Aim of Investigation: Psychophysical quantitative sensory testing (QST) is a choice for semi-obje... more Aim of Investigation: Psychophysical quantitative sensory testing (QST) is a choice for semi-objective measurement of both hypo/hyper-sensory function targeting small (pain transmitting) and large (other sensory) nerve fibers. QST has potential to contribute to the assessment of shoulder disorders (e.g. diagnosis, treatment selection or prognosis). It is established that self-reported and performance-based measures are moderately related in musculoskeletal disorders. However, there is little evidence to compare those measures with QST. The main objective of this study was to estimate the extent to which QSTs and patient factors (age, gender, and comorbidity) predict pain, function and health status in people with shoulder disorder. The second objective of this study was to determine if there are gender differences for QST measures in current perception threshold (CPT), vibration threshold (VT) and pressure pain (PP) threshold and tolerance for this patient population. Methods: The cross-sectional study was done at MacHAND Clinical Research Lab of McMaster University with 34 surgical and 10 nonsurgical patients with shoulder disorder. Participants were asked to complete self-reported outcome measures about pain (numeric pain rating, pain catastrophizing, shoulder pain and disability index) and health status (SF-12). Participants completed QST at 4 standardized locations and then the shoulder functional performance test (FIT-HANSA). Pearson's r was computed to find out relationships between QST variables and patient factors with either pain, function or health status. Eight regression models were built to analysis QST's and patient factors separately as predictors of either pain, function or health status. An independent sample t-test was done to evaluate the gender effect on QST. Results: Greater PP threshold and PP tolerance was significantly correlated with better shoulder functional performance (r =.31-.44) and less self-reported shoulder disability (r = -.32 to -.36). VT or CPT were not significantly related to pain, function or health status, with the exception of VT on the little finger where lower threshold was correlated to a lower pain intensity (r = .50) and better functional performance (r = -.34). Higher comorbidity was consistently correlated (r =.31-.46) with poorer pain, function and health status. Older age was correlated to more pain intensity and less function (r =.31-.57). In multivariate models, Patient factors contributed significantly to pain, function or health status models (r2 =.19-.36); whereas QST did not. QST was significantly different between males and females [in PP threshold (3.9-6.2, p < .001) and PP tolerance (7.6-12.6, p < .001) and CPT (1.6-2.3, p =.02)]. Conclusions: Psychophysical dimensions and patient factors (gender, age and comorbidity) affect self-reported and performance-based outcome measures in shoulder disorder. Given the multivariate nature of disability, large samples are required to identify the most important predictors and interactions.
Critical Reviews in Physical and Rehabilitation Medicine, 2013
The objective of this study was to evaluate the reliability and validity of current perception th... more The objective of this study was to evaluate the reliability and validity of current perception threshold (CPT) tests in patients with mechanical neck disorder (MND). The rapid CPT protocol was performed at 3 frequencies (5, 250, and 2000 Hz) using 3 dermatomal locations (C6-C8) on the hand of patients with MND (n = 106). A subset of patients (n = 34) was reassessed at a second visit to determine the test-retest reliability. The fingertips of both hands were assessed for intertrial reliability. Internal consistencies of CPT between frequencies were calculated from CPT test scores in the most affected hand. The construct validity of CPT was evaluated by correlating the 3 composite scores derived the from the CPT tests with the Neck Disability Index (NDI) and Cervical Spine Outcomes Questionnaire (CSOQ). Intertrial reliability was good to excellent (intraclass correlation coefficient (ICC), 0.73-0.82; P < 0.001). The test-retest reliability of CPT scores was fair to excellent (ICC, 0.47-0.86; P < 0.001). The mean retest difference and the 95% limits of agreement were -0.3 ± 3 for both 2000 and 250 Hz and 0.1 ± 3.9 for 5 Hz. A small to medium-sized correlation was found between CPT and NDI or CSOQ (r = 0.24-0.37). CPT was consistent across occasions and was associated with neck disability.
