Cervical Spine Thrust Joint Manipulation, Education, and a Home Exercise Program for the Management of Individuals with Temporomandibular Disorder: A Prospective Case Series

Background and Purpose: Temporomandibular disorder (TMD) often leads to chronic pain and disability. Current evidence supporting potentially effective physical therapy (PT) intervention in TMD is limited, however, some support exists for manual therapy, education, and exercise. The purpose of this case series was to describe outcomes in participants with TMD treated with cervical spine manual therapy, education, and exercise. Methods: Five participants (mean symptom duration 2.2 years) with TMD were treated with atlanto-occipital and C2-3 cervical spine thrust joint manipulation (TJM), behavioral education, and a home exercise program for 3 visits over 4 weeks. Primary outcomes included jaw range of motion (ROM), Numeric Pain Rating Scale, Jaw Functional Limitation Scale, and Global Rating of Change (GROC). Secondary measures included pain pressure threshold (PPT), Neck Disability Index, TMD Disability Index, and cervical ROM. Results: Clinically meaningful change was noted in cervical and jaw ROM. Three of five participants (60%) reported symptoms at least “moderately better” (≥ 4 GROC) at 4-weeks. No adverse events were reported. Clinical Relevance: All participants had at least 1 year duration of pain indicating spontaneous recovery was unlikely. While cause and effect relationships cannot be determined, outcomes indicate the approach may be effective. Conclusion: Cervical spine TJM added to education and exercise over three visits may be effective in the chronic TMD population. Future randomized clinical trials are necessary to draw specific conclusion

Climate change and the Delta, San Francisco Estuary and Watershed Science

Anthropogenic climate change amounts to a rapidly approaching, “new” stressor in the Sacramento–San Joaquin Delta system. In response to California’s extreme natural hydroclimatic variability, complex water-management systems have been developed, even as the Delta’s natural ecosystems have been largely devastated. Climate change is projected to challenge these management and ecological systems in different ways that are characterized by different levels of uncertainty. For example, there is high certainty that climate will warm by about 2°C more (than late-20th-century averages) by mid-century and about 4°C by end of century, if greenhouse-gas emissions continue their current rates of acceleration. Future precipitation changes are much less certain, with as many climate models projecting wetter conditions as drier. However, the same projections agree that precipitation will be more intense when storms do arrive, even as more dry days will separate storms. Warmer temperatures will likely enhance evaporative demands and raise water temperatures. Consequently, climate change is projected to yield both more extreme flood risks and greater drought risks. Sea level rise (SLR) during the 20th century was about 22cm, and is projected to increase by at least 3-fold this century. SLR together with land subsidence threatens the Delta with greater vulnerabilities to inundation and salinity intrusion. Effects on the Delta ecosystem that are traceable to warming include SLR, reduced snowpack, earlier snowmelt and larger storm-driven streamflows, warmer and longer summers, warmer summer water temperatures, and water-quality changes. These changes and their uncertainties will challenge the operations of water projects and uses throughout the Delta’s watershed and delivery areas. Although the effects of climate change on Delta ecosystems may be profound, the end results are difficult to predict, except that native species will fare worse than invaders. Successful preparation for the coming changes will require greater integration of monitoring, modeling, and decision making across time, variables, and space than has been historically normal

Proverb comprehension in individuals with agenesis of the corpus callosum

Comprehension of non-literal language involves multiple neural systems likely involving callosal connections. We describe proverb comprehension impairments in individuals with isolated agenesis of the corpus callosum (AgCC) and normal-range general intelligence. Experiment 1 compared Gorham Proverb Test (Gorham, 1956) performance in 19 adults with AgCC and 33 neurotypical control participants of similar age, sex, and intelligence. Experiment 2 used the Proverbs subtest of the Delis-Kaplan Executive Function System (D-KEFS, 2001) to compare 19 adults with AgCC and 17 control participants with similar age, sex, and intelligence. Gorham Proverbs performance was impaired in the AgCC group for both the free-response and multiple-choice tasks. On the D-KEFS proverbs test, the AgCC group performed significantly worse on the free-response task (and all derivative scores) despite normal levels of performance on the multiple-choice task. Covarying verbal intelligence did not alter these outcomes. However, covarying a measure of non-literal language comprehension considerably reduced group differences in proverb comprehension on the Gorham test, but had little effect on the D-KEFS group differences. The difference between groups seemed to be greatest when participants had to generate their own interpretation (free response), or in the multiple choice format when the test included many proverbs that were likely to be less familiar. Taken together, the results of this study clearly show that proverb comprehension is diminished in individuals with AgCC compared to their peers

