Defining worthwhile and desired responses to treatment of chronic low back pain

Objective To describe patients' perceptions of minimum worthwhile and desired reductions in pain and disability upon commencing treatment for chronic low back pain. Design and Setting Descriptive study nested within a community-based randomized controlled trial on prolotherapy injections and exercises. Patients A total of 110 participants with chronic low back pain. Interventions Prior to treatment, participants were asked what minimum percentage reductions in pain and disability would make treatment worthwhile and what percentage reductions in pain and disability they desired with treatment. Outcome Measures. Minimum worthwhile reductions and desired reductions in pain and disability. Results. Median (inter-quartile range) minimum worthwhile reductions were 25% (20%, 50%) for pain and 35% (20%, 50%) for disability. This compared with desired reductions of 80% (60%, 100%) for pain and 80% (50%, 100%) for disability. The internal consistency between pain and disability responses was high (Spearman's coefficient of association of 0.81 and 0.87, respectively). A significant association existed between minimum worthwhile reductions and desired reductions, but no association was found between these two factors and patient age, gender, pain severity or duration, disability, anxiety, depression, response to treatment, or treatment satisfaction. Conclusions. Inquiring directly about patients' expectations of reductions in pain and in disability is important in establishing realistic treatment goals and setting benchmarks for success. There is a wide disparity between the reductions that they regard as minimum worthwhile and reductions that they hope to achieve. However, there is a high internal consistency between reductions in pain and disability that they expect.

Temporal dynamics of rabbit haemorrhagic disease virus infection in a low-density population of wild rabbits (Oryctolagus cuniculus) in New Zealand

A longitudinal capture-mark-recapture study was conducted to determine the temporal dynamics of rabbit haemorrhagic disease (RHD) in a European rabbit (Oryctolagus cuniculus) population of low to moderate density on sand-hill country in the lower North Island of New Zealand. A combination of sampling ( trapping and radio-tracking) and diagnostic (cELISA, PCR and isotype ELISA) methods was employed to obtain data weekly from May 1998 until June 2001. Although rabbit haemorrhagic disease virus ( RHDV) infection was detected in the study population in all 3 years, disease epidemics were evident only in the late summer or autumn months in 1999 and 2001. Overall, 20% of 385 samples obtained from adult animals older than 11 weeks were seropositive. An RHD outbreak in 1999 contributed to an estimated population decline of 26%. A second RHD epidemic in February 2001 was associated with a population decline of 52% over the subsequent month. Following the outbreaks, the seroprevalence in adult survivors was between 40% and 50%. During 2000, no deaths from RHDV were confirmed and mortalities were predominantly attributed to predation. Influx of seronegative immigrants was greatest in the 1999 and 2001 breeding seasons, and preceded the RHD epidemics in those years. Our data suggest that RHD epidemics require the population immunity level to fall below a threshold where propagation of infection can be maintained through the population.

Prevalence of patient with low intensity pain symptom severity states during treatment with Rofecoxib and Ibuprofen for osteoarthritis

Aim of study: To examine the prevalence of low intensity symptom severity states in patients taking placebo, rofecoxib 12.5 mg once daily, rofecoxib 25 mg once daily, or ibuprofen 800 mg three times daily using a post-hoc definition of low pain intensity states (BLISS Index) based on the WOMAC Index. Methods: Two 6-week, double-blind, parallel-group, placebocontrolled, ibuprofen-comparator studies were conducted to measure the efficacy of rofecoxib in patients with knee or hip osteoarthritis. These studies employed a flare design requiring a minimum level of symptoms at entry following discontinuation of prior analgesics. The WOMAC Pain subscale (100 mm visual analog scale) was used as the pain measure. In separate analyses, WOMAC pain subscale scores from each patient were compared to five thresholds of pain:%5 mm, %10 mm, %15 mm, %20 mm, and %25 mm. The percent of patients with BLISS states (1) on average over 6 weeks, (2) at any time during the study, and (3) at week 6 was computed for each treatment group and threshold. The treatment group percentages were compared using Fisher’s exact test. Results: During the study, patients received placebo (N Z 143), rofecoxib 12.5 mg (N Z 461), rofecoxib 25 mg (N Z 459), or ibuprofen (N Z 465). For each pain threshold and treatment group, the percent of patients with BLISS states at any time (e.g., 50% for rofecoxib 25 mg) exceeded the percentage at week 6 (e.g., 40% for rofecoxib 25 mg) which, in turn, exceeded the percentage with BLISS states on average (e.g., 32% for rofecoxib 25 mg). The percentages of patients in the active treatment groups with BLISS states on average were significantly different than observed in the placebo group at the%15 mm threshold (8–11% points vs placebo, P ! 0.01), %20 mm level (10–15% points, P ! 0.01), and %25 mm level (14–17% points, P ! 0.001). Significant differences between the active treatments and placebo were also observed at the %10 mm threshold (8–9% points, P ! 0.05) for measurements at week 6 and at the%10 (12–14% points, P !0.001) and%5 mm thresholds (5–7% points, P ! 0.05) for patients with BLISS states at any time. Conclusion: These measures of BLISS states differentiate all three active treatment groups from placebo and further confirm, at an individual patient level, the clinical benefit of rofecoxib in the treatment of osteoarthritis. Furthermore, they provide information on the prevalence of patients achieving low (%15 mm, %20 mm, %25 mm), and very low (%5 mm, %10 mm) pain severity states.

