Predictors of pain relief following spinal cord stimulation in chronic back and leg pain and failed back surgery syndrome: a systematic review and meta-regression analysis

We sought to assess the extent to which pain relief in chronic back and leg pain (CBLP) following spinal cord stimulation (SCS) is influenced by patient‐related factors, including pain location, and technology factors. A number of electronic databases were searched with citation searching of included papers and recent systematic reviews. All study designs were included. The primary outcome was pain relief following SCS, we also sought pain score (pre‐ and post‐SCS). Multiple predictive factors were examined: location of pain, history of back surgery, initial level of pain, litigation/worker's compensation, age, gender, duration of pain, duration of follow‐up, publication year, continent of data collection, study design, quality score, method of SCS lead implant, and type of SCS lead. Between‐study association in predictive factors and pain relief were assessed by meta‐regression. Seventy‐four studies (N = 3,025 patients with CBLP) met the inclusion criteria; 63 reported data to allow inclusion in a quantitative analysis. Evidence of substantial statistical heterogeneity (P < 0.0001) in level of pain relief following SCS was noted. The mean level of pain relief across studies was 58% (95% CI: 53% to 64%, random effects) at an average follow‐up of 24 months. Multivariable meta‐regression analysis showed no predictive patient or technology factors. SCS was effective in reducing pain irrespective of the location of CBLP. This review supports SCS as an effective pain relieving treatment for CBLP with predominant leg pain with or without a prior history of back surgery. Randomized controlled trials need to confirm the effectiveness and cost‐effectiveness of SCS in the CLBP population with predominant low back pain

Women’s Leader Development Programs: Current Landscape and Recommendations for Future Programs

The gender gap in leadership positions is unjust and unproductive. In this paper, we focus on one solution – leader development. We leverage a content analysis of the top U.S. women’s leader development programs (WLDPs) and literature on women’s leadership and leader development. We provide seven evidence-based recommendations for WLDPs including: identify measurable objectives, increase access for emerging leaders, cultivate a paradox mindset around leader and gender identity, leverage experiential learning, expand networks, educate about second-generation gender bias, and align evaluations. We urge administrators to adopt our recommendations as one piece of a systematic effort to pursue gender parity in leadership

Navigating Identity: The Intersection of Social and Biological Identity from the WWII Battle of Tarawa

The 1943 Battle of Tarawa resulted in the loss of approximately 1000 U.S. service members on or around Betio Island, Tarawa Atoll, Republic of Kiribati. Nearly half the casualties were accounted for following the battle. The Defense POW/MIA Accounting Agency (DPAA) has worked to identify the remaining ~510 unaccounted-for service members, with successful identification of ~160 service members to date. Demographic data pulled from historical documentation of the U.S. losses indicate a relatively homogeneous population (99% White, 81% between the ages of 17 to 23 years, and only two individuals documented with a religious preference other than Protestant or Catholic). Using this demographic data as a framework, three case studies are presented to demonstrate how a holistic biosocial approach to identity building could facilitate forensic identifications. The temporal and sociocultural contextualization of analyses enables anthropologists to navigate the inconsistencies between 21st century and historical (1940s) social identity concepts and overcome challenges to identification. The case studies demonstrate how biological evidence, genetic evidence, and material culture (material evidence) differently contribute to the social identity of an individual and can impact identification efforts when analytical conclusions are incongruent with historical documentation. The first case examines how morphometric biological affinity assessments are biased by the fluidity of social identity concepts when complex morphological and metric indicators of biological affinity are not represented in the historical race categories for the U.S. Battle of Tarawa casualties. The second case demonstrates how biogeographic genetic affinity predictions, through a discussion of the G2a4 haplogroup, need to be examined holistically in the context of other lines of evidence. The third case highlights how material evidence can further define social identity beyond physicality, genetic structure, and race. The challenges of interpreting identity from human remains, as highlighted through these examples, are common among anthropologists working in disaster victim identification and other humanitarian contexts. Thus, it is imperative for anthropologists to be self-aware of implicit biases toward the current prevailing definitions of biological and social identity and to consider historical perceptions of identity when working in these contexts

What should an index of school segregation measure?

