Sensory hypersensitivity occurs soon after whiplash injury and is associated with poor recovery

Hypersensitivity to a variety of sensory Stimuli is a feature of persistent whiplash associated disorders (WAD). However, little is known about sensory disturbances from the time Of injury until transition to either recovery or symptom persistence. Quantitative sensory testing (pressure and thermal pain thresholds, the brachial plexus provocation test), the sympathetic vasoconstrictor reflex and psychological distress (GHQ-28) were prospectively measured in 76 whiplash Subjects within 1 month of injury and then 2, 3 and 6 months post-injury. Subjects were classified at 6 months post-injury using scores on the Neck Disability Index: recovered (30). Sensory and sympathetic nervous system tests were also measured in 20 control subjects. All whiplash groups demonstrated local mechanical hyperalgesia in the cervica spine at 1 month post-injury. This hyperalgesia persisted in those with moderate/severe symptoms at 6 months but resolved by 2 months in those who had recovered or reported persistent mild symptoms. Only those with persistent moderate/severe symptoms at 6 months demonstrated generalised hypersensitivity to all sensory tests. These changes Occurred within 1 month of injury and remained Unchanged throughout the Study period. Whilst no significant group differences were evident for the sympathetic vasoconstrictor response, the moderate/severe group showed a tendency for diminished sympathetic reactivity. GHQ-28 scores of the moderate/severe group were higher than those of the other two groups. The differences in GHQ-28 did not impact on any of the sensory measures. These findings suggest that those with persistent moderate/severe symptoms at 6 months display, soon after injury, generalised hypersensitivity suggestive of changes in central pain processing mechanisms. This phenomenon did not Occur in those who recover or those with persistent mild symptoms. (C) 2003 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

A proposed new classification system for whiplash associated disorders - implications for assessment and management

The development of chronic symptoms following whiplash injury is common and contributes substantially to costs associated with this condition. The currently used Quebec Task Force classification system of whiplash associated disorders is primarily based on the severity of signs and symptoms following injury and its usefulness has been questioned. Recent evidence is emerging that demonstrates differences in physical and psychological impairments between individuals who recover from the injury and those who develop persistent pain and disability. Motor dysfunction, local cervical mechanical hyperalgesia and psychological distress are present soon after injury in all whiplash injured persons irrespective of recovery. In contrast those individuals who develop persistent moderate/severe pain and disability show a more complex picture, characterized by additional impairments of widespread sensory hypersensitivity indicative of underlying disturbances in central pain processing as well as acute posttraumatic stress reaction, with these changes present from soon after injury. Based on this heterogeneity a new classification system is proposed that takes into account measurable disturbances in motor, sensory and psychological dysfunction. The implications for the management of this condition are discussed. (C) 2004 Elsevier Ltd. All rights reserved.

An evaluation of different models of water recovery in flotation

Water recovery is one of the key parameters in flotation modelling for the purposes of plant design and process control, as it determines the circulating flow and residence time in the individual process units in the plant and has a significant effect on entrainment and froth recovery. This paper reviews some of the water recovery models available in the literature, including both empirical and fundamental models. The selected models are tested using the data obtained from the experimental work conducted in an Outokumpu 3 m(3) tank cell at the Xstrata Mt Isa copper concentrator. It is found that all the models fit the experimental data reasonably well for a given flotation system. However, the empirical models are either unable to distinguish the effect of different cell operating conditions or required to determine the empirical model parameters to be derived in an existing flotation system. The model developed by [Neethling, SJ., Lee, H.T., Cilliers, J.J., 2003, Simple relationships for predicting the recovery of liquid from flowing foams and froths. Minerals Engineering 16, 1123-1130] is based on fundamental understanding of the froth structure and transfer of the water in the froth. It describes the water recovery as a function of the cell operating conditions and the froth properties which can all be determined on-line. Hence, the fundamental model can be used for process control purposes in practice. By incorporating additional models to relate the air recovery and surface bubble size directly to the cell operating conditions, the fundamental model can also be used for prediction purposes. (C) 2005 Elsevier Ltd. All rights reserved.

Error recovery in a hospital pharmacy

A field study was performed in a hospital pharmacy aimed at identifying positive and negative influences on the process of detection of and further recovery from initial errors or other failures, thus avoiding negative consequences. Confidential reports and follow-up interviews provided data on 31 near-miss incidents involving such recovery processes. Analysis revealed that organizational culture with regard to following procedures needed reinforcement, that some procedures could be improved, that building in extra checks was worthwhile and that supporting unplanned recovery was essential for problems not covered by procedures. Guidance is given on how performance in recovery could be measured. A case is made for supporting recovery as an addition to prevention-based safety methods.

Mice lacking the vascular endothelial growth factor-B gene (Vegfb) have smaller hearts, dysfunctional coronary vasculature, and impaired recovery from cardiac ischemia

Vascular endothelial growth factor-B (VEGF-B) is closely related to VEGF-A, an effector of blood vessel growth during development and disease and a strong candidate for angiogenic therapies. To further study the in vivo function of VEGF-B, we have generated Vegfb knockout mice (Vegfb(-/-)). Unlike Vegfa knockout mice, which die during embryogenesis, Vegfb(-/-) mice are healthy and fertile. Despite appearing overtly normal, Vegfb(-/-) hearts are reduced in size and display vascular dysfunction after coronary occlusion and impaired recovery from experimentally induced myocardial ischemia. These findings reveal a role for VEGF-B in the development or function of coronary vasculature and suggest potential clinical use in therapeutic angiogenesis. The full text of this article is available at http://www.circresaha.org.

Towards pattern-based design recovery

A method and a corresponding tool is described which assist design recovery and program understanding by recognising instances of design patterns semi-automatically. The approach taken is specifically designed to overcome the existing scalability problems caused by many design and implementation variants of design pattern instances. Our approach is based on a new recognition algorithm which works incrementally rather than trying to analyse a possibly large software system in one pass without any human intervention. The new algorithm exploits domain and context knowledge given by a reverse engineer and by a special underlying data structure, namely a special form of an annotated abstract syntax graph. A comparative and quantitative evaluation of applying the approach to the Java AWT and JGL libraries is also given.