Analysis of common attacks in public-key cryptosystems based on low-density parity-check codes

The security and reliability of a class of public-key cryptosystems against attacks by unauthorized parties, who had acquired partial knowledge of one or more of the private key components and/or of the message, were discussed. The standard statistical mechanical methods of dealing with diluted spin systems with replica symmetric considerations were analyzed. The dynamical transition which defined decryption success in practical situation was studied. The phase diagrams which showed the dynamical threshold as a function of the partial acquired knowledge of the private key were also presented.

Binocular summation at contrast threshold:a new look

Contrast sensitivity is better with two eyes than one. The standard view is that thresholds are about 1.4 (v2) times better with two eyes, and that this arises from monocular responses that, near threshold, are proportional to the square of contrast, followed by binocular summation of the two monocular signals. However, estimates of the threshold ratio in the literature vary from about 1.2 to 1.9, and many early studies had methodological weaknesses. We collected extensive new data, and applied a general model of binocular summation to interpret the threshold ratio. We used horizontal gratings (0.25 - 4 cycles deg-1) flickering sinusoidally (1 - 16 Hz), presented to one or both eyes through frame-alternating ferroelectric goggles with negligible cross-talk, and used a 2AFC staircase method to estimate contrast thresholds and psychometric slopes. Four naive observers completed 20 000 trials each, and their mean threshold ratios were 1.63, 1.69, 1.71, 1.81 - grand mean 1.71 - well above the classical v2. Mean ratios tended to be slightly lower (~1.60) at low spatial or high temporal frequencies. We modelled contrast detection very simply by assuming a single binocular mechanism whose response is proportional to (Lm + Rm) p, followed by fixed additive noise, where L,R are contrasts in the left and right eyes, and m, p are constants. Contrast-gain-control effects were assumed to be negligible near threshold. On this model the threshold ratio is 2(?1/m), implying that m=1.3 on average, while the Weibull psychometric slope (median 3.28) equals 1.247mp, yielding p=2.0. Together, the model and data suggest that, at low contrasts across a wide spatiotemporal frequency range, monocular pathways are nearly linear in their contrast response (m close to 1), while a strongly accelerating nonlinearity (p=2, a 'soft threshold') occurs after binocular summation. [Supported by EPSRC project grant GR/S74515/01]

Low spatial frequencies are suppressively masked across spatial scale, orientation, field position, and eye of origin

Masking is said to occur when a mask stimulus interferes with the visibility of a target (test) stimulus. One widely held view of this process supposes interactions between mask and test mechanisms (cross-channel masking), and explicit models (e.g., J. M. Foley, 1994) have proposed that the interactions are inhibitory. Unlike a within-channel model, where masking involves the combination of mask and test stimulus within a single mechanism, this cross-channel inhibitory model predicts that the mask should attenuate the perceived contrast of a test stimulus. Another possibility is that masking is due to an increase in noise, in which case, perception of contrast should be unaffected once the signal exceeds detection threshold. We use circular patches and annuli of sine-wave grating in contrast detection and contrast matching experiments to test these hypotheses and investigate interactions across spatial frequency, orientation, field position, and eye of origin. In both types of experiments we found substantial effects of masking that can occur over a factor of 3 in spatial frequency, 45° in orientation, across different field positions and between different eyes. We found the effects to be greatest at the lowest test spatial frequency we used (0.46 c/deg), and when the mask and test differed in all four dimensions simultaneously. This is surprising in light of previous work where it was concluded that suppression from the surround was strictly monocular (C. Chubb, G. Sperling, & J. A. Solomon, 1989). The results confirm that above detection threshold, cross-channel masking involves contrast suppression and not (purely) mask-induced noise. We conclude that cross-channel masking can be a powerful phenomenon, particularly at low test spatial frequencies and when mask and test are presented to different eyes. © 2004 ARVO.

