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Sample records for trigger point injections

  1. A new look at trigger point injections.

    Science.gov (United States)

    Wong, Clara S M; Wong, Steven H S

    2012-01-01

    Trigger point injections are commonly practised pain interventional techniques. However, there is still lack of objective diagnostic criteria for trigger points. The mechanisms of action of trigger point injection remain obscure and its efficacy remains heterogeneous. The advent of ultrasound technology in the noninvasive real-time imaging of soft tissues sheds new light on visualization of trigger points, explaining the effect of trigger point injection by blockade of peripheral nerves, and minimizing the complications of blind injection.

  2. A New Look at Trigger Point Injections

    OpenAIRE

    Wong, Clara S. M.; Wong, Steven H. S.

    2012-01-01

    Trigger point injections are commonly practised pain interventional techniques. However, there is still lack of objective diagnostic criteria for trigger points. The mechanisms of action of trigger point injection remain obscure and its efficacy remains heterogeneous. The advent of ultrasound technology in the noninvasive real-time imaging of soft tissues sheds new light on visualization of trigger points, explaining the effect of trigger point injection by blockade of peripheral nerves, and ...

  3. Ischemic Compression After Trigger Point Injection Affect the Treatment of Myofascial Trigger Points

    OpenAIRE

    Kim, Soo A; Oh, Ki Young; Choi, Won Hyuck; Kim, In Kyum

    2013-01-01

    Objective To investigate the effects of trigger point injection with or without ischemic compression in treatment of myofascial trigger points in the upper trapezius muscle. Methods Sixty patients with active myofascial trigger points in upper trapezius muscle were randomly divided into three groups: group 1 (n=20) received only trigger point injections, group 2 (n=20) received trigger point injections with 30 seconds of ischemic compression, and group 3 (n=20) received trigger point injectio...

  4. Ischemic compression after trigger point injection affect the treatment of myofascial trigger points.

    Science.gov (United States)

    Kim, Soo A; Oh, Ki Young; Choi, Won Hyuck; Kim, In Kyum

    2013-08-01

    To investigate the effects of trigger point injection with or without ischemic compression in treatment of myofascial trigger points in the upper trapezius muscle. SIXTY PATIENTS WITH ACTIVE MYOFASCIAL TRIGGER POINTS IN UPPER TRAPEZIUS MUSCLE WERE RANDOMLY DIVIDED INTO THREE GROUPS: group 1 (n=20) received only trigger point injections, group 2 (n=20) received trigger point injections with 30 seconds of ischemic compression, and group 3 (n=20) received trigger point injections with 60 seconds of ischemic compression. The visual analogue scale, pressure pain threshold, and range of motion of the neck were assessed before treatment, immediately after treatment, and 1 week after treatment. Korean Neck Disability Indexes were assessed before treatment and 1 week after treatment. We found a significant improvement in all assessment parameters (ptrigger point injections with ischemic compression group showed significant improvement as compared with the receiving only trigger point injections group. And no significant differences between receiving 30 seconds of ischemic compression group and 60 seconds of ischemic compression group. This study demonstrated the effectiveness of ischemic compression for myofascial trigger point. Trigger point injections combined with ischemic compression shows better effects on treatment of myofascial trigger points in the upper trapezius muscle than the only trigger point injections therapy. But the duration of ischemic compression did not affect treatment of myofascial trigger point.

  5. Myositis ossificans of the elbow after a trigger point injection.

    Science.gov (United States)

    Shin, Sang-Jin; Kang, Sung Shik

    2011-03-01

    Trigger point injection is a simple procedure that is widely performed for relieving pain. Even though there are several complications of trigger point injection, myositis ossificans has not been documented as one of its complications. We treated a patient who suffered from painful limitation of elbow motion and this was caused by myositis ossificans between the insertions of brachialis and supinator muscles after a trigger point injection containing lidocaine mixed with saline, and we also review the relevant medical literature.

  6. Myositis Ossificans of the Elbow after a Trigger Point Injection

    OpenAIRE

    Shin, Sang-Jin; Kang, Sung Shik

    2011-01-01

    Trigger point injection is a simple procedure that is widely performed for relieving pain. Even though there are several complications of trigger point injection, myositis ossificans has not been documented as one of its complications. We treated a patient who suffered from painful limitation of elbow motion and this was caused by myositis ossificans between the insertions of brachialis and supinator muscles after a trigger point injection containing lidocaine mixed with saline, and we also r...

  7. Descending necrotizing mediastinitis after a trigger point injection.

    Science.gov (United States)

    Choe, Jae Young; Kim, Jong Kun; Lee, Dong Eun; Seo, Kang Suk; Park, Jung Bae; Lee, Mi Jin; Ryoo, Hyun Wook; Ahn, Jae Yun; Moon, Sungbae

    2017-09-01

    Descending necrotizing mediastinitis (DNM) is a rare form of mediastinal infection. Most cases are associated with esophageal rupture. DNM after a trigger point injection in the upper trapezius has not been described previously. We present a case of DNM after a trigger point injection in the upper trapezius. A 70-year-old man visited the emergency department with chest discomfort and fever after a trigger point injection in the left upper trapezius. Chest computed tomography showed evidence of DNM, and antibiotic therapy was immediately administered intravenously. Because of the risk of sudden death, poor prognosis due to underlying disease, and his age, he declined surgical treatment and died of septic shock. Although trigger point injections are generally considered safe, caution should be used in patients with an underlying disease or in the elderly. Early diagnosis, broad-spectrum antibiotics, and aggressive surgical management are essential to improve the prognosis.

  8. Comparison of acupuncture to injection for myofascial trigger point pain.

    Science.gov (United States)

    Gazi, Miriam C B; Issy, Adriana M; Avila, Ilíada P; Sakata, Rioko K

    2011-01-01

    Many treatments have been proposed for myofascial pain syndrome. The objective of this study was to compare the analgesic effect of acupuncture to trigger point injection combined with cyclobenzaprine chlorhydrate and sodium dipyrone. A randomized study was performed in 30 patients divided into 2 groups: G1 received trigger point injection with 0.25% bupivacaine twice weekly, and both cyclobenzaprine chlorhydrate 10 mg/day and sodium dipyrone 500 mg every 8 hours; G2 received classical and trigger point acupuncture twice weekly. All patients were instructed in physical exercise. The following parameters were evaluated: pain intensity rated on a numerical scale, number of trigger points, and quality of life before and 4 weeks after treatment. The pain scores and the number of trigger points reduced significantly in both groups, with no significant difference between groups. Significant improvement in the quality of life scores was observed for some of the functional domains in the 2 groups, whereas there was no improvement of the general health status domain in either group or of the emotional domain in G1. Acupuncture, when compared with trigger point injection, combined with cyclobenzaprine chlorhydrate and sodium dipyrone provided similar pain relief and improvement in quality of life measures at 4 weeks.  © 2010 World Institute of Pain.

  9. Effect of trigger point injection on lumbosacral radiculopathy source.

    Science.gov (United States)

    Saeidian, Seyed Reza; Pipelzadeh, Mohammad Reza; Rasras, Saleh; Zeinali, Masud

    2014-10-01

    Active muscular trigger points (aMTPs) presenting with radiating pain can interfere in diagnosis and treatment of patients suffering from lumbosacral radiculopathy. We aimed to diagnose and evaluate the trigger point therapy on the outcome of pain in patients with lumbosacral radiculopathy. A total of 98 patients were enrolled suffered with chronic pain andlumbosacral radiculopathy at L4-L5 and L5-S1 who were candidates of non-surgical management. All patients received conservative modalities, including bed rest, non-steroidal anti-inflammatory agents (NSAID), and physiotherapy. These treatments continued for a week. Patients were examined for the presence of trigger points in their lower extremities. Those who had trigger points were divided into 2 groups (TP and N). Patients in TP group underwent trigger point injection therapy. No further therapy was done for the N group. Pain scores and straight leg raise (SLR) test in both groups were collected and analyzed on the seventh and 10th days of the therapy. Results were analyzed by paired t test and chi-square test. Out of 98 patients, 64 had trigger points. Thirty-two patients were assigned to each group. Pain scores (Mean ± SD) in TP group was 7.12 ± 1.13 and in N group was 6.7 ± 1.16, P = 0.196. Following the treatment, pain scores were 2.4 ± 1.5 in TP group and 4.06 ± 1.76 in N group P = 0.008. SLR test became negative in all patients in TP group but only in 6 (19%) patients in N group, P = 0.001. Results show that trigger point injection therapy in patients suffering from chronic lumbosacral radiculopathy with trigger points can significantly improve their recovery, and conservative therapy may not be adequate.

  10. Intramuscular hematoma with motor weakness after trigger point injection

    Science.gov (United States)

    Kim, Sang Gyun; Shim, Kwang Seok; Lee, Dong Won; Kim, Eun ju; Lee, Sang-Gon; Lee, Ji-Hyang; An, Ji hyun

    2017-01-01

    Abstract Rationale: Although trigger point injection is known as an easy and low-risk procedure, it is contraindicated to patients with hemorrhagic disorders or who regularly take anticoagulants/antiplatelets. However, taking clopidogrel is not a defined contraindication to this low-risk procedure. Patient concerns: The chief complaint of a 76-year old woman regularly taking clopidogrel was low back and left buttock pain which prolonged for several years. Diagnoses: The patient was diagnosed with L4-5 and L5-S1 spinal stenosis at the orthopedics department and was referred for lumbar spinal epidural steroid injection. Intervention: She was treated with trigger point injection. Outcomes: Three hours after the injection, she complained motor weakness and pain in the injection area. A hematoma on left gluteus medium muscle was detected with ultrasonography and ultrasound-guided needle aspiration was accomplished to relieve the symptom. Lessons: Trigger point injection for patients taking clopidogrel should be done with a caution to prevent such complication. PMID:28953648

  11. Pneumothorax after trigger point injection: A case report and review of literature.

    Science.gov (United States)

    Ahiskalioglu, Elif Oral; Alici, Haci Ahmet; Dostbil, Aysenur; Celik, Mine; Ahiskalioglu, Ali; Aksoy, Mehmet

    2016-11-21

    Myofascial pain syndrome is defined as ``pain and/or autonomic phenomena referred from active myofascial trigger points''. Trigger point injection is an effective treatment option, which is widely used to treat myofascial pain. Trigger point injection in the cervicothoracic regions can be associated with pneumothorax. In this paper, we presented a patient who developed pneumothorax after trigger point injection. This case report indicates there is a risk of pneumothorax during trigger point injection in the cervicothoracic regions.

  12. Intramuscular hematoma with motor weakness after trigger point injection: A case report.

    Science.gov (United States)

    Kim, Sang Gyun; Shim, Kwang Seok; Lee, Dong Won; Kim, Eun Ju; Lee, Sang-Gon; Lee, Ji-Hyang; An, Ji Hyun

    2017-09-01

    Although trigger point injection is known as an easy and low-risk procedure, it is contraindicated to patients with hemorrhagic disorders or who regularly take anticoagulants/antiplatelets. However, taking clopidogrel is not a defined contraindication to this low-risk procedure. The chief complaint of a 76-year old woman regularly taking clopidogrel was low back and left buttock pain which prolonged for several years. The patient was diagnosed with L4-5 and L5-S1 spinal stenosis at the orthopedics department and was referred for lumbar spinal epidural steroid injection. She was treated with trigger point injection. Three hours after the injection, she complained motor weakness and pain in the injection area. A hematoma on left gluteus medium muscle was detected with ultrasonography and ultrasound-guided needle aspiration was accomplished to relieve the symptom. Trigger point injection for patients taking clopidogrel should be done with a caution to prevent such complication.

  13. Ultrasound-guided trigger point injections in the cervicothoracic musculature: a new and unreported technique.

    Science.gov (United States)

    Botwin, Kenneth P; Sharma, Kavita; Saliba, Romeo; Patel, Bharat C

    2008-01-01

    Myofascial pain is defined as pain that originates from myofascial trigger points in skeletal muscle. It is prevalent in regional musculoskeletal pain syndromes, either alone or in combination with other pain generators. The myofascial pain syndrome is one of the largest groups of under diagnosed and under treated medical problems encountered in clinical practice. Trigger points are commonly seen in patients with myofascial pain which is responsible for localized pain in the affected muscles as well as referred pain patterns. Correct needle placement in a myofascial trigger point is vital to prevent complications and improve efficacy of the trigger point injection to help reduce or relieve myofascial pain. In obese patients, these injections may not reach the target tissue. In the cervicothoracic spine, a misguided or misplaced injection can result in a pneumothorax. Here, we describe an ultrasound-guided trigger point injection technique to avoid this potential pitfall. Office based ultrasound-guided injection techniques for musculoskeletal disorders have been described in the literature with regard to tendon, bursa, cystic, and joint pathologies. For the interventionalist, utilizing ultrasound yields multiple advantages technically and practically, including observation of needle placement in real-time, ability to perform dynamic studies, the possibility of diagnosing musculoskeletal pathologies, avoidance of radiation exposure, reduced overall cost, and portability of equipment within the office setting. To our knowledge, the use of ultrasound guidance in performing trigger point injection in the cervicothoracic area, particularly in obese patients, has not been previously reported. A palpable trigger point in the cervicothoracic musculature was localized and marked by indenting the skin with the tip of a plastic needle cover. The skin was then sterile prepped. Then, using an ultrasound machine with sterile coupling gel and a sterile latex free transducer cover

  14. Myofascial trigger point pain.

    Science.gov (United States)

    Jaeger, Bernadette

    2013-01-01

    Myofascial trigger point pain is an extremely prevalent cause of persistent pain disorders in all parts of the body, not just the head, neck, and face. Features include deep aching pain in any structure, referred from focally tender points in taut bands of skeletal muscle (the trigger points). Diagnosis depends on accurate palpation with 2-4 kg/cm2 of pressure for 10 to 20 seconds over the suspected trigger point to allow the referred pain pattern to develop. In the head and neck region, cervical muscle trigger points (key trigger points) often incite and perpetuate trigger points (satellite trigger points) and referred pain from masticatory muscles. Management requires identification and control of as many perpetuating factors as possible (posture, body mechanics, psychological stress or depression, poor sleep or nutrition). Trigger point therapies such as spray and stretch or trigger point injections are best used as adjunctive therapy.

  15. Dorsal scapular nerve injury after trigger point injection into the rhomboid major muscle: A case report.

    Science.gov (United States)

    Lee, Dong Gyu; Chang, Min Cheol

    2018-02-06

    We report the case of a patient who presented with right dorsal scapular neuropathy after a trigger point injection into the right rhomboid major muscle. Through a nerve conduction study and electromyography, we demonstrated dorsal scapular nerve injury in this patient. A 38-year-old man complained that his right shoulder functioned less optimally during push-up exercises after a trigger point injection 4 weeks prior. Physical examination revealed mildly reduced right shoulder retractor muscle strength compared with the left side. We performed a nerve conduction velocity test and electromyography 5 weeks after the injection. The compound muscle action potential of the right dorsal scapular nerve showed low amplitude (left vs. right side: 5.2 vs. 1.6 mV) and delayed latency (left vs. right side: 4.9 vs. 6.8 ms). Positive sharp wave (1+) and mildly reduced recruitment were seen on electromyography of the rhomboid major muscle. The findings of the nerve conduction velocity test and electromyography indicated partial right dorsal scapular neuropathy. The nerve injury seemed to have been caused by the needle inserted during trigger point injection. Clinicians should pay attention to the occurrence of dorsal scapular nerve injury when performing trigger point injection into the rhomboid muscle.

  16. A needle in the neck: trigger point injections as headache management in the emergency department.

    Science.gov (United States)

    Reisenauer, Sarah J

    2012-01-01

    A review of recent research suggests that the use of trigger point injections are successful in relieving the acute pain of musculoskeletal headaches. Patients with the chief complaint of headache commonly present to the emergency department (ED) and are often treated with multiple intravenous medications including narcotics. The success of outpatient treatment with trigger point injections can be applied to the acute care setting for improved patient outcomes and decongestion of the ED. This article will address the problems of intravenous medication therapy and discuss the benefits of trigger point therapy as management for musculoskeletal headaches specifically in the ED. In addition, discussion aims to provide tools for the nurse practitioner to integrate this skill into clinical practice.

  17. The role of the pain psychologist, trigger point injections, reflex sympathetic dystrophy.

    Science.gov (United States)

    Fishman, Scott M

    2006-01-01

    This feature presents information for patients in a question and answer format. It is written to simulate actual questions that many pain patients ask and to provide answers in a context and language that most pain patients will comprehend. Issues addressed in this issue are the role of the pain psychologist, trigger point injections, and reflex sympathetic dystrophy.

  18. Acupuncture and Trigger Point Injections for Fibromyalgia: East-West Medicine Case Report.

    Science.gov (United States)

    Taw, Lawrence B; Henry, Eve

    2016-01-01

    Fibromyalgia is a clinical syndrome characterized by chronic widespread pain that is often accompanied by ≥1 concomitant symptoms (eg, fatigue, poor sleep, cognitive alterations, and mood disturbances). In 2005, an estimated 5 million people in the United States suffered from fibromyalgia, and its growing effect on health-related quality of life is substantial. An increasingly popular hypothesis proposes that noxious, peripheral sensory input might contribute to the initiation and perpetuation of the diffuse pain seen in patients with fibromyalgia. That theory has led to the evaluation of multiple interventions to stimulate distal areas as a means to modulate the peripheral and central nervous systems. It has been the authors' experiences that the combination of trigger point injections and acupuncture provides improved clinical outcomes. In the current article, the authors present a case report of a patient with fibromyalgia who was successfully treated with an integrative approach that combined acupuncture with trigger point injections.

  19. Application of ultrasound-guided trigger point injection for myofascial trigger points in the subscapularis and pectoralis muscles to post-mastectomy patients: a pilot study.

    Science.gov (United States)

    Shin, Hyuk Jai; Shin, Ji Cheol; Kim, Wan Sung; Chang, Won Hyuk; Lee, Sang Chul

    2014-05-01

    To investigate the therapeutic effectiveness of ultrasound (US)-guided trigger point injection for myofascial trigger points (MTrPs) in the internal rotator muscles of the shoulder in post-mastectomy patients. This pilot study was a non-controlled, prospective, clinical trial. Nineteen post-mastectomy patients with a diagnosis of at least one active MTrP in the subscapularis and/or pectoralis muscles were included. We performed trigger point injections into the subscapularis muscle deep behind the scapula as well as the pectoralis muscle for diagnostic and therapeutic purpose by the newly developed US-guided method. Visual analogue scale and range of motion of the shoulder for external rotation and of abduction showed significant improvement immediately after the first injection and 3 months after the last injection compared with baseline (ptrigger point injections of the subscapularis and/or pectoralis muscles are effective for both diagnosis and treatment when the cause of shoulder pain is suspected to originate from active MTrPs in these muscles, particularly, the subscapularis.

  20. A Case of Trigger-Point Injection-Induced Hypokalemic Paralysis.

    Science.gov (United States)

    Soriano, Paolo K; Bhattarai, Mukul; Vogler, Carrie N; Hudali, Tamer H

    2017-04-26

    BACKGROUND Trigger-point injection (TPI) therapy is an effective modality for symptomatic treatment of myofascial pain. Serious adverse effects are rarely observed. In this report, we present the case of a 39-year-old man who experienced severe, transient hypokalemic paralysis in the context of TPI therapy with methylprednisolone, bupivacaine, and epinephrine. He was successfully treated with electrolyte replacement in a closely monitored setting. CASE REPORT A 39-year-old man with no past medical history except for chronic left hip pain from a work-related injury received a TPI with methylprednisolone and bupivacaine. The TPI targeted the left iliopsoas tendon and was administered using ultrasound guidance. There were no immediately perceived complications, but within 12 h he presented with severe hypokalemic paralysis with a serum potassium 1.7 mmol/L. Judicious potassium repletion was initiated. Repeated tests after 6 h consistently showed normal potassium levels of 4.5 mmol/L. CONCLUSIONS Severe hypokalemic paralysis in the context of trigger-point injection is an incredibly rare occurrence and this is the first case report in English literature. A high index of clinical suspicion and a systematic approach are therefore required for prompt diagnosis and management of this obscure iatrogenic entity. Clinicians can enhance patient safety by allowing the primary pathology to guide them.

  1. Factors Associated with the Efficacy of Trigger Point Injection in Advanced Cancer Patients.

    Science.gov (United States)

    Hasuo, Hideaki; Kanbara, Kenji; Abe, Tetsuya; Sakuma, Hiroko; Fukunaga, Mikihiko

    2017-10-01

    Few studies have reported the efficacy of trigger point injection (TPI) to myofascial trigger points (MTrPs) in advanced cancer patients. Factors that are associated with TPI efficacy have not yet been elucidated. The study was aimed at evaluating factors that are associated with TPI efficacy to MTrPs in advanced cancer patients. Factors that are associated with TPI efficacy were retrospectively identified based on a comparison between clinically relevant responders and nonresponders by using multivariate regression analysis. One hundred five advanced cancer patients who visited the Palliative Care Department with a chief complaint of pain and who received TPI treatment to the MTrP at the pain site. The TPI efficacy rate on the day after TPI treatment was 0.59 (95% confidence interval [CI]: 0.50-0.68). Significant factors associated with TPI efficacy were coexistence of cancer pain with MTrP at the pain site (odds ratio [OR]: 3.87, 95% CI: 1.21-12.4), MTrP at areas other than lower back or hip (OR: 6.45, 95% CI: 1.98-21.0), and fewer MTrPs (OR: 0.64, 95% CI: 0.42-0.99). Coexistence of cancer pain at the pain site of the chief complaint was observed in 64% of study subjects (95% CI: 0.55-0.73). The TPI efficacy is likely high when advanced cancer patients have fewer MTrPs together with cancer pain at areas other than the lower back or hip. MTrPs in advanced cancer patients are more commonly observed together with cancer pain rather than independently. Healthcare providers should recognize the relationship between MTrP and cancer pain and proactively perform physical examinations to detect MTrPs for potential TPI.

  2. Trigger point injections for headache disorders: expert consensus methodology and narrative review.

    Science.gov (United States)

    Robbins, Matthew S; Kuruvilla, Deena; Blumenfeld, Andrew; Charleston, Larry; Sorrell, Michael; Robertson, Carrie E; Grosberg, Brian M; Bender, Steven D; Napchan, Uri; Ashkenazi, Avi

    2014-10-01

    To review the existing literature and describe a standardized methodology by expert consensus for the performance of trigger point injections (TPIs) in the treatment of headache disorders. Despite their widespread use, the efficacy, safety, and methodology of TPIs have not been reviewed specifically for headache disorders by expert consensus. The Peripheral Nerve Blocks and Other Interventional Procedures Special Interest Section of the American Headache Society over a series of meetings reached a consensus for nomenclature, indications, contraindications, precautions, procedural details, outcomes, and adverse effects for the use of TPIs for headache disorders. A subcommittee of the Section also reviewed the literature. Indications for TPIs may include many types of episodic and chronic primary and secondary headache disorders, with the presence of active trigger points (TPs) on physical examination. Contraindications may include infection, a local open skull defect, or an anesthetic allergy, and precautions are necessary in the setting of anticoagulant use, pregnancy, and obesity with unclear anatomical landmarks. The most common muscles selected for TPIs include the trapezius, sternocleidomastoid, and temporalis, with bupivacaine and lidocaine the agents used most frequently. Adverse effects are typically mild with careful patient and procedural selection, though pneumothorax and other serious adverse events have been infrequently reported. When performed in the appropriate setting and with the proper expertise, TPIs seem to have a role in the adjunctive treatment of the most common headache disorders. We hope our effort to characterize the methodology of TPIs by expert opinion in the context of published data motivates the performance of evidence-based and standardized treatment protocols. © 2014 American Headache Society.

  3. Myofascial trigger points of the pelvic floor: associations with urological pain syndromes and treatment strategies including injection therapy.

    Science.gov (United States)

    Moldwin, Robert M; Fariello, Jennifer Yonaitis

    2013-10-01

    Myofascial trigger points (MTrP), or muscle "contraction knots," of the pelvic floor may be identified in as many as 85 % of patients suffering from urological, colorectal and gynecological pelvic pain syndromes; and can be responsible for some, if not all, symptoms related to these syndromes. Identification and conservative treatment of MTrPs in these populations has often been associated with impressive clinical improvements. In refractory cases, more "aggressive" therapy with varied trigger point needling techniques, including dry needling, anesthetic injections, or onabotulinumtoxinA injections, may be used, in combination with conservative therapies.

  4. Effect of Hyaluronidase Addition to Lidocaine for Trigger Point Injection in Myofascial Pain Syndrome.

    Science.gov (United States)

    Choi, Ji Won; Lee, Chul Joong; Lee, Sangmin M; Shin, Byung Seop; Jun, Byunghui; Sim, Woo Seog

    2015-10-07

    This randomized, double-blind study compared the efficacy of hyaluronidase co-injection with that of local anesthesia alone on the degree of pain and quality of life in patients with myofascial pain syndrome (MPS). Sixty-one adults, aged 25 to 75 years, with MPS affecting both trapezius muscles were randomly assigned to one of the 2 treatment groups: lidocaine (group L: n = 31) or hyaluronidase (group H: n = 30). All patients received Trigger point injection (TPI). Group L received 3.2 mL 0.5% lidocaine alone. Group H received the same solution of lidocaine mixed with hyaluronidase (600 iu/mL). Patients were followed for 14 days (pre- and post-TPI days 0, 1, 4, 7, and 14) with the verbal numerical rating scale (VNRS), and the primary outcome was VNRS on day 7. Also, we evaluated the neck disability index (NDI) and the short form of brief pain inventory (BPI-SF) on pre- and post-TPI day 14. In both groups, VNRS decreased on days 4, 7, and 14 compared to the pre-TPI. However, in group H, VNRS decreased on day 1 also. There were no significant differences of VNRS between the 2 groups during 14 days. NDI and BPI-SF scores also significantly decreased after TPI in both groups. There were no significant differences between groups in terms of VNRS, NDI, or BPI-SF scores. However, TPI consisting of lidocaine mixed with hyaluronidase worked more effectively than lidocaine alone on post-TPI day 1. Further, hyaluronidase showed a tendency to reduce TPI-related soreness. © 2015 World Institute of Pain.

  5. Anaesthetic injection versus ischemic compression for the pain relief of abdominal wall trigger points in women with chronic pelvic pain.

    Science.gov (United States)

    Montenegro, Mary L L S; Braz, Carolina A; Rosa-e-Silva, Julio C; Candido-dos-Reis, Francisco J; Nogueira, Antonio A; Poli-Neto, Omero B

    2015-12-01

    Chronic pelvic pain is a common condition among women, and 10 to 30 % of causes originate from the abdominal wall, and are associated with trigger points. Although little is known about their pathophysiology, variable methods have been practiced clinically. The purpose of this study was to evaluate the efficacy of local anaesthetic injections versus ischemic compression via physical therapy for pain relief of abdominal wall trigger points in women with chronic pelvic pain. We conducted a parallel group randomized trial including 30 women with chronic pelvic pain with abdominal wall trigger points. Subjects were randomly assigned to one of two intervention groups. One group received an injection of 2 mL 0.5 % lidocaine without a vasoconstrictor into a trigger point. In the other group, ischemic compression via physical therapy was administered at the trigger points three times, with each session lasting for 60 s, and a rest period of 30 s between applications. Both treatments were administered during one weekly session for four weeks. Our primary outcomes were satisfactory clinical response rates and percentages of pain relief. Our secondary outcomes are pain threshold and tolerance at the trigger points. All subjects were evaluated at baseline and 1, 4, and 12 weeks after the interventions. The study was conducted at a tertiary hospital that was associated with a university providing assistance predominantly to working class women who were treated by the public health system. Clinical response rates and pain relief were significantly better at 1, 4, and 12 weeks for those receiving local anaesthetic injections than ischemic compression via physical therapy. The pain relief of women treated with local anaesthetic injections progressively improved at 1, 4, and 12 weeks after intervention. In contrast, women treated with ischemic compression did not show considerable changes in pain relief after intervention. In the local anaesthetic injection group, pain threshold

  6. Myofascial Trigger Point Pain Syndromes.

    Science.gov (United States)

    Gerwin, Robert D

    2016-10-01

    Myofascial pain syndromes caused by trigger points (TrPs) in muscle are a common cause of local and generalized pain. Trigger points are hyperirritable zones in contracted bands of muscle, thought to be caused by muscle overload or stress. Stress TrPs have characteristic electromyographic features, and can be visualized with ultrasound and magnetic resonance elastography. Trigger point needling or injection can be effective in inactivating TrP, but correcting triggers is also critical. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. Chronic pain in a patient with Ehlers-Danlos syndrome (hypermobility type): The role of myofascial trigger point injections.

    Science.gov (United States)

    Tewari, Saipriya; Madabushi, Rajashree; Agarwal, Anil; Gautam, Sujeet K; Khuba, Sandeep

    2017-01-01

    Chronic widespread musculoskeletal pain is a cardinal symptom in hypermobility type of Ehler Danlos Syndrome (EDS type III). The management of pain in EDS, however, has not been studied in depth. A 30 year old female, known case of EDS, presented to the pain clinic with complaints of severe upper back pain for 6 months. Physical examination of the back revealed two myofascial trigger points over the left rhomboids and the left erector spinae. Local anaesthetic trigger point injections were given at these points, followed by stretching exercises under analgesic cover for the first week. After 1 week the patient reported 60-80% pain relief. This case highlights that we must keep a high index of suspicion for the more treatable causes of pain like myofascial pain syndrome in patients suffering from EDS, and should address it promptly and appropriately in order to maximise patient comfort. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Evaluation of dry needling and 0.5% lidocaine injection therapies in myofascial pain trigger points in masticatory muscles

    Directory of Open Access Journals (Sweden)

    Renato Oliveira Ferreira da Silva

    2012-04-01

    Full Text Available OBJECTIVE: The purpose of this study was to compare the effectiveness of trigger points injections using lidocaine 0.5% and dry needling without any kind of home-based rehabilitation program. METHODS: Sixteen patients with myofascial pain and trigger points in masticatory muscles were randomly assigned to two groups and received only one application session. The pressure pain threshold (PPT was recorded before and after the injection: Ten minutes, 24 hours later, 7, 15, 21 and 30 days after the treatment. Visual analogue scale (VAS was used to in all evaluation periods. RESULTS: There were no difference between groups for PPT, but for all groups the PPT during the time significantly increased when compared the before treatment. VAS showed differences between groups and during the time. The 0.5% lidocaine had the lowest VAS values when compared to dry needling, but at 30 days there were no differences among them. CONCLUSIONS: Despite the differences in VAS and considering there were no differences in PPT increases, we concluded that, in this study, both groups were able to disrupt the mechanisms of trigger point and relieve the myofascial pain symptoms.

  9. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review

    Directory of Open Access Journals (Sweden)

    Cotchett Matthew P

    2010-09-01

    Full Text Available Abstract Background Plantar heel pain (plantar fasciitis is one of the most common musculoskeletal pathologies of the foot. Plantar heel pain can be managed with dry needling and/or injection of myofascial trigger points (MTrPs however the evidence for its effectiveness is uncertain. Therefore, we aimed to systematically review the current evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. Methods We searched specific electronic databases (MEDLINE, EMBASE, AMED, CINAHL, SPORTDiscus and AMI in April 2010 to identify randomised and non-randomised trials. We included trials where participants diagnosed with plantar heel pain were treated with dry needling and/or injections (local anaesthetics, steroids, Botulinum toxin A and saline alone or in combination with acupuncture. Outcome measures that focussed on pain and function were extracted from the data. Trials were assessed for quality using the Quality Index tool. Results Three quasi-experimental trials matched the inclusion criteria: two trials found a reduction in pain for the use of trigger point dry needling when combined with acupuncture and the third found a reduction in pain using 1% lidocaine injections when combined with physical therapy. However, the methodological quality of the three trials was poor, with Quality Index scores ranging form 7 to 12 out of a possible score of 27. A meta-analysis was not conducted because substantial heterogeneity was present between trials. Conclusions There is limited evidence for the effectiveness of dry needling and/or injections of MTrPs associated with plantar heel pain. However, the poor quality and heterogeneous nature of the included studies precludes definitive conclusions being made. Importantly, this review highlights the need for future trials to use rigorous randomised controlled methodology with measures such as blinding to reduce bias. We also recommend that such trials adhere to the

  10. Pretreatment anxiety and pain acceptance are associated with response to trigger point injection therapy for chronic myofascial pain.

    Science.gov (United States)

    Healy, Gerard M; Finn, David P; O'Gorman, David A; Maharaj, Chris; Raftery, Miriam; Ruane, Nancy; Mitchell, Caroline; Sarma, Kiran; Bohacek, Marek; McGuire, Brian E

    2015-10-01

    This study examined the psychosocial profile of patients who responded or did not respond to trigger point injection therapy for chronic myofascial pain. Seventy one patients with a diagnosis of chronic myofascial pain of the paraspinous muscles completed a pretreatment questionnaire measuring demographic and social factors, and validated scales to assess pain intensity, pain interference (physical and emotional), and defined psychological characteristics (pain catastrophizing, pain acceptance, pain self-efficacy, mood and anxiety). Trigger point injection therapy of the affected areas of myofascial pain was performed and follow-up was conducted by telephone at one week (n = 65) and one month (n = 63) post intervention to assess treatment outcome (pain intensity and pain-related physical interference). At one week follow-up and one-month follow-up, using pain-related physical interference as the outcome measure, we found that those who responded well to treatment were characterized by a lower level of pretreatment anxiety and a higher level of pain acceptance, with anxiety being the strongest predictor. These results suggest that responses to interventional pain management in chronic myofascial paraspinous pain may be influenced by psychological characteristics, especially pretreatment anxiety. Wiley Periodicals, Inc.

  11. Analgesic efficacy of ultrasound identified trigger point injection in myofascial pain syndrome: A pilot study in Indian patients

    Directory of Open Access Journals (Sweden)

    S Parthasarathy

    2016-01-01

    Full Text Available Background: Myofascial pain syndrome (MPS is described as sensory symptoms, sometimes with motor and autonomic symptoms caused by myofascial trigger points (TPs. Injection at TPs is most likely to benefit patients with such disorder. The identification of TPs is usually clinical. However, in sites where there are major vital structures, ultrasound guidance and real-time visualization may help in decreasing complications. Methodology: Twenty patients who presented to pain clinic with classic symptoms of MPS in the neck and shoulder area with clinically detectable TPs were selected. The points were imaged with ultrasound to find correlation with clinical positions. They were injected with a mixture of local anesthetic and steroid on TPs with real-time ultrasound guidance and needle visualization. Pretreatment visual analog scale (VAS scores and posttreatment (immediate and after 1 month were noted. The mean reduction in VAS scores was analyzed with paired Student′s t-test. Any side effect was observed and managed. Results: Clinically detectable TPs coincided with an echogenic point on the undersurface of the trapezius. There was a significant reduction in pain scores at both times. The needle sign was positive in all the cases. There were no major complications. Conclusion: The clinically identified TPs in trapezius muscle coincided well with ultrasound imaged echogenic structure in the muscle in all the cases. Ultrasound-assisted injections also produced the needle sign in all the cases. The achieved analgesia both immediately after the injection and a month later was satisfactory in the majority of cases. The echogenic mass corresponding to the TP is found to be on the undersurface of the muscle rather than inside the mass of the muscle.

  12. Extracorporeal Shock Wave Therapy Versus Trigger Point Injection in the Treatment of Myofascial Pain Syndrome in the Quadratus Lumborum.

    Science.gov (United States)

    Hong, Jin Oh; Park, Joon Sang; Jeon, Dae Geun; Yoon, Wang Hyeon; Park, Jung Hyun

    2017-08-01

    To compare the effectiveness of extracorporeal shock wave therapy (ESWT) and trigger point injection (TPI) for the treatment of myofascial pain syndrome in the quadratus lumborum. In a retrospective study at our institute, 30 patients with myofascial pain syndrome in the quadratus lumborum were assigned to ESWT or TPI groups. We assessed ESWT and TPI treatment according to their affects on pain relief and disability improvement. The outcome measures for the pain assessment were a visual analogue scale score and pain pressure threshold. The outcome measures for the disability assessment were Oswestry Disability Index, Roles and Maudsley, and Quebec Back Pain Disability Scale scores. Both groups demonstrated statistically significant improvements in pain and disability measures after treatment. However, in comparing the treatments, we found ESWT to be more effective than TPI for pain relief. There were no statistically significant differences between the groups with respect to disability. Compared to TPI, ESWT showed superior results for pain relief. Thus, we consider ESWT as an effective treatment for myofascial pain syndrome in the quadratus lumborum.

  13. Ultrasound-guided myofascial trigger point injection into brachialis muscle for rotator cuff disease patients with upper arm pain: a pilot study.

    Science.gov (United States)

    Suh, Mi Ri; Chang, Won Hyuk; Choi, Hyo Seon; Lee, Sang Chul

    2014-10-01

    To assess the efficacy of trigger point injection into brachialis muscle for rotator cuff disease patients with upper arm pain. A prospective, randomized, and single-blinded clinical pilot trial was performed at university rehabilitation hospital. Twenty-one patients clinically diagnosed with rotator cuff disease suspected of having brachialis myofascial pain syndrome (MPS) were randomly allocated into two groups. Effect of ultrasound (US)-guided trigger point injection (n=11) and oral non-steroidal anti-inflammatory drug (NSAID) (n=10) was compared by visual analog scale (VAS). US-guided trigger point injection of brachialis muscle resulted in excellent outcome compared to the oral NSAID group. Mean VAS scores decreased significantly after 2 weeks of treatment compared to the baseline in both groups (7.3 vs. 4.5 in the injection group and 7.4 vs. 5.9 in the oral group). The decrease of the VAS score caused by injection (ДVAS=-2.8) was significantly larger than caused by oral NSAID (ДVAS=-1.5) (ptrigger point injection of the brachialis muscle is safe and effective for both diagnosis and treatment when the cause of pain is suspected to be originated from the muscle.

  14. Utility of trigger point injection as an adjunct to physical therapy in men with chronic prostatitis/chronic pelvic pain syndrome

    OpenAIRE

    Tadros, Nicholas N.; Shah, Anup B.; Shoskes, Daniel A.

    2017-01-01

    Background Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is often associated with pelvic floor muscle spasm. While pelvic floor physical therapy (PFPT) is effective, some men are unable to resolve their symptoms and have residual trigger points (TPs). TP injection has been used for treatment in several neuromuscular pain syndromes. The objective of this study was to examine the efficacy and side effects of TP injection in men with CP/CPPS and pelvic floor spasm refractory to PT. ...

  15. Usefulness of a myofascial trigger point injection for groin pain in patients with chronic prostatitis/chronic pelvic pain syndrome: a pilot study.

    Science.gov (United States)

    Kim, Dong Suk; Jeong, Tae Yoong; Kim, Yong-Kyun; Chang, Won Hyuk; Yoon, Jeong-Gyu; Lee, Sang Chul

    2013-05-01

    To investigate the therapeutic effectiveness of trigger point injection into the muscles around the groin in patients with clinically diagnosed chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Prospective, unicenter trial. University rehabilitation hospital. Patients (N=21) with clinically diagnosed CP/CPPS who are suspected of having myofascial pain syndrome. Ultrasound-guided trigger point injection. Visual analog scale (VAS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score, and injection-associated complications. Ultrasound (US)-guided trigger point injection of the iliopsoas, hip adductor, and lower abdominal muscles resulted in excellent outcomes. The mean values of the NIH-CPSI score decreased significantly from 20.2 pretreatment to 12.5 after the first treatment (Ptrigger point injections of the iliopsoas, hip adductor, and abdominal muscles are safe and effective for both diagnosis and treatment when the cause of groin pain is suspected to originate from muscles. In particular, the iliopsoas muscle was affected in all patients in this study. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. A Comparative Study of Trigger Point Therapy with Local Anaesthetic (0.5 % Bupivacaine) Versus Combined Trigger Point Injection Therapy and Levosulpiride in the Management of Myofascial Pain Syndrome in the Orofacial Region.

    Science.gov (United States)

    Gupta, Pranav; Singh, Virendra; Sethi, Sujata; Kumar, Arun

    2016-09-01

    To compare the efficacy of combined local anesthetic injection with 0.5 % bupivacaine and levosulpiride versus local anesthetic injection alone on outcome measures including levels of pain intensity and depression in the management of myofascial pain syndrome in orofacial region. This was a prospective, randomized, controlled and open-label comparative clinical study. Seventy-four patients diagnosed to have myofascial pain syndrome and fulfilling the inclusion criteria were enrolled for the study. Patients were randomly assigned into 2 groups. Group A received local anesthetic injection (0.5 % bupivacaine) on trigger points and Group B received combined trigger point injection therapy and 50 mg of tablet Levosulpiride orally B.I.D. They were assessed for pain intensity and depression at baseline and at follow-up of 1, 4, 6 and 12 week intervals. The mean age of patients was 44.54 + 15.977 years in group A and 39.97 + 14.107 years in group B ( P value = 0.2). Group A comprised of 25 females (67.567 %) and 12 males (32.432 %) while group B had 27 females (75 %) and 9 males (25 %). 70.27 % were diagnosed with moderate depression in group A and 75 % in group B. 18.91 % in group A and 19.44 % in group B were diagnosed with severe depression. When the VAS score and BDI score was compared at the follow-up intervals with the baseline scores in both treatment groups, the mean difference was highly significant at all the follow-up intervals. However when the relative efficacies of two interventions were compared between the two groups, improvement in pain was significant at all the follow-up intervals except the 1st week follow-up whereas the improvement in depression was non-significant at 1st and 4th week interval while it was highly significant at 6th and 12th week intervals. The combined therapy with trigger point injection and levosulpiride as antidepressant significantly reduces pain and depression in the study subjects suffering from chronic

  17. The Effect of Methylprednisolone Acetate Injection at Cervical Trigger Points in both Chronic and Drug Resistant Headache

    Directory of Open Access Journals (Sweden)

    MJ Hadianfard

    2011-06-01

    Full Text Available Introduction & Objective: Most adults have surely once experienced a headache. A high percentage of these headaches are the referred pain from cervical structures, such as neck muscles, known as cervicogenic headaches. This study aimed to assess the efficacy of injection of methylprednisolone acetate at the Gallbladder-20 acupuncture points in muscle originated chronic and drug resistant headaches. Materials & Methods: In this randomized clinical trial study conducted at Shiraz University of Medical Sciences in 2009-2010, 25 patients with both chronic and drug resistant cervicogenic headaches, who had cervical muscle tender points, underwent methylprednisolone acetate injection. To evaluate the severity of these patients' headache, VAS (Visual Analogue Scale was used. The collected data was analyzed using the SPSS software and Wilcoxon test. Results: The Mean headache intensity on the visual scale of these people before the injection was 3 .2 ± 76.7. This value was 2.60±2.9, 3 days after injection. The values at 1 and 3 months post procedure were 3.52±3.3, and 3.48±3.5, respectively. In other words, a statistically significant loss of pain score (P<0.001 was observed. The frequency of headache attacks 1 and 3 months after injection decreased 72% and 76% among patients, respectively. Average duration of headache attacks, one month and three months after injection, was decreased in 72 percent of patients. Conclusion: Injection of methylprednisolone acetate at the GB-20acu points in muscle originated cervicogenic headache could be used as an appropriate therapy that has significant therapeutic efficacies only when injected once.

  18. Latent myofascial trigger points.

    Science.gov (United States)

    Ge, Hong-You; Arendt-Nielsen, Lars

    2011-10-01

    A latent myofascial trigger point (MTP) is defined as a focus of hyperirritability in a muscle taut band that is clinically associated with local twitch response and tenderness and/or referred pain upon manual examination. Current evidence suggests that the temporal profile of the spontaneous electrical activity at an MTP is similar to focal muscle fiber contraction and/or muscle cramp potentials, which contribute significantly to the induction of local tenderness and pain and motor dysfunctions. This review highlights the potential mechanisms underlying the sensory-motor dysfunctions associated with latent MTPs and discusses the contribution of central sensitization associated with latent MTPs and the MTP network to the spatial propagation of pain and motor dysfunctions. Treating latent MTPs in patients with musculoskeletal pain may not only decrease pain sensitivity and improve motor functions, but also prevent latent MTPs from transforming into active MTPs, and hence, prevent the development of myofascial pain syndrome.

  19. A Comparative Pilot Study to Evaluate the Adjunctive Role of Levosulpride with Trigger Point Injection Therapy in the Management of Myofascial Pain Syndrome of Orofacial Region.

    Science.gov (United States)

    Gupta, Pranav; Singh, Virendra; Sethi, Sujata; Kumar, Arun

    2014-12-01

    To evaluate the effect of therapy with levosulpride combined with conventional trigger point injection therapy in terms of pain and depression in the chronic myofascial pain syndrome patients. This was a comparative prospective study in which subjects with at least one trigger point and symptom duration of at least 3 months were recruited and randomized into two groups. Group A subjects received trigger point injections with 0.5 % bupivacaine and tablet levosulpride and group B received trigger point injections and a placebo. Subjects were assessed for pain with visual analog scale (VAS) and depression with Beck's depression inventory (BDI) at the follow-up periods of 1, 4, 6 and 12 weeks. The treatment effect was measured in terms of mean difference of BDI and VAS scores at various studied intervals from the baseline values. The sample was composed of 15 subjects with 8 in group A (6 females and 2 males, with a mean age of 41.88 ± 15.13 years, disease duration of 12.37 ± 16.11 months) and 7 in group B (6 females and 1 male, with a mean age of 43.86 ± 12.34 years, disease duration of 9.64 ± 9.34 months). The mean baseline VAS score and BDI score was 6.75 ± 1.03 in group A and 6.86 ± 1.06 in group B and 24.25 ± 10.20 in group A and 24.43 ± 11.16 in group B respectively. The mean difference of VAS scores at 12th week interval from the baseline values was highly significant. Although the mean difference of VAS scores at all the other intervals and mean difference of BDI scores at all the intervals was statistically nonsignificant, there was improvement in the mean differences at all the follow-up intervals in terms of both pain as well as depression. The combined therapy with conventional trigger point injection and levosulpride as antidepressant significantly reduce pain and depression in the study subjects suffering from chronic myofascial pain with moderate to severe depression in the orofacial region.

  20. Patterns of Use of Peripheral Nerve Blocks and Trigger Point Injections for Pediatric Headache: Results of a Survey of the American Headache Society Pediatric and Adolescent Section.

    Science.gov (United States)

    Szperka, Christina L; Gelfand, Amy A; Hershey, Andrew D

    2016-11-01

    To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache. Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders. A survey was created in REDCap, and sent via email to the 82 members of the Pediatric and Adolescent Section of the American Headache Society in June 2015. The survey queried about current practice and use of nerve blocks, as well as respondents' opinions regarding gaps in the evidence for use of nerve blocks in this patient population. Forty-one complete, five incomplete, and three duplicate responses were submitted (response rate complete 50%). About 78% of the respondents identified their primary specialty as Child Neurology, and 51% were certified in headache medicine. Twenty-six (63%) respondents perform nerve blocks themselves, and seven (17%) refer patients to another provider for nerve blocks. Chronic migraine with status migrainosus was the most common indication for nerve blocks (82%), though occipital neuralgia (79%), status migrainosus (73%), chronic migraine without flare (70%), post-traumatic headache (70%), and new daily persistent headache (67%) were also common indications. The most commonly selected clinically meaningful response for status migrainosus was ≥50% reduction in severity, while for chronic migraine this was a ≥50% decrease in frequency at 4 weeks. Respondents inject the following locations: 100% inject the greater occipital nerve, 69% lesser occipital nerve, 50% supraorbital, 46% trigger point injections, 42% auriculotemporal, and 34% supratrochlear. All respondents used local anesthetic, while 12 (46%) also use

  1. Etiology of myofascial trigger points

    NARCIS (Netherlands)

    Bron, C.; Dommerholt, J.D.

    2012-01-01

    Myofascial pain syndrome (MPS) is described as the sensory, motor, and autonomic symptoms caused by myofascial trigger points (TrPs). Knowing the potential causes of TrPs is important to prevent their development and recurrence, but also to inactivate and eliminate existing TrPs. There is general

  2. Utility of trigger point injection as an adjunct to physical therapy in men with chronic prostatitis/chronic pelvic pain syndrome.

    Science.gov (United States)

    Tadros, Nicholas N; Shah, Anup B; Shoskes, Daniel A

    2017-06-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is often associated with pelvic floor muscle spasm. While pelvic floor physical therapy (PFPT) is effective, some men are unable to resolve their symptoms and have residual trigger points (TPs). TP injection has been used for treatment in several neuromuscular pain syndromes. The objective of this study was to examine the efficacy and side effects of TP injection in men with CP/CPPS and pelvic floor spasm refractory to PT. Using an IRB approved Men's Health Registry we reviewed the records of all men with a diagnosis of CP/CPPS who received at least 1 TP injection. Patients were phenotyped with UPOINT (all had the "T" domain for tenderness of muscle) and symptoms measured with the NIH Chronic Prostatitis Symptom Index (CPSI). Response was measured by a 5-point Global Response Assessment (GRA) and change in CPSI (paired t -test). For pelvic TPs, a pudendal block was done in lithotomy position and then each TP was identified transrectally by palpation. A nerve block needle was passed through the perineum into the TP confirmed by palpation. Between 0.5-1 cc was injected into each TP of a local anesthetic mixture (30:70 of 2% lidocaine and 0.25% bupivacaine). For anterior TPs, an ultrasound guided ilioinguinal block was done first and then each TP injected by direct palpation through the abdominal skin. Men were offered up to three sets of injections separated by 6 weeks each. We identified 37 patients who had a total of 68 procedures. Three men had no follow-up after their first injection and were included for side effects but not included for outcome. The indication was failure to progress on PT in 33, recurrent symptoms in 1 and refusal to do PT in 3. Mean age was 43.7 years (range 21-70 years) and median UPOINT domains was 3 (range 1-5). Initial CPSI was pain 13.7±3.4, urinary 5.3±2.2, quality of life 9.8±2.1 and total 28.8±6.0. 16 men had 1 injection, 11 had 2 and 10 had 3. All had pelvic TPs injected

  3. Does myofascial and trigger point treatment reduce pain and analgesic intake in patients undergoing onabotulinumtoxinA injection due to chronic intractable migraine?

    Science.gov (United States)

    Gandolfi, Marialuisa; Geroin, Christian; Valè, Nicola; Marchioretto, Fabio; Turrina, Andrea; Dimitrova, Eleonora; Tamburin, Stefano; Serina, Anna; Castellazzi, Paola; Meschieri, Andrea; Ricard, François; Saltuari, Leopold; Picelli, Alessandro; Smania, Nicola

    2018-02-01

    Chronic migraine is a disabling disorder associated with myofascial and trigger point disorders in the neck. Pharmacological management is the first line of treatment; however, rehabilitation procedures aimed at lessening symptoms of myofascial and trigger point disorders may add value in the management of headache symptoms. The aim of this study was to evaluate the feasibility of myofascial and trigger point treatment in chronic migraine patients receiving prophylactic treatment with onabotulinumtoxinA. To evaluate the treatment effects on headache frequency and intensity, analgesic consumption, cervical range of motion, trigger point pressure pain threshold, quality of life, and disability. Pilot, single-blind randomized controlled trial with two parallel groups. Neurorehabilitation Unit. Twenty-two outpatients with chronic migraine. Patients were randomly assigned to receive either cervicothoracic manipulative treatment (N.=12) or transcutaneous electrical nerve stimulation (TENS) in the upper trapezius (N.=10). Treatment consisted of 4 sessions (30 min/session, 1 session/week for 4 weeks). A rater blinded to treatment allocation evaluated outcomes before treatment, during treatment, and 1 month after the end of treatment. Consistent with the pilot nature of the study, feasibility was considered the primary outcome and efficacy the secondary outcome. All patients completed the study. No adverse events were reported. No significant between-group differences in pain intensity were observed during the study period. At post-treatment evaluation, the total consumption of analgesics (P=0.02) and non-steroidal anti-inflammatory (P=0.02) drugs was significantly lower in the manipulative treatment group than in the TENS group. These effects paralleled significant improvements in trigger point sensitivity and cervical active range of motion. Manipulative techniques aimed at reducing peripheral nociceptive triggers might add value in the management of chronic migraine

  4. [Diagnosis and therapy of myofascial trigger points].

    Science.gov (United States)

    Simons, D G; Mense, S

    2003-12-01

    Myofascial trigger points (MTrPs) are hyperirritable tender spots in palpable tense bands of skeletal muscle. Muscle is an orphan organ, no medical specialty claims muscle as its organ. The article aims at filling some of the gaps in the current knowledge of MTrPs. The presented findings were partly obtained in experiments on anesthetised rabbits, partly they are the result of ample experience with patients suffering from MTrPs. Each muscle has a characteristic elicited referred pain pattern that, for active MTrPs, is familiar to the patient. Without a laboratory test or imaging method, diagnosis of MTrPs depends entirely on history and physical examination. MTrP symptoms follow muscle overload, are activated acutely by sudden overload, or develop gradually with prolonged contractions or repetitive activity. The diagnostic skill required depends on considerable innate palpation ability, authoritative training, and extensive clinical experience. Effective treatment methods include manual stretching by trigger-point pressure release, contract-relax, vapo coolant spray-and-stretch, and dry needling or injection of MTrPs. The integrated hypothesis presents an explanation for the pathophysiology of MTrPs and begins with excessive release of acetylcholine from involved motor endplates. It depends on a new understanding of the abnormality of endplate noise. Biopsies demonstrate segmental shortening of groups of sarcomeres in individual muscle fibres and possibly waves of contracted sarcomeres to account for palpable taut bands.

  5. Efficacy and Safety of Single Botulinum Toxin Type A (Botox®) Injection for Relief of Upper Trapezius Myofascial Trigger Point: A Randomized, Double-Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Kwanchuay, Photsawee; Petchnumsin, Thavatchai; Yiemsiri, Pichet; Pasuk, Nakkamol; Srikanok, Wannarat; Hathaiareerug, Chanasak

    2015-12-01

    Botulinum toxin injection has been applied for pain relief in various chronic pain syndromes. Recently, systematic review studies reported inconclusive effects of Botulinum toxin in myofascial pain management. The present study aimed to demonstrate the efficacy and safety of Botulinum toxin type A (BTxA) (Botox®) injection for pain reduction in myofascial trigger point (MTrP) of the upper trapezius muscle. Thirty-three patients with 48 MTrP on the upper trapezius muscles over three months with moderate to severe pain intensity diagnosed at physical medicine and rehabilitation outpatient department were recruited between December 2011 and March 2012. Eligible patients were blinded and randomly injected with single 0.2 ml (20 IU) of BTxA for 24 MTrP and 0.2 ml of 0.9% NaCl solution for 24 MTrP at the most tender trigger point on the upper trapezius muscle. All patients were advised for stretching exercise and ergonomic adaptation throughout the study. At 3- and 6-week after injections, visual analogue scale (VAS), the pressure pain threshold (PPT), and reported adverse effects were measured. Both BTxA and control groups demonstrated statistically significant differences in VAS reduction and increased PPT after 3 weeks and 6 weeks compared with before treatment. There were no statistically significant differences in VAS reduction from baseline between the two groups at 3- and 6-week after treatment. A statistically significant difference in improvement of PPT from baseline and 6-week after BTxA injection compared with 0.9% NaCl group was shown (1.0 ± 0.9 and 0.5 ± 0.7, p = 0.036). There was mild degree side-effects that spontaneous resolved within one week in both groups without significant difference in percentage. No severe adverse effects were reported during the study. The efficacy in VAS reduction of a single 20 IU of Botulinum toxin type A (Botox®) injection was not different from 0.9% NaCl for myofascial trigger point at the upper trapezius muscle. However

  6. Triggering processes of microseismic events associated with water injection in Okuaizu Geothermal Field, Japan

    Science.gov (United States)

    Okamoto, Kyosuke; Yi, Li; Asanuma, Hiroshi; Okabe, Takashi; Abe, Yasuyuki; Tsuzuki, Masatoshi

    2018-02-01

    A continuous water injection test was conducted to halt the reduction in steam production in the Okuaizu Geothermal Field, Japan. Understanding the factors triggering microseismicity associated with water injection is essential to ensuring effective steam production. We identified possible triggering processes by applying methods based on microseismic monitoring, including a new method to determine the presence of water in local fractures using scattered P-waves. We found that the evolving microseismicity near the injection point could be explained by a diffusion process and/or water migration. We also found that local microseismicity on a remote fault was likely activated by stress fluctuations resulting from changes in the injection rate. A mediator of this fluctuation might be water remaining in the fracture zone. After the injection was terminated, microseismicity possibly associated with the phase transition of the liquid was found. We conclude that a variety of triggering processes associated with water injection may exist.[Figure not available: see fulltext.

  7. Electrophysiological characteristics according to activity level of myofascial trigger points.

    Science.gov (United States)

    Yu, Seong Hun; Kim, Hyun Jin

    2015-09-01

    [Purpose] This study compared the differences in electrophysiological characteristics of normal muscles versus muscles with latent or active myofascial trigger points, and identified the neuromuscular physiological characteristics of muscles with active myofascial trigger points, thereby providing a quantitative evaluation of myofascial pain syndrome and clinical foundational data for its diagnosis. [Subjects] Ninety adults in their 20s participated in this study. Subjects were equally divided into three groups: the active myofascial trigger point group, the latent myofascial trigger point group, and the control group. [Methods] Maximum voluntary isometric contraction (MVIC), endurance, median frequency (MDF), and muscle fatigue index were measured in all subjects. [Results] No significant differences in MVIC or endurance were revealed among the three groups. However, the active trigger point group had significantly different MDF and muscle fatigue index compared with the control group. [Conclusion] Given that muscles with active myofascial trigger points had an increased MDF and suffered muscle fatigue more easily, increased recruitment of motor unit action potential of type II fibers was evident. Therefore, electrophysiological analysis of these myofascial trigger points can be applied to evaluate the effect of physical therapy and provide a quantitative diagnosis of myofascial pain syndrome.

  8. [Discussing the relationship among theashipoint, tender point and myofascial trigger point].

    Science.gov (United States)

    Chen, Decheng; Yang, Guanhu; Wang, Fuchun; Qi, Wei

    2017-02-12

    The conception and the history of ashi point, tender point and myofascial trigger point are described in the paper. All of three kinds of point are the reaction of musculoskeletal pain and visceral diseases. Theoretically, ashi point originates from the theory of muscle region of meridian, tender point from the theory of soft tissue and muscles and myofascial trigger point from the theory of muscular fasciae. Anatomically, ashi point is localized in the muscle region of meridian, on the boundary between muscles, tender point is on the muscular attachment to skeleton (the starting and ending points) and myofascial trigger point is on the motor point of neuromuscles. Pathologically, ashi point reflects the disorders of soft tissue and internal organ, tender point reflects the disorders of soft tissue and myofascial trigger point reflects the disorders of soft tissue and few disorders of internal organ. To identify the relationship among them is very significant in the target treatment with acupuncture.

  9. Efficacy of myofascial trigger point deactivation for tinnitus control.

    Science.gov (United States)

    Rocha, Carina Bezerra; Sanchez, Tanit Ganz

    2012-12-01

    Chronic pain in areas surrounding the ear may influence tinnitus. To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus. A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37) underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34), 10 sessions with sham deactivation. Treatment of the experimental group was effective for tinnitus relief (p trigger point release may provide better results than others described so far.

  10. Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial.

    Science.gov (United States)

    Moraska, Albert F; Schmiege, Sarah J; Mann, John D; Butryn, Nathan; Krutsch, Jason P

    2017-09-01

    This study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache. Individuals (n = 62) with episodic or chronic tension-type headache were randomized to receive 12 twice-weekly 45-min massage or sham ultrasound sessions or wait-list control. Massage focused on trigger point release (ischemic compression) of MTrPs in the bilateral upper trapezius and suboccipital muscles. PPT was measured at MTrPs with a pressure algometer pre and post the first and final (12th) treatments. PPT increased across the study timeframe in all four muscle sites tested for massage, but not sham ultrasound or wait-list groups (P trigger points to myofascial pain; (2) Describe an effective treatment for decreasing tenderness of a myofascial trigger point; and (3) Discuss the relative values of single vs. multiple massage sessions on increasing pressure-pain thresholds at myofascial trigger points. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

  11. DRY NEEDLING FOR MYOFASCIAL TRIGGER POINT PAIN: A CLINICAL COMMENTARY.

    Science.gov (United States)

    Unverzagt, Casey; Berglund, Kathy; Thomas, J J

    2015-06-01

    Sports and orthopaedic physical therapists have long used a multitude of techniques in order to address pain and dysfunction associated with myofascial trigger points. One technique in particular has recently received overwhelming attention: trigger point dry needling (DN). Despite its efficacy and low risk, questions remain as to its effectiveness, safety, and whether the technique is within the scope of practice of physical therapists. Therefore, the purpose of this clinical commentary is to summarize the current literature related to the associated mechanisms of action of DN, the safety of DN, as well as to discuss relevant scope of practice concerns. 5.

  12. Spectral analysis of heart rate variability during trigger point acupuncture.

    Science.gov (United States)

    Kitagawa, Yoji; Kimura, Kenichi; Yoshida, Sohei

    2014-06-01

    To clarify changes in the cardiovascular autonomic nervous system function due to trigger point acupuncture, we evaluated differences in responses between acupuncture at trigger points and those at other sites using spectral analysis of heart rate variability. Subjects were 35 healthy men. Before measurements began the subjects were assigned to a trigger point acupuncture or control group based on the presence/absence of referred pain on applying pressure to a taut band within the right tibialis anterior muscle. The measurements were conducted in a room with a temperature of 25°C, with subjects in a long sitting position after 10 min rest. Acupuncture needles were retained for 10 min at two sites on the right tibialis anterior muscle. ECG was performed simultaneously with measurements of blood pressure and the respiratory cycle. Based on the R-R interval on the ECG, frequency analysis was performed, low-frequency (LF) and high-frequency (HF) components were extracted and the ratio of LF to HF components (LF/HF) was evaluated. The trigger point acupuncture group showed a transient decrease in heart rate and an increase in the HF component but no significant changes in LF/HF. In the control group, no significant changes were observed in heart rate, the HF component or LF/HF. There were no consistent changes in systolic or diastolic blood pressure in either group. These data suggest that acupuncture stimulation of trigger points of the tibialis anterior muscle transiently increases parasympathetic nerve activity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.

    Science.gov (United States)

    Segura-Ortí, E; Prades-Vergara, S; Manzaneda-Piña, L; Valero-Martínez, R; Polo-Traverso, J A

    2016-06-01

    Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. Randomised controlled trial. 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. The analysis of variance mixed model showed a significant time effect for pain (ppoints) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. NCT01290653. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  14. Induction of muscle cramps by nociceptive stimulation of latent myofascial trigger points.

    Science.gov (United States)

    Ge, Hong-You; Zhang, Yang; Boudreau, Shellie; Yue, Shou-Wei; Arendt-Nielsen, Lars

    2008-06-01

    The aim of this present study is to test the hypothesis that nociceptive stimulation of latent myofascial trigger points (MTrPs) increases the occurrence of local muscle cramps. Nociceptive muscle stimulation was obtained by a bolus injection of glutamate (0.1 ml, 0.5 M) into a latent MTrP and a control point (a non-MTrP) located in the right or left gastrocnemius medialis muscles in 14 healthy subjects. A bolus of isotonic saline (0.9%, 0.1 ml) injection served as a control. The injections were guided by intramuscular electromyography (EMG) showing resting spontaneous electrical activity at a latent MTrP and no such activity at a non-MTrP. Intramuscular and surface EMG activities in the gastrocnemius medialis muscle were recorded pre-, during-, and post-injection for a period of 8 min to monitor the occurrence of muscle cramps, which are characterized by a brief episodic burst of high levels of EMG activity. The results showed that glutamate and isotonic saline injections into the latent MTrPs induced higher peak pain intensity than into the non-MTrPs (both P < 0.05). Glutamate injection induced higher peak pain intensity than isotonic saline injection into either latent MTrPs or non-MTrPs (both P < 0.05). Muscle camps were observed in 92.86% of the subjects following glutamate injection into the latent MTrPs, but not into the non-MTrPs (P < 0.001). No muscle cramps were recorded following isotonic saline injection into either the latent MTrPs or the non-MTrPs. These results suggest that latent MTrPs could be involved in the genesis of muscle cramps. Focal increase in nociceptive sensitivity at MTrPs constitutes one of the mechanisms underlying muscle cramps.

  15. TRIGGER

    CERN Multimedia

    W. Smith

    At the March meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, the program of trigger pattern tests and vertical slice tests and planning for the Global Runs starting this summer. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and integration testing is in full swing. A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. After full checkout, trigger subsystems will be then operated in the CMS Global Runs. Continuous...

  16. TRIGGER

    CERN Multimedia

    W. Smith

    2012-01-01

      Level-1 Trigger The Level-1 Trigger group is ready to deploy improvements to the L1 Trigger algorithms for 2012. These include new high-PT patterns for the RPC endcap, an improved CSC PT assignment, a new PT-matching algorithm for the Global Muon Trigger, and new calibrations for ECAL, HCAL, and the Regional Calorimeter Trigger. These should improve the efficiency, rate, and stability of the L1 Trigger. The L1 Trigger group also is migrating the online systems to SLC5. To make the data transfer from the Global Calorimeter Trigger to the Global Trigger more reliable and also to allow checking the data integrity online, a new optical link system has been developed by the GCT and GT groups and successfully tested at the CMS electronics integration facility in building 904. This new system is now undergoing further tests at Point 5 before being deployed for data-taking this year. New L1 trigger menus have recently been studied and proposed by Emmanuelle Perez and the L1 Detector Performance Group...

  17. Trigger-Point Dry Needling for the SOF Medic.

    Science.gov (United States)

    Cavett, Thomas; Solarczyk, Justin

    We propose that trigger-point dry needle (TrP-DN) therapy is an effective low-risk treatment for pain associated with myofascial trigger points (MTrP), and should be incorporated into the Special Operations Forces (SOF) Medic's scope of practice. Furthermore, TrP-DN therapy can be used as a treatment adjunct on the SOF continuum of care, providing analgesia and increased tolerance for rehabilitative therapy, thereby facilitating improved patient outcomes and faster return to operational readiness. The incidence of musculoskeletal injuries in the SOF community is discussed, as are available treatment options TrP-DN methods, a case study of a Soldier deployed to Afghanistan, the science behind the subject of MTrP and TrP-DN, and the risks associated with TrP-DN and how we can mitigate them effectively. Caution should be used in the interpretation of a body of literature based largely on case studies. Although the amount of published evidence in support of the potential benefits of TrP-DN is growing, larger, randomized, placebo-controlled trials and studies that evaluate the effects of TrP-DN in a methodologically rigorous and statistically significant way are needed. Based on anecdotal evidence of and personal experience with the success of the therapy, as well as its growing use within both civilian and military medicine, the possible therapeutic benefit of TrP-DN is relevant for the SOF community. 2016.

