Guidelines for the use of diagnostic imaging in musculoskeletal pain conditions affecting the lower back, knee and shoulder: A scoping review

Background Musculoskeletal (MSK) pain is one of the most common reasons for primary care consultation, particularly pain in the lower back (LBP), knee and shoulder. The use of diagnostic imaging for MSK pain is increasing, but it is unclear whether this increase is justified on the basis of clinical practice guideline (CPG) recommendations. Aim To identify and map the content of CPGs that informs the use of diagnostic imaging in those with nontraumatic LBP, knee and shoulder pain in primary and intermediate care in the UK. Design and Setting A scoping review of CPGs. Methods This scoping review was conducted and is reported in accordance with PRISMA guidance. A broad search strategy included electronic searches of MEDLINE, CINAHL, PsychINFO and SPORTDiscus from 2009 to 17 April 2019. This was conducted alongside a search of guideline repositories and was combined with a snowball search of Google, relevant professional bodies and use of social media. Results 31 relevant CPGs were included. Routine use of diagnostic imaging for those with nontraumatic LBP, knee or shoulder pain is generally discouraged in primary care or intermediate care. Diagnostic imaging should be reserved for when specific or serious pathology is suspected or where the person is not responding to initial nonsurgical management and the imaging result is expected to change clinical management decisions. Conclusion Diagnostic imaging should not be routinely requested in primary or intermediate care for nontraumatic LBP, knee or shoulder pain. CPGs do not justify the increasing imaging rates in the UK for MSK pain

Ecological Impact Of Historical Land‐Use Patterns In The Great Plains: A Methodological Assessment

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117101/1/eap20051561915.pd

MOLES3: implementing an ISO standards driven data catalogue

ISO19156 Observations and Measurements (O&M) provides a standardised framework for organising information about the collection of information about the environment. Here we describe the implementation of a specialisation of O&M for environmental data, the Metadata Objects for Linking Environmental Sciences (MOLES3). MOLES3 provides support for organising information about data, and for user navigation around data holdings. The implementation described here, “CEDA-MOLES”, also supports data management functions for the Centre for Environmental Data Archival, CEDA. The previous iteration of MOLES (MOLES2) saw active use over five years, being replaced by CEDA-MOLES in late 2014. During that period important lessons were learnt both about the information needed, as well as how to design and maintain the necessary information systems. In this paper we review the problems encountered in MOLES2; how and why CEDA-MOLES was developed and engineered; the migration of information holdings from MOLES2 to CEDA-MOLES; and, finally, provide an early assessment of MOLES3 (as implemented in CEDA-MOLES) and its limitations. Key drivers for the MOLES3 development included the necessity for improved data provenance, for further structured information to support ISO19115 discovery metadata export (for EU INSPIRE compliance), and to provide appropriate fixed landing pages for Digital Object Identifiers (DOIs) in the presence of evolving datasets. Key lessons learned included the importance of minimising information structure in free text fields, and the necessity to support as much agility in the information infrastructure as possible without compromising on maintainability both by those using the systems internally and externally (e.g. citing in to the information infrastructure), and those responsible for the systems themselves. The migration itself needed to ensure continuity of service and traceability of archived assets

Membrane insertion of anthrax protective antigen and cytoplasmic delivery of lethal factor occur at different stages of the endocytic pathway

The protective antigen (PA) of anthrax toxin binds to a cell surface receptor, undergoes heptamerization, and binds the enzymatic subunits, the lethal factor (LF) and the edema factor (EF). The resulting complex is then endocytosed. Via mechanisms that depend on the vacuolar ATPase and require membrane insertion of PA, LF and EF are ultimately delivered to the cytoplasm where their targets reside. Here, we show that membrane insertion of PA already occurs in early endosomes, possibly only in the multivesicular regions, but that subsequent delivery of LF to the cytoplasm occurs preferentially later in the endocytic pathway and relies on the dynamics of internal vesicles of multivesicular late endosomes

Modelling greenhouse gas emissions and mitigation potentials in fertilized paddy rice fields in Bangladesh

The work was supported by Bangabandhu Fellowship on Science and ICT project, Ministry of Science and Technology, People’s Republic of Bangladesh. We are grateful to the model developers at the Natural Resource Ecology Laboratory, Colorado State University, Fort Collins, Colorado, United States of America, for sending us the new methane version of the DayCent model.Peer reviewedPostprin

Cross-biome transplants of plant litter show decomposition models extend to a broader climatic range but lose predictability at the decadal time scale

