Spinal Mechanical Load: A risk factor for non-specific low back pain?

In 1938 Gilcreest wrote: ‘There is no condition which produces more disability and economic loss and, therefore, is so costly to industry as low back pain’ [1]. Seventy years after this statement, a large number of systematic reviews are published concerning the effectiveness of treatments for low back pain [2,3,4,5,6,7,8]. Despite this large amount of evidence regarding the management, low back pain remains a major health problem worldwide [9] with a reported 1-year prevalence ranging from 15% to 40% in a general population [10]. About 85% of the cases with low back pain are labelled as non-specific, i.e. not attributed to recognisable pathology [11]. Acute (i.e. complaints lasting 0-6 weeks) non-specific low back pain is considered a benign self-limiting disease, with a recovery rate of 80-90% within six weeks in the open population, irrespective type of management or treatment [12]. However, recurrence rates are reported as high as 50% in the following 12 months. Therefore, acute non-specific low back pain should be viewed as a persistent condition in many patients [13,14]. Primary as well as secondary prevention might be beneficial in the management of acute low back pain. For prevention, knowledge of the risk factors is essential. Although epidemiological studies have identified many individual, psychosocial and occupational risk factors for the onset of low back pain, their independent prognostic value is usually low [15]

Search for flavour-changing neutral currents in processes with one top quark and a photon using 81 fb⁻¹ of pp collisions at \sqrts = 13 TeV with the ATLAS experiment

A search for flavour-changing neutral current (FCNC) events via the coupling of a top quark, a photon, and an up or charm quark is presented using 81 fb−1 of proton–proton collision data taken at a centre-of-mass energy of 13 TeV with the ATLAS detector at the LHC. Events with a photon, an electron or muon, a b-tagged jet, and missing transverse momentum are selected. A neural network based on kinematic variables differentiates between events from signal and background processes. The data are consistent with the background-only hypothesis, and limits are set on the strength of the tqγ coupling in an effective field theory. These are also interpreted as 95% CL upper limits on the cross section for FCNC tγ production via a left-handed (right-handed) tuγ coupling of 36 fb (78 fb) and on the branching ratio for t→γu of 2.8×10−5 (6.1×10−5). In addition, they are interpreted as 95% CL upper limits on the cross section for FCNC tγ production via a left-handed (right-handed) tcγ coupling of 40 fb (33 fb) and on the branching ratio for t→γc of 22×10−5 (18×10−5). © 2019 The Author(s

Search for long-lived neutral particles in pp collisions at s√=13 TeV that decay into displaced hadronic jets in the ATLAS calorimeter

This paper describes a search for pairs of neutral, long-lived particles decaying in the ATLAS calorimeter. Long-lived particles occur in many extensions to the Standard Model and may elude searches for new promptly decaying particles. The analysis considers neutral, long-lived scalars with masses between 5 and 400 GeV, produced from decays of heavy bosons with masses between 125 and 1000 GeV, where the long-lived scalars decay into Standard Model fermions. The analysis uses either 10.8 fb−1 or 33.0 fb−1 of data (depending on the trigger) recorded in 2016 at the LHC with the ATLAS detector in proton–proton collisions at a centre-of-mass energy of 13 TeV. No significant excess is observed, and limits are reported on the production cross section times branching ratio as a function of the proper decay length of the long-lived particles

Evidence for the production of three massive vector bosons with the ATLAS detector

