Immediate Effects of Cervical Spine Thrust Joint Manipulation on Gait Parameters in Individuals with Neck Pain

Purpose/Hypotheses: 1. To investigate for any change in gait parameters in individuals with neck pain while walking with different functional neck conditions immediately following cervical thrust joint manipulation (TJM) versus a sham intervention. 2. To investigate any association between Global Rating of Change (GROC) scores and gait parameters immediately following cervical thrust joint manipulation versus a sham intervention. The hypotheses were that, a) cervical TJM would have an immediate effect on gait parameters during walking with the neck in at least one of three conditions (neutral, flexion/extension and rotation) among individuals with neck pain; and b) higher scores on the GROC would be associated with improved gait parameters post-intervention. Subjects: Convenience sample of 40 individuals (30 female; mean age 24.5 ± 6.78 years) with neck pain. To qualify, subjects had to have a score \u3e0 on the question of pain intensity in the neck on the Neck Disability Index (NDI) questionnaire and have no contraindications or precautions for cervical TJM. Materials/Methods: Subjects walked on a Zeno Walkway under the following conditions: 1) head in neutral; 2) head rotating from side-to-side, and 3) head nodding up and down. After completing 30 practice trials (10 in each condition), pre-intervention trial 1 gait parameters were recorded for each of the three neck conditions in a randomized order. After a 5-minute rest period, pre-intervention trial 2 was conducted for each condition in same order as trial 1. Subjects then received one of two randomly assigned interventions: cervical spine TJM or active cervical rotation. Immediately after the intervention, the subject returned to the Zeno Walkway for the post-intervention trial 3 in each of the three conditions, in the same order as their previous trials. Gait parameters of average step length, stride length, stride width, velocity, and cadence were analyzed using a 2x2 repeated measures ANOVA (of trials 2 and 3), as well as independent and paired t-tests, to determine if there were any significant changes based on intervention when comparing TJM to sham groups. Results: The results of the 2x2 ANOVA revealed significant interactions between group and time on average gait velocity (p=0.008), step length (p=\u3c0.001), and stride length (p=0.009) when the head was in a neutral position. The TJM group experienced significant increases from pre to post-intervention as shown by paired samples t-test for average gait velocity (p=0.003), step length (p\u3c0.001), and stride length (p=0.008). The sham group however, experienced no significant change in gait velocity (p = 0.290), average step length (p = 0.299), and stride length (p = 0.292). There was also a significant decrease in the Numeric Pain Rating Scale (NPRS) (mean decrease of 1.25; p=0.003) and the group that received cervical TJM reported an improved perception of change demonstrated by an average increase in GROC score by 2.85 (p=0.001). Conclusions: Although our results demonstrate a statistically significant improvement in three gait parameters following TJM while walking with the neck in a neutral position, the improvements are not clinically significant. At this time, there is no evidence-based indication for the clinical use of cervical TJM to improve gait parameters in individuals with neck pain. Our findings cannot confirm clinical significance for reduction of neck pain with cervical TJM based on NDI, NPRS, or GROC questionnaires

Effect of Ring Size and Migratory Groups on [1,n] Suprafacial Shift Reactions. Confirmation of Aromatic and Antiaromatic Transition-State Character by Ring-Current Analysis

Suprafacial sigmatropic shift reactions of 5-substituted cyclopentadienes, 3-substituted cyclopropenes, and 7-substituted cycloheptatrienes have been studied computationally at the MP2/6-31+G* level for structures and energetics, and using the ipsocentric method at the CHF/6-31G** level to calculate current-density maps. The hydrogen shifts in cyclopentadienes have a diatropic ring currents indicating aromatic, cyclopentadienide anion character. This result stands in contrast to the fluorine shift in 5- fluorocyclopentadiene which requires much more energy, and has a paratropic ring current in the TS pointing to antiaromatic, cyclopentadienyl cation character. [1,3] hydrogen shifts in cyclopropenes are very difficult, passing through transition states that have an extended C-C bond. For 3-fluorocyclopropene the [1,3] fluorine shift is much easier than the hydrogen shift. For 7-fluorocycloheptatriene the [1,7] hydrogen shift is predicted, but requires very high energy and has a paratropic ring current and antiaromatic character. The [1,7] suprafacial fluorine shift is relatively easy, having a TS with cycloheptatrienyl cation character. Patterns of currents, and the reversal for H and F migration, are rationalized by orbital analysis based on the ipsocentric method. Calculated charges and structural features for reactants and transition states support these conclusions