Sociology of low expectations: Recalibration as innovation work in biomedicine

"This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm). "Social scientists have drawn attention to the role of hype and optimistic visions of the future in providing momentum to biomedical innovation projects by encouraging innovation alliances. In this article, we show how less optimistic, uncertain, and modest visions of the future can also provide innovation projects with momentum. Scholars have highlighted the need for clinicians to carefully manage the expectations of their prospective patients. Using the example of a pioneering clinical team providing deep brain stimulation to children and young people with movement disorders, we show how clinicians confront this requirement by drawing on their professional knowledge and clinical expertise to construct visions of the future with their prospective patients; visions which are personalized, modest, and tainted with uncertainty. We refer to this vision-constructing work as recalibration, and we argue that recalibration enables clinicians to manage the tension between the highly optimistic and hyped visions of the future that surround novel biomedical interventions, and the exigencies of delivering those interventions in a clinical setting. Drawing on work from science and technology studies, we suggest that recalibration enrolls patients in an innovation alliance by creating a shared understanding of how the “effectiveness” of an innovation shall be judged.This project was funded by the Wellcome Trust (Wellcome Trust Biomedical Strategic Award 086034)

Seeing with sound? Exploring different characteristics of a visual-to-auditory sensory substitution device

Sensory substitution devices convert live visual images into auditory signals, for example with a web camera (to record the images), a computer (to perform the conversion) and headphones (to listen to the sounds). In a series of three experiments, the performance of one such device (‘The vOICe’) was assessed under various conditions on blindfolded sighted participants. The main task that we used involved identifying and locating objects placed on a table by holding a webcam (like a flashlight) or wearing it on the head (like a miner’s light). Identifying objects on a table was easier with a hand-held device, but locating the objects was easier with a head-mounted device. Brightness converted into loudness was less effective than the reverse contrast (dark being loud), suggesting that performance under these conditions (natural indoor lighting, novice users) is related more to the properties of the auditory signal (ie the amount of noise in it) than the cross-modal association between loudness and brightness. Individual differences in musical memory (detecting pitch changes in two sequences of notes) was related to the time taken to identify or recognise objects, but individual differences in self-reported vividness of visual imagery did not reliably predict performance across the experiments. In general, the results suggest that the auditory characteristics of the device may be more important for initial learning than visual associations

A Positive Relationship Between Religious Faith and Forgiveness: Faith in the Absence of Data?

Religious faith and beliefs appear to play an important role in the lives of many individuals and are the topic of much research. The present study investigated the relationship between religious faith and forgiveness in a sample (n = 196) of college students. Students were asked to complete the Heartland Forgiveness Scale and the Santa Clara Strength of Religious Faith Questionnaire. Analyses of scores on both measures revealed a positive, significant correlation between these constructs, suggesting that there is a meaningful relationship between religious faith and the tendency to forgive. Implications and directions for further research are discussed

Use of massively multiple merged data for low‐resolution S‐SAD phasing and refinement of flavivirus NS1

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109310/1/S1399004714017556.pd

Perceptions and Experiences of Environmental Health Risks Among New Mothers: A Qualitative Study in Ontario, Canada