A search for the production of three massive vector bosons in proton-proton collisions is performed using data at $\sqrt{s} = 13$ TeV recorded with the ATLAS detector at the Large Hadron Collider in the years 2015-2017, corresponding to an integrated luminosity of $79.8$ fb$^{-1}$. Events with two same-sign leptons $\ell$ (electrons or muons) and at least two reconstructed jets are selected to search for $WWW \to \ell \nu \ell \nu qq$. Events with three leptons without any same-flavour opposite-sign lepton pairs are used to search for $WWW \to \ell \nu \ell\nu \ell \nu$, while events with three leptons and at least one same-flavour opposite-sign lepton pair and one or more reconstructed jets are used to search for $WWZ \to \ell \nu qq \ell \ell$. Finally, events with four leptons are analysed to search for $WWZ \to \ell \nu \ell \nu \ell \ell$ and $WZZ \to qq \ell \ell \ell \ell$. Evidence for the joint production of three massive vector bosons is observed with a significance of 4.1 standard deviations, where the expectation is 3.1 standard deviations.Comment: 38 pages in total, author list starting page 22, 6 figures, 5 tables, matching published paper in Phys. Lett. B. All figures including auxiliary figures are available at http://atlas.web.cern.ch/Atlas/GROUPS/PHYSICS/PAPERS/STDM-2017-2

Chlorhexidine mouthwash and sodium lauryl sulphate dentifrice: do they mix effectively or interfere?

Focused question: What is the effectiveness of a chlorhexidine (CHX) mouthwash used in combination with a sodium lauryl sulphate (SLS) dentifrice on the parameters of plaque and gingivitis? Material and methods: MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched up to July 2014. The inclusion criteria were (randomized) controlled clinical trials, subjects ≥18 years of age with good general health. Papers evaluating the effect of CHX mouthwash used in combination with SLS dentifrice or a dentifrice slurry compared with CHX mouthwash as a single oral hygiene intervention or in combination with an SLS-free dentifrice were included. From the eligible studies, data were extracted, and a meta-analysis was performed when feasible. Results: Independent screening of 83 unique papers resulted in four eligible publications, with nine comparisons. The meta-analysis showed that when an SLS dentifrice was used as a slurry rinse, the interference on the plaque-inhibiting effect of a CHX mouthwash was significantly decreased (MD 0.33; P ≤ 0.00001; 95% CI: ). No significant difference was observed when SLS dentifrice was applied as a paste in combination with CHX mouthwash (MD 0.08; P = 0.42; 95% CI: ). Descriptive and subgroup analyses support these findings. Moreover, the observed effect for the dentifrice paste occurred regardless of the order of use. Conclusion This review demonstrates that when CHX mouthwash is recommended, it can be used in combination with an SLS dentifrice without any interference regarding its inhibiting effect on dental plaque, regardless of the order of use. Consequently, the collective evidence indicates that the combined use of dentifrice and CHX mouthwash is not contraindicated. However, this recommendation has been graded as moderate taking into account a potential publication bias because three of the four included studies emerged from the same research group

Plaque removal with triple-headed vs single-headed manual toothbrushes-a systematic review

ObjectiveThe aim of this systematic review was to establish the effectiveness of brushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush on plaque removal. Materials and methodsThe MEDLINE-PubMed and Cochrane-CENTRAL databases were searched. The inclusion criteria were clinical trials conducted with humans without fixed orthodontic appliances who were not dental care professionals. Papers that evaluated the effect of toothbrushing with a triple-headed manual toothbrush compared to a single-headed manual toothbrush on plaque removal were included. Data were extracted from the eligible studies, and a descriptive analysis was performed. ResultThe search retrieved 15 eligible publications including 18 relevant comparisons. Heterogeneity was most obvious with respect to the person who performed the brushing, either the participants themselves or a caregiver responsible for daily oral hygiene. Additionally, participant characteristics such as age and individual disabilities varied. A lack of appropriate data and a variation in the indices used allowed only a descriptive analysis. Of the 14 comparisons with self-performed brushing by the participants, the majority showed no difference between triple-headed and single-headed toothbrushes, with a few favouring the triple-headed. In the comparisons in which a caregiver performed the brushing, three of the four showed that the triple-headed toothbrush performed significantly better on the reduction in plaque scores. ConclusionFrom this review emerges the recommendation that the use of a triple-headed manual toothbrush instead of a single-headed manual toothbrush might be favorable with respect to plaque removal in case a care-dependent individual is brushed by a caregive