  18. TRIGGER

    CERN Multimedia

    R. Carlin with contributions from D. Acosta

    2012-01-01

    Level-1 Trigger Data-taking continues at cruising speed, with high availability of all components of the Level-1 trigger. We have operated the trigger up to a luminosity of 7.6E33, where we approached 100 kHz using the 7E33 prescale column.  Recently, the pause without triggers in case of an automatic "RESYNC" signal (the "settle" and "recover" time) was reduced in order to minimise the overall dead-time. This may become very important when the LHC comes back with higher energy and luminosity after LS1. We are also preparing for data-taking in the proton-lead run in early 2013. The CASTOR detector will make its comeback into CMS and triggering capabilities are being prepared for this. Steps to be taken include improved cooperation with the TOTEM trigger system and using the LHC clock during the injection and ramp phases of LHC. Studies are being finalised that will have a bearing on the Trigger Technical Design Report (TDR), which is to be rea...

  19. A systematic, critical review of manual palpation for identifying myofascial trigger points

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Larsen, Anders Holsgaard; Hartvigsen, Jan

    2008-01-01

    To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature.......To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature....

  20. TRIGGER

    CERN Multimedia

    W. Smith from contributions of C. Leonidopoulos

    2010-01-01

    Level-1 Trigger Hardware and Software Since nearly all of the Level-1 (L1) Trigger hardware at Point 5 has been commissioned, activities during the past months focused on the fine-tuning of synchronization, particularly for the ECAL and the CSC systems, on firmware upgrades and on improving trigger operation and monitoring. Periodic resynchronizations or hard resets and a shortened luminosity section interval of 23 seconds were implemented. For the DT sector collectors, an automatic power-off was installed in case of high temperatures, and the monitoring capabilities of the opto-receivers and the mini-crates were enhanced. The DTTF and the CSCTF now have improved memory lookup tables. The HCAL trigger primitive logic implemented a new algorithm providing better stability of the energy measurement in the presence of any phase misalignment. For the Global Calorimeter Trigger, additional Source Cards have been manufactured and tested. Testing of the new tau, missing ET and missing HT algorithms is underw...

  1. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation

    OpenAIRE

    Ge, Hong-You; Fernández-de-las-Peñas, César; Yue, Shou-Wei

    2011-01-01

    Abstract Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activi...

  2. Ultrasound-Guided Hyaluronic Acid Injections for Trigger Finger: A Double-Blinded, Randomized Controlled Trial.

    Science.gov (United States)

    Liu, Ding-Hao; Tsai, Mei-Wun; Lin, Shan-Hui; Chou, Chen-Liang; Chiu, Jan-Wei; Chiang, Chao-Ching; Kao, Chung-Lan

    2015-12-01

    To investigate the effects of ultrasound-guided injections of hyaluronic acid (HA) versus steroid for trigger fingers in adults. Prospective, double-blinded, randomized controlled study. Tertiary care center. Subjects with a diagnosis of trigger finger (N=36; 39 affected digits) received treatment and were evaluated. Subjects were randomly assigned to HA and steroid injection groups. Both study medications were injected separately via ultrasound guidance with 1 injection. The classification of trigger grading, pain, functional disability, and patient satisfaction were evaluated before the injection and 3 weeks and 3 months after the injection. At 3 months, 12 patients (66.7%) in the HA group and 17 patients (89.5%) in the steroid group exhibited no triggering of the affected fingers (P=.124). The treatment results at 3 weeks and 3 months showed similar changes in the Quinnell scale (P=.057 and .931, respectively). A statistically significant interaction effect between group and time was found for visual analog scale (VAS) and Michigan Hand Outcome Questionnaire (MHQ) evaluation (Pinjection (steroid 0.5±1.1 vs HA 2.7±2.4; Pinjection of HA demonstrated promising results for the treatment of trigger fingers. The optimal frequency, dosage, and molecular weight of HA injections for trigger fingers deserve further investigation for future clinical applications. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Injected mass deposition thresholds for lithium granule instigated triggering of edge localized modes on EAST

    Science.gov (United States)

    Lunsford, R.; Sun, Z.; Maingi, R.; Hu, J. S.; Mansfield, D.; Xu, W.; Zuo, G. Z.; Diallo, A.; Osborne, T.; Tritz, K.; Canik, J.; Huang, M.; Meng, X. C.; Gong, X. Z.; Wan, B. N.; Li, J. G.; the EAST team

    2018-03-01

    The ability of an injected lithium granule to promptly trigger an edge localized mode (ELM) has been established in multiple experiments. By horizontally injecting granules ranging in diameter from 200 microns to 1 mm in diameter into the low field side of EAST H-mode discharges we have determined that granules with diameter  >600 microns are successful in triggering ELMs more than 95% of the time. It was also demonstrated that below 600 microns the triggering efficiency decreased roughly with granule size. Granules were radially injected from the outer midplane with velocities ~80 m s‑1 into EAST upper single null discharges with an ITER like tungsten monoblock divertor. These granules were individually tracked throughout their injection cycle in order to determine their efficacy at triggering an ELM. For those granules of sufficient size, ELM triggering was a prompt response to granule injection. By simulating the granule injection with an experimentally benchmarked neutral gas shielding (NGS) model, the ablatant mass deposition required to promptly trigger an ELM is calculated and the fractional mass deposition is determined.

  4. TRIGGER

    CERN Multimedia

    W. Smith

    At the December meeting, the CMS trigger group reported on progress in production, tests in the Electronics Integration Center (EIC) in Prevessin 904, progress on trigger installation in the underground counting room at point 5, USC55, and results from the Magnet Test and Cosmic Challenge (MTCC) phase II. The trigger group is engaged in the final stages of production testing, systems integration, and software and firmware development. Most systems are delivering final tested electronics to CERN. The installation in USC55 is underway and moving towards integration testing. A program of orderly connection and checkout with subsystems and central systems has been developed. This program includes a series of vertical subsystem slice tests providing validation of a portion of each subsystem from front-end electronics through the trigger and DAQ to data captured and stored. This is combined with operations and testing without beam that will continue until startup. The plans for start-up, pilot and early running tri...

  5. Comparison between four treatment modalities for active myofascial triggers points

    Directory of Open Access Journals (Sweden)

    Atef Fouda

    2014-06-01

    Full Text Available Aim: The study aimed at the painful trigger points (TrPs for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction. Methods: We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction. Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain. We used mean and standard deviation values. The Mann-Whitney U-test was used to compare the two groups. The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores. The Student's t-test was used to compare maximum mouth opening (MMO groups. Then paired t-test was also used to study the changes of time in an MMO. Results: The results showed that pulsed electromagnetic field (PEMF therapy is the most effective treatment modality regarding for pain relief. Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods, and a statistically significant increase in mean MMO. Conclusion: The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.

  6. Shower emboli and digital necrosis after a single corticosteroid injection for trigger thumb: case report.

    Science.gov (United States)

    Park, Jonathan; Dumanian, Gregory A

    2009-02-01

    Local corticosteroid injection into the hand is the preferred initial step in the management of trigger finger owing to its safety and efficacy. We report the case of a patient with shower emboli and digital necrosis after a local corticosteroid injection for the treatment of trigger thumb. Given the patient's subsequent negative hypercoagulability workup, we suspect that the patient's symptoms resulted from the injection of steroids into the princeps pollicis artery, with subsequent retrograde flow into multiple other arteries of the hand. The patient was managed conservatively and ultimately her symptoms resolved. No new areas of digital necrosis have appeared in 8 years of follow-up.

  7. TRIGGER

    CERN Multimedia

    W. Smith from contributions of C. Leonidopoulos, I. Mikulec, J. Varela and C. Wulz.

    Level-1 Trigger Hardware and Software Over the past few months, the Level-1 trigger has successfully recorded data with cosmic rays over long continuous stretches as well as LHC splash events, beam halo, and collision events. The L1 trigger hardware, firmware, synchronization, performance and readiness for beam operation were reviewed in October. All L1 trigger hardware is now installed at Point 5, and most of it is completely commissioned. While the barrel ECAL Trigger Concentrator Cards are fully operational, the recently delivered endcap ECAL TCC system is still being commissioned. For most systems there is a sufficient number of spares available, but for a few systems additional reserve modules are needed. It was decided to increase the overall L1 latency by three bunch crossings to increase the safety margin for trigger timing adjustments. In order for CMS to continue data taking during LHC frequency ramps, the clock distribution tree needs to be reset. The procedures for this have been tested. A repl...

  8. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware and Software The road map for the final commissioning of the level-1 trigger system has been set. The software for the trigger subsystems is being upgraded to run under CERN Scientific Linux 4 (SLC4). There is also a new release for the Trigger Supervisor (TS 1.4), which implies upgrade work by the subsystems. As reported by the CERN group, a campaign to tidy the Trigger Timing and Control (TTC) racks has begun. The machine interface was upgraded by installing the new RF2TTC module, which receives RF signals from LHC Point 4. Two Beam Synchronous Timing (BST) signals, one for each beam, can now be received in CMS. The machine group will define the exact format of the information content shortly. The margin on the locking range of the CMS QPLL is planned for study for different subsystems in the next Global Runs, using a function generator. The TTC software has been successfully tested on SLC4. Some TTC subsystems have already been upgraded to SLC4. The TTCci Trigger Supervisor ...

  9. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation

    Science.gov (United States)

    2011-01-01

    Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy. PMID:21439050

  10. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation.

    Science.gov (United States)

    Ge, Hong-You; Fernández-de-Las-Peñas, César; Yue, Shou-Wei

    2011-03-25

    Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.

  11. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation

    Directory of Open Access Journals (Sweden)

    Fernández-de-las-Peñas César

    2011-03-01

    Full Text Available Abstract Active myofascial trigger points are one of the major peripheral pain generators for regional and generalized musculoskeletal pain conditions. Myofascial trigger points are also the targets for acupuncture and/or dry needling therapies. Recent evidence in the understanding of the pathophysiology of myofascial trigger points supports The Integrated Hypothesis for the trigger point formation; however unanswered questions remain. Current evidence shows that spontaneous electrical activity at myofascial trigger point originates from the extrafusal motor endplate. The spontaneous electrical activity represents focal muscle fiber contraction and/or muscle cramp potentials depending on trigger point sensitivity. Local pain and tenderness at myofascial trigger points are largely due to nociceptor sensitization with a lesser contribution from non-nociceptor sensitization. Nociceptor and non-nociceptor sensitization at myofascial trigger points may be part of the process of muscle ischemia associated with sustained focal muscle contraction and/or muscle cramps. Referred pain is dependent on the sensitivity of myofascial trigger points. Active myofascial trigger points may play an important role in the transition from localized pain to generalized pain conditions via the enhanced central sensitization, decreased descending inhibition and dysfunctional motor control strategy.

  12. TRIGGER

    CERN Multimedia

    J. Alimena

    2013-01-01

    Trigger Strategy Group The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for the development of future High-Level Trigger menus, as well as of its DQM and validation, in collaboration and with the technical support of the PdmV group. Taking into account the beam energy and luminosity expected in 2015, a rough estimate of the trigger rates indicates a factor four increase with respect to 2012 conditions. Assuming that a factor two can be tolerated thanks to the increase in offline storage and processing capabilities, a toy menu has been developed using the new OpenHLT workflow to estimate the transverse energy/momentum thresholds that would halve the current trigger rates. The CPU time needed to run the HLT has been compared between data taken with 25 ns and 50 ns bunch spacing, for equivalent pile-up: no significant difference was observed on the global time per event distribution at the only available data point, corresponding to a pile-up of about 10 interactions. Using th...

  13. Subcutaneous accessory pain system (SAPS): A novel pain pathway for myofascial trigger points.

    Science.gov (United States)

    Eloqayli, Haytham

    2018-02-01

    Despite the accumulating neuro-physiological evidence of myofascial pain, many clinicians are skeptical about its existence as a separate disease entity. No single theory can fully explain the four cardinal features of MPS; taut bands, local tenderness, local twitching and the characteristic pattern of referred pain. Bridging the gap between basic and clinical knowledge mandates coupling the local trigger point changes with the clinically seen distant somatically innervated referred pain. The main question addressed by the present theory is why do trigger points behave differently in comparison to the surrounding muscle tissue and are trigger points the primary problem or secondary to a primary pathology. We propose that trigger points have an extra-innervation system that connect them with other spinal structures such as the facet, the annulus and other trigger points with a role for the subcutaneous fascia as part of trigger points pathogenesis or passage for the extra-innervation. The extra-innervation system is Subcutaneous accessory pain system (SAPS). The novel SAPS system connecting trigger points to the spinal segments via dorsal rami is presented. Individuals with this accessory pathway are prone to myofascial pain, trigger point activation and segmental referred somatic pain similar to other axial spinal structures. Despite the high prevalence of myofascial pain, the mechanism is not universally agreed upon. Why do the trigger points act differently from surrounding muscle tissue and are almost constant in location in different individuals is controversial. Why does myofascial pain and its two components, trigger points and referred pain, exist or are more prevalent in some individuals than in others is unexplained. The correlation between axial spinal structures pathology and the trigger points is not explored well. The existing theories about trigger point formation and referred pain is scientifically credible for each separate component and the SAPS

  14. The local twitch response during trigger point dry needling: Is it necessary for successful outcomes?

    Science.gov (United States)

    Perreault, Thomas; Dunning, James; Butts, Raymond

    2017-10-01

    Myofascial trigger point (MTrP) injection and trigger point dry needling (TrPDN) are widely accepted therapies for myofascial pain syndrome (MPS). Empirical evidence suggests eliciting a local twitch response (LTR) during needling is essential. This is the first review exploring the available literature, regardless of study design, on the neurophysiological effects and clinical significance of the LTR as it relates to reductions in pain and disability secondary to MTrP needling. PubMed, MEDLINE, Science Direct and Google Scholar were searched up until October 2016 using terms related to trigger point needling and the LTR. and Discussion: Several studies show that eliciting a LTR does not correlate with changes in pain and disability, and multiple systematic reviews have failed to conclude whether the LTR is relevant to the outcome of TrPDN. Post needling soreness is consistently reported in studies using repeated in and out needling to elicit LTRs and increases in proportion to the number of needle insertions. In contrast, needle winding without LTRs to MTrPs and connective tissue is well supported in the literature, as it is linked to anti-nociception and factors related to tissue repair and remodeling. Additionally, the positive biochemical changes in the MTrP after needling may simply be a wash out effect related to local vasodilation. While the LTR during TrPDN appears unnecessary for managing myofascial pain and unrelated to many of the positive effects of TrPDN, further investigation is required. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  15. Effectiveness of trigger point dry needling for multiple body regions: a systematic review.

    Science.gov (United States)

    Boyles, Robert; Fowler, Rebecca; Ramsey, Derek; Burrows, Erin

    2015-12-01

    Trigger point dry needling (TDN) is commonly used to treat musculoskeletal pain related to myofascial trigger points (MTrPs). To date, no systematic review of high-quality randomised controlled trials (RCTs) investigating TDN to multiple body regions exists. The aim of this review is to determine the effectiveness of TDN based on high-quality RCTs for all body regions. To ensure thorough reporting, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed as the methodological basis for this systematic review. PubMed, Physiotherapy Evidence Database (PEDro), Cinahl, Cochrane and reference lists were searched for the years 2000-2014 and the terms 'TDN', 'dry needling NOT trigger point', 'functional dry needling' and 'intramuscular manual therapy'. RCTs with PEDro scores 6-10 investigating TDN. duplicates, non-human participants, non-English language, exclusive focus on acupuncture or medicinal injections. Three investigators searched databases, applied criteria, read and assigned PEDro scores to every RCT. Nineteen studies met the criteria. As compared to either baseline or control groups, significant differences were found for pain (14 studies), range of motion (ROM) (five studies) and at least one item on function and quality of life measures (six studies). This review was limited by inclusion criteria, timeframe, language and databases searched. The majority of high-quality studies included in this review show measured benefit from TDN for MTrPs in multiple body areas, suggesting broad applicability of TDN treatment for multiple muscle groups. Further high-quality research is warranted to standardise TDN methods to determine clinical applicability.

  16. Do not rush to return to sports after trigger finger injection.

    Science.gov (United States)

    Oh, Jeehae; Jo, Leechan; Lee, Jong In

    2015-04-01

    Trigger finger, or digital stenosing tenosynovitis, is a common hand problem. A widely accepted treatment is steroid injection into the flexor tendon sheath. This can cause rupture of the flexor tendon. However, to the best of our knowledge, there is no report on tendon rupture after a single corticosteroid injection. Moreover, there are no guidelines for patients with tendinopathy who want to return to sports after corticosteroid injection. Clinicians who perform local steroid injections for tendinopathy treatment should be aware of the possible dangers of tendon rupture and should confirm that steroids are not administrated into the tendon. Patients should also be warned about returning to sports prematurely and should be encouraged to gradually resume sports after the injection to prevent further damage. Herein, we report an unusual case of flexor digitorum profundus rupture after a single corticosteroid injection in a 57-yr-old male golfer and we also present a review of the literature.

  17. An Experimental Investigation of the Risk of Triggering Geological Disasters by Injection under Shear Stress

    Science.gov (United States)

    Liu, Yixin; Xu, Jiang; Peng, Shoujian

    2016-12-01

    Fluid injection has been applied in many fields, such as hazardous waste deep well injection, forced circulation in geothermal fields, hydraulic fracturing, and CO2 geological storage. However, current research mainly focuses on geological data statistics and the dominating effects of pore pressure. There are only a few laboratory-conditioned studies on the role of drilling boreholes and the effect of injection pressure on the borehole wall. Through experimental phenomenology, this study examines the risk of triggering geological disasters by fluid injection under shear stress. We developed a new direct shear test apparatus, coupled Hydro-Mechanical (HM), to investigate mechanical property variations when an intact rock experienced step drilling borehole, fluid injection, and fluid pressure acting on the borehole and fracture wall. We tested the peak shear stress of sandstone under different experimental conditions, which showed that drilling borehole, water injection, and increased pore pressure led to the decrease in peak shear stress. Furthermore, as pore pressure increased, peak shear stress dispersion increased due to crack propagation irregularity. Because the peak shear stress changed during the fluid injection steps, we suggest that the risk of triggering geological disaster with injection under shear stress, pore, borehole, and fluid pressure should be considered.

  18. Comparison of shoulder strength in males with and without myofascial trigger points in the upper trapezius.

    Science.gov (United States)

    Kim, H A; Hwang, U J; Jung, S H; Ahn, S H; Kim, J H; Kwon, O Y

    2017-11-01

    This study was conducted in order to compare the strength of scapular elevator and shoulder abductor with and without restricted scapular elevation between male subjects with and without myofascial trigger points in the upper trapezius. In total, 15 male subjects with myofascial trigger points, and 15age- and weight-matched male subjects without myofascial trigger points in the upper trapezius. Each subject was measured in the strength of maximum isometric scapular elevation and shoulder abduction with and without restricted scapular elevation. Maximum isometric contractions were measured using the Smart KEMA strength measurement system. Independent t-tests were used to compare shoulder strength values between the myofascial trigger points and non- myofascial trigger points groups. The results showed that shoulder abductor strength in the group with myofascial trigger points (5.64kgf) was significantly lower than in the group without myofascial trigger points (11.96kgf) when scapular elevation was restricted (p0.05). These findings suggest that decreased strength in the shoulder abductor with restricted scapular elevation should be considered in evaluating and treating individuals with myofascial trigger points of the upper trapezius. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Dynamic Pointing Triggers Shifts of Visual Attention in Young Infants

    Science.gov (United States)

    Rohlfing, Katharina J.; Longo, Matthew R.; Bertenthal, Bennett I.

    2012-01-01

    Pointing, like eye gaze, is a deictic gesture that can be used to orient the attention of another person towards an object or an event. Previous research suggests that infants first begin to follow a pointing gesture between 10 and 13 months of age. We investigated whether sensitivity to pointing could be seen at younger ages employing a technique…

  20. Surgery versus ultrasound-guided steroid injections for trigger finger disease

    DEFF Research Database (Denmark)

    Hansen, Rehne L; Lange, Jeppe

    2013-01-01

    -guided corticosteroid injection in a randomized controlled trial. The results will contribute to evidence-based recommendations for the treatment of trigger finger patients. FUNDING: not relevant. TRIAL REGISTRATION: Danish Data Protection Agency (1-16-02-119-11). The Central Denmark Region Committees on Biomedical...

  1. Traditional Chinese Medicine acupuncture and myofascial trigger needling: The same stimulation points?

    Science.gov (United States)

    Liu, Lizhou; Skinner, Margot A; McDonough, Suzanne M; Baxter, George David

    2016-06-01

    Acupuncture originates in China, and its effectiveness has been well documented in musculoskeletal pain disorders and other conditions. A widely accepted contemporary medical treatment option for myofascial pain is trigger point needling. Although there are many differences between Traditional Chinese Medicine acupuncture theory and the myofascial trigger point needling framework, it is argued that the stimulation sites for these two needling modalities are similar. In this paper we examined the correspondence between Traditional Chinese Medicine acupoints and myofascial trigger points. Based on this correspondence, we considered exploration of Ah-shi points from four aspects: pain recognition, distal Ah-shi points, Anti-Ah-shi points, and management approaches. The extent of correspondence is influenced by definitions of acupoints. Myofascial trigger points are significantly correlated to Traditional Chinese Medicine acupoints, including primary channel acupoints, extra acupoints, and Ah-shi points. Considering the correlation between MTrPs and acupoints and the rarely-studied research area of Ah-shi points, it may be reasonable to incorporate research findings of myofascial trigger points into further investigations into Ah-shi points. Correspondence between myofascial trigger points and acupoints enhances contemporary understanding of the mechanism of action of acupuncture, and may serve to facilitate increased integration of acupuncture into clinical management. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Chronic whiplash and central sensitization; an evaluation of the role of a myofascial trigger points in pain modulation

    Directory of Open Access Journals (Sweden)

    Freeman Michael D

    2009-04-01

    Full Text Available Abstract Objective it has been established that chronic neck pain following whiplash is associated with the phenomenon of central sensitization, in which injured and uninjured parts of the body exhibit lowered pain thresholds due to an alteration in central pain processing. it has furthermore been hypothesized that peripheral sources of nociception in the muscles may perpetuate central sensitization in chronic whiplash. the hypothesis explored in the present study was whether myofascial trigger points serve as a modulator of central sensitization in subjects with chronic neck pain. Design controlled case series. Setting outpatient chronic pain clinic. Subjects seventeen patients with chronic and intractable neck pain and 10 healthy controls without complaints of neck pain. Intervention symptomatic subjects received anesthetic infiltration of myofascial trigger points in the upper trapezius muscles and controls received the anesthetic in the thigh. Outcome measures: pre and post injection cervical range of motion, pressure pain thresholds (ppt over the infraspinatus, wrist extensor, and tibialis anterior muscles. sensitivity to light (photophobia and subjects' perception of pain using a visual analog scale (vas were also evaluated before and after injections. only the ppt was evaluated in the asymptomatic controls. Results immediate (within 1 minute alterations in cervical range of motion and pressure pain thresholds were observed following an average of 3.8 injections with 1–2 cc of 1% lidocaine into carefully identified trigger points. cervical range of motion increased by an average of 49% (p = 0.000 in flexion and 44% (p = 0.001 in extension, 47% (p = 0.000 and 28% (p Conclusion the present data suggest that myofascial trigger points serve to perpetuate lowered pain thresholds in uninjured tissues. additionally, it appears that lowered pain thresholds associated with central sensitization can be immediately reversed, even when associated

  3. Trigger point acupuncture for treatment of knee osteoarthritis--a preliminary RCT for a pragmatic trial.

    Science.gov (United States)

    Itoh, Kazunori; Hirota, Satoko; Katsumi, Yasukazu; Ochi, Hideki; Kitakoji, Hiroshi

    2008-03-01

    There is evidence for the efficacy of acupuncture treatment in knee osteoarthritis, but it remains unclear which acupuncture modes are most effective. We evaluated the effects of trigger point acupuncture on pain and quality of life in knee osteoarthritis patients, compared with acupuncture at standard points, and sham acupuncture. Thirty patients (27 women, 3 men; aged 61-82 years) with non-radiating knee osteoarthritis pain for at least six months and normal neurological examination were randomised to one of three groups for the study period of 21 weeks. Each group received five acupuncture treatment sessions. The standard acupuncture point group (n=10) received treatment at traditional acupuncture points for knee pain; the trigger point acupuncture group (n=10) received treatment at trigger points; and the third group (n=10) received sham acupuncture treatment at the trigger points. Outcome measures were pain intensity (visual analogue scale, VAS) and WOMAC index (Western Ontario and McMaster Universities Arthritis Index). The groups were compared by the area under the curve method. Five patients dropped out of the study because of lack of improvement, and one patient (in the trigger point acupuncture group) dropped out because of deterioration of symptoms; the remaining 24 patients were included in the analysis. After treatment, the trigger point acupuncture group reported less pain intensity on VAS than the standard acupuncture or sham treatment group, but both the trigger point acupuncture and standard acupuncture groups reported improvement of function of knee. There was a significant reduction in pain intensity between pre-treatment and five weeks after treatment for the trigger point acupuncture (Ptrigger point acupuncture and sham treatment groups analysed (Ptrigger point acupuncture therapy may be more effective for osteoarthritis of the knee in some elderly patients than standard acupuncture therapy.

  4. Gas injection may have triggered earthquakes in the Cogdell oil field, Texas.

    Science.gov (United States)

    Gan, Wei; Frohlich, Cliff

    2013-11-19

    Between 1957 and 1982, water flooding was conducted to improve petroleum production in the Cogdell oil field north of Snyder, TX, and a contemporary analysis concluded this induced earthquakes that occurred between 1975 and 1982. The National Earthquake Information Center detected no further activity between 1983 and 2005, but between 2006 and 2011 reported 18 earthquakes having magnitudes 3 and greater. To investigate these earthquakes, we analyzed data recorded by six temporary seismograph stations deployed by the USArray program, and identified 93 well-recorded earthquakes occurring between March 2009 and December 2010. Relocation with a double-difference method shows that most earthquakes occurred within several northeast-southwest-trending linear clusters, with trends corresponding to nodal planes of regional focal mechanisms, possibly indicating the presence of previously unidentified faults. We have evaluated data concerning injection and extraction of oil, water, and gas in the Cogdell field. Water injection cannot explain the 2006-2011 earthquakes, especially as net volumes (injection minus extraction) are significantly less than in the 1957-1982 period. However, since 2004 significant volumes of gases including supercritical CO2 have been injected into the Cogdell field. The timing of gas injection suggests it may have contributed to triggering the recent seismic activity. If so, this represents an instance where gas injection has triggered earthquakes having magnitudes 3 and larger. Further modeling studies may help evaluate recent assertions suggesting significant risks accompany large-scale carbon capture and storage as a strategy for managing climate change.

  5. Surgery versus ultrasound-guided steroid injections for trigger finger disease

    DEFF Research Database (Denmark)

    Hansen, Rehne L; Lange, Jeppe

    2013-01-01

    -centre, randomised controlled trial with a one-year follow-up. Patients are randomly assigned to either ultrasound-guided corticosteroid injection (n = 83) or to open surgical release of A1-pulley (n = 83). Follow-up is conducted at 12 weeks and one year after treatment. The affected finger will be assessed using...... a trigger finger score. Furthermore, any treatment complications, absence from work or sport and use of related medical services or additional treatment are also recorded. DISCUSSION: The present study will be the first to compare treatment of trigger finger by conventional open surgery with ultrasound...

  6. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points

    DEFF Research Database (Denmark)

    Ge, Hong You; Wang, Ying; Danneskiold-Samsøe, Bente

    2010-01-01

    The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site...

  7. Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial.

    Science.gov (United States)

    Itoh, Kazunori; Asai, Sayo; Ohyabu, Hideaki; Imai, Kenji; Kitakoji, Hiroshi

    2012-04-01

    We compared the effects of trigger point acupuncture with that of sham acupuncture treatments on pain and oral function in patients with temporomandibular disorders (TMDs). This 10-week study included 16 volunteers from an acupuncture school with complaints of chronic temporomandibular joint myofascial pain for at least 6 months. The participants were randomized to one of two groups, each receiving five acupuncture treatment sessions. The trigger point acupuncture group received treatment at trigger points for the same muscle, while the other acupuncture group received sham treatment on the trigger points. Outcome measures were pain intensity (visual analogue scale) and oral function (maximal mouth opening). After treatment, pain intensity was less in the trigger point acupuncture group than in the sham treatment group, but oral function remained unchanged in both groups. Pain intensity decreased significantly between pretreatment and 5 weeks after trigger point (ptrigger point acupuncture therapy may be more effective for chronic temporomandibular joint myofascial pain. Copyright © 2012. Published by Elsevier B.V.

  8. Flexor pulley reconstruction after rupture following corticosteroid injections for trigger thumb: a case report.

    Science.gov (United States)

    Kimura, Michio; Kuroshima, Nagatsugu; Matsushita, Takashi

    2013-01-01

    We report a rare case of limitation of active flexion and subcutaneous bow-stringing as a result of flexor pulley rupture after repeated corticosteroid injections for trigger thumb. Complete rupture of the A1 and oblique flexor pulleys was confirmed during surgery, and the pulley system was reconstructed with a "three-loop technique" using a free palmaris longus autograft. This technique provided enough strength to allow early mobilization and prompt recovery to full range of motion.

  9. Capsaicin-induced central sensitization evokes segmental increases in trigger point sensitivity in humans.

    Science.gov (United States)

    Srbely, John Z; Dickey, James P; Bent, Leah R; Lee, David; Lowerison, Mark

    2010-07-01

    This study investigated whether inducing central sensitization evokes segmental increases in trigger point pressure sensitivity. We evoked central sensitization at the C(5) segment and validated its presence via mechanical cutaneous sensitivity (brush allodynia) testing. Trigger point pressure sensitivity was quantified using the pain pressure threshold (PPT) value. A 50 cm(2) area of the C(5) dermatome at the right lateral elbow was pretreated with 45 degrees heat for 10 minutes. Test subjects (n = 20) then received topical capsaicin cream (0.075%; Medicis, Toronto, Canada) to the C(5) dermatome, whereas control subjects (n = 20) received a topical placebo cream (Biotherm Massage, Montreal, Canada). PPT readings were recorded from the infraspinatus (C(5,6)) and gluteus medius (L(4,5)S(1)) trigger points at zero (pre-intervention), 10, 20, and 30 minutes after intervention; all PPT readings were normalized to pre-intervention (baseline) values. The difference between the PPT readings at the 2 trigger point sites represents the direct influence of segmental mechanisms on the trigger point sensitivity at the infraspinatus site (PPT(seg)). Test subjects demonstrated statistically significant increases in Total Allodynia scores and significant decreases in PPT(seg) at 10, 20, and 30 minutes after application, when compared with control subjects. These results demonstrate that increases in central sensitization evoke increases in trigger point pressure sensitivity in segmentally related muscles. Myofascial pain is the most common form of musculoskeletal pain. Myofascial trigger points play an important role in the clinical manifestation of myofascial pain syndrome. Elucidating the role of central sensitization in the pathophysiology of trigger points is fundamental to developing optimal strategies in the management of myofascial pain syndrome.

  10. The effect of trigger point management by positional release therapy on tension type headache.

    Science.gov (United States)

    Ghanbari, Ali; Rahimijaberi, Abbas; Mohamadi, Marzieh; Abbasi, Leila; Sarvestani, Fahimeh Kamali

    2012-01-01

    The aim of this study was to compare the effectiveness of trigger points' management by Positional Release Therapy (PRT) and routine medical therapy in treatment of Tension Type Headache. Tension Type Headache is the most frequent headache with the basis of myofascial and trigger point disorders. PRT is an indirect technique that treats trigger points. 30 Patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT or medical therapy group. Headache frequency, intensity and duration and tablet count were recorded by use of a daily headache diary. Sensitivity of trigger points was assessed by numeric pain intensity and by use of a digital force gauge (FG 5020). Both groups showed significant reduction in headache frequency and duration and tablet count after treatment phase. However, the reduction of study variables was persisted only in PRT group after follow up phase. There was no significant reduction in headache intensity, neither in PRT and nor in medication group. Sensitivity of trigger points was significantly reduced. In comparison of the two study groups, there was no significant difference in headache frequency, intensity, duration and tablet count (p> 0.05). Both procedures were equally effective according to the study. Thus, PRT can be a treatment choice for patients with T.T.H.

  11. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The hardware of the trigger components has been mostly finished. The ECAL Endcap Trigger Concentrator Cards (TCC) are in production while Barrel TCC firmware has been upgraded, and the Trigger Primitives can now be stored by the Data Concentrator Card for readout by the DAQ. The Regional Calorimeter Trigger (RCT) system is complete, and the timing is being finalized. All 502 HCAL trigger links to RCT run without error. The HCAL muon trigger timing has been equalized with DT, RPC, CSC and ECAL. The hardware and firmware for the Global Calorimeter Trigger (GCT) jet triggers are being commissioned and data from these triggers is available for readout. The GCT energy sums from rings of trigger towers around the beam pipe beam have been changed to include two rings from both sides. The firmware for Drift Tube Track Finder, Barrel Sorter and Wedge Sorter has been upgraded, and the synchronization of the DT trigger is satisfactory. The CSC local trigger has operated flawlessly u...

  12. TRIGGER

    CERN Multimedia

    Roberta Arcidiacono

    2013-01-01

    Trigger Studies Group (TSG) The Trigger Studies Group has just concluded its third 2013 workshop, where all POGs presented the improvements to the physics object reconstruction, and all PAGs have shown their plans for Trigger development aimed at the 2015 High Level Trigger (HLT) menu. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger menu development, path timing, Trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – this last task in collaboration with PdmV (Physics Data and Monte Carlo Validation group). In the last months the group has delivered several HLT rate estimates and comparisons, using the available data and Monte Carlo samples. The studies were presented at the Trigger workshops in September and December, and STEAM has contacted POGs and PAGs to understand the origin of the discrepancies observed between 8 TeV data and Monte Carlo simulations. The most recent results show what the...

  13. Trigger point-related sympathetic nerve activity in chronic sciatic leg pain: a case study.

    Science.gov (United States)

    Skorupska, Elżbieta; Rychlik, Michał; Pawelec, Wiktoria; Bednarek, Agata; Samborski, Włodzimierz

    2014-10-01

    Sciatica has classically been associated with irritation of the sciatic nerve by the vertebral disc and consequent inflammation. Some authors suggest that active trigger points in the gluteus minimus muscle can refer pain in similar way to sciatica. Trigger point diagnosis is based on Travel and Simons criteria, but referred pain and twitch response are significant confirmatory signs of the diagnostic criteria. Although vasoconstriction in the area of a latent trigger point has been demonstrated, the vasomotor reaction of active trigger points has not been examined. We report the case of a 22-year-old Caucasian European man who presented with a 3-year history of chronic sciatic-type leg pain. In the third year of symptoms, coexistent myofascial pain syndrome was diagnosed. Acupuncture needle stimulation of active trigger points under infrared thermovisual camera showed a sudden short-term vasodilatation (an autonomic phenomenon) in the area of referred pain. The vasodilatation spread from 0.2 to 171.9 cm(2) and then gradually decreased. After needling, increases in average and maximum skin temperature were seen as follows: for the thigh, changes were +2.6°C (average) and +3.6°C (maximum); for the calf, changes were +0.9°C (average) and +1.4°C (maximum). It is not yet known whether the vasodilatation observed was evoked exclusively by dry needling of active trigger points. The complex condition of the patient suggests that other variables might have influenced the infrared thermovision camera results. We suggest that it is important to check if vasodilatation in the area of referred pain occurs in all patients with active trigger points. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Changes in blood flow and cellular metabolism at a myofascial trigger point with trigger point release (ischemic compression): a proof-of-principle pilot study.

    Science.gov (United States)

    Moraska, Albert F; Hickner, Robert C; Kohrt, Wendy M; Brewer, Alan

    2013-01-01

    To demonstrate proof-of-principle measurement for physiologic change within an active myofascial trigger point (MTrP) undergoing trigger point release (ischemic compression). Interstitial fluid was sampled continuously at a trigger point before and after intervention. A biomedical research clinic at a university hospital. Subjects (N=2) from a pain clinic who had chronic headache pain. A single microdialysis catheter was inserted into an active MTrP of the upper trapezius to allow for continuous sampling of interstitial fluid before and after application of trigger point therapy by a massage therapist. Procedural success, pain tolerance, feasibility of intervention during sample collection, and determination of physiologically relevant values for local blood flow as well as glucose and lactate concentrations. Both patients tolerated the microdialysis probe insertion into the MTrP and treatment intervention without complication. Glucose and lactate concentrations were measured in the physiologic range. After intervention, a sustained increase in lactate was noted for both subjects. Identifying physiologic constituents of MTrPs after intervention is an important step toward understanding pathophysiology and resolution of myofascial pain. The present study forwards that aim by showing that proof-of-concept for collection of interstitial fluid from an MTrP before and after intervention can be accomplished using microdialysis, thus providing methodological insight toward treatment mechanism and pain resolution. Of the biomarkers measured in this study, lactate may be the most relevant for detection and treatment of abnormalities in the MTrP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The trigger synchronization procedures for running with cosmic muons and operating with the LHC were reviewed during the May electronics week. Firmware maintenance issues were also reviewed. Link tests between the new ECAL endcap trigger concentrator cards (TCC48) and the Regional Calorimeter Trigger have been performed. Firmware for the energy sum triggers and an upgraded tau trigger of the Global Calorimeter Triggers has been developed and is under test. The optical fiber receiver boards for the Track-Finder trigger theta links of the DT chambers are now all installed. The RPC trigger is being made more robust by additional chamber and cable shielding and also by firmware upgrades. For the CSC’s the front-end and trigger motherboard firmware have been updated. New RPC patterns and DT/CSC lookup tables taking into account phi asymmetries in the magnetic field configuration are under study. The motherboard for the new pipeline synchronizer of the Global Trigg...

  16. Treatment of Myofascial Trigger Points of Pelvic Floor with Physiotherapeutic Package: A Case Report

    Directory of Open Access Journals (Sweden)

    Esmaeil Shokri

    2015-03-01

    Full Text Available Background: There are various factors that may cause pain and dysfunction in the pelvic region. Myofascial trigger points can likewise contribute in pelvic pain. Common treatments for myofascial trigger points include electrotherapy, laser therapy, massage, ischemic compression, dry-needling, stretch, icing, heating, and biofeedback. Case Report: A 26 year old man with an exertion-related pain that lasted 5 months was referred for physiotherapy consultation. He had no pain at rest but reported a referral pain from perineal region to the anus and muscular stiffness following a bout of physical activity. On palpation there was a trigger point in the perineal region with referral pain to anus. At the beginning of the treatment, the patient was asked to stop his physical activities. The patient received a treatment package which was useful in the management of trigger points. After 7 sessions of treatment the pain was diminished and there was no exercise induced stiffness. The patient was followed for 10 months later and no pain and stiffness was reported. Conclusion: The application of heat, friction massage, stretching, combined with endurance exercise could be an effective treatment for reliving the pain and muscular stiffness caused by trigger points.

  17. TRIGGER

    CERN Multimedia

    by Wesley Smith

    2010-01-01

    Level-1 Trigger Hardware and Software The overall status of the L1 trigger has been excellent and the running efficiency has been high during physics fills. The timing is good to about 1%. The fine-tuning of the time synchronization of muon triggers is ongoing and will be completed after more than 10 nb-1 of data have been recorded. The CSC trigger primitive and RPC trigger timing have been refined. A new configuration for the CSC Track Finder featured modified beam halo cuts and improved ghost cancellation logic. More direct control was provided for the DT opto-receivers. New RPC Cosmic Trigger (RBC/TTU) trigger algorithms were enabled for collision runs. There is further work planned during the next technical stop to investigate a few of the links from the ECAL to the Regional Calorimeter Trigger (RCT). New firmware and a new configuration to handle trigger rate spikes in the ECAL barrel are also being tested. A board newly developed by the tracker group (ReTRI) has been installed and activated to block re...

  18. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The production of the trigger hardware is now basically finished, and in time for the turn-on of the LHC. The last boards produced are the Trigger Concentrator Cards for the ECAL Endcaps (TCC-EE). After the recent installation of the four EE Dees, the TCC-EE prototypes were used for their commissioning. Production boards are arriving and are being tested continuously, with the last ones expected in November. The Regional Calorimeter Trigger hardware is fully integrated after installation of the last EE cables. Pattern tests from the HCAL up to the GCT have been performed successfully. The HCAL triggers are fully operational, including the connection of the HCAL-outer and forward-HCAL (HO/HF) technical triggers to the Global Trigger. The HCAL Trigger and Readout (HTR) board firmware has been updated to permit recording of the tower “feature bit” in the data. The Global Calorimeter Trigger hardware is installed, but some firmware developments are still n...

  19. TRIGGER

    CERN Multimedia

    W. Smith

    2010-01-01

    Level-1 Trigger Hardware and Software The Level-1 Trigger hardware has performed well during both the recent proton-proton and heavy ion running. Efforts were made to improve the visibility and handling of alarms and warnings. The tracker ReTRI boards that prevent fixed frequencies of Level-1 Triggers are now configured through the Trigger Supervisor. The Global Calorimeter Trigger (GCT) team has introduced a buffer cleanup procedure at stops and a reset of the QPLL during configuring to ensure recalibration in case of a switch from the LHC clock to the local clock. A device to test the cables between the Regional Calorimeter Trigger and the GCT has been manufactured. A wrong charge bit was fixed in the CSC Trigger. The ECAL group is improving crystal masking and spike suppression in the trigger primitives. New firmware for the Drift Tube Track Finder (DTTF) sorters was developed to improve fake track tagging and sorting. Zero suppression was implemented in the DT Sector Collector readout. The track finder b...

  20. TRIGGER

    CERN Multimedia

    Wesley Smith

    Trigger Hardware The status of the trigger components was presented during the September CMS Week and Annual Review and at the monthly trigger meetings in October and November. Procedures for cold and warm starts (e.g. refreshing of trigger parameters stored in registers) of the trigger subsystems have been studied. Reviews of parts of the Global Calorimeter Trigger (GCT) and the Global Trigger (GT) have taken place in October and November. The CERN group summarized the status of the Trigger Timing and Control (TTC) system. All TTC crates and boards are installed in the underground counting room, USC55. The central clock system will be upgraded in December (after the Global Run at the end of November GREN) to the new RF2TTC LHC machine interface timing module. Migration of subsystem's TTC PCs to SLC4/ XDAQ 3.12 is being prepared. Work is on going to unify the access to Local Timing Control (LTC) and TTC CMS interface module (TTCci) via SOAP (Simple Object Access Protocol, a lightweight XML-based messaging ...

  1. Inertial fusion energy target injection, tracking, and beam pointing

    International Nuclear Information System (INIS)

    Petzoldt, R.W.

    1995-01-01

    Several cryogenic targets must be injected each second into a reaction chamber. Required target speed is about 100 m/s. Required accuracy of the driver beams on target is a few hundred micrometers. Fuel strength is calculated to allow acceleration in excess of 10,000 m/s 2 if the fuel temperature is less than 17 K. A 0.1 μm thick dual membrane will allow nearly 2,000 m/s 2 acceleration. Acceleration is gradually increased and decreased over a few membrane oscillation periods (a few ms), to avoid added stress from vibrations which could otherwise cause a factor of two decrease in allowed acceleration. Movable shielding allows multiple targets to be in flight toward the reaction chamber at once while minimizing neutron heating of subsequent targets. The use of multiple injectors is recommended for redundancy which increases availability and allows a higher pulse rate. Gas gun, rail gun, induction accelerator, and electrostatic accelerator target injection devices are studied, and compared. A gas gun is the preferred device for indirect-drive targets due to its simplicity and proven reliability. With the gas gun, the amount of gas required for each target (about 10 to 100 mg) is acceptable. A revolver loading mechanism is recommended with a cam operated poppet valve to control the gas flow. Cutting vents near the muzzle of the gas gun barrel is recommended to improve accuracy and aid gas pumping. If a railgun is used, we recommend an externally applied magnetic field to reduce required current by an order of magnitude. Optical target tracking is recommended. Up/down counters are suggested to predict target arrival time. Target steering is shown to be feasible and would avoid the need to actively point the beams. Calculations show that induced tumble from electrostatically steering the target is not excessive

  2. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware and Software The trigger system has been constantly in use in cosmic and commissioning data taking periods. During CRAFT running it delivered 300 million muon and calorimeter triggers to CMS. It has performed stably and reliably. During the abort gaps it has also provided laser and other calibration triggers. Timing issues, namely synchronization and latency issues, have been solved. About half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are installed, and the firmware is being worked on. The production of the other half has started. The HCAL Trigger and Readout (HTR) card firmware has been updated, and new features such as fast parallel zero-suppression have been included. Repairs of drift tube (DT) trigger mini-crates, optical links and receivers of sector collectors are under way and have been completed on YB0. New firmware for the optical receivers of the theta links to the drift tube track finder is being installed. In parallel, tests with new eta track finde...

  3. TRIGGER

    CERN Multimedia

    Wesley Smith

    Level-1 Trigger Hardware and Software The final parts of the Level-1 trigger hardware are now being put in place. For the ECAL endcaps, more than half of the Trigger Concentrator Cards for the ECAL Endcap (TCC-EE) are now available at CERN, such that one complete endcap can be covered. The Global Trigger now correctly handles ECAL calibration sequences, without being influenced by backpressure. The Regional Calorimeter Trigger (RCT) hardware is complete and working in USC55. Intra-crate tests of all 18 RCT crates and the Global Calorimeter Trigger (GCT) are regularly taking place. Pattern tests have successfully captured data from HCAL through RCT to the GCT Source Cards. HB/HE trigger data are being compared with emulator results to track down the very few remaining hardware problems. The treatment of hot and dead cells, including their recording in the database, has been defined. For the GCT, excellent agreement between the emulator and data has been achieved for jets and HF ET sums. There is still som...

  4. [Manual trigger point therapy of shoulder pain : Randomized controlled study of effectiveness].

    Science.gov (United States)

    Sohns, S; Schnieder, K; Licht, G; von Piekartz, H

    2016-12-01

    Although chronic shoulder pain is highly prevalent and myofascial trigger points (mTrP) are thought to be found in the majority of patients with shoulder complaints, the influence on the pain mechanism remains unclear. There are only very few controlled clinical studies on the effects of manual trigger point compression therapy. This randomized controlled trial (RCT) compared the short-term effects of manual trigger point compression therapy (n = 6) with manual sham therapy (n = 6) in patients with unilateral shoulder pain due to myofascial syndrome (MFS). The measurement data were collected before and after two sessions of therapy. Pressure pain thresholds (PPT) of mTrP and symmetrically located points on the asymptomatic side were measured together with neutral points in order to detect a potential unilateral or generalized hyperalgesia. Additionally, the pain was assessed on a visual analog scale (VAS) at rest and during movement and the neck disability index (NDI) and disabilities of the arm, shoulder and hand (DASH) questionnaires were also completed and evaluated. Both treatment modalities led to a significant improvement; however, the manual trigger point compression therapy was significantly more effective in comparison to sham therapy, as measured by different parameters. The significant improvement of PPT values in the interventional group even at sites that were not directly treated, indicates central mechanisms in pain threshold modulation induced by manual compression therapy. The weaker but still measurable effects of sham therapy might be explained by the sham modality being a hands on technique or by sufficient stimulation of the trigger point region during the diagnostics and PPT measurements.

  5. TRIGGER

    CERN Multimedia

    W. Smith, from contributions of D. Acosta

    2012-01-01

      The L1 Trigger group deployed several major improvements this year. Compared to 2011, the single-muon trigger rate has been reduced by a factor of 2 and the η coverage has been restored to 2.4, with high efficiency. During the current technical stop, a higher jet seed threshold will be applied in the Global Calorimeter Trigger in order to significantly reduce the strong pile-up dependence of the HT and multi-jet triggers. The currently deployed L1 menu, with the “6E33” prescales, has a total rate of less than 100 kHz and operates with detector readout dead time of less than 3% for luminosities up to 6.5 × 1033 cm–2s–1. Further prescale sets have been created for 7 and 8 × 1033 cm–2s–1 luminosities. The L1 DPG is evaluating the performance of the Trigger for upcoming conferences and publication. Progress on the Trigger upgrade was reviewed during the May Upgrade Week. We are investigating scenarios for stagin...

  6. TRIGGER

    CERN Multimedia

    Wesley Smith

    2011-01-01

    Level-1 Trigger Hardware and Software New Forward Scintillating Counters (FSC) for rapidity gap measurements have been installed and integrated into the Trigger recently. For the Global Muon Trigger, tuning of quality criteria has led to improvements in muon trigger efficiencies. Several subsystems have started campaigns to increase spares by recovering boards or producing new ones. The barrel muon sector collector test system has been reactivated, new η track finder boards are in production, and φ track finder boards are under revision. In the CSC track finder, an η asymmetry problem has been corrected. New pT look-up tables have also improved efficiency. RPC patterns were changed from four out of six coincident layers to three out of six in the barrel, which led to a significant increase in efficiency. A new PAC firmware to trigger on heavy stable charged particles allows looking for chamber hit coincidences in two consecutive bunch-crossings. The redesign of the L1 Trigger Emulator...

  7. TRIGGER

    CERN Multimedia

    R. Arcidiacono

    2013-01-01

      In 2013 the Trigger Studies Group (TSG) has been restructured in three sub-groups: STEAM, for the development of new HLT menus and monitoring their performance; STORM, for the development of HLT tools, code and actual configurations; and FOG, responsible for the online operations of the High Level Trigger. The Strategy for Trigger Evolution And Monitoring (STEAM) group is responsible for Trigger Menu development, path timing, trigger performance studies coordination, HLT offline DQM as well as HLT release, menu and conditions validation – in collaboration and with the technical support of the PdmV group. Since the end of proton-proton data taking, the group has started preparing for 2015 data taking, with collisions at 13 TeV and 25 ns bunch spacing. The reliability of the extrapolation to higher energy is being evaluated comparing the trigger rates on 7 and 8 TeV Monte Carlo samples with the data taken in the past two years. The effect of 25 ns bunch spacing is being studied on the d...

  8. Treatment of myofascial trigger points in patients with chronic shoulder pain : a randomized, controlled trial

    NARCIS (Netherlands)

    Bron, Carel; de Gast, Arthur; Dommerholt, Jan; Stegenga, Boudewijn; Wensing, Michel; Oostendorp, Rob A. B.

    2011-01-01

    Background: Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the

  9. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome

    DEFF Research Database (Denmark)

    Ge, Hong-You; Nie, Hongling; Madeleine, Pascal

    2009-01-01

    The generalized hypersensitivity associated with fibromyalgia syndrome (FMS) may in part be driven by peripheral nociceptive sources. The aim of the study was to investigate whether local and referred pain from active myofascial trigger points (MTrPs) contributes to fibromyalgia pain. FMS patients...

  10. TRIGGER

    CERN Multimedia

    W. Smith

    2011-01-01

    Level-1 Trigger Hardware and Software Overall the L1 trigger hardware has been running very smoothly during the last months of proton running. Modifications for the heavy-ion run have been made where necessary. The maximal design rate of 100 kHz can be sustained without problems. All L1 latencies have been rechecked. The recently installed Forward Scintillating Counters (FSC) are being used in the heavy ion run. The ZDC scintillators have been dismantled, but the calorimeter itself remains. We now send the L1 accept signal and other control signals to TOTEM. Trigger cables from TOTEM to CMS will be installed during the Christmas shutdown, so that the TOTEM data can be fully integrated within the CMS readout. New beam gas triggers have been developed, since the BSC-based trigger is no longer usable at high luminosities. In particular, a special BPTX signal is used after a quiet period with no collisions. There is an ongoing campaign to provide enough spare modules for the different subsystems. For example...

  11. TRIGGER

    CERN Multimedia

    by Wesley Smith

    2011-01-01

    Level-1 Trigger Hardware and Software After the winter shutdown minor hardware problems in several subsystems appeared and were corrected. A reassessment of the overall latency has been made. In the TTC system shorter cables between TTCci and TTCex have been installed, which saved one bunch crossing, but which may have required an adjustment of the RPC timing. In order to tackle Pixel out-of-syncs without influencing other subsystems, a special hardware/firmware re-sync protocol has been introduced in the Global Trigger. The link between the Global Calorimeter Trigger and the Global Trigger with the new optical Global Trigger Interface and optical receiver daughterboards has been successfully tested in the Electronics Integration Centre in building 904. New firmware in the GCT now allows a setting to remove the HF towers from energy sums. The HF sleeves have been replaced, which should lead to reduced rates of anomalous signals, which may allow their inclusion after this is validated. For ECAL, improvements i...

  12. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    OpenAIRE

    Bablis, Peter; Pollard, Henry; Bonello, Rod

    2008-01-01

    Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET) could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiro...

  13. TRIGGER

    CERN Multimedia

    W. Smith

    Level-1 Trigger Hardware The CERN group is working on the TTC system. Seven out of nine sub-detector TTC VME crates with all fibers cabled are installed in USC55. 17 Local Trigger Controller (LTC) boards have been received from production and are in the process of being tested. The RF2TTC module replacing the TTCmi machine interface has been delivered and will replace the TTCci module used to mimic the LHC clock. 11 out of 12 crates housing the barrel ECAL off-detector electronics have been installed in USC55 after commissioning at the Electronics Integration Centre in building 904. The cabling to the Regional Calorimeter Trigger (RCT) is terminated. The Lisbon group has completed the Synchronization and Link mezzanine board (SLB) production. The Palaiseau group has fully tested and installed 33 out of 40 Trigger Concentrator Cards (TCC). The seven remaining boards are being remade. The barrel TCC boards have been tested at the H4 test beam, and good agreement with emulator predictions were found. The cons...

  14. Remote therapeutic effectiveness of acupuncture in treating myofascial trigger point of the upper trapezius muscle.

    Science.gov (United States)

    Chou, Li-Wei; Hsieh, Yueh-Ling; Chen, Hsin-Shui; Hong, Chang-Zern; Kao, Mu-Jung; Han, Ting-I

    2011-12-01

    This study aimed to investigate the remote effect of acupuncture (AcP) on the pain intensity and the irritability of the myofascial trigger point in the upper trapezius muscle. Forty-five patients were equally divided into three groups: patients in the placebo control group received sham AcP, those in the simple needling group were treated using simple needling, and those in the modified AcP received AcP with the rapid "screwed in and out" into multiple sites to elicit local twitch responses. The acupoints of Wai-guan and Qu-chi were treated. The outcome assessments included changes in subjective pain intensity, pressure pain threshold, range of motion, and mean amplitude of endplate noise in the myofascial trigger point region. Immediately after acupuncture, all measured parameters improved significantly in the simple needling and modified AcP groups, but not in the placebo control group. There were significantly larger changes in all parameters in the modified AcP group than that in the simple needling group. The myofascial trigger point irritability could be suppressed after a remote acupuncture treatment. It appears that needling to the remote AcP points with multiple needle insertions of modified AcP technique is a better technique than simple needling insertion of simple needling technique in terms of the decrease in pain intensity and prevalence of endplate noise and the increase in pressure pain threshold in the needling sites (represented either AcP points and or myofascial trigger points). We have further confirmed that the reduction in endplate noise showed good correlation with a decreased in pain.

  15. Exploration of quantitative sensory testing in latent trigger points and referred pain areas

    DEFF Research Database (Denmark)

    Ambite-Quesada, Silvia; Arías-Buría, José L.; Courtney, Carol A.

    2018-01-01

    OBJECTIVE: To investigate somato-sensory nerve fibre function by applying different quantitative sensory testing including thermal, mechanical and vibration thresholds over latent trigger points (TrP) and in its associated referred pain area. METHODS: A total of 20 subjects with unilateral latent......P area and contra-lateral mirror point compared to their respectively referred pain areas. Finally, VT was higher over the TrP area than in the referred pain area and over both mirror contra-lateral points. DISCUSSION: Assessing sensory changes over latent myofascial TrPs reveal mechanical hyperesthesia...

  16. [Clinical efficacy observation on primary trigeminal neuralgia treated with joint needling method at the trigger point].

    Science.gov (United States)

    Chen, Zhang-mei; Wu, Xin-tian

    2012-06-01

    To observe the clinical efficacy on primary trigeminal neuralgia treated with joint needling method at the trigger point. One hundred and three cases of primary trigeminal neuralgia were divided into a joint needling group (53 cases) and a conventional needling group (50 cases) according to the visit sequence. In the joint needling group, the joint needling method was used at the trigger point in the mandibular joint [the positive point near to Xiaguan (ST 7)]; the conventional needling was used at Hegu (LI 4), Waiguan (TE 5), Taichong (LR 3) and Neiting (ST 44). In the conventional needling group, Xiaguan (ST 7) and Fengchi (GB 20) were used and the supplementary acupoints were selected according to the involved branches of trigeminal nerve. The conventional needling method was used. The Visual Analogue Scale (VAS) and the score of trigeminal neuralgia were adopted to assess the pain severity and the comprehensive symptoms before treatment and after the 1st and 2nd sessions of treatment separately. The efficacy was assessed. After the 1st and 2nd sessions of treatment, VAS score and the comprehensive symptom score were reduced obviously as compared with those before treatment in either group (P trigger point achieves the significant efficacy on primary trigeminal neuralgia, which is superior to that with the conventional needling method.

  17. [Migraine prophylaxis with trigger point therapy and lymphatic drainage : A pilot study].

    Science.gov (United States)

    Yedikardachian, Delphine; Quasthoff, Stefan; Lechner, Anita T; Giuliani, Albrecht; Fazekas, Franz

    2017-11-01

    Migraine is a complex, multifactorial, neurovascular disorder of the brain. Patients frequently have pericranial trigger points, but trigger point (TP) therapy for migraine has not yet been adequately studied. In contrast, lymphatic drainage (LD) has been studied in patients with migraine. The multifactorial origin of migraine suggests using a combination of approaches such as TP therapy and lymphatic drainage. The present study evaluated the effectiveness of TP therapy alone and in combination with LD in preventing migraine during treatment period and over an 8‑week period after completion of treatment. A wait list control group served as a control group. Patients completed a headache calendar. The results of this pilot study suggest a beneficial effect for TP alone and TP combined with LD for migraine prophylaxis for 8 weeks after completion of treatment.

  18. [Clinical Observation of the Proprioceptive Sensibility Reflexotherapy by Tendon Acupuncture at Trigger Points for Cervical Vertigo].

    Science.gov (United States)

    Yao, Fen-Fen; Luo, Jun; Liu, Jiao; Fang, Wen-Yao; Zhang, Chen-Yu; Zhang, Sheng; Mao, Yu-Lin; Yuan, Zhen; Wang, Kai

    2017-10-25

    To evaluate the efficacy of the proprioceptive sensibility reflexotherapy by tendon acupuncture needling at trigger points for patients with proprioceptive disorder of cervical vertigo. Seventy-nine patients with proprioceptive disorder of cervical vertigo were randomly assigned into a treatment group (42 cases) and a control group (37 cases). Patients in the treatment group received the proprioceptive sensibility reflexotherapy with tendon acupuncture at trigger points in the neck. And those in the control group were given traditional traction, massage and intermediate frequency electro therapy. All the treatment was given for 2 courses, once a day and 10 days as a course. The cervical vertigo symptom and function, the joint position error (JPE) and stability index (ST) before and after treatment were observed in the two groups and the effects were evaluated. The cervical vertigo symptom and function were improved, JPE and ST decreased after treatment in the two groups (all P sensibility reflexotherapy with tendon acupuncture at trigger points is effective for proprioceptive disorder of cervical vertigo.

  19. Is There an Association Between Lumbosacral Radiculopathy and Painful Gluteal Trigger Points?: A Cross-sectional Study.

    Science.gov (United States)

    Adelmanesh, Farhad; Jalali, Ali; Jazayeri Shooshtari, Seyed Mostafa; Raissi, Gholam Reza; Ketabchi, Seyed Mehdi; Shir, Yoram

    2015-10-01

    The objective of this study was to compare the prevalence of gluteal trigger point in patients with lumbosacral radiculopathy with that in healthy volunteers. In a cross-sectional, multistage sampling method, patients with clinical, electromyographic, and magnetic resonance imaging findings consistent with lumbosacral radiculopathy were examined for the presence of gluteal trigger point. Age- and sex-matched clusters of healthy volunteers were selected as the control group. The primary outcome of the study was the presence or absence of gluteal trigger point in the gluteal region of the patients and the control group. Of 441 screened patients, 271 met all the inclusion criteria for lumbosacral radiculopathy and were included in the study. Gluteal trigger point was identified in 207 (76.4%) of the 271 patients with radiculopathy, compared with 3 (1.9%) of 152 healthy volunteers (P trigger point matched the side of painful radiculopathy in 74.6% of patients with a unilateral radicular pain. There was a significant correlation between the side of the gluteal trigger point and the side of patients' radicular pain (P trigger point, located at the painful side. Further studies are required to test the hypothesis that specific gluteal trigger point therapy could be beneficial in these patients.

  20. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points

    DEFF Research Database (Denmark)

    Ge, Hongyou; Wang, Ying; Danneskiold-Samsøe, Bente

    2010-01-01

    The aim of this present study is to test the hypotheses that the 18 predetermined sites of examination for tender points (TP sites) in fibromyalgia syndrome (FMS) are myofascial trigger points (MTrPs), and that the induced pain from active MTrPs at TP sites may mimic fibromyalgia pain. Each TP site......), but not latent MTrPs (r = -.001, P = .99), was positively correlated with spontaneous pain intensity in FMS. The current study provides first evidence that pain from active MTrPs at TP sites mimics fibromyalgia pain. MTrPs may relate to generalized increased sensitivity in FMS due to central sensitization....... PERSPECTIVE: This article underlies the importance of active MTrPs in FMS patients. Most of the TP sites in FMS are MTrPs. Active MTrPs may serve as a peripheral generator of fibromyalgia pain and inactivation of active MTrPs may thus be an alternative for the treatment of FMS....

  1. Subcutaneous injection of 99mTc pertechnetate at acupuncture points K-3 and B-60

    International Nuclear Information System (INIS)

    Wu Chung-Chieng; Jong Shiang-Bin; Lin Chun-Ching; Chen Min-Fen; Chen Jong-Rern; Chung Chieng.

    1990-01-01

    The acupuncture points are known to be morphologically related to the nerves and vessels. Yet the physiological role of blood vessels in the formation of acupuncture points remains unknown. With subcutaneous injection of 99m Tc pertechnetate at the acupuncture points K-3 and B-60 and with intra-acupuncture point injection of 99m Tc pertechnetate at K-3 and B-60, a lower-limb venography like what was obtained by intravenous injection of 99m Tc macroaggregated albumin was demonstrated in the present study. It seems that some acupuncture points do play a role in drainage of tissue fluid from soft tissue into the veins. (author)

  2. Immediate effect of electric point stimulation (TENS) in treating latent upper trapezius trigger points: a double blind randomised placebo-controlled trial.

    Science.gov (United States)

    Gemmell, Hugh; Hilland, Axel

    2011-07-01

    The purpose of this study was to investigate the immediate effect of electric point stimulation in treating latent upper trapezius trigger points compared to placebo. Double blind randomised placebo-controlled trial. Anglo-European College of Chiropractic. Sixty participants with latent upper trapezius trigger points. Electric point stimulator type of TENS, or detuned (inactive) electric point stimulator type of TENS. The three outcome measures were pressure pain threshold at the trigger point, a numerical rating scale for pain elicited over the trigger point, and lateral cervical flexion to the side opposite the trigger point. On the outcome of pressure pain threshold the electric point stimulator group had a mean change of 0.49 (0.99) kg/cm(2), while the placebo group had a mean change of 0.45 (0.98) kg/cm(2) (t = 0.16, df = 58, p = 0.88). For change in pain over the trigger point, the electric point stimulator group had a mean decrease of 0.93 (0.87) points, while the placebo group had a mean decrease of 0.23 (0.97) points (t = 0.70, df = 58, p = 0.005). On the outcome of change in lateral cervical flexion the electric point stimulator group had a mean increase of 2.87 (4.55) degrees, while the placebo group had a mean increase of 1.99 (2.49) degrees (t = 0.92, df = 58, p = 0.36). Electric point stimulator type of TENS is superior to placebo only in reduction of pain for treating latent upper trapezius trigger points. Copyright © 2010 Elsevier Ltd. All rights reserved.

  3. Tokamak startup using point-source dc helicity injection.

    Science.gov (United States)

    Battaglia, D J; Bongard, M W; Fonck, R J; Redd, A J; Sontag, A C

    2009-06-05

    Startup of a 0.1 MA tokamak plasma is demonstrated on the ultralow aspect ratio Pegasus Toroidal Experiment using three localized, high-current density sources mounted near the outboard midplane. The injected open field current relaxes via helicity-conserving magnetic turbulence into a tokamaklike magnetic topology where the maximum sustained plasma current is determined by helicity balance and the requirements for magnetic relaxation.

  4. The function of point injection in improving learning and memory dysfunction caused by cerebral ischemia

    Directory of Open Access Journals (Sweden)

    Chen Hua-De

    2001-02-01

    Full Text Available This experiment has investigated the influence of Yamen (Du. 15 point injection on learning and memory dysfunction caused by cerebral ischemia and reprofusion in bilateral cervical general artery combined with bleeding on mouse tail to mimic vascular dementia in human beings. By dividing 40 mice into 4 groups (group1false operation group, group2model group, group3point injection with Cerebrolysin group4point injection with saline. According to random dividing principles, we observed the influence of Yamen(Du. 15 point injection on the time of swimming the whole course used by model mice which had received treatment for different days in different groups, and the influence of those mice on wrong times they entered blind end. The result showed that point injection with Cerebrolysin and saline could improve learning and memory dysfunction of the mice caused by cerebral ischemia.

