A survey of the attitudes and beliefs about the use of TENS for pain management by physiotherapists working in two cities in Sri Lanka.

INTRODUCTION: Transcutaneous electrical nerve stimulation (TENS) is a noninvasive, inexpensive, self-administered technique used throughout the world to relieve pain. In Sri Lanka, physiotherapists may use TENS for their patients as they receive a small amount of education about the principles and practice of TENS in their undergraduate training. To date, there have been no data gathered about the use of TENS by physiotherapists in Sri Lanka. The aim of this study was to assess attitudes and beliefs of physiotherapists working in Sri Lanka about their use of TENS for pain management. METHODS: A postal survey was undertaken using a 12-item questionnaire developed by the investigators to gather information about attitudes, beliefs and use of TENS in clinical practice. The questionnaire was distributed to 100 physiotherapists working in three government hospitals and six private hospitals in the cities of Kandy and Colombo. A descriptive analysis of data was performed. RESULTS: Sixty-seven completed questionnaires were returned (67% response rate). Over half of the respondents (58.2%) reported that they used TENS to treat pain "often" or "very often", with use for musculoskeletal/orthopedic (61.3%) and neuropathic/neuralgic (79.1%) pain being most common. TENS was used less for postsurgical pain and rarely for cancer pain. Most (95.5%) respondents reported that their patients benefitted "considerably" from TENS. 76.1% of the respondents reported that they did not recommend and/or prescribe TENS for patients to use at home. CONCLUSION: Physiotherapists value TENS as a treatment option to manage musculoskeletal and neuropathic pain. However, there is a need for systems and resources to enable to patients to self-administer TENS rather than having to visit clinics

Three-dimensional flow in Kupffer's Vesicle.

Whilst many vertebrates appear externally left-right symmetric, the arrangement of internal organs is asymmetric. In zebrafish, the breaking of left-right symmetry is organised by Kupffer's Vesicle (KV): an approximately spherical, fluid-filled structure that begins to form in the embryo 10 hours post fertilisation. A crucial component of zebrafish symmetry breaking is the establishment of a cilia-driven fluid flow within KV. However, it is still unclear (a) how dorsal, ventral and equatorial cilia contribute to the global vortical flow, and (b) if this flow breaks left-right symmetry through mechanical transduction or morphogen transport. Fully answering these questions requires knowledge of the three-dimensional flow patterns within KV, which have not been quantified in previous work. In this study, we calculate and analyse the three-dimensional flow in KV. We consider flow from both individual and groups of cilia, and (a) find anticlockwise flow can arise purely from excess of cilia on the dorsal roof over the ventral floor, showing how this vortical flow is stabilised by dorsal tilt of equatorial cilia, and (b) show that anterior clustering of dorsal cilia leads to around 40 % faster flow in the anterior over the posterior corner. We argue that these flow features are supportive of symmetry breaking through mechano-sensory cilia, and suggest a novel experiment to test this hypothesis. From our new understanding of the flow, we propose a further experiment to reverse the flow within KV to potentially induce situs inversus.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s00285-016-0967-

Comparison of the Effectiveness of Transcutaneous Electrical Nerve Stimulation and Interferential Therapy on the Upper Trapezius in Myofascial Pain Syndrome: A Randomized Controlled Study.

OBJECTIVE: The aim of this study was to compare the effectiveness of transcutaneous electrical nerve stimulation and interferential therapy (IFT) both in combination with hot pack, myofascial release, active range of motion exercise, and a home exercise program on myofascial pain syndrome patients with upper trapezius myofascial trigger point. DESIGN: A total of 105 patients with an upper trapezius myofascial trigger point were recruited to this single-blind randomized controlled trial. Following random allocation of patients to three groups, three therapeutic regimens-control-standard care (hot pack, active range of motion exercises, myofascial release, and a home exercise program with postural advice), transcutaneous electrical nerve stimulation-standard care and IFT-standard care-were administered eight times during 4 wks at regular intervals. Pain intensity and cervical range of motions (cervical extension, lateral flexion to the contralateral side, and rotation to the ipsilateral side) were measured at baseline, immediately after the first treatment, before the eighth treatment, and 1 wk after the eighth treatment. RESULTS: Immediate and short-term improvements were marked in the transcutaneous electrical nerve stimulation group (n = 35) compared with the IFT group (n = 35) and the control group (n = 35) with respect to pain intensity and cervical range of motions (P < 0.05). The IFT group showed significant improvement on these outcome measurements than the control group did (P < 0.05). CONCLUSION: Transcutaneous electrical nerve stimulation with standard care facilitates recovery better than IFT does in the same combination

