A descriptive study of the usage of spinal manipulative therapy techniques within a randomised clinical trial in acute low back pain

The majority of randomized clinical trials (RCTs) of spinal manipulative therapy have not adequately de?ned the terms ‘mobilization’ and ‘manipulation’, nor distinguished between these terms in reporting the trial interventions. The purpose of this study was to describe the spinal manipulative therapy techniques utilized within a RCT of manipulative therapy (MT; n=80), interferential therapy (IFT; n=80), and a combination of both (CT; n=80) for people with acute low back pain (LBP). Spinal manipulative therapy was de?ned as any ‘mobilization’ (low velocity manual force without a thrust) or ‘manipulation’ (high velocity
thrust) techniques of the spine described by Maitland and Cyriax.
The 16 physiotherapists, all members of the Society of Orthopaedic Medicine, utilized three spinal manipulative therapy patterns in the RCT: Maitland Mobilization (40.4%, n=59), Maitland Mobilization/Cyriax Manipulation (40.4%, n=59) and Cyriax Manipulation (19.1%, n=28). There was a signi?cant difference between the MT and CT groups in their usage of spinal manipulative therapy techniques (w2=9.178; df=2;P=0.01); subjects randomized to the CT group received three times more Cyriax Manipulation (29.2%, n=21/72) than those randomized to the MT group (9.5%, n=7/74; df=1; P=0.003).
The use of mobilization techniques within the trial was comparable with their usage by the general population of physiotherapists in Britain and Ireland for LBP management. However, the usage of manipulation techniques was considerably higher than reported in physiotherapy surveys and may re?ect the postgraduate training of trial therapists.

A cephalometric study of class II malocclusions treated with mandibular surgery

INTRODUCTION:

Class II malocclusion is often associated with retrognathic mandible. Some of these problems require surgical correction. The purposes of this study were to investigate treatment outcomes in patients with Class II malocclusions whose treatment included mandibular advancement surgery and to identify predictors of good outcomes.
METHODS:

Pretreatment and posttreatment cephalometric radiographs of 90 patients treated with mandibular advancement surgery by 57 consultant orthodontists in the United Kingdom before September 1998 were digitized, and cephalometric landmarks were identified. Paired samples t tests were used to compare the pretreatment and posttreatment cephalometric values for each patient. For each cephalometric variable, the proportion of patients falling within the ideal range was identified. Multiple logistic regression analysis was performed to identify predictors of achieving ideal range outcomes for the key skeletal (ANB and SNB angles), dental (overjet and overbite), and soft-tissue (Holdaway angle) measurements.
RESULTS:

An overjet within the ideal range of 1 to 4 mm was achieved in 72% of patients and was more likely with larger initial ANB angles. Horizontal correction of the incisor relationship was achieved by a combination of 75% skeletal movement and 25% dentoalveolar change. An ideal posttreatment ANB angle was achieved in 42% of patients and was more likely in females and those with larger pretreatment ANB angles. Ideal soft-tissue Holdaway angles (7 degrees to 14 degrees ) were achieved in 49% of patients and were more likely in females and those with smaller initial SNA angles. Mandibular incisor decompensation was incomplete in 28% of patients and was more likely in females and patients with greater pretreatment mandibular incisor proclination. Correction of increased overbite was generally successful, although anterior open bites were found in 16% of patients at the end of treatment. These patients were more likely to have had initial open bites.
CONCLUSIONS:

Mandibular surgery had a good success rate in normalizing the main dental and skeletal relationships. Less ideal soft-tissue profile outcomes were associated with larger pretreatment SNA-angle values, larger final mandibular incisor inclinations, and smaller final maxillary incisor inclinations. The use of mandibular surgery to correct anterior open bite was associated with poor outcomes.