The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patie... more The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patient factors predict pain-related disability in patients with neck pain (NP), and to determine if PPS differs by gender. Forty-four participants with a moderate level of chronic NP were recruited for this cross sectional study. All participants were asked to complete self-reported assessments of pain, disability and comorbidity and then underwent PPS testing at 4-selected body locations. Pearson`s r w was computed to explore relationships between the PPS measures and the self-reported assessments. Regression models were built to identify predictors of pain and disability. An independent sample t-test was done to identify gender-related differences in PPS, pain-disability and comorbidity. In this study, greater PPS (threshold and tolerance) was significantly correlated to lower pain-disability (r = -.30 to -.53, p≤0.05). Age was not correlated with pain or disability but comorbidity was (r= 0.42-.43, p≤0.01). PPS at the 4-selected body locations was able to explain neck disability (R 2 =25-28%). Comorbidity was the strongest predictor of neck disability (R 2 =30%) and pain (R 2 =25%). Significant mean differences for gender were found in PPS, disability and comorbidity, but not in pain intensity or rating. This study suggests that PPS may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues.
Accurate assessment of pain or sensory function in clinical practice is challenging. Quantitative... more Accurate assessment of pain or sensory function in clinical practice is challenging. Quantitative Sensory Testing (QST) is a standardized approach to measuring pain and sensory thresholds or tolerances as a means of assessing the functionality of neural pathways from the receptors along the afferent fibers to the brains. This paper reviews two simple QST techniques potentially useful to clinical practice: the Cold Stress Test and Ten Test. The background, evidence for clinical measurement properties and feasibility issues are considered.
Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pat... more Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pathological) based on different aspects of the pain mechanism. The mechanism of hypersensitivity has not been fully defined. However, it is known that over-excitability (too much sensitivity) of neurons can arise in both peripheral and central components of the nervous system. Pain theories can be useful in helping to explain complex phenomenon like hypersensitivity. The Gate control theory and other more bio-psychological pain models may assist us to understand a mechanism of chronic musculoskeletal pain. This article discusses a mechanism based pain model.
ABSTRACT We propose an analytical five-parameter potential function for stable diatomic molecules... more ABSTRACT We propose an analytical five-parameter potential function for stable diatomic molecules V(x) = K/x(3) - e(-tx)(a + bx + cx(2)). Here x=r/r(e), where r is the internuclear distance and re the equilibrium bond length. K, t, a, b, c are five parameters of the function, which are obtained from molecular spectroscopic data in terms of known molecular constants. (C) 2012 Physics Essays Publication. [DOI: 10.4006/0836-1398-25.4.540]
indicators for the Clearing House and the measures could complement indicators on clinical qualit... more indicators for the Clearing House and the measures could complement indicators on clinical quality of providers from the NIH Promis initiative in the United States (or the NHS Proms in the UK). METHODS: The concept development is relevant for chronic care. Five domains represent outpatient drug care: information, communication access, trust and clinical quality. Four process measures and one access measure are proposed with series of 5 -7 items, tested on pharmacy delivery systems and dispensing doctors.The trust indicator has been identified as critical for the US drug delivery system and discussed as an example. RESULTS: Trust adresses the potential patient mistrust when cost interfere with clinical judgement. The process measure is calculated for prescribing and treatment decisions for Hypertension, Diabetes and Asthma.It is a rate base measure . The Facct scoring method is modified to integrate minima in low score values. Mean scores are calculated on samples per practice. Missing values are replaced by mean value. The evidence from the UK PCT on a scale of 0-100, for three practices show scores of 66.78; 63.82;73.92 and 67.72 for the whole sample with a Cronbach of 0.70. CONCLUSIONS: A composite indicator is envisaged for diffferent decision points in clinical practices. It is to be linked to clinical decision points from the Adaptive Knowledge Platform (AKP) (Huttin, Liebamn, 2011) on breast cancer and could fit the requirements for the 12 rules for EGD in cancer. Validations in additional organisations of care and delivery systems are planned in further validation stages.
