Correlation of Body Composition and Low Back Pain Severity in a Cross-Section of US Veterans.

OBJECTIVE: Back pain is more prevalent in the obese, but whether back pain severity is directly correlated to obesity in veterans is unknown. We sought to determine if there was a correlation between body composition and low back pain severity in a sample of veterans. The hypothesis was that veterans with higher body mass index values would report higher low back pain severity scores. METHODS: This study was a retrospective chart review of 1768 veterans presenting to a Veterans Affairs chiropractic clinic with a chief complaint of low back pain between January 1, 2009 and December 31, 2014. Spearman's rho was used to test for correlation between body composition as measured by body mass index and low back pain severity as measured by the Back Bournemouth Questionnaire. RESULTS: On average, the sample was predominantly male (91%), older than 50, and overweight (36.5%) or obese (48.9%). There was no correlation between body mass index and Back Bournemouth Questionnaire scores, r = .088, p < .001. CONCLUSIONS: The majority of veterans with low back pain in this sample were either overweight or obese. There was no correlation between body composition and low back pain severity in this sample of veterans.

Effects of low-frequency naval sonar exposure on three species of fish.

To address growing concern over the impact of anthropogenic sound on fishes, a series of experiments was conducted that exposed several fish species to high-intensity low-frequency naval sonar. This study extends auditory findings by adding largemouth bass, yellow perch, and channel catfish. No effects on hearing were found in largemouth bass and yellow perch and only small effects in channel catfish (a fish with morphological adaptations for enhanced pressure reception). Together with prior findings, these results suggest limited impact on hearing from high-intensity sonar. Susceptibility may be due to genetic stock, developmental conditions, seasonal variation, and/or buoyancy during exposure.

Effects of mid-frequency active sonar on hearing in fish.

Caged fish were exposed to sound from mid-frequency active (MFA) transducers in a 5 × 5 planar array which simulated MFA sounds at received sound pressure levels of 210 dB SPL(re 1 µPa). The exposure sound consisted of a 2 s frequency sweep from 2.8 to 3.8 kHz followed by a 1 s tone at 3.3 kHz. The sound sequence was repeated every 25 s for five repetitions resulting in a cumulative sound exposure level (SEL(cum)) of 220 dB re 1 µPa(2) s. The cumulative exposure level did not affect the hearing sensitivity of rainbow trout, a species whose hearing range is lower than the frequencies in the presented MFA sound. In contrast, one cohort of channel catfish showed a statistically significant temporary threshold shift of 4-6 dB at 2300 Hz, but not at lower tested frequencies, whereas a second cohort showed no change. It is likely that this threshold shift resulted from the frequency spectrum of the MFA sound overlapping with the upper end of the hearing frequency range of the channel catfish. The observed threshold shifts in channel catfish recovered within 24 h. There was no mortality associated with the MFA sound exposure used in this test.

Variation Within and Among Vitis spp. for Foliar Resistance to the Powdery Mildew Pathogen Erysiphe necator.

To complement existing control strategies, grape growers desire cultivars with resistance to powdery mildew caused by Erysiphe necator. Numerous disease resistance screens of diverse Vitis germplasm have been conducted previously to identify powdery mildew resistance but ratings of named cultivars were inconsistent and identities of resistant individuals in wild species were not typically provided. In the current study, controlled inoculations of a single isolate were made onto detached leaves from 1,025 Vitis accessions. The results were compared with natural epidemics in two vineyards: the cold-hardy Vitis spp. repository in Geneva, NY, in 2007-08, and a replicated vineyard of 89 Vitis accessions in Fredonia, NY in 2006-08. Of the genotypes screened using both natural infection and single-isolate inoculation, 33% were resistant to a single isolate but susceptible to diverse isolates in either or both vineyards, possibly due to race-specific resistance. This was exemplified by selection of E. necator genotypes virulent to Vitis labrusca in the Fredonia, NY vineyard, which is surrounded by production of the interspecific labrusca hybrids Concord and Niagara. Otherwise, there was good correlation of ratings between the vineyard and single-isolate ratings (r = 0.55 to 0.56) and between Geneva and Fredonia vineyard ratings (r = 0.75). No accession rated in all three screens was immune from infection. Although individual accessions of V. aestivalis, V. palmata, Vitis × doaniana, and Ampelopsis brevipedunculata were resistant in Geneva and Fredonia, each well-represented species had notable intraspecific variation in resistance. For 129 interspecific hybrids in this and previous studies, ratings infrequently corresponded among previous studies (39%) and between the current and previous studies (17 to 46%). However, three cultivars (Cayuga White, Diana, and Mars) were consistently rated as resistant across four independent studies. The results underscore the importance of uniform testing in multiple environments and the need for strategies for the development of cultivars with durable resistance.

Chiropractic management for veterans with neck pain: a retrospective study of clinical outcomes.

