ObjectiveTo compare the effects of lumbar stabilization exercises and lumbar dynamic strengthening exercises on the maximal isometric strength of the lumbar extensors, pain severity and functional disability in patients with chronic low back pain (LBP).MethodsPatients suffering nonspecific LBP for more than 3 months were included prospectively and randomized into lumbar stabilization exercise group (n=11) or lumbar dynamic strengthening exercise group (n=10). Exercises were performed for 1 hour, twice weekly, for 8 weeks. The strength of the lumbar extensors was measured at various angles ranging from 0° to 72° at intervals of 12°, using a MedX. The visual analog scale (VAS) and the Oswestry Low Back Pain Disability Questionnaire (ODQ) were used to measure the severity of LBP and functional disability before and after the exercise.ResultsCompared with the baseline, lumbar extension strength at all angles improved significantly in both groups after 8 weeks. The improvements were significantly greater in the lumbar stabilization exercise group at 0° and 12° of lumbar flexion. VAS decreased significantly after treatment; however, the changes were not significantly different between the groups. ODQ scores improved significantly in the stabilization exercise group only.ConclusionBoth lumbar stabilization and dynamic strengthening exercise strengthened the lumbar extensors and reduced LBP. However, the lumbar stabilization exercise was more effective in lumbar extensor strengthening and functional improvement in patients with nonspecific chronic LBP.

ObjectiveTo investigate the inter-rater agreement using the Videofluoroscopic Dysphagia Scale (VDS).MethodThe present study was designed as a multicenter, single-blind trial. A Videofluoroscopic Swallowing Study (VFSS) was performed using the protocol described by J.A Logemann. Thick-fluid, pureed food, mechanically altered food, regularly textured food, and thin-fluid boluses were sequentially swallowed. Each participant received a 3 ml bolus followed by a 5 ml bolus of each food material, in the order mentioned above. All study procedures were video recorded. Discs containing these video recordings in random order were distributed to interpreters who were blinded to the participant information. The video recordings were evaluated using a standardized VDS sheet and the inter-rater reliability was calculated.ResultsIn total, 100 patients participated in this study and 10 interpreters analyzed the findings. Inter-rater reliability was fair in terms of lip closure (κ: 0.325), oral transit time (0.253), delayed triggering of pharyngeal swallowing (0.300), vallecular residue (0.275), laryngeal elevation (0.345), pyriform sinus residue (0.310), coating of the pharyngeal wall (0.310), and aspiration (0.393). However, other parameters of the oral phase were lower than those of the pharyngeal phase (0.06-0.153). Moreover, the summation of VDS reliability (intraclass correlation coefficient: 0.556) showed moderate agreement.ConclusionVDS shows a moderate rate of agreement for evaluating the swallowing function. However, many of the parameters demonstrated a lower rate of agreement, particularly the oral phase parameters.

Future greenhouse warming is expected to influence the characteristics of global monsoon systems. However, large regional uncertainties still remain. Here we use 16 Coupled Model Intercomparison Project Phase 6 (CMIP6) models to determine how the length of the summer rainy season and precipitation extremes over the Asian summer monsoon domain will change in response to greenhouse warming. Over East Asia the models simulate on average on the earlier onset and later retreat; whereas over India, the retreat will occur later. The model simulations also show an intensification of extreme rainfall events, as well as an increase of seasonal drought conditions. These results demonstrate the high volatility of the Asian summer monsoon systems and further highlight the need for improved water management strategies in this densely populated part of the world.Plain Language Summary Future climate change is expected to influence the characteristics of the global monsoon system. However, large regional uncertainties still remain. Using 16 Coupled Model Intercomparison Project Phase 6 models, we determine the impact of greenhouse warming on the length of the summer rainy season and precipitation extremes over the Asian subregional monsoon domains (East Asia, western North Pacific, India, and Indo-China Peninsula). Over East Asia the models simulate on average an earlier inception and a later termination of the summer rainy season, whereas over India, the termination will occur later. The model simulations also show an intensification of extreme rainfall events, as well as an increase of seasonal drought conditions. Our results demonstrate the high volatility of the Asian summer monsoon system and further highlight the need for improved water management strategies in this densely populated part of the world.

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Global drought assessment has mainly depended on precipitation‐based drought indices that may also take into account potential evapotranspiration (ETp). In this study, we combined the actual evapotranspiration (ETa) estimated from the Bouchet hypothesis and the structure of the Standardized Precipitation‐Evapotranspiration Index to develop a fully ET‐based drought index, the Standardized Evapotranspiration Deficit Index (SEDI). We found that SEDI, without using precipitation data, produces results that are consistent with the Palmer Drought Severity Index (PDSI) and the Standardized Precipitation Index (SPI) for drought identification in the South‐Central United States. We also found a competitive performance of SEDI through comparisons between the Vegetation Health Index with SEDI, PDSI, and SPI. We suggest the high applicability of the SEDI based on the Bouchet hypothesis as an independent drought index for regions with strong land‐atmosphere coupling or as an alternative drought index to fully precipitation‐dependent indices for assessing agricultural droughts.

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<p><span>Future greenhouse warming is expected to influence the character of global monsoon systems. However, large regional uncertainties still remain. Here we use 16 CMIP6 models to determine how the length of the summer rainy season and precipitation extremes over the Asian summer monsoon domain will change in response to greenhouse warming. Over East Asia the models simulate on average on the earlier onset and later retreat; whereas over India, the retreat will occur later. The model simulations also show an intensification of extreme rainfall events, as well as an increase of seasonal drought conditions. These results demonstrate the high volatility of the Asian summer monsoon systems and further highlight the need for improved water management strategies in this densely-populated part of the world.</span></p>

A salivagram may be a useful method for the evaluation of aspiration in elderly people, and a combination of the VFSS and salivagram methods could enable a more effective investigation of aspiration pneumonia.