  5. Mechanical pain sensitivity of deep tissues in children - possible development of myofascial trigger points in children

    Directory of Open Access Journals (Sweden)

    Han Ting-I

    2012-02-01

    Full Text Available Abstract Background It is still unclear when latent myofascial trigger points (MTrPs develop during early life. This study is designed to investigate the mechanical pain sensitivity of deep tissues in children in order to see the possible timing of the development of latent MTrPs and attachment trigger points (A-TrPs in school children. Methods Five hundreds and five healthy school children (age 4- 11 years were investigated. A pressure algometer was used to measure the pressure pain threshold (PPT at three different sites in the brachioradialis muscle: the lateral epicondyle at elbow (site A, assumed to be the A-TrP site, the mid-point of the muscle belly (site B, assumed to be the MTrP site, and the muscle-tendon junction as a control site (site C. Results The results showed that, for all children in this study, the mean PPT values was significantly lower (p p Conclusions It is concluded that a child had increased sensitivity at the tendon attachment site and the muscle belly (endplate zone after age of 4 years. Therefore, it is likely that a child may develop an A-Trp and a latent MTrP at the brachioradialis muscle after the age of 4 years. The changes in sensitivity, or the development for these trigger points, may not be related to the activity level of children aged 7-11 years. Further investigation is still required to indentify the exact timing of the initial occurrence of a-Trps and latent MTrPs.

  6. Predictors of upper trapezius pain with myofascial trigger points in food service workers

    OpenAIRE

    Hwang, Ui-Jae; Kwon, Oh-Yun; Yi, Chung-Hwi; Jeon, Hye-Seon; Weon, Jong-Hyuck; Ha, Sung-Min

    2017-01-01

    Abstract Shoulder pain occurs commonly in food service workers (FSWs) who repetitively perform motions of the upper limbs. Myofascial trigger points (MTrPs) on the upper trapezius (UT) are among the most common musculoskeletal shoulder pain syndromes. This study determined the psychological, posture, mobility, and strength factors associated with pain severity in FSWs with UT pain due to MTrPs. In this cross-sectional study, we measured 17 variables in 163 FSWs with UT pain due to MTrPs: a vi...

  7. Effectiveness of trigger point dry needling for plantar heel pain: a randomized controlled trial.

    Science.gov (United States)

    Cotchett, Matthew P; Munteanu, Shannon E; Landorf, Karl B

    2014-08-01

    Plantar heel pain can be managed with dry needling of myofascial trigger points; however, there is only poor-quality evidence supporting its use. The purpose of this study was to evaluate the effectiveness of dry needling for plantar heel pain. The study was a parallel-group, participant-blinded, randomized controlled trial. The study was conducted in a university health sciences clinic. Study participants were 84 patients with plantar heel pain of at least 1 month's duration. Participants were randomly assigned to receive real or sham trigger point dry needling. The intervention consisted of 1 treatment per week for 6 weeks. Participants were followed for 12 weeks. Primary outcome measures included first-step pain, as measured with a visual analog scale (VAS), and foot pain, as measured with the pain subscale of the Foot Health Status Questionnaire (FHSQ). The primary end point for predicting the effectiveness of dry needling for plantar heel pain was 6 weeks. At the primary end point, significant effects favored real dry needling over sham dry needling for pain (adjusted mean difference: VAS first-step pain=-14.4 mm, 95% confidence interval [95% CI]=-23.5 to -5.2; FHSQ foot pain=10.0 points, 95% CI=1.0 to 19.1), although the between-group difference was lower than the minimal important difference. The number needed to treat at 6 weeks was 4 (95% CI=2 to 12). The frequency of minor transitory adverse events was significantly greater in the real dry needling group (70 real dry needling appointments [32%] compared with only 1 sham dry needling appointment [Dry needling provided statistically significant reductions in plantar heel pain, but the magnitude of this effect should be considered against the frequency of minor transitory adverse events. © 2014 American Physical Therapy Association.

  8. Investigation of acupuncture-point injection combined with intratumor injection of radionuclide phosphorus 32 in treatment of metastatic carcinoma

    International Nuclear Information System (INIS)

    Chou, H.C.

    1986-01-01

    Seventeen patients with carcinoma and three patients with benign lesions of the head were studied by acupuncture-point injection combined with intratumor injection of radionuclide P-32 for treatment of metastatic carcinoma. The metastatic cervical nodules shrank to half their original sizes within 2-3 weeks in five cases of nasopharyngeal carcinoma. The injected dose ranged from 0.222 to 0.421 mCi, approximately 10 times less than that given by the ordinary method. The acupuncture points are selected according to the Theory of Channels and Collaterals of Chinese traditional medicine. The mechanism of therapeutic action of radionuclide P-32 is possibly by the delivery of destructive ionizing radiation from beta emission properties of P-32. This method appears to offer a low-dose means of P-32 treatment of metastatic carcinoma

  9. Clinical Effectiveness of Dry Needling Immediately After Application on Myofascial Trigger Point in Upper Trapezius Muscle.

    Science.gov (United States)

    Ziaeifar, Maryam; Arab, Amir Massoud; Nourbakhsh, Mohammad Reza

    2016-12-01

    The purpose of this study was to investigate the effect of dry needling (DN) on pain intensity and pressure pain threshold (PPT) compared with ischemic compression (IC) immediately and 48 hours after each treatment session in individuals with myofascial trigger points in the upper trapezius muscle. Thirty-one patients with myofascial trigger points in the upper trapezius muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 14). The treatment protocol for the standard group consisted of IC, whereas the patients in the experimental group received DN. The results indicated that the effect size of the DN methods for pain intensity and PPT was considerably greater after 2 days compared with immediately after the treatment session. In contrast, the effect of the IC for PPT was greater immediately after treatment compared with the measures after 2 days. There was also no noticeable difference in the effect size for IC on pain intensity between the scores obtained immediately and 2 days after treatment. However, our data also revealed a greater effect size for DN on PPT after 2 days compared with the IC technique. In this study, DN improved the pain intensity and PPT after 2 days. However, it had no clinical improvement immediately after application because of muscle soreness. Thus, assessment of the effect of DN immediately after application can be criticized, and the results should be interpreted with caution.

  10. The effect of Kinesio taping technique on trigger points of the piriformis muscle.

    Science.gov (United States)

    Hashemirad, Fahimeh; Karimi, Noureddin; Keshavarz, Roshanak

    2016-10-01

    Kinesio taping (KT) is a novel method which has recently emerged as a viable option to treat various musculoskeletal and neuromuscular deficits. The aim of this study was to determine the effects of KT on pain and hip joint range of motion (ROM) in individuals with myofacial trigger points in the piriformis muscle. 51 patients with involvement of the piriformis muscle were assigned to experimental (N = 33) or control (N = 18) groups. The experimental group received KT with unloading techniques on the piriformis muscle and they were asked to keep this tape in place for three days. Pain and internal rotation (IR) of hip joints were measured at baseline, immediately after the KT application, and at a 72-h follow-up. The analysis of repeated measurement ANOVA yielded no main effects, but the interactions between group and time for each dependent variable (pain and ROM) were significant. A post-hoc analysis revealed significant improvement in pain and hip IR immediately postapplication and at a 72-h follow up in the KT group, while no significant change were found on dependent variables in the control group. Our findings suggests that KT application may be effective for pain relief and increasing ROM in patients with myofacial trigger points in the piriformis muscle. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Randomized trial of trigger point acupuncture treatment for chronic shoulder pain: a preliminary study.

    Science.gov (United States)

    Itoh, Kazunori; Saito, Shingo; Sahara, Shunsaku; Naitoh, Yuki; Imai, Kenji; Kitakoji, Hiroshi

    2014-04-01

    There is evidence for the efficacy of acupuncture treatment for chronic shoulder pain, but it remains unclear which acupuncture modes are most effective. We compared the effect of trigger point acupuncture (TrP), with that of sham (SH) acupuncture treatments, on pain and shoulder function in patients with chronic shoulder pain. The participants were 18 patients (15 women, 3 men; aged 42-65 years) with nonradiating shoulder pain for at least 6 months and normal neurological findings. The participants were randomized into two groups, each receiving five treatment sessions. The TrP group received treatment at trigger points for the muscle, while the other group received SH acupuncture treatment on the same muscle. Outcome measures were pain intensity (visual analogue scale, VAS) and shoulder function (Constant-Murley Score: CMS). After treatment, pain intensity between pretreatment and 5 weeks after TrP decreased significantly (pShoulder function also increased significantly between pretreatment and 5 weeks after TrP (pshoulder pain. Copyright © 2014. Published by Elsevier B.V.

  12. Prevalence of myofascial trigger points in the hip in patellofemoral pain.

    Science.gov (United States)

    Roach, Sean; Sorenson, Eric; Headley, Barbara; San Juan, Jun G

    2013-03-01

    To determine the prevalence of myofascial trigger points (MTrPs) in the gluteus medius (GMe) and quadratus lumborum (QL) for subjects with patellofemoral pain (PFP), and to examine the relationship between MTrPs and force production of the GMe after treatment. Randomized controlled trial. A physical therapy clinic. Subjects (N=52; mean age ± SD, 30±12y; mean height ± SD, 172±10cm; mean mass ± SD, 69±14kg) volunteered and were divided into 2 groups: a PFP group (n=26) consisting of subjects with PFP, and a control group (n=26) with no history of PFP. Patients with PFP received trigger point pressure release therapy (TPPRT). Hip abduction isometric strength and the presence of MTrPs. Prevalence of bilateral GMe and QL MTrPs for the PFP group was significantly higher compared with controls (P=.001). Subjects in the PFP group displayed significantly less hip abduction strength compared with the control group (P=.007). However, TPPRT did not result in increased force production. Subjects with PFP have a higher prevalence of MTrPs in bilateral GMe and QL muscles. They demonstrate less hip abduction strength compared with controls, but the TPPRT did not result in an increase in hip abduction strength. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Treatment of myofascial trigger points in female patients with chronic tension-type headache - A randomized controlled trial

    DEFF Research Database (Denmark)

    Berggreen, S.; Wiik, E.; Lund, Hans

    2012-01-01

    The aim of this study was to evaluate the efficacy of myofascial trigger point massage in the muscles of the head, neck and shoulders regarding pain in the treatment of females with chronic tension-type headache. They were randomized into either a treatment group (n = 20) (one session of trigger......: 8.8 (95% CI 0.1117.4), p = 0.047). Furthermore, a significant decrease in the number of trigger points was observed in the treatment group compared with the control group. Myofascial trigger point massage has a beneficial effect on pain in female patients with chronic tension-type headache....... point massage per week for 10 weeks) or a control group receiving no treatment (n = 19). The patients kept a diary to record their pain on a visual analogue scale (VAS), and the daily intake of drugs (mg) during the 4 weeks before and after the treatment period. The McGill Pain Questionnaire...

  14. Maui Wastewater Injection Points, Maui County HI, 2008, Hawaii State Department of Health

    Data.gov (United States)

    U.S. Environmental Protection Agency — This feature class contains wastewater injection points for the county of Maui. Features were produced by a Hawaii DOH intern in 2008 and represent an unverified...

  15. Myofascial trigger point therapy for triceps surae dysfunction: a case series.

    Science.gov (United States)

    Grieve, Rob; Barnett, Sue; Coghill, Nikki; Cramp, Fiona

    2013-12-01

    The main aim of the case series was to inform further experimental research to determine the effectiveness of myofascial trigger point (MTrP) therapy for the treatment of triceps surae dysfunction. Ten participants with triceps surae dysfunction were recruited (4 females and 6 males); mean age±standard deviation=43±7.1 years. Participants were screened for inclusion/exclusion criteria and the following outcomes measures were assessed at baseline and discharge; lower extremity functional scale (LEFS), verbal numerical rating scale (NRS), MTrP prevalence, ankle dorsiflexion range of movement (ROM) and pressure pain threshold (PPT). Intervention involved trigger point (TrP) pressure release, self MTrP release and a home stretching programme. There was a high prevalence of active/latent MTrPs and possible myofascial pain syndrome (MPS) for all 10 participants at baseline. Active MTrP prevalence decreased to 0%, while latent MTrPs were still present at discharge. There were positive changes in most outcome measures (LEFS, NRS, ROM and PPT) for all 10 participants. Short term to medium term treatment outcomes (6 week post discharge) showed an overall mean LEFS increase of 11 points from 61/80 at baseline to 72/80 at discharge. This case series suggests that a brief course of multimodal MTrP therapy would be helpful for some patients with sub-acute or chronic calf pain. Important preliminary data was gathered, that will inform more rigorous research in this under investigated area. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Effects of Dry Needling on Spinal Mobility and Trigger Points in Patients with Fibromyalgia Syndrome.

    Science.gov (United States)

    Castro-Sanchez, Adelaida Maria; Garcia-Lopez, Hector; Mataran-Penarrocha, Guillermo A; Fernandez-Sanchez, Manuel; Fernandez-Sola, Cayetano; Granero-Molina, Jose; Aguilar-Ferrandiz, Maria Encarnacion

    2017-02-01

    The etiology of fibromyalgia syndrome (FMS) is inconclusive, but central mechanisms are well accepted for this pain condition. Myofascial pain syndrome (MPS) is one of the most common musculoskeletal pain diseases and is characterized by myofascial trigger points (MTrPs). It has been suggest that MTrPs have an important factor in the genesis of FMS. The purpose of the current randomized clinical trial was to compare the effectiveness of dry needling versus cross tape on spinal mobility and MTrPs in spinal muscles in patients with FMS. A single-blind randomized controlled trial was conducted on patients with FMS. Clinical setting. Sixty-four patients with FMS were randomly assigned to an experimental group receiving dry needling therapy or to a control group for cross tape therapy in the MTrPs in the latissimus dorsi, iliocostalis, multifidus, and quadratus lumbourum muscles. Spinal mobility measures and MTrPs algometry were recorded at baseline and after 5 weeks of treatment. The repeated measures analysis of variance (ANOVA) demonstrated that significant differences between groups were achieved for the MTrPs in latissimus dorsi muscle (right axillary portion: F = 9.80, P = 0.003); multifidus muscle (right L2 level: F = 11.80, P = 0.001); quadratus lumborum (right lateral superficial upper: F = 6.67, P = 0.012; and right lateral superficial lower: F = 5.38, P = 0.024). In addition, the ANOVA repeated measures test showed significant differences between groups for the segmental amplitude thoracic spine in the standing erect position (F = 7.33, P = 0.009), and segmental amplitude of lumbar spine (F = 11.60, P = 0.001) in the sitting erect position. The outcomes were not collected from a long-term follow-up period. Dry needling therapy or cross tape were used alone when in reality physical therapists usually treat patients with FMS using a multi-modal approach. A non-treatment control group was not included. This study has demonstrated that dry needling therapy

  17. Resolution and recurrence rates of idiopathic trigger finger after corticosteroid injection

    NARCIS (Netherlands)

    Mol, Marianne F.; Neuhaus, Valentin; Becker, Stéphanie J. E.; Jupiter, Jesse B.; Mudgal, Chaitanya; Ring, David

    2013-01-01

    This study addresses factors associated with apparent resolution and recurrence of triggering using data from providers with various treatment strategies. A retrospective review identified 878 adult patients with 1,210 Quinnell grade 2 or 3 trigger fingers that had one or more corticosteroid

  18. Subcutaneous injection of sup 99m Tc pertechnetate at acupuncture points K-3 and B-60

    Energy Technology Data Exchange (ETDEWEB)

    Wu Chung-Chieng; Jong Shiang-Bin; Lin Chun-Ching; Chen Min-Fen; Chen Jong-Rern (Kaohsiung Medical Coll., Taiwan (China)); Chung Chieng

    1990-06-01

    The acupuncture points are known to be morphologically related to the nerves and vessels. Yet the physiological role of blood vessels in the formation of acupuncture points remains unknown. With subcutaneous injection of {sup 99m}Tc pertechnetate at the acupuncture points K-3 and B-60 and with intra-acupuncture point injection of {sup 99m}Tc pertechnetate at K-3 and B-60, a lower-limb venography like what was obtained by intravenous injection of {sup 99m}Tc macroaggregated albumin was demonstrated in the present study. It seems that some acupuncture points do play a role in drainage of tissue fluid from soft tissue into the veins. (author).

  19. Administering human chorionic gonadotropin injections for triggering follicle maturation could impact fertility during the subsequent menstrual cycle.

    Science.gov (United States)

    Fukuda, Junichiro; Abe, Takashi; Okuno, Takashi; Kobayashi, Tamotsu; Kato, Keiichi

    2016-03-01

    To determine whether the use of a human chorionic gonadotropin (hCG) injection as a follicle-maturation trigger affects a patient's reproductive ability during their subsequent menstrual cycle. Patients that were infertile undergoing natural-cycle in vitro fertilization at Kato Ladies Clinic, Japan, between March and June 2012 were enrolled in a prospective cohort study. Patients who had received fertility treatments other than hCG injections were excluded from the study. The remaining patients were divided into two cohorts; patients who had received injection-administered hCG (study group) and patients who had not received any fertility treatment (control group) during their preceding menstrual cycle. The rates of oocyte retrieval, fertilization, clinical pregnancy, and live deliveries were analyzed using a Fisher exact test. The rate of successful oocyte-retrieval (P<0.001) and the delivery-rate (P=0.002) were significantly lower in the study group in comparison with the control group. Additionally, the incidence of empty follicles (P<0.001) and degenerated oocytes (P=0.002) was significantly higher in the exposure group. Triggering follicle maturation with hCG during in vitro fertilization could impact patient fertility during their next cycle. Treatment with hCG injection has the potential to influence not only the cycle during which it is administered, but also the subsequent menstrual cycle. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle

    Directory of Open Access Journals (Sweden)

    Flavia Emi Akamatsu

    2017-01-01

    Full Text Available Myofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs. We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females. We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Student’s t-test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.

  1. Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle.

    Science.gov (United States)

    Akamatsu, Flavia Emi; Yendo, Tatiana Mina; Rhode, Ciro; Itezerote, Ana Maria; Hojaij, Flávio; Andrade, Mauro; Hsing, Wu Tu; Jacomo, Alfredo Luiz

    2017-01-01

    Myofascial pain syndrome is characterized by pain and limited range of motion in joints and caused by muscular contracture related to dysfunctional motor end plates and myofascial trigger points (MTrPs). We aimed to observe the anatomical correlation between the clinically described MTrPs and the entry point of the branches of the inferior gluteal nerve into the gluteus maximus muscle. We dissected twenty gluteus maximus muscles from 10 human adult cadavers (5 males and 5 females). We measured the muscles and compiled the distribution of the nerve branches into each of the quadrants of the muscle. Statistical analysis was performed by using Student's t -test and Kruskal-Wallis tests. Although no difference was observed either for muscle measurements or for distribution of nerve branching among the subjects, the topography of MTrPs matched the anatomical location of the entry points into the muscle. Thus, anatomical substract of the MTrPs may be useful for a better understanding of the physiopathology of these disorders and provide basis for their surgical and clinical treatment.

  2. The relationship between latent trigger point and muscle strength in healthy subjects: a double-blind study.

    Science.gov (United States)

    Celik, Derya; Yeldan, Ipek

    2011-01-01

    Trigger points on the palpable taut bands of the muscles are promoted as an important cause of musculoskeletal pain. Our hypothesis was latent trigger points (LTrPs) could decrease muscle strength also in healthy people. The aim of our study was to investigate the relationship between LTrPs and muscle strength in a group of healthy adults. In total fifty healthy adults (20 women and 30 men) were included in the study. Trigger point examination for upper and middle trapezius, supraspinatus, serratus anterior and rhomboid major and minor were done bilaterally according to four criteria. Subjects who have at least two trigger points in dominant side were assigned to Group 1 (28 subjects), subjects who don't have any trigger points were assigned to Group 2 (23 subjects). Muscle strength for flexion and scaption was assessed with a Hand-Held Dynamometer (HHD) as break test on both sides. Both the subjects and the examiners were blind. For statistical analysis, independent sample t test was used to compare the differences between two groups. No significant differences were found in muscle strength between dominant and non-dominant sides in both groups (p >0.05). Significant difference was observed in both sides when comparison of muscle strength between Group 1 and 2, muscle strength was lower in subjects who had trigger points (p trigger points in comparison with healthy subjects. Our results underline the importance of palpation of LTrPs in scapular and shoulder muscles in healthy subjects as they may contribute to the muscle strength. Further research is needed to facilitate a better understanding of the mechanism of LTrPs and to test the relationship with muscle strength.

  3. Prevalence of myofascial trigger points in fibromyalgia: the overlap of two common problems.

    Science.gov (United States)

    Ge, Hong-You

    2010-10-01

    With the objective evidence of their existence, myofascial trigger points (MTrPs) contribute to an increasing number of chronic regional and widespread pain conditions. The widespread spontaneous pain pattern in fibromyalgia (FM) is a summation of multiple regional pains due to active MTrPs. A regional pain in FM is from local active MTrPs and/or referred from remote active MTrPs. Positive tender points specified in FM are MTrPs, either active or latent. Manual stimulation of active MTrPs located in the muscles in different body regions completely reproduced overall spontaneous FM pain pattern. Active MTrPs as tonic peripheral nociceptive input contribute tremendously to the initiation and maintenance of central sensitization, to the impairment of descending inhibition, to the increased excitability of motor units, and to the induction of sympathetic hyperactivity observed in FM. The considerable overlap of MTrPs and FM in pain characteristics and pathophysiology suggests that FM pain is largely due to MTrPs.

  4. Changes in a patient with neck pain after application of ischemic compression as a trigger point therapy.

    Science.gov (United States)

    Montañez-Aguilera, F Javier; Valtueña-Gimeno, Noemí; Pecos-Martín, Daniel; Arnau-Masanet, Rosana; Barrios-Pitarque, Carlos; Bosch-Morell, Francisco

    2010-01-01

    To describe the immediate effects of ischemic compression (IC) as a trigger point therapy in a case of a patient with neck pain. The application of IC is a safe and effective method to successfully treat elicited myofascial trigger points. The purpose of this method is to deliberate the blockage of blood in a trigger point area in order to increase local blood flow. This washes away waste products, supplies necessary oxygen and helps the affected tissue to heal. In this case study, we treated a 27-year-old female patient with a medical report of neck pain for at least four months. The physical examination revealed a neck pain and stiffness at the left side and pain increases when moving the neck. An active myofascial trigger point was found in the left trapezius muscle. The following data were recorded: active range of motion of cervical rachis measured with a cervical range of motion instrument, basal electrical activity of the left trapezius measured with electromyography, and pressure tolerance of the myofascial trigger point measured with visual analogue scale, assessing local pain evoked by the application of 2.5 kg/cm2 pressure with an analogue algometer. Immediately after application of the IC, all measured parameters improved compared to base line. The application of IC has been shown effective in the treatment of myofascial trigger points in a patient with neck pain. The results show a relation between active range of motion of cervical rachis, basal electrical activity of the trapezius muscle and myofascial trigger point sensitivity. In this case of a patient with neck pain, active range of motion of cervical rachis, basal electrical activity of the trapezius muscle and myofascial trigger point sensitivity gaining short-term positive effects with the application of one single ischemic compression session. Nevertheless, randomized controlled double-blinded studies should be conducted in future to examine the effectiveness of this ischemic compression

  5. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome.

    Science.gov (United States)

    Weiss, J M

    2001-12-01

    The effectiveness of manual physical therapy was evaluated in patients with interstitial cystitis and the urethral syndrome, that is urgency-frequency with or without pelvic pain. The rationale was based on the hypothesis that pelvic floor myofascial trigger points are not only a source of pain and voiding symptoms, but also a trigger for neurogenic bladder inflammation via antidromic reflexes. From September 1995 to November 2000, 45 women and 7 men, including 10 with interstitial cystitis and 42 with the urgency-frequency syndrome, underwent manual physical therapy to the pelvic floor for 1 to 2 visits weekly for 8 to 12 weeks. Results were determined by patient completed symptom score sheets indicating the rate of improvement according to outcome parameters, including 25% to 50%-mild, 51% to 75%-moderate, 76% to 99%-marked and 100%-complete resolution. In 10 cases these subjective results were confirmed by measuring resting pelvic floor tension by electromyography before and after the treatment course. Of the 42 patients with the urgency-frequency syndrome with or without pain 35 (83%) had moderate to marked improvement or complete resolution, while 7 of the 10 (70%) with interstitial cystitis had moderate to marked improvement. The mean duration of symptoms before treatment in those with interstitial cystitis and the urgency-frequency syndrome was 14 (median 12) and 6 years (median 2.5), respectively. In patients with no symptoms or brief, low intensity flares mean followup was 1.5 years. In 10 patients who underwent electromyography mean resting pelvic floor tension decreased from 9.73 to 3.61 microV., which was a 65% improvement. Pelvic floor manual therapy for decreasing pelvic floor hypertonus effectively ameliorates the symptoms of the urgency/frequency syndrome and interstitial cystitis.

  6. Subcutaneous injection of thallium-201 chloride and gallium-67 citrate at acupuncture point K-3

    International Nuclear Information System (INIS)

    Johg, Shiang-Bin; Wu, Chung-Chieng; Chen, Ming-Feng; Wu, Sheng-Nan

    1992-01-01

    Subcutaneous (SC) injection of 99m Tc pertechnetate ( 99m Tc) at acupuncture points K-3 is a new method of lower-limb radionuclide venography. To investigate the mechanism of absorption of 99m Tc from SC injected sites into vascular system, various radioisotopes such as 201 Tl chloride ( 201 Tl) and 67 Ga citrate ( 67 Ga) were SC injected at K-3 points in animal and human-beings experiments. It was found that 99m Tc and 201 Tl were absorbed rapidly from K-3 points through venous system and into whole body soft tissue. However, 67 Ga with a larger effective ionic radius than 201 Tl was not absorbed throughout the observation of 5 minutes. Furthermore, intravenous administration of digitalis, a Na + -K + pump blocker, did not inhibit the absorption of 99m Tc and 201 Tl after SC injection at K-3 points. These results suggest that absorption of radionuclides on SC injection at K-3 points is mainly through the passive pathway of diffusion rather than the active transport, and the effective ionic radius may be a major factor influencing the absorption rate of the radionuclides. (author)

  7. False triggering of an ultraviolet flame detector after 99mTc-MDP injection.

    Science.gov (United States)

    Yoshizawa, Hisashi; Starkey, Jay

    2016-06-01

    We report a patient who set off a restroom's ultraviolet-spectrum flame detector, occurring 2.5 h after administration of radioisotope 99mTc-MDP (740 MBq) for bone scintigraphy. The radiation dose rate emitted from the patient was estimated to be about 11.82 μSv/h at a distance of 100 cm. To date, many cases have been reported of radiation detector false alarms triggered by radioisotopes administered to patients, presumably due to strengthened security measures and increased radioisotope use. Only one other case of false flame detector triggering in relation to radioisotope administration has been reported, in that case due to therapeutic radioiodine; there have been no prior reports of diagnostic (99m)Tc triggering flame detectors.

  8. Central Sensitization Is Modulated Following Trigger Point Anesthetization in Patients with Chronic Pain from Whiplash Trauma. A Double-Blind, Placebo-Controlled, Crossover Study.

    Science.gov (United States)

    Nystrom, N Ake; Freeman, Michael D

    2018-01-01

    Central sensitization (CS) with low peripheral pain thresholds (PPTs) is a common finding among patients with chronic pain after whiplash (CPWI). While it has been proposed that myofascial myofascial trigger points (MTrPs) may act as modulators of central sensitization, previously reported findings are conflicting and inconclusive. The present study was designed to investigate immediate responsiveness of CS to alterations in nociceptive input. Controlled, double-blind, cross-over. Thirty-one patients with chronic pain (trapezius myalgia) and CS after whiplash. Participants were referred by randomization to group A for injection of a single peripheral pain generator (MTrP or other discrete tender point) with local anesthetic or to group B for sham injection and cross-over. Documentation of PPT (Algometer), maximum jaw opening (caliper), and grip strength (Vigorimeter), as well as subjective overall pain (visual analog scale [VAS]), was made before and after each intervention. Statistical analysis of data (Student's t test, analysis of variance) confirmed that peripheral pain thresholds were significantly higher and maximum jaw opening significantly greater after anesthetizing a focal pain generator in the trapezius, but not after a sham injection. In contrast with the objective variables, subjective generalized pain improved (VAS) after not only an injection of local anesthetic, but also, and to a similar extent, after a sham injection. CS, as expressed by lowered PPT, is a rapidly adjusting physiological response to nociceptive stimuli in some patients with chronic pain after whiplash. PPT are likely modulated by myofascial tender points in selected patients with CS. With reference to the present findings, surgical ablation of MTrPs is discussed as a potential treatment modality for CS. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  9. Migraine responds better to a combination of medical therapy and trigger point management than routine medical therapy alone.

    Science.gov (United States)

    Ghanbari, Ali; Askarzadeh, Saghar; Petramfar, Peyman; Mohamadi, Marzieh

    2015-01-01

    Migraine is one of the most frequent headaches. Cervical myofascial and trigger point disorders are effective factors on accession of this type of headache. PRT is an indirect technique that treats trigger points. The purpose of this study was to compare the effectiveness of trigger points' management by positional release therapy (PRT) combined with routine medical therapy and routine medical therapy alone in treatment of migraine headache. Forty-four patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT-medical therapy or medical therapy group. Headache frequency, intensity, duration and tablet count were recorded by use of a daily headache diary. The sensitivity of trigger points was assessed by the use of a digital force gauge (Wagner-FDIX). Cervical range of motion was measured by a goniometer. Both groups showed significant reduction in headache intensity, frequency, duration and tablet count after 4 months follow up. The sensitivity of trigger points and all cervical range of motions significantly increased in PRT-medical group after 4 months follow up; however in medication group except cervical right lateral flexion, right and left rotation the other factors showed no change after 4 months follow up. In comparison of the two study groups, there was no significant difference in headache-related variables. Apart from the headache intensity and tablet count, the trends of other factors were significantly different between the two groups (p <  0.05). The combined PRT-medical therapy is more effective than the medical therapy alone. Thus, the combination of PRT and medical therapy is suggested as a treatment choice for patients with migraine headache.

  10. Evaluation of myofascial trigger points using infrared thermography: a critical review of the literature.

    Science.gov (United States)

    Dibai-Filho, Almir Vieira; Guirro, Rinaldo Roberto de Jesus

    2015-01-01

    The aim of this study was to review recent studies published on the use of infrared thermography for the assessment of myofascial trigger points (MTrPs). A search of the MEDLINE, CINAHL, PEDro, and SciELO databases was carried out between November 2012 and January 2013 for articles published in English, Portuguese, or Spanish from the year 2000 to 2012. Because of the nature of the included studies and the purpose of this review, the analysis of methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. The search retrieved 11 articles, 2 of which were excluded based on language (German and Chinese). Three were duplicated in different databases, 1 did not use infrared thermography for diagnostic purposes, and the other did not use infrared thermography to measure the skin temperature. Thus, the final sample was made up of 4 observational investigations: 3 comparative studies and 1 accuracy study. At present, there are few studies evaluating the accuracy and reliability of infrared thermography for the diagnosis and assessment of MTrPs. Of the few studies present, there is no agreement on skin temperature patterns in the presence of MTrPs. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  11. EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRAPEZIUS MYOFASCIAL TRIGGER POINTS IN NECK PAIN

    Directory of Open Access Journals (Sweden)

    Pragnya Ravichandran

    2016-04-01

    Full Text Available Background: Neck pain is a common disorder prevailing among individuals of different populations. The myofascial pain syndrome is a disorder related to myofascial trigger points. It is defined as a hyperirritable locus in skeletal muscle and that is associated with a hypersensitive palpable nodule in a taut band of muscle. Manual therapy has got a profound role in treating and ischemic compression technique has been researched widely. Thus the study intends to analyse the effectiveness of Manual Therapy (Ischemic Compression on functional outcome in neck pain. Methods: A single blinded randomized control study was conducted for subjects of sample size 30 who met the inclusion criteria and random allocation was made. The baseline parameters as like pain severity using VAS, pain pressure threshold using pressure Algometer, active cervical lateral flexion using 360 degree goniometer and disability using NDI were recorded. Study group received ischemic compression followed by myofascial stretches while the control group received ultrasonic therapy of 1.4watts/cm2. Both received Cryotherapy post session. After 2 weeks the baseline parameters were again recorded for t-test analysis. Result: There was no statistical significance between groups (p≥0.05. But active cervical lateral flexion showed improved mobility in study group and a high statistical significance within groups (p≤0.01 in relation to all parameters. Conclusion: Both ultrasonic therapy and Ischemic compression technique was found to show better improvement in pain pressure threshold and functional outcome in neck pain.

  12. Sustained nociceptive mechanical stimulation of latent myofascial trigger point induces central sensitization in healthy subjects.

    Science.gov (United States)

    Xu, Yi-Meng; Ge, Hong-You; Arendt-Nielsen, Lars

    2010-12-01

    The aim of the study is to test if sustained nociceptive mechanical stimulation (SNMS) of latent myofascial trigger points (MTrPs) induces widespread mechanical hyperalgesia. SNMS was obtained by inserting and retaining an intramuscular electromyographic (EMG) needle within a latent MTrP or a nonMTrP in the finger extensor muscle for 8 minutes in 12 healthy subjects. Pain intensity (VAS) and referred pain area induced by SNMS were recorded. Pressure pain threshold (PPT) was measured immediately before and after, and 10-, 20-, and 30-minutes after SNMS at the midpoint of the contralateral tibialis anterior muscle. Surface and intramuscular EMG during SNMS were recorded. When compared to nonMTrPs, maximal VAS and the area under VAS curve (VASauc) were significantly higher and larger during SNMS of latent MTrPs (both, P induction of local and referred pain. This study shows that MTrPs are one of the important peripheral pain generators and initiators for central sensitization. Therapeutic methods for decreasing the sensitivity and motor-unit excitability of MTrPs may prevent the development of muscle cramps and thus decrease local and referred pain. Copyright © 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.

  13. Latent myofascial trigger points are associated with an increased antagonistic muscle activity during agonist muscle contraction.

    Science.gov (United States)

    Ibarra, José Miota; Ge, Hong-You; Wang, Chao; Martínez Vizcaíno, Vicente; Graven-Nielsen, Thomas; Arendt-Nielsen, Lars

    2011-12-01

    The aim of this study was to evaluate motor unit activity from a latent myofascial trigger point (MTP) in an antagonist muscle during isometric agonist muscle contraction. Intramuscular activity was recorded with an intramuscular electromyographic (EMG) needle inserted into a latent MTP or a non-MTP in the posterior deltoid muscle at rest and during isometric shoulder flexion performed at 25% of maximum voluntary contraction in 14 healthy subjects. Surface EMGs were recorded from the anterior and posterior deltoid muscles. Maximal pain intensity and referred pain induced by EMG needle insertion were recorded on a visual analogue scale. The results showed that higher local pain was observed following needle insertion into latent MTPs (4.64 ± .48 cm) than non-MTPs (2.35 ± .43 cm, P muscle was significantly higher at rest and during shoulder flexion at latent MTPs than non-MTPs (P muscle relaxation following exercise, disordered fine movement control, and unbalanced muscle activation. Elimination of latent MTPs and/or prevention of latent MTPs from becoming active may improve motor functions. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. Clinical massage and modified Proprioceptive Neuromuscular Facilitation stretching in males with latent myofascial trigger points.

    Science.gov (United States)

    Trampas, Athanasios; Kitsios, Athanasios; Sykaras, Evagelos; Symeonidis, Stamatios; Lazarou, Lazaros

    2010-08-01

    To determine the immediate effects of modified Proprioceptive Neuromuscular Facilitation (PNF) stretching (group I) versus Myofascial Trigger Point (MTrP) therapy plus modified PNF stretching (group II) in comparison to a control group receiving no treatment. Randomized, assessor-blind, (3 x 4) mixed-model repeated measures. University laboratory. Thirty physically active males with tight hamstrings and at least one latent MTrP on muscles innervated by the lumbosacral, sciatic, tibial and common peroneal nerves. Knee range of motion (ROM), stretch perception, pressure pain threshold (PPT) and subjective pain intensity. Outcomes were evaluated at baseline, immediately after treatment, at 10 and 30 min. Significant changes over time occurred for group II in all outcomes (p < or = 0.001). Group II also showed lower pain intensity scores than group I immediately post-treatment (p = 0.045) and a strong clinical effect over group I in ROM at all follow-ups (effect sizes = 0.9-1.0, p < or = 0.05). Other differences were found between both stretching groups as compared to the control group (p < or = 0.05). The results indicate immediate pre- to post-treatment benefits from MTrP therapy combined with modified PNF stretching in young and physically active males with latent MTrPs. 2010 Elsevier Ltd. All rights reserved.

  15. The Ultrasonographic Findings of Trigger Points of Myofascial Pain Syndrome in a Rabbit Model

    International Nuclear Information System (INIS)

    Moon, Kyung Mi; Park, Seog Hee; Lee, Sang Heon; Kim, Joo Hyun; Kim, Han Kyum

    2005-01-01

    Myofascial pain syndrome (MPS) is a common cause of musculoskeletal pain. Myofascial trigger points (MTrPs) have been repeatedly described by numerous authors. However, there have been few studies in which their existence and behavior was supported and their location confirmed. The purpose of this study was to determine whether diagnostic ultrasonography is an objective diagnostic tool which is able to significantly identify or detect the soft tissue changes in the region of clinically identified active MTrPs by using a rabbit experimental model. Ten MPS model rabbits were used in this study. We made an MPS animal model by causing the rabbits to overuse one leg for 3 weeks by cutting the contralateral L4 spinal nerve root. We compared the ultrasonographic findings of the taut band at pre-OP with those at post-OP during the consecutive three week period. To find the taut bands of the muscle, after skin exposure, the muscles were gently rubbed or pinched with the thumb and index finger on the two opposing surfaces of the muscle across the direction of the fibers. Then, the muscle was held in the same way, but with a 5-8 MHz stick probe being used in place of the thumb. After the palpation of various muscles, we selected the hardest and largest myofascial trigger nodule, in order to observe the ultrasonographic and power Doppler findings of the MPS. The size, shape, echogenecity and vascularity of the MTrPs were observed. The analysis of the results of the ultrasonography revealed that all MTrPs have a hyperechoic area. The mean thickness of the hyperechoic lesion in the biceps was 0.96±0.14 cm in the MPS site (at pre-OP?), and 0.49±0.12 cm at post-OP 3weeks (p < 0.01). The hyperechoic lesions in all of the studied biceps femoris of the rabbits were observed by high resolution ultrasonography. No definitively decreased vascularity was observed within the hyperechoic area by power Doppler imaging. Until now, there has been no objective method for the diagnosis of MPS

  16. Effect of bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points on upper back myofascial pain syndrome: a randomized controlled trial.

    Science.gov (United States)

    Jiang, Guimei; Jia, Chao; Lin, Mode

    2016-02-01

    To observe the clinical efficacy of bloodletting therapy and acupuncture at Jiaji points for treating upper back myofascial pain syndrome (MPS), and compare this with lidocaine block therapy. A total of 66 upper back MPS patients were randomly assigned to either the treatment group or the control group in a 1: 1 ratio. The treatment group (n = 33) were treated with bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji (EX-B 2) points; one treatment course consisted of five, single 20-min-treatments with a 2-day break between each treatment. The control group (n = 33) were treated with a lidocaine block at trigger points; one treatment course consisted of five sessions of lidocaine block therapy with a 2-day break between each session. The simplified McGill Scale (SF-MPQ) and tenderness threshold determination were used to assess pain before and after a course of treatment. After the third and fifth treatment, the SF-MPQ values were significantly decreased (P pain assessments between the two groups after three and five treatments (P > 0.05). There were five cases with minor adverse reactions reported in the control patients, while no adverse reactions were reported in the treatment group. Bloodletting therapy at local myofascial trigger points and acupuncture at Jiaji points was effective in treating upper back MPS. Clinically, bloodletting and acupuncture therapy had the same efficacy as the lidocaine block therapy, with fewer adverse reactions.

  17. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: A controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Pollard Henry

    2008-05-01

    Full Text Available Abstract Background Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Methods Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S; levator scapulae region (LS; sternocleidomastoid region (SCM and temporomandibular region (TMJ. For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables using forward stepwise General Linear Model. Results The visual analog scale (0 to 10 had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P Conclusion After a short course of NET treatment, measurements of visual analog scale and pressure algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly

  18. Neuro Emotional Technique for the treatment of trigger point sensitivity in chronic neck pain sufferers: a controlled clinical trial.

    Science.gov (United States)

    Bablis, Peter; Pollard, Henry; Bonello, Rod

    2008-05-21

    Trigger points have been shown to be active in many myofascial pain syndromes. Treatment of trigger point pain and dysfunction may be explained through the mechanisms of central and peripheral paradigms. This study aimed to investigate whether the mind/body treatment of Neuro Emotional Technique (NET) could significantly relieve pain sensitivity of trigger points presenting in a cohort of chronic neck pain sufferers. Sixty participants presenting to a private chiropractic clinic with chronic cervical pain as their primary complaint were sequentially allocated into treatment and control groups. Participants in the treatment group received a short course of Neuro Emotional Technique that consists of muscle testing, general semantics and Traditional Chinese Medicine. The control group received a sham NET protocol. Outcome measurements included pain assessment utilizing a visual analog scale and a pressure gauge algometer. Pain sensitivity was measured at four trigger point locations: suboccipital region (S); levator scapulae region (LS); sternocleidomastoid region (SCM) and temporomandibular region (TMJ). For each outcome measurement and each trigger point, we calculated the change in measurement between pre- and post- treatment. We then examined the relationships between these measurement changes and six independent variables (i.e. treatment group and the above five additional participant variables) using forward stepwise General Linear Model. The visual analog scale (0 to 10) had an improvement of 7.6 at S, 7.2 at LS, 7.5 at SCM and 7.1 at the TMJ in the treatment group compared with no improvement of at S, and an improvement of 0.04 at LS, 0.1 at SCM and 0.1 at the TMJ point in the control group, (P algometer recordings of four trigger point locations in a cohort of chronic neck pain sufferers were significantly improved when compared to a control group which received a sham protocol of NET. Chronic neck pain sufferers may benefit from NET treatment in the relief

  19. Active myofascial trigger points might be more frequent in patients with cervical radiculopathy.

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    Sari, H; Akarirmak, U; Uludag, M

    2012-06-01

    Myofascial trigger points (MTrPs) are commonly observed in the neck, parascapular region, and upper back muscles of patients with cervical pathology. To assess the frequency of latent and active myofascial trigger point (aMTrP) in the neck and upper back muscles in patients with cervical radiculopathy and healthy subjects. Controlled clinical trials. Outpatients and controls. Two hundred and forty four patients and 122 controls The patients clinically diagnosed as cervical radiculopathy with positive Spurling's test and confirmed by MRI, were enrolled in this study. All subjects were examined for active and latent MTrP. In patients with cervical radiculopathy, an aMTrP was distinguished from a latent one when the referred pain elicited by exploration of the MTrP is recognized as familiar. The patients comprised of 128 female (52.5%) and 116 male (47.5%) patients. Mean age was 44.58(20-65 years). In 125 (51.2%) of patients with cervical radiculopathy were found an aMTrP at least one muscle from upper trapezius, multifidus, splenius capitis, levator scapulae, rhomboid major, minor and deep paraspinal muscles. Number and distribution of MTrPs in patients with 244 cervical radiculopathy and in healthy controls. aMTrPs were detected most common in levator scapula (16.3%), splenius capitis (14.7%), rhomboid minor (14.3%), upper part of trapezius (13.5%), rhomboid major (10.2%) and multifidus (8.6%) muscles. Patients with cervical radiculopathy showed latent MTrP in levator scapula (27%), splenius capitis (16.8%), rhomboid minor (24.6%), upper part of trapezius (33.2%), rhomboid major (9%) and multifidus (8.2%) muscles. There was significant difference in terms of distribution of active and latent MTrPs in patients with cervical radiculopathy (P=0.019). Number of latent MTrPs in upper trapezius muscles in patients with cervical radiculopathy was more than the expected distribution. None of the subjects of control group had aMTrP. However, healthy controls showed latent

  20. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernández-de-las-Peñas, César

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern...

  1. EFFECTIVENESS OF INTEGRATED NEUROMUSCULAR INHIBITORY TECHNIQUE (INIT WITH SPECIFIC STRENGTH TRAINING EXERCISES IN SUBJECTS WITH UPPER TRAPEZIUS TRIGGER POINTS

    Directory of Open Access Journals (Sweden)

    B. Jyothirmai

    2015-10-01

    Full Text Available Background: Upper trapezius trigger points is a common cause for neck pain, decreased cervical range of motion and functional activities. The purpose of the study was to evaluate the effectiveness of integrated neuromuscular inhibitory technique (INIT along with specific strength training exercises in reducing pain, improving ROM and functional activities in subjects with upper trapezius trigger point. Methods: Thirty subjects were diagnosed with upper trapezius trigger points were included in the study. These patients were randomly allocated to intervention group (n=15, which underwent a 4- weeks training program of INIT along with specific strength training & control group (n=15 that received INIT alone. The outcome measures were taken before and after treatment. Outcomes were measured by visual analogue scale, cervical range of motion and neck disability index. Within the groups VAS, NDI, and cervical lateral flexion and rotation showed significant change in the mean value. The comparison of pre and post VAS in experimental group and control group showed a significant change in the experimental group .Paired sample t- test was used to analyze changes from before and after intervention programmed. Results: There is a statistically significant (p<0.00 improvement in both variables from baseline to 4th week in experimental group and control group but compared to control group, experimental group shows highly significant values in all parameters. Conclusion: INIT along with specific strength training is proved to be effective in reducing pain, decreasing disability and improving range of motion in individuals with upper trapezius trigger points.

  2. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernandez-de-las-Penas, Cesar

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern. The cu...

  3. Predictors of upper trapezius pain with myofascial trigger points in food service workers

    Science.gov (United States)

    Hwang, Ui-Jae; Kwon, Oh-Yun; Yi, Chung-Hwi; Jeon, Hye-Seon; Weon, Jong-Hyuck; Ha, Sung-Min

    2017-01-01

    Abstract Shoulder pain occurs commonly in food service workers (FSWs) who repetitively perform motions of the upper limbs. Myofascial trigger points (MTrPs) on the upper trapezius (UT) are among the most common musculoskeletal shoulder pain syndromes. This study determined the psychological, posture, mobility, and strength factors associated with pain severity in FSWs with UT pain due to MTrPs. In this cross-sectional study, we measured 17 variables in 163 FSWs with UT pain due to MTrPs: a visual analog scale (VAS) pain score, age, sex, Borg rating of perceived exertion (BRPE) scale, beck depression inventory, forward head posture angle, rounded shoulder angle (RSA), shoulder slope angle, scapular downward rotation ratio, cervical lateral-bending side difference angle, cervical rotation side difference angle, glenohumeral internal rotation angle, shoulder horizontal adduction angle, serratus anterior (SA) strength, lower trapezius (LT) strength, bicep strength, and glenohumeral external rotator strength, in 163 FSWs with UT pain due to MTrPs. The model for factors influencing UT pain with MTrPs included SA strength, age, BRPE, LT strength, and RSA as predictor variables that accounted for 68.7% of the variance in VAS (P < .001) in multiple regression models with a stepwise selection procedure. The following were independent variables influencing the VAS in the order of standardized coefficients: SA strength (β = −0.380), age (β = 0.287), BRPE (β = 0.239), LT strength (β = −0.195), and RSA (β = 0.125). SA strength, age, BRPE, LT strength, and RSA variables should be considered when evaluating and intervening in UT pain with MTrPs in FSWs. PMID:28658117

  4. Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome.

    Science.gov (United States)

    Tornero-Caballero, Maria C; Salom-Moreno, Jaime; Cigarán-Méndez, Margarita; Morales-Cabezas, Matilde; Madeleine, Pascal; Fernández-de-Las-Peñas, César

    2016-10-01

    OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored. Pressure pain thresholds (PPTs) were assessed in a blind manner over seven locations on each foot. Topographical pressure sensitivity maps of the plantar region were generated using the averaged PPT of each location. RESULTS : The prevalence rate of foot pain was 63% (n = 32). The number of active TrPs for each FMS woman with foot pain was 5 ± 1.5 without any latent TrPs. Women with FMS without foot pain and healthy controls had only latent TrPs (2.2 ± 0.8 and 1.5 ± 1.3, respectively). Active TrPs in the flexor hallucis brevis and adductor hallucis muscles were the most prevalent. Topographical pressure pain sensitivity maps revealed that FMS women with foot pain had lower PPT than FMS women without pain and healthy controls, and higher PPT on the calcaneus bone (P pain in women with FMS is high. The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in these patients. FMS women suffering foot pain showed higher pressure hypersensitivity in the plantar region than those FMS women without pain. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Inter- and Intraexaminer Reliability in Identifying and Classifying Myofascial Trigger Points in Shoulder Muscles.

    Science.gov (United States)

    Nascimento, José Diego Sales do; Alburquerque-Sendín, Francisco; Vigolvino, Lorena Passos; Oliveira, Wandemberg Fortunato de; Sousa, Catarina de Oliveira

    2018-01-01

    To determine inter- and intraexaminer reliability of examiners without clinical experience in identifying and classifying myofascial trigger points (MTPs) in the shoulder muscles of subjects asymptomatic and symptomatic for unilateral subacromial impact syndrome (SIS). Within-day inter- and intraexaminer reliability study. Physical therapy department of a university. Fifty-two subjects participated in the study, 26 symptomatic and 26 asymptomatic for unilateral SIS. Two examiners, without experience for assessing MTPs, independent and blind to the clinical conditions of the subjects, assessed bilaterally the presence of MTPs (present or absent) in 6 shoulder muscles and classified them (latent or active) on the affected side of the symptomatic group. Each examiner performed the same assessment twice in the same day. Reliability was calculated through percentage agreement, prevalence- and bias-adjusted kappa (PABAK) statistics, and weighted kappa. Intraexaminer reliability in identifying MTPs for the symptomatic and asymptomatic groups was moderate to perfect (PABAK, .46-1 and .60-1, respectively). Interexaminer reliability was between moderate and almost perfect in the 2 groups (PABAK, .46-.92), except for the muscles of the symptomatic group, which were below these values. With respect to MTP classification, intraexaminer reliability was moderate to high for most muscles, but interexaminer reliability was moderate for only 1 muscle (weighted κ=.45), and between weak and reasonable for the rest (weighted κ=.06-.31). Intraexaminer reliability is acceptable in clinical practice to identify and classify MTPs. However, interexaminer reliability proved to be reliable only to identify MTPs, with the symptomatic side exhibiting lower values of reliability. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. The Effect of Dry Needling Compared With Ischemic Pressure on Pain Intensity on Active Trigger Point in Upper Trapezius Muscle

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    Maryam Ziaeifar

    2013-07-01

    Full Text Available Objective: Myofascial trigger point is one of the most common causes of musculoskeletal pain and disorders. Myofascial trigger point in upper trapezius has been reported as a frequent symptom in patients with neck and thoracic pain. The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on active trigger point in upper trapezius muscle. Materials & Methods: 32 women with active myofascial trigger point in upper trapezius muscle participated in this randomized clinical trial (RCT study. The subjects were randomly assigned into two groups: dry needling (N=15 and ischemic pressure (N=17. The visual analogue scale (VAS was used to assess the pain intensity before and after treatment in both groups. Paired t-test was used to determine any significant difference in pain intensity after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results: Statistical analysis (paired t-test revealed significant decrease in pain intensity after treatment sessions in control and experimental group (P=0.00 compared with pre-treatment score. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups (P=0.8. Conclusion: It seems that that both dry needling and ischemic pressure are effective in improvement in the pain intensity in subjects with myofascial trigger points. However, dry needling can be used by clinicians and therapist in physiotherapy clinics.

  7. [Effect of Dry Needling Stimulation of Myofascial Trigger Point on Sample Entropy of Electromyography of Gastrocnemius Injured Site in Rats].

    Science.gov (United States)

    Ding, Chen-Li; Ma, Yan-Tao; Huang, Qiang-Min; Liu, Qing-Guang; Zhao, Jia-Min

    2018-02-25

    To attempt to establish an objective quantitative indicator to characterize the trigger point activity, so as to evaluate the effect of dry needling on myofascial trigger point activity. Twenty-four male Sprague-Dawley rats were randomly divided into blank control group, dry needling (needling) group, stretching exercise (stretching) group and needling plus stretching group ( n =6 per group). The chronic myofascial pain (trigger point) model was established by freedom vertical fall of a wooden striking device onto the mid-point of gastrocnemius belly of the left hind-limb to induce contusion, followed by forcing the rat to make a continuous downgrade running exercise at a speed of 16 m/min for 90 min on the next day which was conducted once a week for 8 weeks. Electromyography (EMG) of the regional myofascial injured point was monitored and recorded using an EMG recorder via electrodes. It was considered success of the model if spontaneous electrical activities appeared in the injured site. After a 4 weeks' recovery, rats of the needling group were treated by filiform needle stimulation (lifting-thrusting-rotating) of the central part of the injured gastrocnemius belly (about 10 mm deep) for 6 min, and those of the stretching group treated by holding the rat's limb to make the hip and knee joints to an angle of about 180°, and the ankle-joint about 90° for 1 min every time, 3 times altogether (with an interval of 1 min between every 2 times). The activity of the trigger point was estimated by the sample entropy of the EMG signal sequence in reference to Richman's and Moorman's methods to estimate the curative effect of both needling and exercise. After the modeling cycle, the mean sample entropies of EMG signals was significantly decreased in the model groups (needling group [0.034±0.010], stretching group [0.045±0.023], needling plus stretching group [0.047±0.034]) relevant to the blank control group (0.985±0.196, P 0.05), suggesting a better efficacy of

  8. Acupuncture point injection treatment of primary dysmenorrhoea: a randomised, double blind, controlled study.

    Science.gov (United States)

    Wade, C; Wang, L; Zhao, W J; Cardini, F; Kronenberg, F; Gui, S Q; Ying, Z; Zhao, N Q; Chao, M T; Yu, J

    2016-01-05

    To determine if injection of vitamin K3 in an acupuncture point is optimal for the treatment of primary dysmenorrhoea, when compared with 2 other injection treatments. A Menstrual Disorder Centre at a public hospital in Shanghai, China. Chinese women aged 14-25 years with severe primary dysmenorrhoea for at least 6 months not relieved by any other treatment were recruited. Exclusion criteria were the use of oral contraceptives, intrauterine devices or anticoagulant drugs, pregnancy, history of abdominal surgery, participation in other therapies for pain and diagnosis of secondary dysmenorrhoea. Eighty patients with primary dysmenorrhoea, as defined on a 4-grade scale, completed the study. Two patients withdrew after randomisation. A double-blind, double-dummy, randomised controlled trial compared vitamin K3 acupuncture point injection to saline acupuncture point injection and vitamin K3 deep muscle injection. Patients in each group received 3 injections at a single treatment visit. The primary outcome was the difference in subjective perception of pain as measured by an 11 unit Numeric Rating Scale (NRS). Secondary measurements were Cox Pain Intensity and Duration scales and the consumption of analgesic tablets before and after treatment and during 6 following cycles. Patients in all 3 groups experienced pain relief from the injection treatments. Differences in NRS measured mean pain scores between the 2 active control groups were less than 1 unit (-0.71, CI -1.37 to -0.05) and not significant, but the differences in average scores between the treatment hypothesised to be optimal and both active control groups (1.11, CI 0.45 to 1.78) and (1.82, CI 1.45 to 2.49) were statistically significant in adjusted mixed-effects models. Menstrual distress and use of analgesics were diminished for 6 months post-treatment. Acupuncture point injection of vitamin K3 relieves menstrual pain rapidly and is a useful treatment in an urban outpatient clinic. NCT00104546; Results

  9. Treatment of myofascial trigger points in patients with chronic shoulder pain: a randomized, controlled trial

    Science.gov (United States)

    2011-01-01

    Background Shoulder pain is a common musculoskeletal problem that is often chronic or recurrent. Myofascial trigger points (MTrPs) cause shoulder pain and are prevalent in patients with shoulder pain. However, few studies have focused on MTrP therapy. The aim of this study was to assess the effectiveness of multimodal treatment of MTrPs in patients with chronic shoulder pain. Methods A single-assessor, blinded, randomized, controlled trial was conducted. The intervention group received comprehensive treatment once weekly consisting of manual compression of the MTrPs, manual stretching of the muscles and intermittent cold application with stretching. Patients were instructed to perform muscle-stretching and relaxation exercises at home and received ergonomic recommendations and advice to assume and maintain good posture. The control group remained on the waiting list for 3 months. The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score (primary outcome), Visual Analogue Scale for Pain (VAS-P), Global Perceived Effect (GPE) scale and the number of muscles with MTrPs were assessed at 6 and 12 weeks in the intervention group and compared with those of a control group. Results Compared with the control group, the intervention group showed significant improvement (P pain (mean difference, 13.8; 95% CI, 2.6 to 25.0), on the VAS-P2 for pain in the past 7 days (mean difference, 10.2; 95% CI, 0.7 to 19.7) and VAS-P3 most severe pain in the past 7 days (mean difference, 13.8; 95% CI, 0.8 to 28.4). After 12 weeks, 55% of the patients in the intervention group reported improvement (from slightly improved to completely recovered) versus 14% in the control group. The mean number of muscles with active MTrPs decreased in the intervention group compared with the control group (mean difference, 2.7; 95% CI, 1.2 to 4.2). Conclusions The results of this study show that 12-week comprehensive treatment of MTrPs in shoulder muscles reduces the number of muscles with active

  10. High prevalence of shoulder girdle muscles with myofascial trigger points in patients with shoulder pain

    Science.gov (United States)

    2011-01-01

    Background Shoulder pain is reported to be highly prevalent and tends to be recurrent or persistent despite medical treatment. The pathophysiological mechanisms of shoulder pain are poorly understood. Furthermore, there is little evidence supporting the effectiveness of current treatment protocols. Although myofascial trigger points (MTrPs) are rarely mentioned in relation to shoulder pain, they may present an alternative underlying mechanism, which would provide new treatment targets through MTrP inactivation. While previous research has demonstrated that trained physiotherapists can reliably identify MTrPs in patients with shoulder pain, the percentage of patients who actually have MTrPs remains unclear. The aim of this observational study was to assess the prevalence of muscles with MTrPs and the association between MTrPs and the severity of pain and functioning in patients with chronic non-traumatic unilateral shoulder pain. Methods An observational study was conducted. Subjects were recruited from patients participating in a controlled trial studying the effectiveness of physical therapy on patients with unilateral non-traumatic shoulder pain. Sociodemographic and patient-reported symptom scores, including the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, and Visual Analogue Scales for Pain were compared with other studies. To test for differences in age, gender distribution, and education level between the current study population and the populations from Dutch shoulder studies, the one sample T-test was used. One observer examined all subjects (n = 72) for the presence of MTrPs. Frequency distributions, means, medians, standard deviations, and 95% confidence intervals were calculated for descriptive purposes. The Spearman's rank-order correlation (ρ) was used to test for association between variables. Results MTrPs were identified in all subjects. The median number of muscles with MTrPs per subject was 6 (active MTrPs) and 4 (latent MTr

  11. The Prevalence of Latent Trigger Points in Lower Limb Muscles in Asymptomatic Subjects.

    Science.gov (United States)

    Zuil-Escobar, Juan Carlos; Martínez-Cepa, Carmen Belén; Martín-Urrialde, Jose Antonio; Gómez-Conesa, Antonia

    2016-11-01

    Latent trigger points (LTrPs) are prevalent in persons with musculoskeletal pain. Because they could be present in healthy persons, it is necessary to evaluate the prevalence of LTrPs in asymptomatic subjects. To assess the prevalence of LTrPs in lower limb muscles, to evaluate the relationship between LTrP prevalence, gender, and leg dominance, and to determine intra-rater reliability for the diagnosis of LTrPs. Cross-sectional study. University community. A total of 206 asymptomatic subjects (113 women and 93 men, aged 23.2 ± 5.2 years). Not applicable. The prevalence of the LTrPs located in the gastrocnemius, soleus, peroneus longus, peroneus brevis, tibialis anterior, extensor digitorum longus, flexor digitorum longus, rectus femoris, vastus medialis, and vastus lateralis was studied, using the diagnosis criteria recommended by Simons, Travell, and Simons. The pressure pain threshold was also evaluated. Of the 206 subjects evaluated, 166 (77.7%; 95% confidence interval [CI], 72-83.4) were found to have at least one LTrP in the lower limb muscles. The average number of LTrPs found per individual was 7.5 ± 7.7. The prevalence in each muscle group ranged from 19.9% (95% CI, 14.4-25.4) to 37.4% (95% CI, 30.8-44), with gastrocnemius LTrPs being the most prevalent. Women had more LTrPs (9.6 ± 7.8) than did men (4.9 ± 6.6) (P .05). The most prevalent diagnosis criteria were the presence of a taut band and a tender spot (98%-100%); the local twitch response was the least prevalent diagnosis criteria (0%-3.5%). Intra-rater reliability was excellent for all the diagnosis criteria in all the muscles evaluated (κ = 0.762-1), except for the jump sign and the referred pain in several LTrPs. LTrPs were prevalent in the lower limb muscles of asymptomatic subjects. Women have more LTrPs than do men. No differences in LTrP prevalence were found between sides. The presence of the taut band and the tender spot were the most prevalent and reliable diagnosis criteria. It is

  12. Test-retest reliability of myofascial trigger point detection in hip and thigh areas.

    Science.gov (United States)

    Rozenfeld, E; Finestone, A S; Moran, U; Damri, E; Kalichman, L

    2017-10-01

    Myofascial trigger points (MTrP's) are a primary source of pain in patients with musculoskeletal disorders. Nevertheless, they are frequently underdiagnosed. Reliable MTrP palpation is the necessary for their diagnosis and treatment. The few studies that have looked for intra-tester reliability of MTrPs detection in upper body, provide preliminary evidence that MTrP palpation is reliable. Reliability tests for MTrP palpation on the lower limb have not yet been performed. To evaluate inter- and intra-tester reliability of MTrP recognition in hip and thigh muscles. Reliability study. 21 patients (15 males and 6 females, mean age 21.1 years) referred to the physical therapy clinic, 10 with knee or hip pain and 11 with pain in an upper limb, low back, shin or ankle. Two experienced physical therapists performed the examinations, blinded to the subjects' identity, medical condition and results of the previous MTrP evaluation. Each subject was evaluated four times, twice by each examiner in a random order. Dichotomous findings included a palpable taut band, tenderness, referred pain, and relevance of referred pain to patient's complaint. Based on these, diagnosis of latent MTrP's or active MTrP's was established. The evaluation was performed on both legs and included a total of 16 locations in the following muscles: rectus femoris (proximal), vastus medialis (middle and distal), vastus lateralis (middle and distal) and gluteus medius (anterior, posterior and distal). Inter- and intra-tester reliability (Cohen's kappa (κ)) values for single sites ranged from -0.25 to 0.77. Median intra-tester reliability was 0.45 and 0.46 for latent and active MTrP's, and median inter-tester reliability was 0.51 and 0.64 for latent and active MTrPs, respectively. The examination of the distal vastus medialis was most reliable for latent and active MTrP's (intra-tester k = 0.27-0.77, inter-tester k = 0.77 and intra-tester k = 0.53-0.72, inter-tester k = 0.72, correspondingly

  13. Effect of pointed and diffused air injection on premixed flame confined in a Rijke tube

    Directory of Open Access Journals (Sweden)

    Nilaj N. Deshmukh

    2016-12-01

    Full Text Available The coupling between pressure fluctuations and unsteady heat release in a combustion systems results in acoustic oscillations inside the combustion system. These acoustic oscillations, when grow sufficiently, may cause serious structural damage thereby reducing the lifespan of jet engines, gas turbines, and industrial burners. The aim of the first part of study is to define acoustically stable and unstable regions. The second part is focused on studying the effect of change in pressure field near the flame on the amplitude and frequency of the oscillations of instability. This study is carried out for three-burner positions and equivalence ratio of 0.7 by varying heat supply and total flow rate. The results show two acoustically unstable regions for 0.1 and 0.2 burner positions and only one acoustically unstable region for 0.25 burner position. The effect of pointed injection and diffused injection over a premixed flame on the sound pressure level was studied. The results show for burner position of x/L = 0.2 there is 25 dB suppression is possible using pointed injection at higher total flow rate. The experiment of diffused injection shows sound amplification more than 12 dB was observed.

  14. Twenty Thousand Needles Under the Sea. Trigger Point Dry Needling Aboard an Israeli Navy Submarine: A Case Report.

    Science.gov (United States)

    Ronel, Dror; Gabbay, Oren; Esterson, Akiva; Brand, Ronen; Vulfsons, Simon

    2018-04-04

    Nonspecific lower back pain affects a major part of the population at a certain point of their life. The intensity of pain can be debilitating and it causes a significant burden on society. Trigger point dry needling is a method of alleviating such pain by the introduction of needles into trigger points in muscles. A growing body of evidence supports its use in myofascial pain and specifically lower back pain. Submarine Medicine is a unique field due to the special characteristics and the environment of the submarine. It poses challenges that are not always seen by primary care physicians. Here, we present a case of a 40-yr-old senior submarine officer who complained of pain in his lower back and pelvis before departing on a mission. The pain persisted in spite of treatment with nonsteroidal anti-inflammatory drugs and he was then treated by the submarine's physician with trigger point dry needling. The officer showed rapid improvement following this treatment, both regarding pain and the range of motion.

  15. Use of sequential diagnostic pain blocks in a patient of posttraumatic complex regional pain syndrome-not otherwise specified complicated by myofascial trigger points and thoracolumbar pain syndrome

    Directory of Open Access Journals (Sweden)

    Kailash Kothari

    2017-01-01

    Full Text Available We are presenting a case of posttraumatic lower limb Complex regional pain syndrome – Not otherwise specified (CRPS – NOS. As it was not treated in acute phase, the pain became chronic and got complicated by myofascial and thoracolumbar pain syndrome. This case posed us a diagnostic challenge. We used sequential diagnostic pain blocks to identify the pain generators and successfully treat the patient. We used diagnostic blocks step by step to identify and treat pain generators – T12,L1 and L2 Facet joints, Lumbar sympathetic block for CRPS NOS and Trigger point injection with dry needling for myofascial pain syndrome. This case highlights the facet that additional pain generators unrelated to original pain may complicate the presentation. Identifying these pain generators requires out of box thinking and high index of suspicion.