The prevalence of obesity (BMI ≥30) remains above 35% and when combined with the overweight popul... more The prevalence of obesity (BMI ≥30) remains above 35% and when combined with the overweight population (BMI ≥25), the age-adjusted prevalence is 68.8%. The objective was to develop a model demonstrating the cost savings associated with the prevention of hypertension (HTN), diabetes (DM), and dyslipidemia (DLP) in an overweight and obese population by treating patients with phentermine/topiramate extended-release (ER) in conjunction with lifestyle modification. METHODS: A 1-year model was developed using data from the National Health and Nutrition Examination Survey (NHANES), clinical trial data, and published literature. The model estimates the cost of incident cases of HTN, DM and DLP in an overweight and obese population. Rates of progression to comorbidities are based on patients who progressed from no medication use for comorbidities at baseline to at least one medication at endpoint in the CONQUER study in obese and overweight subjects with ≥2 comorbidities. The risk of progression to HTN, DM, and DLP is applied to literature-based cost estimates to calculate the per-patient annual cost savings associated with phentermine/topiramate ER compared with lifestyle modification alone. RESULTS: The average cost savings per patient associated with the prevention of comorbidities with phentermine/topiramate ER compared with lifestyle modification alone is $179.06, $177.44, and no savings in grade 1 (BMI ≥30), grade 2 (BMI ≥35), and grade 3 (BMI ≥40) obese populations, respectively. HTN-specific cost savings ranged from $40.20 for grade 2 obesity to $10.42 for grade 3 obesity. DM-specific cost savings ranged from $109.23 for grade 2 obesity to no savings for grade 3 obesity. DLP-specific cost savings ranged from $56.02 for grade 1 obesity to $28.01 for grade 2 obesity. CONCLUSIONS: This analysis suggests that treatment with phentermine/topiramate ER may be associated with cost savings by preventing the development of comorbidities in overweight or obese patients.
The hyperfine (hf) structure of some spectral lines of the praseodymium atom has been investigate... more The hyperfine (hf) structure of some spectral lines of the praseodymium atom has been investigated by the laser-induced fluorescence method in a hollow cathode discharge lamp. We report the discovery of 18 new energy levels of even parity and 22 new energy levels of odd parity and their magnetic dipole hf interaction constants A. Using these newly discovered levels, 268 lines were classified by means of laser spectroscopy, 97 of them by laser excitation and 171 via laser-induced fluorescence. In addition, 23 lines, observed in a Fourier transform spectrum, were classified by means of their wavenumbers and their hf patterns.
Journal of Physics B: Atomic, Molecular and Optical Physics, 2012
Abstract Hyperfine structure (hf) patterns of unclassified spectral lines of the praseodymium ato... more Abstract Hyperfine structure (hf) patterns of unclassified spectral lines of the praseodymium atom, as appear in a high-resolution Fourier transform spectrum, have been simulated. In this way, the J-values and hf constants of the levels involved in the transitions were ...
Journal of Physics B: Atomic, Molecular and Optical Physics, 2011
ABSTRACT We report the recording of new highly resolved Fourier transform spectra of the neutral ... more ABSTRACT We report the recording of new highly resolved Fourier transform spectra of the neutral praseodymium atom. With the help of the new spectra we found about 9000 new lines from which---in the region 3260 to 9880 Å---1194 could be classified as transitions between energy levels of the Pr atom and 19 as transitions of the Pr ion. Twenty-three new atomic energy levels of odd parity and one of even parity were discovered during this first examination. The spectra might be very helpful for further laser spectroscopic investigations of the hyperfine structure of Pr I and Pr II transitions.
Journal of Orthopaedic & Sports Physical Therapy, 2014
T T CONCLUSION: CPT testing has moderate discriminatory accuracy, specificity, and sensitivity fo... more T T CONCLUSION: CPT testing has moderate discriminatory accuracy, specificity, and sensitivity for classification of MND categories into neck pain with or without neurological signs.