Correlation of TACC3, FGFR3, MMSET and p21 expression with the t(4;14)(p16.3;q32) in multiple myeloma

The t(4;14)(p16;q32) translocation seen in c. 18% of newly diagnosed multiple myeloma (MM) cases, results in FGFR3 activation and creation of an IGH/MMSET fusion transcript. We have recently shown that FGFR3 is activated in only 75% of t(4;14)(+) cases, suggesting that alternative genes near the breakpoint may be involved in the transforming event. The gene, TACC3, located just 50 kb telomeric of FGFR3, with transforming capacity, therefore represented a candidate gene. Using a real-time quantitative polymerase chain reaction-based approach on a cohort of 54 patients, we found a statistically significant, twofold increase in TACC3 expression in t(4;14)(+) cases. TACC3, MMSET and p21 values were positively correlated in all cases and, of particular interest, six patient samples [three t(4;14)(-), three t(4;14)(+)] samples showed a joint up-regulation of TACC3, MMSET and p21. Although a poor prognosis is linked with elevated MMSET expression, an extended follow-up period will be required to evaluate the significance of elevated TACC3 and p21 expression in this subgroup of MM.

Fragmentation of positronium

The impulse approximation is used to calculate cross sections for fragmentation of Ps(1s) in collision with He, Ne, Ar, Kr, and Xe. Triple, double, single, and total cross sections are evaluated. Reasonably good agreement is found with the measurements of Armitage [Phys. Rev. Lett. 89, 173402 (2002)] on Ps(1s)+He(1(1)S) scattering. These absolute measurements comprise the total Ps ionization cross section and the cross section differential with respect to the longitudinal energy of the ejected positron. Characteristics of free electron and free positron scattering are explored in the double and triple differential cross sections for Ps(1s)+Xe scattering.

Quantum-information processing with noisy cluster states

We provide an analysis of basic quantum-information processing protocols under the effect of intrinsic nonidealities in cluster states. These nonidealities are based on the introduction of randomness in the entangling steps that create the cluster state and are motivated by the unavoidable imperfections faced in creating entanglement using condensed-matter systems. Aided by the use of an alternative and very efficient method to construct cluster-state configurations, which relies on the concatenation of fundamental cluster structures, we address quantum-state transfer and various fundamental gate simulations through noisy cluster states. We find that a winning strategy to limit the effects of noise is the management of small clusters processed via just a few measurements. Our study also reinforces recent ideas related to the optical implementation of a one-way quantum computer.

Polymorphisms in the interleukin-4 and IL-4 receptor genes modify risk for chronic inflammatory arthropathies in women.

Rheumatoid and juvenile idiopathic arthritis (RA, JIA) are chronic inflammatory arthropathies with polygenic autoimmune background. We analysed the IL-4 +33 C/T and IL-4R Q551R single nucleotide polymorphisms (SNPs) in 294 RA, 72 JIA and 165 controls from Northern Ireland. Analysis of the individual phenotypes (RA or JIA) showed that both the IL-4 +33 TT (P = 0.02; OR: 0.25, 95% CI: 0.07-0.87) and the IL-4R Q551R CC genotypes (P = 0.001; OR: 0.19, 95% CI: 0.06-0.56) were exclusively decreased in female RA patients compared to female controls. Similar non-significant trends were observed in female JIA patients (OR: 0.25, 95% CI: 0.03-2.11 and OR: 0.31, 95% CI: 0.07-1.47, respectively). Analysis of the common phenotype (inflammatory arthropathy; i.e. JIA and RA combined) corroborated the unique association of these polymorphisms with female inflammatory arthropathy (P = 0.013 and 0.002, respectively). This is the first demonstration of sex-specific association of the two foremost genes of the IL-4 signalling cascade with chronic inflammatory arthropathies.

The causes and consequences of Rent-seeking in Northern Ireland, 1945-72

Northern Ireland's economic performance during the 'golden age' was weak. Crafts suggested that rent-seeking was an important determinant of this poor record. This article offers support for such a conclusion. It is suggested that the growth record was shaped by British regulations preventing conflicts of ministerial interest not being made operational until 1963. This institutional divergence tended to promote rent-seeking behaviour, which impeded the pursuit of an industrial policy that could promote economic efficiency. In 1963 the institutional structure and the industrial policy framework changed. These changes stimulated the pursuit of efficiency and contributed to an improved regional economic performance.

