Effectiveness of global postural re-education in reducing chronic non-specific low back pain and improving daily function in adults

Clinical Scenario: Low back pain (LBP) is one of the most common complaints in adults. Research indicates that the implementation of global postural re-education may decrease pain in those with chronic low back pain and improve daily function.Clinical Question: How effective is the Global Postural Re-education technique in reducing chronic or non-specific low back pain in adults compared to conventional treatment methods?Summary of Key Findings: A search was conducted for articles comparing GPR to standard physical therapy techniques. Three articles were included in this critically appraised topic; two randomized controlled trials and one quasi-randomized controlled trial. All compared GPR to standard physical therapy techniques including static stretching and motor control exercises. All three articles found a significant improvement in both control and treatment groups, but a greater improvement in pain, daily function, and range of motion.Clinical Bottom Line: There is moderate level of evidence that clinicians may opt to use GPR and postural re-education methods when treating patients with chronic LBP to reduce pain levels, increase hip and back range of motion, and improve overall function with activities of daily living.Strength of Recommendation: The studies included in this review show level B evidence based on the SORT scale that GPR may be an effective treatment method for reducing chronic LBP short term compared to conventional treatment methods

Spin-dynamics of the low-dimensional magnet (CH3)2NH2CuCl3

Dimethylammonium copper (II) chloride (also known as DMACuCl3 or MCCL) is a low dimensional S=1/2 quantum spin system proposed to be an alternating ferro-antiferromagnetic chain with similar magnitude ferromagnetic (FM) and antiferromagnetic (AFM) exchange interactions. Subsequently, it was shown that the existing bulk measurements could be adequately modeled by considering DMACuCl3 as independent AFM and FM dimer spin pairs. We present here new inelastic neutron scattering measurements of the spin-excitations in single crystals of DMACuCl3. These results show significant quasi-one-dimensional coupling, however the magnetic excitations do not propagate along the expected direction. We observe a band of excitations with a gap of 0.95 meV and a bandwidth of 0.82 meV.Comment: 3 pages, 2 figures included in text, submitted to proceedings of International Conference on Neutron Scattering, December 200

Detecting SARS-CoV-2 3CLpro Expression and Activity Using a Polyclonal Antiserum and a Luciferase-Based Biosensor

The need to stem the current outbreak of SARS-CoV-2 responsible for COVID-19 is driving the search for inhibitors that will block coronavirus replication and pathogenesis. The coronavirus 3C-like protease (3CLpro) encoded in the replicase polyprotein is an attractive target for antiviral drug development because protease activity is required for generating a functional replication complex. Reagents that can be used to screen for protease inhibitors and for identifying the replicase products of SARS-CoV-2 are urgently needed. Here we describe a luminescence-based biosensor assay for evaluating small molecule inhibitors of SARS-CoV-2 3CLpro/main protease. We also document that a polyclonal rabbit antiserum developed against SARS-CoV 3CLpro cross reacts with the highly conserved 3CLpro of SARS-CoV-2. These reagents will facilitate the pre-clinical evaluation of SARS-CoV-2 protease inhibitors

Intensive HST, RXTE and ASCA Monitoring of NGC 3516: Evidence Against Thermal Reprocessing

During 1998 April 13-16, NGC 3516 was monitored almost continuously with HST for 10.3 hr in the UV and 2.8 d in the optical, and simultaneous RXTE and ASCA monitoring covered the same period. The X-rays were strongly variable with the soft (0.5-2 keV) showing stronger variations (~65% peak-to-peak) than the hard (2-10 keV; ~50% peak-to-peak). The optical continuum showed much smaller but highly significant variations: a slow ~2.5% rise followed by a faster ~3.5% decline. The short UV observation did not show significant variability. The soft and hard X-ray light curves were strongly correlated with no significant lag. Likewise, the optical continuum bands (3590 and 5510 A) were also strongly correlated with no measurable lag above limits of <0.15 d. However no significant correlation or simple relationship could be found for the optical and X-ray light curves. These results appear difficult to reconcile with previous reports of correlations between X-ray and optical variations and of measurable lags within the optical band for some other Seyfert 1s. These results also present serious problems for "reprocessing" models in which the X-ray source heats a stratified accretion disk which then reemits in the optical/ultraviolet: the synchronous variations within the optical would suggest that the emitting region is <0.3 lt-d across, while the lack of correlation between X-ray and optical variations would indicate, in the context of this model, that any reprocessing region must be >1 lt-d in size. It may be possible to resolve this conflict by invoking anisotropic emission or special geometry, but the most natural explanation appears to be that the bulk of the optical luminosity is generated by some other mechanism than reprocessing.Comment: 23 pages including 6 figures, accepted for publication in Ap

Transgenic amplification of glucocorticoid action in adipose tissue causes high blood pressure in mice

Obesity is closely associated with the metabolic syndrome, a combination of disorders including insulin resistance, diabetes, dyslipidemia, and hypertension. A role for local glucocorticoid reamplification in obesity and the metabolic syndrome has been suggested. The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) regenerates active cortisol from inactive 11-keto forms, and aP2-HSD1 mice with relative transgenic overexpression of this enzyme in fat cells develop visceral obesity with insulin resistance and dyslipidemia. Here we report that aP2-HSD1 mice also have high arterial blood pressure (BP). The mice have increased sensitivity to dietary salt and increased plasma levels of angiotensinogen, angiotensin II, and aldosterone. This hypertension is abolished by selective angiotensin II receptor AT-1 antagonist at a low dose that does not affect BP in non-Tg littermates. These findings suggest that activation of the circulating renin-angiotensin system (RAS) develops in aP2-HSD1 mice. The long-term hypertension is further reflected by an appreciable hypertrophy and hyperplasia of the distal tubule epithelium of the nephron, resembling salt-sensitive or angiotensin II–mediated hypertension. Taken together, our findings suggest that overexpression of 11β-HSD1 in fat is sufficient to cause salt-sensitive hypertension mediated by an activated RAS. The potential role of adipose 11β-HSD1 in mediating critical features of the metabolic syndrome extends beyond obesity and metabolic complications to include the most central cardiovascular feature of this disorder

