHYY



Weight Loss Is Confusing. Here’s Why Fat Loss May Be A Better Measure – Yahoo Lifestyle

Aug 14th, 2021
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When you have a weight loss goal, you probably break out the scale first. After all, it's one of the easiest ways to measure your progress. But, there are limitations to what that number can tell you, and in many instances, it can take you down the wrong path. Namely: Weight loss and fat loss are not the same thing. We turned to an expert to break it all down.

So, the number on the scale is lower than the week before. When you see that number go down, you can't automatically assume that it's all fat. "Weight loss is a reduction of total body mass. When you see the number on the scale go down it could be from one or a combination of fat, muscle, and water loss," says Chicago-based registered dietitian, Maggie Michalczyk.

Your body is mostly just water. As much as 60 percent of the adult body weight is made up of water weight. The term 'losing water weight' just means a fluid loss in the body, says Michalczyk. Lots of things can cause fluid retention, like your hormones or eating a lot of salt (we see you, chips and salsa!) or a higher carb meal. For each gram of carbohydrate stored in the body as glycogen, the body also stores three grams of water.

When you consume fewer calories, it's also likely you're also consuming fewer carbohydrates, whether that decrease is intentional (e.g., a lower carb diet) or natural (you're eating less). During calorie restriction, your body dips into these glycogen stores for energy and releases the accompanying water. (So long water weight.)

The scale goes down as a result of losing water weight, and this accounts for much of the weight loss in the very beginning. Adding to the confusion, "Water weight can fluctuate, so it can feel discouraging to see the number on the scale go up and down at different times of the day if you are not aware of the different variables and factors that can contribute to these changes," says Michalczyk. This is one reason why the scale can be a source of frustration and confusion and can really tank motivation.

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More likely, though, your long-term goal is to lose fat.

Weight loss can also result from fat loss (so consider fat loss under the umbrella of weight loss!). It's tricky, though, because traditional scales can only tell you how much you weigh, and most won't tell you if there's been a reduction in body fat in particular. The scale simply shows your body weight, but does not specify anything beyond that. Just by looking at that number you don't know if you're losing water weight, fat, or muscle," Michalczyk says.

Body fat percentage, specifically, can be measured in the following ways, says Michalczyk:

The DEXA scan is widely considered as one of the most accurate and comprehensive body composition tests. However, it can be expensive, and it's usually accessible. "You can also get a body composition test with calipers or use a smart scale that estimates body fat," she adds. "These methods may not be as accurate, but could be a good starting place for those looking to learn more about their body composition."

Waist circumference is also another important measure, according to the Centers for Disease Control and Prevention (CDC). For women, having a waist circumference of more than 35 inches signals excess abdominal fat, a marker of your risk for diseases like heart disease and type 2 diabetes.

When you lose weight, some is from muscle loss. To preserve this lean tissue (which supports your metabolism), eat enough protein and strength train, two factors that will aid in eventual fat loss, says Michalczyk. For sustained fat loss, being in a small calorie deficit every day, along with exercise, instead of cutting out entire food groups and over-exercising, is what I would recommend for sustained fat loss.

Michalczyk advises a gradual reduction in calories to minimize muscle loss while still accomplishing fat loss. Focus on eating less fried foods, processed foods, and sugar while enjoying more fresh fruits, quality protein sources, and (of course) vegetables.

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Weight Loss Is Confusing. Here's Why Fat Loss May Be A Better Measure - Yahoo Lifestyle


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