The entropic basis of collective behaviour

We identify a unique viewpoint on the collective behaviour of intelligent agents. We first develop a highly general abstract model for the possible future lives these agents may encounter as a result of their decisions. In the context of these possibilities, we show that the causal entropic principle, whereby agents follow behavioural rules that maximize their entropy over all paths through the future, predicts many of the observed features of social interactions among both human and animal groups. Our results indicate that agents are often able to maximize their future path entropy by remaining cohesive as a group and that this cohesion leads to collectively intelligent outcomes that depend strongly on the distribution of the number of possible future paths. We derive social interaction rules that are consistent with maximum entropy group behaviour for both discrete and continuous decision spaces. Our analysis further predicts that social interactions are likely to be fundamentally based on Weber's law of response to proportional stimuli, supporting many studies that find a neurological basis for this stimulus-response mechanism and providing a novel basis for the common assumption of linearly additive 'social forces' in simulation studies of collective behaviour

Modeling the Adaptive Role of Negative Signaling in Honey Bee Intraspecific Competition

Collective decision making in the social insects often proceeds via feedback cycles based on positive signaling. Negative signals have, however, been found in a few contexts in which costs exist for paying attention to no longer useful information. Here we incorporate new research on the specificity and context of the negative stop signal into an agent based model of honey bee foraging to explore the adaptive basis of negative signaling in the dance language. Our work suggests that the stop signal, by acting as a counterbalance to the waggle dance, allows colonies to rapidly shut down attacks on other colonies. This could be a key adaptation, as the costs of attacking a colony strong enough to defend itself are significant

Friends of hot Jupiters. II. No correspondence between hot-Jupiter spin-orbit misalignment and the incidence of directly imaged stellar companions

This is the final version of the article. Available from American Astronomical Society / IOP Publishing via the DOI in this record.Multi-star systems are common, yet little is known about a stellar companion's influence on the formation and evolution of planetary systems. For instance, stellar companions may have facilitated the inward migration of hot Jupiters toward to their present day positions. Many observed short-period gas giant planets also have orbits that are misaligned with respect to their star's spin axis, which has also been attributed to the presence of a massive outer companion on a non-coplanar orbit. We present the results of a multi-band direct imaging survey using Keck NIRC2 to measure the fraction of short-period gas giant planets found in multi-star systems. Over three years, we completed a survey of 50 targets ("Friends of Hot Jupiters") with 27 targets showing some signature of multi-body interaction (misaligned or eccentric orbits) and 23 targets in a control sample (well-aligned and circular orbits). We report the masses, projected separations, and confirmed common proper motion for the 19 stellar companions found around 17 stars. Correcting for survey incompleteness, we report companion fractions of 48% ± 9%, 47% ± 12%, and 51% ± 13% in our total, misaligned/eccentric, and control samples, respectively. This total stellar companion fraction is 2.8σ larger than the fraction of field stars with companions approximately 50-2000 AU. We observe no correlation between misaligned/eccentric hot Jupiter systems and the incidence of stellar companions. Combining this result with our previous radial velocity survey, we determine that 72% ± 16% of hot Jupiters are part of multi-planet and/or multi-star systems.This work was supported by NASA grant NNX14AD24G. H.N. is grateful for funding support from the Natural Sciences and Engineering Research Council of Canada. J.A.J. gratefully acknowledges support from generous fellowships from the David & Lucile Packard and Alfred P. Sloan foundations