Aromatic Superhalogens

No organic molecules with electron affinities near or above those of halogens are known. We show for the first time that aromaticity rules can be used to design molecules with electron affinities far exceeding those of halogen atoms either by tailoring the ligands of cyclopentadienyl or by multiple benzo-annulations of cyclopentadienyl in conjunction with the substitution of CH groups with isoelectronic N atoms. Results based on density functional theory reveal that the electron affinities of some of these organic molecules can reach as high as 5.59 eV, thus opening the door to new class of superhalogens that contain neither a metal nor a halogen atom

Atelier Herenplaats, un Taller Extraordinario

Este artículo trata sobre artistas que trabajan en los márgenes, personas con enfermedades mentales o que padecen alguna discapacidad, la historia del llamado arte outsider, su contexto y aceptación en el mundo del arte

Calcium-induced Ca2+ release from sarcoplasmic reticulum of pigs susceptible to malignant hyperthermia The effects of halothane and dantrolene

AbstractCalcium-induced calcium release and halothane-induced calcium release from pig sarcoplasmic reticulum (SR) were studied. The SR prepared from pig susceptible to malignant hyperthermia (MH) was shown to release calcium at a much lower level of calcium content than in normal pig SR. The concentration above which halothane can release calcium is 40 μM for both MH-SR and normal SR, although the latter required a high calcium content to demonstrate the calcium release. Dantrolene was shown to inhibit the halothane-induced calcium release. Results suggests that SR plays an importnat role in pathogenesis of MH

Landfill gas generation and methane recovery at Naboro landfill, Fiji Islands: a case study from a developing Pacific Island country

The Naboro landfill in Suva, the capital city of Fiji Islands, is a sanitary engineered landfill, consisting of a compacted clay protective liner and leachate collection system. The waste is selectively placed, compacted and then covered with soil. The landfill was commisioned in 2005 and is currently receiving an average of 70,000 tonnes of waste annually. The municipal solid waste deposited in the landfill undergoes anaerobic decomposition and the methane gas generated escapes into the atmosphere, adding to the national greenhouse gas inventory. Currently there are no methane recovery and biogas utilisation technology in place or methane flaring at the Naboro landfill site. A feasibility study was carried out recently and based on the model output and field experiments, it was noted that methane recovery and utilisation could be a viable option although there could be some challenges associated with it. According to the waste chaacterization data supplied by the landfill operator it was noted that 83% is house hold waste, 11% is garden waste and 5% is food waste and 1% construction and demolition waste. Based on the type of waste deposited and the tropical weather condition it was calculated using the model that approximately 800 m3/h of methane is generated in 2016. Figure below shows the landfill gas generated at the Naboro landfill from stage 1 to stage 4. Due to tropical humid weather condition and waste rich is organic waste that decomposes rapidly results in the yearly average emission of 74% of total methane generated despite methane recovery via vertical wells installed at the end of each stage. The emission equates to 47,000 tons of CO2 equivalent per year despite methane recovery. The emission can be reduced if the methane generated could be extracted using vertical recovery wells half way through each stage rather than at the end of each stage and as a consequence a slight decrease in yearly average emissions of 41,000 tons of CO2 equivalent were noted. Another approach is to lay horizontal wells as the waste is compacted in the active cell and this could increase the efficiency of landfill gas extraction. The model result indicate that the use of horizontal wells reduces the yearly average emission to 55% of total methane generated. This highlights the fact that approximately 45 % of the methane generated could be harnessed and could be utilized to generate energy using gas engines. However a large fraction of the methane generated is still lost as emission to the atmopshere and this can be further reduced by enhancing the oxdising capacity of the soil cover. The methane oxidation in cover soil was measured to be 10.3% by measuring the CH4-CO2 ratios in the static chamber measurements. The experimental value is close to the IPCC default value of 10%. The paper will discuss other challenges associated with methane recovery at Naboro landfill particularly with landfill gas management