Manipulation-induced hypoalgesia in musculoskeletal pain populations: A systematic critical review and meta-analysis

Background Manipulation-induced hypoalgesia (MIH) represents reduced pain sensitivity following joint manipulation, and has been documented in various populations. It is unknown, however, whether MIH following high-velocity low-amplitude spinal manipulative therapy is a specific and clinically relevant treatment effect. Methods This systematic critical review with meta-analysis investigated changes in quantitative sensory testing measures following high-velocity low-amplitude spinal manipulative therapy in musculoskeletal pain populations, in randomised controlled trials. Our objectives were to compare changes in quantitative sensory testing outcomes after spinal manipulative therapy vs. sham, control and active interventions, to estimate the magnitude of change over time, and to determine whether changes are systemic or not. Results Fifteen studies were included. Thirteen measured pressure pain threshold, and four of these were sham-controlled. Change in pressure pain threshold after spinal manipulative therapy compared to sham revealed no significant difference. Pressure pain threshold increased significantly over time after spinal manipulative therapy (0.32 kg/cm2, CI 0.22–0.42), which occurred systemically. There were too few studies comparing to other interventions or for other types of quantitative sensory testing to make robust conclusions about these. Conclusions We found that systemic MIH (for pressure pain threshold) does occur in musculoskeletal pain populations, though there was low quality evidence of no significant difference compared to sham manipulation. Future research should focus on the clinical relevance of MIH, and different types of quantitative sensory tests

Pressure pain threshold and temporal summation in adults with episodic and persistent low back pain trajectories: A secondary analysis at baseline and after lumbar manipulation or sham

Background People with chronic low back pain (LBP) typically have increased pain sensitivity compared to healthy controls, however its unknown if pain sensitivity differs based on LBP trajectory at baseline or after manual therapy interventions. We aimed to compare baseline pressure pain threshold (PPT) and temporal summation (TS) between people without LBP, with episodic LBP, and with persistent LBP, and to compare changes over time in PPT and TS after a lumbar spinal manipulation or sham manipulation in those with LBP. Methods Participants were aged 18–59, with or without LBP. Those with LBP were categorised as having either episodic or persistent LBP. PPT and TS were tested at baseline. LBP participants then received a lumbar spinal manipulation or sham, after which PPT and TS were re-tested three times over 30 min. Generalised linear mixed models were used to analyse data. Results One hundred participants (49 female) were included and analysed. There were 20 non-LBP participants (mean age 31 yrs), 23 episodic LBP (mean age 35 yrs), and 57 persistent LBP (mean age 37 yrs). There were no significant differences in PPT or TS between groups at baseline. There was a non-significant pattern of lower PPT (higher sensitivity) from the non-LBP group to the persistent LBP group at baseline, and high variability. Changes in PPT and TS after the interventions did not differ between the two LBP groups. Discussion We found no differences between people with no LBP, episodic LBP, or persistent LBP in baseline PPT or TS. Changes in PPT and TS following a lumbar manual therapy intervention do not appear to differ between LBP trajectories

Automated Motion Analysis of Adherent Cells in Monolayer Culture

This paper presents a novel method for tracking and characterizing adherent cells in monolayer culture. A system of cell tracking employing computer vision techniques was applied to time-lapse videos of replicate normal human uro-epithelial cell cultures exposed to different concentrations of adenosine triphosphate (ATP), acquired over a 20 h period. Subsequent analysis, comprising feature extraction, demonstrated the ability of the technique to successfully separate the modulated classes of cell

Effect of pressure on the superconducting transition temperature of doped and neutron-damaged MgB2

Measurements of the superconducting transition temperatures for Al-doped, C-doped and neutron-damaged-annealed MgB2 samples under pressure up to ~8 kbar are presented. The dT_c/dP values change systematically with the decrease of the ambient pressure T_c in a regular fashion. The evolution of the pressure derivatives can be understood assuming that the change in phonon spectrum is a dominant contribution to dT_c/dP

Slow, fast and in between: habitat distribution and behaviour of larvae in nine species of libellulid dragonfly

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72093/1/j.1365-2427.2007.01889.x.pd

Distribution of Mesoscale Convective Complex Rainfall in the United States

Several annual mesoscale convective complex (MCC) summaries have been compiled since Maddox strictly defined their criteria in 1980. These previous studies have largely been independent of each other and therefore have not established the extended spatial and temporal patterns associated with these large, quasi-circular, and, typically, severe convective systems. This deficiency is primarily due to the difficulty of archiving enough satellite imagery to accurately record each MCC based on Maddox’s criteria. Consequently, this study utilizes results from each of the MCC summaries compiled between 1978 and 1999 for the United States in order to develop a more complete climatology, or description of long-term means and interannual variation, of these storms. Within the 22-yr period, MCC summaries were compiled for a total of 15 yr. These 15 yr of MCC data are employed to establish estimated tracks for all MCCs documented and, thereafter, are utilized to determine MCC populations on a monthly, seasonal, annual, and multiyear basis. Subsequent to developing an extended climatology of MCCs, the study ascertains the spatial and temporal patterns of MCC rainfall and determines the precipitation contributions made by MCCs over the central and eastern United States. Results indicate that during the warm season, significant portions of the Great Plains receive, on average, between 8% and 18% of their total precipitation from MCC rainfall. However, there is large yearly and even monthly variability in the location and frequency of MCC events that leads to highly variable precipitation contributions

