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BACK PAIN: THE STUDY OF MECHANISMS AND THE TRANSLATION IN INTERVENTIONS WITHIN THE MISPEX NETWORK
(2016)
Background:
Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain.
Methods and study design:
A multicentre, single-blind two-armed randomized controlled trial to evaluate the
effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires – clinical examination – biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing.
Discussion:
The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain.
Trial registration:
Identification number DRKS00010129. German Clinical Trial registered on 3 March 2016.
Background: Arising from the relevance of sensorimotor training in the therapy of nonspecific low back pain patients and from the value of individualized therapy, the present trial aims to test the feasibility and efficacy of individualized sensorimotor training interventions in patients suffering from nonspecific low back pain. Methods and study design: A multicentre, single-blind two-armed randomized controlled trial to evaluate the effects of a 12-week (3 weeks supervised centre-based and 9 weeks home-based) individualized sensorimotor exercise program is performed. The control group stays inactive during this period. Outcomes are pain, and pain-associated function as well as motor function in adults with nonspecific low back pain. Each participant is scheduled to five measurement dates: baseline (M1), following centre-based training (M2), following home-based training (M3) and at two follow-up time points 6 months (M4) and 12 months (M5) after M1. All investigations and the assessment of the primary and secondary outcomes are performed in a standardized order: questionnaires - clinical examination biomechanics (motor function). Subsequent statistical procedures are executed after the examination of underlying assumptions for parametric or rather non-parametric testing. Discussion: The results and practical relevance of the study will be of clinical and practical relevance not only for researchers and policy makers but also for the general population suffering from nonspecific low back pain.
Oceanic lithospheric S-wave velocities from the analysis of P-wave polarization at the ocean floor
(2016)
Our knowledge of the absolute S-wave velocities of the oceanic lithosphere is mainly based on global surface wave tomography, local active seismic or compliance measurements using oceanic infragravity waves. The results of tomography give a rather smooth picture of the actual S-wave velocity structure and local measurements have limitations regarding the range of elastic parameters or the geometry of the measurement. Here, we use the P-wave polarization (apparent P-wave incidence angle) of teleseismic events to investigate the S-wave velocity structure of the oceanic crust and the upper tens of kilometres of the mantle beneath single stations. In this study, we present an up to our knowledge new relation of the apparent P-wave incidence angle at the ocean bottom dependent on the half-space S-wave velocity. We analyse the angle in different period ranges at ocean bottom stations (OBSs) to derive apparent S-wave velocity profiles. These profiles are dependent on the S-wave velocity as well as on the thickness of the layers in the subsurface. Consequently, their interpretation results in a set of equally valid models. We analyse the apparent P-wave incidence angles of an OBS data set which was collected in the Eastern Mid Atlantic. We are able to determine reasonable S-wave-velocity-depth models by a three-step quantitative modelling after a manual data quality control, although layer resonance sometimes influences the estimated apparent S-wave velocities. The apparent S-wave velocity profiles are well explained by an oceanic PREM model in which the upper part is replaced by four layers consisting of a water column, a sediment, a crust and a layer representing the uppermost mantle. The obtained sediment has a thickness between 0.3 and 0.9 km with S-wave velocities between 0.7 and 1.4 km s(-1). The estimated total crustal thickness varies between 4 and 10 km with S-wave velocities between 3.5 and 4.3 km s(-1). We find a slight increase of the total crustal thickness from similar to 5 to similar to 8 km towards the South in the direction of a major plate boundary, the Gloria Fault. The observed crustal thickening can be related with the known dominant compression in the vicinity of the fault. Furthermore, the resulting mantle S-wave velocities decrease from values around 5.5 to 4.5 km s(-1) towards the fault. This decrease is probably caused by serpentinization and indicates that the oceanic transform fault affects a broad region in the uppermost mantle. Conclusively, the presented method is useful for the estimation of the local S-wave velocity structure beneath ocean bottom seismic stations. It is easy to implement and consists of two main steps: (1) measurement of apparent P-wave incidence angles in different period ranges for real and synthetic data, and (2) comparison of the determined apparent S-wave velocities for real and synthetic data to estimate S-wave velocity-depth models.
Polychlorinated biphenyls (PCBs) can cause endocrine disruption, cancer, immunosuppression, or reproductive failure in animals. We used an individual-based model to explore whether and how PCB-associated reproductive failure could affect the dynamics of a hypothetical polar bear (Ursus maritimus) population exposed to PCBs to the same degree as the East Greenland subpopulation. Dose-response data from experimental studies on a surrogate species, the mink (Mustela vision), were used in the absence of similar data for polar bears. Two alternative types of reproductive failure in relation to maternal sum-PCB concentrations were considered: increased abortion rate and increased cub mortality. We found that the quantitative impact of PCB-induced reproductive failure on population growth rate depended largely on the actual type of reproductive failure involved. Critical potencies of the dose-response relationship for decreasing the population growth rate were established for both modeled types of reproductive failure. Comparing the model predictions of the age-dependent trend of sum-PCBs concentrations in females with actual field measurements from East Greenland indicated that it was unlikely that PCB exposure caused a high incidence of abortions in the subpopulation. However, on the basis of this analysis, it could not be excluded that PCB exposure contributes to higher cub mortality. Our results highlight the necessity for further research on the possible influence of PCBs on polar bear reproduction regarding their physiological pathway. This includes determining the exact cause of reproductive failure, i.e., in utero exposure versus lactational exposure of offspring; the timing of offspring death; and establishing the most relevant reference metrics for the dose-response relationship.