A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy

Aim: To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy.

Background: International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness.

Design: A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy.

Data Sources: Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013).

Review Methods: Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool.

Results: Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low.

Conclusion: There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice.

Parents' perceptions of microneedle-mediated monitoring as an alternative to blood sampling in the monitoring of their infants

OBJECTIVES: Microneedle (MN) arrays could offer a pain-free, minimally invasive approach to monitoring. This is envisaged to be particularly beneficial for younger patients, but parents' views to date are unknown. The aim of this study was to explore parental perceptions of MN-mediated ISF monitoring, as an alternative to the use of conventional blood sampling, and to understand the important factors for technique approval.

METHODS: Semi-structured interviews were conducted with parents with recent experience of a premature birth. Recruitment was through the Northern Ireland premature infant charity, Tinylife. Interviews progressed until data saturation was reached and thematic analysis employed.

KEY FINDINGS: The study included 16 parents. Parental support for MN-mediated monitoring was evident, alongside the unpopularity of traditional blood sampling in neonates. Factors facilitating MN approval included the opportunity for pain reduction, the simplicity of the procedure, the potential for increased parental involvement and the more favourable appearance, owing to the minute size of MNs and similarities with a sticking plaster. Confirmation of correct application, a pain-free patch removal and endorsement from trusted healthcare professionals were important.

CONCLUSION: These findings will inform researchers in the field of MN development and enlighten practitioners regarding parental distress resulting from conventional blood sampling. Further work is necessary to understand MN acceptability among practitioners. This work should assist in the development of an acceptable MN device and facilitate the reduction of parental distress.

An alternative methodology in Schottky diode physics

The fabrication and electrical characterization of Schottky junction diodes have been extensively researched for three-quarters of a century since the original work of Schottky in 1938. This study breaks from the highly standardized regime of such research and provides an alternative methodology that prompts novel, more efficient applications of the adroit Schottky junction in areas such as chemical and thermal sensing. The core departure from standard Schottky diode configuration is that the metal electrode is of comparable or higher resistance than the underlying semiconductor. Further, complete electrical characterization is accomplished through recording four-probe resistance-temperature (R-D-T) characteristics of the device, where electrical sourcing and sensing is done only via the metal electrode and not directly through the semiconductor. Importantly, this results in probing a nominally unbiased junction while eliminating the need for an Ohmic contact to the semiconductor. The characteristic R-D-T plot shows two distinct regions of high (metal) and low (semiconductor) resistances at low and high temperatures, respectively, connected by a crossover region of width, DT, within which there is a large negative temperature coefficient of resistance. The R-D-T characteristic is highly sensitive to the Schottky barrier height; consequently, at a fixed temperature, R-D responds appreciably to small changes in barrier height such as that induced by absorption of a chemical species (e.g., H-2) at the interface. A theoretical model is developed to simulate the R-D-T data and applied to Pd/p-Si and Pt/p-Si Schottky diodes with a range of metal electrode resistance. The analysis gives near-perfect fits to the experimental R-D-T characteristics, yielding the junction properties as fit parameters. The modelling not only helps elucidate the underlying physics but also helps to comprehend the parameter space essential for the discussed applications. Although the primary regime of application is limited to a relatively narrow range (DT) for a given type of diode, the alternative methodology is of universal applicability to all metal-semiconductor combinations forming Schottky contacts. (C) 2015 AIP Publishing LLC.

Prevalence of germ-line mutations in p16, p19ARF, and CDK4 in familial melanoma:analysis of a clinic-based population

Five to ten percent of individuals with melanoma have another affected family member, suggesting familial predisposition. Germ-line mutations in the cyclin-dependent kinase (CDK) inhibitor p16 have been reported in a subset of melanoma pedigrees, but their prevalence is unknown in more common cases of familial melanoma that do not involve large families with multiple affected members. We screened for germ-line mutations in p16 and in two other candidate melanoma genes, p19ARF and CDK4, in 33 consecutive patients treated for melanoma; these patients had at least one affected first or second degree relative (28 independent families). Five independent, definitive p16 mutations were detected (18%, 95% confidence interval: 6%, 37%), including one nonsense, one disease-associated missense, and three small deletions. No mutations were detected in CDK4. Disease-associated mutations in p19ARF, whose transcript is derived in part from an alternative codon reading frame of p16, were only detected in patients who also had mutations inactivating p16. We conclude that germ-line p16 mutations are present in a significant fraction of individuals who have melanoma and a positive family history.