ABSTRACT Introduction Touch threshold screening instruments must accurately distinguish normal ve... more ABSTRACT Introduction Touch threshold screening instruments must accurately distinguish normal versus abnormal sensation to screen nerve pathology. This study was conducted to find out whether two touch threshold measuring devices (i.e. Weinstein Enhanced Sensory Test (WEST) and Pressure-Specified Sensory Device (PSSD) provide consistent results and indicators of “normal” sensation, and secondarily what rules best define normality. Methods The study design was a cross-sectional reliability and validity assessment with 23 healthy participants. Instruments were applied in random order on the pulp of the middle and little fingers of both hands; with five applications on each digit. Cut-offs of 3, 4, and 5 correct responses were used to classify the response as being normal. Weighted kappa and percent agreement were used to indicate test–retest reliability of the WEST, and validity was determined by calculating the percentage of normal controls that achieved a normal score. The Bland–Altman method was used to characterize the retest reliability of PSSD, and validity was determined by whether the mean of the score is different from the normative scores. Results The agreement between test and retest of WEST (detection level = 3/5) was almost perfect (k = 1). The average percentages of normal detection of the WEST on two test/retest were 93% and 97% (detection level = 4/5) and 82% and 85% (detection level = 5/5). All mean PSSD tests values were found within the predetermined normal range. The Bland–Altman plot demonstrated a minimal mean difference between test occasions and similar limits of agreement across the four test locations. Discussion The study found that more than 90% of the tests with healthy young participants were reliable and valid in relation to their ability to detect a normal WEST filament or PSSD within a normal force range. Our study was limited by a small sample with healthy participants.
Critical Reviews in Physical and Rehabilitation Medicine, 2012
Executive function (EF) is a control mechanism of human cognition that provides the capability to... more Executive function (EF) is a control mechanism of human cognition that provides the capability to select actions in relation to internal goals organized by the prefrontal cortex (PFC). The PFC is essential for the temporal integration of sensory information in the sequencing of optimum motor behavior to achieve an internal goal. The temporal integration of sensory information also explains why the PFC has an additional role in the central modulation of pain. Pain modulation and motor function are altered in chronic pain, and this alteration can contribute to the reduced physical activity. EF is the driver of conscious control of thought and action that is critical to rehabilitation in chronic pain. However, EF is impaired in chronic pain. Rehabilitation practitioners typically use activity modification, exercise, and movement to enhance function in patients with chronic pain; exercise has beneficial effects on EF. However, impairments in EF can be barriers to adherence to exercise, activity, and lifestyle modifications required to optimize rehabilitation. Greater awareness of EF can enhance rehabilitation. This narrative review explores current theories of EF structure and function, how impairment of EF can be assessed in a clinical context, and its implications for rehabilitation in chronic pain.
Aim of Investigation: Psychophysical quantitative sensory testing (QST) is a choice for semi-obje... more Aim of Investigation: Psychophysical quantitative sensory testing (QST) is a choice for semi-objective measurement of both hypo/hyper-sensory function targeting small (pain transmitting) and large (other sensory) nerve fibers. QST has potential to contribute to the assessment of shoulder disorders (e.g. diagnosis, treatment selection or prognosis). It is established that self-reported and performance-based measures are moderately related in musculoskeletal disorders. However, there is little evidence to compare those measures with QST. The main objective of this study was to estimate the extent to which QSTs and patient factors (age, gender, and comorbidity) predict pain, function and health status in people with shoulder disorder. The second objective of this study was to determine if there are gender differences for QST measures in current perception threshold (CPT), vibration threshold (VT) and pressure pain (PP) threshold and tolerance for this patient population. Methods: The cross-sectional study was done at MacHAND Clinical Research Lab of McMaster University with 34 surgical and 10 nonsurgical patients with shoulder disorder. Participants were asked to complete self-reported outcome measures about pain (numeric pain rating, pain catastrophizing, shoulder pain and disability index) and health status (SF-12). Participants completed QST at 4 standardized locations and then the shoulder functional performance test (FIT-HANSA). Pearson's r was computed to find out relationships between QST variables and patient factors with either pain, function or health status. Eight regression models were built to analysis QST's and patient factors separately as predictors of either pain, function or health status. An independent sample t-test was done to evaluate the gender effect on QST. Results: Greater PP threshold and PP tolerance was significantly correlated with better shoulder functional performance (r =.31-.44) and less self-reported shoulder disability (r = -.32 to -.36). VT or CPT were not significantly related to pain, function or health status, with the exception of VT on the little finger where lower threshold was correlated to a lower pain intensity (r = .50) and better functional performance (r = -.34). Higher comorbidity was consistently correlated (r =.31-.46) with poorer pain, function and health status. Older age was correlated to more pain intensity and less function (r =.31-.57). In multivariate models, Patient factors contributed significantly to pain, function or health status models (r2 =.19-.36); whereas QST did not. QST was significantly different between males and females [in PP threshold (3.9-6.2, p < .001) and PP tolerance (7.6-12.6, p < .001) and CPT (1.6-2.3, p =.02)]. Conclusions: Psychophysical dimensions and patient factors (gender, age and comorbidity) affect self-reported and performance-based outcome measures in shoulder disorder. Given the multivariate nature of disability, large samples are required to identify the most important predictors and interactions.