  16. Phreatic eruptions and deformation of Ioto Island (Iwo-jima), Japan, triggered by deep magma injection

    Science.gov (United States)

    Ueda, Hideki; Nagai, Masashi; Tanada, Toshikazu

    2018-03-01

    On Ioto Island (Iwo-jima), 44 phreatic eruptions have been recorded since 1889, when people began to settle there. Four of these eruptions, after the beginning of continuous observation by seismometers in 1976, were accompanied by intense seismic activity and rapid crustal deformation beforehand. Other eruptions on Ioto were without obvious crustal activities. In this paper, we discuss the mechanisms of phreatic eruptions on Ioto. Regular geodetic surveys and continuous GNSS observations show that Ioto intermittently uplifts at an abnormally high rate. All of the four eruptions accompanied by the precursors took place during intermittent uplifts. The crustal deformation before and after one of these eruptions revealed that a sill-like deformation source in the shallow part of Motoyama rapidly inflated before and deflated after the beginning of the eruption. From the results of a seismic array and a borehole survey, it is estimated that there is a layer of lava at a depth of about 100-200 m, and there is a tuff layer about 200-500 m beneath it. The eruptions accompanied by the precursors probably occurred due to abrupt boiling of hot water in hydrothermal reservoirs in the tuff layer, sealed by the lava layer and triggered by intermittent uplift. For the eruptions without precursors, the hydrothermal systems are weakly sealed by clay or probably occurred on the same principle as a geyser because phreatic eruptions had occurred beforehand and hydrostatic pressure is applied to the hydrothermal reservoirs.

  17. Reproduction of overall spontaneous pain pattern by manual stimulation of active myofascial trigger points in fibromyalgia patients

    DEFF Research Database (Denmark)

    Ge, Hong-You; Wang, Ying; Fernández-de-las-Peñas, César

    2011-01-01

    It has previously been reported that local and referred pain from active myofascial trigger points (MTPs) in the neck and shoulder region contribute to fibromyalgia (FM) pain and that the pain pattern induced from active MTPs can reproduce parts of the spontaneous clinical FM pain pattern....... The current study investigated whether the overall spontaneous FM pain pattern can be reproduced by local and referred pain from active MTPs located in different muscles....

  18. Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cuadrado, Maria L; Pareja, Juan A

    2007-05-01

    To assess the differences in the presence of trigger points (TrPs) in head and neck muscles, forward head posture (FHP) and neck mobility between episodic tension-type headache (ETTH) subjects and healthy controls. In addition, we assess the relationship between these muscle TrPs, FHP, neck mobility, and several clinical variables concerning the intensity and the temporal profile of headache. TTH is a headache in which musculoskeletal disorders of the craniocervical region might play an important role in its pathogenesis. Design.-A blinded, controlled pilot study. Fifteen ETTH subjects and 15 matched controls without headache were studied. TrPs in both upper trapezius, both sternocleidomastoids, and both temporalis muscles were identified according to Simons and Gerwin diagnostic criteria (tenderness in a hypersensible spot within a palpable taut band, local twitch response elicited by snapping palpation, and elicited referred pain with palpation). Side-view pictures of each subject were taken in both sitting and standing positions, in order to assess FHP by measuring the craniovertebral angle. A cervical goniometer was employed to measure neck mobility. All measures were taken by a blinded assessor. A headache diary was kept for 4 weeks in order to assess headache intensity, frequency, and duration. The mean number of TrPs for each ETTH subject was 3.7 (SD: 1.3), of which 1.9 (SD: 0.9) were active, and 1.8 (SD: 0.9) were latent. Control subjects only had latent TrPs (mean: 1.5; SD: 1). TrP occurrence between the 2 groups was significantly different for active TrPs (P .05). Differences in the distribution of TrPs were significant for the right upper trapezius muscles (P= .04), the left sternocleidomastoid (P= .03), and both temporalis muscles (P < .001). Within the ETTH group, headache intensity, frequency, and duration outcomes did not differ depending on TrP activity, whether the TrP was active or latent. The craniovertebral angle was smaller, ie, there was a

  19. Effect of ischemic compression for cervicogenic headache and elastic behavior of active trigger point in the sternocleidomastoid muscle using ultrasound imaging.

    Science.gov (United States)

    Jafari, Mehdi; Bahrpeyma, Farid; Togha, Mansoureh

    2017-10-01

    To investigate the effect of ischemic compression on clinical outcomes of a cervicogenic headache and elastic behavior of myofascial trigger points. Randomized, controlled trial. Outpatient headache clinic. 19 subjects with a cervicogenic headache originating from myofascial trigger point within the sternocleidomastoid muscle. Subjects were randomized in treatment group (n = 9) and control group (n = 10). Subjects in the treatment group received 4 sessions of ischemic compression in the myofascial trigger point region. Headache intensity, frequency, and duration, trigger point elastic modulus, trigger point area, pressure tolerance, and pressure pain threshold were assessed before and after treatment. Subjects in the treatment group compared with those in control group showed significant improvements in headache intensity (P = 0.002), headache frequency (P = 0.005), headache duration (P = 0.015), pressure tolerance (P trigger point area (P = 0.017). Changes in myofascial trigger point elastic modulus did not reach a significant level (P > 0.05). The improvements in outcome measures suggest that ischemic compression may be effective in subjects with a cervicogenic headache associated with a myofascial trigger point in the sternocleidomastoid muscle. Data suggests that biomechanical properties of MTrP and severity of headache symptoms are not directly linked, and other mechanisms could be more influential in contributing to symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. SPECIFIC SEQUENTIAL MYOFASCIAL TRIGGER POINT THERAPY IN THE TREATMENT OF A PATIENT WITH MYOFASCIAL PAIN SYNDROME ASSOCIATED WITH REFLEX SYMPATHETIC DYSTROPHY

    Science.gov (United States)

    Hong, Chang-Zern

    2000-01-01

    A patient with traumatic rotator cuff tear of the left shoulder developed severe myofascial pain syndrome with reflex sympathetic dystrophy (RSD) involving the left upper extremity. He was unable to tolerate any type of manual therapy or needle treatment due to severe allodynia in the whole left upper limb. This patient presented for treatment approximately 6 months after the onset of trauma. Treatment consisting of specific myofascial trigger point (MTrP) therapy, beginning with desensitization and gentle massage on the MTrP of the first dorsal interosseous muscle, followed by treatment of MTrPs of the wrist-finger extensors and anterior deltoid muscles was commenced. Allodynia was remarkably reduced and further physical therapy with modalities was administered. After 2 weeks of daily MTrP therapy, he received local steroid injection to the left shoulder and continued MTrP therapy 2-3 times per week. Approximately 2 months after the injection the patient was almost pain free with nearly full range of motion in his left shoulder. The mechanism of MTrPs and their association with RSD is discussed in this paper. PMID:17987165

  1. Trigger point dry needling as an adjunct treatment for a patient with adhesive capsulitis of the shoulder.

    Science.gov (United States)

    Clewley, Derek; Flynn, Timothy W; Koppenhaver, Shane

    2014-02-01

    Case report. Prognosis for adhesive capsulitis has been described as self-limiting and can persist for 1 to 3 years. Conservative treatment that includes physical therapy is commonly advised. The patient was a 54-year-old woman with primary symptoms of shoulder pain and loss of motion consistent with adhesive capsulitis. Manual physical therapy intervention initially consisted of joint mobilizations of the shoulder region and thrust manipulation of the cervicothoracic region. Although manual techniques seemed to result in some early functional improvement, continued progression was limited by pain. Subsequent examination identified trigger points in the upper trapezius, levator scapula, deltoid, and infraspinatus muscles, which were treated with dry needling to decrease pain and allow for higher grades of manual intervention. The patient was treated for a total of 13 visits over a 6-week period. After trigger point dry needling was introduced on the third visit, improvements in pain-free shoulder range of motion and functional outcome measures, assessed with the Shoulder Pain and Disability Index and the shortened form of the Disabilities of the Arm, Shoulder and Hand questionnaire, exceeded the minimal clinically important difference after 2 treatment sessions. At discharge, the patient had achieved significant improvements in shoulder range of motion in all planes, and outcome measures were significantly improved. This case report describes the clinical reasoning behind the use of trigger point dry needling in the treatment of a patient with adhesive capsulitis. The rapid improvement seen in this patient following the initiation of dry needling to the upper trapezius, levator scapula, deltoid, and infraspinatus muscles suggests that surrounding muscles may be a significant source of pain in this condition.

  2. The effect of the combination of dry needling and MET on latent trigger point upper trapezius in females.

    Science.gov (United States)

    Yeganeh Lari, Ameneh; Okhovatian, Farshad; Naimi, Sedigheh sadat; Baghban, Alireza Akbarzadeh

    2016-02-01

    The purpose of this clinical trial experiment was to compare the effects of the combination of dry needling (DN) and the muscle energy technique (MET) on the upper trapezius latent myofascial trigger point. Sixty female patients, aged 18-30 with latent myofascial trigger points in the upper trapezius muscle were randomly divided into three groups: group 1 (n = 20) received DN and MET, group 2 (n = 20) received only MET, and group 3 (n = 20) received only DN. The visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) were measured before each treatment. The patients were treated for three sessions in a one-week period with at least a two-day break between each session, and in session four, an assessment of primary outcomes was conducted without any treatment. All three treatment groups showed decreases in pain (p = 0.001) and increases in PPT levels (p = 0.001) as well as increases in CLF (p = 0.001). But the group receiving trigger point DN together with MET showed more significant improvement than the other two groups in VAS, PPT and ROM. No significant differences were found between the MET-only group and the DN-only group. Our results indicate that all three treatments used in this study were effective for treating MTP. According to this study, DN and MET is suggested as a new method for the treatment of MTP. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Rehabilitation of proximal hamstring tendinopathy utilizing eccentric training, lumbopelvic stabilization, and trigger point dry needling: 2 case reports.

    Science.gov (United States)

    Jayaseelan, Dhinu J; Moats, Nick; Ricardo, Christopher R

    2014-03-01

    Case report. Proximal hamstring tendinopathy is a relatively uncommon overuse injury seen in runners. In contrast to the significant amount of literature guiding the evaluation and treatment of hamstring strains, there is little literature about the physical therapy management of proximal hamstring tendinopathy, other than the general recommendations to increase strength and flexibility. Two runners were treated in physical therapy for proximal hamstring tendinopathy. Each presented with buttock pain with running and sitting, as well as tenderness to palpation at the ischial tuberosity. Each patient was prescribed a specific exercise program focusing on eccentric loading of the hamstrings and lumbopelvic stabilization exercises. Trigger point dry needling was also used with both runners to facilitate improved joint motion and to decrease pain. Both patients were treated in 8 to 9 visits over 8 to 10 weeks. Clinically significant improvements were seen in pain, tenderness, and function in each case. Each patient returned to running and sitting without symptoms. Proximal hamstring tendinopathy can be difficult to treat. In these 2 runners, eccentric loading of the hamstrings, lumbopelvic stabilization exercises, and trigger point dry needling provided short- and long-term pain reduction and functional benefits. Further research is needed to determine the effectiveness of this cluster of interventions for this condition. Therapy, level 4.

  4. Chronic pelvic pain syndrome: reduction of medication use after pelvic floor physical therapy with an internal myofascial trigger point wand.

    Science.gov (United States)

    Anderson, Rodney U; Harvey, Richard H; Wise, David; Nevin Smith, J; Nathanson, Brian H; Sawyer, Tim

    2015-03-01

    This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).

  5. Evolution of Skin Temperature after the Application of Compressive Forces on Tendon, Muscle and Myofascial Trigger Point.

    Science.gov (United States)

    Magalhães, Marina Figueiredo; Dibai-Filho, Almir Vieira; de Oliveira Guirro, Elaine Caldeira; Girasol, Carlos Eduardo; de Oliveira, Alessandra Kelly; Dias, Fabiana Rodrigues Cancio; Guirro, Rinaldo Roberto de Jesus

    2015-01-01

    Some assessment and diagnosis methods require palpation or the application of certain forces on the skin, which affects the structures beneath, we highlight the importance of defining possible influences on skin temperature as a result of this physical contact. Thus, the aim of the present study is to determine the ideal time for performing thermographic examination after palpation based on the assessment of skin temperature evolution. Randomized and crossover study carried out with 15 computer-user volunteers of both genders, between 18 and 45 years of age, who were submitted to compressive forces of 0, 1, 2 and 3 kg/cm2 for 30 seconds with a washout period of 48 hours using a portable digital dynamometer. Compressive forces were applied on the following spots on the dominant upper limb: myofascial trigger point in the levator scapulae, biceps brachii muscle and palmaris longus tendon. Volunteers were examined by means of infrared thermography before and after the application of compressive forces (15, 30, 45 and 60 minutes). In most comparisons made over time, a significant decrease was observed 30, 45 and 60 minutes after the application of compressive forces (p 0.05). In conclusion, infrared thermography can be used after assessment or diagnosis methods focused on the application of forces on tendons and muscles, provided the procedure is performed 15 minutes after contact with the skin. Regarding to the myofascial trigger point, the thermographic examination can be performed within 60 minutes after the contact with the skin.

  6. The Effect of Dry Needling of the Trigger Points of Shoulder Muscles on Pain and Grip Strength in Patients with Lateral Epicondylitis: A Pilot Study

    OpenAIRE

    Alireza Kheradmandi; Maryam Ebrahimian; Farahnaz Ghaffarinejad; Venous Ehyaii; Mohammad Reza Farazdaghi

    2015-01-01

    Background: Lateral epicondylitis, also known as tennis elbow, is the most common overuse syndrome of the elbow. The severity of pain may not be directly caused by tendinopathy of wrist extensors since trigger points of the shoulder muscles have a referral zone in the arm and elbow. Therefore the aim of this study was to evaluate the effect of dry needling of shoulder myofascial trigger points on wrist extensors muscles pain and function. Methods: Fourteen female patients with tennis elbow (a...

  7. Remote Effect of Lower Limb Acupuncture on Latent Myofascial Trigger Point of Upper Trapezius Muscle: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kai-Hua Chen

    2013-01-01

    Full Text Available Objectives. To demonstrate the use of acupuncture in the lower limbs to treat myofascial pain of the upper trapezius muscles via a remote effect. Methods. Five adults with latent myofascial trigger points (MTrPs of bilateral upper trapezius muscles received acupuncture at Weizhong (UB40 and Yanglingquan (GB34 points in the lower limbs. Modified acupuncture was applied at these points on a randomly selected ipsilateral lower limb (experimental side versus sham needling on the contralateral lower limb (control side in each subject. Each subject received two treatments within a one-week interval. To evaluate the remote effect of acupuncture, the range of motion (ROM upon bending the contralateral side of the cervical spine was assessed before and after each treatment. Results. There was significant improvement in cervical ROM after the second treatment (P=0.03 in the experimental group, and the increased ROM on the modified acupuncture side was greater compared to the sham needling side (P=0.036. Conclusions. A remote effect of acupuncture was demonstrated in this pilot study. Using modified acupuncture needling at remote acupuncture points in the ipsilateral lower limb, our treatments released tightness due to latent MTrPs of the upper trapezius muscle.

  8. Reduction of edge localized mode intensity on DIII-D by on-demand triggering with high frequency pellet injection and implications for ITERa)

    Science.gov (United States)

    Baylor, L. R.; Commaux, N.; Jernigan, T. C.; Meitner, S. J.; Combs, S. K.; Isler, R. C.; Unterberg, E. A.; Brooks, N. H.; Evans, T. E.; Leonard, A. W.; Osborne, T. H.; Parks, P. B.; Snyder, P. B.; Strait, E. J.; Fenstermacher, M. E.; Lasnier, C. J.; Moyer, R. A.; Loarte, A.; Huijsmans, G. T. A.; Futatani, S.

    2013-08-01

    The injection of small deuterium pellets at high repetition rates up to 12× the natural edge localized mode (ELM) frequency has been used to trigger high-frequency ELMs in otherwise low natural ELM frequency H-mode deuterium discharges in the DIII-D tokamak [J. L. Luxon and L. G. Davis, Fusion Technol. 8, 441 (1985)]. The resulting pellet-triggered ELMs result in up to 12× lower energy and particle fluxes to the divertor than the natural ELMs. The plasma global energy confinement and density are not strongly affected by the pellet perturbations. The plasma core impurity density is strongly reduced with the application of the pellets. These experiments were performed with pellets injected from the low field side pellet in plasmas designed to match the ITER baseline configuration in shape and normalized β operation with input heating power just above the H-mode power threshold. Nonlinear MHD simulations of the injected pellets show that destabilization of ballooning modes by a local pressure perturbation is responsible for the pellet ELM triggering. This strongly reduced ELM intensity shows promise for exploitation in ITER to control ELM size while maintaining high plasma purity and performance.

  9. A Comparison of Combustion Dynamics for Multiple 7-Point Lean Direct Injection Combustor Configurations

    Science.gov (United States)

    Tacina, K. M.; Hicks, Y. R.

    2017-01-01

    The combustion dynamics of multiple 7-point lean direct injection (LDI) combustor configurations are compared. LDI is a fuel-lean combustor concept for aero gas turbine engines in which multiple small fuel-air mixers replace one traditionally-sized fuel-air mixer. This 7-point LDI configuration has a circular cross section, with a center (pilot) fuel-air mixer surrounded by six outer (main) fuel-air mixers. Each fuel-air mixer consists of an axial air swirler followed by a converging-diverging venturi. A simplex fuel injector is inserted through the center of the air swirler, with the fuel injector tip located near the venturi throat. All 7 fuel-air mixers are identical except for the swirler blade angle, which varies with the configuration. Testing was done in a 5-atm flame tube with inlet air temperatures from 600 to 800 F and equivalence ratios from 0.4 to 0.7. Combustion dynamics were measured using a cooled PCB pressure transducer flush-mounted in the wall of the combustor test section.

  10. Foreign body reaction triggered by cytotoxic T lymphocyte-associated protein 4 blockade 25 years after dermal filler injection

    NARCIS (Netherlands)

    Bisschop, C.; Bruijn, M. S.; Stenekes, M. W.; Diercks, G. F. H.; Hospers, G. A. P.

    2016-01-01

    Foreign body reactions are regularly seen as a late complication of cosmetic treatment with synthetic dermal fillers. Often this foreign body reaction is triggered by a systemic infection, but other systemic triggers are also reported. In this case report, we present a woman in her 60s who was

  11. The Effects of Active Trigger Point of Upper Trapezius Muscle on Its Electromyography Activity and Maximal Isometric Contraction Force during Scapular Plane Elevation (Scaption

    Directory of Open Access Journals (Sweden)

    Zahra Mohammadi

    2014-01-01

    Full Text Available Objective: Trigger points may result in referral pain of their close areas. Recent evidence suggests that latent trigger points although they are not sensitive enough to cause pain, can interfere with the normal muscle function. These myofascial trigger points are estimated as an electro-physiological phenomenon. However, there are a few studies which investigated the effect of these points on the muscle activity. Muscle activity is a determinant factor in injuries which may cause or worsen shoulder-neck pain. The aim of the study was to evaluate upper trapezius muscle activity and delay time at the presence of active trigger point during scapular plane elevation (scaption. Materials & Methods: In a case-control comparative study in spring 2012, Seventeen women with active trigger points (mean age 26.76 y and 17 healthy women (mean age 26.18 y in bio-mechanic laboratory of University of Social Welfare and Rehabilitation sciences (USWR participated in the study. Using surface EMG, the amplitude of muscle activity and the onset time of upper trapezius during scaption, were recorded and analyzed. Results: The maximum amplitude of the upper trapezius muscle activity (during maximal voluntary isometric contraction of 90°scaption in patients showed significant decrease in comparison with the healthy subjects (P=0.01.Also, the onset time of upper trapezius muscle activation time in the patient group was significantly delayed in comparison to the healthy group (P=0.04. Conclusion: At the presence of trigger points in Upper trapezius muscle, muscle activation pattern changes trigger points can change the amplitude and timing of muscle activity and may consequently lead to abnormal patterns of motion of the shoulder girdle. These findings can be used in the prevention and treatment of shoulder disorders.

  12. Effect of myofascial trigger point therapy with an inflatable ball in elderlies with chronic non-specific low back pain.

    Science.gov (United States)

    Oh, Sejun; Kim, Minhee; Lee, Minyoung; Kim, Taeyeong; Lee, Dongshin; Yoon, Bumchul

    2018-02-06

    Myofascial trigger points (MTrPs) are related to low back pain and back muscle stiffening, and secondarily to movement impairment. MTrP therapy with an inflatable ball would improve clinical outcomes for chronic non-specific low back pain (CNSLBP) after 6 weeks. The aim of this study was to investigate the effects of MTrPs with an inflatable ball for the elderly with CNSLBP. Fifteen elderly patients with chronic non-specific low back pain were evaluated for pain, pressure sensitivity, and physical function at baseline and 1, 3, and 6 weeks of therapy. The visual analog scale (VAS) and pressure pain threshold (PPT) were used to measure pain intensity and sensitivity, respectively. Straight-leg-raise (SLR) test, back range of motion (BROM), and Oswestry disability index were used to assess physical function. Significant differences were observed between the 3- and 6-week VAS scores (-34.6%; p= 0.03); baseline and 1-week (7%; p= 0.02), 1- and 3-week (-14%; p= 0.01), and 3- and 6-week PPTs (18%; p= 0.01); 3- and 6-week BROMs (Flexion, 7.1%; Extension, 41%; p= 0.048); baseline and 1-week (-6.9%; p= 0.02), 1- and 3-week (3%; p= 0.01), and 3- and 6-week active SLR test scores (7%; p= 0.011); and baseline and 1-week (-2.6%; p= 0.03), 1- and 3-week (8.34%; p= 0.01), and 3- and 6-week passive SLR test scores (5.3%; p= 0.025). Myofascial trigger point therapy with an inflatable ball relieved pain and improved physical function in the elderly with CNSLBP.

  13. Effect of Therapeutic Sequence of Hot Pack and Ultrasound on Physiological Response Over Trigger Point of Upper Trapezius.

    Science.gov (United States)

    Benjaboonyanupap, Dararat; Paungmali, Aatit; Pirunsan, Ubon

    2015-09-01

    Musculoskeletal pain is a common problem among athletes. Apart from sport injuries, the myofascial pain syndrome is another important problem that affects performance of the athlete. The aim of this study was to evaluate the effects of therapeutic sequences of the hot pack in combination with ultrasound on the physiological responses over the latent myofascial trigger point (LMTrP) of upper trapezius muscle. Thirty subjects with a latent myofascial trigger point (LMTrP) in both sides of the upper trapezius muscle participated in the study (age 27.33 ± 4.34 years, weight 58.11 ± 7.47 kg, height 161.50 ± 5.82 cm, pressure pain threshold 2.28 ± 0.24 kg/cm(2), pain intensity 7.17 ± 2.25 VAS). All subjects received both treatments (hot pack followed by ultrasound: HP + US; and ultrasound followed by hot pack: US + HP) by randomization with a 24 to 48-hour interval between sessions. Outcome measures, including the tissue blood flow (TBF), pressure pain threshold (PPT), supra-thermal threshold (STT) and visual analog scale (VAS) were evaluated at baseline, immediately, after 30 minutes and after 60 minutes. The TBF and PPT significantly increased from baseline in both treatment conditions (i.e. HP + US and US + HP), while the HP + US condition showed a trend toward significant difference in VAS and STT in 45°C. The application of HP and US treatment induces physiological responses (especially, TBF and PPT) on the LMTrP. This finding provides the direction toward the management of MTrPs condition.

  14. Under digital fluoroscopic guidance multiple-point injection with absolute alcohol and pinyangmycin for the treatment of superficial venous malformations

    International Nuclear Information System (INIS)

    Yang Ming; Xiao Gang; Peng Youlin

    2010-01-01

    Objective: to investigate the therapeutic efficacy of multiple-point injection with absolute alcohol and pinyangmycin under digital fluoroscopic guidance for superficial venous malformations. Methods: By using a disposal venous transfusion needle the superficial venous malformation was punctured and then contrast media lohexol was injected in to visualize the tumor body, which was followed by the injection of ethanol and pinyangmycin when the needle was confirmed in the correct position. The procedure was successfully performed in 31 patients. The clinical results were observed and analyzed. Results: After one treatment complete cure was achieved in 21 cases and marked effect was obtained in 8 cases, with a total effectiveness of 93.5%. Conclusion: Multiple-point injection with ethanol and pinyangmycin under digital fluoroscopic guidance is an effective and safe technique for the treatment of superficial venous malformations, especially for the lesions that are deeply located and ill-defined. (authors)

  15. The Effect of Ouhyul Herbal Acupuncture Point Injections on Shoulder Pain after Stroke

    Directory of Open Access Journals (Sweden)

    Yu-Ri Seo

    2013-01-01

    Full Text Available An effective and safe remedy for shoulder pain is needed as shoulder pain is a common complication of stroke and restricts recovery of patients. This study was carried out to evaluate the effect of Ouhyul herbal acupuncture point injection (O-API on shoulder pain in patients with stroke. Twenty-four participants with shoulder pain after stroke were recruited and randomized to the O-API and control groups. Treatment was conducted for 2 weeks three times per week. We evaluated the effects of treatment with a numerical rating scale (NRS, painless passive range of motion (PROM of external shoulder rotation, and the Fugl-Meyer Motor Assessment (FMMA at baseline, each week, and 1 week after the final treatment. All measures were similar between the O-API and control groups at baseline. The O-API group showed significant improvement on the NRS compared with that in the control group after 2 weeks of treatment, and the treatment effect was maintained until the follow-up period. PROM decreased significantly in both groups, but the reduction was maintained only in the O-API group. No significant difference was observed on the FMMA between the two groups. O-API resulted in significant improvement in shoulder pain after stroke, and its effect was maintained after termination of treatment without any severe side effects.

  16. Trigger Point Dry Needling.

    Science.gov (United States)

    2017-03-01

    Increasingly, physical therapists in the United States and throughout the world are using dry needling to treat musculoskeletal pain, even though this treatment has been a controversial addition to practice. To better generalize to physical therapy practice the findings about dry needling thus far, the authors of a study published in the March 2017 issue of JOSPT identified the need for a systematic review examining the effectiveness of dry needling performed by physical therapists on people with musculoskeletal pain. Their review offers a meta-analysis of data from several included studies and assesses the evidence for risks of bias. J Orthop Sports Phys Ther 2017;47(3):150. doi:10.2519/jospt.2017.0502.

  17. Comparison of the short-term outcomes between trigger point dry needling and trigger point manual therapy for the management of chronic mechanical neck pain: a randomized clinical trial.

    Science.gov (United States)

    Llamas-Ramos, Rocio; Pecos-Martín, Daniel; Gallego-Izquierdo, Tomás; Llamas-Ramos, Inés; Plaza-Manzano, Gustavo; Ortega-Santiago, Ricardo; Cleland, Joshua; Fernández-de-Las-Peñas, César

    2014-11-01

    Randomized clinical study. To compare the effects of trigger point (TrP) dry needling (DN) and TrP manual therapy (MT) on pain, function, pressure pain sensitivity, and cervical range of motion in subjects with chronic mechanical neck pain. Recent evidence suggests that TrP DN could be effective in the treatment of neck pain. However, no studies have directly compared the outcomes of TrP DN and TrP MT in this population. Ninety-four patients (mean ± SD age, 31 ± 3 years; 66% female) were randomized into a TrP DN group (n = 47) or a TrP MT group (n = 47). Neck pain intensity (11-point numeric pain rating scale), cervical range of motion, and pressure pain thresholds (PPTs) over the spinous process of C7 were measured at baseline, postintervention, and at follow-ups of 1 week and 2 weeks after treatment. The Spanish version of the Northwick Park Neck Pain Questionnaire was used to measure disability/function at baseline and the 2-week follow-up. Mixed-model, repeated-measures analyses of variance (ANOVAs) were used to determine if a time-by-group interaction existed on the effects of the treatment on each outcome variable, with time as the within-subject variable and group as the between-subject variable. The ANOVA revealed that participants who received TrP DN had outcomes similar to those who received TrP MT in terms of pain, function, and cervical range of motion. The 4-by-2 mixed-model ANOVA also revealed a significant time-by-group interaction (PTherapy, level 1b.

  18. Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials

    Directory of Open Access Journals (Sweden)

    He C

    2017-08-01

    Full Text Available Chunhui He,1,* Hua Ma2,* 1Internal Medicine of Traditional Chinese Medicine, 2Medical Image Center, The First Affiliated Hospital of Xinjiang Medical University, Wulumuqi, People’s Republic of China *These authors contributed equally to this work Background: Plantar heel pain can be managed with dry needling of myofascial trigger points (MTrPs; however, whether MTrP needling is effective remains controversial. Thus, we conducted this meta-analysis to evaluate the effect of MTrP needling in patients with plantar heel pain. Materials and methods: PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, People’s Republic of China, and CNKI (National Knowledge Infrastructure, People’s Republic of China databases were systematically reviewed for randomized controlled trials (RCTs that assessed the effects of MTrP needling. Pooled weighted mean difference (WMD with 95% CIs were calculated for change in visual analog scale (VAS score, and pooled risk ratio (RR with 95% CIs were calculated for success rate for pain and incidence of adverse events. A fixed-effects model or random-effects model was used to pool the estimates, depending on the heterogeneity among the included studies. Results: Extensive literature search yielded 1,941 articles, of which only seven RCTs met the inclusion criteria and were included in this meta-analysis. The pooled results showed that MTrP needling significantly reduced the VAS score (WMD =–15.50, 95% CI: –19.48, –11.53; P<0.001 compared with control, but it had a similar success rate for pain with control (risk ratio [RR] =1.15, 95% CI: 0.87, 1.51; P=0.320. Moreover, MTrP needling was associated with a similar incidence of adverse events with control (RR =1.89, 95% CI: 0.38, 9.39; P=0.438. Conclusion: MTrP needling effectively reduced the heel pain due to plantar fasciitis. However, considering the potential limitations in this study, more large-scale, adequately powered, good

  19. The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

    NARCIS (Netherlands)

    K.H. Njoo (Khing Hua); E. van der Does (Emiel)

    1994-01-01

    textabstractThe presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger

  20. Inclusion of trigger point dry needling in a multimodal physical therapy program for postoperative shoulder pain: a randomized clinical trial.

    Science.gov (United States)

    Arias-Buría, José L; Valero-Alcaide, Raquel; Cleland, Joshua Aland; Salom-Moreno, Jaime; Ortega-Santiago, Ricardo; Atín-Arratibel, María A; Fernández-de-las-Peñas, César

    2015-01-01

    The purpose of this study was to evaluate the effects of including 1 session of trigger point dry needling (TrP-DN) into a multimodal physiotherapy treatment on pain and function in postoperative shoulder pain. Twenty patients (5 male; 15 female; age, 58 ± 12 years) with postoperative shoulder pain after either open reduction and internal fixation with Proximal Humeral Internal Locking System plate plate or rotator cuff tear repair were randomly divided into 2 groups: physiotherapy group (n = 10) who received best evidence physical therapy interventions and a physical therapy plus TrP-DN group (n = 10) who received the same intervention plus a single session of TrP-DN targeted at active TrPs. The Constant-Murley score was used to determine pain, activities of daily living, range of motion, and strength, which was captured at baseline and 1 week after by an assessor blinded to group assignment. Analysis of variance showed that subjects receiving TrP-DN plus physical therapy exhibited greater improvement in the Constant-Murley total score (P physical therapy alone. Between-group effect sizes were large in favor of the TrP-DN group (0.97 physical therapy approach may assist with faster increases in function in individuals with postoperative shoulder pain. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  1. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jaime Salom-Moreno

    2015-01-01

    Full Text Available Objective. To compare the effects of combined trigger point dry needling (TrP-DN and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33±3 years individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM and ankle pain intensity assessed with a numerical pain rate scale (NPRS. They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F=8.211; P=0.008; SPORTS: F=13.943; P 2.1 in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability.

  2. Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial

    Science.gov (United States)

    Salom-Moreno, Jaime; Ayuso-Casado, Blanca; Tamaral-Costa, Beatriz; Sánchez-Milá, Zacarías; Fernández-de-las-Peñas, César; Alburquerque-Sendín, Francisco

    2015-01-01

    Objective. To compare the effects of combined trigger point dry needling (TrP-DN) and proprioceptive/strengthening exercises to proprioceptive/strengthening exercises on pain and function in ankle instability. Methods. Twenty-seven (44% female, mean age: 33 ± 3 years) individuals with unilateral ankle instability were randomly assigned to an experimental group who received proprioceptive/strengthening exercises combined with TrP-DN into the lateral peroneus muscle and a comparison group receiving the same proprioceptive/strengthening exercise program alone. Outcome included function assessed with the Foot and Ankle Ability Measure (FAAM) and ankle pain intensity assessed with a numerical pain rate scale (NPRS). They were captured at baseline and 1-month follow-up after the intervention. Results. The ANOVAs found significant Group ∗ Time Interactions for both subscales of the FAAM (ADL: F = 8.211; P = 0.008; SPORTS: F = 13.943; P 2.1) in favor of the TrP-DN group. Conclusions. This study provides evidence that the inclusion of TrP-DN within the lateral peroneus muscle into a proprioceptive/strengthening exercise program resulted in better outcomes in pain and function 1 month after the therapy in ankle instability. PMID:26064172

  3. Coexistence of Miyofascial Trigger Points and Cervical Disc Herniation: Which One is the Main Source of Pain?

    Directory of Open Access Journals (Sweden)

    Gülcan Öztürk

    2016-04-01

    Full Text Available Objective: The aim of this study was to investigate the coexistence of myofascial trigger points (MTrPs and cervical disc herniations (CDH in patients with neck and upper back pain. Materials and Methods: In this retrospective study, patients having only MTrPs were defined as group-1, patients having only CDH were defined as group-2, patients having both MTrPs and CDH were defined as Group-3. Two hundred twenty three patients (151 females/72 males; mean age 38.2±10.1 years were enrolled in this study. There were 30 patients in group 1, 46 patients in group 2, 147 patients in group 3. Results: Thirty eight patients had radiculopathy, 27 of them had MTrP(s. There was no significant difference in terms of CDH level (p=0.275 and degree of herniation (p=0.188 between groups 2 and 3. There was no significant difference in terms of MTrP localisation (p=0.684 between groups 1 and 3. There was no significant difference in terms of MTrP localisations according to CDH level and nerve root compression level in groups 3. Conclusion: MTrP and CDH coexistence is frequent. Management of the pain in the upper back region should be based on whether if the pain originates from MTrP, CDH or both

  4. Single-shot measurements of low emittance beams from laser-plasma accelerators comparing two triggered injection methods

    Science.gov (United States)

    van Tilborg, Jeroen

    2017-10-01

    The success of laser plasma accelerator (LPA) based applications, such as a compact x-ray free electron laser (FEL), relies on the ability to produce electron beams with excellent 6D brightness, where brightness is defined as the ratio of charge to the product of the three normalized emittances. As such, parametric studies of the emittance of LPA generated electron beams are essential. Profiting from a stable and tunable LPA setup, combined with a carefully designed single-shot energy-dispersed emittance diagnostic, we present a direct comparison of charge dependent emittance measurements of electron beams generated by two different injection mechanisms: ionization injection and shock-induced density down-ramp injection. Both injection mechanisms have gained in popularity in recent years due to their demonstrated stable LPA performance. For the down-ramp injection configuration, normalized emittances a factor of two lower were recorded: less than 1 micron at spectral charge densities up to 2 pC/MeV. For both injection mechanisms, a contributing correlation of space charge to the emittance was identified. This measurement technique in general, and these results specifically, are critical to the evaluation of LPA injection methods and development of high-quality LPA beam lines worldwide. This work is supported by the U.S. DOE under Contract No. DE-AC02-05CH11231, by the U.S. DOE NNSA, DNN R&D (NA22), by the National Science Foundation under Grant No. PHY-1415596, and by the Gordon and Betty Moore Foundation under Grant ID GBMF4898.

  5. On the effective stress law for rock-on-rock frictional sliding, and fault slip triggered by means of fluid injection

    Science.gov (United States)

    Rutter, Ernest; Hackston, Abigail

    2017-08-01

    Fluid injection into rocks is increasingly used for energy extraction and for fluid wastes disposal, and can trigger/induce small- to medium-scale seismicity. Fluctuations in pore fluid pressure may also be associated with natural seismicity. The energy release in anthropogenically induced seismicity is sensitive to amount and pressure of fluid injected, through the way that seismic moment release is related to slipped area, and is strongly affected by the hydraulic conductance of the faulted rock mass. Bearing in mind the scaling issues that apply, fluid injection-driven fault motion can be studied on laboratory-sized samples. Here, we investigate both stable and unstable induced fault slip on pre-cut planar surfaces in Darley Dale and Pennant sandstones, with or without granular gouge. They display contrasting permeabilities, differing by a factor of 105, but mineralogies are broadly comparable. In permeable Darley Dale sandstone, fluid can access the fault plane through the rock matrix and the effective stress law is followed closely. Pore pressure change shifts the whole Mohr circle laterally. In tight Pennant sandstone, fluid only injects into the fault plane itself; stress state in the rock matrix is unaffected. Sudden access by overpressured fluid to the fault plane via hydrofracture causes seismogenic fault slips. This article is part of the themed issue 'Faulting, friction and weakening: from slow to fast motion'.

  6. On the effective stress law for rock-on-rock frictional sliding, and fault slip triggered by means of fluid injection.

    Science.gov (United States)

    Rutter, Ernest; Hackston, Abigail

    2017-09-28

    Fluid injection into rocks is increasingly used for energy extraction and for fluid wastes disposal, and can trigger/induce small- to medium-scale seismicity. Fluctuations in pore fluid pressure may also be associated with natural seismicity. The energy release in anthropogenically induced seismicity is sensitive to amount and pressure of fluid injected, through the way that seismic moment release is related to slipped area, and is strongly affected by the hydraulic conductance of the faulted rock mass. Bearing in mind the scaling issues that apply, fluid injection-driven fault motion can be studied on laboratory-sized samples. Here, we investigate both stable and unstable induced fault slip on pre-cut planar surfaces in Darley Dale and Pennant sandstones, with or without granular gouge. They display contrasting permeabilities, differing by a factor of 10 5 , but mineralogies are broadly comparable. In permeable Darley Dale sandstone, fluid can access the fault plane through the rock matrix and the effective stress law is followed closely. Pore pressure change shifts the whole Mohr circle laterally. In tight Pennant sandstone, fluid only injects into the fault plane itself; stress state in the rock matrix is unaffected. Sudden access by overpressured fluid to the fault plane via hydrofracture causes seismogenic fault slips.This article is part of the themed issue 'Faulting, friction and weakening: from slow to fast motion'. © 2017 The Authors.

  7. Treatment of nonspecific thoracic spine pain with trigger point dry needling and intramuscular electrical stimulation: a case series.

    Science.gov (United States)

    Rock, Jodie M; Rainey, Charles E

    2014-10-01

    Case Series. Myofascial trigger points (MTrPs) are a common occurrence in many musculoskeletal issues and have been shown to be prevalent in both subjects with nonspecific low back pain and whiplash associated disorder. Trigger point dry needling (DN) has been shown to reduce pain and improve function in areas such as the cervical and lumbar spine, shoulder, hip, and knee, but has not been investigated in the thoracic spine. The purpose of this case series was to document the use of DN with intramuscular electrical stimulation (IES) in subjects with nonspecific thoracic spine pain. The subjects were both active duty military males aged 31 and 27 years who self-referred to physical therapy for thoracic spinal pain. Physical examination demonstrated thoracic motor control dysfunction, tissue hypertonicity, and tenderness to palpation of bilateral thoracic paraspinal musculature in both subjects. This indicated the presence of possible MrTPs. Objective findings in the first subject included painful thoracic flexion and bilateral rotation in each of these planes of movement. Pain reduction was observed when postural demands of the spine and trunk musculature were reduced through positional changes. Patient 1 demonstrated pain with posterior to anterior (P/A) pressure at T9 to T12. The second subject had bilaterally limited and painful thoracic rotation actively with normal passive rotation and demonstrated pain with P/A pressure at T4 to T7. The subjects were treated with DN and IES for a total of two visits each. DN was performed to paraspinal and multifidus musculature at the levels of elicited pain with P/A testing and IES set at a frequency level of 4 (1.5Hz) for 20 minutes. Subject 1 reported reduced pain with standing flexion from a 62mm VAS score on initial evaluation to 26mm at his second visit. Subject 2 reported being "quite a bit better" in symptoms on the GROC following his second treatment. His VAS score reported following weightlifting activities changed

  8. Effects of dry needling trigger point therapy in the shoulder region on patients with upper extremity pain and dysfunction: a systematic review with meta-analysis.

    Science.gov (United States)

    Hall, Michelle Louise; Mackie, Angela Claire; Ribeiro, Daniel Cury

    2017-08-07

    What is the effectiveness and what are the adverse effects. Systematic review with meta-analysis. Patients with shoulder or upper extremity pain or dysfunction. Trigger point dry needling (TDN) compared to control, another intervention or another needling technique. Primary outcome measures included shoulder or upper limb pain, shoulder or upper limb dysfunction. Eleven randomized trials involving 496 participants were appraised. There was very low evidence that trigger point dry needling of the shoulder region is effective for reducing pain and improving function in the short term. There is some evidence that needling both active and latent trigger points is more effective than needling an active trigger point alone for pain immediately and 1-week after treatment (SMD=-0.74, 95%CI=-1.2 to -0.3; and SMD=-1.0, 95%CI=-1.52 to -0.59). There is very low evidence to support the use of TDN in the shoulder region for treating patients with upper extremity pain or dysfunction. Two studies reported adverse effects to TDN interventions. Most common adverse effects included bruising, bleeding, and pain during or after treatment. Future studies are likely to change the estimates of the effectiveness of TDN for patients with upper extremity pain or dysfunction. CRD42016045639. Copyright © 2017. Published by Elsevier Ltd.

  9. Standardized manual palpation of myofascial trigger points in relation to neck/shoulder pain; the influence of clinical experience on inter-examiner reproducibility

    DEFF Research Database (Denmark)

    Myburgh, Corrie; Lauridsen, Henrik Hein; Larsen, Anders H

    2011-01-01

    A diagnosis of Myofascial Pain Syndrome (MPS) requires palpation for the identification of at least one clinically relevant trigger point (TP). However, few comparable, high quality studies currently exist from which to draw firm conclusions regarding the robustness of TP examination. An inter-ob...

  10. Treatment of subacute posterior knee pain in an adolescent ballet dancer utilizing trigger point dry needling: a case report.

    Science.gov (United States)

    Mason, John S; Tansey, Kimberly A; Westrick, Richard B

    2014-02-01

    Case Report. Dry needling (DN) is an increasingly popular intervention used by clinicians as a treatment of regional neuromusculoskeletal pain. DN is an invasive procedure that involves insertion of a thin monofilament needle directly into a muscle trigger point (MTP) with the intent of stimulating a local twitch response. Current evidence is somewhat limited, but recent literature supports the use of this intervention in specific neuromusculoskeletal conditions. The purpose of this case report is to present the outcomes of DN as a primary treatment intervention in an adolescent subject with subacute posterior knee pain. The subject was a 16-year-old female competitive ballet dancer referred to physical therapy with a two month history of right posterior knee pain. Palpation identified MTPs which reproduced the patient's primary symptoms. In addition to an exercise program promoting lower extremity flexibility and hip stability, the subject was treated with DN to the right gastrocnemius, soleus, and popliteus muscles. The subject reported being pain free on the Numerical Pain Scale and a +7 improvement in perceived change in recovery on the Global Rating of Change at final follow-up. Physical examination demonstrated no observed impairments or functional limitations, including normal mobility, full strength, and unrestricted execution of dance maneuvers. The patient was able to return to high level dance training and competition without physical limitations and resumed pre-injury dynamic movement activities including dancing, running, jumping, and pivoting without pain. DN can be an effective and efficient intervention to assist patients in decreasing pain and returning to high intensity physical activity. Additional research is needed to determine if DN is effective for other body regions and has long-term positive outcomes. Level 4.

  11. The effects of arm movement on reaction time in patients with latent and active upper trapezius myofascial trigger point.

    Science.gov (United States)

    Yassin, Marzieh; Talebian, Saeed; Ebrahimi Takamjani, Ismail; Maroufi, Nader; Ahmadi, Amir; Sarrafzadeh, Javad; Emrani, Anita

    2015-01-01

    Myofascial pain syndrome is a significant source of mechanical pain. The aim of this study was to investigate the effects of arm movement on reaction time in females with latent and active upper trapezius myofascial trigger point. In this interventional study, a convenience sample of fifteen women with one active MTP, fifteen women with one latent MTP in the upper trapezius, and fifteen normal healthy women were participated. Participants were asked to stand for 10 seconds in an erect standing position. Muscle reaction times were recorded including anterior deltoid (AD), cervical paraspinal (CP) lumbar paraspinal (LP), both of upper trapezius (UT), sternocleidomastoid (SCM) and medial head of gastrocnemius (GcM). Participants were asked to flex their arms in response to a sound stimulus preceded by a warning sound stimulus. Data were analyzed using one-way ANOVA Test. There was significant differences in motor time and reaction time between active and control groups (p< 0.05) except for GcM. There was no significant difference in motor time between active and passive groups except for UT without MTP and SCM (p< 0.05). Also, there were no significant differences in motor times between latent MTP and control groups. Furthermore, there was no significant difference in premotor times between the three groups. The present study shows that patients with active MTP need more time to react to stimulus, but patients with latent MTP are similar to healthy subjects in the reaction time. Patients with active MTP had less compatibility with environmental stimulations, and they responded to a specific stimulation with variability in Surface Electromyography (SEMG).

  12. Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent myofascial trigger point.

    Science.gov (United States)

    Martín-Pintado Zugasti, Aitor; Rodríguez-Fernández, Ángel L; García-Muro, Francisco; López-López, Almudena; Mayoral, Orlando; Mesa-Jiménez, Juan; Fernández-Carnero, Josue

    2014-10-01

    To investigate (1) the effect of spray and stretch versus control on reducing postneedling soreness of 1 latent myofascial trigger point (MTrP) and (2) whether higher levels of psychological distress are associated with increased postneedling pain intensity. A 72-hour follow-up, single-blind randomized controlled trial. University community. Healthy volunteers (N=70; 40 men, 30 women) aged 18 to 36 years (mean age, 21±4y) with latent MTrP in 1 upper trapezius muscle. All subjects received a dry needling application over the upper trapezius muscle. Then, participants were randomly divided into 2 groups: an intervention group, which received spray and stretch over the needled trapezius muscle, and a control group, which did not receive any intervention. Visual analog scale (at postneedling, posttreatment, and 6, 12, 24, 48, and 72h after needling), pressure pain threshold (at preneedling, postneedling, and 24 and 48h after needling). Psychological distress was evaluated by using the Symptom Checklist-90-Revised. Repeated-measures analysis of variance demonstrated a significant interaction between group and time (F3,204.8=3.19; P.05). Repeated measures of covariance showed that none of the psychological covariates affected these results. Somatization, anxiety, interpersonal sensitivity, and hostility were significantly correlated (P<.05) with postneedling pain intensity. Repeated-measures analysis of variance did not show a significant effect of spray and stretch on mechanical hyperalgesia (F2.6,175=1.9; P=.131; ηp(2)=.02). The spray and stretch had a short-term (<6h) effect in reducing postneedling soreness of a latent MTrP. Pressure pain threshold did not significantly change after spray and stretch. Psychological factors are related to postneedling pain. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. The Relationship between Rate of Algometer Application and Pain Pressure Threshold in the Assessment of Myofascial Trigger Point Sensitivity.

    Science.gov (United States)

    Linde, Lukas D; Kumbhare, Dinesh A; Joshi, Maneil; Srbely, John Z

    2018-02-01

    Pressure algometry is a commonly employed technique in the assessment of both regional and widespread musculoskeletal pain. Despite its acceptance amongst clinicians and scientists, the relationship between rate of pressure application (RoA) and pain pressure threshold (PPT) remains poorly understood. We set out to test the hypothesis that a strong, positive, linear relationship exists between the RoA and the PPT within the infraspinatus of young healthy subjects. Thirty-three participants were randomly recruited from the local university community. PPT measures were recorded from a clinically identified myofascial trigger point within the right infraspinatus muscle during pressure algometry. A total of 2 PPT measures were recorded using each of 3 different RoAs, including low (15 N/s), medium (35 N/s), and high (55 N/s). Three baseline trials were also conducted at 30 N/s. The Pearson's correlation coefficient between RoA and PPT was calculated for each subject and averaged across participants. The mean(SD) correlation between subjects was 0.77 (0.19), and the mean (SD) slope of the linear regression was 0.13 (0.09). Our results demonstrate that there is a strong, linear relationship between the RoA and PPT when using the pressure algometry technique. The low slope between RoA and PPT suggests clinicians can rely on PPT assessments despite small RoA fluctuations. Future research should explore this relationship further in a clinical population and in other muscles affected by chronic myofascial pain. Advancing cost-effective, reliable, and clinically feasible tools such as algometry is important to enhancing the diagnosis and management of chronic myofascial pain. © 2017 World Institute of Pain.

  14. Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials.

    Science.gov (United States)

    He, Chunhui; Ma, Hua

    2017-01-01

    Plantar heel pain can be managed with dry needling of myofascial trigger points (MTrPs); however, whether MTrP needling is effective remains controversial. Thus, we conducted this meta-analysis to evaluate the effect of MTrP needling in patients with plantar heel pain. PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, People's Republic of China), and CNKI (National Knowledge Infrastructure, People's Republic of China) databases were systematically reviewed for randomized controlled trials (RCTs) that assessed the effects of MTrP needling. Pooled weighted mean difference (WMD) with 95% CIs were calculated for change in visual analog scale (VAS) score, and pooled risk ratio (RR) with 95% CIs were calculated for success rate for pain and incidence of adverse events. A fixed-effects model or random-effects model was used to pool the estimates, depending on the heterogeneity among the included studies. Extensive literature search yielded 1,941 articles, of which only seven RCTs met the inclusion criteria and were included in this meta-analysis. The pooled results showed that MTrP needling significantly reduced the VAS score (WMD =-15.50, 95% CI: -19.48, -11.53; P <0.001) compared with control, but it had a similar success rate for pain with control (risk ratio [RR] =1.15, 95% CI: 0.87, 1.51; P =0.320). Moreover, MTrP needling was associated with a similar incidence of adverse events with control (RR =1.89, 95% CI: 0.38, 9.39; P =0.438). MTrP needling effectively reduced the heel pain due to plantar fasciitis. However, considering the potential limitations in this study, more large-scale, adequately powered, good-quality placebo-controlled trials are needed to provide more trustworthy evidence in this area.

  15. Histopathological nature of myofascial trigger points at different stages of recovery from injury in a rat model.

    Science.gov (United States)

    Zhang, Hui; Lü, Jiao-Jiao; Huang, Qiang-Min; Liu, Lin; Liu, Qing-Guang; Eric, Opoku-Antwi

    2017-12-01

    To investigate the histopathological nature of myofascial trigger points (MTrPs) or spots (MTrSs) at different stages of recovery from injury in a rat model. Forty Sprague-Dawley rats were randomly divided into two groups: a control group (CG) and experimental group (EG). The CG was further randomly subdivided into CG1 and CG2 subgroups. The CG2 was used for palpating the taut band and CG1 as a blank. EG was subdivided into three groups according to recovery times: 4 weeks (4W), 8 weeks (8W) and 12 weeks (12W); these groups consisted of eight rats each. All CG rats received no intervention, whereas the intervention in EG rats was by a blunt strike to the vastus medialis and eccentric exercise for 8 weeks. The taut bands with spontaneous electrical activity were then detected in the muscle to guide a muscle biopsy. The histopathological findings were investigated under optical and electron microscopes in all groups. Under optical microscopy, the differently augmented sizes of round fibres (contracture knots) with deep staining in the transverse section and fusiform shapes in a longitudinal view were clearly seen in CG2 and EGs with a large diameter; the number of contracture knots was significantly more in EGs than in CGs. Under an electron microscope, the mitochondria in EGs significantly decreased with abnormal structures. The sarcomeres were significantly shortened in the 8W and 12W EGs. An injury can cause activation of MTrSs in a muscle and an activated level of MTrPs depending on the number of contracture knots in muscle with impaired energy production. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. TREATMENT OF SUBACUTE POSTERIOR KNEE PAIN IN AN ADOLESCENT BALLET DANCER UTILIZING TRIGGER POINT DRY NEEDLING: A CASE REPORT

    Science.gov (United States)

    Tansey, Kimberly A.; Westrick, Richard B.

    2014-01-01

    Study Design: Case Report. Background and Purpose: Dry needling (DN) is an increasingly popular intervention used by clinicians as a treatment of regional neuromusculoskeletal pain. DN is an invasive procedure that involves insertion of a thin monofilament needle directly into a muscle trigger point (MTP) with the intent of stimulating a local twitch response. Current evidence is somewhat limited, but recent literature supports the use of this intervention in specific neuromusculoskeletal conditions. The purpose of this case report is to present the outcomes of DN as a primary treatment intervention in an adolescent subject with subacute posterior knee pain. Case Description: The subject was a 16‐year‐old female competitive ballet dancer referred to physical therapy with a two month history of right posterior knee pain. Palpation identified MTPs which reproduced the patient’s primary symptoms. In addition to an exercise program promoting lower extremity flexibility and hip stability, the subject was treated with DN to the right gastrocnemius, soleus, and popliteus muscles. Outcomes: The subject reported being pain free on the Numerical Pain Scale and a +7 improvement in perceived change in recovery on the Global Rating of Change at final follow‐up. Physical examination demonstrated no observed impairments or functional limitations, including normal mobility, full strength, and unrestricted execution of dance maneuvers. Discussion: The patient was able to return to high level dance training and competition without physical limitations and resumed pre‐injury dynamic movement activities including dancing, running, jumping, and pivoting without pain. DN can be an effective and efficient intervention to assist patients in decreasing pain and returning to high intensity physical activity. Additional research is needed to determine if DN is effective for other body regions and has long‐term positive outcomes. Level of Evidence: Level 4 PMID:24567862

  17. Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome.

    Science.gov (United States)

    Ma, Chao; Wu, Shaoling; Li, Guoqi; Xiao, Xiuhong; Mai, Mingquan; Yan, Tiebin

    2010-01-01

    Myofascial pain syndrome (MPS) is one of the most common causes of chronic musculoskeletal pain. Several methods have been recommended for the inactivation of trigger points (TrPs). We carried out this study to investigate the effectiveness of miniscalpel-needle (MSN) release and acupuncture needling and self neck-stretching exercises on myofascial TrPs of the upper trapezius muscle. Eighty-three TrPs in 43 patients with MPS were treated and randomly assigned to 3 groups: group 1 received MSN release in conjunction with self neck-stretching exercises; group 2 received acupuncture needling treatment and performed self neck-stretching exercises; and group 3, the control group, was assigned self neck-stretching exercises only. The therapeutic effectiveness was evaluated using subjective pain intensity (PI) with a visual analog scale, pressure pain threshold (PPT), and contralateral bending range of motion (ROM) of cervical spine at pretreatment, 2 weeks, and 3 months after treatment. The improvement of PI, PPT, and contralateral bending ROM of cervical spine was significantly greater in group 1 and 2 than that in control group at 2 weeks and 3 months follow-up. Compared with group 2, patients in group 1 had a statistically significant reduction in PI, an increase in PPT, contralateral bending ROM of cervical spine at 3 months follow-up. The effectiveness of MSN release for MPS is superior to that of acupuncture needling treatment or self neck-stretching exercises alone. The MSN release is also safe, without severe side effects in treatment of MPS.

  18. Effect of temperature of CO2 injection on the pH and freezing point of milks and creams.

    Science.gov (United States)

    Ma, Y; Barbano, D M

    2003-05-01

    The objectives of this study were to measure the impact of CO2 injection temperature (0 degree C and 40 degrees C) on the pH and freezing point (FP) of (a) milks with different fat contents (i.e., 0, 15, 30%) and (b) creams with 15% fat but different fat characteristics. Skim milk and unhomogenized creams containing 15 and 30% fat were prepared from the same batch of whole milk and were carbonated at 0 and 40 degrees C in a continuous flow CO2 injection unit (230 ml/min). At 0 degree C, milk fat was mostly solid; at 40 degrees C, milk fat was liquid. At the same total CO2 concentration with CO2 injection at 0 degree C, milk with a higher fat content had a lower pH and FP, while with CO2 injection at 40 degrees C, milks with 0%, 15%, and 30% fat had the same pH. This indicated that less CO2 was dissolved in the fat portion of the milk when the CO2 was injected at 0 degree C than when it was injected at 40 degrees C. Three creams, 15% unhomogenized cream, 15% butter oil emulsion in skim milk, and 15% vegetable oil emulsion in skim milk were also carbonated and analyzed as described above. Vegetable oil was liquid at both 0 and 40 degrees C. At a CO2 injection temperature of 0 degree C, the 15% vegetable oil emulsion had a slightly higher pH than the 15% butter oil emulsion and the 15% unhomogenized cream, indicating that the liquid vegetable oil dissolved more CO2 than the mostly solid milk fat and butter oil. No difference in the pH or FP of the 15% unhomogenized cream and 15% butter oil emulsion was observed when CO2 was injected at 0 degree C, suggesting that homogenization or physical dispersion of milk fat globules did not influence the amount of CO2 dissolved in milk fat at a CO2 injection temperature of 0 degree C. At a CO2 injection temperature of 40 degrees C and at the same total CO2 concentration, the 15% unhomogenized cream, 15% vegetable oil emulsion, and 15% butter oil emulsion had similar pH. At the same total concentration of CO2 in cream, injection

  19. Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.

    Science.gov (United States)

    Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J

    2016-06-01

    Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.

  20. Hydrogeochemical modelling of fluid–rock interactions triggered by seawater injection into oil reservoirs: Case study Miller field (UK North Sea)

    International Nuclear Information System (INIS)

    Fu, Yunjiao; Berk, Wolfgang van; Schulz, Hans-Martin

    2012-01-01

    A hydrogeochemical model is presented and applied to quantitatively elucidate interdependent reactions among minerals and formation water–seawater mixtures at elevated levels of CO 2 partial pressure. These hydrogeochemical reactions (including scale formation) occur within reservoir aquifers and wells and are driven by seawater injection. The model relies on chemical equilibrium thermodynamics and reproduces the compositional development of the produced water (formation water–seawater mixtures) of the Miller field, UK North Sea. This composition of the produced water deviates from its calculated composition, which could result solely from mixing of both the end members (formation water and seawater). This indicates the effect of hydrogeochemical reactions leading to the formation and/or the dissolution of mineral phases. A fairly good match between the modelled and measured chemical composition of produced water indicates that hydrogeochemical interactions achieve near-equilibrium conditions within the residence time of formation water–seawater mixtures at reservoir conditions. Hence the model enables identification of minerals (including scale minerals), to quantitatively reproduce and to predict their dissolution and/or formation. The modelling results indicate that admixing of seawater into formation water triggers the precipitation of Sr–Barite solid solution, CaSO 4 phases and dolomite. In contrast, calcite and microcrystalline quartz are dissolved along the seawater flow path from the injection well towards the production well. Depending on the fraction of seawater admixed, interdependent reactions induce profound modifications to the aquifer mineral phase assemblage. At low levels of seawater admixture, Ba–Sr sulfate solid solution is precipitated and coupled to concurrent dissolution of calcite and microcrystalline quartz. Massive dissolution of calcite and the formation of CaSO 4 phases and dolomite are triggered by intense seawater admixture

  1. Platelet-rich plasma versus dry needling of myofascial meridian trigger points in the treatment of plantar fasciitis

    Directory of Open Access Journals (Sweden)

    Reem El Mallah

    2017-01-01

    Conclusion PRP injection is a promising line of treatment for chronic PF with documented ultrasonographic healing effect. Dry needling is a simple and safe technique for treating pain associated with PF, yet it is more invasive and less effective compared with PRP injection.

  2. Triggering Collapse of the Presolar Dense Cloud Core and Injecting Short-lived Radioisotopes with a Shock Wave. V. Nonisothermal Collapse Regime

    Science.gov (United States)

    Boss, Alan P.

    2017-08-01

    Recent meteoritical analyses support an initial abundance of the short-lived radioisotope (SLRI) 60Fe that may be high enough to require nucleosynthesis in a core-collapse supernova, followed by rapid incorporation into primitive meteoritical components, rather than a scenario where such isotopes were inherited from a well-mixed region of a giant molecular cloud polluted by a variety of supernovae remnants and massive star winds. This paper continues to explore the former scenario, by calculating three-dimensional, adaptive mesh refinement, hydrodynamical code (FLASH 2.5) models of the self-gravitational, dynamical collapse of a molecular cloud core that has been struck by a thin shock front with a speed of 40 km s-1, leading to the injection of shock front matter into the collapsing cloud through the formation of Rayleigh-Taylor fingers at the shock-cloud intersection. These models extend the previous work into the nonisothermal collapse regime using a polytropic approximation to represent compressional heating in the optically thick protostar. The models show that the injection efficiencies of shock front materials are enhanced compared to previous models, which were not carried into the nonisothermal regime, and so did not reach such high densities. The new models, combined with the recent estimates of initial 60Fe abundances, imply that the supernova triggering and injection scenario remains a plausible explanation for the origin of the SLRIs involved in the formation of our solar system.

  3. Triggering Collapse of the Presolar Dense Cloud Core and Injecting Short-lived Radioisotopes with a Shock Wave. V. Nonisothermal Collapse Regime

    Energy Technology Data Exchange (ETDEWEB)

    Boss, Alan P., E-mail: aboss@carnegiescience.edu [Department of Terrestrial Magnetism, Carnegie Institution for Science, 5241 Broad Branch Road, NW, Washington, DC 20015-1305 (United States)

    2017-08-01

    Recent meteoritical analyses support an initial abundance of the short-lived radioisotope (SLRI) {sup 60}Fe that may be high enough to require nucleosynthesis in a core-collapse supernova, followed by rapid incorporation into primitive meteoritical components, rather than a scenario where such isotopes were inherited from a well-mixed region of a giant molecular cloud polluted by a variety of supernovae remnants and massive star winds. This paper continues to explore the former scenario, by calculating three-dimensional, adaptive mesh refinement, hydrodynamical code (FLASH 2.5) models of the self-gravitational, dynamical collapse of a molecular cloud core that has been struck by a thin shock front with a speed of 40 km s{sup −1}, leading to the injection of shock front matter into the collapsing cloud through the formation of Rayleigh–Taylor fingers at the shock–cloud intersection. These models extend the previous work into the nonisothermal collapse regime using a polytropic approximation to represent compressional heating in the optically thick protostar. The models show that the injection efficiencies of shock front materials are enhanced compared to previous models, which were not carried into the nonisothermal regime, and so did not reach such high densities. The new models, combined with the recent estimates of initial {sup 60}Fe abundances, imply that the supernova triggering and injection scenario remains a plausible explanation for the origin of the SLRIs involved in the formation of our solar system.

  4. Bee venom acupuncture point injection for central post stroke pain: a preliminary single-blind randomized controlled trial.

    Science.gov (United States)

    Cho, Seung-Yeon; Park, Joo-Young; Jung, Woo-Sang; Moon, Sang-Kwan; Park, Jung-Mi; Ko, Chang-Nam; Park, Seong-Uk

    2013-06-01

    We investigated apipuncture, or acupuncture point injection with diluted bee venom, as a promising new treatment for central post stroke pain (CPSP). Bee venom, diluted to 0.005% in normal saline, was administered to the treatment group, and normal saline given to control group as twice-weekly injections for three weeks. The points were LI15, GB21, LI11, GB31, ST36 and GB39 of the affected side and the amount of injection was 0.05 ml at each point. Eight patients in each group were included in the analysis. After three weeks there were significant decreases in visual analogue pain scores compared with baseline in both groups and the treatment group improved more significantly than the control group (p = 0.009). Apipuncture significantly improved CPSP in this pilot trial. Further studies of its mechanisms and a larger and long-term follow-up trial will be needed to determine more definitely the efficacy of apipuncture and to elucidate duration of improvement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. PENURUNAN NYERI DAN DISABILITAS DENGAN INTEGRATED NEUROMUSCULAR INHIBITION TECHNIQUES (INIT DAN MASSAGE EFFLEURAGE PADA MYOFASCIAL TRIGGER POINT SYNDROME OTOT TRAPESIUS BAGIAN ATAS

    Directory of Open Access Journals (Sweden)

    Veni Fatmawati

    2013-07-01

    Full Text Available Myofascia Trigger Point Syndrome (MTrPs is trigger point muscle happens in musculoskeletal. Factors which strengthen and trigger the emerge of MTrPs are the muscle contraction which happens continuously, poor body position, wrong body position or movement, poor occupation activity and unsuitable workplace arrangement that affect the unergonomic work behavior. The objective of this reseacrh is to reveal the effectivity of  integrated neuromuscular  inhibition techniques (init and massage efflurage in decreasing pain and disability in myofasial trigger point of upper trapesius muscle. The subjects this research are 34 people which are taken randomly in Puskesmas 2 Kartosuro, Surakarta with 17 samples of each group. Group 1 is integrated neuromuscular inhibition techniques (init and group 2 is massage efflurage. The data used in this research is NDI scale taken before and after therapy. The data collected is processed by using differential test through computer base of SPSS 15.0 version. The data analysis by using paired sample t-test, in group 1 the data resulted before therapy is 48,35±6,68 and the data resulted after therapy is 25,94±5,87 with p = 0,000 (p < 0,05. Whereas in group 2, the  resulted before therapy is 47,53±5,17 and the data resulted before therapy is 28,00±8,91 with p = 0,000 (p < 0,05. To conclude, based on the data resulted in this research, integrated neuromuscular  inhibition techniques (init and massage effleurage are there is no difference decrease pain and disability in myofascial trigger point of upper trapezius muscle.

  6. Effectiveness of trigger point dry needling for plantar heel pain: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Landorf Karl B

    2011-01-01

    be reported in accordance with the Consolidated Standards of Reporting Trials and the Standards for Reporting Interventions in Clinical Trials of Acupuncture guidelines. The findings from this trial will provide evidence for the effectiveness of trigger point dry needling for plantar heel pain. Trial registration Australian New Zealand 'Clinical Trials Registry'. ACTRN12610000611022.