Does dentifrice use help to remove plaque?: A systematic review

Aims: The aim of this systematic review was to establish the efficacy of brushing with and without a dentifrice for dental plaque removal. Materials and Methods: MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched. The inclusion criteria were randomized controlled trials and controlled clinical trials and subjects ≥18 years of age with good general health. Studies that evaluated the effect of toothbrushing with a dentifrice compared to brushing without a dentifrice were included. Data were extractedfrom the eligible studies, and a meta-analysis was performed where feasible. Result: The search was conducted until June 2016 and retrieved 10 eligible publications that included 20 comparisons. On average, 49.2% of plaque was removed when brushing was performed with a dentifrice, and 50.3% of plaque was removed when toothbrushing was performed without a dentifrice. The descriptive analysis indicated that the majority of the comparisons did not show an additional effect of dentifrice use. Regarding the meta-analysis of post-brushing scores, no significant difference was observed between toothbrushing with and without a dentifrice (DiffM 0.00, 95%CI [_0.05: 0.05], p = 0.91). The meta-analysis of incremental data (as means or percentages) supported and strengthened these findings. Conclusion: The cumulative evidence for this systematic review demonstrates that there is moderate certainty that toothbrushing with a dentifrice does not provide an added effect for the mechanical removal of dental plaque

The effect of an oxygenating agent on chlorhexidine-induced extrinsic tooth staining: a systematic review

BACKGROUND: Although chlorhexidine digluconate (CHX) is currently the most effective mouthwash for reducing plaque and gingivitis, one of its side effects is extrinsic tooth staining. Interestingly, oxygenating agents may reduce this staining. OBJECTIVE: The aim of this review was to systematically search the literature for data concerning the inhibiting effect of an oxygenating agent (OA) on CHX-induced tooth staining. METHODS: MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other relevant electronic databases were searched for articles that were published up to November 2011. Articles were included if they were randomized controlled trials or controlled clinical trials conducted with healthy subjects ≥ 16 years of age that compared the effects of CHX mouthrinse combined with an OA with the effects of CHX alone. RESULTS: An independent screening of 1183 titles and abstracts resulted in 4 publications that met the inclusion criteria. The extracted data allowed meta-analyses of intermediate length studies and showed that combining an OA with CHX mouthrinses led to a significant reduction in tooth staining (mean difference: 0.27; P = 0.02) and plaque scores (mean difference: 0.10; P = 0.003) when compared with CHX alone. One of the included studies reported a side effect for one participant. The present review was limited by the availability of data, and the included studies were methodologically and clinically heterogeneous, which affected the quality and interpretation of the evidence. CONCLUSION: There is moderate evidence that a combination of CHX and an OA reduces tooth staining without interfering with plaque growth inhibition

Spinal mechanical load: A predictor of persistent low back pain? A prospective cohort study

Prospective inception cohort. To assess the prognostic value of spinal mechanical load, assessed with the 24-hour schedule (24HS), in subjects with acute non-specific low back pain (ALBP) and to examine the influence of spinal mechanical load on the course of ALBP. In view of the characteristics of the natural course of ALBP, this should be viewed as a persistent condition in many patients rather that a benign self-limiting disease. Therefore, secondary prevention could be beneficial. Spinal mechanical load is a risk factor for ALBP and possibly a (modifiable) prognostic factor for persistent (i.e. recurrent and/or chronic) LBP. One hundred patients from primary care with ALBP were eligible for inclusion. At 6 months, 88 subjects completed the follow-up. For the follow-up assessment a research assistant, unaware of our interest in the prognostic factors, contacted the subjects by telephone. Questionnaires were completed focusing on changes in demographic data and on the course and current status of ALBP. Persistent LBP occurred in 60% subjects. After multivariate regression analysis smoking (harmful) and advanced age (protective) were associated with persistent LBP. Differences in 24HS scores at baseline and follow-up were univariate-related to persistent LBP. Spinal mechanical load, quantified with the 24HS, is not a prognostic factor for persistent LBP. Modification of spinal mechanical load in terms of 24HS scores could be beneficial for secondary prevention in patients with acute LBP