Efficacy of a movement control injury-prevention programme in an adult community rugby union population; a cluster randomised controlled trial

Background Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in collision sports such as rugby union is lacking. Objective To evaluate the efficacy of an evidence-informed injury prevention exercise programme in reducing match injuries in adult community rugby union players. Design Prospective cluster randomised (single-blind) controlled trial. Clubs were the unit of randomisation. Setting English adult community clubs (2015–2016 season) with a formally qualified medical professional to diagnose and report match-injuries. Participants 860 clubs were invited to participate of which 81 volunteered and were randomly assigned. Data was received from 41 clubs (control, 19; intervention, 22). Interventions A 42-week exercise programme comprising 6-week graduated exercise blocks was introduced during pre-season. The control programme reflected ‘normal practice’ exercises, whereas the intervention focused on proprioception, balance, cutting, landing, and resistance exercises. Main Outcome Measurements Match-injury incidence and burden for: all ≥8 days time-loss injuries and targeted (lower-limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. Results Poisson regression identified unclear differences between groups for overall injury incidence (rate ratio (RR), 90% confidence interval (CI)=0.9, 0.6–1.3) and injury burden (RR, 90% CI=0.8, 0.5–1.4). A likely beneficial difference in targeted injury incidence (RR, 90% CI=0.6, 0.4–1.0) was identified, with ∼40% lower lower-limb incidence (RR, 90% CI=0.6, 0.4–1.0) and ∼60% lower concussion incidence (RR, 90%CI=0.36, 0.18–0.70) in the intervention group. Completing the intervention at least once per week was associated with a likely beneficial difference between groups (intervention n=15, control n=13; RR, 90% CI=0.7, 0.4–1.0). Conclusions This movement-control injury-prevention programme appeared efficacious, with likely beneficial differences for lower-limb injuries and concussion for the treatment clubs. Targeted injury incidence was ∼30% lower when 1 or more intervention sessions were completed each wee

Multicentre open label randomised controlled trial of immediate enhanced ambulatory ECG monitoring versus standard monitoring in acute unexplained syncope patients:the ASPIRED study

Introduction Diagnosing underlying arrhythmia in emergency department (ED) syncope patients is difficult. There is a evidence that diagnostic yield for detecting underlying arrhythmia is highest when cardiac monitoring devices are applied early, ideally at the index visit. This strategy has the potential to change current syncope management from low diagnostic yield Holter to higher yield ambulatory monitoring, reduce episodes of syncope, reduce risk of recurrence and its potential serious consequences, reduce hospital admissions, reduce overall health costs and increase quality of life by allowing earlier diagnosis, treatment and exclusion of clinically important arrhythmias. Methods and analyses This is a UK open prospective parallel group multicentre randomised controlled trial of an immediate 14-day ambulatory patch heart monitor vs standard care in 2234 patients presenting acutely with unexplained syncope. Our patient focused primary endpoint will be number of episodes of syncope at 1 year. Health economic evaluation will estimate the incremental cost per syncope episode avoided and quality-adjusted life year gained. Ethics and dissemination Informed consent for participation will be sought. The ASPIRED trial received a favourable ethical opinion from South East Scotland Research Ethics Committee 01 (21/SS/0073). Results will be disseminated via scientific publication, lay summary and visual abstract

The use of nanovibration to discover specific and potent bioactive metabolites that stimulate osteogenic differentiation in mesenchymal stem cells

Bioactive metabolites have wide-ranging biological activities and are a potential source of future research and therapeutic tools. Here, we use nanovibrational stimulation to induce osteogenic differentiation of mesenchymal stem cells, in the absence of off-target, nonosteogenic differentiation. We show that this differentiation method, which does not rely on the addition of exogenous growth factors to culture media, provides an artifact-free approach to identifying bioactive metabolites that specifically and potently induce osteogenesis. We first identify a highly specific metabolite, cholesterol sulfate, an endogenous steroid. Next, a screen of other small molecules with a similar steroid scaffold identified fludrocortisone acetate with both specific and highly potent osteogenic-inducing activity. Further, we implicate cytoskeletal contractility as a measure of osteogenic potency and cell stiffness as a measure of specificity. These findings demonstrate that physical principles can be used to identify bioactive metabolites and then enable optimization of metabolite potency can be optimized by examining structure-function relationships

OpenFermion: The Electronic Structure Package for Quantum Computers

Quantum simulation of chemistry and materials is predicted to be an important application for both near-term and fault-tolerant quantum devices. However, at present, developing and studying algorithms for these problems can be difficult due to the prohibitive amount of domain knowledge required in both the area of chemistry and quantum algorithms. To help bridge this gap and open the field to more researchers, we have developed the OpenFermion software package (www.openfermion.org). OpenFermion is an open-source software library written largely in Python under an Apache 2.0 license, aimed at enabling the simulation of fermionic models and quantum chemistry problems on quantum hardware. Beginning with an interface to common electronic structure packages, it simplifies the translation between a molecular specification and a quantum circuit for solving or studying the electronic structure problem on a quantum computer, minimizing the amount of domain expertise required to enter the field. The package is designed to be extensible and robust, maintaining high software standards in documentation and testing. This release paper outlines the key motivations behind design choices in OpenFermion and discusses some basic OpenFermion functionality which we believe will aid the community in the development of better quantum algorithms and tools for this exciting area of research.Comment: 22 page