Previous systematic reviews have identified the benefits of exercise for chronic neck pain on subjective reports of pain, but not with objective measures such as quantitative sensory testing (QST). A ...systematic review was conducted to identify the effects of neck specific exercise on QST measures in adults with chronic neck pain to synthesise existing literature and provide clinical recommendations.
The study protocol was registered prospectively with PROSPERO (PROSPERO CRD42021297383). For both randomised and non-randomised trials, the following databases and trial registries were searched: AMED, CINAHL, Embase, Google Scholar, Medline, PEDro, PubMed, Scopus, SPORTDiscus, Science Citation Index and Social Science Citation Index from Web of Science Core Collection, clinicaltrials.gov, GreyOpen, and ISRCTN registry. These searches were conducted from inception to February 2022 and were updated until September 2023. Reference lists of eligible studies were screened. Study selection was performed independently by two reviewers, with data extraction and quality appraisal completed by one reviewer and independently ratified by a second reviewer. Due to high heterogeneity, narrative synthesis was performed with results grouped by exercise type.
Three trials were included. Risk of bias was rated as moderate and the certainty of evidence as low or moderate for all studies. All exercise groups demonstrated statistically significant improvement at an intermediate-term follow-up, with progressive resistance training combined with graded physical training demonstrating the highest certainty of evidence. Fixed resistance training demonstrated statistically significant improvement in QST measures at a short-term assessment.
Fixed resistance training is effective for short-term changes in pain sensitivity based on low-quality evidence, whilst moderate-quality evidence supports progressive resistance training combined with graded physical training for intermediate-term changes in pain sensitivity.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
2.
Photothermal Perylene Bisimide Hydrogels Thomson, Lisa; Ginesi, Rebecca E.; Osborne, Daniel D. ...
Chemistry,
July 3, 2023, Letnik:
29, Številka:
37
Journal Article
Recenzirano
Odprti dostop
Gels formed using a perylene bisimide (PBI) as a low molecular weight gelator can show the photothermal effect. Formation of the PBI radical anion results in new absorption bands forming, meaning ...that subsequent irradiation with a wavelength of light overlapping with the new absorption band leads to heating of the gel. This approach can be used to heat the gel, as well as the surrounding milieu. We show how we can use electrochemical methods as well as multicomponent systems to form the radical anion without the need for UV light, and how we can use the photothermal effect to induce phase transitions in the solutions above the gels by exploiting photothermal behavior.
In this paper, perylene bisimide gels are prepared that can exhibit the photothermal effect. This can be used for example to heat a solution above the gel.
In this article, we revisit a Shape-based Glaucoma Index previously examined in Derado et al. (
2004
) using Scanning Confocal Laser (Heidelberg Retina) Tomographic (HRT) images. Here, we examine the ...use of 2D stereographic images for detecting glaucomatous shape change. Similar to Derado et al. (
2004
), we are interested in detecting such change from the same Rhesus monkeys experimental data. In contrast to Derado et al. (
2004
), in this study we use 2D stereographic images that were taken on the same sample of Rhesus monkeys before and after receiving an eye injection, inducing glaucoma-like Intra-Ocular Pressure (IOP) in one of their eyes, while keeping the other eye as control. Once we retrieve the 3D Kendall Shape reconstruction for the stereographic images of the Rhesus monkeys eye using Agisoft PhotoScan, we summarize the shape by selecting three matched corresponding biological landmarks on the neural-rim and the fourth matched landmark as the point of maximum depth. Clinicians believes that the ratio depth to diameter of the eye cup provides useful measure of shape change. We calculate the glaucoma index, (G), a normalized depth of the eye cup of Rhesus monkeys before and after receiving an injection. Parametric and nonparametric analyses were performed. Both procedures detected a positive mean glaucoma index increase in the medically induced glaucomatous eye. Our analyses supports a similar conclusion obtained in Derado et al. (
2004
) using HRT images.
