Background. Neck and shoulder complaints caused by poor posture may influence upper trapezius stiffness. The relationship between the shear elastic modulus of the upper trapezius and cervical flexion angles is unknown. Therefore, it is essential to assess upper trapezius stiffness during cervical flexion. The objectives of this study were to (1) determine the intra- and interoperator reliabilities of evaluating upper trapezius stiffness and calculate the minimal detectable change (MDC); (2) examine the elastic modulus alterations of the upper trapezius during cervical flexion; and (3) explore the difference of upper trapezius stiffness between the dominant and nondominant sides. Methods. Twenty healthy male participants were recruited in this study. The shear modulus of the upper trapezius was evaluated by two independent investigators using shear wave elastography (SWE) during cervical flexion at 0° and 50°. Findings. The intraoperator (intraclass correlation coefficient ICC=0.85–0.86) and interoperator (ICC=0.94–0.98) reliabilities for measuring the shear elastic modulus of the upper trapezius during the cervical flexion ranged from good to excellent. An increase of 35.58% in upper trapezius stiffness was found at 0° to 50° of cervical flexion, and the MDC was 7.04 kPa. In addition, a significant difference was obtained in the elastic modulus of the upper trapezius muscle between the dominant and nondominant sides (P<0.05). Conclusions. Our findings revealed that SWE could quantify the elastic modulus of the upper trapezius and monitor its changes. Therefore, further studies are required to delineate the modulation in upper trapezius muscle stiffness among subjects with neck and shoulder pain.

BackgroundHand, Foot, and Mouth Disease (HFMD) is most frequently caused by Enterovirus71 (EV-A71) or Coxsackie virus A16 (CV-A16), infants and young children are at greatest risk. Describing the epidemiology of HFMD can help develop and better target interventions, including the use of pediatric EV-A71 vaccination.MethodsWe obtained data from the national surveillance system for HFMD cases with onset dates from 2009 to 2015. We defined probable cases as patient with skin papular or vesicular rashes on the hands, feet, mouth, or buttocks and confirmed cases as patients with the above symptoms along with laboratory-based enterovirus detection. We generated overall and age-specific annual incidence rates and described the temporal variability and seasonality of HFMD in Qinghai Province. We identified spatial clustering of HFMD incidence at the county level using the Local Indicator of Spatial Associationand an alpha level of 0.05.ResultsDuring the study period, 14,480 HFMD probable or confirmed cases were reported in Qinghai Province. Of the 2158 (14.9%) with laboratory confirmation, 924 (42.6%) were caused by CV-A16 and 830 (38.2%) were caused by EV-A71. The majority (89%) of all case-patients were ≤ 5 years of age and male (61.5%). The overall mean annual HFMD incidence rate was 36.4 cases per 100,000 populations, while the incidence rate for children ≤5 years of age was 379.5 cases per 100,000. Case reports peaked during the months of May through July. HFMD was predominantly caused by EV-A71, except in 2010 and 2014 when CV-A16 was the predominant causative agent. High incidence rates of HFMD were clustered (Moran’s I = 0.59, P < 0.05) in the eastern region of the province.ConclusionHFMD remains an important cause of childhood disease in Qinghai Province, occurring in an acyclical pattern of increased incidence, primarily due to CV-A16 circulation every three years. Incidence is also seasonal and tends to spatially cluster in the eastern region of the province. Since approximately 40% of confirmed HFMD cases were due to EV-A71, EV-A71 vaccination is likely to have a positive impact on the HFMD disease burden. Routine analysis of local surveillance data is crucial for describing disease occurrence and changes in etiology.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3509-7) contains supplementary material, which is available to authorized users.

To develop a nonbearing prefabricated straw sandwich concrete wallboard (I-beam beetle elytron plate: IBEPsc), the effect of certain structural parameters (e.g., panel thickness T, number of I-cores N and core height h) on the mechanical and thermal insulation performance was investigated by using the finite element method. The results are as follows: 1) The bearing capacity of the IBEPsc is controlled by the maximum principal tensile stress; the optimal structural parameters of the IBEPsc for a self-insulated wall with a large safety margin are presented. 2) The consideration of strips vs. whole plates and the selected upper bearing constraint type have little influence on the mechanical properties. In practical applications, the strips and whole plates can be reasonably selected according to engineering needs, and these components can be connected with the main structure by conventional mortar. 3) According to a qualitative analysis and comparison with common I-shaped thermal insulation walls, the IBEPsc requires the least material and weight while ensuring a sufficient safety margin in terms of mechanical and thermal insulation performance. Hence, biomimic techniques can play a key role in breaking through the limitations of traditional structures. This paper can help direct the application of beetle elytron plates in prefabricated wallboards.

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In the present study, the shear failure mode and mechanical properties of the core structure of biomimetic fully integrated honeycomb plates with sealing edges were investigated experimentally and through the finite element method. The findings are as follows: (1) the failure mode of the sealing edges and honeycomb walls perpendicular to the shear direction is mainly debonding between the fiber and matrix, whereas fiber breakage, debonding between the fiber and matrix and exfoliation of the resin matrix occur in the sealing edges parallel to the shear direction. Meanwhile, the reasonableness and feasibility of the double shear testing apparatus designed in this study were verified, thus confirming the results of research are reliable and valid. (2) Shear failure of the core structure of fully integrated honeycomb plates is mainly fiber debonding appearing in the middle surface of the core structure, which is a failure of the material interface. Stripping failure in the joint interface of the core layer and upper and lower plates does not occur, which indicates that the biological structure possesses excellent integral mechanical properties. (3) The sealing edges parallel to the shear direction and the honeycomb walls that are oriented 30 degrees to the shear direction are the first to fail, followed by the sealing edges and honeycomb walls perpendicular to the shear direction, which is consistent with the microscopic failure phenomenon observed in both directions. To prevent failure at the material interface, the fully integrated honeycomb plates manufactured in this experiment require further improvements. Thus, countermeasures are proposed, such as pre-treating the fiber surface. These findings will specify future research directions to perfect fully integrated honeycomb plates and improve the shear mechanical properties of core structures.