Superior outcomes of decompression with an interlaminar dynamic device versus decompression alone in patients with lumbar spinal stenosis and back pain: a cross registry study.

INTRODUCTION Surgical decompression for lumbar spinal stenosis (LSS) has been associated with poorer outcomes in patients with pronounced low back pain (LBP) as compared to patients with predominant leg pain. This cross registry study assessed potential benefits of the interlaminar coflex® device as an add-on to bony decompression alone. METHODS Patients with lumbar decompression plus coflex® (SWISSspine registry) were compared with decompressed controls (Spine Tango registry). Inclusion criteria were LSS and a preoperative back pain level of ≥5 points. 1:1 propensity score-based matching was performed. Outcome measures were back and leg pain relief, COMI score improvement, patient satisfaction, complication, and revision rates. RESULTS 50 matched pairs without residual significant differences but age were created. At the 7-9 months follow-up interval the coflex® group had higher back (p=0.014) and leg pain relief (p<0.001) and COMI score improvement (p=0.029) than the decompression group. Patient satisfaction was 90% in both groups. No revision was documented in the coflex® and one in the decompression group (2.0%). DISCUSSION In the short-term, lumbar decompression with coflex® compared with decompression alone in patients with LSS and pronounced LBP at baseline is a safe and effective treatment option that appears beneficial regarding clinical and functional outcomes. However, residual confounding of non-measured covariables may have partially influenced our findings. Also, despite careful inclusion and exclusion of cases the cross registry approach introduces a potential for selection bias that we could not totally control for and that makes additional studies necessary.

Distribution of Pelagic Fishes in Sheepscot River-Back River Estuary, Wiscasset, Maine

Fifteen species of pelagic fishes were collected in 156 gill net sets at eight locations in the Sheepscot River-Back River estuary, Wiscasset, Maine, June 1970 through December 1971. Highest catches occurred June through August. Only the rainbow smelt is a year-round resident. Differences in abundance in space and time are apparently related to temperature. During the summer, alewives, blueback herring, and Atlantic menhaden were most abundant in the relatively warm Back River estuary, while Atlantic herring, Atlantic mackerel, and spiny dogfish were most abundant in the more oceanic Sheepscot River estuary. Prolonged near-freezing temperatures apparently limit the time pelagic fishes spend in the estuary and limit the number of species which can inhabit it. It is hypothesized that the distribution of pelagic species which exhibited preferences for colder water, such as Atlantic herring, would be most affected by artificial warming of the surface waters of the Back River estuary, if a new atomic powered generating plant were allowed to discharge heated effluent directly into it.

Back pain in migrant farmworker families and farmworker high school students from Starr County, Texas

Back symptoms are a major global public health problem with the lifetime prevalence ranging between 50-80%. Research suggests that work-related factors contribute to the occurrence of back pain in various industries. Despite the hazardous nature, strenuous tasks, and awkward postures associated with farm work, little is known about back injury and symptoms in farmworker adults and children. Research in the United States is particularly limited. This is a concern given the large proportion of migrant farmworkers in the United States without adequate access to healthcare as well as a substantial number of youth working in agriculture. The present study describes back symptoms and identifies work-related factors associated with back pain in migrant farmworker families and farmworker high school students from Starr County, TX. Two separate datasets were used from two cohort studies "Injury and Illness Surveillance in Migrant Farmworkers (MANOS)" (study A: n=267 families) and "South Texas Adolescent Rural Research Study (STARRS)" (study B: n=345). Descriptive and inferential statistics including multivariable logistic regression were used to identify work-related factors associated with back pain in each study. In migrant farmworker families, the prevalence of chronic back pain during the last migration season ranged from 9.5% among youngest children to 33.3% among mothers. Chronic back pain was significantly associated with increasing age; fairly bad/very bad quality of sleep while migrating; fewer than eight hours of sleep at home in Starr County, TX; depressive symptoms while migrating; self-provided water for washing hands/drinking; weeding at work; and exposure to pesticide drift/direct spray. Among farmworker adolescents, the prevalence of severe back symptoms was 15.7%. Severe back symptoms were significantly associated with being female; history of a prior accident/back injury; feeling tense, stressed, or anxious sometimes/often; lifting/carrying heavy objects not at work; current tobacco use; increasing lifetime number of migrant farmworker years; working with/around knives; and working on corn crops. Overall, results support that associations between work-related exposures and chronic back pain and severe back symptoms remain after controlling for the effect of non-work exposures in farmworker populations. ^