  7. Treatment of phantom pain with contralateral injection into tender points: a new method of treatment

    Directory of Open Access Journals (Sweden)

    Alaa A El Aziz Labeeb

    2015-01-01

    Conclusion Contralateral injections of 1 ml of 0.25% bupivacaine in the myofascial hyperalgesic areas attenuated phantom limb pain and affected phantom limb sensation. Our study gives a basis of a new method of management of that kind of severe pain to improve the method of rehabilitation of amputee. However, further longitudinal studies with larger number of patients are needed to confirm our study.

  8. The Effect of Dry Needling on Range of Motion of Neck Lateral Flexion in Subjects With Active Trigger Point in Upper Trapezius Muscle

    Directory of Open Access Journals (Sweden)

    Ziaeifar

    2014-12-01

    Full Text Available Background Myofascial trigger point is one of the most common causes of musculoskeletal disorders. Myofascial trigger point in upper trapezius has been reported as a symptom in patients with neck and upper thoracic pain. Objectives The purpose of this study was to investigate the effect of dry needling compared with ischemic pressure on trigger point in upper trapezius muscle. Materials and Methods 28 subjects with myofascial trigger point in upper trapezius participated in this study. The subjects were randomly assigned to two groups: dry needling (n = 13 and ischemic pressure (n = 15. The neck lateral flexion range of motion was measured before and after treatment in both groups using a standard goniometer. Paired t-test was used to determine any significant difference in range of motion after treatment sessions compared with pre-treatment score in control and experimental group. Analysis of Covariance (ANCOVA was calculated to determine the significance of differences between the control and experimental groups in post-test scores, with pre-treatment scores used as covariates in the analysis. Results Statistical analysis (paired t-test revealed significant increase in neck lateral flexion range of motion in contra-lateral side after treatment sessions in control and experimental group compared with pre-treatment score (P < 0.05. However, only dry needling was effective in increase of range of motion in Ipsi-lateral side (P = 0.001. In the ANCOVA, controlling for pre-test scores, no significant difference was found between the two groups in the after treatment sessions (P = 0.06 and (P = 0.15. Conclusions The application of DN produces an improvement in ILF and CLF can be prescribed for subjects with MTP in UT muscles.

  9. Treatment of myofascial trigger points in common shoulder disorders by physical therapy: A randomized controlled trial [ISRCTN75722066

    Directory of Open Access Journals (Sweden)

    Franssen Jo LM

    2007-11-01

    Full Text Available Abstract Background Shoulder disorders are a common health problem in western societies. Several treatment protocols have been developed for the clinical management of persons with shoulder pain. However available evidence does not support any protocol as being superior over others. Systematic reviews provide some evidence that certain physical therapy interventions (i.e. supervised exercises and mobilisation are effective in particular shoulder disorders (i.e. rotator cuff disorders, mixed shoulder disorders and adhesive capsulitis, but there is an ongoing need for high quality trials of physical therapy interventions. Usually, physical therapy consists of active exercises intended to strengthen the shoulder muscles as stabilizers of the glenohumeral joint or perform mobilisations to improve restricted mobility of the glenohumeral or adjacent joints (shoulder girdle. It is generally accepted that a-traumatic shoulder problems are the result of impingement of the subacromial structures, such as the bursa or rotator cuff tendons. Myofascial trigger points (MTrPs in shoulder muscles may also lead to a complex of symptoms that are often seen in patients diagnosed with subacromial impingement or rotator cuff tendinopathy. Little is known about the treatment of MTrPs in patients with shoulder disorders. The primary aim of this study is to investigate whether physical therapy modalities to inactivate MTrPs can reduce symptoms and improve shoulder function in daily activities in a population of chronic a-traumatic shoulder patients when compared to a wait-and-see strategy. In addition we investigate the recurrence rate during a one-year-follow-up period. Methods/Design This paper presents the design for a randomized controlled trial to be conducted between September 2007 – September 2008, evaluating the effectiveness of a physical therapy treatment for non-traumatic shoulder complaints. One hundred subjects are included in this study. All subjects

  10. A RANDOMIZED TRIAL TO STUDY THE COMPARISON OF TRIGGER POINT DRY NEEDLING VERSUS KINESIO TAPING TECHNIQUE IN MYOFASCIAL PAIN SYNDROME DURING A 3-MONTH FOLLOW UP

    Directory of Open Access Journals (Sweden)

    Emrullah Hayta

    2016-10-01

    Full Text Available Background: Managemen of myofascial pain syndrome (MPS is a current research subject since there is a small number of randomized studies comparing different management techniques. Multiple studies attempted to assess various treatment options including trigger point dry needling and kinesiotaping. We compared the effects of trigger point dry needling and kinesiotaping in the management of myofascial pain syndome during a 3-month follow-up period. Methods: In this prospective randomized studyin MPS patients with upper trapezius muscle trigger points, the effects of dry needling (n=28 and kinesiotaping (n=27 was compared with regard to the visual analog scale (VAS, neck disability index (NDI, and Nottingham health profile (NHP scores measured at the weeks 0, 4, and 12. Results: Both dry needling and kinesiotaping comparably reduced VAS scores measured at the weeks 4 and 12 and their efficacies were more remarkable at the week 12 (p<0.05. These interventions significantly reduced the NDI and NHP score and their effects were also more remarkable at the week 12; however, dry needling was found more effective (p<0.05. Conclusion: Overall, in current clinical settings, during the management of MPS, pain can be reduced comparably by both dry needling and kinesiotaping; however, restriction in the range of motionin neck region and quality of life are more remarkably reduced by dry needling. Both dry needling and kinesiotaping can provide an increasing effectiveness up to 12 weeks.

  11. Timing of Magma Mixing Prior to the 2011 Eruption of Shinmoedake, Japan: On the Relationship Between Magma Injection, Magma Mixing, and Eruption Triggering

    Science.gov (United States)

    Tomiya, A.; Miyagi, I.; Saito, G.; Geshi, N.

    2013-12-01

    Various petrological evidences indicate magma mixing often preceded volcanic eruptions. Magma injection into the associated magma chambers also often occurs prior to eruptions as evidenced by inflation of a volcanic edifice. However, the relationship between magma injection, magma mixing, and eruption triggering is unclear because injection does not necessarily cause instantaneous mixing if the injected magma is sufficiently denser than the pre-existing magma and has formed stable stratified layers. To investigate the relationship, we estimated the timing of magma mixing prior to the 2011 sub-Plinian eruptions of Shinmoedake volcano, Kirishima volcanic group, Japan, on the basis of chemical zoning observed in magnetite phenocrysts and numerical diffusion modeling. We compared the timing with that of volcanic inflation/deflation processes. The eruptive products are comprised mainly of phenocryst-rich (28 vol%) gray pumice (SiO2 = 57 wt%) with minor amount of white pumice (SiO2 = 62 wt%). We recognized two magmatic end members, low-T dacitic magma and high-T mafic magma (basalt or basaltic andesite), and hybrid andesitic magma on the basis of our petrologic studies. Gray pumice is comprised mainly of the hybrid andesitic magma. White pumice is comprised mainly of the low-T dacitic magma with mixing of small volume of the hybrid andesitic magma. Most of the magnetite phenocrysts (type-A1) were crystallized in the hybrid andesitic magma. Their zoning profiles showed considerable increase in Mg and Al contents toward the rims of the phenocrysts, due to mixing with the high-T mafic magma. We calculated the time for diffusion to form these zoning profiles to be only 0.4 to 3 days. The short time scale suggests that the mixing of high-T magma triggered the sub-Plinian eruptions. This mixing process was not accompanied by a significant change in the volume of the magma chamber because no significant crustal deformation was observed several days prior to the eruptions (Japan

  12. Dirac-Point Shift by Carrier Injection Barrier in Graphene Field-Effect Transistor Operation at Room Temperature.

    Science.gov (United States)

    Lee, Sungsik; Nathan, Arokia; Alexander-Webber, Jack; Braeuninger-Weimer, Philipp; Sagade, Abhay A; Lu, Haichang; Hasko, David; Robertson, John; Hofmann, Stephan

    2018-03-21

    A positive shift in the Dirac point in graphene field-effect transistors was observed with Hall-effect measurements coupled with Kelvin-probe measurements at room temperature. This shift can be explained by the asymmetrical behavior of the contact resistance by virtue of the electron injection barrier at the source contact. As an outcome, an intrinsic resistance is given to allow a retrieval of an intrinsic carrier mobility found to be decreased with increasing gate bias, suggesting the dominance of short-range scattering in a single-layer graphene field-effect transistor. These results analytically correlate the field-effect parameters with intrinsic graphene properties.

  13. Simulation Investigation on Combustion Characteristics in a Four-Point Lean Direct Injection Combustor with Hydrogen/Air

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    Jianzhong Li

    2017-06-01

    Full Text Available To investigate the combustion characteristics in multi-point lean direct injection (LDI combustors with hydrogen/air, two swirl–venturi 2 × 2 array four-point LDI combustors were designed. The four-point LDI combustor consists of injector assembly, swirl–venturi array and combustion chamber. The injector, swirler and venturi together govern the rapid mixing of hydrogen and air to form the mixture for combustion. Using clockwise swirlers and anticlockwise swirlers, the co-swirling and count-swirling swirler arrays LDI combustors were achieved. Using Reynolds-Averaged Navier–Stokes (RANS code for steady-state reacting flow computations, the four-point LDI combustors with hydrogen/air were simulated with an 11 species and 23 lumped reaction steps H2/Air reaction mechanism. The axial velocity, turbulence kinetic energy, total pressure drop coefficient, outlet temperature, mass fraction of OH and emission of pollutant NO of four-point LDI combustors, with different equivalence ratios, are here presented and discussed. As the equivalence ratios increased, the total pressure drop coefficient became higher because of increasing heat loss. Increasing equivalence ratios also corresponded with the rise in outlet temperature of the four-point LDI combustors, as well as an increase in the emission index of NO EINO in the four-point LDI combustors. Along the axial distance, the EINO always increased and was at maximum at the exit of the dump. Along the chamber, the EINO gradually increased, maximizing at the exit of chamber. The total temperature of four-point LDI combustors with different equivalence ratios was identical to the theoretical equilibrium temperature. The EINO was an exponential function of the equivalence ratio.

  14. A case study utilizing myofascial release, acupressure and trigger point therapy to treat bilateral "Stringhalt" in a 12 year old Akhal-Teke horse.

    Science.gov (United States)

    Brockman, Tammy

    2017-07-01

    "Stringhalt" is a horse condition that causes one or both hind legs to spasm when walking, trotting or backing. The condition is thought to be related to a neurological cause from either plant toxicity or peripheral nerve injury. The prognosis is poor and the horse's performance and quality of life can be affected. Treatment has included surgically cutting the digital extensors with varied results. The objective of the study is to utilize soft tissue release via acupressure, trigger point and myofascial release to decrease symptoms of stringhalt. The case study is a 12 year old Akhal-Teke horse of excellent pedigree. In 2011, she was caught in barbed wire overnight and sustained lacerations to the bone in her hindlimbs. Shortly after the injury the horse was placed in a stall for several months and was unable to walk or run, developing stringhalt. Currently, her condition is aggravated by stress and alleviated by certain types of massage (myofascial, acupressure, and trigger point release). The incidence of stringhalt occurs every 3-5 min, with more frequent and severe symptoms on the right hindlimb. The horse is unable to run or back up. Six 1 to 1½ hour bi-weekly treatments were performed. The treatments consisted of myofascial release at the cervical, sacrum and iliums, acupressure of the bladder meridian (including c-spine, t-spine, l-spine, and hamstring), and trigger point release of the iliacus. The stringhalt symptoms were monitored for 30 min prior to each of the 6 treatment sessions. After 6 treatments, the horse was observed running and standing in a position that promotes hip extension. She has not been able to do either since the injury. The frequency and severity of the spasms have decreased to every 10-20 min. The horse's owners report that her disposition, stress and quality of life are much improved. The results suggest that myofascial release, acupressure and trigger point therapy may be utilized to provide a positive treatment outcome in the

  15. The Effect of Dry Needling of the Trigger Points of Shoulder Muscles on Pain and Grip Strength in Patients with Lateral Epicondylitis: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Alireza Kheradmandi

    2015-09-01

    Full Text Available Background: Lateral epicondylitis, also known as tennis elbow, is the most common overuse syndrome of the elbow. The severity of pain may not be directly caused by tendinopathy of wrist extensors since trigger points of the shoulder muscles have a referral zone in the arm and elbow. Therefore the aim of this study was to evaluate the effect of dry needling of shoulder myofascial trigger points on wrist extensors muscles pain and function. Methods: Fourteen female patients with tennis elbow (aged 20 - 45 years old were recruited after primary evaluation by an orthopedist. They entered the study if they had pain in the lateral aspect of elbow of the dominant hand for more than 3 months along with the presence of myofascial trigger points in any muscles of supra spinatus, infra spinatus, sub scapularis or scalenes. Pain pressure threshold, maximal grip force and pain intensity of the hand extensors on lateral epicondyle of elbow were measured before and after treatment. Pain intensity was measured on a one to ten scale of visual analogue scale (VAS. A hand dynamometer used to measure the maximal grip force value of the affected hand in 0˚shoulder flexion/ abduction, 90˚ elbow extension and mid-poison of forearm in sitting position. A pressure algometer was applied on hand extensor muscles to define their trigger point sensitivity. For the control group, treatment regimens consisted of routine physical therapy of tennis elbow. This regime was accompanied by dry needling of mentioned muscles for the intervention group. Wilcoxon and Mann-Whitney non-parametric tests were used for statistical analysis. Results: Comparison of the results after intervention showed that the patients’ pain significantly decreased in both groups (P<0.001; but the patient’s PPT and grip force significantly increased solely in the intervention group (P<0.05. Mann Whitney test showed significant pain differences in both groups (P=0.001. The comparison of differences

  16. Low-pressure, single-point grout injection for tank heel sludge mixing and in-situ immobilization

    International Nuclear Information System (INIS)

    Whyatt, G.A.; Hymas, C.R.

    1998-09-01

    This report describes tests conducted in an approximately 9-ft diameter test tank situated outside the 336 building in Hanford's 300 area. The tests were performed to measure the ability of jets of grout slurry to mobilize and mix simulated tank sludge. The technique is intended for in situ immobilization of tank waste heels. The current approach uses a single, rotated, larger-diameter nozzle driven at lower pressure. Due to the larger diameter, the potential for plugging is reduced and the effective radius around an injection point over which the jet is effective in mobilizing sludge from the tank bottom can be made larger. A total of three grout injection tests were conducted in a 9-ft diameter tank. In each case, a 2-in. layer of kaolin clay paste was placed on a dry tank floor to simulate a sludge heel. The clay was covered with 4 inches of water. The grout slurry, consisting of Portland cement, class F fly ash, and eater, was prepared and delivered by an offsite vendor. In the third test, the sludge in half of the tank was replaced by a layer of 20x50 mesh zeolite, and bentonite clay was added to the grout formulation. After injection, the grout was allowed to set and then the entire grout monolith was manually broken up and excavated using a jack hammer. Intact pieces of clay were visually apparent due to a sharp color contrast between the grout and clay. Remaining clay deposits were collected and weighed and suspended clay pieces within the monolith were photographed. The mobilization performance of the grout jets exceeded expectations

  17. Modeling Metallic Precipitate Dissolution in Silicon Under Point Defect Injection: Final Subcontract Report, 20 January 2004--19 January 2005

    Energy Technology Data Exchange (ETDEWEB)

    Tan, T. Y.

    2005-05-01

    We have formulated the problem of gettering of metallic precipitates in Si for which there exists a volume misfit between the precipitate and the Si matrix material. The gettering process is modeled using an Al-Si liquid layer, and the volume misfit associated with dissolving the precipitates is assumed as accommodated by point defects, which may be dominated by vacancies (V), self-interstitials (I), or both contributing. Under the condition that V and I attained dynamical equilibrium, we found that for analytic purposes, the problem reduces to either the V or the I alone case, with the fast-diffusing case dominating. Our initial simulation results on gettering of FeSi2 (with a misfit of -0.15) showed that the process can be sped up by the injection of V.

  18. Multi-point injection demonstration for solidification of shallow buried waste at Oak Ridge Reservation, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1996-10-01

    The multi-point injection (MPI) technology is a precision, high-velocity jetting process for the in situ delivery of various agents to treat radiological and/or chemical wastes. A wide variety of waste forms can be treated, varying from heterogeneous waste dumped into shallow burial trenches to contaminated soils consisting of sands/gravels, silts/clays and soft rock. The robustness of the MPI system is linked to its broad range of applications which vary from in situ waste treatment to creation of both vertical and horizontal barriers. The only major constraint on the type of in situ treatment which can be delivered by the NTI system is that agents must be in a slurry form

  19. Trigger point treatment with radial shock waves in musicians with nonspecific shoulder-neck pain: data from a special physio outpatient clinic for musicians.

    Science.gov (United States)

    Damian, Malika; Zalpour, Christoff

    2011-12-01

    Musicians often suffer from disorders of the musculoskeletal system that are related to their instrument playing. Among the most frequent symptoms are complaints in the shoulder-neck area. Radial shock wave therapy is increasingly used in trigger point treatment, but only few high-level studies have examined of shock wave therapy used together with physical therapy in the treatment of musicians. This randomized blinded study in musicians (n = 26) with nonspecific shoulder-neck problems was done to examine the effect of shock wave therapy in addition to current physical therapy on the symptoms and quality of life of the musicians as well as their habits of playing musical instruments (intervention group shock wave vs reference group placebo). The effects were documented by a pain VAS and other instruments. A questionnaire designed specifically for musicians (with initial and final questions) recorded intensity and manifestation of pain and handicaps in daily life, especially when practicing and playing. The Shoulder Pain and Disability Index (SPADI) and the Neck Pain Disability Index Questionnaire (NPDIQ) were also used. Both groups reported subjective improvement in pain, but significance was found only for the intervention group for the SPADI and NPDIQ. Trigger point treatment with radial shock wave used in combination with physical therapy makes the subjects feel temporarily relieved of neck and shoulder pains. The effects of radial shock wave without physical therapy will need to be examined in further studies.

  20. The Comparison of the Effects of Trigger Points Pressure Release and Kinesio Taping on Pain and Hip Abductor Muscles Strength in Patients with Patellofemoral Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Vahid Mazloum

    2016-10-01

    Full Text Available Background & objectives: Hip muscles insufficiency plays a significant role in deterioration of patellofemoral pain syndrome (PFPS, which can be manifested as myofascial trigger point (MTrPs in hip muscles. Then, our purpose was to determine the prevalence of MTrPs in the gluteus medius (GMe and quadratus lumborum (QL muscles and to investigate the effect of a therapeutic intervention on pain intensity and hip abductor muscles isometric strength in patients with PFPS. Methods: Forty volunteer subjects (20 patients and 20 healthy participated in the study. Latent MTrPs in GMe and QL were evaluated and a handheld dynamometer was used to measure peak isometric strength test (PIST for hip abductors. Patients with PFPS having MTrPs in GMe were randomly divided into either a treatment group (Mean age±SD: 23.2±4.3 years or control (Mean age±SD: 24.4±4.6 years. The therapeutic intervention included trigger point pressure release (TrPPR and Kinesio Taping® (KT. Pain intensity and PIST for hip abductors were assessed at baseline and after intervention in both groups. Results: There is more significant patients with PFPS having latent MTrPs in GMe and QL than the healthy counterparts (p0.05. Conclusion: Concomitant using of TrPPR therapy and KT method can decrease pain intensity in individuals with PFPS. Further studies are required to understand the underlying mechanisms.

  1. Subcutaneous injection of thallium-201 chloride and gallium-67 citrate at acupuncture point K-3; An animal experiment and human-being study

    Energy Technology Data Exchange (ETDEWEB)

    Johg, Shiang-Bin; Wu, Chung-Chieng; Chen, Ming-Feng; Wu, Sheng-Nan (Kaohsiung Medical Coll., Taiwan (China))

    1992-09-01

    Subcutaneous (SC) injection of [sup 99m]Tc pertechnetate ([sup 99m]Tc) at acupuncture points K-3 is a new method of lower-limb radionuclide venography. To investigate the mechanism of absorption of [sup 99m]Tc from SC injected sites into vascular system, various radioisotopes such as [sup 201]Tl chloride ([sup 201]Tl) and [sup 67]Ga citrate ([sup 67]Ga) were SC injected at K-3 points in animal and human-beings experiments. It was found that [sup 99m]Tc and [sup 201]Tl were absorbed rapidly from K-3 points through venous system and into whole body soft tissue. However, [sup 67]Ga with a larger effective ionic radius than [sup 201]Tl was not absorbed throughout the observation of 5 minutes. Furthermore, intravenous administration of digitalis, a Na[sup +]-K[sup +] pump blocker, did not inhibit the absorption of [sup 99m]Tc and [sup 201]Tl after SC injection at K-3 points. These results suggest that absorption of radionuclides on SC injection at K-3 points is mainly through the passive pathway of diffusion rather than the active transport, and the effective ionic radius may be a major factor influencing the absorption rate of the radionuclides. (author).

  2. Evolution of the methodological quality of controlled clinical trials for myofascial trigger point treatments for the period 1978-2015: A systematic review.

    Science.gov (United States)

    Stoop, Rahel; Clijsen, Ron; Leoni, Diego; Soldini, Emiliano; Castellini, Greta; Redaelli, Valentina; Barbero, Marco

    2017-08-01

    The methodological quality of controlled clinical trials (CCTs) of physiotherapeutic treatment modalities for myofascial trigger points (MTrP) has not been investigated yet. To detect the methodological quality of CCTs for physiotherapy treatments of MTrPs and demonstrating the possible increase over time. Systematic review. A systematic search was conducted in two databases, Physiotherapy Evidence Database (PEDro) and Medicine Medical Literature Analysis and Retrieval System online (MEDLINE), using the same keywords and selection procedure corresponding to pre-defined inclusion criteria. The methodological quality, assessed by the 11-item PEDro scale, served as outcome measure. The CCTs had to compare at least two interventions, where one intervention had to lay within the scope of physiotherapy. Participants had to be diagnosed with myofascial pain syndrome or trigger points (active or latent). A total of n = 230 studies was analysed. The cervico-thoracic region was the most frequently treated body part (n = 143). Electrophysical agent applications was the most frequent intervention. The average methodological quality reached 5.5 on the PEDro scale. A total of n = 6 studies scored the value of 9. The average PEDro score increased by 0.7 points per decade between 1978 and 2015. The average PEDro score of CCTs for MTrP treatments does not reach the cut-off of 6 proposed for moderate to high methodological quality. Nevertheless, a promising trend towards an increase of the average methodological quality of CCTs for MTrPs was recorded. More high-quality CCT studies with thorough research procedures are recommended to enhance methodological quality. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  3. Comparison of Upper Trapezius and Infraspinatus Myofascial Trigger Point Therapy by Dry Needling in Overhead Athletes With Unilateral Shoulder Impingement Syndrome.

    Science.gov (United States)

    Kamali, Fahimeh; Sinaei, Ehsan; Morovati, Maryam

    2018-01-24

    Chronic musculoskeletal disorders in shoulder joint are often associated with myofascial trigger points (MTrP), particularly in the upper trapezius (UT) muscle. Dry needling (DN) is a treatment of choice for myofascial pain syndrome. However, local lesions and severe post-needle soreness sometimes hamper the direct application of DN in the UT. Therefore, finding an alternative point of treatment seems useful in this regard. To compare the efficacy of UT versus infraspinatus (ISP) DN on pain and disability of subjects with shoulder pain. We hypothesized that ISP DN could be as effective as the direct application of DN in UT MTrP. Single-blind randomized clinical trial. Sports medicine physical therapy clinic. 40 overhead athletes (age 36±16 yo; 20 females, 20 males) with unilateral shoulder impingement syndrome were randomly assigned to the UT DN (n=21) and ISP DN (n=19) groups. An acupuncture needle was directly inserted into the trigger point of UT muscle in the UT DN group and of ISP muscle in the ISP DN group. DN was applied in three sessions (2-day interval between sessions) for each group. Pain intensity (visual analog scale), pain pressure threshold (PPT) and disability in the arm, hand and shoulder (DASH) were assessed before and after the interventions. Pain and disability decreased significantly in both groups (P0.05). Application of DN for active MTrPs in the ISP can be as effective as direct DN of active MTrPs in the UT in improving pain and disability in athletes with shoulder pain, and may be preferred due to greater patient comfort in comparison with direct UT needling.

  4. Distance of cleavage trigger point (weakest-link) to the crack tip - fractographic analysis; Distancias dos elos-mais-fracos ate a ponta da trinca - analise fractografica

    Energy Technology Data Exchange (ETDEWEB)

    Miranda, Carlos Alexandre de J. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil). E-mail: cmiranda@net.ipen.br

    2000-07-01

    Among the existing approaches approaches to predict J{sub c,} in the transition region of the ferritic steels, there are statistical and deterministic methods. Among the formers we have the methodology based on the two-parameter J-Q theory and the weakest-link concept with its characteristic distance, r{sub wl.} For this work, an experimental program was developed using 65 fracture mechanics specimens made from an A508 steel, in three geometries with thickness B < 1T = 25.4 mm, and tested at four transition temperatures. After the tests to measure J{sub c,} all specimen fracture surfaces were observed by scanning electron microscopy to identify the cleavage trigger points (weak-links) and to measure their characteristic distances r{sub wl} to the crap tip. The J{sub c} and r{sub wl} values were presented and compared with the theoretical ones. (author)

  5. [The first exploration of a minimally invasive lysis subcutaneouly for the treatment of gluteal muscle contracture based on relatively safe region around standard injection point of gluteal muscle].

    Science.gov (United States)

    Xiao, Ying; Tang, Zhi-hong; Zhang, Si-rong; Zou, Guo-yao; Xiao, Rong-chi; Liu, Rui-duan; Hu, Jun-zu

    2011-06-01

    To explore the solution of choosing the minimally invasive incision site for gluteal muscle contracture patient based on standard injection point of gluteal muscle. from September 2008 to August 2010, 25 patients (14 males and 11 females with an average of 16.5 years, ranging from 12 to 26 years) with injected gluteal muscle contracture were prospectively studied. The course of disease was from 6 to 12 years. Firstly, the connective skin Surface line from anterior superior iliac spine to coccyx (line AD) was delineated and the point (point O) was marked out as the standard gluteal muscle injection site which was on the one-third of the distance from the anterior superior iliac spine(point A) to the coccyx (point D). Secondly, the anterior and posterior edge lines of surface projection of the gluteal muscle contracture banding (line a, line p) were delineated. Thirdly, the distance from B to O and C to O (B is the point of intersection of line a and line AD,C is the point of intersection of line P and line AD)were measured which was the intersection of line a,p and line AD to point O. Lastly, the minimally invasive surgery was operformed via the skin entry of point C. OB = (0 +/- 0.76) cm, OC = (2.86 +/- 0.78) cm, BC = (2.86 +/- 1.01) cm,the mean postoperative drainage was less than 10 ml,there was no nerve damage,hematoma and other complications. All patients achieved the function of squatting in 4 to 6 days. The solution of choosing the minimally invasive incision site based on standard injection point of gluteal muscle has advantages of positioning precisely,handling easily, recoverying quickly, less trauma and safety, etc.

  6. Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial.

    Science.gov (United States)

    Calvo-Lobo, César; Pacheco-da-Costa, Soraya; Martínez-Martínez, Jorge; Rodríguez-Sanz, David; Cuesta-Álvaro, Pedro; López-López, Daniel

    Shoulder pain is a prevalent condition in older adults. Some authors associate nonspecific shoulder pain with myofascial trigger points (MTrPs) in the infraspinatus muscle. Dry needling is recommended to relieve the MTrP pain of shoulders in the short term (dry needling improves shoulder pain and the irritability of the satellite MTrPs in the referred pain area. Nociceptive activity at a latent MTrP may influence motor activity and the sensitivity of MTrPs in distant muscles at a similar segmental level. Therefore, this study aimed to evaluate dry needling on 1 latent MTrP, in conjunction with 1 active MTrP, in the infraspinatus muscle of older adults with nonspecific shoulder pain. A single-center, randomized, single-blinded, controlled study (NCT02032602) was carried out. Sixty-six patients aged 65 years and older with trigger points in the ipsilateral infraspinatus of the painful shoulder were randomly assigned to (1) of (2) treatment groups. A session of dry needling on the infraspinatus was performed in (1) the most hyperalgesic active and latent MTrP or (2) only the most hyperalgesic active MTrP. The Numeric Rating Scale, the pressure pain threshold (primary outcome) on the anterior deltoid and extensor carpi radialis brevis latent MTrPs, and grip strength were assessed before, after, and 1 week after the intervention. Statistically significant differences in the reduction of pain intensity (P ≤ .001; η = 0.159-0.269; d = 1.017-1.219) and the increase of pressure pain threshold (P . 05; η = 0.006-0.033; d = 0.158-0.368). One dry needling intervention of the latent MTrP associated with the key active MTrP of the infraspinatus reduces pain intensity and the irritability of the satellite MTrPs located in the referred pain area in the short term in older adults with nonspecific shoulder pain.

  7. The effect of dry needling on pain, pressure pain threshold and disability in patients with a myofascial trigger point in the upper trapezius muscle.

    Science.gov (United States)

    Ziaeifar, Maryam; Arab, Amir Massoud; Karimi, Noureddin; Nourbakhsh, Mohammad Reza

    2014-04-01

    Dry needling (DN) has been used recently by physical therapists as a therapy of choice for patients with myofascial trigger points (TrP). The purpose of this randomized controlled trial was to investigate the effect of DN in the treatment of TrPs in the upper trapezius (UT) muscle. A sample of convenience of 33 patients with TrP in the UT muscle participated in this study. Patients were randomly assigned to a standard (N = 17) or experimental group (N = 16). The treatment protocol for the standard group consisted of trigger point compression technique (TCT) on MTP, while the patients in the experimental group received DN. Pain intensity and pressure pain thresholds were assessed for both groups before and after the treatment sessions. In addition, the Disability of Arm, Hand, and Shoulder (DASH) was administered. Statistical analysis (paired t-test) revealed a significant improvement in pain, PPT and DASH scores after treatment in the experimental (DN) and standard (TCT) group compared with before treatment (P < 0.05). The ANCOVA revealed significant differences between the DN and TCT groups on the post-measurement VAS score (P = 0.01). There was, however, no significant difference between the two groups on the post-measurement score of the PPT (P = 0.08) and DASH (P = 0.34). DN produces an improvement in pain intensity, PPT and DASH and may be prescribed for subjects with TrP in UT muscles especially when pain relief is the goal of the treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Comparison of ischemic compression and lumbopelvic manipulation as trigger point therapy for patellofemoral pain syndrome in young adults: A double-blind randomized clinical trial.

    Science.gov (United States)

    Behrangrad, Shabnam; Kamali, Fahimeh

    2017-07-01

    To compare the effectiveness of ischemic compression (IC) directly to the vastus medialis obliquus (VMO) versus lumbopelvic manipulation (LPM) in improving pain, functional status and sensitivity to mechanical stimulation of the VMO trigger point in patients with patellofemoral pain syndrome (PFPS). 40 patients with unilateral PFPS aged 20-30 years were selected randomly among patients with unilateral PFPS referred to physical therapy clinics of Shiraz University of Medical Sciences in Shiraz, Iran, between March 2014 and July 2014. 30 young adults participated. Participants were blinded to treatment allocation, and 15 patients were allocated to either IC or LPM. Patients in both groups were treated in three sessions per week. IC consisted of three sets of continuous pressure applied for on the myofascial trigger point (MTrP) of VMO. LPM consisted of supine rotational glide manipulation of the ipsilateral lumbopelvic region of the involved knee. Numeric pain rating scale (VAS) for pain intensity, Kujala questionnaire for functional status, and pressure pain threshold (PPT) for sensitivity to mechanical stimulation. All three were recorded before treatment, 1 week, 1 month and 3 months after the last session. Both groups showed significant improvement (p < 0.05, 95% confidence interval) in pain, functional status and PPT values. However, the IC group showed greater improvements, and outcome measures remained significantly better than in the LPM group during post-intervention follow-up. Both groups showed improvements throughout the study and follow-up period. However, the IC showed better short-term and long-term effectiveness than LPM for treating PFPS. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Validity and Reliability of Clinical Examination in the Diagnosis of Myofascial Pain Syndrome and Myofascial Trigger Points in Upper Quarter Muscles.

    Science.gov (United States)

    Mayoral Del Moral, Orlando; Torres Lacomba, María; Russell, I Jon; Sánchez Méndez, Óscar; Sánchez Sánchez, Beatriz

    2017-12-15

    To determine whether two independent examiners can agree on a diagnosis of myofascial pain syndrome (MPS). To evaluate interexaminer reliability in identifying myofascial trigger points in upper quarter muscles. To evaluate the reliability of clinical diagnostic criteria for the diagnosis of MPS. To evaluate the validity of clinical diagnostic criteria for the diagnosis of MPS. Validity and reliability study. Provincial Hospital. Toledo, Spain. Twenty myofascial pain syndrome patients and 20 healthy, normal control subjects, enrolled by a trained and experienced examiner. Ten bilateral muscles from the upper quarter were evaluated by two experienced examiners. The second examiner was blinded to the diagnosis group. The MPS diagnosis required at least one muscle to have an active myofascial trigger point. Three to four days separated the two examinations. The primary outcome measure was the frequency with which the two examiners agreed on the classification of the subjects as patients or as healthy controls. The kappa statistic (K) was used to determine the level of agreement between both examinations, interpreted as very good (0.81-1.00), good (0.61-0.80), moderate (0.41-0.60), fair (0.21-0.40), or poor (≤0.20). Interexaminer reliability for identifying subjects with MPS was very good (K = 1.0). Interexaminer reliability for identifying muscles leading to a diagnosis of MPS was also very good (K = 0.81). Sensitivity and specificity showed high values for most examination tests in all muscles, which confirms the validity of clinical diagnostic criteria in the diagnosis of MPS. Interrater reliability between two expert examiners identifying subjects with MPS involving upper quarter muscles exhibited substantial agreement. These results suggest that clinical criteria can be valid and reliable in the diagnosis of this condition.

  10. Triggering Artefacts

    DEFF Research Database (Denmark)

    Mogensen, Preben Holst; Robinson, Mike

    1995-01-01

    The paper presents a general critique of the use of conceptual frameworks in design, illustrated by the well known synchronous/asynchronous, co-located/non-co-located framework. It argues that while frameworks are a necessary and inevitable starting point for design, the business of tailoring...... and adapting them to specific situations need not be ad hoc.Triggering artefacts are a way of systematically challenging both designers' preunderstandings and the conservatism of work practice. Experiences from the Great Belt tunnel and bridge project are used to illustrate howtriggering artefacts change...

  11. The use of trigger point dry needling and intramuscular electrical stimulation for a subject with chronic low back pain: a case report.

    Science.gov (United States)

    Rainey, Charles E

    2013-04-01

    Case Report. Myofascial trigger points (MTrPs) are widely accepted by clinicians and researchers as a primary source of regional neuromusculoskeletal pain. Trigger point dry needling (TrP-DN) is an invasive procedure that involves stimulation of MTrPs using an monofilament needle. The purpose of this case report is to report the outcomes of TrP-DN and intramuscular electrical stimulation (IES) as a primary treatment intervention in a subject with chronic low back pain. The subject was a 30-year-old female, active duty military, who was referred to physical therapy for low back and right posterolateral hip pain. She noticed symptoms after suffering a lumbar flexion injury while picking up a barbell during weight training. Physical examination demonstrated findings that supported the diagnosis of lumbar segmental instability with a right hip stability dysfunction. Objective findings included a multi-segmental flexion movement pattern dysfunction and MTrPs in the right gluteus maximus and gluteus medius muscles with deep palpation. The subject was treated with TrP-DN and IES for a total of two visits. Bilateral L3 and L5 multifidus and right gluteus maximus and medius muscles were treated, along with implementing a home exercise program consisting of core stability exercises. The subject reported no existing pain and disability on the Numerical Pain Rating Scale and Oswestry Disability Questionnaire and a large perceived change in recovery on the Global Rating of Change at final follow-up. Physical examination was normal, demonstrating no observed impairments or functional limitations, including normal multi-segmental flexion and no MTrPs with deep palpation. The subject was able to return to full military active duty without any physical limitations and resumed pre-injury activity levels, including the ability to resume all activities without pain. There is much promise regarding the use of TrP-DN with IES intervention for the treatment of lumbar and/or hip stability

  12. Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration.

    Science.gov (United States)

    Martín-Pintado-Zugasti, Aitor; Pecos-Martin, Daniel; Rodríguez-Fernández, Ángel Luis; Alguacil-Diego, Isabel María; Portillo-Aceituno, Alicia; Gallego-Izquierdo, Tomás; Fernandez-Carnero, Josue

    2015-10-01

    To investigate the effect of ischemic compression (IC) versus placebo and control on reducing postneedling soreness of 1 latent myofascial trigger point and on improving cervical range of motion (CROM) in asymptomatic subjects. A randomized, double-blind, placebo-controlled trial with 72-hour follow-up. A university community. Asymptomatic volunteers (N = 90: 40 men and 50 women) aged 18 to 39 years (mean ± standard deviation [SD]: 22 ± 3 years). All subjects received a dry needling application over the upper trapezius muscle. Participants were then randomly divided into 3 groups: a treatment group who received IC over the needled trapezius muscle, a placebo group who received sham IC, and a control group who did not receive any treatment after needling. Visual analog scale (VAS; during needling, at posttreatment and 6, 12, 24, 48, and 72 hours) and CROM (at preneedling, postneedling, and 24 and 72 hours). Subjects in the IC group showed significantly lower postneedling soreness than the placebo and the control group subjects immediately after treatment (mean ± standard deviation [SD]: IC, 20.1 ± 4.8; placebo, 36.7 ± 4.8; control, 34.8 ± 3.6) and at 48 hours (mean ± SD: IC, 0.6 ± 1; placebo, 4.8 ± 1; control, 3.8 ± 0.7). In addition, subjects in the dry needling+IC group showed significantly lower postneedling soreness duration (P = .026). All subjects significantly improved CROM in contralateral lateroflexion and both homolateral and contralateral rotations, but only the improvements found in the IC group reached the minimal detectable change. IC can potentially be added immediately after dry needling of myofascial trigger point in the upper trapezius muscle because it has the effect of reducing postneedling soreness intensity and duration. The combination of dry needling and IC seems to improve CROM in homolateral and contralateral cervical rotation movements. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by

  13. THE USE OF TRIGGER POINT DRY NEEDLING AND INTRAMUSCULAR ELECTRICAL STIMULATION FOR A SUBJECT WITH CHRONIC LOW BACK PAIN: A CASE REPORT

    Science.gov (United States)

    2013-01-01

    Study Design: Case Report. Background and Purpose: Myofascial trigger points (MTrPs) are widely accepted by clinicians and researchers as a primary source of regional neuromusculoskeletal pain. Trigger point dry needling (TrP‐DN) is an invasive procedure that involves stimulation of MTrPs using an monofilament needle. The purpose of this case report is to report the outcomes of TrP‐DN and intramuscular electrical stimulation (IES) as a primary treatment intervention in a subject with chronic low back pain. Case Description: The subject was a 30‐year‐old female, active duty military, who was referred to physical therapy for low back and right posterolateral hip pain. She noticed symptoms after suffering a lumbar flexion injury while picking up a barbell during weight training. Physical examination demonstrated findings that supported the diagnosis of lumbar segmental instability with a right hip stability dysfunction. Objective findings included a multi‐segmental flexion movement pattern dysfunction and MTrPs in the right gluteus maximus and gluteus medius muscles with deep palpation. The subject was treated with TrP‐DN and IES for a total of two visits. Bilateral L3 and L5 multifidus and right gluteus maximus and medius muscles were treated, along with implementing a home exercise program consisting of core stability exercises. Outcomes: The subject reported no existing pain and disability on the Numerical Pain Rating Scale and Oswestry Disability Questionnaire and a large perceived change in recovery on the Global Rating of Change at final follow‐up. Physical examination was normal, demonstrating no observed impairments or functional limitations, including normal multi‐segmental flexion and no MTrPs with deep palpation. Discussion: The subject was able to return to full military active duty without any physical limitations and resumed pre‐injury activity levels, including the ability to resume all activities without pain. There is much promise

  14. Multiple active myofascial trigger points and pressure pain sensitivity maps in the temporalis muscle are related in women with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Caminero, Ana B; Madeleine, Pascal; Guillem-Mesado, Amparo; Ge, Hong-You; Arendt-Nielsen, Lars; Pareja, Juan A

    2009-01-01

    To describe the common locations of active trigger points (TrPs) in the temporalis muscle and their referred pain patterns in chronic tension type headache (CTTH), and to determine if pressure sensitivity maps of this muscle can be used to describe the spatial distribution of active TrPs. Forty women with CTTH were included. An electronic pressure algometer was used to assess pressure pain thresholds (PPT) from 9 points over each temporalis muscle: 3 points in the anterior, medial and posterior part, respectively. Both muscles were examined for the presence of active TrPs over each of the 9 points. The referred pain pattern of each active TrP was assessed. Two-way analysis of variance detected significant differences in mean PPT levels between the measurement points (F=30.3; P<0.001), but not between sides (F=2.1; P=0.2). PPT scores decreased from the posterior to the anterior column (P<0.001). No differences were found in the number of active TrPs (F=0.3; P=0.9) between the dominant side the nondominant side. Significant differences were found in the distribution of the active TrPs (chi2=12.2; P<0.001): active TrPs were mostly found in the anterior column and in the middle of the muscle belly. The analysis of variance did not detect significant differences in the referred pain pattern between active TrPs (F=1.1, P=0.4). The topographical pressure pain sensitivity maps showed the distinct distribution of the TrPs indicated by locations with low PPTs. Multiple active TrPs in the temporalis muscle were found, particularly in the anterior column and in the middle of the muscle belly. Bilateral posterior to anterior decreased distribution of PPTs in the temporalis muscle in women with CTTH was found. The locations of active TrPs in the temporalis muscle corresponded well to the muscle areas with lower PPT, supporting the relationship between multiple active muscle TrPs and topographical pressure sensitivity maps in the temporalis muscle in women with CTTH.

  15. Method to minimize the low-frequency neutral-point voltage oscillations with time-offset injection for neutral-point-clamped inverters

    DEFF Research Database (Denmark)

    Choi, Uimin; Lee, Kyo-Beum; Blaabjerg, Frede

    2013-01-01

    This paper proposes a method to reduce the low-frequency neutral-point voltage oscillations. The neutral-point voltage oscillations are considerably reduced by adding a time-offset to the three phase turn-on times. The proper time-offset is simply calculated considering the phase currents and dwe...... of the proposed strategy....

  16. Efficacy of Myofascial Trigger Point Dry Needling in the Prevention of Pain after Total Knee Arthroplasty: A Randomized, Double-Blinded, Placebo-Controlled Trial

    Science.gov (United States)

    Mayoral, Orlando; Salvat, Isabel; Martín, María Teresa; Martín, Stella; Santiago, Jesús; Cotarelo, José; Rodríguez, Constantino

    2013-01-01

    The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4–5 hours before surgery. Immediately following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when pain was the most severe. Results show a superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented. PMID:23606888

  17. Experienced versus Inexperienced Interexaminer Reliability on Location and Classification of Myofascial Trigger Point Palpation to Diagnose Lateral Epicondylalgia: An Observational Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Raquel Mora-Relucio

    2016-01-01

    Full Text Available The purpose was to evaluate the interexaminer reliability of experienced and inexperienced examiners on location and classification of myofascial trigger points (MTrPs in two epicondylar muscles and the association between the MTrP found and the diagnosis of lateral epicondylalgia (LE. Fifty-two pianists (some suffered LE voluntarily participated in the study. Three physiotherapists (one inexperienced in myofascial pain examined, located, and marked MTrPs in the extensor carpi radialis brevis (ECRB and extensor digitorum communis (EDC muscles. Forearms were photographed and analyzed to establish the degree of agreement on MTrPs diagnosis. Data showed 81.73% and 77.88% of agreement on MTrP classification and 85.58% and 72.12% on MTrP location between the expert evaluators for ECRB and EDC, respectively. The agreement on MTrP classification between experienced and inexperienced examiners was 54.81% and 51.92% for ECRB and 50.00% and 55.77% for EDC. Also, agreement on MTrP location was 54.81% and 60.58% for ECRB and 48.08% and 48.08% for EDC. A strong association was found between presence of relevant MTrPs, LE diagnosis, and forearm pain when the examiners were experts. The analysis of location and classification of MTrPs in the epicondylar muscles through physical examination by experienced evaluators is reliable, reproducible, and suitable for diagnosing LE.

  18. The immediate effect of triceps surae myofascial trigger point therapy on restricted active ankle joint dorsiflexion in recreational runners: a crossover randomised controlled trial.

    Science.gov (United States)

    Grieve, Rob; Cranston, Amy; Henderson, Andrew; John, Rachel; Malone, George; Mayall, Christopher

    2013-10-01

    To investigate the immediate effect on restricted active ankle joint dorsiflexion range of motion (ROM), after a single intervention of myofascial trigger point (MTrP) therapy on latent triceps surae MTrPs in recreational runners. A crossover randomised controlled trial. Twenty-two recreational runners (11 men and 11 women; mean age 24.57; ±8.7 years) with a restricted active ankle joint dorsiflexion and presence of latent MTrPs. Participants were screened for a restriction in active ankle dorsiflexion in either knee flexion (soleus) or knee extension (gastrocnemius) and the presence of latent MTrPs. Participants were randomly allocated a week apart to both the intervention (combined pressure release and 10 s passive stretch) and the control condition. A clinically meaningful (large effect size) and statistically significant increase in ankle ROM in the intervention compared to the control group was achieved, for the soleus (p = 0.004) and the gastrocnemius (p = 0.026). Apart from the statistical significance (p < 0.05), these results are clinically relevant due to the immediate increase in ankle dorsiflexion. These results must be viewed in caution due to the carry-over effect in the RCT crossover design and the combined MTrP therapy approach. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Postneedling soreness after deep dry needling of a latent myofascial trigger point in the upper trapezius muscle: Characteristics, sex differences and associated factors.

    Science.gov (United States)

    Martín-Pintado-Zugasti, Aitor; Rodríguez-Fernández, Ángel Luis; Fernandez-Carnero, Josue

    2016-04-27

    Postneedling soreness is considered the most frequent secondary effect associated to dry needling. A detailed description of postneedling soreness characteristics has not been previously reported. (1) to assess the intensity and duration of postneedling soreness and tenderness after deep dry needling of a trapezius latent myofascial trigger point (MTrP), (2) to evaluate the possible differences in postneedling soreness between sexes and (3) to analyze the influence on postneedling soreness of factors involved in the dry needling process. Sixty healthy subjects (30 men, 30 women) with latent MTrPs in the upper trapezius muscle received a dry needling intervention in the MTrP. Pain and pressure pain threshold (PPT) were assessed during a 72 hours follow-up period. Repeated measures analysis of covariance showed a significant effect for time in pain and in PPT. An interaction between sex and time in pain was obtained: women exhibited higher intensity in postneedling pain than men. The pain during needling and the number of needle insertions significantly correlated with postneedling soreness. Soreness and hyperalgesia are present in all subjects after dry needling of a latent MTrP in the upper trapezius muscle. Women exhibited higher intensity of postneedling soreness than men.

  20. Does Deep Cervical Flexor Muscle Training Affect Pain Pressure Thresholds of Myofascial Trigger Points in Patients with Chronic Neck Pain? A Prospective Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Pavlos Bobos

    2016-01-01

    Full Text Available Background. We need to understand more about how DNF performs in different contexts and whether it affects the pain threshold over myofascial trigger points (MTrPs. Purpose. The objectives were to investigate the effect of neck muscles training on disability and pain and on pain threshold over MTrPs in people with chronic neck pain. Methods. Patients with chronic neck pain were eligible for participation with a Neck Disability Index (NDI score of over 5/50 and having at least one MTrP on either levator scapulae, upper trapezoid, or splenius capitis muscle. Patients were randomly assigned into either DNF training, superficial neck muscle exercise, or advice group. Generalized linear model (GLM was used to detect differences in treatment groups over time. Results. Out of 67 participants, 60 (47 females, mean age: 39.45 ± 12.67 completed the study. Neck disability and neck pain were improved over time between and within groups (p<0.05. However, no differences were found within and between the therapeutic groups (p<0.05 in the tested muscles’ PPTs and in cervicothoracic angle over a 7-week period. Conclusion. All three groups improved over time. This infers that the pain pathways involved in the neck pain relief are not those involved in pain threshold.

  1. Structure, Stability and Emissions of Lean Direct Injection Combustion, including a Novel Multi-Point LDI System for NOx Reduction

    Science.gov (United States)

    Villalva Gomez, Rodrigo

    Experimental research on Lean Direct Injection (LDI) combustors for gas turbine applications is presented. LDI combustion is an alternative to lean premixed combustion which has the potential of equivalent reduction of oxides of nitrogen (NOx) emissions and of peak combustor exit temperatures, but without some drawbacks of premixed combustors, such as flashback and autoignition. Simultaneous observations of the velocity field and reaction zone of an LDI swirl-stabilized combustor with a mixing tube at atmospheric conditions, with the goal of studying the flame stabilization mechanism, are shown. The flame was consistently anchored at the shear layer formed by the high-speed reactants exiting the mixing tube and the low speed recirculation region. Individual image analysis of the location of the tip of the recirculation zone and tip of the reaction region confirmed previously observed trends, but showed that calculation of the distance between these two points for corresponding image pairs yields results no different than when calculated from random image pairs. This most likely indicates a lag in the anchoring of the flame to changes in the recirculation zone, coupled with significant stochastic variation. An alternate LDI approach, multi-point LDI (MLDI), is also tested experimentally. A single large fuel nozzle is replaced by multiple small fuel nozzles to improve atomization and reduce the total volume of the high-temperature, low velocity recirculation zones, reducing NOx formation. The combustor researched employs a novel staged approach to allow good performance across a wide range of conditions by using a combination of nozzle types optimized to various power settings. The combustor has three independent fuel circuits referenced as pilot, intermediate, and outer. Emissions measurements, OH* chemiluminescence imaging, and thermoacoustic instability studies were run in a pressurized combustion facility at pressures from 2.0 to 5.3 bar. Combustor performance

  2. Method to Minimize the Low-Frequency Neutral-Point Voltage Oscillations With Time-Offset Injection for Neutral-Point-Clamped Inverters

    DEFF Research Database (Denmark)

    Choi, Ui-Min; Blaabjerg, Frede; Lee, Kyo-Beum

    2015-01-01

    This paper proposes a method to reduce the low-frequency neutral-point voltage oscillations. The neutral-point voltage oscillations are considerably reduced by adding a time offset to the three-phase turn-on times. The proper time offset is simply calculated considering the phase currents and dwe...... is also proposed. The change in switching frequency by the proposed method and its effects on the outputs are negligible. Simulation and experimental results verify the validity and feasibility of the proposed strategy....

  3. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Liu, Lin; Huang, Qiang-Min; Liu, Qing-Guang; Thitham, Nguyen; Li, Li-Hui; Ma, Yan-Tao; Zhao, Jia-Min

    2018-01-01

    To evaluate the current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with low back pain (LBP). PubMed, Ovid, EBSCO, ScienceDirect, Web of Science, Cochrane Library, CINAHL, and China National Knowledge Infrastructure databases were searched until January 2017. Randomized controlled trials (RCTs) that used dry needling as the main treatment and included participants diagnosed with LBP with the presence of MTrPs were included. Two reviewers independently screened articles, scored methodologic quality, and extracted data. The primary outcomes were pain intensity and functional disability at postintervention and follow-up. A total of 11 RCTs involving 802 patients were included in the meta-analysis. Results suggested that compared with other treatments, dry needling of MTrPs was more effective in alleviating the intensity of LBP (standardized mean difference [SMD], -1.06; 95% confidence interval [CI], -1.77 to -0.36; P=.003) and functional disability (SMD, -0.76; 95% CI, -1.46 to -0.06; P=.03); however, the significant effects of dry needling plus other treatments on pain intensity could be superior to dry needling alone for LBP at postintervention (SMD, 0.83; 95% CI, 0.55-1.11; Pdry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of LBP at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  4. Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache: a pilot study.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Cuadrado, María Luz; Arendt-Nielsen, Lars; Ge, Hong-You; Pareja, Juan A

    2008-03-01

    To investigate whether cross-sectional area (CSA) of the suboccipital muscles was associated with active trigger points (TrPs) in chronic tension-type headache (CTTH). Magnetic resonance imaging (MRI) of the cervical spine was performed in 11 females with CTTH aged from 26 to 50 yrs old. CSA for both rectus capitis posterior minor (RCPmin) and rectus capitis posterior major (RCPmaj) muscles were measured from axial T1-weighted images, using axial MRI slices aligned parallel to the C2/3 intervertebral disc. A headache diary was kept for 4 wks to record the pain history. TrPs in the suboccipital muscle were identified by eliciting referred pain to palpation, and increased referred pain with muscle contraction. TrPs were considered active if the elicited referred pain reproduced the head pain pattern and features of the pattern seen during spontaneous headache attacks. Active TrPs were found in six patients (55%), whereas the remaining five patients showed latent TrPs. CSA of the RCPmin was significantly smaller (F = 13.843; P = 0.002) in the patients with active TrPs (right side: 55.9 +/- 4.4 mm; left side: 61.1 +/-: 3.8 mm) than in patients with latent TrPs (right side: 96.9 +/- 14.4 mm; left side: 88.7 +/- 9.7 mm). No significant differences were found for CSA of the RCPmaj between the patients with either active or latent TrP (P > 0.5). It seems that muscle atrophy in the RCPmin, but not in the RCPmaj, was associated with suboccipital active TrPs in CTTH, although studies with larger sample sizes are now required. It may be that nociceptive inputs in active TrPs could lead to muscle atrophy of the involved muscles. Muscle disuse or avoidance behavior can also be involved in atrophy.

  5. Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.

    Science.gov (United States)

    Fernández-de-las-Peñas, César; Fernández-Mayoralas, Daniel M; Ortega-Santiago, Ricardo; Ambite-Quesada, Silvia; Palacios-Ceña, Domingo; Pareja, Juan A

    2011-02-01

    Our aim was to describe the referred pain pattern and areas from trigger points (TrPs) in head, neck, and shoulder muscles in children with chronic tension type headache (CTTH). Fifty children (14 boys, 36 girls, mean age: 8 ± 2) with CTTH and 50 age- and sex- matched children participated. Bilateral temporalis, masseter, superior oblique, upper trapezius, sternocleidomastoid, suboccipital, and levator scapula muscles were examined for TrPs by an assessor blinded to the children's condition. TrPs were identified with palpation and considered active when local and referred pains reproduce headache pain attacks. The referred pain areas were drawn on anatomical maps, digitalized, and also measured. The total number of TrPs was significantly greater in children with CTTH as compared to healthy children (P < 0.001). Active TrPs were only present in children with CTTH (P < 0.001). Within children with CTTH, a significant positive association between the number of active TrPs and headache duration (r (s) = 0.315; P = 0.026) was observed: the greater the number of active TrPs, the longer the duration of headache attack. Significant differences in referred pain areas between groups (P < 0.001) and muscles (P < 0.001) were found: the referred pain areas were larger in CTTH children (P < 0.001), and the referred pain area elicited by suboccipital TrPs was larger than the referred pain from the remaining TrPs (P < 0.001). Significant positive correlations between some headache clinical parameters and the size of the referred pain area were found. Our results showed that the local and referred pains elicited from active TrPs in head, neck and shoulder shared similar pain pattern as spontaneous CTTH in children, supporting a relevant role of active TrPs in CTTH in children.

  6. Trigger finger

    Science.gov (United States)

    ... digit; Trigger finger release; Locked finger; Digital flexor tenosynovitis ... cut or hand Yellow or green drainage from the cut Hand pain or discomfort Fever If your trigger finger returns, call your surgeon. You may need another surgery.

  7. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis.

    Science.gov (United States)

    Liu, Lin; Huang, Qiang-Min; Liu, Qing-Guang; Ye, Gang; Bo, Cheng-Zhi; Chen, Meng-Jin; Li, Ping

    2015-05-01

    To evaluate current evidence of the effectiveness of dry needling of myofascial trigger points (MTrPs) associated with neck and shoulder pain. PubMed, EBSCO, Physiotherapy Evidence Database, ScienceDirect, The Cochrane Library, ClinicalKey, Wanfang Data Chinese database, China Knowledge Resource Integrated Database, Chinese Chongqing VIP Information, and SpringerLink databases were searched from database inception to January 2014. Randomized controlled trials were performed to determine whether dry needling was used as the main treatment and whether pain intensity was included as an outcome. Participants were diagnosed with MTrPs associated with neck and shoulder pain. Two reviewers independently screened the articles, scored methodological quality, and extracted data. The results of the study of pain intensity were extracted in the form of mean and SD data. Twenty randomized controlled trials involving 839 patients were identified for meta-analysis. Meta-analyses were performed using RevMan version 5.2 and Stata version 12.0. The results suggested that compared with control/sham, dry needling of MTrPs was effective in the short term (immediately to 3 days) (standardized mean difference [SMD]=-1.91; 95% confidence interval [CI], -3.10 to -.73; P=.002) and medium term (SMD=-1.07; 95% CI, -1.87 to -.27; P=.009); however, wet needling (including lidocaine) was superior to dry needling in relieving MTrP pain in the medium term (SMD=1.69; 95% CI, .40-2.98; P=.01). Other therapies (including physiotherapy) were more effective than dry needling in treating MTrP pain in the medium term (9-28d) (SMD=.62; 95% CI, .02-1.21; P=.04). Dry needling can be recommended for relieving MTrP pain in neck and shoulders in the short and medium term, but wet needling is found to be more effective than dry needling in relieving MTrP pain in neck and shoulders in the medium term. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. The local and referred pain from myofascial trigger points in the temporalis muscle contributes to pain profile in chronic tension-type headache.

    Science.gov (United States)

    Fernández-de-Las-Peñas, César; Ge, Hong-You; Arendt-Nielsen, Lars; Cuadrado, Maria Luz; Pareja, Juan A

    2007-01-01

    To assess the local and referred pain areas and pain characteristics evoked from temporalis muscle trigger points (TrPs) in chronic tension-type headache (CTTH). Thirty CTTH patients and 30 age and sex-matched controls were studied. A headache diary was kept for 4 weeks to substantiate the diagnosis and record the pain history. Both temporalis muscles were examined for the presence of myofascial TrPs in a blinded fashion. The local and referred pain intensities, referred pain pattern, and pressure pain threshold were recorded. Referred pain was evoked in 87% and 54% on the dominant and nondominant sides in CTTH patients, which was significantly higher (P<0.001) than in controls (10% vs. 17%, respectively). Referred pain spread to the temple ipsilateral to the stimulated muscle in both patients and controls, with additional referral behind the eyes in most patients, but none in controls. CTTH patients reported a higher local [visual analog scale (VAS): 5.6+/-1.2 right side, 5.3+/-1.4 left side] and referred pain (VAS: 4.7+/-2 right side, 3.5+/-2.8 left side) intensity than healthy controls (VAS: 0.8+/-0.7 right side, 0.7+/-0.7 left side for local pain; and 0.3+/-0.2 right side, 0.4+/-0.3 left side for referred pain) in both temporalis muscles (both, P<0.001). The local and referred pain areas were larger in patients than in controls (P<0.001). Twenty-three out of 30 CTTH patients (77%) had active TrPs in the temporalis muscle leading to their usual headache (17 patients on the right side; 12 on the left side, whereas 6 with bilateral active TrPs). CTTH patients with active TrPs in either right or left temporalis muscle showed longer headache duration than those with latent TrPs (P=0.004). CTTH patients showed significantly (P<0.001) lower pressure pain threshold (1.1+/-0.2 right side, 1.2+/-0.3 left side) as compared with controls (2.5+/-0.5 right side, 2.6+/-0.4 left side). In CTTH patients, the evoked local and referred pain from active TrPs in the temporalis

  9. [Appraisal of treatment of the trigger points associated with relaxation to treat chronic headache in the adult. Relationship with anxiety and stress adaptation strategies].

    Science.gov (United States)

    Goffaux-Dogniez, C; Vanfraechem-Raway, R; Verbanck, P

    2003-01-01

    Since the 1950's and even still today, the concomitance between headaches and psychological symptoms (anxiety and depression) is the subject of considerable research. Even so, headaches still pose a problem of difficult diagnosis related to their multiform aspect. Their understanding may be regarded as neurological, psychological or musculo-articular. This complexity explains the lack of effectiveness of anti-migraine treatments in certain cases. This situation encourages recourse to complementary procedures such as those used in physiotherapy. The questions that could be posed regarding physiotherapeutic treatment are: Is the treatment effective? How does it act on the level of pain? and How does it act at the psychological level? It is to answer these questions that the work, which is the basis of this article, has been carried out. Two groups were studied during this research: a group of 25 patients and a reference group of 100 people. The headache patients were sent for physiotherapy by a GP or consultant neurologist. The pathologies retained for experimentation were: migraines without aura; Arnold's neuralgia; headaches of spinal origin; tension headaches and associated migraines. These pathologies are covered in International Headache Society Classification: Essential headache and in Section 45.4 of DSM IV: Painful problems . The physiotherapeutic treatments applied to the patients were: muscular massage and friction plus ultra-sound vibration of the trigger-points in the spinal, scapular, dorsal and facial regions; articular reharmonisation work on the spinal column; thermotherapy and relaxation as a technique allowing control of physical (muscular) and psychological (anxiety, fear of pain) tension to be regained. The treatment is evaluated by comparison of the periodicity and intensity of the headaches before and after treatment; comparison of anxiety (state and trait) before and after treatment and comparison of coping strategies before and after treatment

  10. Pb enamel biomarker: Deposition of pre- and postnatal Pb isotope injection in reconstructed time points along rat enamel transect

    International Nuclear Information System (INIS)

    Rinderknecht, A.L.; Kleinman, M.T.; Ericson, J.E.

    2005-01-01

    Exposure to lead (Pb) as well as other heavy metals in the environment is still a matter of public health concern. The development of the enamel biomarker for heavy metal exposure assessment is designed to improve studies of dose-effect relationships to developmental anomalies, particularly embryonic dysfunctions, and to provide a time-specific recount of past exposures. The work presented in this paper demonstrates maternal transfer across the placental barrier of the enriched isotope 206 Pb tracer to the enamel of the rat pup. Likewise, injections of 204 Pb-enriched tracer in the neonate rat resulted in deposition of the tracer in the enamel histology as measured by secondary ion microprobe spectrometry. Through enamel, we were able to observe biological removal and assimilation of prenatal and postnatal tracers, respectively. This research demonstrates that enamel can be used as a biomarker of exposure to Pb and may illustrate the toxicokinetics of incorporating Pb into fetal and neonatal steady-state system processes. The biomarker technique, when completely developed, may be applied to cross-sectional and longitudinal epidemiological research

  11. Whistler Triggered Upper Band Chorus Observed in Alaska

    Science.gov (United States)

    Hosseini, P.; Golkowski, M.

    2017-12-01

    VLF radiation from lightning discharges is one of several sources of energy injection into the inner magnetosphere from the Earth. Lightning discharges initially produce a broadband impulse or `sferic' but after propagation in the dispersive magnetosphere this waveform soon becomes quasi narrow band with the characteristic spectrographic form of the whistler. Most of the lightning induced VLF wave energy injected into the magnetosphere will be unducted with a k-vector which becomes increasingly oblique. Although unducted radiation is ubiquitous throughout the inner magnetosphere, it is generally of a low amplitude due to Landau damping and is not expected to produce strong nonlinear phenomena such as triggered emissions and chorus waves. However, VLF wave energy ducted or trapped in field-aligned plasma density enhancements can have relatively large amplitudes due to focusing and also linear cyclotron resonance growth. Therefore high amplitude ducted whistler waves can trigger a number of complex nonlinear phenomena. These include the triggering of VLF emissions and triggering of VLF hiss or chorus. Such phenomena are generally considered to result from nonlinear electron cyclotron phase trapping. Observation of such VLF emissions triggered by natural whistlers have been reported since the 1970s in Antarctica. We present observations of whistlers triggered upper band chorus emission from Alaska. Dispersion analyze of whistlers determine the L-shell range to be 4.5 clear frequency band gap between upper and lower band of the observed chorus emissions. The observations point to ducted chorus generation in the vicinity of the plasmapause boundary.

  12. Eficácia da desativação dos pontos-gatilho miofasciais para o controle do zumbido Efficacy of myofascial trigger point deactivation for tinnitus control

    Directory of Open Access Journals (Sweden)

    Carina Bezerra Rocha

    2012-12-01

    Full Text Available Dor crônica nas imediações do ouvido pode influenciar o zumbido. OBJETIVO: Investigar a eficácia da desativação de pontos-gatilho miofasciais na melhora do zumbido. MÉTODO: Ensaio clínico randomizado com 71 pacientes com zumbido e síndrome dolorosa miofascial. O Grupo Experimental (n = 37 foi submetido a 10 sessões de desativação dos pontos-gatilho miofasciais e o Grupo Controle (n = 34, a 10 sessões de desativação placebo. RESULTADOS: O tratamento do Grupo Experimental foi eficaz para o controle do zumbido (p Chronic pain in areas surrounding the ear may influence tinnitus. OBJECTIVE: To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus. METHOD: A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37 underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34, 10 sessions with sham deactivation. RESULTS: Treatment of the experimental group was effective for tinnitus relief (p < 0.001. Pain and tinnitus relieves were associated (p = 0.013, so were the ear with worst tinnitus and the side of the body with more pain (p < 0.001. The presence of temporary tinnitus modulation (increase or decrease upon initial muscle palpation was frequent in both groups, but its temporary decrease was related to the persistent relief at the end of treatment (p = 0.002. CONCLUSION: Besides medical and audiological investigation, patients with tinnitus should also be checked for: 1 presence of myofascial pain surrounding the ear; 2 laterality between both symptoms; 3 initial decrease of tinnitus during muscle palpation. Treating this specific subgroup of tinnitus patients with myofascial trigger point release may provide better results than others described so far.

  13. Ectopic expression of AID in a non-B cell line triggers A:T and G:C point mutations in non-replicating episomal vectors.

