Prolotherapy injections, saline injections, and exercises for chronic low-back pain: A randomized trial

Objectives. To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain. Design. Randomized controlled trial with two- by- two factorial design, triple- blinded for injection status, and single- blinded for exercise status. Setting. General practice. Participants. One hundred ten participants with nonspecific low- back pain of average 14 years duration were randomized to have repeated prolotherapy ( 20% glucose/ 0.2% lignocaine) or normal saline injections into tender lumbo- pelvic ligaments and randomized to perform either flexion/ extension exercises or normal activity over 6 months. Main outcome measures: Pain intensity ( VAS) and disability scores ( Roland- Morris) at 2.5, 4, 6, 12, and 24 months. Results. Follow- up was achieved in 96% at 12 months and 80% at 2 years. Ligament injections, with exercises and with normal activity, resulted in significant and sustained reductions in pain and disability throughout the trial, but no attributable effect was found for prolotherapy injections over saline injections or for exercises over normal activity. At 12 months, the proportions achieving more than 50% reduction in pain from baseline by injection group were glucose- lignocaine: 0.46 versus saline: 0.36. By activity group these proportions were exercise: 0.41 versus normal activity: 0.39. Corresponding proportions for > 50% reduction in disability were glucose- lignocaine: 0.42 versus saline 0.36 and exercise: 0.36 versus normal activity: 0.38. There were no between group differences in any of the above measures. Conclusions. In chronic nonspecific low- back pain, significant and sustained reductions in pain and disability occur with ligament injections, irrespective of the solution injected or the concurrent use of exercises.

SQLator: An online SQL learning workbench

SQL (Structured Query Language) is one of the essential topics in foundation databases courses in higher education. Due to its apparent simple syntax, learning to use the full power of SQL can be a very difficult activity. In this paper, we introduce SQLator, which is a web-based interactive tool for learning SQL. SQLator's key function is the evaluate function, which allows a user to evaluate the correctness of his/her query formulation. The evaluate engine is based on complex heuristic algorithms. The tool also provides instructors the facility to create and populate database schemas with an associated pool of SQL queries. Currently it hosts two databases with a query pool of 300+ across the two databases. The pool is divided into 3 categories according to query complexity. The SQLator user can perform unlimited executions and evaluations on query formulations and/or view the solutions. The SQLator evaluate function has a high rate of success in evaluating the user's statement as correct (or incorrect) corresponding to the question. We will present in this paper, the basic architecture and functions of SQLator. We will further discuss the value of SQLator as an educational technology and report on educational outcomes based on studies conducted at the School of Information Technology and Electrical Engineering, The University of Queensland.

Do intravitreal Ranibizumab injections for wet age-related macular degeneration affect the vitreomacular interface?

Presentation Abstract - Purpose:Serial intravitreal ranibizumab injections are the main treatment for wet age- related macular degeneration (AMD), and patients are monitored by optical coherence tomography (OCT). Our objective in conducting this study is to determine whether serial intravitreal injections of ranibizumab in eyes with wet AMD alter the vitreo-macular interface (VMI) Methods - Using a Topcon Spectral Domain OCT, we performed a prospective, observational study of 87 eyes of 82 consecutive patients undergoing treatment with intravitreal ranibizumab for wet AMD, with each patient followed up for a minimum of 6 months. The mean number of intravitreal ranibizumab injections was 4.28, range 3-6. Using macular OCT scans, the area of VMI was closely examined, for vitreo-macular adhesion (VMA), defined as perifoveal posterior vitreous detachment (PVD) with posterior vitreous attached to fovea. Any OCT separation of posterior vitreous face was observed and measured, every month for 6 months. Results - There was no change in the OCT appearance or measurement of VM interface in 80 eyes (92%). VM adhesion, defined on OCT as when the posterior hyaloid line is attached to inner foveal surface and dettached perifoveally, was identified in 7 out of 87 treated eyes (8%) .Of these 7 eyes, 1 eye developed complete PVD following three injections, 1 eye developed partial PVD and the remaining 5 eyes had no significant change in VM adhesion. Conclusions - To our knowledge this is the first study that has examined the VM interface following serial ranibizumab injections for wet AMD. This small pilot study suggests that most cases undergoing ranibizumab therapy suffer no disturbance to VM interface.