We analyzed results from 10-year long field incubations of foliar and fine root litter from the Long-term Intersite Decomposition Experiment Team (LIDET) study. We tested whether a variety of climate and litter quality variables could be used to develop regression models of decomposition parameters across wide ranges in litter quality and climate and whether these models changed over short to long time periods. Six genera of foliar and three genera of root litters were studied with a 10-fold range in the ratio of acid unhydrolyzable fraction (AUF, or ‘lignin’) to N. Litter was incubated at 27 field sites across numerous terrestrial biomes including arctic and alpine tundra, temperate and tropical forests, grasslands and warm deserts. We used three separate mathematical models of first-order (exponential) decomposition, emphasizing either the first year or the entire decade. One model included the proportion of relatively stable material as an asymptote. For short-term (first-year) decomposition, nonlinear regressions of exponential or power function form were obtained with r 2 values of 0.82 and 0.64 for foliar and fine-root litter, respectively, across all biomes included. AUF and AUF : N ratio were the most explanative litter quality variables, while the combined temperature-moisture terms AET (actual evapotranspiration) and CDI (climatic decomposition index) were best for climatic effects. Regressions contained some systematic bias for grasslands and arctic and boreal sites, but not for humid tropical forests or temperate deciduous and coniferous forests. The ability of the regression approach to fit climate-driven decomposition models of the 10-year field results was dramatically reduced from the ability to capture drivers of short-term decomposition. Future work will require conceptual and methodological improvements to investigate processes controlling decadal-scale litter decomposition, including the formation of a relatively stable fraction and its subsequent decomposition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78615/1/j.1365-2486.2009.02086.x.pd

Impact of historical land‐use changes on greenhouse gas exchange in the U.S. Great Plains, 1883–2003

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117205/1/eap20112141105.pd

Assessing precipitation, evapotranspiration, and NDVI as controls of U.S. Great Plains plant production

Productivity throughout the North American Great Plains grasslands is generally considered to be water limited, with the strength of this limitation increasing as precipitation decreases. We hypothesize that cumulative actual evapotranspiration water loss (AET) from April to July is the precipitation-related variable most correlated to aboveground net primary production (ANPP) in the U.S. Great Plains (GP). We tested this by evaluating the relationship of ANPP to AET, precipitation, and plant transpiration (Tr). We used multi-year ANPP data from five sites ranging from semiarid grasslands in Colorado and Wyoming to mesic grasslands in Nebraska and Kansas, mean annual NRCS ANPP, and satellite-derived normalized difference vegetation index (NDVI) data. Results from the five sites showed that cumulative April-to-July AET, precipitation, and Tr were well correlated (R2: 0.54–0.70) to annual changes in ANPP for all but the wettest site. AET and Tr were better correlated to annual changes in ANPP compared to precipitation for the drier sites, and precipitation in August and September had little impact on productivity in drier sites. April-to-July cumulative precipitation was best correlated (R2 = 0.63) with interannual variability in ANPP in the most mesic site, while AET and Tr were poorly correlated with ANPP at this site. Cumulative growing season (May-to-September) NDVI (iNDVI) was strongly correlated with annual ANPP at the five sites (R2 = 0.90). Using iNDVI as a surrogate for ANPP, we found that county-level cumulative April–July AET was more strongly correlated to ANPP than precipitation for more than 80% of the GP counties, with precipitation tending to perform better in the eastern more mesic portion of the GP. Including the ratio of AET to potential evapotranspiration (PET) improved the correlation of AET to both iNDVI and mean county-level NRCS ANPP. Accounting for how different precipitation-related variables control ANPP (AET in drier portion, precipitation in wetter portion) provides opportunity to develop spatially explicit forecasting of ANPP across the GP for enhancing decision-making by land managers and use of grassland ANPP for biofuels

Guidelines for the use of diagnostic imaging in musculoskeletal (MSK) pain conditions affecting the lower back, knee and shoulder: a scoping review

Musculoskeletal (MSK) pain is one of the most common reasons for primary care consultation, particularly pain in the lower back (LBP), knee, and shoulder. The use of diagnostic imaging for musculoskeletal pain is increasing but it is unclear whether this increase is justified based on clinical practice guideline (CPG) recommendations. Aim To identify and map the content of CPGs that inform the use of diagnostic imaging in those with non-traumatic LBP, knee, and shoulder pain in primary and intermediate care in the UK. Design and Setting A scoping review of CPGs. Methods This scoping review was conducted and is reported in accordance with PRISMA guidance. A broad search strategy included electronic searches of MEDLINE, CINAHL, PsychINFO and SPORTDiscus from 2009 to the 17th April 2019. This was conducted alongside a search of guideline repositories and was combined with a snowball search of Google, relevant professional bodies and use of social media. Results 31 relevant CPGs were included. Routine use of diagnostic imaging for those with non-traumatic LBP, knee or shoulder pain is generally discouraged in primary care or intermediate care. Diagnostic imaging should be reserved for when specific or serious pathology is suspected or where the person is not responding to initial non-surgical management and the imaging result is expected to change clinical management decisions. Conclusion Diagnostic imaging should not be routinely requested in primary or intermediate care for non-traumatic LBP, knee, or shoulder pain. CPGs do not justify the increasing imaging rates in the UK for musculoskeletal pain