The impact of complications and errors on surgeons

All surgical procedures carry with them the potential for adverse events. Dealing with the sequelae of the complications and errors that arise in the course of normal practice is therefore part and parcel of a surgeon’s working life. The challenges and stresses that this creates are now well recognised although surgical training has, until recently, done little to help surgeons prepare for such events and on-going professional and personal support is limited. This review shows that much of the research examining the impact of adverse events has been concentrated in healthcare systems outside of the UK, often markedly different to our own. With notable exceptions, sample sizes are often small and studies are often qualitative. While the latter provide rich and fascinating data, they may not always be representative, particularly if the focus is on serious errors where there is a risk of litigation. Despite the preponderance of complications, which are an acknowledged risk of surgical procedures, there is no research to date which has examined whether or not there are differences in the impact of complications versus errors on surgeons’ professional and personal lives. A national survey is currently planned to provide detailed information about the impact of adverse events – both complications and errors – which will map the way for better targeted support for surgeons to help them use their experiences to enhance their wellbeing and improve their practice

Response to novel objects and foraging tasks by common marmoset (Callithrix Jacchus) female Pairs

Many studies have shown that environmental enrichment can significantly improve the psychological well-being of captive primates, increasing the occurrence of explorative behavior and thus reducing boredom. The response of primates to enrichment devices may be affected by many factors such as species, sex, age, personality and social context. Environmental enrichment is particularly important for social primates living in unnatural social groupings (i.e. same-sex pairs or singly housed animals), who have very few, or no, benefits from the presence of social companions in addition to all the problems related to captivity (e.g. increased inactivity). This study analyses the effects of enrichment devices (i.e. novel objects and foraging tasks) on the behavior of common marmoset (Callithrix jacchus) female pairs, a species that usually lives in family groups. It aims to determine which aspects of an enrichment device are more likely to elicit explorative behaviors, and how aggressive and stress-related behaviors are affected by its presence. Overall, the marmosets explored foraging tasks significantly longer than novel objects. The type of object, which varied in size, shape and aural responsiveness (i.e. they made a noise when the monkey touched them), did not affect the response of the monkeys, but they explored objects that were placed higher in the enclosure more than those placed lower down.Younger monkeys were more attracted to the enrichment devices than the older ones. Finally, stress-related behavior (i.e. scratching) significantly decreased when the monkeys were presented with the objects; aggressive behavior as unaffected. This study supports the importance of environmental enrichment for captive primates and shows that in marmosets its effectiveness strongly depends upon the height of the device in the enclosure and the presence of hidden food. The findings can be explained ifone considers the foraging behavior of wild common marmosets. Broader applications for the research findings are suggested in relation to enrichment

Unguided low intensity cognitive behaviour therapy for anxiety and depression during the COVID-19 pandemic: A randomised trial.

The COVID-19 pandemic has had a severe impact on mental health worldwide, with increased rates of anxiety and depression widely documented. The aim of this study was to examine unguided low intensity cognitive behaviour therapy for anxiety and depression during the pandemic. A sample of 225 individuals in Australia and the United Kingdom (M age 37.79, SD = 14.02, range 18-80 years; 85% female) were randomised into intervention or waitlist control. The intervention group demonstrated significant decreases in anxiety (d = 0.36 [0.18, 0.54]) and depression (d = 0.28 [0.11, 0.45]) compared to controls. The majority of participants (96%) rated the intervention as useful, and most (83%) reported they spent 30 min or less reading the guide, with 83% agreeing the intervention was easy to read. The results indicate that low intensity cognitive behaviour therapy has efficacy in reducing anxiety and depression during the COVID-19 pandemic. There is an urgent need to disseminate low intensity psychological therapies to improve mental health in this challenging time

Sharing Cyber Threat Intelligence under the General Data Protection Regulation

Sharing Cyber Threat Intelligence (CTI) is a key strategy for improving cyber defense, but there are risks of breaching regulations and laws regarding privacy. With regulations such as the General Data Protection Regulation (GDPR) that are designed to protect citizens’ data privacy, the managers of CTI datasets need clear guidance on how and when it is legal to share such information. This paper defines the impact that GDPR legal aspects may have on the sharing of CTI. In addition, we define adequate protection levels for sharing CTI to ensure compli- ance with the GDPR. We also present a model for evaluating the legal require- ments for supporting decision making when sharing CTI, which also includes advice on the required protection level. Finally, we evaluate our model using use cases of sharing CTI datasets between entities