Returning Texas Senate Bill 530 back to 1100 Congress Avenue: The need for effective surveillance reporting of student fitness levels to Texas house representatives

Every Texas student is required to complete the FITNESSGRAM fitness assessment under legislation outlined in Senate Bill 530. This study described cardiovascular, body mass index (BMI), and overall fitness levels of students (grades 3–12) in the state of Texas during the 2009–2010 school year, and provides examples of how to effectively present results to Texas House Representatives using three unique health communication strategies. Given the Texas legislature mandates FITNESSGRAM collection yet did not require reporting according to their election district, the data were aggregated to 150 Texas House Representative Districts by sex and grade category to facilitate effective fitness data dissemination. Fitness data were also analyzed with results from the Texas Assessment of Knowledge and Skills (TAKS) to provide insight into potential relationships between fitness and academic achievement. ^ The majority of students in Texas need improvement on at least 1 fitness assessment. In general, female students have superior fitness in elementary and middle school but the fitness edge is erased by high school. Female cardiovascular fitness deteriorates faster from elementary to high school compared to male students. Female BMI deteriorates and male BMI improves from elementary to high school. Cardiovascular fitness and overall fitness decreases from elementary to high school for both male and female students. ^ Student fitness was significantly and strongly independently correlated with academic achievement. Further analysis showed that House Representatives with TAKS scores in the top quartile consistently showed superior fitness. Small significant partial correlations remain between fitness and TAKS assessment after controlling for socioeconomic status. In general, correlations were stronger between female BMI and TAKS assessment compared to male students. Cardiovascular fitness was significantly correlated with TAKS assessment for both genders. This paper supports student fitness as a confounder in the relationship between socioeconomic status and academic achievement. Plus, student fitness has a strong correlation with academic that deserves further exploration. ^ Senate Bill 530 fails to organize and implement a health communication strategy that effectively disseminates the health data collected to stakeholders of interest. The lack of a vital health communication strategy results in an incomplete student health surveillance system. This paper outlines three unique strategies tailored to legislators. It is important to disseminate health information using a variety of methods tailored to your targeted audience. The use of interactive mapping technology presented (GIS) uses new technology that has the potential to effectively reach a large audience.^

Relation between acid back -diffusion and luminal surface hydrophobicity in canine gastric mucosa: Effects of salicylate and prostaglandin

The stomach is thought to be protected from luminal acid by a gastric mucosal barrier that restricts the diffusion of acid into tissue. This study tested the hypothesis that the hydrophobic luminal surface of canine gastric mucosa incubated in Ussing chambers, impedes the back-diffusion of luminal acid into the tissue. Isolated sheets of mucosa were treated with cimetidine to inhibit spontaneous acid secretion, and incubated under conditions that prevented significant secretion of luminal bicarbonate. By measuring acid loss from the luminal compartment using the pH-stat technique, acid back-diffusion was continuously monitored; potential difference (PD) was measured as an index of tissue viability. Tissue luminal surface hydrophobicity was estimated by contact angle analysis at the end of each experiment. Addition of 16,16-dimethyl prostaglandin E$\sb2$ to the nutrient compartment enhanced luminal surface hydrophobicity, but did not reduce acid back-diffusion in tissues that maintained a constant PD. 10 mM salicylate at pH 4.00 in the luminal compartment reduced surface hydrophobicity, but this decrease did not occur if 1 ug/ml prostaglandin was present in the nutrient solution. Despite possessing relatively hydrophilic and relatively hydrophobic surface properties, respectively, acid back-diffusion in the absence of salicylate was not significantly different between these two groups. Neither group maintained a PD after incubation with salicylate. Lastly, radiolabelled salicylate was used to calculate the free (non-salicylate associated) acid loss in tissues incubated with salicylate and/or prostaglandin. No significant correlation was found between free acid back-diffusion and luminal surface hydrophobicity. These data do not support the hypothesis that acid back-diffusion in impeded by the hydrophobic surface presented by isolated canine gastric mucosa. ^

