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The Journal of Manual & Manipulative... Jun 2023To describe variability in spinal manipulation technique details and adverse event (AE) documentation of spinal manipulation during pregnancy. (Review)
Review
OBJECTIVE
To describe variability in spinal manipulation technique details and adverse event (AE) documentation of spinal manipulation during pregnancy.
METHODS
Five databases were searched for peer-reviewed investigations of spinal manipulation during pregnancy. Criteria for inclusion was as follows: high velocity, low amplitude thrust manipulation performed, subjects pregnant during manipulation, and English language. Studies were excluded when participants were not currently pregnant, and when the manipulation performed was not high-velocity, low-amplitude thrust. Data extraction included study design, number of participants, gestational age, spinal region, number of manipulations, manipulation technique details, profession of manipulator, AE reporting (Yes vs. No), type, and number of AE.
RESULTS
Out of 18 studies included in the review, only three provide details of the spinal manipulation technique. The reported variables include patient position, practitioner position, and direction of thrust. Fourteen studies documented AE; however, only seven provide AE details.
DISCUSSION
Reporting of spinal manipulation techniques and AE during pregnancy were inconsistent. Replication of methods in future investigations is limited without more detailed documentation of manipulation techniques performed. Furthermore, determining the relative risk and safety of spinal manipulation during pregnancy is not possible without more detailed reporting of AE. Due to these inconsistencies, a checklist is proposed for standardized reporting of spinal manipulation techniques and AE. With more consistent reporting of these parameters, results of future investigations may allow for more definitive and generalizable safety recommendations on spinal manipulation during pregnancy.
Topics: Humans; Pregnancy; Female; Manipulation, Spinal; Risk; Posture; Checklist
PubMed: 36047253
DOI: 10.1080/10669817.2022.2118653 -
Neuron Oct 2019Scientific experimentation depends on the artificial control of natural phenomena. The inaccessibility of cognitive processes to direct manipulation can make such... (Review)
Review
Scientific experimentation depends on the artificial control of natural phenomena. The inaccessibility of cognitive processes to direct manipulation can make such control difficult to realize. Here, we discuss approaches for overcoming this challenge. We advocate the incorporation of experimental techniques from sensory psychophysics into the study of cognitive processes such as decision making and executive control. These techniques include the use of simple parameterized stimuli to precisely manipulate available information and computational models to jointly quantify behavior and neural responses. We illustrate the potential for such techniques to drive theoretical development, and we examine important practical details of how to conduct controlled experiments when using them. Finally, we highlight principles guiding the use of computational models in studying the neural basis of cognition.
Topics: Animals; Cognition; Cognitive Neuroscience; Computer Simulation; Decision Making; Decision Theory; Executive Function; Humans; Psychophysics; Research Design
PubMed: 31600507
DOI: 10.1016/j.neuron.2019.09.016 -
Sports Medicine (Auckland, N.Z.) Nov 2020Autoregulation is a process that is used to manipulate training based primarily on the measurement of an individual's performance or their perceived capability to... (Review)
Review
Autoregulation is a process that is used to manipulate training based primarily on the measurement of an individual's performance or their perceived capability to perform. Despite being established as a training framework since the 1940s, there has been limited systematic research investigating its broad utility. Instead, researchers have focused on disparate practices that can be considered specific examples of the broader autoregulation training framework. A primary limitation of previous research includes inconsistent use of key terminology (e.g., adaptation, readiness, fatigue, and response) and associated ambiguity of how to implement different autoregulation strategies. Crucially, this ambiguity in terminology and failure to provide a holistic overview of autoregulation limits the synthesis of existing research findings and their dissemination to practitioners working in both performance and health contexts. Therefore, the purpose of the current review was threefold: first, we provide a broad overview of various autoregulation strategies and their development in both research and practice whilst highlighting the inconsistencies in definitions and terminology that currently exist. Second, we present an overarching conceptual framework that can be used to generate operational definitions and contextualise autoregulation within broader training theory. Finally, we show how previous definitions of autoregulation fit within the proposed framework and provide specific examples of how common practices may be viewed, highlighting their individual subtleties.
Topics: Homeostasis; Humans; Research Design; Resistance Training
PubMed: 32813181
DOI: 10.1007/s40279-020-01330-8 -
The Journal of Cardiovascular Surgery Jun 2023All endovascular procedures need an effective anticoagulation regimen that avoids thrombo-embolic complications due to the insertion and manipulation of various... (Review)
Review
All endovascular procedures need an effective anticoagulation regimen that avoids thrombo-embolic complications due to the insertion and manipulation of various intravascular devices. Systemic heparinization reduces the risk of thrombosis but there is no conclusive evidence regarding the correct use of anticoagulant medications and accordant monitoring, especially in endovascular peripheral arterial procedures. Anticoagulation must be maintained during the whole vascular procedure, especially during partial or complete blood flow interruption. Reaching and maintaining the correct coagulative status is mandatory to avoid or reduce thromboembolic complications that could limit the procedure's effectiveness or be harmful to the patient. Patients' baseline variables and procedure-related elements can influence the way anticoagulation should be administered and how coagulative status has to be monitored. This review aimed to clarify the critical points of anticoagulation and monitoring management for non-cardiac arterial procedures in order to understand the best way to manage vascular procedures anticoagulation.
