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

Variations in hydrological connectivity of Australian semiarid landscapes indicate abrupt changes in rainfall-use efficiency of vegetation

[1] Dryland vegetation frequently shows self‐organized spatial patterns as mosaic‐like structures of sources (bare areas) and sinks (vegetation patches) of water runoff and sediments with variable interconnection. Good examples are banded landscapes displayed by Mulga in semiarid Australia, where the spatial organization of vegetation optimizes the redistribution and use of water (and other scarce resources) at the landscape scale. Disturbances can disrupt the spatial distribution of vegetation causing a substantial loss of water by increasing landscape hydrological connectivity and consequently, affecting ecosystem function (e.g., decreasing the rainfall‐use efficiency of the landscape). We analyze (i) connectivity trends obtained from coupled analysis of remotely sensed vegetation patterns and terrain elevations in several Mulga landscapes subjected to different levels of disturbance, and (ii) the rainfall‐use efficiency of these landscapes, exploring the relationship between rainfall and remotely sensed Normalized Difference Vegetation Index. Our analyses indicate that small reductions in the fractional cover of vegetation near a particular threshold can cause abrupt changes in ecosystem function, driven by large nonlinear increases in the length of the connected flowpaths. In addition, simulations with simple vegetation‐thinning algorithms show that these nonlinear changes are especially sensitive to the type of disturbance, suggesting that the amount of alterations that an ecosystem can absorb and still remain functional largely depends on disturbance type. In fact, selective thinning of the vegetation patches from their edges can cause a higher impact on the landscape hydrological connectivity than spatially random disturbances. These results highlight surface connectivity patterns as practical indicators for monitoring landscape health

The Fungal Cell Wall : Structure, Biosynthesis, and Function

N.G. is funded by the Wellcome Trust via a senior investigator award and a strategic award and by the MRC Centre for Medical Mycology. C.M. acknowledges the support of the Wellcome Trust and the MRC. N.G. and C.M. are part of the MRC Centre for Medical Mycology. J.P.L. acknowledges support from ANR, Aviesan, and FRM.Peer reviewedPublisher PD

Chemically Orthogonal Three‐Patch Microparticles

Compared to two‐dimensional substrates, only a few methodologies exist for the spatially controlled decoration of three‐dimensional objects, such as microparticles. Combining electrohydrodynamic co‐jetting with synthetic polymer chemistry, we were able to create two‐ and three‐patch microparticles displaying chemically orthogonal anchor groups on three distinct surface patches of the same particle. This approach takes advantage of a combination of novel chemically orthogonal polylactide‐based polymers and their processing by electrohydrodynamic co‐jetting to yield unprecedented multifunctional microparticles. Several micropatterned particles were fabricated displaying orthogonal click functionalities. Specifically, we demonstrate novel two‐ and three‐patch particles. Multi‐patch particles are highly sought after for their potential to present multiple distinct ligands in a directional manner. This work clearly establishes a viable route towards orthogonal reaction strategies on multivalent micropatterned particles. Patchwork‐Familie : Mikropartikel aus drei Patches (siehe Schema) mit funktionalisierten Poly(lactid)‐Derivaten in ausgewählten Kompartimenten wurden durch elektrohydrodynamisches (EHD) Co‐Sprühen hergestellt. Die Mikropartikel wurden durch konfokale Raman‐Mikrospektroskopie charakterisiert, und die bioorthogonale Oberflächenmodifikation eines jedes Patches wurde belegt.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106097/1/2364_ftp.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/106097/2/ange_201310727_sm_miscellaneous_information.pd

PRIMAGE project : predictive in silico multiscale analytics to support childhood cancer personalised evaluation empowered by imaging biomarkers

PRIMAGE is one of the largest and more ambitious research projects dealing with medical imaging, artificial intelligence and cancer treatment in children. It is a 4-year European Commission-financed project that has 16 European partners in the consortium, including the European Society for Paediatric Oncology, two imaging biobanks, and three prominent European paediatric oncology units. The project is constructed as an observational in silico study involving high-quality anonymised datasets (imaging, clinical, molecular, and genetics) for the training and validation of machine learning and multiscale algorithms. The open cloud-based platform will offer precise clinical assistance for phenotyping (diagnosis), treatment allocation (prediction), and patient endpoints (prognosis), based on the use of imaging biomarkers, tumour growth simulation, advanced visualisation of confidence scores, and machine-learning approaches. The decision support prototype will be constructed and validated on two paediatric cancers: neuroblastoma and diffuse intrinsic pontine glioma. External validation will be performed on data recruited from independent collaborative centres. Final results will be available for the scientific community at the end of the project, and ready for translation to other malignant solid tumours

Technology Acceptance Model y mayores: ¿la educación y la actividad laboral desarrollada son variables moderadoras?

