Treatment of chronic back pain by sensory discrimination training. A Phase I RCT of a novel device (FairMed) vs. TENS

Background: The causes of chronic low back pain (CLBP) remain obscure and effective treatment of symptoms remains elusive. A mechanism of relieving chronic pain based on the consequences of conflicting unpleasant sensory inputs to the central nervous system has been hypothesised. As a result a device was generated to deliver sensory discrimination training (FairMed), and this randomised controlled trial compared therapeutic effects with a comparable treatment modality, TENS. Methods: 60 patients with CLBP were recruited from physiotherapy referrals to a single-blinded, randomised controlled, non-inferiority trial. They were randomised to receive either FairMed or TENS and asked to use the allocated device for 30 minutes, twice a day, for 3 weeks. The primary outcome variable measured at 0 and 3 weeks was pain intensity measured using a visual analogue scale averaged over 7 days. Secondary outcome measures were Oswestry Disability Index, 3 timed physical tests, 4 questionnaires assessing different aspects of emotional coping and a global measure of patient rating of change. Data were analysed for the difference in change of scores between groups using one-way ANOVA. Results: Baseline characteristics of the two groups were comparable. The primary outcome, change in pain intensity (VAS) at 3 weeks showed a mean difference between groups of -0.1, (non significant p = 0.82). The mean difference in change in ODI scores was 0.4; (non significant p = 0.85). Differences in change of physical functioning showed that no significant difference in change of scores for any of these test (p = 0.58 – 0.90). Changes in scores of aspects of emotional coping also demonstrated no significant difference in change scores between the groups (p = 0.14 – 0.94). Conclusion: FairMed was not inferior to TENS treatment. The findings have implications for further research on current chronic pain theories and treatments. Further work to explore these mechanisms is important to expand our understanding of chronic pain and the role of neuro-modulation

Effect of type and concentration of ballasting particles on sinking rate of marine snow produced by the Appendicularian Oikopleura dioica

Ballast material (organic, opal, calcite, lithogenic) is suggested to affect sinking speed of aggregates in the ocean. Here, we tested this hypothesis by incubating appendicularians in suspensions of different algae or Saharan dust, and observing the sinking speed of the marine snow formed by their discarded houses. We show that calcite increases the sinking speeds of aggregates by ~100% and lithogenic material by ~150% while opal only has a minor effect. Furthermore the effect of ballast particle concentration was causing a 33 m d(-1) increase in sinking speed for a 5×10(5) µm(3) ml(-1) increase in particle concentration, near independent on ballast type. We finally compare our observations to the literature and stress the need to generate aggregates similar to those in nature in order to get realistic estimates of the impact of ballast particles on sinking speeds

Thermal Sensitivity To Warmth During Rest and Exercise: A Sex Comparison.

Purpose The study aimed to compare thermal sensation in response to a fixed warm stimulus across 31 body locations in resting and active males and females. Methods Twelve males (20.6 ± 1.0 yrs, 78.1 ± 15.6 kg, 180 ± 8.9 cm, 34.4 ± 5.2 ml•kg-1•min-1) and 12 females (20.6 ± 1.4 yrs, 62.9 ± 5.5 kg, 167 ± 5.7 cm, 36.5 ± 6.6 ml•kg-1•min-1) rested in a thermoneutral (22.2 ± 2.2°C, 35.1 ± 5.8% RH) room whilst a thermal probe (25 cm2), set at 40°C was applied in a balanced order to 31 locations across the body. Participants reported their thermal sensation 10 seconds after initial application. Following this, participants began cycling at 50% 〖"V" ̇"O" 〗_"2max" for 20 minutes, which was then lowered to 30% 〖"V" ̇"O" 〗_"2max" and the sensitivity test repeated. Results Females had significantly warmer magnitude sensations than males at all locations (4.7 ± 1.8 vs 3.6 ± 2.2, p0.05). Conclusion The data provides evidence that the thermal sensation response to warmth varies between genders and between body regions and reduces during exercise. These findings have important implications for clothing design and thermophysiological modellin

Distribution of Skin Thermal Sensitivity

The chapter explores measurement techniques to investigate thermal sensitivity of the skin across numerous locations over the body. Different definitions of thermal sensitivity are provided which will inform the method of stimulation. Techniques of stimulating the skin are proposed (e.g., thermal peltier probe, water-perfused suit, or patches), and temperature, surface area, and duration are discussed. Sensitivity can be assessed immediately (transient) or after a given period of time (steady state), and data can be presented in a variety of forms. The chapter proposed presenting the data as body maps to add clarity for the reader and examples are provided

Adenosine A2A agonist and A2B antagonist mediate an inhibition of inflammation-induced contractile disturbance of a rat gastrointestinal preparation

Adenosine can show anti-inflammatory as well as pro-inflammatory activities. The contribution of the specific adenosine receptor subtypes in various cells, tissues and organs is complex. In this study, we examined the effect of the adenosine A2A receptor agonist CGS 21680 and the A2BR antagonist PSB-1115 on acute inflammation induced experimentally by 2,4,6-trinitrobenzenesulfonic acid (TNBS) on rat ileum/jejunum preparations. Pre-incubation of the ileum/jejunum segments with TNBS for 30 min resulted in a concentration-dependent inhibition of acetylcholine (ACh)-induced contractions. Pharmacological activation of the A2AR with CGS 21680 (0.1–10 µM) pre-incubated simultaneously with TNBS (10 mM) prevented concentration-dependently the TNBS-induced inhibition of the ACh contractions. Stimulation of A2BR with the selective agonist BAY 60-6583 (10 µM) did neither result in an increase nor in a further decrease of ACh-induced contractions compared to the TNBS-induced inhibition. The simultaneous pre-incubation of the ileum/jejunum segments with TNBS (10 mM) and the selective A2BR antagonist PSB-1115 (100 µM) inhibited the contraction-decreasing effect of TNBS. The effects of the A2AR agonist and the A2BR antagonist were in the same range as the effect induced by 1 µM methotrexate. The combination of the A2AR agonist CGS 21680 and the A2BR antagonist PSB-1115 at subthreshold concentrations of both agents found a significant amelioration of the TNBS-diminished contractility. Our results demonstrate that the activation of A2A receptors or the blockade of the A2B receptors can prevent the inflammation-induced disturbance of the ACh-induced contraction in TNBS pre-treated small intestinal preparations. The combination of both may be useful for the treatment of inflammatory bowel diseases