The article aims to make a methodological contribution to the education segregation literature, providing a critique of previous measures of segregation used in the literature, as well as suggesting an alternative approach to measuring segregation. Specifically, the paper examines Gorard, Fitz and Taylor's finding that social segregation between schools, as measured by free school meals (FSM) entitlement, fell significantly in the years following the 1988 Education Reform Act. Using Annual Schools Census data from 1989 to 2004, the paper challenges the magnitude of their findings, suggesting that the method used by Gorard et al. seriously overstates the size of the fall in segregation. We make the case for a segregation curve approach to measuring segregation, where comparisons of the level of segregation are possible regardless of the percentage FSM eligibility. Using this approach, we develop a new method for describing both the level and the location of school segregation

Did the COVID-19 pandemic impact the dietary intake of individuals living with and beyond breast, prostate, and colorectal cancer and who were most likely to experience change?

Purpose: The present work investigated dietary changes amongst individuals living with and beyond cancer (LWBC) from before to during the pandemic. To identify those at greatest risk of unhealthy changes, it was further examined whether patterns varied by sociodemographic, health-related, and COVID-19-related characteristics. // Methods: This longitudinal cohort study analysed data from 716 individuals LWBC participating in the Advancing Survivorship Cancer Outcomes Trial (ASCOT). Using data provided before and during the pandemic, changes in fruit and vegetable, snack, and alcohol intake were tested using mixed-effect regression models. // Results: Fruit and vegetable (95%CI: − 0.30; − 0.04) and alcohol consumption (95%CI: − 1.25; − 0.31) decreased, whilst snacking increased (95%CI: 0.19; 0.53). Women and individuals with limited social contact were more likely to reduce fruit and vegetable intake during the pandemic. Women and individuals with poorer sleep quality, limited social contact, and shielding requirements and without higher education were more likely to increase snacking during the pandemic. Individuals with poorer sleep quality, poorer mental health, and regular social contact were more likely to decrease alcohol consumption during the pandemic. // Conclusions: Findings suggest decreased intake for fruit, vegetable, and alcohol consumption and increased snack intake in response to the pandemic amongst individuals LWBC. These changes appear to differ across various characteristics, suggesting the pandemic has not equally impacted everyone in this population. Findings highlight the need for targeted post-COVID strategies to support individuals LWBC most adversely affected by the pandemic, including women and socially isolated individuals. This encourages resources to be prioritised amongst these groups to prevent further negative impact of the pandemic. Whilst the findings are statistically significant, practically they appear less important. This is necessary to acknowledge when considering interventions and next steps

Preprotachykinin A (PPTA) is expressed by a distinct population of excitatory neurons in the mouse superficial spinal dorsal horn including cells that respond to noxious and pruritic stimuli

The superficial dorsal horn, which is the main target for nociceptive and pruritoceptive primary afferents, contains a high density of excitatory interneurons. Our understanding of their roles in somatosensory processing has been restricted by the difficulty of distinguishing functional populations among these cells. We recently defined three non-overlapping populations among the excitatory neurons, based on the expression of neurotensin, neurokinin B (NKB) and gastrin-releasing peptide (GRP). Here we identify and characterise another population: neurons that express the tachykinin peptide substance P. We show with immunocytochemistry that its precursor protein (preprotachykinin A, PPTA) can be detected in ~14% of lamina I-II neurons, and these are concentrated in the outer part of lamina II. Over 80% of the PPTA-positive cells lack the transcription factor Pax2 (which determines an inhibitory phenotype), and these account for ~15% of the excitatory neurons in this region. They are different from the neurotensin, NKB or GRP neurons, although many of them contain somatostatin, which is widely expressed among superficial dorsal horn excitatory interneurons. We show that many of these cells respond to noxious thermal and mechanical stimuli, and to intradermal injection of pruritogens. Finally, we demonstrate that these cells can also be identified in a knock-in Cre mouse line (Tac1Cre), although our findings suggest that there is an additional population of neurons that transiently express PPTA. This population of substance P-expressing excitatory neurons is likely to play an important role in transmission of signals that are perceived as pain and itch