ResumenEl objetivo de este trabajo es analizar la influencia, como variables moderadoras, del nivel educativo y la actividad laboral desarrollada por los mayores de 50 años en su proceso de aceptación de Internet, dentro del marco del modelo TAM (Technology Acceptance Model). Proponemos un modelo basado en TAM, testado mediante PLS y multi-grupo para comprobar el cumplimiento de las hipótesis de moderación propuestas. Los resultados apoyan la idoneidad del modelo aunque el poder moderador de la actividad laboral no es significativo mientras que el nivel educativo tiene mayor capacidad explicativa en el caso de los mayores sin estudios universitarios. A su vez el TAM se muestra como una herramienta apropiada para explicar la heterogeneidad de los mayores con respecto a Internet.AbstractOur aim in this work is to analyze the impact, as moderator variables, of the level of education and the profession on the Internet acceptance level in people older than 50 years old. We propose a model based on a Technology Acceptance Model (TAM). We contrast the moderator hypotheses proposed using Partial Least Squares (PLS) and multi-group analysis. The results support the suitability of the model showing a non-significant moderator effect of the profession, whereas the education level presents a higher explanatory power for older adults with no university degree. In addition, TAM appears to be an appropriatetool to explain the heterogeneity of this segment as regards the Internet

Migralepsy, hemicrania epileptica, post-ictal headache and “ictal epileptic headache”: a proposal for terminology and classification revision

Despite the fact that migraine and epilepsy are among the commoner brain diseases and that comorbidity of these conditions is well known, only few reports of migralepsy and hemicrania epileptica (HE) have been published according to the current ICHD-II criteria. Particularly, ICHD-II describes “migraine-triggered seizure” (i.e., migralepsy) among complications of migraine at “1.5.5” (as a rare event in which a seizure happens during migrainous aura), while hemicrania epileptica (coded at “7.6.1”) and post-ictal headache (coded at “7.6.2”) are described among headaches attributed to epileptic seizure. However, to date neither the International Headache Society nor the International League against Epilepsy mention that headache/migraine may be the sole ictal epileptic manifestation. Based on the current knowledge, migralepsy is highly unlikely to exist as such. We, therefore, propose to delete this term until clear evidence its existence is provided. Moreover, we herein propose a revision of terminology and classification criteria to properly represent the migraine/headache relationships. We suggest the term “ictal epileptic headache” in cases in which headache/migraine is the sole ictal epileptic manifestation

Learning form Nature to improve the heat generation of iron-oxide nanoparticles for magnetic hyperthermia applications.

The performance of magnetic nanoparticles is intimately entwined with their structure, mean size and magnetic anisotropy. Besides, ensembles offer a unique way of engineering the magnetic response by modifying the strength of the dipolar interactions between particles. Here we report on an experimental and theoretical analysis of magnetic hyperthermia, a rapidly developing technique in medical research and oncology. Experimentally, we demonstrate that single-domain cubic iron oxide particles resembling bacterial magnetosomes have superior magnetic heating efficiency compared to spherical particles of similar sizes. Monte Carlo simulations at the atomic level corroborate the larger anisotropy of the cubic particles in comparison with the spherical ones, thus evidencing the beneficial role of surface anisotropy in the improved heating power. Moreover we establish a quantitative link between the particle assembling, the interactions and the heating properties. This knowledge opens new perspectives for improved hyperthermia, an alternative to conventional cancer therapies

Effectiveness of manual therapies: the UK evidence report

<p>Abstract</p> <p>Background</p> <p>The purpose of this report is to provide a succinct but comprehensive summary of the scientific evidence regarding the effectiveness of manual treatment for the management of a variety of musculoskeletal and non-musculoskeletal conditions.</p> <p>Methods</p> <p>The conclusions are based on the results of systematic reviews of randomized clinical trials (RCTs), widely accepted and primarily UK and United States evidence-based clinical guidelines, plus the results of all RCTs not yet included in the first three categories. The strength/quality of the evidence regarding effectiveness was based on an adapted version of the grading system developed by the US Preventive Services Task Force and a study risk of bias assessment tool for the recent RCTs.</p> <p>Results</p> <p>By September 2009, 26 categories of conditions were located containing RCT evidence for the use of manual therapy: 13 musculoskeletal conditions, four types of chronic headache and nine non-musculoskeletal conditions. We identified 49 recent relevant systematic reviews and 16 evidence-based clinical guidelines plus an additional 46 RCTs not yet included in systematic reviews and guidelines.</p> <p>Additionally, brief references are made to other effective non-pharmacological, non-invasive physical treatments.</p> <p>Conclusions</p> <p>Spinal manipulation/mobilization is effective in adults for: acute, subacute, and chronic low back pain; migraine and cervicogenic headache; cervicogenic dizziness; manipulation/mobilization is effective for several extremity joint conditions; and thoracic manipulation/mobilization is effective for acute/subacute neck pain. The evidence is inconclusive for cervical manipulation/mobilization alone for neck pain of any duration, and for manipulation/mobilization for mid back pain, sciatica, tension-type headache, coccydynia, temporomandibular joint disorders, fibromyalgia, premenstrual syndrome, and pneumonia in older adults. Spinal manipulation is not effective for asthma and dysmenorrhea when compared to sham manipulation, or for Stage 1 hypertension when added to an antihypertensive diet. In children, the evidence is inconclusive regarding the effectiveness for otitis media and enuresis, and it is not effective for infantile colic and asthma when compared to sham manipulation.</p> <p>Massage is effective in adults for chronic low back pain and chronic neck pain. The evidence is inconclusive for knee osteoarthritis, fibromyalgia, myofascial pain syndrome, migraine headache, and premenstrual syndrome. In children, the evidence is inconclusive for asthma and infantile colic.</p