Topics: Humans; Anticoagulants; Blood Coagulation; Thromboembolism; Thrombosis; Arteries; Endovascular Procedures
PubMed: 37260152
DOI: 10.23736/S0021-9509.23.12703-0 -
BMC Medical Research Methodology Feb 2021Natural or quasi experiments are appealing for public health research because they enable the evaluation of events or interventions that are difficult or impossible to... (Review)
Review
BACKGROUND
Natural or quasi experiments are appealing for public health research because they enable the evaluation of events or interventions that are difficult or impossible to manipulate experimentally, such as many policy and health system reforms. However, there remains ambiguity in the literature about their definition and how they differ from randomized controlled experiments and from other observational designs. We conceptualise natural experiments in the context of public health evaluations and align the study design to the Target Trial Framework.
METHODS
A literature search was conducted, and key methodological papers were used to develop this work. Peer-reviewed papers were supplemented by grey literature.
RESULTS
Natural experiment studies (NES) combine features of experiments and non-experiments. They differ from planned experiments, such as randomized controlled trials, in that exposure allocation is not controlled by researchers. They differ from other observational designs in that they evaluate the impact of events or process that leads to differences in exposure. As a result they are, in theory, less susceptible to bias than other observational study designs. Importantly, causal inference relies heavily on the assumption that exposure allocation can be considered 'as-if randomized'. The target trial framework provides a systematic basis for evaluating this assumption and the other design elements that underpin the causal claims that can be made from NES.
CONCLUSIONS
NES should be considered a type of study design rather than a set of tools for analyses of non-randomized interventions. Alignment of NES to the Target Trial framework will clarify the strength of evidence underpinning claims about the effectiveness of public health interventions.
Topics: Bias; Causality; Humans; Public Health; Research Design
PubMed: 33573595
DOI: 10.1186/s12874-021-01224-x -
Digestive Surgery 2019Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical...
BACKGROUND
Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure.
OBJECTIVE
The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions.
METHODS
A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea.
RESULTS
Early concerns regarding port site/peritoneal metastasis after laparoscopic surgery have been abated by improved preoperative recognition of GBC and careful manipulation to avoid bile spillage. There is no evidence that laparoscopic surgery is associated with decreased survival compared with open surgery in patients with early-stage GBC if definitive resection during/after laparoscopic cholecystectomy is performed. Although experience with laparoscopic extended cholecystectomy for GBC has been limited to a few experts, the postoperative and survival outcomes were similar between laparoscopic and open surgeries. Laparoscopic reoperation for postoperatively diagnosed GBC is technically challenging, but its feasibility has been demonstrated by a few experts.
CONCLUSIONS
Laparoscopic surgery for GBC is still in the early phase of the adoption curve, and more evidence is required to assess this procedure.
Topics: Cholecystectomy, Laparoscopic; Consensus; Contraindications, Procedure; Gallbladder Neoplasms; Hepatectomy; Humans; Incidental Findings; Lymph Node Excision; Patient Selection; Practice Guidelines as Topic; Reoperation; Survival Rate
PubMed: 29339660
DOI: 10.1159/000486207 -
Molecular Psychiatry Jan 2023Oxytocin, a neuropeptide known for its role in reproduction and socioemotional processes, may hold promise as a therapeutic agent in treating social impairments in... (Review)
Review
Oxytocin, a neuropeptide known for its role in reproduction and socioemotional processes, may hold promise as a therapeutic agent in treating social impairments in patient populations. However, research has yet to uncover precisely how to manipulate this system for clinical benefit. Moreover, inconsistent use of standardized and validated oxytocin measurement methodologies-including the design and study of hormone secretion and biochemical assays-present unresolved challenges. Human studies measuring peripheral (i.e., in plasma, saliva, or urine) or central (i.e., in cerebrospinal fluid) oxytocin concentrations have involved very diverse methods, including the use of different assay techniques, further compounding this problem. In the present review, we describe the scientific value in measuring human endogenous oxytocin concentrations, common issues in biochemical analysis and study design that researchers face when doing so, and our recommendations for improving studies using valid and reliable methodologies.
Topics: Humans; Oxytocin; Neuropeptides; Saliva; Research Design; Plasma
PubMed: 35999276
DOI: 10.1038/s41380-022-01719-z -
Environmental Health : a Global Access... Aug 2021Critical knowledge of what we know about health and disease, risk factors, causation, prevention, and treatment, derives from epidemiology. Unfortunately, its methods...