Periodate – an alternative oxidant for testing potential water oxidation catalysts

The redox catalyst ruthenium dioxide, prepared via the Adams technique, i.e.Ru(Adams), is used as a water oxidation catalyst using the oxidants (i) Ce(IV) in 0.5M H2SO4 and (ii) periodate in 0.5 M H2SO4, water and 0.1 M KOH. Like Ce(IV),periodate is a very strong oxidant that is able to oxidise water to oxygen and can bereadily monitored spectrophotometrically at 280 nm, compared with 430 nm for Ce(IV).More importantly, unlike Ce(IV), which is unstable towards hydrolysis above pH 1,periodate is stable in acid, water and strong alkali. A spectrophotometric study of thekinetics of periodate reduction, and concomitant oxidation of water to O2, reveals thatin the presence of a suitable redox catalyst, Ru(Adams) in this work, periodate is ableto effect the stoichiometric oxidation of water, with a turnover number > 64. In justwater, the kinetics of the latter reaction appear diffusion-controlled, due to the largethermodynamic driving force, a measure of which is the difference in redox potential,i.e. ∆E = 423 mV. As this difference is decreased, ∆E = 396 mV in acid and 290 mVin strong alkali (0.1 M KOH), the kinetics become increasingly activation-controlledand slower. These findings are discussed briefly with regard to the possible use of (i)periodate as an alternative oxidant in the rapid screening of new potential wateroxidation catalyst material powders that are stable only under near neutral and/oralkaline conditions, and (ii) Ru(Adams) as a benchmark catalyst.

PTEN mRNA detection by chromogenic, RNA in situ technologies: a reliable alternative to PTEN immunohistochemistry

Immunohistochemical staining for phosphatase and tensin homolog (PTEN) does not have either an acceptable standard protocol or concordance of scoring between pathologists. Evaluation of PTEN mRNA with a unique and verified sequence probe may offer a realistic alternative providing a robust and reproducible protocol. In this study, we have evaluated an in situ hybridization (ISH) protocol for PTEN mRNA using RNAScope technology and compared it with a standard protocol for PTEN immunohistochemistry (IHC). PTEN mRNA expression by ISH was consistently more sensitive than PTEN IHC, with 56% of samples on a mixed-tumor tissue microarray (TMA) showing high expression by ISH compared with 42% by IHC. On a prostate TMA, 49% of cases showed high expression by ISH compared with 43% by IHC. Variations in PTEN mRNA expression within malignant epithelium were quantifiable using image analysis on the prostate TMAs. Within tumors, clear overexpression of PTEN mRNA on malignant epithelium compared with benign epithelium was frequently observed and quantified. The use of SpotStudio software in the mixed-tumor TMA allowed for clear demonstration of varying levels of PTEN mRNA between tumor samples by the mRNA methodology. This was evident by the quantifiable differences between distinct oropharyngeal tumors (up to 3-fold increase in average number of spots per cell between 2 cases). mRNA detection of PTEN or other biomarkers, for which optimal or standardized immunohistochemical techniques are not available, represents a means by which heterogeneity of expression within focal regions of tumor can be explored with more confidence.

Measurement of fibre fracture toughness using an alternative specimen geometry

This paper presents an experimental and numerical study focused on the tensile fibre fracture toughness characterisation of hybrid plain weave composite laminates using non-standardized Overheight Compact Tension (OCT) specimens. The position as well as the strain field ahead of the crack tip in the specimens was determined using a digital speckle photogrammetry system. The limitation on the applicability of standard data reduction schemes for the determination of the intralaminar fibre fracture toughness of composites is presented and discussed. A methodology based on the numerical evaluation of the strain energy release rate using the J-integral method is proposed to derive new geometric correction functions for the determination of stress intensity factor for alternative composite specimen geometries. A comparison between different methods currently available to compute the intralaminar fracture toughness in composites is also presented and discussed. Good agreement between numerical and experimental results using the proposed methodology was obtained.

Seed dormancy in Arabidopsis thaliana is controlled by alternative polyadenylation of DOG1

DOG1 is a key regulator of seed dormancy in Arabidopsis and other plants. Interestingly, the C-terminus of DOG1 is either absent or not conserved in many plant species. Here, we show that in Arabidopsis DOG1 transcript is subject to alternative polyadenylation. In line with this, mutants in RNA 3' processing complex display weakened seed dormancy in parallel with defects in DOG1 proximal polyadenylation site selection, suggesting that the short DOG1 transcript, is functional. This is corroborated by the finding that the proximally polyadenylated short DOG1 mRNA is translated in vivo and complements the dog1 mutation. In summary, our findings indicate that the short DOG1 protein isoform produced from the proximally polyadenylated DOG1 mRNA is a key player in the establishment of seed dormancy in Arabidopsis and characterize a set of mutants in RNA 3' processing complex required for production of proximally polyadenylated functional DOG1 transcript.