Carbon Free Boston: Buildings Technical Report

Part of a series of reports that includes: Carbon Free Boston: Summary Report; Carbon Free Boston: Social Equity Report; Carbon Free Boston: Technical Summary; Carbon Free Boston: Transportation Technical Report; Carbon Free Boston: Waste Technical Report; Carbon Free Boston: Energy Technical Report; Carbon Free Boston: Offsets Technical Report; Available at http://sites.bu.edu/cfb/OVERVIEW: Boston is known for its historic iconic buildings, from the Paul Revere House in the North End, to City Hall in Government Center, to the Old South Meeting House in Downtown Crossing, to the African Meeting House on Beacon Hill, to 200 Clarendon (the Hancock Tower) in Back Bay, to Abbotsford in Roxbury. In total, there are over 86,000 buildings that comprise more than 647 million square feet of area. Most of these buildings will still be in use in 2050. Floorspace (square footage) is almost evenly split between residential and non-residential uses, but residential buildings account for nearly 80,000 (93 percent) of the 86,000 buildings. Boston’s buildings are used for a diverse range of activities that include homes, offices, hospitals, factories, laboratories, schools, public service, retail, hotels, restaurants, and convention space. Building type strongly influences energy use; for example, restaurants, hospitals, and laboratories have high energy demands compared to other commercial uses. Boston’s building stock is characterized by thousands of turn-of-the-20th century homes and a postWorld War II building boom that expanded both residential buildings and commercial space. Boston is in the midst of another boom in building construction that is transforming neighborhoods across the city. [TRUNCATED]Published versio

The influence of taphonomy on histological and isotopic analyses of treated and untreated buried modern human bone

The chemical (e.g., preservation/embalming) treatment of skeletal remains can reduce overall DNA quality and quantity. The histological and stable isotope examination of treated and untreated human remains improves our understanding of how chemical preservatives impact bone diagenesis and will determine if chemical treatment adversely affects stable isotope ratio analysis of collagen. Fidelity in the application(s) of stable isotope interpretations requires that the isotope delta (δ) values have not been altered postmortem. Re-associated antimeres and refits of chemically treated and untreated rib and long bones from eight casualties [thin-sectioned human bone (n = 43) and collagen extraction/stable isotope analysis (n = 42)] from the World War II Battle of Tarawa were examined to compare skeletal elements from the same individual that had different taphonomic histories. Histological analyses included scoring upon the Oxford Histological Index (OHI) and Birefringence scale, recording microbial invasion, and general observations. The collected data were analyzed via simple descriptive statistics and paired samples t-tests. Treated remains scored higher on the OHI and for Birefringence, indicating that bone quality was good to excellent. The untreated samples scored lower on the OHI and Birefringence scales suggesting poorer preservation than the treated remains. Histology results were supported by the isotope sample preparation results: the collagen % yield was higher for treated bone than untreated bone. Additionally, chemical preservation had no meaningful impact on isotope δ values of treated and untreated remains from the same element or pair-matched elements. Overall, treated remains exhibited good preservation while untreated remains exhibit poorer preservation with significant microfocal destruction to the extent that little histological analyses can be applied. Stable isotope ratio analysis is viable for both treated and untreated remains indicating this testing modality likely can be used for most treated remains, regardless of origin

Embedding Core Information Skills At The Point Of Need In First Year Science

Online information literacy modules have been integrated into semester 1 units of study so that every commencing first year science student is now engaged in developing information skills as part of their disciplinary learning (Kift, 2004). A certificate of completion system has enabled these activities to be easily introduced by staff from a range of disciplines. This methodology has enabled skill development to be introduced with no duplication or overlap in the workload for students despite the range of course choices available and without core units