Interocular transfer of spatial adaptation is weak at low spatial frequencies

Adapting one eye to a high contrast grating reduces sensitivity to similar target gratings shown to the same eye, and also to those shown to the opposite eye. According to the textbook account, interocular transfer (IOT) of adaptation is around 60% of the within-eye effect. However, most previous studies on this were limited to using high spatial frequencies, sustained presentation, and criterion-dependent methods for assessing threshold. Here, we measure IOT across a wide range of spatiotemporal frequencies, using a criterion-free 2AFC method. We find little or no IOT at low spatial frequencies, consistent with other recent observations. At higher spatial frequencies, IOT was present, but weaker than previously reported (around 35%, on average, at 8c/deg). Across all conditions, monocular adaptation raised thresholds by around a factor of 2, and observers showed normal binocular summation, demonstrating that they were not binocularly compromised. These findings prompt a reassessment of our understanding of the binocular architecture implied by interocular adaptation. In particular, the output of monocular channels may be available to perceptual decision making at low spatial frequencies.

Reflecting on mirror mechanisms:motor resonance effects during action observation only present with low-intensity transcranial magnetic stimulation

Transcranial magnetic stimulation (TMS) studies indicate that the observation of other people's actions influences the excitability of the observer's motor system. Motor evoked potential (MEP) amplitudes typically increase in muscles which would be active during the execution of the observed action. This 'motor resonance' effect is thought to result from activity in mirror neuron regions, which enhance the excitability of the primary motor cortex (M1) via cortico-cortical pathways. The importance of TMS intensity has not yet been recognised in this area of research. Low-intensity TMS predominately activates corticospinal neurons indirectly, whereas high-intensity TMS can directly activate corticospinal axons. This indicates that motor resonance effects should be more prominent when using low-intensity TMS. A related issue is that TMS is typically applied over a single optimal scalp position (OSP) to simultaneously elicit MEPs from several muscles. Whether this confounds results, due to differences in the manner that TMS activates spatially separate cortical representations, has not yet been explored. In the current study, MEP amplitudes, resulting from single-pulse TMS applied over M1, were recorded from the first dorsal interosseous (FDI) and abductor digiti minimi (ADM) muscles during the observation of simple finger abductions. We tested if the TMS intensity (110% vs. 130% resting motor threshold) or stimulating position (FDI-OSP vs. ADM-OSP) influenced the magnitude of the motor resonance effects. Results showed that the MEP facilitation recorded in the FDI muscle during the observation of index-finger abductions was only detected using low-intensity TMS. In contrast, changes in the OSP had a negligible effect on the presence of motor resonance effects in either the FDI or ADM muscles. These findings support the hypothesis that MN activity enhances M1 excitability via cortico-cortical pathways and highlight a methodological framework by which the neural underpinnings of action observation can be further explored. © 2013 Loporto et al.

43Gbit/s RZ-DQPSK transmission over 1000km of G.652 ultra-low-loss fibre with 250km amplifier spans

We demonstrate 40x43Gbit/s RZ-DQPSK transmission over 1000km of ultra-low-loss G.652 fibre with 250km amplifier spacing. Hybrid Raman-EDFA amplification with co- and contra-directional Raman pumping enables 27dB Raman gain per span and error-free post-FEC performance. ©2010 IEEE.

Second harmonic generation in a low-loss orientation-patterned GaAs waveguide

The technology of low-loss orientation-patterned gallium arsenide (OP-GaAs) waveguided crystals was developed and realized by reduction of diffraction scattering on the waveguide pattern. The propagation losses in the OP-GaAs waveguide were estimated to be as low as 2.1 dB/cm, thus demonstrating the efficient second harmonic generation at 1621 nm under an external pumping. © 2013 Optical Society of America.