Comparison of Three CIDR Based Fixed-time AI Protocols for Beef Heifers

Several effective fixed-time AI (FTAI) protocols have been developed to facilitate AI while eliminating the need for estrus detection. Among these are the 5-d CO-Synch+CIDR (5d), PG 6-d CIDR (PG-CIDR), and 14-d CIDR-PG (CIDR-PG) protocols. While each of these protocols varies in duration and approach to synchronizing estrus and ovulation, each has been reported as an effective method to facilitate FTAI in beef heifers. Therefore, the objective of this study was to compare FTAI pregnancy rates in beef heifers synchronized with these three CIDR based protocols. Virgin beef heifers (n = 801) at four locations were synchronized with one of three protocols: 1) (5-day CO-Synch + CIDR) an injection of GnRH (100 μg; i.m.) and insertion of a CIDR on d -5, PG (25 mg; i.m.) and CIDR removal on d 0 with a second injection of PG (\u3e4 h after CIDR removal) on d 0 and FTAI at 72 h after CIDR removal, 2) (PG 6-day CIDR) PG (25 mg; i.m.) on d -9, GnRH (100 μg; i.m.) and insertion of a CIDR on d -6, PG and CIDR removal on d 0, and FTAI at 66 h after CIDR removal, or 3) (14-day CIDR-PG) a 14-day CIDR insert from d -30 to -16, PG (25 mg; i.m.) on d 0, and FTAI at 66 h after PG. All heifers received an injection of GnRH (100 μg; i.m.) concurrent with FTAI. Timing of treatment initiation was offset to allow all heifers to receive FTAI concomitantly and at random. Pregnancy success was determined between 35 and 40 d after FTAI by transrectal ultrasonography. Blood samples were collected approximately 12 d before the beginning of each protocol and at the initiation of each protocol to determine estrous cycling status (77%). Data were analyzed using the GLIMMIX procedures of SAS. Fixed-time AI pregnancy success did not differ between treatments (P = 0.13; 62.5%, 56.9%, and 53.3%, for 5-day CO-Synch + CIDR, PG 6-day CIDR, and 14-day CIDR-PG; respectively) or location (P = 0.16; 51.5%, 62.7%, 56.1%, and 58.6% for location 1, 2, 3, and 4; respectively). However, heifers that had reached puberty by initiation of synchronization had greater (P \u3c 0.01) pregnancy success compared to heifers that were prepubertal (60.7% and 47.3%; respectively). In summary, all three protocols had similar FTAI pregnancy success, and puberty status had the greatest impact on pregnancy success

Strong Electron-Phonon Coupling in Superconducting MgB2_2: A Specific Heat Study

We report on measurements of the specific heat of the recently discovered superconductor MgB$_2$ in the temperature range between 3 and 220 K. Based on a modified Debye-Einstein model, we have achieved a rather accurate account of the lattice contribution to the specific heat, which allows us to separate the electronic contribution from the total measured specific heat. From our result for the electronic specific heat, we estimate the electron-phonon coupling constant $\lambda$ to be of the order of 2, significantly enhanced compared to common weak-coupling values $\leq 0.4$. Our data also indicate that the electronic specific heat in the superconducting state of MgB$_2$ can be accounted for by a conventional, s-wave type BCS-model.Comment: 4 pages, 4 figure

The association between dry needling-induced twitch response and change in pain and muscle function in patients with low back pain: a quasi-experimental study

Objective To investigate the relationship between dry needling-induced twitch response and change in pain, disability, nociceptive sensitivity, and lumbar multifidus muscle function, in patients with low back pain (LBP). Design Quasi-experimental study. Setting Department of Defense Academic Institution. Participants Sixty-six patients with mechanical LBP (38 men, 28 women, age: 41.3 [9.2] years). Interventions Dry needling treatment to the lumbar multifidus muscles between L3 and L5 bilaterally. Main outcome measures Examination procedures included numeric pain rating, the Modified Oswestry Disability Index, pressure algometry, and real-time ultrasound imaging assessment of lumbar multifidus muscle function before and after dry needling treatment. Pain pressure threshold (PPT) was used to measure nocioceptive sensitivity. The percent change in muscle thickness from rest to contraction was calculated to represent muscle function. Participants were dichotomized and compared based on whether or not they experienced at least one twitch response on the most painful side and spinal level during dry needling. Results Participants experiencing local twitch response during dry needling exhibited greater immediate improvement in lumbar multifidus muscle function than participants who did not experience a twitch (thickness change with twitch: 12.4 [6]%, thickness change without twitch: 5.7 [11]%, mean difference adjusted for baseline value, 95%CI: 4.4 [1 to 8]%). However, this difference was not present after 1-week, and there were no between-groups differences in disability, pain intensity, or nociceptive sensitivity. Conclusions The twitch response during dry needling might be clinically relevant, but should not be considered necessary for successful treatment

Pleuroparenchymal sarcoidosis - A recognised but rare manifestation of disease

Pleural involvement is rare in sarcoidosis. The presence of a large symptomatic effusion in a patient with sarcoidosis should therefore prompt further investigation for an alternate aetiology. Here we present a case of confirmed pleuro-parenchymal sarcoidosis. We discuss the important differential diagnoses and review the current literature