    Directory of Open Access Journals (Sweden)

    Tihana Jovanic

    Full Text Available Somatic hypermutation (SHM of immunoglobulin genes is currently viewed as a two step process initiated by the deamination of deoxycytidine (C to deoxyuridine (U, catalysed by the activation induced deaminase (AID. Phase 1 mutations arise from DNA replication across the uracil residue or the abasic site, generated by the uracil-DNA glycosylase, yielding transitions or transversions at G:C pairs. Phase 2 mutations result from the recognition of the U:G mismatch by the Msh2/Msh6 complex (MutS Homologue, followed by the excision of the mismatched nucleotide and the repair, by the low fidelity DNA polymerase eta, of the gap generated by the exonuclease I. These mutations are mainly focused at A:T pairs. Whereas in activated B cells both G:C and A:T pairs are equally targeted, ectopic expression of AID was shown to trigger only G:C mutations on a stably integrated reporter gene. Here we show that when using non-replicative episomal vectors containing a GFP gene, inactivated by the introduction of stop codons at various positions, a high level of EGFP positive cells was obtained after transient expression in Jurkat cells constitutively expressing AID. We show that mutations at G:C and A:T pairs are produced. EGFP positive cells are obtained in the absence of vector replication demonstrating that the mutations are dependent only on the mismatch repair (MMR pathway. This implies that the generation of phase 1 mutations is not a prerequisite for the expression of phase 2 mutations.

  14. On-line complexation/cloud point preconcentration for the sensitive determination of dysprosium in urine by flow injection inductively coupled plasma-optical emission spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Ortega, Claudia; Cerutti, Soledad; Silva, Maria F. [Departamento de Quimica Analitica, Facultad de Quimica, Bioquimica y Farmacia, Universidad Nacional de San Luis, Chacabuco y Pedernera, 5700, San Luis (Argentina); Olsina, Roberto A.; Martinez, Luis D. [Departamento de Quimica Analitica, Facultad de Quimica, Bioquimica y Farmacia, Universidad Nacional de San Luis, Chacabuco y Pedernera, 5700, San Luis (Argentina); Consejo Nacional de Investigaciones Cientificas y Tecnicas (CONICET), Avda. Rivadavia 1917, CP C1033AAJJ, Buenos Aires (Argentina)

    2003-01-01

    An on-line dysprosium preconcentration and determination system based on the hyphenation of cloud point extraction (CPE) to flow injection analysis (FIA) associated with ICP-OES was studied. For the preconcentration of dysprosium, a Dy(III)-2-(5-bromo-2-pyridylazo)-5-diethylaminophenol complex was formed on-line at pH 9.22 in the presence of nonionic micelles of PONPE-7.5. The micellar system containing the complex was thermostated at 30 C in order to promote phase separation, and the surfactant-rich phase was retained in a microcolumn packed with cotton at pH 9.2. The surfactant-rich phase was eluted with 4 mol L{sup -1} nitric acid at a flow rate of 1.5 mL min{sup -1}, directly in the nebulizer of the plasma. An enhancement factor of 50 was obtained for the preconcentration of 50 mL of sample solution. The detection limit value for the preconcentration of 50 mL of aqueous solution of Dy was 0.03 {mu}g L{sup -1}. The precision for 10 replicate determinations at the 2.0 {mu}g L{sup -1}Dy level was 2.2% relative standard deviation (RSD), calculated from the peak heights obtained. The calibration graph using the preconcentration system for dysprosium was linear with a correlation coefficient of 0.9994 at levels near the detection limits up to at least 100 {mu}g L {sup -1}. The method was successfully applied to the determination of dysprosium in urine. (orig.)

  15. Short-term changes in neck pain, widespread pressure pain sensitivity, and cervical range of motion after the application of trigger point dry needling in patients with acute mechanical neck pain: a randomized clinical trial.

    Science.gov (United States)

    Mejuto-Vázquez, María J; Salom-Moreno, Jaime; Ortega-Santiago, Ricardo; Truyols-Domínguez, Sebastián; Fernández-de-Las-Peñas, César

    2014-04-01

    Randomized clinical trial. To determine the effects of trigger point dry needling (TrPDN) on neck pain, widespread pressure pain sensitivity, and cervical range of motion in patients with acute mechanical neck pain and active trigger points in the upper trapezius muscle. TrPDN seems to be effective for decreasing pain in individuals with upper-quadrant pain syndromes. Potential effects of TrPDN for decreasing pain and sensitization in individuals with acute mechanical neck pain are needed. Methods Seventeen patients (53% female) were randomly assigned to 1 of 2 groups: a single session of TrPDN or no intervention (waiting list). Pressure pain thresholds over the C5-6 zygapophyseal joint, second metacarpal, and tibialis anterior muscle; neck pain intensity; and cervical spine range-of-motion data were collected at baseline (pretreatment) and 10 minutes and 1 week after the intervention by an assessor blinded to the treatment allocation of the patient. Mixed-model analyses of variance were used to examine the effects of treatment on each outcome variable. Patients treated with 1 session of TrPDN experienced greater decreases in neck pain, greater increases in pressure pain threshold, and higher increases in cervical range of motion than those who did not receive an intervention at both 10 minutes and 1 week after the intervention (Pneck pain intensity and widespread pressure pain sensitivity, and also increase active cervical range of motion, in patients with acute mechanical neck pain. Changes in pain, pressure pain threshold, and cervical range of motion surpassed their respective minimal detectable change values, supporting clinically relevant treatment effects. Level of Evidence Therapy, level 1b-.

  16. Transvaginal Pelvic Floor Muscle Injection Technique: A Cadaver Study.

    Science.gov (United States)

    Gupta, Priyanka; Ehlert, Michael; Sirls, Larry T; Peters, Kenneth

    Women with pelvic floor dysfunction can have tender areas on vaginal examination, which can be treated with trigger-point injections. There are no publications to evaluate the accuracy of pelvic floor muscle injections. Trigger-point injections were performed on 2 fresh cadaveric pelvises using a curved nasal cannula guide and 7-in spinal needle. This was performed using our standard template of 2 sets of injections at the 1-, 3-, and 5-o'clock positions distally and proximally. The first pelvis was dissected to examine dye penetration. Based on these results, we modified our technique and repeated the injections on the second cadaver. We dissected the second pelvis and compared our findings. The 1-o'clock proximal and distal injections stained the obturator internus and externus near the insertion at the ischiopubic ramus. The 3-o'clock injections stained the midbody of the pubococcygeus and puborectalis. The distal 5-o'clock position was too deep and stained the fat of the ischiorectal space. The proximal 5-o'clock injection stained the area of the pudendal nerve. Our goal at the distal 5-o'clock position was to infuse the iliococcygeus muscle, so we shortened the needle depth from 2 to 1 cm beyond the cannula tip. In our second dissection, the distal 5-o'clock injection again stained only the fat of the ischiorectal space. This is the first study to characterize the distribution of pelvic floor muscle injections in a cadaver model and confirms the ability to deliver medications effectively to the pelvic floor muscles.

  17. Injection techniques in the management of local pain.

    Science.gov (United States)

    Fischer, A A

    1996-01-01

    This is a review of local anesthetic (LA) injections and infiltrations particularly combined with 'needling' for management of local musculoskeletal pain. New techniques are described including preinjection blocks (PIBs) which consist of blocking the sensory input from an area prior to giving an injection. PIBs prevent pain which would be caused by needle penetration of sensitive tissue. Needling and infiltration (N and I) with 1% lidocaine has been performed after PIB in 179 tender spots (TSs), trigger points (TrPs), and muscle spasms by the author, in 123 patients with the goal to relieve pain and promote healing. The immediate effect after the procedure as well as long-term results from 1 week to 7 months have been evaluated independently by a physiatrist experienced with injections (Dr. Tae Mo Chang). N and I extending over the entire taut band of abnormal muscle fibers, caused effective relief of pain and functional improvement in tender spots (TSs), trigger points (TrPs) and in muscle spasm caused by a variety of conditions including: acute and chronic sports and work injuries, motor vehicle accidents, muscle and ligament sprains (supraspinous, sacroiliac), overuse and repetitive stress syndromes, tennis elbow; local injuries or radicular irritation; and local inflammations such as bursitis, tendinitis, and osteoarthritis; and traumatic dystrophy, a type of reflex sympathetic dystrophy. Needling and infiltration of trigger areas and tender spots is effective treatment in several conditions. Pre-injection blocks allow the performance of the N and I of tender areas without pain.

  18. Validation and Test-Retest Reliability of New Thermographic Technique Called Thermovision Technique of Dry Needling for Gluteus Minimus Trigger Points in Sciatica Subjects and TrPs-Negative Healthy Volunteers

    Directory of Open Access Journals (Sweden)

    Elżbieta Skorupska

    2015-01-01

    Full Text Available The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN for the gluteus minimus muscle. TTDN is a new thermography approach used to support trigger points (TrPs diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain. Method. Thirty chronic sciatica patients (n=15 TrP-positive and n=15 TrPs-negative and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the gluteus minimus muscle confirmed additionally by referred pain presence. TTDN employs average temperature (Tavr, maximum temperature (Tmax, low/high isothermal-area, and autonomic referred pain phenomenon (AURP that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently. Results. Two components of TTDN validity and reliability, Tavr and AURP, had almost perfect agreement according to κ (e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.. The sensitivity for Tavr, Tmax, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was for Tavr and AURP only. Conclusion. TTDN is a valid and reliable method for Tavr and AURP measurement to support TrPs diagnostic criteria for the gluteus minimus muscle when digitally evoked referred pain pattern is present.

  19. The short-term effects of trigger point therapy, stretching and medicine ball exercises on accuracy and back swing hip turn in elite, male golfers - A randomised controlled trial.

    Science.gov (United States)

    Quinn, Samantha-Lynn; Olivier, Benita; Wood, Wendy-Ann

    2016-11-01

    This study aimed to compare the effect of myofascial trigger point therapy (MTPT) and stretching, MTPT and medicine ball exercises, and no intervention, on hip flexor length (HFL), golf swing biomechanics and performance in elite, male golfers. Single blind, randomised controlled trial with two experimental groups (stretch group: MTPT and stretching; and the ball group: MTPT, a single stretch and medicine ball exercises) and one control group (no intervention). Professional golf academy. One hundred, elite, male golfers aged 16-25 years. HFL, 3D biomechanical analysis of the golf swing, club head speed (CHS), smash ratio, accuracy and distance at baseline and after the interventions. Backswing hip turn (BSHT) improved in the ball group relative to the control group (p = 0.0248). Accuracy in the ball group and the stretch group improved relative to the control group (Fisher's exact = 0.016). Other performance parameters such as: smash ratio, distance and CHS were not compromised by either intervention. This study advocates the use of MTPT combined with medicine ball exercises over MTPT combined with stretching in the treatment of golfers with shortened hip flexors - even immediately preceding a tournament. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Short-Term Effects of Kinesio Taping and Cross Taping Application in the Treatment of Latent Upper Trapezius Trigger Points: A Prospective, Single-Blind, Randomized, Sham-Controlled Trial

    Directory of Open Access Journals (Sweden)

    Tomasz Halski

    2015-01-01

    Full Text Available Kinesio taping (KT may be a new treatment in patients with myofascial trigger points (MTrPs. A new method available for taping practitioners is cross taping (CT. The main objective was to determine how CT, KT, and medical adhesive tape (sham group affect the subjective assessment of resting bioelectrical activity and pain of the upper trapezius muscle (UT in patients with MTrPs. 105 volunteers were recruited to participate. The primary outcome was resting bioelectrical activity of UT muscle as assessed by surface electromyography (sEMG in each group and pain intensity on a visual analog scale (VAS. Assessments were collected before and after intervention and after the 24-hours follow-up. No significant differences were observed in bioelectrical activity of UT between pre-, post-, and follow-up results. In three groups patients had significantly lower pain VAS score after the intervention (CT—p<0.001, KT—p<0.001, and sham—p<0.01. The Kruskal-Wallis ANOVA showed no significant differences in almost all measurements between groups. The application of all three types of tapes does not influence the resting bioelectrical activity of UT muscle and may not lead to a reduction in muscle tone in the case of MTrPs.

  1. Validation and Test-Retest Reliability of New Thermographic Technique Called Thermovision Technique of Dry Needling for Gluteus Minimus Trigger Points in Sciatica Subjects and TrPs-Negative Healthy Volunteers

    Science.gov (United States)

    Rychlik, Michał; Samborski, Włodzimierz

    2015-01-01

    The aim of this study was to assess the validity and test-retest reliability of Thermovision Technique of Dry Needling (TTDN) for the gluteus minimus muscle. TTDN is a new thermography approach used to support trigger points (TrPs) diagnostic criteria by presence of short-term vasomotor reactions occurring in the area where TrPs refer pain. Method. Thirty chronic sciatica patients (n=15 TrP-positive and n=15 TrPs-negative) and 15 healthy volunteers were evaluated by TTDN three times during two consecutive days based on TrPs of the gluteus minimus muscle confirmed additionally by referred pain presence. TTDN employs average temperature (T avr), maximum temperature (T max), low/high isothermal-area, and autonomic referred pain phenomenon (AURP) that reflects vasodilatation/vasoconstriction. Validity and test-retest reliability were assessed concurrently. Results. Two components of TTDN validity and reliability, T avr and AURP, had almost perfect agreement according to κ (e.g., thigh: 0.880 and 0.938; calf: 0.902 and 0.956, resp.). The sensitivity for T avr, T max, AURP, and high isothermal-area was 100% for everyone, but specificity of 100% was for T avr and AURP only. Conclusion. TTDN is a valid and reliable method for T avr and AURP measurement to support TrPs diagnostic criteria for the gluteus minimus muscle when digitally evoked referred pain pattern is present. PMID:26137486

  2. DUMAND data acquisition with triggering

    International Nuclear Information System (INIS)

    Brenner, A.E.; Theriot, D.; March, R.H.

    1980-01-01

    A data acquisition scheme for the standard DUMAND array that includes a simple triggering scheme as a fundamental part of the system is presented. Although there are a number of not yet fully understood parameters, it is assumed that thresholds can be set in such a manner as to give rise to a triggered signal that is not so dominated by randoms that it gives a substantial decrease in the data acquisition rate over that which would be required by a nontriggered system. It is also assumed that the triggering logic is relatively simple and does not need major computational capabilities for a trigger logic decision. With these assumptions, it is possible to generate the trigger at the array and restrict the data transfer to shore. However, with a not unreasonable delay of 200 microseconds, it is even possible to transmit the information for the trigger to shore and perform all that logic on the shore. The critical point is to send the minimum amount of information necessary to construct the trigger such that one need not send all the possible information in all detectors of the array continuously to shore. 1 figure

  3. Mise au point de microparticules polysaccharides injectables pour l'imagerie moléculaire de pathologies artérielles

    OpenAIRE

    Bonnard , Thomas

    2014-01-01

    Cardiovascular diseases and their consequences constitute nowadays a major health issue. Their treatment could be substantially improved with the development of new non invasive diagnostic techniques. The aim of this doctoral project is to develop injectable into blood stream polysaccharide microparticles that would permit molecular imaging of arterial pathologies. From an emulsion- crosslinking process, we synthesized these microparticles which are on the one hand functionalized with fucoida...

  4. Hybrid imaging with contrast enhanced CT scan: A nuclear physician's point of view; Point de vue d'un medecin nucleaire pratiquant les examens hybrides avec injection de produit de contraste

    Energy Technology Data Exchange (ETDEWEB)

    Houzard, C.; Tychyj-Pinel, C.; Defez, D.; Valette, P.J.; Giammarile, F. [Pole d' activite medicale d' imagerie, service de medecine nucleaire, hopital Lyon-Sud, centre hospitalier Lyon-Sud, 69 - Pierre-Benite (France); Houzard, C.; Valette, P.J.; Giammarile, F. [EA 37 38, faculte de medecine Lyon-Sud, UCB Lyon-I, 69 - Pierre-Benite (France)

    2010-08-15

    The ongoing development of hybrid imaging, with physical association of CT scan and PET or SPECT scan, allows integrating morphological and functional information on a single exam. This important technological evolution changes diagnostic and therapeutic strategy in a major manner, essentially in oncology. The possibility to inject intravenously iodinated contrast media in order to enhance CT image contrast is still a controversial question in France. We present our experience in this domain by approaching technical problems and diagnostic advantages. (authors)

  5. Injecting drug use via femoral vein puncture: preliminary findings of a point-of-care ultrasound service for opioid-dependent groin injectors in treatment

    Directory of Open Access Journals (Sweden)

    Senbanjo Richard

    2012-01-01

    Full Text Available Abstract Background Within the UK, injecting in the femoral vein (FV, often called 'groin injecting', is a serious cause of risk and harm. This study aimed to use ultrasound scanning as a means to engage groin injectors (GIs, examine their femoral injecting sites and assess their venous health, with the intention of developing improved responses. Methods Between September 2006 and March 2009, GIs attending a network of community drug treatment centres in South East England were invited to attend an ultrasound 'health-check' clinic. This paper provides a narrative account of the scanning procedure and operation of the service, with descriptive statistical analysis of GIs who attended. The analysis uses a structured, specially-developed clinical data set that incorporates a categorisation for the severity of FV damage. Case studies using ultrasound images and a link to a video are provided to illustrate the range of presentations encountered and the categorisations used for severity. Results A total of 160 groin scans (76 bilateral and 8 unilateral were performed in 84 GIs. The majority were men (69.0% and the mean age of the sample was 36.8 years. The mean duration of drug use and injecting drug use was 19.7 years and 13.8 years, respectively. FV damage at the injecting site in the right groin was graded as minimal in 20 patients (25%, moderate in 27 (33.8%, severe in 16 (20.0% and very-severe in 17 (21.3%. Corresponding figures for left FV were 24 (30.0%, 22 (27.5%, 18 (22.5% and 16 (20.0%. Wide variation was observed in the time to the development of these grades of FV damage. Conclusions Modern, portable ultrasound scanners make it possible to examine the venous health of GIs in community treatment settings. Ultrasound scanning identified extensive FV damage, much hitherto-unrecognised in this population. These findings should further alert clinicians, policy-makers and patients to the urgent need for effective harm reduction responses to GI

  6. Testosterone Injection

    Science.gov (United States)

    ... typical male characteristics. Testosterone injection works by supplying synthetic testosterone to replace the testosterone that is normally ... as a pellet to be injected under the skin.Testosterone injection may control your symptoms but will ...

  7. The LHCb trigger

    International Nuclear Information System (INIS)

    Korolko, I.

    1998-01-01

    This paper describes progress in the development of the LHCb trigger system since the letter of intent. The trigger philosophy has significantly changed, resulting in an increase of trigger efficiency for signal B events. It is proposed to implement a level-1 vertex topology trigger in specialised hardware. (orig.)

  8. The trigger-tube: A new apparatus and method for mixing solutes for ...

    African Journals Online (AJOL)

    The trigger-tube apparatus and method was developed for mixing solutes and tracers for injection tests. The apparatus is a cap-trigger tube segment and the technique mixes solutes in boreholes in 2 min. Trigger-tube with solute/tracer is introduced into the well, the trigger is released, the tube is withdrawn and the ...

  9. The trigger-tube: A new apparatus and method for mixing solutes for ...

    African Journals Online (AJOL)

    2009-07-17

    Jul 17, 2009 ... The trigger-tube apparatus and method was developed for mixing solutes and tracers for injection tests. The apparatus is a cap-trigger tube segment and the technique mixes solutes in boreholes in 2 min. Trigger-tube with solute/tracer is intro- duced into the well, the trigger is released, the tube is ...

  10. The Central Trigger Processor (CTP)

    CERN Multimedia

    Franchini, Matteo

    2016-01-01

    The Central Trigger Processor (CTP) receives trigger information from the calorimeter and muon trigger processors, as well as from other sources of trigger. It makes the Level-1 decision (L1A) based on a trigger menu.

  11. Common Asthma Triggers

    Science.gov (United States)

    ... Grass Other Triggers If you have asthma, an asthma attack can happen when you are exposed to “asthma ... a second person. Secondhand smoke can trigger an asthma attack. If you have asthma, people should never smoke ...

  12. The KLOE trigger system

    International Nuclear Information System (INIS)

    Adinolfi, M.; Aloisio, A.; Ambrosino, F.; Andryakov, A.; Antonelli, A.; Antonelli, M.; Anulli, F.; Bacci, C.; Bankamp, A.; Barbiellini, G.; Bellini, F.; Bencivenni, G.; Bertolucci, S.; Bini, C.; Bloise, C.; Bocci, V.; Bossi, F.; Branchini, P.; Bulychjov, S.A.; Cabibbo, G.; Calcaterra, A.; Caloi, R.; Campana, P.; Capon, G.; Carboni, G.; Cardini, A.; Casarsa, M.; Cataldi, G.; Ceradini, F.; Cervelli, F.; Cevenini, F.; Chiefari, G.; Ciambrone, P.; Conetti, S.; Conticelli, S.; De Lucia, E.; De Robertis, G.; De Sangro, R.; De Simone, P.; De Zorzi, G.; Dell'Agnello, S.; Denig, E.; Di Domenico, A.; Di Donato, C.; Di Falco, S.; Doria, A.; Drago, E.; Elia, V.; Erriquez, O.; Farilla, A.; Felici, G.; Ferrari, A.; Ferrer, M.L.; Finocchiaro, G.; Forti, C.; Franceschi, A.; Franzini, P.; Gao, M.L.; Gatti, C.; Gauzzi, P.; Giovannella, S.; Golovatyuk, V.; Gorini, E.; Grancagnolo, F.; Grandegger, W.; Graziani, E.; Guarnaccia, P.; Hagel, U. von; Han, H.G.; Han, S.W.; Huang, X.; Incagli, M.; Ingrosso, L.; Jang, Y.Y.; Kim, W.; Kluge, W.; Kulikov, V.; Lacava, F.; Lanfranchi, G.; Lee-Franzini, J.; Lomtadze, F.; Luisi, C.; Mao, C.S.; Martemianov, M.; Matsyuk, M.; Mei, W.; Merola, L.; Messi, R.; Miscetti, S.; Moalem, A.; Moccia, S.; Moulson, M.; Mueller, S.; Murtas, F.; Napolitano, M.; Nedosekin, A.; Panareo, M.; Pacciani, L.; Pages, P.; Palutan, M.; Paoluzi, L.; Pasqualucci, E.; Passalacqua, L.; Passaseo, M.; Passeri, A.; Patera, V.; Petrolo, E.; Petrucci, G.; Picca, D.; Pirozzi, G.; Pistillo, C.; Pollack, M.; Pontecorvo, L.; Primavera, M.; Ruggieri, F.; Santangelo, P.; Santovetti, E.; Saracino, G.; Schamberger, R.D.; Schwick, C.; Sciascia, B.; Sciubba, A.; Scuri, F.; Sfiligoi, I.; Shan, J.; Silano, P.; Spadaro, T.; Spagnolo, S.; Spiriti, E.; Stanescu, C.; Tong, G.L.; Tortora, L.; Valente, E.; Valente, P.; Valeriani, B.; Venanzoni, G.; Veneziano, S.; Wu, Y.; Xie, Y.G.; Zhao, P.P.; Zhou, Y.

    2001-01-01

    A double-level trigger system has been developed for the KLOE experiment. Custom electronics asserts a trigger in a 2 μs decision time. The decision is based on the combined information of the electromagnetic calorimeter and the drift chamber. The entire trigger system is continuously monitored, and data flowing from the trigger system have allowed both an efficient online monitoring of the detector and an online luminosity measurement

  13. Cefoxitin Injection

    Science.gov (United States)

    ... injection is used to treat infections caused by bacteria including pneumonia and other lower respiratory tract (lung) infections; and urinary tract, abdominal (stomach area), female reproductive organs, blood, ... by killing bacteria.Antibiotics such as cefoxitin injection will not work ...

  14. Golimumab Injection

    Science.gov (United States)

    ... damaged, and do not use an auto-injection device if the security seal is broken. Look through the viewing window on the prefilled syringe or auto-injection device. The liquid inside should be clear and colorless ...

  15. Doxycycline Injection

    Science.gov (United States)

    ... may have been exposed to anthrax in the air. Doxycycline injection is in a class of medications ... decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, or injections). Talk to your doctor ...

  16. Abaloparatide Injection

    Science.gov (United States)

    ... injection may cause osteosarcoma (bone cancer) in laboratory rats. It is not known whether abaloparatide injection increases ... too have too much calcium in the blood, hyperparathyroidism (condition in which the body produces too much ...

  17. Paliperidone Injection

    Science.gov (United States)

    Paliperidone extended-release injections (Invega Sustenna, Invega Trinza) are used to treat schizophrenia (a mental illness that ... interest in life, and strong or inappropriate emotions). Paliperidone extended-release injection (Invega Sustenna) is also used ...

  18. Doripenem Injection

    Science.gov (United States)

    ... injection is in a class of medications called carbapenem antibiotics. It works by killing bacteria.Antibiotics such ... if you are allergic to doripenem injection; other carbapenem antibiotics such as imipenem/cilastatin (Primaxin) or meropenem ( ...

  19. Ceftriaxone Injection

    Science.gov (United States)

    Ceftriaxone injection is used to treat certain infections caused by bacteria such as gonorrhea (a sexually transmitted ... skin, urinary tract, blood, bones, joints, and abdomen. Ceftriaxone injection is also sometimes given before certain types ...

  20. Nalbuphine Injection

    Science.gov (United States)

    ... injection is in a class of medications called opioid agonist-antagonists. It works by changing the way ... suddenly stop using nalbuphine injection, you may experience withdrawal symptoms including restlessness; teary eyes; runny nose; yawning; ...

  1. Naltrexone Injection

    Science.gov (United States)

    ... Videos & Tools Español You Are Here: Home → Drugs, Herbs and Supplements → Naltrexone Injection URL of this page: ... become depressed and sometimes try to harm or kill themselves. Receiving naltrexone injection does not decrease the ...

  2. Screening for impaired renal function in outpatients before iodinated contrast injection: Comparing the Choyke questionnaire with a rapid point-of-care-test

    Energy Technology Data Exchange (ETDEWEB)

    Too, C.W., E-mail: toochowwei@gmail.com [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Ng, W.Y., E-mail: ng.wai.yoong@sgh.com.sg [Department of Pathology, Singapore General Hospital, 20 College Road, Academia, Singapore 169856 (Singapore); Tan, C.C., E-mail: tan.chin.chong@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Mahmood, M.I., E-mail: muhd.illyyas.mahmood@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore); Tay, K.H., E-mail: tay.kiang.hiong@sgh.com.sg [Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore 169608 (Singapore)

    2015-07-15

    Highlights: • Iodinated intravenous contrast carries a low risk of contrast induced nephropathy (CIN). • Patients with eGFR less than 45 mL/min/1.73 m{sup 2} are particularly at risk for CIN. • The Choyke questionnaire is used to screen for impaired renal function in outpatients. • Choyke questionnaire is a good screening tool for eGFR less than 45 mL/min/1.73 m{sup 2}. • Point of care test (POCT) for serum creatinine can reduce waiting time. - Abstract: Rationale and purpose: To determine the usefulness of the Choyke questionnaire with a creatinine point-of-care test (POCT) to detect impaired renal function amongst outpatients receiving intravenous iodinated contrast in a tertiary centre. Materials and methods: Between July and December 2012, 1361 outpatients had their serum creatinine determined by POCT and answered the Chokye questionnaire just before their examination. Results: Four hundred and eighty (35.2%) patients had at least one ‘Yes’ response. Forty-four patients (3.2%) had estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m{sup 2} and 14 patients (1.0%) have eGFR <45 mL/min/1.73 m{sup 2}. Sensitivity, specificity, positive predictive value and negative predictive value of the Choyke criteria in detecting patients with eGFR <60 mL/min/1.73 m{sup 2} are respectively: 65.9%, 65.8%, 6.0% and 98.3% and to detect eGFR <45 mL/min/1.73 m{sup 2}: 92.9%, 65.3%, 2.7% and 99.9%. Only ‘Yes’ responses to ‘Have you ever been told you have renal problems?’ and ‘Do you have diabetes mellitus?’ were statistically significant in predicting eGFR <45 mL/min/1.73 m{sup 2}, with odds ratio 98.7 and 4.4 respectively. Conclusion: The Choyke questionnaire has excellent sensitivity and moderate-to-good specificity in detecting patients with <45 mL/min/1.73 m{sup 2}, below this level it has been shown that risk of contrast induced nephropathy increases significantly, making it an effective screening tool. Also the use of POCT can potentially

  3. Electronic trigger for the ASP experiment

    International Nuclear Information System (INIS)

    Wilson, R.J.

    1985-11-01

    The Anomalous Single Photon (ASP) electronic trigger is described. The experiments is based on an electromagnetic calorimeter composed of arrays of lead glass blocks, read out with photo-multiplier tubes, surrounding the interaction point at the PEP storage ring. The primary requirement of the trigger system is to be sensitive to low energy (approx. =0.5 GeV and above) photons whilst discriminating against high backgrounds at PEP. Analogue summing of the PMT signals and a sequence of programmable digital look-up tables produces a ''dead-timeless'' trigger for the beam collision rate of 408 kHz. 6 refs., 6 figs

  4. Electronic trigger for the ASP experiment

    International Nuclear Information System (INIS)

    Wilson, R.J.

    1985-01-01

    The ASP electronic trigger is described. The experiment is based on an electromagnetic calorimeter composed of arrays of lead glass blocks, read out with photo-multiplier tubes, surrounding the interaction point at the PEP storage ring. The primary requirement of the trigger system is to be sensitive to low energy (≅ 0.5 GeV and above) photons whilst discriminating against high rate backgrounds at PEP. Analogue summing of the PMT signals and a sequence of programmable digital look-up tables produces a ''dead-timeless'' trigger for the beam collision rate of 408 kHz

  5. The Trigger Processor and Trigger Processor Algorithms for the ATLAS New Small Wheel Upgrade

    CERN Document Server

    Lazovich, Tomo; The ATLAS collaboration

    2015-01-01

    The ATLAS New Small Wheel (NSW) is an upgrade to the ATLAS muon endcap detectors that will be installed during the next long shutdown of the LHC. Comprising both MicroMegas (MMs) and small-strip Thin Gap Chambers (sTGCs), this system will drastically improve the performance of the muon system in a high cavern background environment. The NSW trigger, in particular, will significantly reduce the rate of fake triggers coming from track segments in the endcap not originating from the interaction point. We will present an overview of the trigger, the proposed sTGC and MM trigger algorithms, and the hardware implementation of the trigger. In particular, we will discuss both the heart of the trigger, an ATCA system with FPGA-based trigger processors (using the same hardware platform for both MM and sTGC triggers), as well as the full trigger electronics chain, including dedicated cards for transmission of data via GBT optical links. Finally, we will detail the challenges of ensuring that the trigger electronics can ...

  6. Trigger Finger (Stenosing Tenosynovitis)

    Science.gov (United States)

    ... a friend * required fields From * To * DESCRIPTION Stenosing tenosynovitis is a condition commonly known as “trigger finger.” It is sometimes also called “trigger thumb.” The tendons that bend the fingers glide easily with ...

  7. Causality and headache triggers

    Science.gov (United States)

    Turner, Dana P.; Smitherman, Todd A.; Martin, Vincent T.; Penzien, Donald B.; Houle, Timothy T.

    2013-01-01

    Objective The objective of this study was to explore the conditions necessary to assign causal status to headache triggers. Background The term “headache trigger” is commonly used to label any stimulus that is assumed to cause headaches. However, the assumptions required for determining if a given stimulus in fact has a causal-type relationship in eliciting headaches have not been explicated. Methods A synthesis and application of Rubin’s Causal Model is applied to the context of headache causes. From this application the conditions necessary to infer that one event (trigger) causes another (headache) are outlined using basic assumptions and examples from relevant literature. Results Although many conditions must be satisfied for a causal attribution, three basic assumptions are identified for determining causality in headache triggers: 1) constancy of the sufferer; 2) constancy of the trigger effect; and 3) constancy of the trigger presentation. A valid evaluation of a potential trigger’s effect can only be undertaken once these three basic assumptions are satisfied during formal or informal studies of headache triggers. Conclusions Evaluating these assumptions is extremely difficult or infeasible in clinical practice, and satisfying them during natural experimentation is unlikely. Researchers, practitioners, and headache sufferers are encouraged to avoid natural experimentation to determine the causal effects of headache triggers. Instead, formal experimental designs or retrospective diary studies using advanced statistical modeling techniques provide the best approaches to satisfy the required assumptions and inform causal statements about headache triggers. PMID:23534872

  8. Triggering the GRANDE array

    International Nuclear Information System (INIS)

    Wilson, C.L.; Bratton, C.B.; Gurr, J.; Kropp, W.; Nelson, M.; Sobel, H.; Svoboda, R.; Yodh, G.; Burnett, T.; Chaloupka, V.; Wilkes, R.J.; Cherry, M.; Ellison, S.B.; Guzik, T.G.; Wefel, J.; Gaidos, J.; Loeffler, F.; Sembroski, G.; Goodman, J.; Haines, T.J.; Kielczewska, D.; Lane, C.; Steinberg, R.; Lieber, M.; Nagle, D.; Potter, M.; Tripp, R.

    1990-01-01

    A brief description of the Gamma Ray And Neutrino Detector Experiment (GRANDE) is presented. The detector elements and electronics are described. The trigger logic for the array is then examined. The triggers for the Gamma Ray and the Neutrino portions of the array are treated separately. (orig.)

  9. Triggering trigeminal neuralgia

    DEFF Research Database (Denmark)

    Di Stefano, Giulia; Maarbjerg, Stine; Nurmikko, Turo

    2018-01-01

    Introduction Although it is widely accepted that facial pain paroxysms triggered by innocuous stimuli constitute a hallmark sign of trigeminal neuralgia, very few studies to date have systematically investigated the role of the triggers involved. In the recently published diagnostic classification...

  10. Effectiveness of myofascial trigger point therapy in chronic back pain patients is considerably increased when combined with a new, integrated, low-frequency shock wave vibrotherapy (Cellconnect Impulse): A two-armed, measurement repeated, randomized, controlled pragmatic trial.

    Science.gov (United States)

    Schneider, Rainer

    2018-02-06

    The prevalence of chronic back pain poses major challenges for all health care systems and patients worldwide. Myofascial trigger therapy (MT), although a very popular standard non-pharmaceutical form of treatment, only shows small to medium effectiveness. To test a new vibrotreatment (Cellconnect Impulse) transmitting low-frequency, vertical shock waves in a routine clinical practice. Eligible patients were adults seeking physiotherapeutic treatment. They were randomly allocated to either six treatments of MT or to six treatments of combined MT and vibrotreatment. Outcome parameters were pain intensity, pain days, pain duration, and quality of life. The pain relieving effects of the combined treatment were very large (d= 1.6). It clearly outperformed MT and considerably improved patients' health related quality of life. Combining MT with Cellconnect Impulse enhances the physiotherapeutic effectiveness of treating chronic back pain.

  11. Iatrogenic axillary neuropathy after intramuscular injection of the deltoid muscle.

    Science.gov (United States)

    Davidson, Loren T; Carter, Gregory T; Kilmer, David D; Han, Jay J

    2007-06-01

    A previously healthy 26-yr-old male presented for an electrodiagnostic evaluation with complaints of significant right deltoid muscle atrophy and shoulder abduction weakness after receiving an intramuscular (IM) deltoid injection of an antiemetic 4 wk earlier. Electrodiagnostic evaluation confirmed an acute axillary neuropathy. We hypothesize that direct mechanical trauma to the anterior branch of the axillary nerve resulted in axillary mononeuropathy with axonal loss, although chemically induced nerve injury cannot be excluded. Injections in and about the shoulder complex are performed routinely for the purposes of vaccination, IM medication administration, deltoid trigger-point injections, and intra-articular and bursal steroid injections. Although such injections are considered routine office procedures, there is increased risk of neurovascular injury if they are performed incorrectly. The purpose of this brief report is to make practitioners aware of the potential for axillary neuropathy with such procedures, to review the salient anatomy, and to propose a potential guideline for clinical practice to minimize iatrogenic axillary neuropathy.

  12. The updated Cochrane review 2014 on GnRH agonist trigger

    DEFF Research Database (Denmark)

    Kol, Shahar; Humaidan, Peter; Alsbjerg, Birgit

    2015-01-01

    Cochrane reviews are powerful tools, internationally recognized as the highest standard in evidence-based health care. A Cochrane analysis makes use of precise, reproducible criteria in the selection of studies for review. In the context of a previous Cochrane review (2010) on the subject...... of gonadotrophin-releasing hormone agonist (GnRHa) trigger, we questioned whether a review should be conducted during the research phase when new concepts are being developed. Recently, an updated Cochrane review was published, reaching the same general conclusion as the first one, i.e., GnRHa triggers lower...... the chance of pregnancy in fresh autologous IVF and intracytoplasmic injection treatment cycles. We argue that the new review repeats previous errors by compiling data from studies that were not comparable as different luteal phase protocols were used. From the clinical point of view, the luteal support used...

  13. Cefazolin Injection

    Science.gov (United States)

    ... is used to treat certain infections caused by bacteria including skin, bone, joint, genital, blood, heart valve, respiratory tract (including pneumonia), biliary tract, and urinary tract infections. Cefazolin injection ...

  14. Atezolizumab Injection

    Science.gov (United States)

    ... is in a class of medications called monoclonal antibodies. It works by blocking the action of a ... infection breath that smells fruity slowed, fast or irregular heartbeat Atezolizumab injection may cause other side effects. ...

  15. Cidofovir Injection

    Science.gov (United States)

    Cidofovir injection is used along with another medication (probenecid) to treat cytomegaloviral retinitis (CMV retinitis) in people ... body's response to the medication.You must take probenecid tablets by mouth with each dose of cidofovir. ...

  16. Acyclovir Injection

    Science.gov (United States)

    ... It is also used to treat first-time genital herpes outbreaks (a herpes virus infection that causes sores ... in the body. Acyclovir injection will not cure genital herpes and may not stop the spread of genital ...

  17. Alirocumab Injection

    Science.gov (United States)

    ... further decrease the amount of low-density lipoprotein (LDL) cholesterol ('bad cholesterol') in the blood. Alirocumab injection is ... antibodies. It works by blocking the production of LDL cholesterol in the body to decrease the amount of ...

  18. Pegloticase Injection

    Science.gov (United States)

    ... doctor if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency (an inherited blood disease). Your doctor may test you for G6PD deficiency before you start to receive pegloticase injection. If ...

  19. Risperidone Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Risperidone extended-release injection is used alone or ... during your treatment: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important ...

  20. Olanzapine Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Olanzapine injection is used to treat episodes of ... during your treatment: extreme thirst, frequent urination, extreme hunger, blurred vision, or weakness. It is very important ...

  1. Tacrolimus Injection

    Science.gov (United States)

    ... in people who have received kidney, liver, or heart transplants. Tacrolimus injection should only be used by people ... or nurse will watch you closely during the first 30 minutes of your treatment and then will ...

  2. Omalizumab Injection

    Science.gov (United States)

    ... injection is used to decrease the number of asthma attacks (sudden episodes of wheezing, shortness of breath, and ... about how to treat symptoms of a sudden asthma attack. If your asthma symptoms get worse or if ...

  3. Daclizumab Injection

    Science.gov (United States)

    ... neck, armpits, or groin; diarrhea; bloody stools; stomach pain; or any new, unexplained symptom affecting any part of your body.Because of the risks with this medication, daclizumab injection is available only through a special ...

  4. Temozolomide Injection

    Science.gov (United States)

    ... balance or coordination fainting dizziness hair loss insomnia memory problems pain, itching, swelling, or redness in the place where the medication was injected changes in vision Some side effects can be serious. If you ...

  5. Moxifloxacin Injection

    Science.gov (United States)

    ... tendon area, or inability to move or to bear weight on an affected area.Using moxifloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  6. Delafloxacin Injection

    Science.gov (United States)

    ... a tendon area, or inability to move or bear weight on an affected area.Using delafloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  7. Levofloxacin Injection

    Science.gov (United States)

    ... tendon area, or inability to move or to bear weight on an affected area.Using levofloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  8. Ciprofloxacin Injection

    Science.gov (United States)

    ... a tendon area, or inability to move or bear weight on an affected area.Using ciprofloxacin injection ... muscle weakness) and cause severe difficulty breathing or death. Tell your doctor if you have myasthenia gravis. ...

  9. Butorphanol Injection

    Science.gov (United States)

    ... Butorphanol is in a class of medications called opioid agonist-antagonists. It works by changing the way ... suddenly stop using butorphanol injection, you may experience withdrawal symptoms such as nervousness, agitation, shakiness, diarrhea, chills, ...

  10. Haloperidol Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Haloperidol injection is also used to control motor ... and the laboratory. Your doctor may order certain lab tests to check your body's response to haloperidol ...

  11. Ketorolac Injection

    Science.gov (United States)

    ... of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or ... You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ ...

  12. The ATLAS Trigger System

    CERN Document Server

    Hauser, R

    2004-01-01

    ATLAS is one of two general-purpose detectors at the next generation proton-proton collider, the LHC. The high rate of interactions and the large number of read-out channels make the trigger system for ATLAS a challenging task. The initial bunch crossing rate of 40~MHz has to be reduced to about 200 Hz while preserving the physics signals against a large background. ATLAS uses a three-level trigger system, with the first level implemented in custom hardware, while the high level trigger systems are implemented in software on commodity hardware. This note describes the physics motivation, the various selection strategies for different channels as well as the physical implementation of the trigger system.

  13. Calo trigger acquisition system

    CERN Multimedia

    Franchini, Matteo

    2016-01-01

    Calo trigger acquisition system - Evolution of the acquisition system from a multiple boards system (upper, orange cables) to a single board one (below, light blue cables) where all the channels are collected in a single board.

  14. Asthma Triggers: Gain Control

    Science.gov (United States)

    ... in your house and may trigger asthma. Your asthma or your child's asthma may be worse around products such as ... You Can Take If you find that your asthma or your child's asthma gets worse when you use a certain ...

  15. Calorimetry triggering in ATLAS

    CERN Document Server

    Igonkina, O; Adragna, P; Aharrouche, M; Alexandre, G; Andrei, V; Anduaga, X; Aracena, I; Backlund, S; Baines, J; Barnett, B M; Bauss, B; Bee, C; Behera, P; Bell, P; Bendel, M; Benslama, K; Berry, T; Bogaerts, A; Bohm, C; Bold, T; Booth, J R A; Bosman, M; Boyd, J; Bracinik, J; Brawn, I, P; Brelier, B; Brooks, W; Brunet, S; Bucci, F; Casadei, D; Casado, P; Cerri, A; Charlton, D G; Childers, J T; Collins, N J; Conde Muino, P; Coura Torres, R; Cranmer, K; Curtis, C J; Czyczula, Z; Dam, M; Damazio, D; Davis, A O; De Santo, A; Degenhardt, J; Delsart, P A; Demers, S; Demirkoz, B; Di Mattia, A; Diaz, M; Djilkibaev, R; Dobson, E; Dova, M, T; Dufour, M A; Eckweiler, S; Ehrenfeld, W; Eifert, T; Eisenhandler, E; Ellis, N; Emeliyanov, D; Enoque Ferreira de Lima, D; Faulkner, P J W; Ferland, J; Flacher, H; Fleckner, J E; Flowerdew, M; Fonseca-Martin, T; Fratina, S; Fhlisch, F; Gadomski, S; Gallacher, M P; Garitaonandia Elejabarrieta, H; Gee, C N P; George, S; Gillman, A R; Goncalo, R; Grabowska-Bold, I; Groll, M; Gringer, C; Hadley, D R; Haller, J; Hamilton, A; Hanke, P; Hauser, R; Hellman, S; Hidvgi, A; Hillier, S J; Hryn'ova, T; Idarraga, J; Johansen, M; Johns, K; Kalinowski, A; Khoriauli, G; Kirk, J; Klous, S; Kluge, E-E; Koeneke, K; Konoplich, R; Konstantinidis, N; Kwee, R; Landon, M; LeCompte, T; Ledroit, F; Lei, X; Lendermann, V; Lilley, J N; Losada, M; Maettig, S; Mahboubi, K; Mahout, G; Maltrana, D; Marino, C; Masik, J; Meier, K; Middleton, R P; Mincer, A; Moa, T; Monticelli, F; Moreno, D; Morris, J D; Mller, F; Navarro, G A; Negri, A; Nemethy, P; Neusiedl, A; Oltmann, B; Olvito, D; Osuna, C; Padilla, C; Panes, B; Parodi, F; Perera, V J O; Perez, E; Perez Reale, V; Petersen, B; Pinzon, G; Potter, C; Prieur, D P F; Prokishin, F; Qian, W; Quinonez, F; Rajagopalan, S; Reinsch, A; Rieke, S; Riu, I; Robertson, S; Rodriguez, D; Rogriquez, Y; Rhr, F; Saavedra, A; Sankey, D P C; Santamarina, C; Santamarina Rios, C; Scannicchio, D; Schiavi, C; Schmitt, K; Schultz-Coulon, H C; Schfer, U; Segura, E; Silverstein, D; Silverstein, S; Sivoklokov, S; Sjlin, J; Staley, R J; Stamen, R; Stelzer, J; Stockton, M C; Straessner, A; Strom, D; Sushkov, S; Sutton, M; Tamsett, M; Tan, C L A; Tapprogge, S; Thomas, J P; Thompson, P D; Torrence, E; Tripiana, M; Urquijo, P; Urrejola, P; Vachon, B; Vercesi, V; Vorwerk, V; Wang, M; Watkins, P M; Watson, A; Weber, P; Weidberg, T; Werner, P; Wessels, M; Wheeler-Ellis, S; Whiteson, D; Wiedenmann, W; Wielers, M; Wildt, M; Winklmeier, F; Wu, X; Xella, S; Zhao, L; Zobernig, H; de Seixas, J M; dos Anjos, A; Asman, B; Özcan, E

    2009-01-01

    The ATLAS experiment is preparing for data taking at 14 TeV collision energy. A rich discovery physics program is being prepared in addition to the detailed study of Standard Model processes which will be produced in abundance. The ATLAS multi-level trigger system is designed to accept one event in 2 105 to enable the selection of rare and unusual physics events. The ATLAS calorimeter system is a precise instrument, which includes liquid Argon electro-magnetic and hadronic components as well as a scintillator-tile hadronic calorimeter. All these components are used in the various levels of the trigger system. A wide physics coverage is ensured by inclusively selecting events with candidate electrons, photons, taus, jets or those with large missing transverse energy. The commissioning of the trigger system is being performed with cosmic ray events and by replaying simulated Monte Carlo events through the trigger and data acquisition system.

  16. The ATLAS Trigger System

    CERN Document Server

    Owen, Rhys Edward; The ATLAS collaboration

    2018-01-01

    The ATLAS experiment employs a complex trigger system to enable the collaborations physics program. The LHC is now well in to its second running period delivering proton proton collisions at $\\sqrt{s}=13$ TeV with high instantaneous luminosity. This talk will describe the two level hardware and software trigger used to select events in this environment including recent improvements and the latest performance results.

  17. 2017 Tau Trigger Efficiencies

    CERN Document Server

    CMS Collaboration

    2018-01-01

    Triggers selecting events with hadronically decaying $\\tau$ leptons ($\\tau_h$) are used in a wide variety of CMS analyses, in particular those targeting processes with a $H \\rightarrow \\tau\\tau$ decay. The performance of the $\\tau_h$ triggers is presented for data collected in 2017, corresponding to an integrated luminosity of 41.5\\,fb$^{-1}$ at 13 TeV, and compared with simulation.

  18. LHCb Topological Trigger Reoptimization

    CERN Document Server

    INSPIRE-00400931; Ilten, Philip; Khairullin, Egor; Rogozhnikov, Alex; Ustyuzhanin, Andrey; Williams, Michael

    2015-12-23

    The main b-physics trigger algorithm used by the LHCb experiment is the so-called topological trigger. The topological trigger selects vertices which are a) detached from the primary proton-proton collision and b) compatible with coming from the decay of a b-hadron. In the LHC Run 1, this trigger, which utilized a custom boosted decision tree algorithm, selected a nearly 100% pure sample of b-hadrons with a typical efficiency of 60-70%; its output was used in about 60% of LHCb papers. This talk presents studies carried out to optimize the topological trigger for LHC Run 2. In particular, we have carried out a detailed comparison of various machine learning classifier algorithms, e.g., AdaBoost, MatrixNet and neural networks. The topological trigger algorithm is designed to select all "interesting" decays of b-hadrons, but cannot be trained on every such decay. Studies have therefore been performed to determine how to optimize the performance of the classification algorithm on decays not used in the training. ...

  19. Topological Trigger Developments

    CERN Multimedia

    Likhomanenko, Tatiana

    2015-01-01

    The main b-physics trigger algorithm used by the LHCb experiment is the so-called topological trigger. The topological trigger selects vertices which are a) detached from the primary proton-proton collision and b) compatible with coming from the decay of a b-hadron. In the LHC Run 1, this trigger utilized a custom boosted decision tree algorithm, selected an almost 100% pure sample of b-hadrons with a typical efficiency of 60-70%, and its output was used in about 60% of LHCb papers. This talk presents studies carried out to optimize the topological trigger for LHC Run 2. In particular, we have carried out a detailed comparison of various machine learning classifier algorithms, e.g., AdaBoost, MatrixNet and uBoost. The topological trigger algorithm is designed to select all "interesting" decays of b-hadrons, but cannot be trained on every such decay. Studies have therefore been performed to determine how to optimize the performance of the classification algorithm on decays not used in the training. These inclu...

  20. A new apparatus and method for mixing solutes for injection tests in ...

    African Journals Online (AJOL)

    2009-07-17

    Jul 17, 2009 ... The trigger-tube apparatus and method was developed for mixing solutes and tracers for injection tests. The apparatus is a cap-trigger tube segment and the technique mixes solutes in boreholes in 2 min. Trigger-tube with solute/tracer is intro- duced into the well, the trigger is released, the tube is ...

  1. CMS Trigger Performance

    CERN Document Server

    Donato, Silvio

    2017-01-01

    During its second run of operation (Run 2) which started in 2015, the LHC will deliver a peak instantaneous luminosity that may reach $2 \\cdot 10^{34}$ cm$^{-2}$s$^{-1}$ with an average pile-up of about 55, far larger than the design value. Under these conditions, the online event selection is a very challenging task. In CMS, it is realized by a two-level trigger system the Level-1 (L1) Trigger, implemented in custom-designed electronics, and the High Level Trigger (HLT), a streamlined version of the offline reconstruction software running on a computer farm. In order to face this challenge, the L1 trigger has been through a major upgrade compared to Run 1, whereby all electronic boards of the system have been replaced, allowing more sophisticated algorithms to be run online. Its last stage, the global trigger, is now able to perform complex selections and to compute high-level quantities, like invariant masses. Likewise, the algorithms that run in the HLT go through big improvements; in particular, new appr...

