Rethinking clinical trials of transcranial direct current stimulation: Participant and assessor blinding is inadequate at intensities of 2mA

Copyright @ 2012 The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and 85 reproduction in any medium, provided the original author and source are credited. The article was made available through the Brunel University Open Access Publishing Fund.Background: Many double-blind clinical trials of transcranial direct current stimulation (tDCS) use stimulus intensities of 2 mA despite the fact that blinding has not been formally validated under these conditions. The aim of this study was to test the assumption that sham 2 mA tDCS achieves effective blinding. Methods: A randomised double blind crossover trial. 100 tDCS-naïve healthy volunteers were incorrectly advised that they there were taking part in a trial of tDCS on word memory. Participants attended for two separate sessions. In each session, they completed a word memory task, then received active or sham tDCS (order randomised) at 2 mA stimulation intensity for 20 minutes and then repeated the word memory task. They then judged whether they believed they had received active stimulation and rated their confidence in that judgement. The blinded assessor noted when red marks were observed at the electrode sites post-stimulation. Results: tDCS at 2 mA was not effectively blinded. That is, participants correctly judged the stimulation condition greater than would be expected to by chance at both the first session (kappa level of agreement (κ) 0.28, 95% confidence interval (CI) 0.09 to 0.47 p = 0.005) and the second session (κ = 0.77, 95%CI 0.64 to 0.90), p = <0.001) indicating inadequate participant blinding. Redness at the reference electrode site was noticeable following active stimulation more than sham stimulation (session one, κ = 0.512, 95%CI 0.363 to 0.66, p<0.001; session two, κ = 0.677, 95%CI 0.534 to 0.82) indicating inadequate assessor blinding. Conclusions: Our results suggest that blinding in studies using tDCS at intensities of 2 mA is inadequate. Positive results from such studies should be interpreted with caution.GLM is supported by the National Health & Medical Research Council of Australia ID 571090

Chandra View of DA 530: A Sub-Energetic Supernova Remnant with a Pulsar Wind Nebula?

Based on a Chandra ACIS observation, we report the detection of an extended X-ray feature close to the center of the remnant DA 530 with 5.3 sigma above the background within a circle of 20'' radius. This feature, characterized by a power-law with the photon index gamma=1.6+-0.8 and spatially coinciding with a nonthermal radiosource, most likely represents a pulsar wind nebula. We have further examined the spectrum of the diffuse X-ray emission from the remnant interior with a background-subtracted count rate of ~0.06 counts s^-1 in 0.3-3.5 keV. The spectrum of the emission can be described by a thermal plasma with a temperature of ~0.3-0.6 keV and a Si over-abundance of >~7 solar. These spectral characteristics, together with the extremely low X-ray luminosity, suggest that the remnant arises from a supernova with an anomalously low mechanical energy (<10^50 ergs). The centrally-filled thermal X-ray emission of the remnant may indicate an early thermalization of the SN ejecta by the circum-stellar medium. Our results suggest that the remnant is likely the product of a core-collapsed SN with a progenitor mass of 8-12 Msun. Similar remnants are probably common in the Galaxy, but have rarely been studied.Comment: 23 pages, 7 figures, accepted for publication in ApJ; complete the abstract on astro-ph and correct some typo

Recent data from radiofrequency denervation trials further emphasise that treating nociception is not the same as treating pain

Chronic low back pain is a condition that current health care provision is failing and we suggest that recent evidence from the interventional pain medicine field points to what these failings are. Radiofrequency denervation is performed on the presumption that denervation of a peripheral structure will eradicate or significantly reduce pain and improve function. The results of six moderately sized and well conducted clinical trials that demonstrate no efficacy and no real-world effectiveness for denervation procedures are a stark illustration of how flawed this approach is. We suggest that these results represent a line-in-the-sand for back pain research and management. This is a clear signal to finally abandon research agendas and management paradigms that focus primarily on nociception and instead, truly embrace the biopsychosocial model of pain

A precise mass measurement of the intermediate-mass binary pulsar PSR J1802-2124

PSR J1802-2124 is a 12.6-ms pulsar in a 16.8-hour binary orbit with a relatively massive white dwarf (WD) companion. These properties make it a member of the intermediate-mass class of binary pulsar (IMBP) systems. We have been timing this pulsar since its discovery in 2002. Concentrated observations at the Green Bank Telescope, augmented with data from the Parkes and Nancay observatories, have allowed us to determine the general relativistic Shapiro delay. This has yielded pulsar and white dwarf mass measurements of 1.24(11) and 0.78(4) solar masses (68% confidence), respectively. The low mass of the pulsar, the high mass of the WD companion, the short orbital period, and the pulsar spin period may be explained by the system having gone through a common-envelope phase in its evolution. We argue that selection effects may contribute to the relatively small number of known IMBPs.Comment: 9 pages, 4 figures, 3 tables, accepted for publication in the Astrophysical Journa

Effects of the background radiation on radio pulsar and supernova remnant searches and the birth rates of these objects