Variable temperature NMR spectroscopic measurements on (S)-warfarin open-form: 3-(1′-phenyl-3′-oxobut-1′-yl)-4-hydroxycoumarin in CDCl
3
, CD
3
OD and d
6
-DMSO generally showed tautomeric ...compositions in the order
trans
(2S,4S) coumarin hemiketal >
cis
(2R,4S) coumarin hemiketal > open (S) coumarin enol in slow dynamic equilibrium over temperature ranges rising modestly from ambient. A computational (DFT-M06-2X) examination of the lower energy tautomers including coumarin and chromone open and cyclic forms (gas phase, chloroform or DMSO fields) was consistent with the general solution compositions. The crystal and molecular structures for model compounds of the major solution tautomers are reported: (2S,4S)-warfarin methyl ketal orthorhombic,
P
2
1
2
1
2
1
, (2R,4S)-warfarin methyl ketal orthorhombic,
P
2
1
2
1
2
1
, (
rac
)-warfarin-4-methyl ether monoclinic,
P
2
1
/
n
, and the open chromone (S)-warfarin-2-methyl ether monoclinic,
P
2
1
, Z = 8. A combination of direct integration and line-fitting methods were used to determine solution (S)-warfarin tautomer compositions. As temperatures were increased, the concentrations of the open coumarin form increased at the expense of the cyclic hemiketals. Equilibrium constants were used to determine the standard free-energy differences for the two open-cyclic equilibria (
trans
hemiketal
⇌
open, open
⇌
cis
hemiketal, respectively) in three solvents: CDCl
3
+ 3.7(4), − 2.8(6) kJ/mol, CD
3
OD + 7.6(16), − 4.7(9) k/mol, d
6
-DMSO + 3.5(7), − 1.1(2) kJ/mol. Standard enthalpy and entropy differences were also determined from van’t Hoff analysis. Rates of the respective reactions were estimated from line-widths for the cyclic hemiketals and solution equilibrium compositions for each species. Eyring analysis gave ΔG
‡
, ΔH
‡
, and ΔS
‡
, respectively, for the forward and reverse reactions of coumarin
trans
hemiketal
⇌
open-form and for the open-form
⇌
cis
hemiketal. Negative entropic contributions to the observed transition state energies were consistent with solvent or solute ordering in the prototropic reactions. Open-form NMR signals were broader than could be accounted for by the open-cyclic equilibria alone, increasingly so in polar and protic solvents and with rising temperatures. While a conformational equilibrium may operate, an increasingly faster intermediate dynamic equilibrium between open coumarin-chromone tautomers may be a more likely explanation.
Graphical Abstract
Structures of methylated warfarin tautomers and computational models enabled assignment of overlapping warfarin tautomeric NMR spectra and through variable temperature analysis, provided the thermodynamics of the tautomeric equilibria in three solvents.
Symmetric positive definite (SPD) matrices arise in a wide range of applications including diffusion tensor imaging (DTI), cosmic background radiation, and as covariance matrices. A complication when ...working with such data is that the space of SPD matrices is a manifold, so traditional statistical methods may not be directly applied. However, there are nonparametric procedures based on resampling for statistical inference for such data, but these can be slow and computationally tedious. Schwartzman (Int Stat Rev 84(3):456–486, 2016). introduced a lognormal distribution on the space of SPD matrices, providing a convenient framework for parametric inference on this space. Our goal is to check how robust confidence regions based on this distributional assumption are to a lack of lognormality. The methods are illustrated in a simulation study by examining the coverage probability of various mixtures of distributions.