Critical Reviews in Physical and Rehabilitation Medicine, 2013
The objective of this study was to evaluate the reliability and validity of current perception th... more The objective of this study was to evaluate the reliability and validity of current perception threshold (CPT) tests in patients with mechanical neck disorder (MND). The rapid CPT protocol was performed at 3 frequencies (5, 250, and 2000 Hz) using 3 dermatomal locations (C6-C8) on the hand of patients with MND (n = 106). A subset of patients (n = 34) was reassessed at a second visit to determine the test-retest reliability. The fingertips of both hands were assessed for intertrial reliability. Internal consistencies of CPT between frequencies were calculated from CPT test scores in the most affected hand. The construct validity of CPT was evaluated by correlating the 3 composite scores derived the from the CPT tests with the Neck Disability Index (NDI) and Cervical Spine Outcomes Questionnaire (CSOQ). Intertrial reliability was good to excellent (intraclass correlation coefficient (ICC), 0.73-0.82; P < 0.001). The test-retest reliability of CPT scores was fair to excellent (ICC, 0.47-0.86; P < 0.001). The mean retest difference and the 95% limits of agreement were -0.3 ± 3 for both 2000 and 250 Hz and 0.1 ± 3.9 for 5 Hz. A small to medium-sized correlation was found between CPT and NDI or CSOQ (r = 0.24-0.37). CPT was consistent across occasions and was associated with neck disability.
The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patie... more The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patient factors predict pain-related disability in patients with neck pain (NP), and to determine if PPS differs by gender. Forty-four participants with a moderate level of chronic NP were recruited for this cross sectional study. All participants were asked to complete self-reported assessments of pain, disability and comorbidity and then underwent PPS testing at 4-selected body locations. Pearson`s r w was computed to explore relationships between the PPS measures and the self-reported assessments. Regression models were built to identify predictors of pain and disability. An independent sample t-test was done to identify gender-related differences in PPS, pain-disability and comorbidity. In this study, greater PPS (threshold and tolerance) was significantly correlated to lower pain-disability (r = -.30 to -.53, p≤0.05). Age was not correlated with pain or disability but comorbidity was (r= 0.42-.43, p≤0.01). PPS at the 4-selected body locations was able to explain neck disability (R 2 =25-28%). Comorbidity was the strongest predictor of neck disability (R 2 =30%) and pain (R 2 =25%). Significant mean differences for gender were found in PPS, disability and comorbidity, but not in pain intensity or rating. This study suggests that PPS may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues.
Accurate assessment of pain or sensory function in clinical practice is challenging. Quantitative... more Accurate assessment of pain or sensory function in clinical practice is challenging. Quantitative Sensory Testing (QST) is a standardized approach to measuring pain and sensory thresholds or tolerances as a means of assessing the functionality of neural pathways from the receptors along the afferent fibers to the brains. This paper reviews two simple QST techniques potentially useful to clinical practice: the Cold Stress Test and Ten Test. The background, evidence for clinical measurement properties and feasibility issues are considered.
Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pat... more Hypersensitivity is a phenomenon that has a dual role: adaptive (protective) and maladaptive (pathological) based on different aspects of the pain mechanism. The mechanism of hypersensitivity has not been fully defined. However, it is known that over-excitability (too much sensitivity) of neurons can arise in both peripheral and central components of the nervous system. Pain theories can be useful in helping to explain complex phenomenon like hypersensitivity. The Gate control theory and other more bio-psychological pain models may assist us to understand a mechanism of chronic musculoskeletal pain. This article discusses a mechanism based pain model.