There is a growing awareness and concern in contemporary societies about potential health impacts of environmental contaminants on children. Mothers are traditionally more involved than other family members in managing family health and household decisions and thus targeted by public health campaigns to minimise risks. However little is known about how new mothers perceive and experience environmental health risks to their children. In 2010, we undertook a parallel case study using qualitative, in-depth interviews with new mothers and focus groups with public health key informants in two Public Health Units in Ontario Province, Canada. We found that the concern about environmental hazards among participants ranged from having no concerns to actively incorporating prevention into daily life. Overall, there was a common perception among participants that many risks, particularly in the indoor environment, were controllable and therefore of little concern. But environmental risks that originate outside the home were viewed as less controllable and more threatening. In response to such threats, mothers invoked coping strategies such as relying on the capacity of children\u27s bodies to adapt. Regardless of the strategies adopted, actions (or inactions) were contingent upon active information seeking. We also found an optimistic bias in which new mothers reported that other children were at greater risk despite similar environmental circumstances. The findings suggest that risk communication experts must attend to the social and environmental contexts of risk and coping when designing strategies around risk reducing behaviours

Electron spin coherence in metallofullerenes: Y, Sc and La@C82

Endohedral fullerenes encapsulating a spin-active atom or ion within a carbon cage offer a route to self-assembled arrays such as spin chains. In the case of metallofullerenes the charge transfer between the atom and the fullerene cage has been thought to limit the electron spin phase coherence time (T2) to the order of a few microseconds. We study electron spin relaxation in several species of metallofullerene as a function of temperature and solvent environment, yielding a maximum T2 in deuterated o-terphenyl greater than 200 microseconds for Y, Sc and La@C82. The mechanisms governing relaxation (T1, T2) arise from metal-cage vibrational modes, spin-orbit coupling and the nuclear spin environment. The T2 times are over 2 orders of magnitude longer than previously reported and consequently make metallofullerenes of interest in areas such as spin-labelling, spintronics and quantum computing.Comment: 5 pages, 4 figure

Comparing identity, attitudes, and indicators of effectiveness in people who smoke, vape or use heated tobacco products: a cross-sectional study

Background: There is limited long-term and independent research on heated tobacco products (HTPs). We compared people who used HTPs with those who used nicotine vaping products (NVP) or cigarettes on smoker identity, indicators of effectiveness and, among NVP/HTP users, perceptions of these products. // Methods: Adults exclusive cigarette smokers (N=45) and ex-smokers with medium/long-term (>3months) NVP (N=46) or HTP use (N=45) were recruited in London, UK. Participants completed a questionnaire assessing socio-demographics, smoking characteristics, smoker identity, dependence, intention to stop and attitudes towards HTP/NVP. // Results: In adjusted analysis, people who used cigarettes (Mean Difference (MD)=1.4, 95%Confidence Intervals (CI) 0.7,2.0) and HTPs (MD=0.8, 95%CI 0.1,1.5) reported stronger smoker identities than those who used NVPs. Compared with smokers, HTP/NVP users had lower cravings for cigarettes (MD=3.0, 95%CI 1.6,4.3; MD=3.1, 95%CI 1.9,4.3, respectively), and higher intention to stop product use (MD=-0.8, 95%CI -1.7,-0.01; MD=-1.2, 95%CI -2.0,-0.3, respectively). People using HTPs or NVPs reported similar perceived product satisfaction (HTP:M=3.4, 95%CI 2.8,3.9; NVP:M=3.0, 95%CI 2.5,3.5), efficacy for smoking cessation (HTP:M=4.5, 95%CI 4.2,4.9; NVP:M=4.6, 95%CI 4.3,4.9) and safety (HTP:M=2.1, 95%CI 2.0,2.2; NVP:M=2.0, 95%CI 1.8,2.1). HTP users reported greater perceived addictiveness than NVPs (MD=0.3, 95%CI 0.2,0.6). // Conclusions: HTP and NVP users perceived products to be similarly acceptable and effective suggesting that HTPs, like NVPs, may support smoking cessation. However, since HTP use appears to maintain a stronger smoker identity and perceived addiction, this may suggest a more limited role of HTP for a permanent transition away from cigarettes