  2. The CMS trigger system

    CERN Document Server

    Khachatryan, Vardan; Tumasyan, Armen; Adam, Wolfgang; Aşılar, Ece; Bergauer, Thomas; Brandstetter, Johannes; Brondolin, Erica; Dragicevic, Marko; Erö, Janos; Flechl, Martin; Friedl, Markus; Fruehwirth, Rudolf; Ghete, Vasile Mihai; Hartl, Christian; Hörmann, Natascha; Hrubec, Josef; Jeitler, Manfred; Knünz, Valentin; König, Axel; Krammer, Manfred; Krätschmer, Ilse; Liko, Dietrich; Matsushita, Takashi; Mikulec, Ivan; Rabady, Dinyar; Rahbaran, Babak; Rohringer, Herbert; Schieck, Jochen; Schöfbeck, Robert; Strauss, Josef; Treberer-Treberspurg, Wolfgang; Waltenberger, Wolfgang; Wulz, Claudia-Elisabeth; Mossolov, Vladimir; Shumeiko, Nikolai; Suarez Gonzalez, Juan; Alderweireldt, Sara; Cornelis, Tom; De Wolf, Eddi A; Janssen, Xavier; Knutsson, Albert; Lauwers, Jasper; Luyckx, Sten; Van De Klundert, Merijn; Van Haevermaet, Hans; Van Mechelen, Pierre; Van Remortel, Nick; Van Spilbeeck, Alex; Abu Zeid, Shimaa; Blekman, Freya; D'Hondt, Jorgen; Daci, Nadir; De Bruyn, Isabelle; Deroover, Kevin; Heracleous, Natalie; Keaveney, James; Lowette, Steven; Moreels, Lieselotte; Olbrechts, Annik; Python, Quentin; Strom, Derek; Tavernier, Stefaan; Van Doninck, Walter; Van Mulders, Petra; Van Onsem, Gerrit Patrick; Van Parijs, Isis; Barria, Patrizia; Brun, Hugues; Caillol, Cécile; Clerbaux, Barbara; De Lentdecker, Gilles; Fasanella, Giuseppe; Favart, Laurent; Grebenyuk, Anastasia; Karapostoli, Georgia; Lenzi, Thomas; Léonard, Alexandre; Maerschalk, Thierry; Marinov, Andrey; Perniè, Luca; Randle-conde, Aidan; Reis, Thomas; Seva, Tomislav; Vander Velde, Catherine; Vanlaer, Pascal; Yonamine, Ryo; Zenoni, Florian; Zhang, Fengwangdong; Beernaert, Kelly; Benucci, Leonardo; Cimmino, Anna; Crucy, Shannon; Dobur, Didar; Fagot, Alexis; Garcia, Guillaume; Gul, Muhammad; Mccartin, Joseph; Ocampo Rios, Alberto Andres; Poyraz, Deniz; Ryckbosch, Dirk; Salva Diblen, Sinem; Sigamani, Michael; Strobbe, Nadja; Tytgat, Michael; Van Driessche, Ward; Yazgan, Efe; Zaganidis, Nicolas; Basegmez, Suzan; Beluffi, Camille; Bondu, Olivier; Brochet, Sébastien; Bruno, Giacomo; Caudron, Adrien; Ceard, Ludivine; Da Silveira, Gustavo Gil; Delaere, Christophe; Favart, Denis; Forthomme, Laurent; Giammanco, Andrea; Hollar, Jonathan; Jafari, Abideh; Jez, Pavel; Komm, Matthias; Lemaitre, Vincent; Mertens, Alexandre; Musich, Marco; Nuttens, Claude; Perrini, Lucia; Pin, Arnaud; Piotrzkowski, Krzysztof; Popov, Andrey; Quertenmont, Loic; Selvaggi, Michele; Vidal Marono, Miguel; Beliy, Nikita; Hammad, Gregory Habib; Aldá Júnior, Walter Luiz; Alves, Fábio Lúcio; Alves, Gilvan; Brito, Lucas; Correa Martins Junior, Marcos; Hamer, Matthias; Hensel, Carsten; Mora Herrera, Clemencia; Moraes, Arthur; Pol, Maria Elena; Rebello Teles, Patricia; Belchior Batista Das Chagas, Ewerton; Carvalho, Wagner; Chinellato, Jose; Custódio, Analu; Melo Da Costa, Eliza; De Jesus Damiao, Dilson; De Oliveira Martins, Carley; Fonseca De Souza, Sandro; Huertas Guativa, Lina Milena; Malbouisson, Helena; Matos Figueiredo, Diego; Mundim, Luiz; Nogima, Helio; Prado Da Silva, Wanda Lucia; Santoro, Alberto; Sznajder, Andre; Tonelli Manganote, Edmilson José; Vilela Pereira, Antonio; Ahuja, Sudha; Bernardes, Cesar Augusto; De Souza Santos, Angelo; Dogra, Sunil; Tomei, Thiago; De Moraes Gregores, Eduardo; Mercadante, Pedro G; Moon, Chang-Seong; Novaes, Sergio F; Padula, Sandra; Romero Abad, David; Ruiz Vargas, José Cupertino; Aleksandrov, Aleksandar; Hadjiiska, Roumyana; Iaydjiev, Plamen; Rodozov, Mircho; Stoykova, Stefka; Sultanov, Georgi; Vutova, Mariana; Dimitrov, Anton; Glushkov, Ivan; Litov, Leander; Pavlov, Borislav; Petkov, Peicho; Ahmad, Muhammad; Bian, Jian-Guo; Chen, Guo-Ming; Chen, He-Sheng; Chen, Mingshui; Cheng, Tongguang; Du, Ran; Jiang, Chun-Hua; Plestina, Roko; Romeo, Francesco; Shaheen, Sarmad Masood; Spiezia, Aniello; Tao, Junquan; Wang, Chunjie; Wang, Zheng; Zhang, Huaqiao; Asawatangtrakuldee, Chayanit; Ban, Yong; Li, Qiang; Liu, Shuai; Mao, Yajun; Qian, Si-Jin; Wang, Dayong; Xu, Zijun; Avila, Carlos; Cabrera, Andrés; Chaparro Sierra, Luisa Fernanda; Florez, Carlos; Gomez, Juan Pablo; Gomez Moreno, Bernardo; Sanabria, Juan Carlos; Godinovic, Nikola; Lelas, Damir; Puljak, Ivica; Ribeiro Cipriano, Pedro M; Antunovic, Zeljko; Kovac, Marko; Brigljevic, Vuko; Kadija, Kreso; Luetic, Jelena; Micanovic, Sasa; Sudic, Lucija; Attikis, Alexandros; Mavromanolakis, Georgios; Mousa, Jehad; Nicolaou, Charalambos; Ptochos, Fotios; Razis, Panos A; Rykaczewski, Hans; Bodlak, Martin; Finger, Miroslav; Finger Jr, Michael; Assran, Yasser; El Sawy, Mai; Elgammal, Sherif; Ellithi Kamel, Ali; Mahmoud, Mohammed; Calpas, Betty; Kadastik, Mario; Murumaa, Marion; Raidal, Martti; Tiko, Andres; Veelken, Christian; Eerola, Paula; Pekkanen, Juska; Voutilainen, Mikko; Härkönen, Jaakko; Karimäki, Veikko; Kinnunen, Ritva; Lampén, Tapio; Lassila-Perini, Kati; Lehti, Sami; Lindén, Tomas; Luukka, Panja-Riina; Mäenpää, Teppo; Peltola, Timo; Tuominen, Eija; Tuominiemi, Jorma; Tuovinen, Esa; Wendland, Lauri; Talvitie, Joonas; Tuuva, Tuure; Besancon, Marc; Couderc, Fabrice; Dejardin, Marc; Denegri, Daniel; Fabbro, Bernard; Faure, Jean-Louis; Favaro, Carlotta; Ferri, Federico; Ganjour, Serguei; Givernaud, Alain; Gras, Philippe; Hamel de Monchenault, Gautier; Jarry, Patrick; Locci, Elizabeth; Machet, Martina; Malcles, Julie; Rander, John; Rosowsky, André; Titov, Maksym; Zghiche, Amina; Antropov, Iurii; Baffioni, Stephanie; Beaudette, Florian; Busson, Philippe; Cadamuro, Luca; Chapon, Emilien; Charlot, Claude; Dahms, Torsten; Davignon, Olivier; Filipovic, Nicolas; Florent, Alice; Granier de Cassagnac, Raphael; Lisniak, Stanislav; Mastrolorenzo, Luca; Miné, Philippe; Naranjo, Ivo Nicolas; Nguyen, Matthew; Ochando, Christophe; Ortona, Giacomo; Paganini, Pascal; Pigard, Philipp; Regnard, Simon; Salerno, Roberto; Sauvan, Jean-Baptiste; Sirois, Yves; Strebler, Thomas; Yilmaz, Yetkin; Zabi, Alexandre; Agram, Jean-Laurent; Andrea, Jeremy; Aubin, Alexandre; Bloch, Daniel; Brom, Jean-Marie; Buttignol, Michael; Chabert, Eric Christian; Chanon, Nicolas; Collard, Caroline; Conte, Eric; Coubez, Xavier; Fontaine, Jean-Charles; Gelé, Denis; Goerlach, Ulrich; Goetzmann, Christophe; Le Bihan, Anne-Catherine; Merlin, Jeremie Alexandre; Skovpen, Kirill; Van Hove, Pierre; Gadrat, Sébastien; Beauceron, Stephanie; Bernet, Colin; Boudoul, Gaelle; Bouvier, Elvire; Carrillo Montoya, Camilo Andres; Chierici, Roberto; Contardo, Didier; Courbon, Benoit; Depasse, Pierre; El Mamouni, Houmani; Fan, Jiawei; Fay, Jean; Gascon, Susan; Gouzevitch, Maxime; Ille, Bernard; Lagarde, Francois; Laktineh, Imad Baptiste; Lethuillier, Morgan; Mirabito, Laurent; Pequegnot, Anne-Laure; Perries, Stephane; Ruiz Alvarez, José David; Sabes, David; Sgandurra, Louis; Sordini, Viola; Vander Donckt, Muriel; Verdier, Patrice; Viret, Sébastien; Toriashvili, Tengizi; Tsamalaidze, Zviad; Autermann, Christian; Beranek, Sarah; Edelhoff, Matthias; Feld, Lutz; Heister, Arno; Kiesel, Maximilian Knut; Klein, Katja; Lipinski, Martin; Ostapchuk, Andrey; Preuten, Marius; Raupach, Frank; Schael, Stefan; Schulte, Jan-Frederik; Verlage, Tobias; Weber, Hendrik; Wittmer, Bruno; Zhukov, Valery; Ata, Metin; Brodski, Michael; Dietz-Laursonn, Erik; Duchardt, Deborah; Endres, Matthias; Erdmann, Martin; Erdweg, Sören; Esch, Thomas; Fischer, Robert; Güth, Andreas; Hebbeker, Thomas; Heidemann, Carsten; Hoepfner, Kerstin; Klingebiel, Dennis; Knutzen, Simon; Kreuzer, Peter; Merschmeyer, Markus; Meyer, Arnd; Millet, Philipp; Olschewski, Mark; Padeken, Klaas; Papacz, Paul; Pook, Tobias; Radziej, Markus; Reithler, Hans; Rieger, Marcel; Scheuch, Florian; Sonnenschein, Lars; Teyssier, Daniel; Thüer, Sebastian; Cherepanov, Vladimir; Erdogan, Yusuf; Flügge, Günter; Geenen, Heiko; Geisler, Matthias; Hoehle, Felix; Kargoll, Bastian; Kress, Thomas; Kuessel, Yvonne; Künsken, Andreas; Lingemann, Joschka; Nehrkorn, Alexander; Nowack, Andreas; Nugent, Ian Michael; Pistone, Claudia; Pooth, Oliver; Stahl, Achim; Aldaya Martin, Maria; Asin, Ivan; Bartosik, Nazar; Behnke, Olaf; Behrens, Ulf; Bell, Alan James; Borras, Kerstin; Burgmeier, Armin; Campbell, Alan; Choudhury, Somnath; Costanza, Francesco; Diez Pardos, Carmen; Dolinska, Ganna; Dooling, Samantha; Dorland, Tyler; Eckerlin, Guenter; Eckstein, Doris; Eichhorn, Thomas; Flucke, Gero; Gallo, Elisabetta; Garay Garcia, Jasone; Geiser, Achim; Gizhko, Andrii; Gunnellini, Paolo; Hauk, Johannes; Hempel, Maria; Jung, Hannes; Kalogeropoulos, Alexis; Karacheban, Olena; Kasemann, Matthias; Katsas, Panagiotis; Kieseler, Jan; Kleinwort, Claus; Korol, Ievgen; Lange, Wolfgang; Leonard, Jessica; Lipka, Katerina; Lobanov, Artur; Lohmann, Wolfgang; Mankel, Rainer; Marfin, Ihar; Melzer-Pellmann, Isabell-Alissandra; Meyer, Andreas Bernhard; Mittag, Gregor; Mnich, Joachim; Mussgiller, Andreas; Naumann-Emme, Sebastian; Nayak, Aruna; Ntomari, Eleni; Perrey, Hanno; Pitzl, Daniel; Placakyte, Ringaile; Raspereza, Alexei; Roland, Benoit; Sahin, Mehmet Özgür; Saxena, Pooja; Schoerner-Sadenius, Thomas; Schröder, Matthias; Seitz, Claudia; Spannagel, Simon; Trippkewitz, Karim Damun; Walsh, Roberval; Wissing, Christoph; Blobel, Volker; Centis Vignali, Matteo; Draeger, Arne-Rasmus; Erfle, Joachim; Garutti, Erika; Goebel, Kristin; Gonzalez, Daniel; Görner, Martin; Haller, Johannes; Hoffmann, Malte; Höing, Rebekka Sophie; Junkes, Alexandra; Klanner, Robert; Kogler, Roman; Kovalchuk, Nataliia; Lapsien, Tobias; Lenz, Teresa; Marchesini, Ivan; Marconi, Daniele; Meyer, Mareike; Nowatschin, Dominik; Ott, Jochen; Pantaleo, Felice; Peiffer, Thomas; Perieanu, Adrian; Pietsch, Niklas; Poehlsen, Jennifer; Rathjens, Denis; Sander, Christian; Scharf, Christian; Schettler, Hannes; Schleper, Peter; Schlieckau, Eike; Schmidt, Alexander; Schwandt, Joern; Sola, Valentina; Stadie, Hartmut; Steinbrück, Georg; Tholen, Heiner; Troendle, Daniel; Usai, Emanuele; Vanelderen, Lukas; Vanhoefer, Annika; Vormwald, Benedikt; Akbiyik, Melike; Barth, Christian; Baus, Colin; Berger, Joram; Böser, Christian; Butz, Erik; Chwalek, Thorsten; Colombo, Fabio; De Boer, Wim; Descroix, Alexis; Dierlamm, Alexander; Fink, Simon; Frensch, Felix; Friese, Raphael; Giffels, Manuel; Gilbert, Andrew; Haitz, Dominik; Hartmann, Frank; Heindl, Stefan Michael; Husemann, Ulrich; Katkov, Igor; Kornmayer, Andreas; Lobelle Pardo, Patricia; Maier, Benedikt; Mildner, Hannes; Mozer, Matthias Ulrich; Müller, Thomas; Müller, Thomas; Plagge, Michael; Quast, Gunter; Rabbertz, Klaus; Röcker, Steffen; Roscher, Frank; Sieber, Georg; Simonis, Hans-Jürgen; Stober, Fred-Markus Helmut; Ulrich, Ralf; Wagner-Kuhr, Jeannine; Wayand, Stefan; Weber, Marc; Weiler, Thomas; Wöhrmann, Clemens; Wolf, Roger; Anagnostou, Georgios; Daskalakis, Georgios; Geralis, Theodoros; Giakoumopoulou, Viktoria Athina; Kyriakis, Aristotelis; Loukas, Demetrios; Psallidas, Andreas; Topsis-Giotis, Iasonas; Agapitos, Antonis; Kesisoglou, Stilianos; Panagiotou, Apostolos; Saoulidou, Niki; Tziaferi, Eirini; Evangelou, Ioannis; Flouris, Giannis; Foudas, Costas; Kokkas, Panagiotis; Loukas, Nikitas; Manthos, Nikolaos; Papadopoulos, Ioannis; Paradas, Evangelos; Strologas, John; Bencze, Gyorgy; Hajdu, Csaba; Hazi, Andras; Hidas, Pàl; Horvath, Dezso; Sikler, Ferenc; Veszpremi, Viktor; Vesztergombi, Gyorgy; Zsigmond, Anna Julia; Beni, Noemi; Czellar, Sandor; Karancsi, János; Molnar, Jozsef; Szillasi, Zoltan; Bartók, Márton; Makovec, Alajos; Raics, Peter; Trocsanyi, Zoltan Laszlo; Ujvari, Balazs; Mal, Prolay; Mandal, Koushik; Sahoo, Deepak Kumar; Sahoo, Niladribihari; Swain, Sanjay Kumar; Bansal, Sunil; Beri, Suman Bala; Bhatnagar, Vipin; Chawla, Ridhi; Gupta, Ruchi; Bhawandeep, Bhawandeep; Kalsi, Amandeep Kaur; Kaur, Anterpreet; Kaur, Manjit; Kumar, Ramandeep; Mehta, Ankita; Mittal, Monika; Singh, Jasbir; Walia, Genius; Kumar, Ashok; Bhardwaj, Ashutosh; Choudhary, Brajesh C; Garg, Rocky Bala; Kumar, Ajay; Malhotra, Shivali; Naimuddin, Md; Nishu, Nishu; Ranjan, Kirti; Sharma, Ramkrishna; Sharma, Varun; Bhattacharya, Satyaki; Chatterjee, Kalyanmoy; Dey, Sourav; Dutta, Suchandra; Jain, Sandhya; Majumdar, Nayana; Modak, Atanu; Mondal, Kuntal; Mukherjee, Swagata; Mukhopadhyay, Supratik; Roy, Ashim; Roy, Debarati; Roy Chowdhury, Suvankar; Sarkar, Subir; Sharan, Manoj; Abdulsalam, Abdulla; Chudasama, Ruchi; Dutta, Dipanwita; Jha, Vishwajeet; Kumar, Vineet; Mohanty, Ajit Kumar; Pant, Lalit Mohan; Shukla, Prashant; Topkar, Anita; Aziz, Tariq; Banerjee, Sudeshna; Bhowmik, Sandeep; Chatterjee, Rajdeep Mohan; Dewanjee, Ram Krishna; Dugad, Shashikant; Ganguly, Sanmay; Ghosh, Saranya; Guchait, Monoranjan; Gurtu, Atul; Kole, Gouranga; Kumar, Sanjeev; Mahakud, Bibhuprasad; Maity, Manas; Majumder, Gobinda; Mazumdar, Kajari; Mitra, Soureek; Mohanty, Gagan Bihari; Parida, Bibhuti; Sarkar, Tanmay; Sur, Nairit; Sutar, Bajrang; Wickramage, Nadeesha; Chauhan, Shubhanshu; Dube, Sourabh; Kothekar, Kunal; Sharma, Seema; Bakhshiansohi, Hamed; Behnamian, Hadi; Etesami, Seyed Mohsen; Fahim, Ali; Goldouzian, Reza; Khakzad, Mohsen; Mohammadi Najafabadi, Mojtaba; Naseri, Mohsen; Paktinat Mehdiabadi, Saeid; Rezaei Hosseinabadi, Ferdos; Safarzadeh, Batool; Zeinali, Maryam; Felcini, Marta; Grunewald, Martin; Abbrescia, Marcello; Calabria, Cesare; Caputo, Claudio; Colaleo, Anna; Creanza, Donato; Cristella, Leonardo; De Filippis, Nicola; De Palma, Mauro; Fiore, Luigi; Iaselli, Giuseppe; Maggi, Giorgio; Maggi, Marcello; Miniello, Giorgia; My, Salvatore; Nuzzo, Salvatore; Pompili, Alexis; Pugliese, Gabriella; Radogna, Raffaella; Ranieri, Antonio; Selvaggi, Giovanna; Silvestris, Lucia; Venditti, Rosamaria; Verwilligen, Piet; Abbiendi, Giovanni; Battilana, Carlo; Benvenuti, Alberto; Bonacorsi, Daniele; Braibant-Giacomelli, Sylvie; Brigliadori, Luca; Campanini, Renato; Capiluppi, Paolo; Castro, Andrea; Cavallo, Francesca Romana; Chhibra, Simranjit Singh; Codispoti, Giuseppe; Cuffiani, Marco; Dallavalle, Gaetano-Marco; Fabbri, Fabrizio; Fanfani, Alessandra; Fasanella, Daniele; Giacomelli, Paolo; Grandi, Claudio; Guiducci, Luigi; Marcellini, Stefano; Masetti, Gianni; Montanari, Alessandro; Navarria, Francesco; Perrotta, Andrea; Rossi, Antonio; Rovelli, Tiziano; Siroli, Gian Piero; Tosi, Nicolò; Travaglini, Riccardo; Cappello, Gigi; Chiorboli, Massimiliano; Costa, Salvatore; Di Mattia, Alessandro; Giordano, Ferdinando; Potenza, Renato; Tricomi, Alessia; Tuve, Cristina; Barbagli, Giuseppe; Ciulli, Vitaliano; Civinini, Carlo; D'Alessandro, Raffaello; Focardi, Ettore; Gonzi, Sandro; Gori, Valentina; Lenzi, Piergiulio; Meschini, Marco; Paoletti, Simone; Sguazzoni, Giacomo; Tropiano, Antonio; Viliani, Lorenzo; Benussi, Luigi; Bianco, Stefano; Fabbri, Franco; Piccolo, Davide; Primavera, Federica; Calvelli, Valerio; Ferro, Fabrizio; Lo Vetere, Maurizio; Monge, Maria Roberta; Robutti, Enrico; Tosi, Silvano; Brianza, Luca; Dinardo, Mauro Emanuele; Fiorendi, Sara; Gennai, Simone; Gerosa, Raffaele; Ghezzi, Alessio; Govoni, Pietro; Malvezzi, Sandra; Manzoni, Riccardo Andrea; Marzocchi, Badder; Menasce, Dario; Moroni, Luigi; Paganoni, Marco; Pedrini, Daniele; Ragazzi, Stefano; Redaelli, Nicola; Tabarelli de Fatis, Tommaso; Buontempo, Salvatore; Cavallo, Nicola; Di Guida, Salvatore; Esposito, Marco; Fabozzi, Francesco; Iorio, Alberto Orso Maria; Lanza, Giuseppe; Lista, Luca; Meola, Sabino; Merola, Mario; Paolucci, Pierluigi; Sciacca, Crisostomo; Thyssen, Filip; Bacchetta, Nicola; Bellato, Marco; Benato, Lisa; Bisello, Dario; Boletti, Alessio; Carlin, Roberto; Checchia, Paolo; Dall'Osso, Martino; Dosselli, Umberto; Gasparini, Fabrizio; Gasparini, Ugo; Gozzelino, Andrea; Lacaprara, Stefano; Margoni, Martino; Meneguzzo, Anna Teresa; Montecassiano, Fabio; Passaseo, Marina; Pazzini, Jacopo; Pegoraro, Matteo; Pozzobon, Nicola; Simonetto, Franco; Torassa, Ezio; Tosi, Mia; Vanini, Sara; Ventura, Sandro; Zanetti, Marco; Zotto, Pierluigi; Zucchetta, Alberto; Zumerle, Gianni; Braghieri, Alessandro; Magnani, Alice; Montagna, Paolo; Ratti, Sergio P; Re, Valerio; Riccardi, Cristina; Salvini, Paola; Vai, Ilaria; Vitulo, Paolo; Alunni Solestizi, Luisa; Biasini, Maurizio; Bilei, Gian Mario; Ciangottini, Diego; Fanò, Livio; Lariccia, Paolo; Mantovani, Giancarlo; Menichelli, Mauro; Saha, Anirban; Santocchia, Attilio; Androsov, Konstantin; Azzurri, Paolo; Bagliesi, Giuseppe; Bernardini, Jacopo; Boccali, Tommaso; Castaldi, Rino; Ciocci, Maria Agnese; Dell'Orso, Roberto; Donato, Silvio; Fedi, Giacomo; Foà, Lorenzo; Giassi, Alessandro; Grippo, Maria Teresa; Ligabue, Franco; Lomtadze, Teimuraz; Martini, Luca; Messineo, Alberto; Palla, Fabrizio; Rizzi, Andrea; Savoy-Navarro, Aurore; Serban, Alin Titus; Spagnolo, Paolo; Tenchini, Roberto; Tonelli, Guido; Venturi, Andrea; Verdini, Piero Giorgio; Barone, Luciano; Cavallari, Francesca; D'imperio, Giulia; Del Re, Daniele; Diemoz, Marcella; Gelli, Simone; Jorda, Clara; Longo, Egidio; Margaroli, Fabrizio; Meridiani, Paolo; Organtini, Giovanni; Paramatti, Riccardo; Preiato, Federico; Rahatlou, Shahram; Rovelli, Chiara; Santanastasio, Francesco; Traczyk, Piotr; Amapane, Nicola; Arcidiacono, Roberta; Argiro, Stefano; Arneodo, Michele; Bellan, Riccardo; Biino, Cristina; Cartiglia, Nicolo; Costa, Marco; Covarelli, Roberto; Degano, Alessandro; Demaria, Natale; Finco, Linda; Kiani, Bilal; Mariotti, Chiara; Maselli, Silvia; Migliore, Ernesto; Monaco, Vincenzo; Monteil, Ennio; Obertino, Maria Margherita; Pacher, Luca; Pastrone, Nadia; Pelliccioni, Mario; Pinna Angioni, Gian Luca; Ravera, Fabio; Romero, Alessandra; Ruspa, Marta; Sacchi, Roberto; Solano, Ada; Staiano, Amedeo; Tamponi, Umberto; Belforte, Stefano; Candelise, Vieri; Casarsa, Massimo; Cossutti, Fabio; Della Ricca, Giuseppe; Gobbo, Benigno; La Licata, Chiara; Marone, Matteo; Schizzi, Andrea; Zanetti, Anna; Kropivnitskaya, Anna; Nam, Soon-Kwon; Kim, Dong Hee; Kim, Gui Nyun; Kim, Min Suk; Kong, Dae Jung; Lee, Sangeun; Oh, Young Do; Sakharov, Alexandre; Son, Dong-Chul; Brochero Cifuentes, Javier Andres; Kim, Hyunsoo; Kim, Tae Jeong; Song, Sanghyeon; Choi, Suyong; Go, Yeonju; Gyun, Dooyeon; Hong, Byung-Sik; Jo, Mihee; Kim, Hyunchul; Kim, Yongsun; Lee, Byounghoon; Lee, Kisoo; Lee, Kyong Sei; Lee, Songkyo; Park, Sung Keun; Roh, Youn; Yoo, Hwi Dong; Choi, Minkyoo; Kim, Hyunyong; Kim, Ji Hyun; Lee, Jason Sang Hun; Park, Inkyu; Ryu, Geonmo; Ryu, Min Sang; Choi, Young-Il; Goh, Junghwan; Kim, Donghyun; Kwon, Eunhyang; Lee, Jongseok; Yu, Intae; Dudenas, Vytautas; Juodagalvis, Andrius; Vaitkus, Juozas; Ahmed, Ijaz; Ibrahim, Zainol Abidin; Komaragiri, Jyothsna Rani; Md Ali, Mohd Adli Bin; Mohamad Idris, Faridah; Wan Abdullah, Wan Ahmad Tajuddin; Yusli, Mohd Nizam; Casimiro Linares, Edgar; Castilla-Valdez, Heriberto; De La Cruz-Burelo, Eduard; Heredia-De La Cruz, Ivan; Hernandez-Almada, Alberto; Lopez-Fernandez, Ricardo; Sánchez Hernández, Alberto; Carrillo Moreno, Salvador; Vazquez Valencia, Fabiola; Pedraza, Isabel; Salazar Ibarguen, Humberto Antonio; Morelos Pineda, Antonio; Krofcheck, David; Butler, Philip H; Ahmad, Ashfaq; Ahmad, Muhammad; Hassan, Qamar; Hoorani, Hafeez R; Khan, Wajid Ali; Khurshid, Taimoor; Shoaib, Muhammad; Bialkowska, Helena; Bluj, Michal; Boimska, Bożena; Frueboes, Tomasz; Górski, Maciej; Kazana, Malgorzata; Nawrocki, Krzysztof; Romanowska-Rybinska, Katarzyna; Szleper, Michal; Zalewski, Piotr; Brona, Grzegorz; Bunkowski, Karol; Byszuk, Adrian; Doroba, Krzysztof; Kalinowski, Artur; Konecki, Marcin; Krolikowski, Jan; Misiura, Maciej; Olszewski, Michal; Pozniak, Krzysztof; Walczak, Marek; Bargassa, Pedrame; Beirão Da Cruz E Silva, Cristóvão; Di Francesco, Agostino; Faccioli, Pietro; Ferreira Parracho, Pedro Guilherme; Gallinaro, Michele; Leonardo, Nuno; Lloret Iglesias, Lara; Nguyen, Federico; Rodrigues Antunes, Joao; Seixas, Joao; Toldaiev, Oleksii; Vadruccio, Daniele; Varela, Joao; Vischia, Pietro; Afanasiev, Serguei; Bunin, Pavel; Gavrilenko, Mikhail; Golutvin, Igor; Gorbunov, Ilya; Kamenev, Alexey; Karjavin, Vladimir; Konoplyanikov, Viktor; Lanev, Alexander; Malakhov, Alexander; Matveev, Viktor; Moisenz, Petr; Palichik, Vladimir; Perelygin, Victor; Shmatov, Sergey; Shulha, Siarhei; Skatchkov, Nikolai; Smirnov, Vitaly; Zarubin, Anatoli; Golovtsov, Victor; Ivanov, Yury; Kim, Victor; Kuznetsova, Ekaterina; Levchenko, Petr; Murzin, Victor; Oreshkin, Vadim; Smirnov, Igor; Sulimov, Valentin; Uvarov, Lev; Vavilov, Sergey; Vorobyev, Alexey; Andreev, Yuri; Dermenev, Alexander; Gninenko, Sergei; Golubev, Nikolai; Karneyeu, Anton; Kirsanov, Mikhail; Krasnikov, Nikolai; Pashenkov, Anatoli; Tlisov, Danila; Toropin, Alexander; Epshteyn, Vladimir; Gavrilov, Vladimir; Lychkovskaya, Natalia; Popov, Vladimir; Pozdnyakov, Ivan; Safronov, Grigory; Spiridonov, Alexander; Vlasov, Evgueni; Zhokin, Alexander; Bylinkin, Alexander; Andreev, Vladimir; Azarkin, Maksim; Dremin, Igor; Kirakosyan, Martin; Leonidov, Andrey; Mesyats, Gennady; Rusakov, Sergey V; Baskakov, Alexey; Belyaev, Andrey; Boos, Edouard; Dubinin, Mikhail; Dudko, Lev; Ershov, Alexander; Gribushin, Andrey; Kaminskiy, Alexandre; Klyukhin, Vyacheslav; Kodolova, Olga; Lokhtin, Igor; Miagkov, Igor; Obraztsov, Stepan; Petrushanko, Sergey; Savrin, Viktor; Azhgirey, Igor; Bayshev, Igor; Bitioukov, Sergei; Kachanov, Vassili; Kalinin, Alexey; Konstantinov, Dmitri; Krychkine, Victor; Petrov, Vladimir; Ryutin, Roman; Sobol, Andrei; Tourtchanovitch, Leonid; Troshin, Sergey; Tyurin, Nikolay; Uzunian, Andrey; Volkov, Alexey; Adzic, Petar; Milosevic, Jovan; Rekovic, Vladimir; Alcaraz Maestre, Juan; Calvo, Enrique; Cerrada, Marcos; Chamizo Llatas, Maria; Colino, Nicanor; De La Cruz, Begona; Delgado Peris, Antonio; Domínguez Vázquez, Daniel; Escalante Del Valle, Alberto; Fernandez Bedoya, Cristina; Fernández Ramos, Juan Pablo; Flix, Jose; Fouz, Maria Cruz; Garcia-Abia, Pablo; Gonzalez Lopez, Oscar; Goy Lopez, Silvia; Hernandez, Jose M; Josa, Maria Isabel; Navarro De Martino, Eduardo; Pérez-Calero Yzquierdo, Antonio María; Puerta Pelayo, Jesus; Quintario Olmeda, Adrián; Redondo, Ignacio; Romero, Luciano; Santaolalla, Javier; Senghi Soares, Mara; Albajar, Carmen; de Trocóniz, Jorge F; Missiroli, Marino; Moran, Dermot; Cuevas, Javier; Fernandez Menendez, Javier; Folgueras, Santiago; Gonzalez Caballero, Isidro; Palencia Cortezon, Enrique; Vizan Garcia, Jesus Manuel; Cabrillo, Iban Jose; Calderon, Alicia; Castiñeiras De Saa, Juan Ramon; De Castro Manzano, Pablo; Duarte Campderros, Jordi; Fernandez, Marcos; Garcia-Ferrero, Juan; Gomez, Gervasio; Lopez Virto, Amparo; Marco, Jesus; Marco, Rafael; Martinez Rivero, Celso; Matorras, Francisco; Munoz Sanchez, Francisca Javiela; Piedra Gomez, Jonatan; Rodrigo, Teresa; Rodríguez-Marrero, Ana Yaiza; Ruiz-Jimeno, Alberto; Scodellaro, Luca; Trevisani, Nicolò; Vila, Ivan; Vilar Cortabitarte, Rocio; Abbaneo, Duccio; Auffray, Etiennette; Auzinger, Georg; Bachtis, Michail; Baillon, Paul; Ball, Austin; Barney, David; Benaglia, Andrea; Bendavid, Joshua; Benhabib, Lamia; Benitez, Jose F; Berruti, Gaia Maria; Bloch, Philippe; Bocci, Andrea; Bonato, Alessio; Botta, Cristina; Breuker, Horst; Camporesi, Tiziano; Castello, Roberto; Cerminara, Gianluca; D'Alfonso, Mariarosaria; D'Enterria, David; Dabrowski, Anne; Daponte, Vincenzo; David Tinoco Mendes, Andre; De Gruttola, Michele; De Guio, Federico; De Roeck, Albert; De Visscher, Simon; Di Marco, Emanuele; Dobson, Marc; Dordevic, Milos; Dorney, Brian; Du Pree, Tristan; Dünser, Marc; Dupont, Niels; Elliott-Peisert, Anna; Franzoni, Giovanni; Funk, Wolfgang; Gigi, Dominique; Gill, Karl; Giordano, Domenico; Girone, Maria; Glege, Frank; Guida, Roberto; Gundacker, Stefan; Guthoff, Moritz; Hammer, Josef; Harris, Philip; Hegeman, Jeroen; Innocente, Vincenzo; Janot, Patrick; Kirschenmann, Henning; Kortelainen, Matti J; Kousouris, Konstantinos; Krajczar, Krisztian; Lecoq, Paul; Lourenco, Carlos; Lucchini, Marco Toliman; Magini, Nicolo; Malgeri, Luca; Mannelli, Marcello; Martelli, Arabella; Masetti, Lorenzo; Meijers, Frans; Mersi, Stefano; Meschi, Emilio; Moortgat, Filip; Morovic, Srecko; Mulders, Martijn; Nemallapudi, Mythra Varun; Neugebauer, Hannes; Orfanelli, Styliani; Orsini, Luciano; Pape, Luc; Perez, Emmanuelle; Peruzzi, Marco; Petrilli, Achille; Petrucciani, Giovanni; Pfeiffer, Andreas; Piparo, Danilo; Racz, Attila; Rolandi, Gigi; Rovere, Marco; Ruan, Manqi; Sakulin, Hannes; Schäfer, Christoph; Schwick, Christoph; Seidel, Markus; Sharma, Archana; Silva, Pedro; Simon, Michal; Sphicas, Paraskevas; Steggemann, Jan; Stieger, Benjamin; Stoye, Markus; Takahashi, Yuta; Treille, Daniel; Triossi, Andrea; Tsirou, Andromachi; Veres, Gabor Istvan; Wardle, Nicholas; Wöhri, Hermine Katharina; Zagoździńska, Agnieszka; Zeuner, Wolfram Dietrich; Bertl, Willi; Deiters, Konrad; Erdmann, Wolfram; Horisberger, Roland; Ingram, Quentin; Kaestli, Hans-Christian; Kotlinski, Danek; Langenegger, Urs; Renker, Dieter; Rohe, Tilman; Bachmair, Felix; Bäni, Lukas; Bianchini, Lorenzo; Casal, Bruno; Dissertori, Günther; Dittmar, Michael; Donegà, Mauro; Eller, Philipp; Grab, Christoph; Heidegger, Constantin; Hits, Dmitry; Hoss, Jan; Kasieczka, Gregor; Lustermann, Werner; Mangano, Boris; Marionneau, Matthieu; Martinez Ruiz del Arbol, Pablo; Masciovecchio, Mario; Meister, Daniel; Micheli, Francesco; Musella, Pasquale; Nessi-Tedaldi, Francesca; Pandolfi, Francesco; Pata, Joosep; Pauss, Felicitas; Perrozzi, Luca; Quittnat, Milena; Rossini, Marco; Starodumov, Andrei; Takahashi, Maiko; Tavolaro, Vittorio Raoul; Theofilatos, Konstantinos; Wallny, Rainer; Aarrestad, Thea Klaeboe; Amsler, Claude; Caminada, Lea; Canelli, Maria Florencia; Chiochia, Vincenzo; De Cosa, Annapaola; Galloni, Camilla; Hinzmann, Andreas; Hreus, Tomas; Kilminster, Benjamin; Lange, Clemens; Ngadiuba, Jennifer; Pinna, Deborah; Robmann, Peter; Ronga, Frederic Jean; Salerno, Daniel; Yang, Yong; Cardaci, Marco; Chen, Kuan-Hsin; Doan, Thi Hien; Jain, Shilpi; Khurana, Raman; Konyushikhin, Maxim; Kuo, Chia-Ming; Lin, Willis; Lu, Yun-Ju; Yu, Shin-Shan; Kumar, Arun; Bartek, Rachel; Chang, Paoti; Chang, You-Hao; Chang, Yu-Wei; Chao, Yuan; Chen, Kai-Feng; Chen, Po-Hsun; Dietz, Charles; Fiori, Francesco; Grundler, Ulysses; Hou, George Wei-Shu; Hsiung, Yee; Liu, Yueh-Feng; Lu, Rong-Shyang; Miñano Moya, Mercedes; Petrakou, Eleni; Tsai, Jui-fa; Tzeng, Yeng-Ming; Asavapibhop, Burin; Kovitanggoon, Kittikul; Singh, Gurpreet; Srimanobhas, Norraphat; Suwonjandee, Narumon; Adiguzel, Aytul; Bakirci, Mustafa Numan; Demiroglu, Zuhal Seyma; Dozen, Candan; Eskut, Eda; Girgis, Semiray; Gokbulut, Gul; Guler, Yalcin; Gurpinar, Emine; Hos, Ilknur; Kangal, Evrim Ersin; Onengut, Gulsen; Ozdemir, Kadri; Polatoz, Ayse; Sunar Cerci, Deniz; Tali, Bayram; Topakli, Huseyin; Vergili, Mehmet; Zorbilmez, Caglar; Akin, Ilina Vasileva; Bilin, Bugra; Bilmis, Selcuk; Isildak, Bora; Karapinar, Guler; Yalvac, Metin; Zeyrek, Mehmet; Gülmez, Erhan; Kaya, Mithat; Kaya, Ozlem; Yetkin, Elif Asli; Yetkin, Taylan; Cakir, Altan; Cankocak, Kerem; Sen, Sercan; Vardarlı, Fuat Ilkehan; Grynyov, Boris; Levchuk, Leonid; Sorokin, Pavel; Aggleton, Robin; Ball, Fionn; Beck, Lana; Brooke, James John; Clement, Emyr; Cussans, David; Flacher, Henning; Goldstein, Joel; Grimes, Mark; Heath, Greg P; Heath, Helen F; Jacob, Jeson; Kreczko, Lukasz; Lucas, Chris; Meng, Zhaoxia; Newbold, Dave M; Paramesvaran, Sudarshan; Poll, Anthony; Sakuma, Tai; Seif El Nasr-storey, Sarah; Senkin, Sergey; Smith, Dominic; Smith, Vincent J; Bell, Ken W; Belyaev, Alexander; Brew, Christopher; Brown, Robert M; Calligaris, Luigi; Cieri, Davide; Cockerill, David JA; Coughlan, John A; Harder, Kristian; Harper, Sam; Olaiya, Emmanuel; Petyt, David; Shepherd-Themistocleous, Claire; Thea, Alessandro; Tomalin, Ian R; Williams, Thomas; Womersley, William John; Worm, Steven; Baber, Mark; Bainbridge, Robert; Buchmuller, Oliver; Bundock, Aaron; Burton, Darren; Casasso, Stefano; Citron, Matthew; Colling, David; Corpe, Louie; Cripps, Nicholas; Dauncey, Paul; Davies, Gavin; De Wit, Adinda; Della Negra, Michel; Dunne, Patrick; Elwood, Adam; Ferguson, William; Fulcher, Jonathan; Futyan, David; Hall, Geoffrey; Iles, Gregory; Kenzie, Matthew; Lane, Rebecca; Lucas, Robyn; Lyons, Louis; Magnan, Anne-Marie; Malik, Sarah; Nash, Jordan; Nikitenko, Alexander; Pela, Joao; Pesaresi, Mark; Petridis, Konstantinos; Raymond, David Mark; Richards, Alexander; Rose, Andrew; Seez, Christopher; Tapper, Alexander; Uchida, Kirika; Vazquez Acosta, Monica; Virdee, Tejinder; Zenz, Seth Conrad; Cole, Joanne; Hobson, Peter R; Khan, Akram; Kyberd, Paul; Leggat, Duncan; Leslie, Dawn; Reid, Ivan; Symonds, Philip; Teodorescu, Liliana; Turner, Mark; Borzou, Ahmad; Call, Kenneth; Dittmann, Jay; Hatakeyama, Kenichi; Liu, Hongxuan; Pastika, Nathaniel; Charaf, Otman; Cooper, Seth; Henderson, Conor; Rumerio, Paolo; Arcaro, Daniel; Avetisyan, Aram; Bose, Tulika; Fantasia, Cory; Gastler, Daniel; Lawson, Philip; Rankin, Dylan; Richardson, Clint; Rohlf, James; St John, Jason; Sulak, Lawrence; Zou, David; Alimena, Juliette; Berry, Edmund; Bhattacharya, Saptaparna; Cutts, David; Dhingra, Nitish; Ferapontov, Alexey; Garabedian, Alex; Hakala, John; Heintz, Ulrich; Laird, Edward; Landsberg, Greg; Mao, Zaixing; Narain, Meenakshi; Piperov, Stefan; Sagir, Sinan; Syarif, Rizki; Breedon, Richard; Breto, Guillermo; Calderon De La Barca Sanchez, Manuel; Chauhan, Sushil; Chertok, Maxwell; Conway, John; Conway, Rylan; Cox, Peter Timothy; Erbacher, Robin; Gardner, Michael; Ko, Winston; Lander, Richard; Mulhearn, Michael; Pellett, Dave; Pilot, Justin; Ricci-Tam, Francesca; Shalhout, Shalhout; Smith, John; Squires, Michael; Stolp, Dustin; Tripathi, Mani; Wilbur, Scott; Yohay, Rachel; Cousins, Robert; Everaerts, Pieter; Farrell, Chris; Hauser, Jay; Ignatenko, Mikhail; Saltzberg, David; Takasugi, Eric; Valuev, Vyacheslav; Weber, Matthias; Burt, Kira; Clare, Robert; Ellison, John Anthony; Gary, J William; Hanson, Gail; Heilman, Jesse; Paneva, Mirena Ivova; Jandir, Pawandeep; Kennedy, Elizabeth; Lacroix, Florent; Long, Owen Rosser; Luthra, Arun; Malberti, Martina; Olmedo Negrete, Manuel; Shrinivas, Amithabh; Wei, Hua; Wimpenny, Stephen; Yates, Brent; Branson, James G; Cerati, Giuseppe Benedetto; Cittolin, Sergio; D'Agnolo, Raffaele Tito; Derdzinski, Mark; Holzner, André; Kelley, Ryan; Klein, Daniel; Letts, James; Macneill, Ian; Olivito, Dominick; Padhi, Sanjay; Pieri, Marco; Sani, Matteo; Sharma, Vivek; Simon, Sean; Tadel, Matevz; Vartak, Adish; Wasserbaech, Steven; Welke, Charles; Würthwein, Frank; Yagil, Avraham; Zevi Della Porta, Giovanni; Bradmiller-Feld, John; Campagnari, Claudio; Dishaw, Adam; Dutta, Valentina; Flowers, Kristen; Franco Sevilla, Manuel; Geffert, Paul; George, Christopher; Golf, Frank; Gouskos, Loukas; Gran, Jason; Incandela, Joe; Mccoll, Nickolas; Mullin, Sam Daniel; Richman, Jeffrey; Stuart, David; Suarez, Indara; West, Christopher; Yoo, Jaehyeok; Anderson, Dustin; Apresyan, Artur; Bornheim, Adolf; Bunn, Julian; Chen, Yi; Duarte, Javier; Mott, Alexander; Newman, Harvey B; Pena, Cristian; Pierini, Maurizio; Spiropulu, Maria; Vlimant, Jean-Roch; Xie, Si; Zhu, Ren-Yuan; Andrews, Michael Benjamin; Azzolini, Virginia; Calamba, Aristotle; Carlson, Benjamin; Ferguson, Thomas; Paulini, Manfred; Russ, James; Sun, Menglei; Vogel, Helmut; Vorobiev, Igor; Cumalat, John Perry; Ford, William T; Gaz, Alessandro; Jensen, Frank; Johnson, Andrew; Krohn, Michael; Mulholland, Troy; Nauenberg, Uriel; Stenson, Kevin; Wagner, Stephen Robert; Alexander, James; Chatterjee, Avishek; Chaves, Jorge; Chu, Jennifer; Dittmer, Susan; Eggert, Nicholas; Mirman, Nathan; Nicolas Kaufman, Gala; Patterson, Juliet Ritchie; Rinkevicius, Aurelijus; Ryd, Anders; Skinnari, Louise; Soffi, Livia; Sun, Werner; Tan, Shao Min; Teo, Wee Don; Thom, Julia; Thompson, Joshua; Tucker, Jordan; Weng, Yao; Wittich, Peter; Abdullin, Salavat; Albrow, Michael; Anderson, Jacob; Apollinari, Giorgio; Banerjee, Sunanda; Bauerdick, Lothar AT; Beretvas, Andrew; Berryhill, Jeffrey; Bhat, Pushpalatha C; Bolla, Gino; Burkett, Kevin; Butler, Joel Nathan; Cheung, Harry; Chlebana, Frank; Cihangir, Selcuk; Elvira, Victor Daniel; Fisk, Ian; Freeman, Jim; Gottschalk, Erik; Gray, Lindsey; Green, Dan; Grünendahl, Stefan; Gutsche, Oliver; Hanlon, Jim; Hare, Daryl; Harris, Robert M; Hasegawa, Satoshi; Hirschauer, James; Hu, Zhen; Jayatilaka, Bodhitha; Jindariani, Sergo; Johnson, Marvin; Joshi, Umesh; Jung, Andreas Werner; Klima, Boaz; Kreis, Benjamin; Kwan, Simon; Lammel, Stephan; Linacre, Jacob; Lincoln, Don; Lipton, Ron; Liu, Tiehui; Lopes De Sá, Rafael; Lykken, Joseph; Maeshima, Kaori; Marraffino, John Michael; Martinez Outschoorn, Verena Ingrid; Maruyama, Sho; Mason, David; McBride, Patricia; Merkel, Petra; Mishra, Kalanand; Mrenna, Stephen; Nahn, Steve; Newman-Holmes, Catherine; O'Dell, Vivian; Pedro, Kevin; Prokofyev, Oleg; Rakness, Gregory; Sexton-Kennedy, Elizabeth; Soha, Aron; Spalding, William J; Spiegel, Leonard; Taylor, Lucas; Tkaczyk, Slawek; Tran, Nhan Viet; Uplegger, Lorenzo; Vaandering, Eric Wayne; Vernieri, Caterina; Verzocchi, Marco; Vidal, Richard; Weber, Hannsjoerg Artur; Whitbeck, Andrew; Yang, Fan; Acosta, Darin; Avery, Paul; Bortignon, Pierluigi; Bourilkov, Dimitri; Carnes, Andrew; Carver, Matthew; Curry, David; Das, Souvik; Di Giovanni, Gian Piero; Field, Richard D; Furic, Ivan-Kresimir; Gleyzer, Sergei V; Hugon, Justin; Konigsberg, Jacobo; Korytov, Andrey; Low, Jia Fu; Ma, Peisen; Matchev, Konstantin; Mei, Hualin; Milenovic, Predrag; Mitselmakher, Guenakh; Rank, Douglas; Rossin, Roberto; Shchutska, Lesya; Snowball, Matthew; Sperka, David; Terentyev, Nikolay; Thomas, Laurent; Wang, Jian; Wang, Sean-Jiun; Yelton, John; Hewamanage, Samantha; Linn, Stephan; Markowitz, Pete; Martinez, German; Rodriguez, Jorge Luis; Ackert, Andrew; Adams, Jordon Rowe; Adams, Todd; Askew, Andrew; Bochenek, Joseph; Diamond, Brendan; Haas, Jeff; Hagopian, Sharon; Hagopian, Vasken; Johnson, Kurtis F; Khatiwada, Ajeeta; Prosper, Harrison; Weinberg, Marc; Baarmand, Marc M; Bhopatkar, Vallary; Colafranceschi, Stefano; Hohlmann, Marcus; Kalakhety, Himali; Noonan, Daniel; Roy, Titas; Yumiceva, Francisco; Adams, Mark Raymond; Apanasevich, Leonard; Berry, Douglas; Betts, Russell Richard; Bucinskaite, Inga; Cavanaugh, Richard; Evdokimov, Olga; Gauthier, Lucie; Gerber, Cecilia Elena; Hofman, David Jonathan; Kurt, Pelin; O'Brien, Christine; Sandoval Gonzalez, Irving Daniel; Silkworth, Christopher; Turner, Paul; Varelas, Nikos; Wu, Zhenbin; Zakaria, Mohammed; Bilki, Burak; Clarida, Warren; Dilsiz, Kamuran; Durgut, Süleyman; Gandrajula, Reddy Pratap; Haytmyradov, Maksat; Khristenko, Viktor; Merlo, Jean-Pierre; Mermerkaya, Hamit; Mestvirishvili, Alexi; Moeller, Anthony; Nachtman, Jane; Ogul, Hasan; Onel, Yasar; Ozok, Ferhat; Penzo, Aldo; Snyder, Christina; Tiras, Emrah; Wetzel, James; Yi, Kai; Anderson, Ian; Barnett, Bruce Arnold; Blumenfeld, Barry; Eminizer, Nicholas; Fehling, David; Feng, Lei; Gritsan, Andrei; Maksimovic, Petar; Martin, Christopher; Osherson, Marc; Roskes, Jeffrey; Cocoros, Alice; Sarica, Ulascan; Swartz, Morris; Xiao, Meng; Xin, Yongjie; You, Can; Baringer, Philip; Bean, Alice; Benelli, Gabriele; Bruner, Christopher; Kenny III, Raymond Patrick; Majumder, Devdatta; Malek, Magdalena; Murray, Michael; Sanders, Stephen; Stringer, Robert; Wang, Quan; Ivanov, Andrew; Kaadze, Ketino; Khalil, Sadia; Makouski, Mikhail; Maravin, Yurii; Mohammadi, Abdollah; Saini, Lovedeep Kaur; Skhirtladze, Nikoloz; Toda, Sachiko; Lange, David; Rebassoo, Finn; Wright, Douglas; Anelli, Christopher; Baden, Drew; Baron, Owen; Belloni, Alberto; Calvert, Brian; Eno, Sarah Catherine; Ferraioli, Charles; Gomez, Jaime; Hadley, Nicholas John; Jabeen, Shabnam; Kellogg, Richard G; Kolberg, Ted; Kunkle, Joshua; Lu, Ying; Mignerey, Alice; Shin, Young Ho; Skuja, Andris; Tonjes, Marguerite; Tonwar, Suresh C; Apyan, Aram; Barbieri, Richard; Baty, Austin; Bierwagen, Katharina; Brandt, Stephanie; Busza, Wit; Cali, Ivan Amos; Demiragli, Zeynep; Di Matteo, Leonardo; Gomez Ceballos, Guillelmo; Goncharov, Maxim; Gulhan, Doga; Iiyama, Yutaro; Innocenti, Gian Michele; Klute, Markus; Kovalskyi, Dmytro; Lai, Yue Shi; Lee, Yen-Jie; Levin, Andrew; Luckey, Paul David; Marini, Andrea Carlo; Mcginn, Christopher; Mironov, Camelia; Narayanan, Siddharth; Niu, Xinmei; Paus, Christoph; Ralph, Duncan; Roland, Christof; Roland, Gunther; Salfeld-Nebgen, Jakob; Stephans, George; Sumorok, Konstanty; Varma, Mukund; Velicanu, Dragos; Veverka, Jan; Wang, Jing; Wang, Ta-Wei; Wyslouch, Bolek; Yang, Mingming; Zhukova, Victoria; Dahmes, Bryan; Evans, Andrew; Finkel, Alexey; Gude, Alexander; Hansen, Peter; Kalafut, Sean; Kao, Shih-Chuan; Klapoetke, Kevin; Kubota, Yuichi; Lesko, Zachary; Mans, Jeremy; Nourbakhsh, Shervin; Ruckstuhl, Nicole; Rusack, Roger; Tambe, Norbert; Turkewitz, Jared; Acosta, John Gabriel; Oliveros, Sandra; Avdeeva, Ekaterina; Bloom, Kenneth; Bose, Suvadeep; Claes, Daniel R; Dominguez, Aaron; Fangmeier, Caleb; Gonzalez Suarez, Rebeca; Kamalieddin, Rami; Keller, Jason; Knowlton, Dan; Kravchenko, Ilya; Meier, Frank; Monroy, Jose; Ratnikov, Fedor; Siado, Joaquin Emilo; Snow, Gregory R; Alyari, Maral; Dolen, James; George, Jimin; Godshalk, Andrew; Harrington, Charles; Iashvili, Ia; Kaisen, Josh; Kharchilava, Avto; Kumar, Ashish; Rappoccio, Salvatore; Roozbahani, Bahareh; Alverson, George; Barberis, Emanuela; Baumgartel, Darin; Chasco, Matthew; Hortiangtham, Apichart; Massironi, Andrea; Morse, David Michael; Nash, David; Orimoto, Toyoko; Teixeira De Lima, Rafael; Trocino, Daniele; Wang, Ren-Jie; Wood, Darien; Zhang, Jinzhong; Hahn, Kristan Allan; Kubik, Andrew; Mucia, Nicholas; Odell, Nathaniel; Pollack, Brian; Pozdnyakov, Andrey; Schmitt, Michael Henry; Stoynev, Stoyan; Sung, Kevin; Trovato, Marco; Velasco, Mayda; Brinkerhoff, Andrew; Dev, Nabarun; Hildreth, Michael; Jessop, Colin; Karmgard, Daniel John; Kellams, Nathan; Lannon, Kevin; Lynch, Sean; Marinelli, Nancy; Meng, Fanbo; Mueller, Charles; Musienko, Yuri; Pearson, Tessa; Planer, Michael; Reinsvold, Allison; Ruchti, Randy; Smith, Geoffrey; Taroni, Silvia; Valls, Nil; Wayne, Mitchell; Wolf, Matthias; Woodard, Anna; Antonelli, Louis; Brinson, Jessica; Bylsma, Ben; Durkin, Lloyd Stanley; Flowers, Sean; Hart, Andrew; Hill, Christopher; Hughes, Richard; Ji, Weifeng; Kotov, Khristian; Ling, Ta-Yung; Liu, Bingxuan; Luo, Wuming; Puigh, Darren; Rodenburg, Marissa; Winer, Brian L; Wulsin, Howard Wells; Driga, Olga; Elmer, Peter; Hardenbrook, Joshua; Hebda, Philip; Koay, Sue Ann; Lujan, Paul; Marlow, Daniel; Medvedeva, Tatiana; Mooney, Michael; Olsen, James; Palmer, Christopher; Piroué, Pierre; Saka, Halil; Stickland, David; Tully, Christopher; Zuranski, Andrzej; Malik, Sudhir; Barnes, Virgil E; Benedetti, Daniele; Bortoletto, Daniela; Gutay, Laszlo; Jha, Manoj; Jones, Matthew; Jung, Kurt; Miller, David Harry; Neumeister, Norbert; Radburn-Smith, Benjamin Charles; Shi, Xin; Shipsey, Ian; Silvers, David; Sun, Jian; Svyatkovskiy, Alexey; Wang, Fuqiang; Xie, Wei; Xu, Lingshan; Parashar, Neeti; Stupak, John; Adair, Antony; Akgun, Bora; Chen, Zhenyu; Ecklund, Karl Matthew; Geurts, Frank JM; Guilbaud, Maxime; Li, Wei; Michlin, Benjamin; Northup, Michael; Padley, Brian Paul; Redjimi, Radia; Roberts, Jay; Rorie, Jamal; Tu, Zhoudunming; Zabel, James; Betchart, Burton; Bodek, Arie; de Barbaro, Pawel; Demina, Regina; Eshaq, Yossof; Ferbel, Thomas; Galanti, Mario; Garcia-Bellido, Aran; Han, Jiyeon; Harel, Amnon; Hindrichs, Otto; Khukhunaishvili, Aleko; Petrillo, Gianluca; Tan, Ping; Verzetti, Mauro; Arora, Sanjay; Barker, Anthony; Chou, John Paul; Contreras-Campana, Christian; Contreras-Campana, Emmanuel; Duggan, Daniel; Ferencek, Dinko; Gershtein, Yuri; Gray, Richard; Halkiadakis, Eva; Hidas, Dean; Hughes, Elliot; Kaplan, Steven; Kunnawalkam Elayavalli, Raghav; Lath, Amitabh; Nash, Kevin; Panwalkar, Shruti; Park, Michael; Salur, Sevil; Schnetzer, Steve; Sheffield, David; Somalwar, Sunil; Stone, Robert; Thomas, Scott; Thomassen, Peter; Walker, Matthew; Foerster, Mark; Riley, Grant; Rose, Keith; Spanier, Stefan; York, Andrew; Bouhali, Othmane; Castaneda Hernandez, Alfredo; Dalchenko, Mykhailo; De Mattia, Marco; Delgado, Andrea; Dildick, Sven; Eusebi, Ricardo; Gilmore, Jason; Kamon, Teruki; Krutelyov, Vyacheslav; Mueller, Ryan; Osipenkov, Ilya; Pakhotin, Yuriy; Patel, Rishi; Perloff, Alexx; Rose, Anthony; Safonov, Alexei; Tatarinov, Aysen; Ulmer, Keith; Akchurin, Nural; Cowden, Christopher; Damgov, Jordan; Dragoiu, Cosmin; Dudero, Phillip Russell; Faulkner, James; Kunori, Shuichi; Lamichhane, Kamal; Lee, Sung Won; Libeiro, Terence; Undleeb, Sonaina; Volobouev, Igor; Appelt, Eric; Delannoy, Andrés G; Greene, Senta; Gurrola, Alfredo; Janjam, Ravi; Johns, Willard; Maguire, Charles; Mao, Yaxian; Melo, Andrew; Ni, Hong; Sheldon, Paul; Snook, Benjamin; Tuo, Shengquan; Velkovska, Julia; Xu, Qiao; Arenton, Michael Wayne; Cox, Bradley; Francis, Brian; Goodell, Joseph; Hirosky, Robert; Ledovskoy, Alexander; Li, Hengne; Lin, Chuanzhe; Neu, Christopher; Sinthuprasith, Tutanon; Sun, Xin; Wang, Yanchu; Wolfe, Evan; Wood, John; Xia, Fan; Clarke, Christopher; Harr, Robert; Karchin, Paul Edmund; Kottachchi Kankanamge Don, Chamath; Lamichhane, Pramod; Sturdy, Jared; Belknap, Donald; Carlsmith, Duncan; Cepeda, Maria; Dasu, Sridhara; Dodd, Laura; Duric, Senka; Gomber, Bhawna; Grothe, Monika; Hall-Wilton, Richard; Herndon, Matthew; Hervé, Alain; Klabbers, Pamela; Lanaro, Armando; Levine, Aaron; Long, Kenneth; Loveless, Richard; Mohapatra, Ajit; Ojalvo, Isabel; Perry, Thomas; Pierro, Giuseppe Antonio; Polese, Giovanni; Ruggles, Tyler; Sarangi, Tapas; Savin, Alexander; Sharma, Archana; Smith, Nicholas; Smith, Wesley H; Taylor, Devin; Woods, Nathaniel

    2017-01-24

    This paper describes the CMS trigger system and its performance during Run 1 of the LHC. The trigger system consists of two levels designed to select events of potential physics interest from a GHz (MHz) interaction rate of proton-proton (heavy ion) collisions. The first level of the trigger is implemented in hardware, and selects events containing detector signals consistent with an electron, photon, muon, $\\tau$ lepton, jet, or missing transverse energy. A programmable menu of up to 128 object-based algorithms is used to select events for subsequent processing. The trigger thresholds are adjusted to the LHC instantaneous luminosity during data taking in order to restrict the output rate to 100 kHz, the upper limit imposed by the CMS readout electronics. The second level, implemented in software, further refines the purity of the output stream, selecting an average rate of 400 Hz for offline event storage. The objectives, strategy and performance of the trigger system during the LHC Run 1 are described.

  3. Ceftazidime Injection

    Science.gov (United States)

    ... is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) infections; meningitis (infection of the membranes that surround the brain and spinal cord) and ... killing bacteria.Antibiotics such as ceftazidime injection will not work ...

  4. Teduglutide Injection

    Science.gov (United States)

    ... who need additional nutrition or fluids from intravenous (IV) therapy. Teduglutide injection is in a class of medications ... of the ingredients.tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking ...

  5. Dexrazoxane Injection

    Science.gov (United States)

    ... are used to treat or prevent certain side effects that may be caused by chemotherapy medications. Dexrazoxane injection (Zinecard) is used to prevent or decrease heart damage caused by doxorubicin in women who are taking the medication to treat breast cancer that has spread to other parts of the ...

  6. Dulaglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given dulaglutide developed tumors, but it ... your doctor will probably tell you not to use dulaglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  7. Albiglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given medications similar to albiglutide developed ... your doctor will probably tell you not to use albiglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  8. Semaglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given semaglutide developed tumors, but it ... your doctor will probably tell you not to use semaglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  9. Liraglutide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given liraglutide developed tumors, but it ... your doctor will probably tell you not to use liraglutide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  10. Exenatide Injection

    Science.gov (United States)

    ... thyroid carcinoma (MTC; a type of thyroid cancer). Laboratory animals who were given exenatide developed tumors, but it ... your doctor will probably tell you not to use exenatide injection. If you ... doctor and the laboratory. Your doctor may order certain tests to check ...

  11. Etoposide Injection

    Science.gov (United States)

    ... used in combination with other medications to treat cancer of the testicles that has not improved or that has worsened after treatment with other medications or radiation therapy. Etoposide injection ... type of lung cancer (small cell lung cancer; SCLC). Etoposide is in ...

  12. Cefepime Injection

    Science.gov (United States)

    ... infection because they have a low number of white blood cells. Cefepime injection is in a class ... In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has ...

  13. Triptorelin Injection

    Science.gov (United States)

    ... puberty too soon, resulting in faster than normal bone growth and development of sexual characteristics) in children 2 years and older. Triptorelin injection is in a class of medications called gonadotropin-releasing hormone (GnRH) agonists. It works by decreasing the amount ...

  14. On the evening of June 15, 2008, ALICE physicists saw the first tracks at LHC during the first injection test in transfer line TI 2. The Silicon Pixel detector recorded muon tracks produced in the beam dump near Point 2 of the LHC.

    CERN Multimedia

    Manzari, Vito

    2008-01-01

    On the evening of June 15, 2008, ALICE physicists saw the first tracks at LHC during the first injection test in transfer line TI 2. The Silicon Pixel detector recorded muon tracks produced in the beam dump near Point 2 of the LHC

  15. The ATLAS Tau Trigger

    CERN Document Server

    Rados, PK; The ATLAS collaboration

    2014-01-01

    Physics processes involving tau leptons play a crucial role in understanding particle physics at the high energy frontier. The ability to efficiently trigger on events containing hadronic tau decays is therefore of particular importance to the ATLAS experiment. During the 2012 run, the Large Hadronic Collder (LHC) reached instantaneous luminosities of nearly $10^{34} cm^{-2}s^{-1}$ with bunch crossings occurring every $50 ns$. This resulted in a huge event rate and a high probability of overlapping interactions per bunch crossing (pile-up). With this in mind it was necessary to design an ATLAS tau trigger system that could reduce the event rate to a manageable level, while efficiently extracting the most interesting physics events in a pile-up robust manner. In this poster the ATLAS tau trigger is described, its performance during 2012 is presented, and the outlook for the LHC Run II is briefly summarized.

  16. Microfabricated triggered vacuum switch

    Science.gov (United States)

    Roesler, Alexander W [Tijeras, NM; Schare, Joshua M [Albuquerque, NM; Bunch, Kyle [Albuquerque, NM

    2010-05-11

    A microfabricated vacuum switch is disclosed which includes a substrate upon which an anode, cathode and trigger electrode are located. A cover is sealed over the substrate under vacuum to complete the vacuum switch. In some embodiments of the present invention, a metal cover can be used in place of the trigger electrode on the substrate. Materials used for the vacuum switch are compatible with high vacuum, relatively high temperature processing. These materials include molybdenum, niobium, copper, tungsten, aluminum and alloys thereof for the anode and cathode. Carbon in the form of graphitic carbon, a diamond-like material, or carbon nanotubes can be used in the trigger electrode. Channels can be optionally formed in the substrate to mitigate against surface breakdown.

  17. Trigger and decision processors

    International Nuclear Information System (INIS)

    Franke, G.

    1980-11-01

    In recent years there have been many attempts in high energy physics to make trigger and decision processes faster and more sophisticated. This became necessary due to a permanent increase of the number of sensitive detector elements in wire chambers and calorimeters, and in fact it was possible because of the fast developments in integrated circuits technique. In this paper the present situation will be reviewed. The discussion will be mainly focussed upon event filtering by pure software methods and - rather hardware related - microprogrammable processors as well as random access memory triggers. (orig.)

  18. ALICE High Level Trigger

    CERN Multimedia

    Alt, T

    2013-01-01

    The ALICE High Level Trigger (HLT) is a computing farm designed and build for the real-time, online processing of the raw data produced by the ALICE detectors. Events are fully reconstructed from the raw data, analyzed and compressed. The analysis summary together with the compressed data and a trigger decision is sent to the DAQ. In addition the reconstruction of the events allows for on-line monitoring of physical observables and this information is provided to the Data Quality Monitor (DQM). The HLT can process event rates of up to 2 kHz for proton-proton and 200 Hz for Pb-Pb central collisions.

  19. Frictional stability and earthquake triggering during fluid pressure stimulation of an experimental fault

    Science.gov (United States)

    Scuderi, M. M.; Collettini, C.; Marone, C.

    2017-11-01

    It is widely recognized that the significant increase of M > 3.0 earthquakes in Western Canada and the Central United States is related to underground fluid injection. Following injection, fluid overpressure lubricates the fault and reduces the effective normal stress that holds the fault in place, promoting slip. Although, this basic physical mechanism for earthquake triggering and fault slip is well understood, there are many open questions related to induced seismicity. Models of earthquake nucleation based on rate- and state-friction predict that fluid overpressure should stabilize fault slip rather than trigger earthquakes. To address this controversy, we conducted laboratory creep experiments to monitor fault slip evolution at constant shear stress while the effective normal stress was systematically reduced via increasing fluid pressure. We sheared layers of carbonate-bearing fault gouge in a double direct shear configuration within a true-triaxial pressure vessel. We show that fault slip evolution is controlled by the stress state acting on the fault and that fluid pressurization can trigger dynamic instability even in cases of rate strengthening friction, which should favor aseismic creep. During fluid pressurization, when shear and effective normal stresses reach the failure condition, accelerated creep occurs in association with fault dilation; further pressurization leads to an exponential acceleration with fault compaction and slip localization. Our work indicates that fault weakening induced by fluid pressurization can overcome rate strengthening friction resulting in fast acceleration and earthquake slip. Our work points to modifications of the standard model for earthquake nucleation to account for the effect of fluid overpressure and to accurately predict the seismic risk associated with fluid injection.

  20. Triggering in Thermoacoustics

    Directory of Open Access Journals (Sweden)

    Matthew P. Juniper

    2012-09-01

    Full Text Available Under certain conditions, the flow in a combustion chamber can sustain large amplitude oscillations even when its steady state is linearly stable. Experimental studies show that these large oscillations can sometimes be triggered by very low levels of background noise. This theoretical paper sets out the conditions that are necessary for triggering to occur. It uses a weakly nonlinear analysis to show when these conditions will be satisfied for cases where the heat release rate is a function of the acoustic velocity. The role played by non-normality is investigated. It is shown that, when a state triggers to sustained oscillations from the lowest possible energy, it exploits transient energy growth around an unstable limit cycle. The positions of these limit cycles in state space is determined by nonlinearity, but the tangled-ness of trajectories in state space is determined by non-normality. When viewed in this dynamical systems framework, triggering in thermoacoustics is seen to be directly analogous to bypass transition to turbulence in pipe flow.

  1. Solated Muon Trigger

    CERN Document Server

    Albajar, Carmen

    2000-01-01

    An Isolated Muon L1 Trigger is proposed to reject muons from decays of b and c-quarks preserving high efficiency for muons from heavier objects. It is shown that the proposed algorithm is feasible and significant rejection factor ( 3-10) can be achieved. Similar algorithm can be applied at L2.

  2. Dealing with Asthma Triggers

    Science.gov (United States)

    ... one trigger that you shouldn't avoid because exercise is important for your health. Your doctor will want you to be active, so talk with him or her about what to do before playing ... or 15 minutes before you exercise or play sports. And, of course, you'll ...

  3. The ATLAS Level-1 Central Trigger System 012

    CERN Document Server

    Borrego-Amaral, P; Farthouat, Philippe; Gällnö, P; Haller, J; Maeno, T; Pauly, T; Schuler, G; Spiwoks, R; Torga-Teixeira, R; Wengler, T; Pessoa-Lima, H; De Seixas, J M

    2004-01-01

    The central part of the ATLAS Level-1 trigger system consists of the Central Trigger Processor (CTP), the Local Trigger Processors (LTPs), the Timing, Trigger and Control (TTC) system, and the Read-out Driver Busy (ROD_BUSY) modules. The CTP combines information from calorimeter and muon trigger processors, as well as from other sources and makes the final Level-1 Accept decision (L1A) on the basis of lists of selection criteria, implemented as a trigger menu. Timing and trigger signals are fanned out to about 40 LTPs which inject them into the sub-detector TTC partitions. The LTPs also support stand-alone running and can generate all necessary signals from memory. The TTC partitions fan out the timing and trigger signals to the sub-detector front-end electronics. The ROD_BUSY modules receive busy signals from the front-end electronics and send them to the CTP (via an LTP) to throttle the generation of L1As. An overview of the ATLAS Level-1 Central trigger system will be presented, with emphasis on the design...

  4. A comparison of molding procedures - Contact, injection and vacuum injection

    Science.gov (United States)

    Cathiard, G.

    1980-06-01

    The technical and economic aspects of the contact, injection and vacuum injection molding of reinforced plastic components are compared for the example of a tractor roof with a gel-coated surface. Consideration is given to the possibility of reinforcement, number of smooth faces, condition of the gel-coated surface, reliability, and labor and workplace requirements of the three processes, and advantages of molding between the mold and a countermold in smooth faces, reliability, labor requirements, working surface and industrial hygiene are pointed out. The times and labor requirements of each step in the molding cycles are examined, and material requirements and yields, investment costs, amortization and product cost prices of the processes are compared. It is concluded that, for the specific component examined, the processes of vacuum injection and injection molding appear very interesting, with injection molding processes resulting in lower cost prices than contact molding for any production volume.

  5. ELM mitigation with pellet ELM triggering and implications for PFCs and plasma performance in ITER

    International Nuclear Information System (INIS)

    Baylor, L.R.; Lang, P.T.; Allen, S.L.; Combs, S.K.; Commaux, N.; Evans, T.E.; Fenstermacher, M.E.; Huijsmans, G.; Jernigan, T.C.; Lasnier, C.J.; Leonard, A.W.; Loarte, A.; Maingi, R.; Maruyama, S.; Meitner, S.J.; Moyer, R.A.; Osborne, T.H.

    2015-01-01

    The triggering of rapid small edge localized modes (ELMs) by high frequency pellet injection has been proposed as a method to prevent large naturally occurring ELMs that can erode the ITER plasma facing components (PFCs). Deuterium pellet injection has been used to successfully demonstrate the on-demand triggering of edge localized modes (ELMs) at much higher rates and with much smaller intensity than natural ELMs. The proposed hypothesis for the triggering mechanism of ELMs by pellets is the local pressure perturbation resulting from reheating of the pellet cloud that can exceed the local high-n ballooning mode threshold where the pellet is injected. Nonlinear MHD simulations of the pellet ELM triggering show destabilization of high-n ballooning modes by such a local pressure perturbation. A review of the recent pellet ELM triggering results from ASDEX Upgrade (AUG), DIII-D, and JET reveals that a number of uncertainties about this ELM mitigation technique still remain. These include the heat flux impact pattern on the divertor and wall from pellet triggered and natural ELMs, the necessary pellet size and injection location to reliably trigger ELMs, and the level of fueling to be expected from ELM triggering pellets and synergy with larger fueling pellets. The implications of these issues for pellet ELM mitigation in ITER and its impact on the PFCs are presented along with the design features of the pellet injection system for ITER

  6. ELM mitigation with pellet ELM triggering and implications for PFCs and plasma performance in ITER

    Science.gov (United States)

    Baylor, L. R.; Lang, P. T.; Allen, S. L.; Combs, S. K.; Commaux, N.; Evans, T. E.; Fenstermacher, M. E.; Huijsmans, G.; Jernigan, T. C.; Lasnier, C. J.; Leonard, A. W.; Loarte, A.; Maingi, R.; Maruyama, S.; Meitner, S. J.; Moyer, R. A.; Osborne, T. H.

    2015-08-01

    The triggering of rapid small edge localized modes (ELMs) by high frequency pellet injection has been proposed as a method to prevent large naturally occurring ELMs that can erode the ITER plasma facing components (PFCs). Deuterium pellet injection has been used to successfully demonstrate the on-demand triggering of edge localized modes (ELMs) at much higher rates and with much smaller intensity than natural ELMs. The proposed hypothesis for the triggering mechanism of ELMs by pellets is the local pressure perturbation resulting from reheating of the pellet cloud that can exceed the local high-n ballooning mode threshold where the pellet is injected. Nonlinear MHD simulations of the pellet ELM triggering show destabilization of high-n ballooning modes by such a local pressure perturbation. A review of the recent pellet ELM triggering results from ASDEX Upgrade (AUG), DIII-D, and JET reveals that a number of uncertainties about this ELM mitigation technique still remain. These include the heat flux impact pattern on the divertor and wall from pellet triggered and natural ELMs, the necessary pellet size and injection location to reliably trigger ELMs, and the level of fueling to be expected from ELM triggering pellets and synergy with larger fueling pellets. The implications of these issues for pellet ELM mitigation in ITER and its impact on the PFCs are presented along with the design features of the pellet injection system for ITER.

  7. The ATLAS Tau Trigger

    International Nuclear Information System (INIS)

    Rados, Petar Kevin

    2013-06-01

    The tau lepton plays a crucial role in understanding particle physics at the Tera scale. One of the most promising probes of the Higgs boson coupling to fermions is with detector signatures involving taus. In addition, many theories beyond the Standard Model, such as supersymmetry and exotic particles (W' and Z'), predict new physics with large couplings to taus. The ability to trigger on hadronic tau decays is therefore critical to achieving the physics goals of the ATLAS experiment. The higher instantaneous luminosities of proton-proton collisions achieved by the Large Hadron Collider (LHC) in 2012 resulted in a larger probability of overlap (pile-up) between bunch crossings, and so it was critical for ATLAS to have an effective tau trigger strategy. The details of this strategy are summarized in this paper, and the results of the latest performance measurements are presented. (authors)

  8. Minimum risk trigger indices

    International Nuclear Information System (INIS)

    Tingey, F.H.

    1979-01-01

    A viable safeguards system includes among other things the development and use of indices which trigger various courses of action. The usual limit of error calculation provides such an index. The classical approach is one of constructing tests which, under certain assumptions, make the likelihood of a false alarm small. Of concern also is the test's failure to indicate a loss (diversion) when in fact one has occurred. Since false alarms are usually costly and losses both costly and of extreme strategic sinificance, there remains the task of balancing the probability of false alarm and its consequences against the probability of undetected loss and its consequences. The application of other than classical hypothesis testing procedures are considered in this paper. Using various consequence models, trigger indices are derived which have certain optimum properties. Application of the techniques would enhance the material control function

  9. The LPS trigger system

    International Nuclear Information System (INIS)

    Benotto, F.; Costa, M.; Staiano, A.; Zampieri, A.; Bollito, M.; Isoardi, P.; Pernigotti, E.; Sacchi, R.; Trapani, P.P.; Larsen, H.; Massam, T.; Nemoz, C.

    1996-03-01

    The Leading Proton Spectrometer (LPS) has been equipped with microstrip silicon detectors specially designed to trigger events with high values of x L vertical stroke anti p' p vertical stroke / vertical stroke anti p p vertical stroke ≥0.95 where vertical stroke anti p' p vertical stroke and vertical stroke anti p p vertical stroke are respectively the momenta of outgoing and incoming protons. The LPS First Level Trigger can provide a clear tag for very high momentum protons in a kinematical region never explored before. In the following we discuss the physics motivation in tagging very forward protons and present a detailed description of the detector design, the front end electronics, the readout electronics, the Monte Carlo simulation and some preliminary results from 1995 data taking. (orig.)

  10. GLAST's GBM Burst Trigger

    Science.gov (United States)

    Band, D.; Briggs, M.; Connaughton, V.; Kippen, M.; Preece, R.

    2003-01-01

    The GLAST Burst Monitor (GBM) will detect and localize bursts for the GLAST mission, and provide the spectral and temporal context in the traditional 10 keV to 25 MeV band for the high energy observations by the Large Area Telescope (LAT). The GBM will use traditional rate triggers in up to three energy bands, and on a variety of timescales between 16 ms and 16 s.

  11. The ARGUS vertex trigger

    International Nuclear Information System (INIS)

    Koch, N.; Kolander, M.; Kolanoski, H.; Siegmund, T.; Bergter, J.; Eckstein, P.; Schubert, K.R.; Waldi, R.; Imhof, M.; Ressing, D.; Weiss, U.; Weseler, S.

    1995-09-01

    A fast second level trigger has been developed for the ARGUS experiment which recognizes tracks originating from the interaction region. The processor compares the hits in the ARGUS Micro Vertex Drift Chamber to 245760 masks stored in random access memories. The masks which are fully defined in three dimensions are able to reject tracks originating in the wall of the narrow beampipe of 10.5 mm radius. (orig.)

  12. Neural networks for triggering

    International Nuclear Information System (INIS)

    Denby, B.; Campbell, M.; Bedeschi, F.; Chriss, N.; Bowers, C.; Nesti, F.

    1990-01-01

    Two types of neural network beauty trigger architectures, based on identification of electrons in jets and recognition of secondary vertices, have been simulated in the environment of the Fermilab CDF experiment. The efficiencies for B's and rejection of background obtained are encouraging. If hardware tests are successful, the electron identification architecture will be tested in the 1991 run of CDF. 10 refs., 5 figs., 1 tab

  13. Physics issues on triggering

    Indian Academy of Sciences (India)

    The detector at the international linear collider (ILC) should be able to run 'trig- gerless' which means that all events can be read out and then be analysed with the offline reconstruction program in a trigger farm. The event rates for 'high Q2' events like W-pairs or q¯q are low, about 0.1/train. However, there is a significant.

  14. Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats

    Directory of Open Access Journals (Sweden)

    Fei Meng

    2015-01-01

    Full Text Available Myofascial trigger points (MTrPs are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P0.05. 30 min after the injection, MPTs at MTrSs were significantly lower than those of non-MTrSs (P<0.01. Therefore, we concluded that proliferated myelinated afferents existed at MTrSs, which were closely related to pathology of SEA and mechanical hyperalgesia of MTrSs.

  15. Estudo comparativo entre toxina botulínica e bupivacaína para infiltração de pontos-gatilho em síndrome miofascial crônica Estudio comparativo entre toxina botulínica y bupivacaína para infiltración de puntos-gatillo en síndrome miofascial crónica Comparative study between botulin toxin and bupivacaine for triggering-points infiltration in chronic myofascial syndrome

    Directory of Open Access Journals (Sweden)

    Eduardo Keiichi Unno

    2005-04-01

    . Pain intensity was evaluated through verbal numeric scale and quality of analgesia was evaluated by patients in moments zero (before injection, 30 minutes after, and at 1, 2, 3, 4, 5, 6, 7 and 8 weeks. Results were submitted to statistical analysis (Mann-Whitney and Fisher Exact tests. RESULTS: After 30 minutes, 1 and 4 weeks, pain intensity was lower for G1 as compared to G2. After 2, 3, 5, 7 and 8 weeks, there was no significant difference between groups. Quality of analgesia was considered better by G1 patients as compared to G2, except after 2 weeks. CONCLUSIONS: Analgesic effect was better with botulin toxin (25U as compared to 0.25% bupivacaine for triggering-points infiltration.