ABSTRACT We propose an analytical five-parameter potential function for stable diatomic molecules... more ABSTRACT We propose an analytical five-parameter potential function for stable diatomic molecules V(x) = K/x(3) - e(-tx)(a + bx + cx(2)). Here x=r/r(e), where r is the internuclear distance and re the equilibrium bond length. K, t, a, b, c are five parameters of the function, which are obtained from molecular spectroscopic data in terms of known molecular constants. (C) 2012 Physics Essays Publication. [DOI: 10.4006/0836-1398-25.4.540]
indicators for the Clearing House and the measures could complement indicators on clinical qualit... more indicators for the Clearing House and the measures could complement indicators on clinical quality of providers from the NIH Promis initiative in the United States (or the NHS Proms in the UK). METHODS: The concept development is relevant for chronic care. Five domains represent outpatient drug care: information, communication access, trust and clinical quality. Four process measures and one access measure are proposed with series of 5 -7 items, tested on pharmacy delivery systems and dispensing doctors.The trust indicator has been identified as critical for the US drug delivery system and discussed as an example. RESULTS: Trust adresses the potential patient mistrust when cost interfere with clinical judgement. The process measure is calculated for prescribing and treatment decisions for Hypertension, Diabetes and Asthma.It is a rate base measure . The Facct scoring method is modified to integrate minima in low score values. Mean scores are calculated on samples per practice. Missing values are replaced by mean value. The evidence from the UK PCT on a scale of 0-100, for three practices show scores of 66.78; 63.82;73.92 and 67.72 for the whole sample with a Cronbach of 0.70. CONCLUSIONS: A composite indicator is envisaged for diffferent decision points in clinical practices. It is to be linked to clinical decision points from the Adaptive Knowledge Platform (AKP) (Huttin, Liebamn, 2011) on breast cancer and could fit the requirements for the 12 rules for EGD in cancer. Validations in additional organisations of care and delivery systems are planned in further validation stages.
The prevalence of obesity (BMI ≥30) remains above 35% and when combined with the overweight popul... more The prevalence of obesity (BMI ≥30) remains above 35% and when combined with the overweight population (BMI ≥25), the age-adjusted prevalence is 68.8%. The objective was to develop a model demonstrating the cost savings associated with the prevention of hypertension (HTN), diabetes (DM), and dyslipidemia (DLP) in an overweight and obese population by treating patients with phentermine/topiramate extended-release (ER) in conjunction with lifestyle modification. METHODS: A 1-year model was developed using data from the National Health and Nutrition Examination Survey (NHANES), clinical trial data, and published literature. The model estimates the cost of incident cases of HTN, DM and DLP in an overweight and obese population. Rates of progression to comorbidities are based on patients who progressed from no medication use for comorbidities at baseline to at least one medication at endpoint in the CONQUER study in obese and overweight subjects with ≥2 comorbidities. The risk of progression to HTN, DM, and DLP is applied to literature-based cost estimates to calculate the per-patient annual cost savings associated with phentermine/topiramate ER compared with lifestyle modification alone. RESULTS: The average cost savings per patient associated with the prevention of comorbidities with phentermine/topiramate ER compared with lifestyle modification alone is $179.06, $177.44, and no savings in grade 1 (BMI ≥30), grade 2 (BMI ≥35), and grade 3 (BMI ≥40) obese populations, respectively. HTN-specific cost savings ranged from $40.20 for grade 2 obesity to $10.42 for grade 3 obesity. DM-specific cost savings ranged from $109.23 for grade 2 obesity to no savings for grade 3 obesity. DLP-specific cost savings ranged from $56.02 for grade 1 obesity to $28.01 for grade 2 obesity. CONCLUSIONS: This analysis suggests that treatment with phentermine/topiramate ER may be associated with cost savings by preventing the development of comorbidities in overweight or obese patients.
The hyperfine (hf) structure of some spectral lines of the praseodymium atom has been investigate... more The hyperfine (hf) structure of some spectral lines of the praseodymium atom has been investigated by the laser-induced fluorescence method in a hollow cathode discharge lamp. We report the discovery of 18 new energy levels of even parity and 22 new energy levels of odd parity and their magnetic dipole hf interaction constants A. Using these newly discovered levels, 268 lines were classified by means of laser spectroscopy, 97 of them by laser excitation and 171 via laser-induced fluorescence. In addition, 23 lines, observed in a Fourier transform spectrum, were classified by means of their wavenumbers and their hf patterns.