A Journey of 1,588 Miles: A Story of Success, Failure and Getting Back on Track

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Geochemistry of lavas from the Lau-Tonga arc and back-arc system

Detailed comparison of mineralogy, and major and trace geochemistry are presented for the modern Lau Basin spreading centers, the Sites 834-839 lavas, the modern Tonga-Kermadec arc volcanics, the northern Tongan boninites, and the Lau Ridge volcanics. The data clearly confirm the variations from near normal mid-ocean-ridge basalt (N-MORB) chemistries (e.g., Site 834, Central Lau Spreading Center) to strongly arc-like (e.g., Site 839, Valu Fa), the latter closely comparable to the modern arc volcanoes. Sites 835 and 836 and the East Lau Spreading Center represent transitional chemistries. Bulk compositions range from andesitic to basaltic, but lavas from Sites 834 and 836 and the Central Lau Spreading Center extend toward more silica-undersaturated compositions. The Valu Fa and modern Tonga-Kermadec arc lavas, in contrast, are dominated by basaltic andesites. The phenocryst and groundmass mineralogies show the strong arc-like affinities of the Site 839 lavas, which are also characterized by the existence of very magnesian olivines (up to Fo90-92) and Cr-rich spinels in Units 3 and 6, and highly anorthitic plagioclases in Units 2 and 9. The regional patterns of mineralogical and geochemical variations are interpreted in terms of two competing processes affecting the inferred magma sources: (1) mantle depletion processes, caused by previous melt extractions linked to backarc magmatism, and (2) enrichment in large-ion-lithophile elements, caused by a subduction contribution. A general trend of increasing depletion is inferred both eastward across the Lau Basin toward the modern arc, and northward along the Tongan (and Kermadec) Arc. Numerical modeling suggests that multistage magma extraction can explain the low abundances (relative to N-MORB) of elements such as Nb, Ta, and Ti, known to be characteristic of island arc magmas. It is further suggested that a subduction jump following prolonged slab rollback could account for the initiation of the Lau Basin opening, plausibly allowing a later influx of new mantle, as required by the recognition of a two-stage opening of the Lau Basin.

Back to the future to revisit meanings

Tanto en los estudios sincrónicos como en los diacrónicos queda en evidencia que el español posee diferentes formas de expresar el tiempo futuro. Por ejemplo, la desinencia del futuro morfológico (-ré) alterna en el español actual con la perífrasis verbal ir+a+infinitivo tal y como se ve en los siguientes ejemplos de la variedad rioplatense: (1) CFK advirtió que "Vamos a sostener este modelo de crecimiento con todas las decisiones que haya que tomar" (Diario Digital 25-04-2012); (2) Rossi aseguró que votarán a favor de YPF unos doscientos diputados (La Nación 28-04-2012). Este hecho ha sido analizado por innumerables estudios y autores, muchos de los cuales se han aproximado a este tema desde la perspectiva variacionista que relaciona significados y contextos (Martínez 1987, Sedano 1994, Company 1999, Alaniz 2010); esta perspectiva explica dicha alternancia por medio de un continuum de factualidad el cual va desde la mayor factualidad de la perífrasis a la menor factualidad de la forma sintética. El análisis de los datos de acuerdo con dichos significados básicos postulados parecía confirmar la hipótesis, al menos en los contextos relacionados con la comunicación oral cotidiana (Martínez 1987). Sin embargo, un estudio más profundo sobre los usos de dichas formas en otros géneros discursivos (Mailhes 2010) nos lleva a replantearnos los significados básicos. En este sentido, la hipótesis que nos interesa confirmar es que las formas se encuentran vinculadas a la evaluación de los hechos por medio de la posibilidad de ejercer control sobre los mismos . Si existe control, se puede seleccionar la perífrasis; si no existe, la forma sintética será más apropiada. La ausencia de control puede dar lugar a una posibilidad más o menos remota así como a la profecía, dos esferas donde la variación es explotada