BACKGROUND
Critical knowledge of what we know about health and disease, risk factors, causation, prevention, and treatment, derives from epidemiology. Unfortunately, its methods and language can be misused and improperly applied. A repertoire of methods, techniques, arguments, and tactics are used by some people to manipulate science, usually in the service of powerful interests, and particularly those with a financial stake related to toxic agents. Such interests work to foment uncertainty, cast doubt, and mislead decision makers by seeding confusion about cause-and-effect relating to population health. We have compiled a toolkit of the methods used by those whose interests are not aligned with the public health sciences. Professional epidemiologists, as well as those who rely on their work, will thereby be more readily equipped to detect bias and flaws resulting from financial conflict-of-interest, improper study design, data collection, analysis, or interpretation, bringing greater clarity-not only to the advancement of knowledge, but, more immediately, to policy debates.
METHODS
The summary of techniques used to manipulate epidemiological findings, compiled as part of the 2020 Position Statement of the International Network for Epidemiology in Policy (INEP) entitled Conflict-of-Interest and Disclosure in Epidemiology, has been expanded and further elucidated in this commentary.
RESULTS
Some level of uncertainty is inherent in science. However, corrupted and incomplete literature contributes to confuse, foment further uncertainty, and cast doubt about the evidence under consideration. Confusion delays scientific advancement and leads to the inability of policymakers to make changes that, if enacted, would-supported by the body of valid evidence-protect, maintain, and improve public health. An accessible toolkit is provided that brings attention to the misuse of the methods of epidemiology. Its usefulness is as a compendium of what those trained in epidemiology, as well as those reviewing epidemiological studies, should identify methodologically when assessing the transparency and validity of any epidemiological inquiry, evaluation, or argument. The problems resulting from financial conflicting interests and the misuse of scientific methods, in conjunction with the strategies that can be used to safeguard public health against them, apply not only to epidemiologists, but also to other public health professionals.
CONCLUSIONS
This novel toolkit is for use in protecting the public. It is provided to assist public health professionals as gatekeepers of their respective specialty and subspecialty disciplines whose mission includes protecting, maintaining, and improving the public's health. It is intended to serve our roles as educators, reviewers, and researchers.
Topics: Conflict of Interest; Epidemiologic Methods; Research Design; Uncertainty
PubMed: 34412643
DOI: 10.1186/s12940-021-00771-6 -
SLAS Technology Feb 2022Increasing the level of automation in pharmaceutical laboratories and production facilities plays a crucial role in delivering medicine to patients. However, the... (Review)
Review
Increasing the level of automation in pharmaceutical laboratories and production facilities plays a crucial role in delivering medicine to patients. However, the particular requirements of this field make it challenging to adapt cutting-edge technologies present in other industries. This article provides an overview of relevant approaches and how they can be utilized in the pharmaceutical industry, especially in development laboratories. Recent advancements include the application of flexible mobile manipulators capable of handling complex tasks. However, integrating devices from many different vendors into an end-to-end automation system is complicated due to the diversity of interfaces. Therefore, various approaches for standardization are considered in this article, and a concept is proposed for taking them a step further. This concept enables a mobile manipulator with a vision system to "learn" the pose of each device and - utilizing a barcode - fetch interface information from a universal cloud database. This information includes control and communication protocol definitions and a representation of robot actions needed to operate the device. In order to define the movements in relation to the device, devices have to feature - besides the barcode - a fiducial marker as standard. The concept will be elaborated following appropriate research activities in follow-up papers.
Topics: Automation, Laboratory; Humans; Laboratories; Robotic Surgical Procedures; Robotics
PubMed: 35058216
DOI: 10.1016/j.slast.2021.11.003 -
Proceedings of the National Academy of... May 2021Harnessing placebo and nocebo effects has significant implications for research and medical practice. Placebo analgesia and nocebo hyperalgesia, the most well-studied... (Randomized Controlled Trial)
Randomized Controlled Trial
Harnessing placebo and nocebo effects has significant implications for research and medical practice. Placebo analgesia and nocebo hyperalgesia, the most well-studied placebo and nocebo effects, are thought to initiate from the dorsal lateral prefrontal cortex (DLPFC) and then trigger the brain's descending pain modulatory system and other pain regulation pathways. Combining repeated transcranial direct current stimulation (tDCS), an expectancy manipulation model, and functional MRI, we investigated the modulatory effects of anodal and cathodal tDCS at the right DLPFC on placebo analgesia and nocebo hyperalgesia using a randomized, double-blind and sham-controlled design. We found that compared with sham tDCS, active tDCS could 1) boost placebo and blunt nocebo effects and 2) modulate brain activity and connectivity associated with placebo analgesia and nocebo hyperalgesia. These results provide a basis for mechanistic manipulation of placebo and nocebo effects and may lead to improved clinical outcomes in medical practice.
Topics: Adult; Analgesia; Analysis of Variance; Brain; Double-Blind Method; Female; Humans; Hyperalgesia; Magnetic Resonance Imaging; Male; Nocebo Effect; Pain; Pain Management; Placebo Effect; Prefrontal Cortex; Surveys and Questionnaires; Transcranial Direct Current Stimulation; Young Adult
PubMed: 33941677
DOI: 10.1073/pnas.2101273118