Journal of Physics B: Atomic, Molecular and Optical Physics, 2012
Abstract Hyperfine structure (hf) patterns of unclassified spectral lines of the praseodymium ato... more Abstract Hyperfine structure (hf) patterns of unclassified spectral lines of the praseodymium atom, as appear in a high-resolution Fourier transform spectrum, have been simulated. In this way, the J-values and hf constants of the levels involved in the transitions were ...
Journal of Physics B: Atomic, Molecular and Optical Physics, 2011
ABSTRACT We report the recording of new highly resolved Fourier transform spectra of the neutral ... more ABSTRACT We report the recording of new highly resolved Fourier transform spectra of the neutral praseodymium atom. With the help of the new spectra we found about 9000 new lines from which---in the region 3260 to 9880 Å---1194 could be classified as transitions between energy levels of the Pr atom and 19 as transitions of the Pr ion. Twenty-three new atomic energy levels of odd parity and one of even parity were discovered during this first examination. The spectra might be very helpful for further laser spectroscopic investigations of the hyperfine structure of Pr I and Pr II transitions.
Journal of Orthopaedic & Sports Physical Therapy, 2014
T T CONCLUSION: CPT testing has moderate discriminatory accuracy, specificity, and sensitivity fo... more T T CONCLUSION: CPT testing has moderate discriminatory accuracy, specificity, and sensitivity for classification of MND categories into neck pain with or without neurological signs.
ABSTRACT Introduction Touch threshold screening instruments must accurately distinguish normal ve... more ABSTRACT Introduction Touch threshold screening instruments must accurately distinguish normal versus abnormal sensation to screen nerve pathology. This study was conducted to find out whether two touch threshold measuring devices (i.e. Weinstein Enhanced Sensory Test (WEST) and Pressure-Specified Sensory Device (PSSD) provide consistent results and indicators of “normal” sensation, and secondarily what rules best define normality. Methods The study design was a cross-sectional reliability and validity assessment with 23 healthy participants. Instruments were applied in random order on the pulp of the middle and little fingers of both hands; with five applications on each digit. Cut-offs of 3, 4, and 5 correct responses were used to classify the response as being normal. Weighted kappa and percent agreement were used to indicate test–retest reliability of the WEST, and validity was determined by calculating the percentage of normal controls that achieved a normal score. The Bland–Altman method was used to characterize the retest reliability of PSSD, and validity was determined by whether the mean of the score is different from the normative scores. Results The agreement between test and retest of WEST (detection level = 3/5) was almost perfect (k = 1). The average percentages of normal detection of the WEST on two test/retest were 93% and 97% (detection level = 4/5) and 82% and 85% (detection level = 5/5). All mean PSSD tests values were found within the predetermined normal range. The Bland–Altman plot demonstrated a minimal mean difference between test occasions and similar limits of agreement across the four test locations. Discussion The study found that more than 90% of the tests with healthy young participants were reliable and valid in relation to their ability to detect a normal WEST filament or PSSD within a normal force range. Our study was limited by a small sample with healthy participants.
Critical Reviews in Physical and Rehabilitation Medicine, 2012
Executive function (EF) is a control mechanism of human cognition that provides the capability to... more Executive function (EF) is a control mechanism of human cognition that provides the capability to select actions in relation to internal goals organized by the prefrontal cortex (PFC). The PFC is essential for the temporal integration of sensory information in the sequencing of optimum motor behavior to achieve an internal goal. The temporal integration of sensory information also explains why the PFC has an additional role in the central modulation of pain. Pain modulation and motor function are altered in chronic pain, and this alteration can contribute to the reduced physical activity. EF is the driver of conscious control of thought and action that is critical to rehabilitation in chronic pain. However, EF is impaired in chronic pain. Rehabilitation practitioners typically use activity modification, exercise, and movement to enhance function in patients with chronic pain; exercise has beneficial effects on EF. However, impairments in EF can be barriers to adherence to exercise, activity, and lifestyle modifications required to optimize rehabilitation. Greater awareness of EF can enhance rehabilitation. This narrative review explores current theories of EF structure and function, how impairment of EF can be assessed in a clinical context, and its implications for rehabilitation in chronic pain.
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