Interobserver agreement of the Gross Motor Function Classification System in an ambulant population of children with cerebral palsy

Gross Motor Function Classification System (GMFCS) level was reported by three independent assessors in a population of children with cerebral palsy (CP) aged between 4 and 18 years (n=184; 112 males, 72 females; mean age 10y 10mo [SD 3y 7mo]). A software algorithm also provided a computed GMFCS level from a regional CP registry. Participants had clinical diagnoses of unilateral (n=94) and bilateral (n=84) spastic CP, ataxia (n=4), dyskinesia (n=1), and hypotonia (n=1), and could walk independently with or without the use of an aid (GMFCS Levels I-IV). Research physiotherapist (n=184) and parent/guardian data (n=178) were collected in a research environment. Data from the child's community physiotherapist (n=143) were obtained by postal questionnaire. Results, using the kappa statistic with linear weighting (?1w), showed good agreement between the parent/guardian and research physiotherapist (?1w=0.75) with more moderate levels of agreement between the clinical physiotherapist and researcher (?1w=0.64) and the clinical physiotherapist and parent/guardian (?1w=0.57). Agreement was consistently better for older children (>2y). This study has shown that agreement with parent report increases with therapists'experience of the GMFCS and knowledge of the child at the time of grading. Substantial agreement between a computed GMFCS and an experienced therapist (?1w=0.74) also demonstrates the potential for extrapolation of GMFCS rating from an existing CP registry, providing the latter has sufficient data on locomotor ability.

Strain gradients in epitaxial ferroelectrics

X-ray analysis of ferroelectric thin layers of Ba1/2Sr1/2TiO3 with different thicknesses reveals the presence of strain gradients across the films and allows us to propose a functional form for the internal strain profile. We use this to calculate the influence of strain gradient, through flexoelectric coupling, on the degradation of the ferroelectric properties of films with decreasing thickness, in excellent agreement with the observed behavior. This paper shows that strain relaxation can lead to smooth, continuous gradients across hundreds of nanometers, and it highlights the pressing need to avoid such strain gradients in order to obtain ferroelectric films with bulklike properties.

Species boundaries and phylogenetic relationships within the green algal genus Codium (Bryopsidales) based on plastid DNA sequences

Despite the potential model role of the green algal genus Codium for studies of marine speciation and evolution, there have been difficulties with species delimitation and a molecular phylogenetic framework was lacking. In the present study, 74 evolutionarily significant units (ESUs) are delimited using 227 rbcL exon 1 sequences obtained from specimens collected throughout the genus' range. Several morpho-species were shown to be poorly defined, with some clearly in need of lumping and others containing pseudo-cryptic diversity. A phylogenetic hypothesis of 72 Codium ESUs is inferred from rbcL exon 1 and rps3-rp/16 sequence data using a conventional nucleotide substitution model (GTR + Gamma + I), a codon position model and a covariotide (covarion) model, and the fit of a multitude of substitution models and alignment partitioning strategies to the sequence data is reported. Molecular clock tree rooting was carried out because out-group rooting was probably affected by phylogenetic bias. Several aspects of the evolution of morphological features of Codium are discussed and the inferred phylogenetic hypothesis is used as a framework to study the biogeography of the genus, both at a global scale and within the Indian Ocean. (c) 2007 Elsevier Inc. All rights reserved.

Patterns of neurocognitive impairment in first-episode bipolar disorder and schizophrenia.

BACKGROUND:
Researching psychotic disorders in unison rather than as separate diagnostic groups is widely advocated, but the viability of such an approach requires careful consideration from a neurocognitive perspective.
AIMS:
To describe cognition in people with bipolar disorder and schizophrenia and to examine how known causes of variability in individual's performance contribute to any observed diagnostic differences.
METHOD:
Neurocognitive functioning in people with bipolar disorder (n = 32), schizophrenia (n = 46) and healthy controls (n = 67) was compared using analysis of covariance on data from the Northern Ireland First Episode Psychosis Study.
RESULTS:
The bipolar disorder and schizophrenia groups were most impaired on tests of memory, executive functioning and language. The bipolar group performed significantly better on tests of response inhibition, verbal fluency and callosal functioning. Between-group differences could be explained by the greater proclivity of individuals with schizophrenia to experience global cognitive impairment and negative symptoms.
CONCLUSIONS:
Particular impairments are common to people with psychosis and may prove useful as endophenotypic markers. Considering the degree of individuals' global cognitive impairment is critical when attempting to understand patterns of selective impairment both within and between these diagnostic groups.