Back to the future to revisit meanings

Tanto en los estudios sincrónicos como en los diacrónicos queda en evidencia que el español posee diferentes formas de expresar el tiempo futuro. Por ejemplo, la desinencia del futuro morfológico (-ré) alterna en el español actual con la perífrasis verbal ir+a+infinitivo tal y como se ve en los siguientes ejemplos de la variedad rioplatense: (1) CFK advirtió que "Vamos a sostener este modelo de crecimiento con todas las decisiones que haya que tomar" (Diario Digital 25-04-2012); (2) Rossi aseguró que votarán a favor de YPF unos doscientos diputados (La Nación 28-04-2012). Este hecho ha sido analizado por innumerables estudios y autores, muchos de los cuales se han aproximado a este tema desde la perspectiva variacionista que relaciona significados y contextos (Martínez 1987, Sedano 1994, Company 1999, Alaniz 2010); esta perspectiva explica dicha alternancia por medio de un continuum de factualidad el cual va desde la mayor factualidad de la perífrasis a la menor factualidad de la forma sintética. El análisis de los datos de acuerdo con dichos significados básicos postulados parecía confirmar la hipótesis, al menos en los contextos relacionados con la comunicación oral cotidiana (Martínez 1987). Sin embargo, un estudio más profundo sobre los usos de dichas formas en otros géneros discursivos (Mailhes 2010) nos lleva a replantearnos los significados básicos. En este sentido, la hipótesis que nos interesa confirmar es que las formas se encuentran vinculadas a la evaluación de los hechos por medio de la posibilidad de ejercer control sobre los mismos . Si existe control, se puede seleccionar la perífrasis; si no existe, la forma sintética será más apropiada. La ausencia de control puede dar lugar a una posibilidad más o menos remota así como a la profecía, dos esferas donde la variación es explotada

Back to the future to revisit meanings

Tanto en los estudios sincrónicos como en los diacrónicos queda en evidencia que el español posee diferentes formas de expresar el tiempo futuro. Por ejemplo, la desinencia del futuro morfológico (-ré) alterna en el español actual con la perífrasis verbal ir+a+infinitivo tal y como se ve en los siguientes ejemplos de la variedad rioplatense: (1) CFK advirtió que "Vamos a sostener este modelo de crecimiento con todas las decisiones que haya que tomar" (Diario Digital 25-04-2012); (2) Rossi aseguró que votarán a favor de YPF unos doscientos diputados (La Nación 28-04-2012). Este hecho ha sido analizado por innumerables estudios y autores, muchos de los cuales se han aproximado a este tema desde la perspectiva variacionista que relaciona significados y contextos (Martínez 1987, Sedano 1994, Company 1999, Alaniz 2010); esta perspectiva explica dicha alternancia por medio de un continuum de factualidad el cual va desde la mayor factualidad de la perífrasis a la menor factualidad de la forma sintética. El análisis de los datos de acuerdo con dichos significados básicos postulados parecía confirmar la hipótesis, al menos en los contextos relacionados con la comunicación oral cotidiana (Martínez 1987). Sin embargo, un estudio más profundo sobre los usos de dichas formas en otros géneros discursivos (Mailhes 2010) nos lleva a replantearnos los significados básicos. En este sentido, la hipótesis que nos interesa confirmar es que las formas se encuentran vinculadas a la evaluación de los hechos por medio de la posibilidad de ejercer control sobre los mismos . Si existe control, se puede seleccionar la perífrasis; si no existe, la forma sintética será más apropiada. La ausencia de control puede dar lugar a una posibilidad más o menos remota así como a la profecía, dos esferas donde la variación es explotada