A non-surgical approach to the management of lumbar spinal stenosis: A prospective observational cohort study

BACKGROUND: While it is widely held that non-surgical management should be the first line of approach in patients with lumbar spinal stenosis (LSS), little is known about the efficacy of non-surgical treatments for this condition. Data are needed to determine the most efficacious and safe non-surgical treatment options for patients with LSS. The purpose of this paper is to describe the clinical outcomes of a novel approach to patients with LSS that focuses on distraction manipulation (DM) and neural mobilization (NM). METHODS: This is a prospective consecutive case series with long term follow up (FU) of fifty-seven consecutive patients who were diagnosed with LSS. Two were excluded because of absence of baseline data or failure to remain in treatment to FU. Disability was measured using the Roland Morris Disability Questionnaire (RM) and pain intensity was measured using the Three Level Numerical Rating Scale (NRS). Patients were also asked to rate their perceived percentage improvement. RESULTS: The mean patient-rated percentage improvement from baseline to the end to treatment was 65.1%. The mean improvement in disability from baseline to the end of treatment was 5.1 points. This was considered to be clinically meaningful. Clinically meaningful improvement in disability from baseline to the end of treatment was seen in 66.7% of patients. The mean improvement in "on average" pain intensity was 1.6 points. This did not reach the threshold for clinical meaningfulness. The mean improvement in "at worst" pain was 3.1 points. This was considered to be clinically meaningful. The mean duration of FU was 16.5 months. The mean patient-rated percentage improvement from baseline to long term FU was 75.6%. The mean improvement in disability was 5.2 points. This was considered to be clinically meaningful. Clinically meaningful improvement in disability was seen in 73.2% of patients. The mean improvement in "on average" pain intensity from baseline to long term FU was 3.0 points. This was considered to be clinically meaningful. The mean improvement in "at worst" pain was 4.2 points. This was considered to be clinically meaningful. Only two patients went on to require surgery. No major complications to treatment were noted. CONCLUSION: A treatment approach focusing on DM and NM may be useful in bringing about clinically meaningful improvement in disability in patients with LSS

Different behavioral effects of neurotoxic dorsal hippocampal lesions placed under either isoflurane or propofol anesthesia

Anesthetic protocols for behavioral neuroscience experiments are evolving as new anesthetics are developed and surgical procedures are refined to improve animal welfare. We tested whether neurotoxic dorsal hippocampal lesions produced under two different anesthetic protocols would have different behavioral and/or histo-pathological effects. Rats were anesthetized with either propofol, an intravenous anesthetic, or isoflurane, a gaseous anesthetic, and multiple injections of an excitotoxin (N-methyl-d-aspartate) were stereotaxically placed in the dorsal hippocampus bilaterally. Intraoperative physiological parameters were similar in the two surgical groups, as were the volumes of the lesions, although the profile of postoperative impairment in a spatial learning task differed between the lesion groups depending on the anesthetic regimen used. These results show that the choice of anesthetic protocol is a critical variable in designing behavioral neuroscience experiments using neurosurgical procedures. This factor should be considered carefully in experimental design and in cross-study comparisons of lesion effects on behavior. © 2007 Wiley-Liss, Inc

Semantic memory redux: an experimental test of hierarchical category representation

Four experiments investigated the classic issue in semantic memory of whether people organize categorical information in hierarchies and use inference to retrieve information from them, as proposed by Collins & Quillian (1969). Past evidence has focused on RT to confirm sentences such as “All birds are animals” or “Canaries breathe.” However, confounding variables such as familiarity and associations between the terms have led to contradictory results. Our experiments avoided such problems by teaching subjects novel materials. Experiment 1 tested an implicit hierarchical structure in the features of a set of studied objects (e.g., all brown objects were large). Experiment 2 taught subjects nested categories of artificial bugs. In Experiment 3, subjects learned a tree structure of novel category hierarchies. In all three, the results differed from the predictions of the hierarchical inference model. In Experiment 4, subjects learned a hierarchy by means of paired associates of novel category names. Here we finally found the RT signature of hierarchical inference. We conclude that it is possible to store information in a hierarchy and retrieve it via inference, but it is difficult and avoided whenever possible. The results are more consistent with feature comparison models than hierarchical models of semantic memory

The Role of Meaning in Past-Tense Inflection: Evidence from Polysemy and Denominal Derivation

Although English verbs can be either regular (walk-walked) or irregular (sing-sang), “denominal verbs” that are derived from nouns, such as the use of the verb ring derived from the noun a ring, take the regular form even if they are homophonous with an existing irregular verb: The soldiers ringed the city rather than *The soldiers rang the city. Is this regularization due to a semantic difference from the usual verb, or is it due to the application of the default rule, namely VERB + -ed suffix? To gain a new source of insight into this debate, we compared the central senses of verbs to extended verbal senses and to denominal senses. In Experiment 1, participants rated the semantic similarity of the extended senses of polysemous verbs and denominal verbs to their central senses. Experiment 2 examined the acceptability of the regular and irregular past-tenses of the different verbs. The results showed that all the denominal verbs were rated as more acceptable for the regular inflection than the same verbs used polysemously, even though the two were semantically equally similar to the central meaning. Thus, the derivation of the verb (nominal or verbal) determined the past-tense preference more than semantic variables, consistent with dual-route models of verb inflection

An assessment of high touch object cleaning thoroughness using a fluorescent marker in two Australian hospitals

An Unassigned Group, An Unassigned DepartmentFull Tex

Microscopic Approach to Analyze Solar-Sail Space-Environment Effects

Near-sun space-environment effects on metallic thin films solar sails as well as hollow-body sails with inflation fill gas are considered. Analysis of interaction of the solar radiation with the solar sail materials is presented. This analysis evaluates worst-case solar radiation effects during solar-radiation-pressure acceleration. The dependence of the thickness of solar sail on temperature and on wavelength of the electromagnetic spectrum of solar radiation is investigated. Physical processes of the interaction of photons, electrons, protons and helium nuclei with sail material atoms and nuclei, and inflation fill gas molecules are analyzed. Calculations utilized conservative assumptions with the highest values for the available cross sections for interactions of solar photons, electrons and protons with atoms, nuclei and hydrogen molecules. It is shown that for high-energy photons, electrons and protons the beryllium sail is mostly transparent. Sail material will be partially ionized by solar UV and low-energy solar electrons. For a hollow-body photon sail effects including hydrogen diffusion through the solar sail walls, and electrostatic pressure is considered. Electrostatic pressure caused by the electrically charged sail's electric field may require mitigation since sail material tensile strength decreases with elevated temperature.Comment: 10 pages, 6 figures. Talk given on the 59 International Astronautical Congress, Glasgow, Scotland, 29 September - 2 October, 200