OBJECTIVE: The purpose of this study was to report demographic characteristics, chiropractic treatment methods and frequency, and clinical outcomes for chiropractic management of neck pain in a sample of veteran patients. METHODS: This is a retrospective case series of 54 veterans with a chief complaint of neck pain who received chiropractic care through a Veterans Health Administration medical center. Descriptive statistics and paired t tests were used with the numeric rating scale and Neck Bournemouth Questionnaire serving as the outcome measures. A minimum clinically important difference was set as 30% improvement from baseline for both outcomes. RESULTS: The mean number of chiropractic treatments was 8.7. For the numeric rating scale, the mean raw score improvement was 2.6 points, representing 43% change from baseline. For the Neck Bournemouth Questionnaire, the mean raw score improvement was 13.9 points, representing 33% change from baseline. For both measures, 36 (67%) patients met or exceeded the minimum clinically important difference. CONCLUSION: Mean chiropractic clinical outcomes were both statistically significant and clinically meaningful for this sample of veterans presenting with neck pain.

Microarray analysis of replicate populations selected against a wing-shape correlation in Drosophila melanogaster.

We selected bidirectionally to change the phenotypic correlation between two wing dimensions in Drosophila melanogaster and measured gene expression differences in late third instar wing disks, using microarrays. We tested an array of 12 selected lines, including 10 from a Massachusetts population (5 divergently selected pairs) and 2 from a California population (1 divergently selected pair). In the Massachusetts replicates, 29 loci showed consistent, significant expression differences in all 5 line-pair comparisons. However, the significant loci in the California lines were almost completely different from these. The disparity between responding genes in different gene pools confirms recent evidence that surprisingly large numbers of loci can affect wing shape. Our results also show that with well-replicated selection lines, of large effective size, the numbers of candidate genes in microarray-based searches can be reduced to realistic levels.

A cross-sectional analysis of clinical outcomes following chiropractic care in veterans with and without post-traumatic stress disorder.

This study was a cross-sectional analysis of clinical outcomes for 130 veteran patients with neck or low back complaints completing a course of care within the chiropractic clinic at the VA of Western New York in 2006. Multivariate analysis of variance (MANOVA) was utilized, comparing baseline and discharge scores for both the neck and low back regions and for those patients with and without post-traumatic stress disorder (PTSD). Patients with PTSD (n = 21) experienced significantly lower levels of score improvement than those without PTSD (n = 119) on self-reported outcome measures of neck and low back disability. These findings, coupled with the theorized relationships between PTSD and chronic pain, suggest that the success of conservative forms of management for veteran patients with musculoskeletal disorders may be limited by the presence of PTSD. Further research is warranted to examine the potential contributions of PTSD on chiropractic clinical outcomes with this unique patient population.

Retrospective case series of clinical outcomes associated with chiropractic management for veterans with low back pain.

Musculoskeletal complaints, most notably low back pain (LBP), are prevalent among veterans. Despite a focus on LBP management by chiropractors within the Veterans Health Administration, limited published accounts detail clinical outcomes with chiropractic management of LBP among veterans. This was a retrospective case series of 171 veterans with a chief complaint of LBP who were managed with chiropractic care. Descriptive statistics and paired t-tests were used, with the Numeric Rating Scale (NRS) and the Back Bournemouth Questionnaire (BBQ) serving as the outcome measures. A minimum clinically important difference (MCID) was set as 30% improvement from baseline for both measures. The mean number of treatments was 8.7. For the NRS, the mean raw score improvement was 2.2 points, representing 37.4% change from baseline; 103 (60.2%) patients met or exceeded the MCID. For the BBQ, the mean raw score improvement was 13.6 points, representing 34.6% change from baseline; 92 patients (53.8%) met or exceeded the MCID. For this sample of veterans with LBP, the mean percentages of clinical improvement were statistically significant and clinically meaningful for both the NRS and BBQ.

Preliminary analysis of posttraumatic stress disorder screening within specialty clinic setting for OIF/OEF veterans seeking care for neck or back pain.

Escalating prevalence estimates of posttraumatic stress disorder (PTSD) among recently returning Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans highlight the need for early detection and management for reducing chronic mental illness and disability. Because PTSD and chronic pain are common comorbid conditions among veterans, PTSD screening within specialty clinic settings addressing musculoskeletal pain may be of value. This retrospective study evaluated measures of diagnostic value for the PTSD Checklist (PCL) for a sample (n = 79) of OIF/OEF veterans seeking care for neck or back pain within a Department of Veterans Affairs specialty clinic. Because published accounts of optimal PCL cutoff scores vary considerably, we used receiver operating characteristic curves to identify whether the optimal PCL cutoff score for the sample differed from a conventional cutoff score of 50. A clinical psychologist experienced in diagnosing and managing PTSD confirmed the diagnosis of PTSD for 37 veterans through a review of clinical records. The prevalence of diagnosed PTSD was 46.8%, with an optimal PCL cutoff score of 44. These findings may guide future research and influence clinical practice regarding PTSD screening for recently returning veterans with chronic pain.