Residual stress effects during near-threshold fatigue crack growth

The fatigue crack propagation behaviour of a low alloy, boron-containing steel has been examined after austenitizing at 900°C or 1250°C and tempering at a range of temperatures up to 400°C. Fatigue threshold values were found to vary with austenitizing and tempering treatment in a range between 3.3 to 6 MPa √m when tested at a stress ratio (R) of 0.2. Crack propagation rates in the Paris regime were insensitive to heat treatment variations. The crack propagation path was essentially transgranular in all conditions with small regions of intergranular facets appearing at growth rates around the knee of the da/dN vs ΔK curve. The crack front shape showed marked retardation in the centre of the specimen at low tempering temperatures. Experimental determinations and computer predictions of residual stress levels in the specimens indicated that this was due to a central residual compressive stress resulting from differential cooling rates and the volume change associated with the martensite transformation. The results are discussed in terms of microstructural and residual stress effects on fatigue behaviour. © 1987.

Effects of grain size and microstructure on threshold values and near threshold crack growth in powder-formed Ni-base superalloy

Threshold stress intensity values, ranging from ∼6 to 16 MN m −3/2 can be obtained in powder-formed Nimonic AP1 by changing the microstructure. The threshold and low crack growth rate behaviour at room temperature of a number of widely differing API microstructures, with both ‘necklace’ and fully recrystallized grain structures of various sizes and uniform and bimodal γ′-distributions, have been investigated. The results indicate that grain size is an important microstructural parameter which can control threshold behaviour, with the value of threshold stress intensity increasing with increasing grain size, but that the γ′-distribution is also important. In this Ni-base alloy, as in many others, near threshold fatigue crack growth occurs in a crystallographic manner along {111} planes. This is due to the development of a dislocation structure involving persistent slip bands on {111} planes in the plastic zone, caused by the presence of ordered shearable precipitates in the microstructure. However, as the stress intensity range is increased, a striated growth mode takes over. The results presented show that this transition from faceted to striated growth is associated with a sudden increase in crack propagation rate and occurs when the size of the reverse plastic zone at the crack tip becomes equal to the grain size, independent of any other microstructural variables.

Random distributed feedback Raman fiber laser with polarized pumping

In this letter, the polarization properties of a random fiber laser operating via Raman gain and random distributed feedback owing to Rayleigh scattering are investigated for the first time. Using polarized pump, the partially polarized generation is obtained with a generation spectrum exhibiting discrete narrow spectral features contrary to the smooth spectrum observed for the depolarized pump. The threshold, output power, degree of polarization and the state of polarization (SOP) of the lasing can be significantly influenced by the SOP of the pump. Fine narrow spectral components are also sensitive to the SOP of the pump wave. Furthermore, we found that random lasing's longitudinal power distributions are different in the case of polarized and depolarized pumping that results in considerable reduction of the generation slope efficiency for the polarized radiation. Our results indicate that polarization effects play an important role on the performance of the random fiber laser. This work improves the understanding of the physics of random lasing in fibers and makes a step forward towards the establishment of the vector model of random fiber lasers.

On-off and multistate intermittencies in cascaded random distributed feedback fibre laser