The more polar product of the Michael addition of 4-hydroxycoumarin to mesityl oxide, an analog of warfarin, crystallizes as the racemic cyclic coumarin hemiketal ...2-hydroxy-2,4,4-trimethyl-3,4-dihydro-2
H
,5
H
-pyrano3,2-c1 benzopyran-5-one. Crystals occur in the monoclinic system, space group
P
2(1)/
n
, with
a
6.6655(4)Å,
b
12.9450(7)Å,
c
14.5809(7)Å,
β
97.909(5)°, Z = 4. In solution by nuclear magnetic resonance (400 MHz), a dynamic equilibrium exists between the enantiomeric coumarin hemiketals through an unobserved intermediate open tautomer. Diastereomeric methylene and methyl Hs exchange slowly in non-polar solvents (acetic acid and chloroform), much faster in polar, aprotic solvents (acetone and dimethylsulfoxide). In methanol, dynamic behavior begins in the slow-exchange region at 288–310 K, with signal coalescence at 310.5 K, followed by fast-exchange behavior. The barrier to cyclic-open-cyclic (racemization) was found to be ΔG
‡
= + 63(1) kJ/mol (in CD
3
OD), with a racemization rate of 30 s
−1
at 298 K, 155 s
−1
at 310.5 K. Density functional theory (DFT) computations modelling the open and cyclic coumarin tautomers, including solvent fields, confirms that the open-form is 60–70 kJ/mol higher in energy than the cyclic hemiketal. Additionally, modelling supports the contention that chromone tautomers are insignificant participators in solution. An operative
gem
-dimethyl effect, supported by the proximity of the methyls to the coumarin carboxy oxygen, apparently favors rotamers that bring the side-chain ketone into proximity with the coumarin enolic hydroxy. The less-polar by-product of the Michael addition has been characterized by spectroscopy and crystallography as 2,2,4-trimethyl2
H
,5
H
pyrano3,2-c1benzopyran-5-one. Computations on the alkyl warfarin analog 2-hydroxy-2,4-dimethyl-3,4-dihydro-2
H
,5
H
-pyrano3,2-c 1benzopyran-5-one, lacking the
gem
-dimethyl effect significantly stabilizes the intermediate open coumarin form, which accords with open-form observations in solution for this analog and for warfarin reported in the literature.
Graphical Abstract
Nystagmus is a disorder of uncontrolled eye movement and can occur as an isolated trait (idiopathic INS, IINS) or as part of multisystem disorders such as albinism, significant visual disorders or ...neurological disease. Eighty-one unrelated patients with nystagmus underwent routine ocular phenotyping using commonly available phenotyping methods and were grouped into four sub-cohorts according to the level of phenotyping information gained and their findings. DNA was extracted and sequenced using a broad utility next generation sequencing (NGS) gene panel. A clinical subpanel of genes for nystagmus/albinism was utilised and likely causal variants were prioritised according to methods currently employed by clinical diagnostic laboratories. We determine the likely underlying genetic cause for 43.2% of participants with similar yields regardless of prior phenotyping. This study demonstrates that a diagnostic workflow combining basic ocular phenotyping and a clinically available targeted NGS panel, can provide a high diagnostic yield for patients with infantile nystagmus, enabling access to disease specific management at a young age and reducing the need for multiple costly, often invasive tests. By describing diagnostic yield for groups of patients with incomplete phenotyping data, it also permits the subsequent design of 'real-world' diagnostic workflows and illustrates the changing role of genetic testing in modern diagnostic workflows for heterogeneous ophthalmic disorders.
Introduction
Amblyopia therapy appears to be most effective in children under the age of 7 years, but results from randomized control trials (RCTs) have shown that occlusion therapy and/or atropine ...penalization therapy may improve visual acuity in an older age group. Which of these two therapies is the most effective with fewer adverse effects in an older age group has not yet been agreed upon.
Methods
We systematically searched the literature for RCTs that compared atropine penalization therapy and occlusion therapy in terms of their visual acuity outcomes and adverse events and performed a meta-analysis on the visual acuity data obtained. The adverse effects reported and their implications for clinical practice are discussed.
Results
Two RCTs were identified, with the authors of both concluding that there was no detectable difference between the two therapies for the age groups they studied. The mean difference between atropine penalization and occlusion therapies was calculated to be − 0.01 logMAR (95% confidence interval − 0.07 to 0.03 logMAR) in favor of occlusion therapy, and no statistical difference between the two groups was detected (
P
= 0.45). Neither study detected a marked difference in terms of reported adverse effects from the two interventions.
Conclusion
Based on the results of our meta-analysis we conclude that there is no difference in visual acuity outcomes between atropine penalization therapy and occlusion therapy after 17 to 24 weeks of treatment in children aged 7–12 years. Further evidence to determine the efficacy of amblyopia therapy for an older patient population is required before studies comparing atropine penalization and occlusion therapy in patients older than 12 years can be performed. Atropine penalization therapy may cause more frequent minor adverse effects, such as light sensitivity, but in the clinical setting this needs to be balanced with the potential practical benefits of twice-weekly eye drops versus daily occlusion.
Funding
The funding for this study was provided by the National Institute for Health Research (NIHR) and Health Education England (HEE).
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