Efficacy and safety of second-generation antipsychotic long-acting injections (SGA LAIs) in maintenance treatment of bipolar disorder:protocol for a systematic review and meta-analysis

INTRODUCTION: Bipolar disorder requires long-term treatment but non-adherence is a common problem. Antipsychotic long-acting injections (LAIs) have been suggested to improve adherence but none are licensed in the UK for bipolar. However, the use of second-generation antipsychotics (SGA) LAIs in bipolar is not uncommon albeit there is a lack of systematic review in this area. This study aims to systematically review safety and efficacy of SGA LAIs in the maintenance treatment of bipolar disorder. METHODS AND ANALYSIS: The protocol is based on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and will include only randomised controlled trials comparing SGA LAIs in bipolar. PubMed, EMBASE, CINAHL, Cochrane Library (CENTRAL), PsychINFO, LiLACS, http://www.clinicaltrials.gov will be searched, with no language restriction, from 2000 to January 2016 as first SGA LAIs came to the market after 2000. Manufacturers of SGA LAIs will also be contacted. Primary efficacy outcome is relapse rate or delayed time to relapse or reduction in hospitalisation and primary safety outcomes are drop-out rates, all-cause discontinuation and discontinuation due to adverse events. Qualitative reporting of evidence will be based on 21 items listed on standards for reporting qualitative research (SRQR) focusing on study quality (assessed using the Jadad score, allocation concealment and data analysis), risk of bias and effect size. Publication bias will be assessed using funnel plots. If sufficient data are available meta-analysis will be performed with primary effect size as relative risk presented with 95% CI. Sensitivity analysis, conditional on number of studies and sample size, will be carried out on manic versus depressive symptoms and monotherapy versus adjunctive therapy.

Applied web traffic analysis for numerical encoding of SQL Injection attack features.

SQL Injection Attack (SQLIA) remains a technique used by a computer network intruder to pilfer an organisation’s confidential data. This is done by an intruder re-crafting web form’s input and query strings used in web requests with malicious intent to compromise the security of an organisation’s confidential data stored at the back-end database. The database is the most valuable data source, and thus, intruders are unrelenting in constantly evolving new techniques to bypass the signature’s solutions currently provided in Web Application Firewalls (WAF) to mitigate SQLIA. There is therefore a need for an automated scalable methodology in the pre-processing of SQLIA features fit for a supervised learning model. However, obtaining a ready-made scalable dataset that is feature engineered with numerical attributes dataset items to train Artificial Neural Network (ANN) and Machine Leaning (ML) models is a known issue in applying artificial intelligence to effectively address ever evolving novel SQLIA signatures. This proposed approach applies numerical attributes encoding ontology to encode features (both legitimate web requests and SQLIA) to numerical data items as to extract scalable dataset for input to a supervised learning model in moving towards a ML SQLIA detection and prevention model. In numerical attributes encoding of features, the proposed model explores a hybrid of static and dynamic pattern matching by implementing a Non-Deterministic Finite Automaton (NFA). This combined with proxy and SQL parser Application Programming Interface (API) to intercept and parse web requests in transition to the back-end database. In developing a solution to address SQLIA, this model allows processed web requests at the proxy deemed to contain injected query string to be excluded from reaching the target back-end database. This paper is intended for evaluating the performance metrics of a dataset obtained by numerical encoding of features ontology in Microsoft Azure Machine Learning (MAML) studio using Two-Class Support Vector Machines (TCSVM) binary classifier. This methodology then forms the subject of the empirical evaluation.

An investigation into PL/SQL Injection.

SQL injection is a common attack method used to leverage infor-mation out of a database or to compromise a company’s network. This paper investigates four injection attacks that can be conducted against the PL/SQL engine of Oracle databases, comparing two recent releases (10g, 11g) of Oracle. The results of the experiments showed that both releases of Oracle were vulner-able to injection but that the injection technique often differed in the packages that it could be conducted in.