A range of physical and engineering systems exhibit an irregular complex dynamics featuring alternation of quiet and burst time intervals called the intermittency. The intermittent dynamics most popular in laser science is the on-off intermittency [1]. The on-off intermittency can be understood as a conversion of the noise in a system close to an instability threshold into effective time-dependent fluctuations which result in the alternation of stable and unstable periods. The on-off intermittency has been recently demonstrated in semiconductor, Erbium doped and Raman lasers [2-5]. Recently demonstrated random distributed feedback (random DFB) fiber laser has an irregular dynamics near the generation threshold [6,7]. Here we show the intermittency in the cascaded random DFB fiber laser. We study intensity fluctuations in a random DFB fiber laser based on nitrogen doped fiber. The laser generates first and second Stokes components 1120 nm and 1180 nm respectively under an appropriate pumping. We study the intermittency in the radiation of the second Stokes wave. The typical time trace near the generation threshold of the second Stokes wave (Pth) is shown at Fig. 1a. From the number of long enough time-traces we calculate statistical distribution between major spikes in time dynamics, Fig. 1b. To eliminate contribution of high frequency components of spikes we use a low pass filter along with the reference value of the output power. Experimental data is fitted by power law, ~(P-Pth)y, where is a mean time between pikes. There are two different intermittency regimes. Just above Pth, the mean time is approximated by the -3/2 power law. The -3/2 power law is typical to the on-off intermittency with hopping between two states (first and second Stokes waves in our case) [7]. At higher power, the mean time is approximated by -4 power law, that indicates a change in intermittency type to multistate. Multistable dynamics is observed in erbium-doped fiber lasers [8]. The origin of multiples states in our system could be probably connected with polarization hopping or other reasons and should be further investigated. We have presented a first experimental statistical characterisation of the on-off and multistate intermittencies that occur in the generation of the second Stokes wave in nitrogen doped random DFB fiber laser. References [1] H. Fujisaka and T. Yamada, “A New Intermittency in Coupled Dynamical Systems,” Prog. Theor. Phys. 74, 918 (1985). [2] S. Osborne, A. Amann, D. Bitauld, and S. O’Brien, “On-off intermittency in an optically injected semiconductor laser,” Phys. Rev. E 85, 056204 (2012). [3] S. Sergeyev, K. O'Mahoney, S. Popov, and A. T. Friberg, “Coherence and anticoherence resonance in high-concentration erbium-doped fiber laser,” Opt. Lett. 35, 3736 (2010). [4] A.E. El-Taher, S.V. Sergeyev, E.G. Turitsyna, P. Harper, and S. K. Turitsyn, “Intermittent Self-Pulsing in a Fiber Raman Laser”, In proc. Conf. Nonlin. Photon., paper ID 1367139, Colorado Springs, USA, 2012 [5] S.K. Turitsyn, S.A. Babin, A.E. El-Taher, P. Harper, D.V. Churkin, S.I. Kablukov, J.D. Ania-Castañón, V. Karalekas, and E.V. Podivilov, “Random distributed feedback fibre laser”, Nat. Photon..4, 231 (2010). [6] I. D. Vatnik, D. V. Churkin, S. A. Babin, and S. K. Turitsyn, "Cascaded random distributed feedback Raman fiber laser operating at 1.2 μm," Opt. Express 19, 18486 (2011). [7] W. Feller, An introduction to probability theory and its applications, Vol. 1, 3rd ed. (Wiley, New-York, 1968). [8] G. Huerta-Cuellar, A.N. Pisarchik, and Y.O. Barmenkov, “Experimental characterization of hopping dynamics in a multistable fiber laser,” Phys. Rev. E 78, 035202(R) (2008).

Oxygen, pH and calcium dynamics and fluxes at the thallus surface under ambient (8.1) and low (7.8) seawater pH and across a range of irradiances

Presently, an incomplete mechanistic understanding of tropical reef macroalgae photosynthesis and calcification restricts predictions of how these important autotrophs will respond to global change. Therefore, we investigated the mechanistic link between inorganic carbon uptake pathways, photosynthesis and calcification in a tropical crustose coralline alga (CCA) using microsensors. We measured pH, oxygen (O2), and calcium (Ca2+) dynamics and fluxes at the thallus surface under ambient (8.1) and low (7.8) seawater pH (pHSW) and across a range of irradiances. Acetazolamide (AZ) was used to inhibit extracellular carbonic anhydrase (CAext), which mediates hydrolysis of HCO3-, and 4,4' diisothiocyanatostilbene-2,2'-disulphonate (DIDS) that blocks direct HCO3- uptake by anion exchange transport. Both inhibited photosynthesis, suggesting both diffusive uptake of CO2 via HCO3- hydrolysis to CO2 and direct HCO3- ion transport are important in this CCA. Surface pH was raised approximately 0.3 units at saturating irradiance, but less when CAext was inhibited. Surface pH was lower at pHSW 7.8 than pHSW 8.1 in the dark, but not in the light. The Ca2+ fluxes were large, complex and temporally variable, but revealed net Ca2+ uptake under all conditions. The temporal variability in Ca2+ dynamics was potentially related to localized dissolution during epithallial cell sloughing, a strategy of CCA to remove epiphytes. Simultaneous Ca2+ and pH dynamics suggest the presence of Ca2+/H+ exchange. Rapid light-induced H+ surface dynamics that continued after inhibition of photosynthesis revealed the presence of a light-mediated, but photosynthesis-independent, proton pump. Thus, the study indicates metabolic control of surface pH can occur in CCA through photosynthesis and light-inducible H+ pumps. Our results suggest that complex light-induced ion pumps play an important role in biological processes related to inorganic carbon uptake and calcification in CCA.