In different directions of the Galaxy the Galactic background radio radiation and radiation of complex star formation regions which include large number of OB associations have different influences on radio pulsar (PSR) and supernova remnant (SNR) searches. In this work we analyse the effects of these background radiations on the observations of PSRs at 1400 MHz and SNRs at 1000 MHz. In the interval l=0$^o$$\pm60^o$ the PSRs with flux F$_{1400}$$>$0.2 mJy and the SNRs with surface brightness $\Sigma$$>10^{-21}$ Wm$^{-2}$Hz$^{-1}$sr$^{-1}$ are observable for all values of l and b. All the SNRs with $\Sigma$$>3\times10^{-22}$ Wm$^{-2}$Hz$^{-1}$sr$^{-1}$ can be observed in the interval 60$^o$$<$l$<300^o$. We have examined samples of PSRs and SNRs to estimate the birth rates of these objects in the region up to 3.2 kpc from the Sun and also in the Galaxy. The birth rate of PSRs is about one in 200 years and the birth rate of SNRs is about one in 65 years in our galaxy.Comment: revised versio

Pulsar Jets: Implications for Neutron Star Kicks and Initial Spins

We study implications for the apparent alignment of the spin axes, proper-motions, and polarization vectors of the Crab and Vela pulsars. The spin axes are deduced from recent Chandra X-ray Observatory images that reveal jets and nebular structure having definite symmetry axes. The alignments indicate these pulsars were born either in isolation or with negligible velocity contributions from binary motions. We examine the effects of rotation and the conditions under which spin-kick alignment is produced for various models of neutron star kicks. If the kick is generated when the neutron star first forms by asymmetric mass ejection or/and neutrino emission, then the alignment requires that the protoneutron star possesses an original spin with period $P_s$ much less than the kick timescale, thus spin-averaging the kick forces. The kick timescale ranges from 100 ms to 10 s depending on whether the kick is hydrodynamically driven or neutrino-magnetic field driven. For hydrodynamical models, spin-kick alignment further requires the rotation period of an asymmetry pattern at the radius near shock breakout (>100 km) to be much less than ~100 ms; this is difficult to satisfy unless rotation plays a dynamically important role in the core collapse and explosion (P_s\lo 1 ms). Aligned kick and spin vectors are inherent to the slow process of asymmetric electromagnetic radiation from an off-centered magnetic dipole. We reassess the viability of this effect, correcting a factor of 4 error in Harrison and Tademaru's calculation that increases the size of the effect. To produce a kick velocity of order a few hundred km/s requires that the neutron star be born with an initial spin close to 1 ms and that spindown due to r-mode driven gravitational radiation be inefficient compared to standard magnetic braking.Comment: Small changes/additions; final version to be published in ApJ, Vol.549 (March 10, 2001

The Parkes multibeam pulsar survey: IV. Discovery of 180 pulsars and parameters for 281 previously known pulsars

The Parkes multibeam pulsar survey has led to the discovery of more than 700 pulsars. In this paper, we provide timing solutions, flux densities and pulse profiles for 180 of these new discoveries. Two pulsars, PSRs J1736-2843 and J1847-0130 have rotational periods P > 6s and are therefore among the slowest rotating radio pulsars known. Conversely, with P = 1.8ms, PSR J1843-1113 has the third shortest period of pulsars currently known. This pulsar and PSR J1905+0400 (P = 3.8ms) are both solitary. We also provide orbital parameters for a new binary system, PSR J1420-5625, which has P = 34ms, an orbital period of 40 days and a minimum companion mass of 0.4 solar masses. The 10 degree-wide strip along the Galactic plane that was surveyed is known to contain 264 radio pulsars that were discovered prior to the multibeam pulsar survey. We have redetected almost all of these pulsars and provide new dispersion measure values and flux densities at 20cm for the redetected pulsars.Comment: 35 pages, accepted for publication in MNRAS, a high quality image of the figure on page 32 is available from http://www.atnf.csiro.au/research/pulsar/images/pmsurvey_fig.p

A Search for Sub-Millisecond Pulsars

We have conducted a search of 19 southern Galactic globular clusters for sub-millisecond pulsars at 660 MHz with the Parkes 64-m radio telescope. To minimize dispersion smearing we used the CPSR baseband recorder, which samples the 20 MHz observing band at the Nyquist rate. By possessing a complete description of the signal we could synthesize an optimal filterbank in software, and in the case of globular clusters of known dispersion measure, much of the dispersion could be removed using coherent techniques. This allowed for very high time resolution (25.6 us in most cases), making our searches in general sensitive to sub-millisecond pulsars with flux densities greater than about 3 mJy at 50 cm. No new pulsars were discovered, placing important constraints on the proportion of pulsars with very short spin periods in these clusters.Comment: 8 pages, 3 figures, to appear in Ap

Upper Limits On Periodic, Pulsed Radio Emission from the X-Ray Point Source in Cassiopeia A

The Chandra X-ray Observatory recently discovered an X-ray point source near the center of Cassiopeia A, the youngest known Galactic supernova remnant. We have conducted a sensitive search for radio pulsations from this source with the Very Large Array, taking advantage of the high angular resolution of the array to resolve out the emission from the remnant itself. No convincing signatures of a dispersed, periodic source or of isolated dispersed pulses were found, whether for an isolated or a binary source. We derive upper limits of 30 and 1.3 mJy at 327 and 1435 MHz for the phase-averaged pulsed flux density from this source. The corresponding luminosity limits are lower than those for any pulsar with age less than 10^4 years. The sensitivities of our search to single pulses were 25 and 1.0 Jy at 327 and 1435 MHz. For comparison, the Crab pulsar emits roughly 80 pulses per minute with flux densities greater than 100 Jy at 327 MHz and 8 pulses per minute with flux densities greater than 50 Jy at 1435 MHz. These limits are consistent with the suggestion that the X-ray point source in Cas A adds to the growing number of neutron stars which are not radio pulsars.Comment: accepted by ApJ Letter