  16. The Fast Interaction Trigger Upgrade for ALICE

    CERN Document Server

    Garcia-Solis, Edmundo

    2016-01-01

    The ALICE Collaboration is preparing a major detector upgrade for the second LHC long shutdown (2019–20). The LHC heavy-ion luminosity and collision rate from 2021 onwards will considerably exceed the design parameters of the present ALICE forward trigger detectors. Furthermore, the introduction of a new Muon Forward Tracker (MFT) will significantly reduce the space available for the upgraded trigger detectors. To comply with these conditions a Fast Interaction Trigger (FIT) has been designed. FIT will be the primary forward trigger, luminosity, and collision time measurement detector. The FIT will be capable of triggering at an interaction rate of 50 kHz, with a time resolution better than 30 ps, with 99% efficiency. It will also determine multiplicity, centrality, and reaction plane. FIT will consist of two arrays of Cherenkov radiators with MCP-PMT sensors and of a single, large-size scintillator ring. The arrays will be placed on both sides of the interaction point (IP). Because of the presence of the h...

  17. Simulation and Validation of the ATLAS Level-1 Topological Trigger

    CERN Document Server

    Bakker, Pepijn Johannes; The ATLAS collaboration

    2017-01-01

    The ATLAS experiment has recently commissioned a new component of its first-level trigger: the L1 topological trigger. This system, using state-of-the-art FPGA processors, makes it possible to reject events by applying topological requirements, such as kinematic criteria involving clusters, jets, muons, and total transverse energy. The data recorded using the L1Topological trigger demonstrates that this innovative trigger strategy allows for an improved rejection rate without efficiency loss. This improvement has been shown for several relevant physics processes leading to low-$p_T$ leptons, including $H\\to{}\\tau{}\\tau{}$ and $J/\\Psi\\to{}\\mu{}\\mu{}$. In addition, an accurate simulation of the L1Topological trigger is used to validate and optimize the performance of this trigger. To reach such an accuracy, this simulation must take into account the fact that the firmware algorithms are executed on a FPGA architecture, while the simulation is executed on a floating point architecture.

  18. ATLAS Tau Trigger

    CERN Document Server

    Belanger-Champagne, C; Bosman, M; Brenner, R; Casado, MP; Czyczula, Z; Dam, M; Demers, S; Farrington, S; Igonkina, O; Kalinowski, A; Kanaya, N; Osuna, C; Pérez, E; Ptacek, E; Reinsch, A; Saavedra, A; Sopczak, A; Strom, D; Torrence, E; Tsuno, S; Vorwerk, V; Watson, A; Xella, S

    2008-01-01

    Moving to the high energy scale of the LHC, the identification of tau leptons will become a necessary and very powerful tool, allowing a discovery of physics beyond Standard Model. Many models, among them light SM Higgs and various SUSY models, predict an abundant production of taus with respect to other leptons. The reconstruction of hadronic tau decays, although a very challenging task in hadronic enviroments, allows to increase a signal efficiency by at least of factor 2, and provides an independent control sample to disantangle lepton tau decays from prompt electrons and muons. Thanks to the advanced calorimetry and tracking, the ATLAS experiment has developed tools to efficiently identify hadronic taus at the trigger level. In this presentation we will review the characteristics of taus and the methods to suppress low-multiplicity, low-energy jets contributions as well as we will address the tau trigger chain which provide a rejection rate of 10^5. We will further present plans for commissioning the ATLA...

  19. The D0 calorimeter trigger

    International Nuclear Information System (INIS)

    Guida, J.

    1992-12-01

    The D0 calorimeter trigger system consists of many levels to make physics motivated trigger decisions. The Level-1 trigger uses hardware techniques to reduce the trigger rate from ∼ 100kHz to 200Hz. It forms sums of electromagnetic and hadronic energy, globally and in towers, along with finding the missing transverse energy. A minimum energy is set on these energy sums to pass the event. The Level-2 trigger is a set of software filters, operating in a parallel-processing microvax farm which further reduces the trigger rate to a few Hertz. These filters will reject events which lack electron candidates, jet candidates, or missing transverse energy in the event. The performance of these triggers during the early running of the D0 detector will also be discussed

  20. Minimum Bias Trigger in ATLAS

    CERN Document Server

    Kwee, R E; The ATLAS collaboration

    2010-01-01

    Since the restart of the LHC in November 2009, ATLAS has collected inelastic pp-collisions to perform first measurements on charged particle densities. These measurements will help to constrain various models describing phenomenologically soft parton interactions. Understanding the trigger efficiencies for different event types are therefore crucial to minimize any possible bias in the event selection. ATLAS uses two main minimum bias triggers, featuring complementary detector components and trigger levels. While a hardware based first trigger level situated in the forward regions with 2.09 < |eta| < 3.8 has been proven to select pp-collisions very efficiently, the Inner Detector based minimum bias trigger uses a random seed on filled bunches and central tracking detectors for the event selection. Both triggers were essential for the analysis of kinematic spectra of charged particles. Their performance and trigger efficiency measurements as well as studies on possible bias sources will be presen...

  1. Alcoholic drinks as triggers in primary headaches.

    Science.gov (United States)

    Panconesi, Alessandro; Franchini, Michela; Bartolozzi, Maria Letizia; Mugnai, Stefania; Guidi, Leonello

    2013-08-01

    This project aims to investigate the role of alcoholic drinks (ADs) as triggers for primary headaches. Patients followed in the Headache Centre and presenting with migraine without aura, migraine with aura (MA), chronic migraine (CM), and tension-type headache (TH) were asked if their headache was precipitated by AD and also about their alcohol habits. Individual characteristics and drink habits were evaluated within two binary logistic models. About one half (49.7%) of patients were abstainers, 17.6% were habitual consumers, and 32.5% were occasional consumers. Out of 448 patients, only 22 (4.9%), all with migraine, reported AD as a trigger factor. None of 44 patients with MA and none of 47 patients with TH reported AD as a trigger factor. Among those patients with migraine who consume AD, only 8% reported that AD can precipitate their headache. Multivariate analyses showed that AD use, both occasional and habitual, is unrelated to TH. Moreover, analysis performed among migraine patients, points out that occasional and habitual drinkers have a lower risk of presenting with CM than abstainers, although statistical significance occurred only among occasional drinkers. Only 3% of migraine patients who abstain from AD reported that they do not consume alcohol because it triggers their headache. Our study shows that AD acts as headache triggers in a small percentage of migraine patients. Differing from some prior studies, our data suggest that AD do not trigger MA and TH attacks. Moreover, the percentage of abstainers in our sample is higher compared with that reported in general population surveys. Wiley Periodicals, Inc.

  2. The ZEUS second level calorimeter trigger

    International Nuclear Information System (INIS)

    Jong, S.J. de.

    1990-01-01

    ZEUS is a detector for the HERA ep collider, consisting of several large components. The most important being the inner tracking detectors, which are positioned nearest to the interaction point, the calorimeter surrounding the inner tracking detectors and the muon detectors on the outside of the experimental setup. Each component will deliver a vast amount of information. In order to keep this information manageable, data is preprocessed and condensed per component and then combined to obtain the final global trigger result. The main subject of this thesis is the second level calorimeter trigger processor of the ZEUS detector. In order to be able to reject the unwanted events passing the first level, the topological event signature will have to be used at the second level. The most demanding task of the second level is the recognition of local energy depositions corresponding to isolated electrons and hadron jets. Also part of the work performed by the first level will be repeated with a higher level of accuracy. Additional information not available to the first level trigger will be processed and will be made available to the global second level trigger decision module. For the second level calorimeter trigger processor a special VME module, containing two transputers, has been developed. The second level calorimeter trigger algorithm described in this thesis was tested with simulated events, that were tracked through a computer simulation of the ZEUS detector. A part of this thesis is therefore devoted to the description of the various Monte Carlo models and the justification of the way in which they were used. (author). 132 refs.; 76 figs.; 18 tabs

  3. Out-of-plane integration of a multimode optical fiber for single particle/cell detection at multiple points on a microfluidic device with applications to particle/cell counting, velocimetry, size discrimination and the analysis of single cell lysate injections.

    Science.gov (United States)

    Sadeghi, Jalal; Patabadige, Damith E W; Culbertson, Anne H; Latifi, Hamid; Culbertson, Christopher T

    2016-12-20

    In this paper a single particle/cell-tracking microfluidic device that integrates an out-of-plane multimode optical fiber (OP-MMF) is reported. This OP-MMF is used to generate three excitation light-lines and three detection spots using only one excitation source and one detector. It takes advantage of an optical tunneling mode to create two excitation lines in a microfluidic channel emanating from a single fiber end. This method was used to accurately count particles/cells and perform velocity measurements and size discrimination. The velocity and size distributions of 5, 7, and 10 μm fluorescently labeled polystyrene beads were determined using the OP-MMF. Additionally, this method was used to analyze cell lysates with the third excitation line in the separation channel. The OP-MMF setup accurately detected an intact cell twice ∼2 mm prior to lysis, determined its velocity, and detected the injected cell lysate 3 mm downstream of the injection point in the separation channel. Using this setup, the velocity of cells entering the lysis intersection and the absolute migration times of fluorescently labeled analytes injected into the separation channel were determined in an automated fashion. This method enabled us to determine a lysing/injection efficiency coefficient (K) using signals from the injected lysate signal and from the intact cell before lysing. K provided a reliable measurement of the amount of cell lysate that was injected into the separation channel. The approach reported here could be used in the future to track particles, cells or droplets in a variety of existing microfluidic devices without the need for multiplexed masks, layers, bulky optical elements or complex optical designs.

  4. Arctic climate tipping points.

    Science.gov (United States)

    Lenton, Timothy M

    2012-02-01

    There is widespread concern that anthropogenic global warming will trigger Arctic climate tipping points. The Arctic has a long history of natural, abrupt climate changes, which together with current observations and model projections, can help us to identify which parts of the Arctic climate system might pass future tipping points. Here the climate tipping points are defined, noting that not all of them involve bifurcations leading to irreversible change. Past abrupt climate changes in the Arctic are briefly reviewed. Then, the current behaviour of a range of Arctic systems is summarised. Looking ahead, a range of potential tipping phenomena are described. This leads to a revised and expanded list of potential Arctic climate tipping elements, whose likelihood is assessed, in terms of how much warming will be required to tip them. Finally, the available responses are considered, especially the prospects for avoiding Arctic climate tipping points.

  5. Triggering at high luminosity: fake triggers from pile-up

    International Nuclear Information System (INIS)

    Johnson, R.

    1983-01-01

    Triggers based on a cut in transverse momentum (p/sub t/) have proved to be useful in high energy physics both because they indicte that a hard constituent scattering has occurred and because they can be made quickly enough to gate electronics. These triggers will continue to be useful at high luminosities if overlapping events do not cause an excessive number of fake triggers. In this paper, I determine if this is indeed a problem at high luminosity machines

  6. Nostalgia: content, triggers, functions.

    Science.gov (United States)

    Wildschut, Tim; Sedikides, Constantine; Arndt, Jamie; Routledge, Clay

    2006-11-01

    Seven methodologically diverse studies addressed 3 fundamental questions about nostalgia. Studies 1 and 2 examined the content of nostalgic experiences. Descriptions of nostalgic experiences typically featured the self as a protagonist in interactions with close others (e.g., friends) or in momentous events (e.g., weddings). Also, the descriptions contained more expressions of positive than negative affect and often depicted the redemption of negative life scenes by subsequent triumphs. Studies 3 and 4 examined triggers of nostalgia and revealed that nostalgia occurs in response to negative mood and the discrete affective state of loneliness. Studies 5, 6, and 7 investigated the functional utility of nostalgia and established that nostalgia bolsters social bonds, increases positive self-regard, and generates positive affect. These findings demarcate key landmarks in the hitherto uncharted research domain of nostalgia.

  7. Compressed air injection technique to standardize block injection pressures.

    Science.gov (United States)

    Tsui, Ban C H; Li, Lisa X Y; Pillay, Jennifer J

    2006-11-01

    Presently, no standardized technique exists to monitor injection pressures during peripheral nerve blocks. Our objective was to determine if a compressed air injection technique, using an in vitro model based on Boyle's law and typical regional anesthesia equipment, could consistently maintain injection pressures below a 1293 mmHg level associated with clinically significant nerve injury. Injection pressures for 20 and 30 mL syringes with various needle sizes (18G, 20G, 21G, 22G, and 24G) were measured in a closed system. A set volume of air was aspirated into a saline-filled syringe and then compressed and maintained at various percentages while pressure was measured. The needle was inserted into the injection port of a pressure sensor, which had attached extension tubing with an injection plug clamped "off". Using linear regression with all data points, the pressure value and 99% confidence interval (CI) at 50% air compression was estimated. The linearity of Boyle's law was demonstrated with a high correlation, r = 0.99, and a slope of 0.984 (99% CI: 0.967-1.001). The net pressure generated at 50% compression was estimated as 744.8 mmHg, with the 99% CI between 729.6 and 760.0 mmHg. The various syringe/needle combinations had similar results. By creating and maintaining syringe air compression at 50% or less, injection pressures will be substantially below the 1293 mmHg threshold considered to be an associated risk factor for clinically significant nerve injury. This technique may allow simple, real-time and objective monitoring during local anesthetic injections while inherently reducing injection speed.

  8. Short-term efficacy of joint and soft tissue injections for musculoskeletal pain: An interventional cohort study.

    Science.gov (United States)

    Sucuoğlu, Hamza; Süzen Özbayrak, Sibel; Uludağ, Murat; Tüzün, Şansın

    2016-04-01

    Musculoskeletal injections (MIs) are frequently used in conservative treatment-resistant cases. Joint or soft tissue (ST) corticosteroid (CS) or local anesthetic (LA) injections can be used to relieve musculoskeletal pain. Assessed in the present study was the short-term efficacy of MIs for pain relief, as was the relative efficacy of injections in various joint and ST sites. An interventional prospective cohort design was employed in the present study. Joint or ST injections for musculoskeletal pathologies were performed in patients over 18 years of age who were resistant to conservative treatment methods. Pain during rest and activity were evaluated using visual analog scale (VAS) by different clinicians prior to treatment and 3 weeks after. At the end of the study, efficacy at 7 injection sites (myofascial trigger points, shoulder, knee, lateral epicondyle, plantar fascia, lumbar, and coccyx regions) was analyzed. Injections were administered to 225 of the 250 patients included. A total of 128 patients, of whom 94 were female, completed the study. Resting VAS values before and after treatment were 4.35±1.49 and 1.63±1.74, respectively. Activity VAS values before and after treatment were 8.41±1.33 and 4.04±2.37, respectively. Changes in resting and activity VAS values were significant (ppain were observed at all injection sites following treatment. Significant improvement in pain scores was observed 3 weeks after injections among all injection sites. LA or CS injections can be used safely and efficiently for pain relief over short time periods.

  9. ATLAS trigger: Design and commissioning

    Science.gov (United States)

    Pastore, F.; Atlas Collaboration

    2012-12-01

    The ATLAS detector at CERN's Large Hadron Collider (LHC) will be exposed to proton-proton collisions from beams crossing at 40 MHz. A three-level trigger system was designed to select potentially interesting events and reduce the incoming rate to 100-200 Hz. The first trigger level (LVL1) is implemented in custom-built electronics, the second and third trigger levels are realised in software. The trigger system and its design parameters will be described with focus on computing and data aquision challenges. The results from both commissioning cosmic runs and first experiences from the LHC beam in 2008 will be overviewed. These running periods allowed us to exercise the trigger system online, including its configuration and monitoring infrastructure, as well as reconstruction and selection algorithms. The details on the plans for commissioning the ATLAS trigger when the LHC starts operations will be presented.

  10. Flexible trigger menu implementation on the Global Trigger for the CMS Level-1 trigger upgrade

    Science.gov (United States)

    MATSUSHITA, Takashi; CMS Collaboration

    2017-10-01

    The CMS experiment at the Large Hadron Collider (LHC) has continued to explore physics at the high-energy frontier in 2016. The integrated luminosity delivered by the LHC in 2016 was 41 fb‑1 with a peak luminosity of 1.5 × 1034 cm‑2s‑1 and peak mean pile-up of about 50, all exceeding the initial estimations for 2016. The CMS experiment has upgraded its hardware-based Level-1 trigger system to maintain its performance for new physics searches and precision measurements at high luminosities. The Global Trigger is the final step of the CMS Level-1 trigger and implements a trigger menu, a set of selection requirements applied to the final list of objects from calorimeter and muon triggers, for reducing the 40 MHz collision rate to 100 kHz. The Global Trigger has been upgraded with state-of-the-art FPGA processors on Advanced Mezzanine Cards with optical links running at 10 GHz in a MicroTCA crate. The powerful processing resources of the upgraded system enable implementation of more algorithms at a time than previously possible, allowing CMS to be more flexible in how it handles the available trigger bandwidth. Algorithms for a trigger menu, including topological requirements on multi-objects, can be realised in the Global Trigger using the newly developed trigger menu specification grammar. Analysis-like trigger algorithms can be represented in an intuitive manner and the algorithms are translated to corresponding VHDL code blocks to build a firmware. The grammar can be extended in future as the needs arise. The experience of implementing trigger menus on the upgraded Global Trigger system will be presented.

  11. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Safe injection procedures, injection practices, and needlestick injuries among health care workers in operating rooms. Nermine Mohamed Tawfik Foda, Noha Selim Mohamed Elshaer, Yasmine Hussein Mohamed Sultan ...

  12. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Nermine Mohamed Tawfik Foda

    2017-01-10

    Jan 10, 2017 ... tionnaire was administered to HCWs (n = 318) at the Alexandria Main University Hospital. Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while mea- sures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices ...

  13. Penicillin G Procaine Injection

    Science.gov (United States)

    Penicillin G procaine injection is used to treat certain infections caused by bacteria. Penicillin G procaine injection should not be used to treat ... in the treatment of certain serious infections. Penicillin G procaine injection is in a class of medications ...

  14. Thermally activated trigger device

    International Nuclear Information System (INIS)

    Harty, R.B.; Camaret, T.L.

    1988-01-01

    This patent describes a nuclear space reactor, a thermally activated trigger device for rendering the reactor subcritical upon reentry to the earth's atmosphere, the device comprising: a closed vessel, a piston slideably mounted in the vessel to divide it into first and second compartments, an inert gas contained within each of the compartments at substantially the same pressure, a connecting rod operatively connected to the piston and to actuator means, the actuator means providing for moving means for rendering the reactor subcritical upon movement of the connecting rod; a bellows having opposite ends, one of the ends being affixed to and in sealing engagement with the connecting rod and the other of the ends being affixed to and in sealing engagement with the vessel for permitting linear movement of the connecting rod and preventing any escape of the inert gas from the closed vessel; and normally closed pipes communicating with one of the compartments for venting the inert gas therefrom when any of the pipes is open, the pipes being located at different parts of the nuclear space reactor so that the closed ends thereof are exposed to the atmosphere upon reentry of the reactor to the atmosphere. The pipes are designed to open at a selected temperature resulting from the reentry so that the gas leaves the communicating compartment via an open pipe to cause a difference in pressure between the compartments sufficient for the higher pressure in the other compartment to move the piston and thereby activate the actuator means

  15. Trigger and data acquisition

    CERN Multimedia

    CERN. Geneva; Gaspar, C

    2001-01-01

    Past LEP experiments generate data at 0.5 MByte/s from particle detectors with over a quarter of a million readout channels. The process of reading out the electronic channels, treating them, and storing the date produced by each collision for further analysis by the physicists is called "Data Acquisition". Not all beam crossings produce interesting physics "events", picking the interesting ones is the task of the "Trigger" system. In order to make sure that the data is collected in good conditions the experiment's operation has to be constantly verified. In all, at LEP experiments over 100 000 parameters were monitored, controlled, and synchronized by the "Monotoring and control" system. In the future, LHC experiments will produce as much data in a single day as a LEP detector did in a full year's running with a raw data rate of 10 - 100 MBytes/s and will have to cope with some 800 million proton-proton collisions a second of these collisions only one in 100 million million is interesting for new particle se...

  16. Tipping Point

    Medline Plus

    Full Text Available ... en español Blog About OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point The Tipping Point by ... danger death electrical fall furniture head injury product safety television tipover tv Watch the video in Adobe ...

  17. The TOTEM modular trigger system

    Energy Technology Data Exchange (ETDEWEB)

    Bagliesi, M.G., E-mail: mg.bagliesi@pi.infn.i [University of Siena and INFN Pisa (Italy); Berretti, M.; Cecchi, R.; Greco, V.; Lami, S.; Latino, G.; Oliveri, E.; Pedreschi, E.; Scribano, A.; Spinella, F.; Turini, N. [University of Siena and INFN Pisa (Italy)

    2010-05-21

    The TOTEM experiment will measure the total cross-section with the luminosity independent method and study elastic and diffractive scattering at the LHC. We are developing a modular trigger system, based on programmable logic, that will select meaningful events within 2.5{mu}s. The trigger algorithm is based on a tree structure in order to obtain information compression. The trigger primitive is generated directly on the readout chip, VFAT, that has a specific fast output that gives low resolution hits information. In two of the TOTEM detectors, Roman Pots and T2, a coincidence chip will perform track recognition directly on the detector readout boards, while for T1 the hits are transferred from the VFATs to the trigger hardware. Starting from more than 2000 bits delivered by the detector electronics, we extract, in a first step, six trigger patterns of 32 LVDS signals each; we build, then, on a dedicated board, a 1-bit (L1) trigger signal for the TOTEM experiment and 16 trigger bits to the CMS experiment global trigger system for future common data taking.

  18. The TOTEM modular trigger system

    International Nuclear Information System (INIS)

    Bagliesi, M.G.; Berretti, M.; Cecchi, R.; Greco, V.; Lami, S.; Latino, G.; Oliveri, E.; Pedreschi, E.; Scribano, A.; Spinella, F.; Turini, N.

    2010-01-01

    The TOTEM experiment will measure the total cross-section with the luminosity independent method and study elastic and diffractive scattering at the LHC. We are developing a modular trigger system, based on programmable logic, that will select meaningful events within 2.5μs. The trigger algorithm is based on a tree structure in order to obtain information compression. The trigger primitive is generated directly on the readout chip, VFAT, that has a specific fast output that gives low resolution hits information. In two of the TOTEM detectors, Roman Pots and T2, a coincidence chip will perform track recognition directly on the detector readout boards, while for T1 the hits are transferred from the VFATs to the trigger hardware. Starting from more than 2000 bits delivered by the detector electronics, we extract, in a first step, six trigger patterns of 32 LVDS signals each; we build, then, on a dedicated board, a 1-bit (L1) trigger signal for the TOTEM experiment and 16 trigger bits to the CMS experiment global trigger system for future common data taking.

  19. Upgrade trigger: Biannual performance update

    CERN Document Server

    Aaij, Roel; Couturier, Ben; Esen, Sevda; De Cian, Michel; De Vries, Jacco Andreas; Dziurda, Agnieszka; Fitzpatrick, Conor; Fontana, Marianna; Grillo, Lucia; Hasse, Christoph; Jones, Christopher Rob; Le Gac, Renaud; Matev, Rosen; Neufeld, Niko; Nikodem, Thomas; Polci, Francesco; Del Buono, Luigi; Quagliani, Renato; Schwemmer, Rainer; Seyfert, Paul; Stahl, Sascha; Szumlak, Tomasz; Vesterinen, Mika Anton; Wanczyk, Joanna; Williams, Mark Richard James; Yin, Hang; Zacharjasz, Emilia Anna

    2017-01-01

    This document presents the performance of the LHCb Upgrade trigger reconstruction sequence, incorporating changes to the underlying reconstruction algorithms and detector description since the Trigger and Online Upgrade TDR. An updated extrapolation is presented using the most recent example of an Event Filter Farm node.

  20. ITER Neutral Beam Injection System

    International Nuclear Information System (INIS)

    Ohara, Yoshihiro; Tanaka, Shigeru; Akiba, Masato

    1991-03-01

    A Japanese design proposal of the ITER Neutral Beam Injection System (NBS) which is consistent with the ITER common design requirements is described. The injection system is required to deliver a neutral deuterium beam of 75MW at 1.3MeV to the reactor plasma and utilized not only for plasma heating but also for current drive and current profile control. The injection system is composed of 9 modules, each of which is designed so as to inject a 1.3MeV, 10MW neutral beam. The most important point in the design is that the injection system is based on the utilization of a cesium-seeded volume negative ion source which can produce an intense negative ion beam with high current density at a low source operating pressure. The design value of the source is based on the experimental values achieved at JAERI. The utilization of the cesium-seeded volume source is essential to the design of an efficient and compact neutral beam injection system which satisfies the ITER common design requirements. The critical components to realize this design are the 1.3MeV, 17A electrostatic accelerator and the high voltage DC acceleration power supply, whose performances must be demonstrated prior to the construction of ITER NBI system. (author)

  1. Cost of Immediate Surgery Versus Non-operative Treatment for Trigger Finger in Diabetic Patients.

    Science.gov (United States)

    Luther, Gaurav Aman; Murthy, Praveen; Blazar, Philip E

    2016-11-01

    As health care costs continue to rise, providers must increasingly identify and implement cost-effective practice measures without sacrificing quality of care. Corticosteroid injections are an established treatment for trigger finger; however, numerous clinical trials have documented the limited efficacy of these injections in the diabetic population. Furthermore, the most cost-effective treatment strategy for diabetic trigger finger has not been determined. The purpose of this study was to perform a decision analysis to identify the least costly strategy for effective treatment of diabetic trigger finger using existing evidence in the literature. Four treatment strategies for diabetic trigger finger were identified: (1) 1 steroid injection followed by surgical release, (2) 2 steroid injections followed by surgical release, (3) immediate surgical release in the operating room, and (4) immediate surgical release in the clinic. A literature review was conducted to determine success rates of the different treatment strategies. Costing analysis was performed using our institutional reimbursement from Medicare. One-way sensitivity and threshold analysis was utilized to determine the least costly treatment strategy. The least costly treatment strategy was immediate surgical release in the clinic. In patients with insulin-dependent diabetes mellitus, this strategy results in a 32% and a 39% cost reduction when compared with treatment with 1 or 2 corticosteroid injections, respectively. For 1 or 2 corticosteroid injections to be the most cost-effective strategy, injection failure rates would need to be less than 36% and 34%, respectively. The overall cost of care for immediate surgical release in the clinic was $642. Diabetic trigger finger is a common problem faced by hand surgeons, with a variety of acceptable treatment algorithms. Management of diabetic trigger finger with immediate surgical release in the clinic is the most cost-effective treatment strategy, assuming a

  2. LHC MD 2042: Persistent Injection Oscillations

    CERN Document Server

    Karpov, Ivan; Argyropoulos, Theodoros; Baudrenghien, Philippe; Chapochnikova, Elena; Timko, Helga; CERN. Geneva. ATS Department

    2018-01-01

    This MD note summarizes the measurements performed to study persistent longitudinal oscillations after injection into the LHC. It was found that they build up due to mismatch, and can lead to particle losses and uncontrolled bunch lengthening. For the first time, profile measurements and ObsBox data acquisitions were triggered at injection to obtain first-turn data. The measurements took place on 16th September 2017 between 14:30 and 19:30, and between 27th November 2017 20:00 and 28th November 2017 04:00.

  3. ATLAS Trigger: design and commissioning

    CERN Document Server

    Pastore, F; The ATLAS collaboration

    2009-01-01

    The ATLAS detector at CERN's Large Hadron Collider (LHC) will be exposed to proton-proton collisions from beams crossing at 40 MHz. A three-level trigger system was designed to select potentially interesting events and reduce the incoming rate to 100-200 Hz. The first trigger level (LVL1) is implemented in custom-built electronics, the second and third trigger levels are realised in software. Based on calorimeter information and hits in dedicated muon-trigger detectors, the LVL1 decision is made by the central-trigger processor yielding an output rate of less than 100 kHz. The allowed latency for the trigger decision at this stage is less than 2.5 micro seconds. The two subsequent levels, called, High-Level Trigger (HLT) further reduce the rate to the offline storage rate while retaining the most interesting physics. The HLT is implemented in software running in commercially available computer farms and consists of Level 2 and Event Filter. To reduce the network data traffic and the processing time to managea...

  4. The ATLAS Missing ET trigger

    CERN Document Server

    Beauchemin, P; The ATLAS collaboration

    2010-01-01

    Over the last few months, the ATLAS detector collected 900 GeV LHC collision events which allowed for the study the performance of the ATLAS Trigger and Data Acquisition system (TDAQ). With the 7 TeV collision data collected recently, the performance studies of the trigger system are critical for a successful physics program. In particular a large spectrum of physics results will rely on the capacity of the ATLAS TDAQ system to collect events based on the estimate of the missing transverse energy (MET) contained in each event. The MET trigger would be, for example, the primary trigger to be used in new physics searches for processes involving new weakly interacting particles, which could account for the astronomically observed dark matter. In addition to discovery perspectives, the MET trigger can also be used in combination with other triggers to control the rate of signatures involving low energy objects. For example, the MET trigger is necessary in order to measure non-boosted W in the tau channel. Finally...

  5. VLF wave injections from the ground

    Science.gov (United States)

    Helliwell, R. A.

    1983-01-01

    Experiments on wave-particle interactions using VLF whistler-mode waves injected into the magnetosphere from Antartica are described. The injected signals are single-frequency coherent waves whose amplitudes and frequencies may be changed slowly with time, or else two or more coherent wave trains transmitted simultaneously to determine the nature of the response to multifrequency excitation. The waves may be amplified 30 dB or more and may trigger intense emissions having bandwidths that vary from a few to several hundred Hertz. In most cases significant growth and triggering occur only when the driving signal is essentially monochromatic (bandwidth 10 Hz). If two frequencies are transmitted simultaneously the signal at the lower frequency tends to be suppressed by 20 dB or more. These results are interpreted in terms of a feedback interaction between the waves and counter-streaming cyclotron resonant electrons in a region several hundred wavelengths long, centered on the magnetic equator.

  6. A calorimeter trigger system for the ISR axial field spectrometer

    International Nuclear Information System (INIS)

    Rosselet, L.

    1981-01-01

    A fast and flexible trigger processor system designed to run in parallel up to 51 different types of trigger is used in a large hadron calorimeter experiment at CERN-ISR. A very fast data bus connected to 255 10 bit address ECE memory chips allows programmable selection of events according to their topology and energy pattern in less than 150 ns. In addition this system can interrogate two programmable processors (ESOP) to isolate events characterized by a large energy flow in the central drift chamber (< 500 μs). All functions of the trigger processor can be checked externally by a computer through injecting in parallel simulated input signals into various stages of the system. Salient features and performances will be discussed. (orig.)

  7. The ITER disruption mitigation trigger: developing its preliminary design

    Science.gov (United States)

    Pautasso, G.; de Vries, P. C.; Humphreys, D.; Lehnen, M.; Rapson, C.; Raupp, G.; Snipes, J. A.; Treutterer, W.; Vergara-Fernandez, A.; Zabeo, L.

    2018-03-01

    A concept for the generation of the trigger for the ITER disruption mitigation system is described in this paper. The issuing of the trigger will be the result of a complex decision process, taken by the plasma control system, or by the central interlock system, determining that the plasma is unavoidably going to disrupt—or has disrupted—and that a fast mitigated shut-down is required. Given the redundancy of the mitigation system, the plasma control system must also formulate an injection scheme and specify when and how the injectors of the mitigation system should be activated. The parameters and the conceptual algorithms required for the configuration and generation of the trigger are discussed.

  8. Nanocomposite thin films for triggerable drug delivery.

    Science.gov (United States)

    Vannozzi, Lorenzo; Iacovacci, Veronica; Menciassi, Arianna; Ricotti, Leonardo

    2018-05-01

    Traditional drug release systems normally rely on a passive delivery of therapeutic compounds, which can be partially programmed, prior to injection or implantation, through variations in the material composition. With this strategy, the drug release kinetics cannot be remotely modified and thus adapted to changing therapeutic needs. To overcome this issue, drug delivery systems able to respond to external stimuli are highly desirable, as they allow a high level of temporal and spatial control over drug release kinetics, in an operator-dependent fashion. Areas covered: On-demand drug delivery systems actually represent a frontier in this field and are attracting an increasing interest at both research and industrial level. Stimuli-responsive thin films, enabled by nanofillers, hold a tremendous potential in the field of triggerable drug delivery systems. The inclusion of responsive elements in homogeneous or heterogeneous thin film-shaped polymeric matrices strengthens and/or adds intriguing properties to conventional (bare) materials in film shape. Expert opinion: This Expert Opinion review aims to discuss the approaches currently pursued to achieve an effective on-demand drug delivery, through nanocomposite thin films. Different triggering mechanisms allowing a fine control on drug delivery are described, together with current challenges and possible future applications in therapy and surgery.

  9. Triggered Release from Polymer Capsules

    Energy Technology Data Exchange (ETDEWEB)

    Esser-Kahn, Aaron P. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Chemistry; Odom, Susan A. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Chemistry; Sottos, Nancy R. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Materials Science and Engineering; White, Scott R. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Aerospace Engineering; Moore, Jeffrey S. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Chemistry

    2011-07-06

    Stimuli-responsive capsules are of interest in drug delivery, fragrance release, food preservation, and self-healing materials. Many methods are used to trigger the release of encapsulated contents. Here we highlight mechanisms for the controlled release of encapsulated cargo that utilize chemical reactions occurring in solid polymeric shell walls. Triggering mechanisms responsible for covalent bond cleavage that result in the release of capsule contents include chemical, biological, light, thermal, magnetic, and electrical stimuli. We present methods for encapsulation and release, triggering methods, and mechanisms and conclude with our opinions on interesting obstacles for chemically induced activation with relevance for controlled release.

  10. Seismology: dynamic triggering of earthquakes.

    Science.gov (United States)

    Gomberg, Joan; Johnson, Paul

    2005-10-06

    After an earthquake, numerous smaller shocks are triggered over distances comparable to the dimensions of the mainshock fault rupture, although they are rare at larger distances. Here we analyse the scaling of dynamic deformations (the stresses and strains associated with seismic waves) with distance from, and magnitude of, their triggering earthquake, and show that they can cause further earthquakes at any distance if their amplitude exceeds several microstrain, regardless of their frequency content. These triggering requirements are remarkably similar to those measured in the laboratory for inducing dynamic elastic nonlinear behaviour, which suggests that the underlying physics is similar.

  11. ATLAS FTK: Fast Track Trigger

    CERN Document Server

    Amerio, S; The ATLAS collaboration; Andreazza, A; Annovi, A; Beretta, M; Bevacqua, V; Bogdan, M; Bossini, E; Boveia, A; Cavaliere, V; Canelli, F; Blazey, G; Cervigni, F; Cheng, Y; Citterio, M; Crescioli, F; Dell’Orso, M; Drake, G; Dunford, M; Giannetti, P; Giorgi, F; Hoff, J; Kapliy, A; Kasten, M; Kim, Y K; Kimura, N; Lanza, A; Liberali, V; Liu, T; Magalotti, D; McCarn, A; Melachrinos, C; Meroni, C; Negri, A; Neubauer, M; Penning, B; Piendibene, M; Proudfoot, J; Riva, M; Roda, C; Sabatini, F; Sacco, I; Shochet, M; Stabile, A; Tang, F; Tang, J; Tripiccione, R; Tuggle, J; Vercesi, V; Verzocchi, M; Villa, M; Vitillo, R A; Volpi, G; Webster, J; Wu, J; Yorita, K; Zhang, J

    2011-01-01

    A track reconstruction system for the trigger of the ATLAS detector at the Large Hadron Collider is described. The Fast Tracker is a highly parallel hardware system designed to operate at the Level-1 trigger output rate. It will provide high-quality tracks reconstructed over the entire inner detector by the start of processing in the Level-2 trigger. The system is based on associative memories for pattern recognition and fast FPGA’s for track reconstruction. Its design and expected performance under instantaneous luminosities up to 3 × 10^34/cm^2/s are discussed.

  12. Tipping Point

    Medline Plus

    Full Text Available ... OnSafety CPSC Stands for Safety The Tipping Point Home > 60 Seconds of Safety (Videos) > The Tipping Point ... 24 hours a day. For young children whose home is a playground, it’s the best way to ...

  13. Fixed Points

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 5; Issue 5. Fixed Points - From Russia with Love - A Primer of Fixed Point Theory. A K Vijaykumar. Book Review Volume 5 Issue 5 May 2000 pp 101-102. Fulltext. Click here to view fulltext PDF. Permanent link:

  14. The HLT inclusive B triggers

    CERN Document Server

    Gligorov, Vladimir V; Williams, Michael

    2011-01-01

    The inclusive HLT strategy relies on triggering any B decay based on two signatures: a single significantly displaced, high transverse momentum track, and a significantly displaced vertex containing this track and 1-3 other tracks, with high total transverse momentum. In order to provide optimal signal efficiency and background rejection the displaced vertex selection is implemented in a novel boosted decision tree algorithm incorporating information about the experimental resolution in the boosting procedure to protect against overtraining. The performance of these triggers has been commissioned using data taken during 2011 LHCb running and is evaluated here in a data-driven manner. The HLT inclusive triggers are found to have a rejection factor of around 1000 with respect to events selected by the L0 hardware trigger and a bbar purity close to 100%.

  15. GnRH agonist triggering

    DEFF Research Database (Denmark)

    Kol, Shahar; Humaidan, Peter; Al Humaidan, Peter Samir Heskjær

    2013-01-01

    The concept that a bolus of gonadotrophin-releasing hormone agonist (GnRHa) can replace human chorionic gonadotrophin (HCG) as a trigger of final oocyte maturation was introduced several years ago. Recent developments in the area strengthen this premise. GnRHa trigger offers important advantages......, including virtually complete prevention of ovarian hyperstimulation syndrome (OHSS), the introduction of a surge of FSH in addition to the LH surge and finally the possibility to individualize luteal-phase supplementation based on ovarian response to stimulation. We maintain that the automatic HCG...... triggering concept should be challenged and that the GnRHa trigger is the way to move forward with thoughtful consideration of the needs, safety and comfort of our patients. Routinely, human chorionic gonadotrophin (HCG) is used to induce ovulation in fertility treatments. This approach deviates...

  16. FERMIGTRIG - Fermi GBM Trigger Catalog

    Data.gov (United States)

    National Aeronautics and Space Administration — This table lists all of the triggers observed by one or more of the 14 GBM detectors (12 NaI and 2 BGO). Note that there are two Browse catalogs resulting from GBM...

  17. The CDF level-3 trigger

    International Nuclear Information System (INIS)

    Devlin, T.

    1993-01-01

    The Collider Detector at Fermilab (CDF) has been operating at the Tevatron and collecting data on proton-antiproton interactions with collision rates above 250,000 Hz. Three levels of filtering select events for data logging at a rate of about 4 Hz. The Level 3 trigger provides most of the capabilities of the offline production programs for event reconstruction and physics analysis. The type of physics triggers, application of cuts, and combinations of logical requirements for event selection are controlled at run time by a trigger table using a syntax fully integrated with the Level 1 and Level 2 hardware triggers. The level 3 software operates in 48 RISC/UNIX processors (over 1000 mips) served by four 20-MByte/sec data buses for input, output and control. The system architecture, debugging, code validation, error reporting, analysis capabilities and performance will be described

  18. Resin injection in clays with high plasticity

    Science.gov (United States)

    Nowamooz, Hossein

    2016-11-01

    Regarding the injection process of polyurethane resins in clays with high plasticity, this paper presents the experimental results of the pressuremeter and cone penetration tests before and after injection. A very important increase in pressure limit or in soil resistance can be observed for all the studied depths close to the injection points. An analytical analysis for cylindrical pore cavity expansion in cohesive frictional soils obeying the Mohr-Coulomb criterion was then used to reproduce the pressuremeter tests before and after injection. The model parameters were calibrated by maintaining constant the elasticity parameters as well as the friction angel before and after injection. A significant increase in cohesion was observed because of soil densification after resin expansion. The estimated undrained cohesions, derived from the parameters of the Mohr-Coulomb criterion, were also compared with the cone penetration tests. Globally, the model predictions show the efficiency of resin injection in clay soils with high plasticity.

  19. B physics triggers at CMS

    CERN Document Server

    Starodumov, Andrei

    2003-01-01

    The CMS detector is mainly designed to investigate hard events. Only few Level-1 Trigger conditions are suitable to select soft B-meson decays. The B-physics potential of CMS depends strongly on a selection strategy at High-Level Trigger. The selection algorithms for some benchmark B-decay channels that allow CMS to perform competitive B-physics program are presented.

  20. LHCb detector and trigger performance in Run II

    Science.gov (United States)

    Francesca, Dordei

    2017-12-01

    The LHCb detector is a forward spectrometer at the LHC, designed to perform high precision studies of b- and c- hadrons. In Run II of the LHC, a new scheme for the software trigger at LHCb allows splitting the triggering of events into two stages, giving room to perform the alignment and calibration in real time. In the novel detector alignment and calibration strategy for Run II, data collected at the start of the fill are processed in a few minutes and used to update the alignment, while the calibration constants are evaluated for each run. This allows identical constants to be used in the online and offline reconstruction, thus improving the correlation between triggered and offline selected events. The required computing time constraints are met thanks to a new dedicated framework using the multi-core farm infrastructure for the trigger. The larger timing budget, available in the trigger, allows to perform the same track reconstruction online and offline. This enables LHCb to achieve the best reconstruction performance already in the trigger, and allows physics analyses to be performed directly on the data produced by the trigger reconstruction. The novel real-time processing strategy at LHCb is discussed from both the technical and operational point of view. The overall performance of the LHCb detector on the data of Run II is presented as well.

  1. Characterization of pore volume of cumulative water injection distribution

    Directory of Open Access Journals (Sweden)

    Guoqing Feng

    2015-06-01

    Full Text Available Pore volume of Cumulative water injection is one of the factors for evaluating water flood effect in a water flood oil field. In previous study, there were limited lab studies for evaluating oil displacement efficiency. A method to characterize the distribution of pore volume of cumulative water injection is proposed in this paper, and it is verified by a five-spot water flooding streamline simulation model. The logarithmic relation between pore volume of cumulative water injection and water saturation is established by regression. An inflection point and limit point of cumulative water injection pore volume are identified. Current simulation model indicates inflection point appears after 2–5 pore volume (PV injection, and limit point appears after 15–25 PV injection. Both inflection and limit point vary in different regions of reservoir.

  2. Tipping Point

    Medline Plus

    Full Text Available ... Point by CPSC Blogger September 22, 2009 appliance child Childproofing CPSC danger death electrical fall furniture head ... see news reports about horrible accidents involving young children and furniture, appliance and tv tip-overs. The ...

  3. Simulation of rockfalls triggered by earthquakes

    Science.gov (United States)

    Kobayashi, Y.; Harp, E.L.; Kagawa, T.

    1990-01-01

    A computer program to simulate the downslope movement of boulders in rolling or bouncing modes has been developed and applied to actual rockfalls triggered by the Mammoth Lakes, California, earthquake sequence in 1980 and the Central Idaho earthquake in 1983. In order to reproduce a movement mode where bouncing predominated, we introduced an artificial unevenness to the slope surface by adding a small random number to the interpolated value of the mid-points between the adjacent surveyed points. Three hundred simulations were computed for each site by changing the random number series, which determined distances and bouncing intervals. The movement of the boulders was, in general, rather erratic depending on the random numbers employed, and the results could not be seen as deterministic but stochastic. The closest agreement between calculated and actual movements was obtained at the site with the most detailed and accurate topographic measurements. ?? 1990 Springer-Verlag.

  4. Flexible trigger menu implementation on the Global Trigger for the CMS Level-1 trigger upgrade

    CERN Document Server

    Matsushita, Takashi

    2017-01-01

    The CMS experiment at the Large Hadron Collider (LHC) has continued to explore physics at the high-energy frontier in 2016. The integrated luminosity delivered by the LHC in 2016 was 41~fb$^{-1}$ with a peak luminosity of 1.5 $\\times$ 10$^{34}$ cm$^{-2}$s$^{-1}$ and peak mean pile-up of about 50, all exceeding the initial estimations for 2016. The CMS experiment has upgraded its hardware-based Level-1 trigger system to maintain its performance for new physics searches and precision measurements at high luminosities. The Global Trigger is the final step of the CMS \\mbox{Level-1} trigger and implements a trigger menu, a set of selection requirements applied to the final list of objects from calorimeter and muon triggers, for reducing the 40 MHz collision rate to 100 kHz. The Global Trigger has been upgraded with state-of-the-art FPGA processors on Advanced Mezzanine Cards with optical links running at 10 GHz in a MicroTCA crate. The powerful processing resources of the upgraded system enable implemen...

  5. TileGap3 Correction in ATLAS Jet Triggers

    CERN Document Server

    Carmiggelt, Joris Jip

    2017-01-01

    Study done to correct for the excess of jets in the TileGap3 (TG3) region of the ATLAS detector. Online leading jet pt is scaled down proportional to its energy fraction in TG3. This study shows that such a correction is undesirable for high pt triggers, since it leads to a slow turn-on and thus high losses in triggerrates. For low pt triggers there seems to be some advantageous effects as counts are slightly reduced below the 95% efficiency point of the trigger. There is, however, a pay-off: An increase of missed counts above the 95% efficiency point due to an shifting of the turn-on curve. Suggestion for further research are made to compensate for this and optimise the correction.

  6. Evaluation and investigation of regional cerebral blood flow by 1 point arterial blood collection method using 99mTc-ECD. Intravenous injection for 4 minutes with constant speed

    International Nuclear Information System (INIS)

    Itoh, Takeo; Shibata, Kazuhiro; Sudoh, Hideaki; Tanaka, Masato; Itoh, Kenjiro; Ueno, Yasushi

    1998-01-01

    Regional cerebral blood flow (rCBF) was measured using a 99m Tc-ECD through the 4-min constant intravenous infusion/one point arterial blood sampling method, proposed by Nakagawara et al. of Nakamura Memorial Hospital, and 133Xenon ( 133 Xe)-SPECT was performed on the same subjects to investigate the reproducibility of this method. We also determined whether cerebral blood flow (CBF) could be measured on the day of blood sampling through dilution of the obtained blood because it was difficult to measure the radioactivity in the blood on the day of blood sampling by this method. More, we investigated fixation of an octanol extraction rate and the substitution of venous blood for arterial blood in this method. The results revealed that CBF measured by this method with a 99m Tc-ECD were closely correlated to those measured by 133 Xe-SPECT, indicating the reliability as a method of measuring CBF. rCBF could be measured on the day of blood sampling through appropriate dilution of the obtained arterial blood. Octanol extraction rates were almost constant, indicating possible omission of cumbersome extraction procedure by fixation. However, the substitution of venous blood for arterial blood showed no correlation under the study system examined. (author)

  7. External triggering and triggered targeting strategies for drug delivery

    Science.gov (United States)

    Wang, Yanfei; Kohane, Daniel S.

    2017-06-01

    Drug delivery systems that are externally triggered to release drugs and/or target tissues hold considerable promise for improving the treatment of many diseases by minimizing nonspecific toxicity and enhancing the efficacy of therapy. These drug delivery systems are constructed from materials that are sensitive to a wide range of external stimuli, including light, ultrasound, electrical and magnetic fields, and specific molecules. The responsiveness conferred by these materials allows the release of therapeutics to be triggered on demand and remotely by a physician or patient. In this Review, we describe the rationales for such systems and the types of stimuli that can be deployed, and provide an outlook for the field.

  8. Trigger processing using reconfigurable logic in the CMS calorimeter trigger

    CERN Document Server

    Brooke, J J; Heath, G P; Maddox, A J; Newbold, D; Rabbetts, P D

    2001-01-01

    We present the design of the Global Calorimeter Trigger processor for the CMS detector at LHC. This is a fully pipelined processor system which collects data from all the CMS calorimeters and produces summary information used in forming the Level-1 trigger decision for each event. The design in based on the use of state-of-the-art reconfigurable logic devices (FPGAs) and fast data links. We present the results of device testing using a low-latency pipelined sort algorithm, which demonstrate that an FPGA can be used to perform processing previously foreseen to require custom ASICs. Our design approach results in a powerful, flexible and compact processor system. (0 refs).

  9. Cluster beam injection

    International Nuclear Information System (INIS)

    Bottiglioni, F.; Coutant, J.; Fois, M.

    1977-11-01

    Areas of possible applications of cluster injection are discussed. The deposition inside the plasma of molecules, issued from the dissociation of the injected clusters, has been computed. Some empirical scaling laws for the penetration are given

  10. Cluster beam injection

    International Nuclear Information System (INIS)

    Bottiglioni, F.; Coutant, J.; Fois, M.

    1978-01-01

    Areas of possible applications of cluster injection are discussed. The deposition inside the plasma of molecules, issued from the dissociation of the injected clusters, has been computed. Some empirical scaling laws for the penetration are given

  11. Sodium Ferric Gluconate Injection

    Science.gov (United States)

    Sodium ferric gluconate injection is used to treat iron-deficiency anemia (a lower than normal number of ... are also receiving the medication epoetin (Epogen, Procrit). Sodium ferric gluconate injection is in a class of ...

  12. Aminocaproic Acid Injection

    Science.gov (United States)

    Aminocaproic acid injection is used to control bleeding that occurs when blood clots are broken down too quickly. This ... the baby is ready to be born). Aminocaproic acid injection is also used to control bleeding in ...

  13. Deoxycholic Acid Injection

    Science.gov (United States)

    Deoxycholic acid injection is used to improve the appearance and profile of moderate to severe submental fat ('double chin'; fatty tissue located under the chin). Deoxycholic acid injection is in a class of medications called ...

  14. Corticotropin, Repository Injection

    Science.gov (United States)

    ... injection is used to treat the following conditions:infantile spasms (seizures that usually begin during the first year ... tell how corticotropin repository injection works to treat infantile spasms.

  15. Review Document: Full Software Trigger

    CERN Document Server

    Albrecht, J; Raven, G

    2014-01-01

    This document presents a trigger system for the upgraded LHCb detector, scheduled to begin operation in 2020. This document serves as input for the internal review towards the "DAQ, online and trigger TDR". The proposed trigger system is implemented entirely in software. In this document we show that track reconstruction of a similar quality to that available in the offline algorithms can be performed on the full inelastic $pp$-collision rate, without prior event selections implemented in custom hardware and without relying upon a partial event reconstruction. A track nding eciency of 98.8 % relative to oine can be achieved for tracks with $p_T >$ 500 MeV/$c$. The CPU time required for this reconstruction is about 40 % of the available budget. Proof-of-principle selections are presented which demonstrate that excellent performance is achievable using an inclusive beauty trigger, in addition to exclusive beauty and charm triggers. Finally, it is shown that exclusive beauty and charm selections that do not intr...

  16. Geothermal injection monitoring project

    Energy Technology Data Exchange (ETDEWEB)

    Younker, L.

    1981-04-01

    Background information is provided on the geothermal brine injection problem and each of the project tasks is outlined in detail. These tasks are: evaluation of methods of monitoring the movement of injected fluid, preparation for an eventual field experiment, and a review of groundwater regulations and injection programs. (MHR)

  17. Injection moulding antireflective nanostructures

    DEFF Research Database (Denmark)

    Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik; Mortensen, N. Asger

    2014-01-01

    in an injection moulding process, to fabricate the antireflective surfaces. The cycle-time was 35 s. The injection moulded structures had a height of 125 nm, and the visible spectrum reflectance of injection moulded black polypropylene surfaces was reduced from 4.5±0.5% to 2.5±0.5%. The gradient of the refractive...

  18. Injection moulding antireflective nanostructures

    DEFF Research Database (Denmark)

    Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik; Mortensen, N. Asger

    in an injection moulding process, to fabricate the antireflective surfaces. The cycle-time was 35 s. The injection moulded structures had a height of 125 nm, and the visible spectrum reflectance of injection moulded black polypropylene surfaces was reduced from 4.5±0.5% to 2.5±0.5%. The gradient of the refractive...

  19. Identificação do linfonodo sentinela no câncer de mama com injeção subdérmica periareolar em quatro pontos do radiofármaco Sentinel lymph node identification in breast cancer using periareolar and subdermal injection of the radiopharmaceutical in four points

    Directory of Open Access Journals (Sweden)

    Afrânio Coelho-Oliveira

    2004-08-01

    Full Text Available Este estudo visa identificar o linfonodo sentinela por meio da injeção exclusiva de radiofármaco periareolar subdérmico em quatro pontos, independente da topografia do tumor. A biópsia do linfonodo sentinela diminui a morbidade no estadiamento da axila. Foram realizadas 57 biópsias do linfonodo sentinela, em pacientes com câncer de mama, prospectivamente, em dois grupos: grupo A (25 pacientes e grupo B (32 pacientes. Realizamos a injeção do radiofármaco peritumoral no grupo A, e nova técnica periareolar em quatro pontos no grupo B. A biópsia do linfonodo sentinela foi estudada por "imprint" citológico e hematoxilina e eosina, seguida de linfadenectomia axilar no grupo A e nos casos positivos do grupo B. No grupo A foram identificados 88% (22/25 de linfonodos sentinelas, não houve falso-negativo, com sensibilidade e especificidade de 100%; no grupo B foram identificados 96% (31/32 de linfonodos sentinelas e valor preditivo positivo de 100%. O número de linfonodos sentinelas variou de 1 a 7, moda de 1 e média de 2,7, a área de maior captação variou de 10 a 100 vezes. A injeção periareolar em quatro pontos se apresenta como bom método no mapeamento linfático para identificação do linfonodo sentinela. A padronização deste sítio pode ser o de escolha para identificação do linfonodo sentinela, sendo necessário maior número de casos para confirmação destes achados.The aim of this study was to identify the sentinel node by periareolar injection of the radiopharmaceutical in four points, regardless of tumor topography. The sentinel node biopsy reduces morbidity in axillary staging. Fifty-seven sentinel node biopsies were prospectively performed in two groups: group A (25 patients and group B (32 patients. The peritumoral injection technique was used in group A and the new injection technique in four points was used in group B. The sentinel node biopsies were studied by imprint cytology and hematoxilin and eosin staining

  20. A Study of a Subsea Chemicals Storage & Injection-Station

    OpenAIRE

    Lundal, Vegard; Festøy, Sigurd van Dijk

    2017-01-01

    Total and Doris have announced that they want to challenge the way of thinking of how to supply subsea field developments with chemicals. With a Subsea Chemicals Storage & Injection-station (SCS&I) the chemicals are injected much closer to their injection points compared to a conventional solution, where they are injected from a topside facility. This reduces the response time of hydrate inhibitors which leads to a shorter well shutdown/start-up operation. Also, dosing of production chemicals...

  1. Fast processor for dilepton triggers

    International Nuclear Information System (INIS)

    Katsanevas, S.; Kostarakis, P.; Baltrusaitis, R.

    1983-01-01

    We describe a fast trigger processor, developed for and used in Fermilab experiment E-537, for selecting high-mass dimuon events produced by negative pions and anti-protons. The processor finds candidate tracks by matching hit information received from drift chambers and scintillation counters, and determines their momenta. Invariant masses are calculated for all possible pairs of tracks and an event is accepted if any invariant mass is greater than some preselectable minimum mass. The whole process, accomplished within 5 to 10 microseconds, achieves up to a ten-fold reduction in trigger rate

  2. Upgrade trigger: Bandwidth strategy proposal

    CERN Document Server

    Fitzpatrick, Conor; Meloni, Simone; Boettcher, Thomas Julian; Whitehead, Mark Peter; Dziurda, Agnieszka; Vesterinen, Mika Anton

    2017-01-01

    This document describes a selection strategy for the upgrade trigger using charm signals as a benchmark. The Upgrade trigger uses a 'Run 2-like' sequence consisting of a first and second stage, in between which the calibration and alignment is performed. The first stage, HLT1, uses an inclusive strategy to select beauty and charm decays, while the second stage uses offline-quality exclusive selections. A novel genetic algorithm-based bandwidth division is performed at the second stage to distribute the output bandwidth among different physics channels, maximising the efficiency for useful physics events. The performance is then studied as a function of the available output bandwidth.

  3. Rosacea Triggers: Alcohol and Smoking.

    Science.gov (United States)

    Alinia, Hossein; Tuchayi, Sara Moradi; Patel, Nupur U; Patel, Nishit; Awosika, Olabola; Bahrami, Naeim; Cardwell, Leah A; Richardson, Irma; Huang, Karen E; Feldman, Steven R

    2018-04-01

    A variety of triggers are thought to exacerbate rosacea. A validated self-assessment tool and survey was used to study the relationship between rosacea severity and triggers. Subjects were adult patients with a clinical diagnosis of rosacea. Increased severity of disease was significantly associated with consumption of many alcoholic beverages in 1 day and employment at a job requiring extensive sun exposure. The authors' findings may inform physician counseling practices; patients may be provided with practical measures for managing their rosacea, such as limiting alcohol consumption over short periods of time and increasing sun protection, especially in the summer. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. IMAGE ANALYSIS DEDICATED TO POLYMER INJECTION MOLDING

    Directory of Open Access Journals (Sweden)

    David Garcia

    2011-05-01

    Full Text Available This work follows the general framework of polymer injection moulding simulation whose objectives are the mastering of the injection moulding process. The models of numerical simulation make it possible to predict the propagation of the molten polymer during the filling phase from the positioning of one point of injection or more. The objective of this paper is to propose a particular way to optimize the geometry of mold cavity in accordance with physical laws. A direct correlation is pointed out between geometric parameters issued from skeleton transformation and Hausdorff's distance and results provided by implementation of a classical model based on the Hele-Shaw equations which are currently used in the main computer codes of polymer injection.

  5. Communication between Trigger/DAQ and DCS in ATLAS

    International Nuclear Information System (INIS)

    Burckhart, H.; Jones, R.; Hart, R.; Khomoutnikov, V.; Ryabov, Y.

    2001-01-01

    Within the ATLAS experiment Trigger/DAQ and DCS are both logically and physically separated. Nevertheless there is a need to communicate. The initial problem definition and analysis suggested three subsystems the Trigger/DAQ DCS Communication (DDC) project should support the ability to: 1. exchange data between Trigger/DAQ and DCS; 2. send alarm messages from DCS to Trigger/DAQ; 3. issue commands to DCS from Trigger/DAQ. Each subsystem is developed and implemented independently using a common software infrastructure. Among the various subsystems of the ATLAS Trigger/DAQ the Online is responsible for the control and configuration. It is the glue connecting the different systems such as data flow, level 1 and high-level triggers. The DDC uses the various Online components as an interface point on the Trigger/DAQ side with the PVSS II SCADA system on the DCS side and addresses issues such as partitioning, time stamps, event numbers, hierarchy, authorization and security. PVSS II is a commercial product chosen by CERN to be the SCADA system for all LHC experiments. Its API provides full access to its database, which is sufficient to implement the 3 subsystems of the DDC software. The DDC project adopted the Online Software Process, which recommends a basic software life-cycle: problem statement, analysis, design, implementation and testing. Each phase results in a corresponding document or in the case of the implementation and testing, a piece of code. Inspection and review take a major role in the Online software process. The DDC documents have been inspected to detect flaws and resulted in a improved quality. A first prototype of the DDC is ready and foreseen to be used at the test-beam during summer 2001

  6. Alkaline sorbent injection for mercury control

    Science.gov (United States)

    Madden, Deborah A.; Holmes, Michael J.

    2002-01-01

    A mercury removal system for removing mercury from combustion flue gases is provided in which alkaline sorbents at generally extremely low stoichiometric molar ratios of alkaline earth or an alkali metal to sulfur of less than 1.0 are injected into a power plant system at one or more locations to remove at least between about 40% and 60% of the mercury content from combustion flue gases. Small amounts of alkaline sorbents are injected into the flue gas stream at a relatively low rate. A particulate filter is used to remove mercury-containing particles downstream of each injection point used in the power plant system.

  7. Conflict-Triggered Top-Down Control: Default Mode, Last Resort, or No Such Thing?

    Science.gov (United States)

    Bugg, Julie M.

    2014-01-01

    The conflict monitoring account posits that globally high levels of conflict trigger engagement of top-down control; however, recent findings point to the mercurial nature of top-down control in high conflict contexts. The current study examined the potential moderating effect of associative learning on conflict-triggered top-down control…

  8. Triggering on Long-Lived Neutral Particles in the ATLAS Detector

    CERN Document Server

    Aad, G; Abdallah, J; Abdelalim, A A; Abdesselam, A; Abdinov, O; Abi, B; Abolins, M; Abramowicz, H; Acerbi, E; Acharya, B S; Adams, D L; Addy, T N; Adelman, J; Adorisio, C; Adragna, P; Adye, T; Aefsky, S; Aguilar Saavedra, J A; Aharrouche, M; Ahlen, S P; Ahles, F; Ahmad, A; Ahmed, H; Ahsan, M; Aielli, G; Akdogan, T; Akesson, T P A; Akimoto, G; Akimov, A V; Alam, M S; Alam, M A; Albert, J; Albrand, S; Aleksa, M; Aleksandrov, I N; Alexa, C; Alexander, G; Alexandre, G; Alexopoulos, T; Alhroob, M; Aliev, M; Alimonti, G; Alison, J; Aliyev, M; Allport, P P; Allwood-Spiers, S E; Aloisio, A; Alon, R; Alonso, A; Alviggi, M G; Amako, K; Amelung, C; Ammosov, V V; Amorim, A; Amorós, G; Amram, N; Anastopoulos, C; Anders, C F; Anderson, K J; Andreazza, A; Andrei, V; Anduaga, X S; Angerami, A; Anghinolfi, F; Anjos, N; Antonaki, A; Antonelli, M; Antonelli, S; Antunovic, B; Anulli, F; Arabidze, G; Aracena, I; Arai, Y; Arce, A T H; Archambault, J P; Arfaoui, S; Arguin, J-F; Argyropoulos, T; Arik, M; Armbruster, A J; Arnaez, O; Arnault, C; Artamonov, A; Arutinov, D; Asai, M; Asai, S; Asfandiyarov, R; Ask, S; Asman, B; Asner, D; Asquith, L; Assamagan, K; Astbury, A; Astvatsatourov, A; Atoian, G; Auerbach, B; Auge, E; Augsten, K; Aurousseau, M; Austin, N; Avolio, G; Avramidou, R; Axen, D; Ay, C; Azuelos, G; Azuma, Y; Baak, M A; Bacci, C; Bach, A; Bachacou, H; Bachas, K; Backes, M; Badescu, E; Bagnaia, P; Bai, Y; Bailey, D C; Bain, T; Baines, J T; Baker, O K; Baker, M D; Baltasar Dos Santos Pedrosa, F; Banas, E; Banerjee, P; Banerjee, S; Banfi, D; Bangert, A; Bansal, V; Baranov, S P; Baranov, S; Barashkou, A; Barber, T; Barberio, E L; Barberis, D; Barbero, M; Bardin, D Y; Barillari, T; Barisonzi, M; Barklow, T; Barlow, N; Barnett, B M; Barnett, R M; Baroncelli, A; Barr, A J; Barreiro, F; Barreiro Guimaraes da Costa, J; Barrillon, P; Barros, N; Bartoldus, R; Bartsch, D; Bastos, J; Bates, R L; Bathe, S; Batley, J R; Battaglia, A; Battistin, M; Bauer, F; Bazalova, M; Beare, B; Beauchemin, P H; Beccherle, R; Becerici, N; Bechtle, P; Beck, G A; Beck, H P; Beckingham, M; Becks, K H; Beddall, A J; Beddall, A; Bednyakov, V A; Bee, C; Begel, M; Behar Harpaz, S; Behera, P K; Beimforde, M; Belanger- Champagne, C; Bell, P J; Bell, W H; Bella, G; Bellagamba, L; Bellina, F; Bellomo, M; Belloni, A; Belotskiy, K; Beltramello, O; Ben Ami, S; Benary, O; Benchekroun, D; Bendel, M; Benedict, B H; Benekos, N; Benhammou, Y; Benincasa, G P; Benjamin, D P; Benoit, M; Bensinger, J R; Benslama, K; Bentvelsen, S; Beretta, M; Berge, D; Bergeaas Kuutmann, E; Berger, N; Berghaus, F; Berglund, E; Beringer, J; Bernardet, K; Bernat, P; Bernhard, R; Bernius, C; Berry, T; Bertin, A; Besson, N; Bethke, S; Bianchi, R M; Bianco, M; Biebel, O; Biesiada, J; Biglietti, M; Bilokon, H; Binet, S; Bingul, A; Bini, C; Biscarat, C; Bitenc, U; Black, K M; Blair, R E; Blanchot, G; Blocker, C; Blondel, A; Blum, W; Blumenschein, U; Bobbink, G J; Bocci, A; Boek, J; Boelaert, N; Boeser, S; Bogaerts, J A; Bogouch, A; Bohm, C; Bohm, J; Boisvert, V; Bold, T; Boldea, V; Boldyrev, A; Bondarenko, V G; Bondioli, M; Boonekamp, M; Borisov, A; Borissov, G; Borjanovic, I; Borroni, S; Bos, K; Boscherini, D; Bosman, M; Boterenbrood, H; Bouchami, J; Boudreau, J; Bouhova-Thacker, E V; Boulahouache, C; Bourdarios, C; Boyd, J; Boyko, I R; Bozovic-Jelisavcic, I; Bracinik, J; Braem, A; Branchini, P; Brandenburg, G W; Brandt, A; Brandt, G; Brandt, O; Bratzler, U; Brau, J E; Braun, H M; Brelier, B; Bremer, J; Brenner, R; Bressler, S; Breton, D; Britton, D; Brochu, F M; Brock, I; Brock, R; Brodet, E; Bromberg, C; Brooijmans, G; Brooks, W K; Brubaker, E; Bruckman de Renstrom, P A; Bruncko, D; Bruneliere, R; Brunet, S; Bruni, A; Bruni, G; Bruschi, M; Bucci, F; Buchanan, J; Buchholz, P; Buckley, A G; Budagov, I A; Budick, B; Buescher, V; Bugge, L; Bulekov, O; Bunse, M; Buran, T; Burckhart, H; Burdin, S; Burgess, T; Burke, S; Busato, E; Bussey, P; Buszello, C P; Butin, F; Butler, B; Butler, J M; Buttar, C M; Butterworth, J M; Byatt, T; Caballero-Bejar, J; Cabrera Urbán, S; Caforio, D; Cakir, O; Calafiura, P; Calderini, G; Calfayan, P; Calkins, R; Caloba, L P; Calvet, D; Camarri, P; Cameron, D; Campana, S; Campanelli, M; Canale, V; Canelli, F; Cantero, J; Capasso, L; Caprini, I; Caprini, M; Capua, M; Caputo, R; Caracinha, D; Caramarcu, C; Cardarelli, R; Carli, T; Carlino, G; Carminati, L; Caron, B; Caron, S; Carrillo Montoya, G D; Carron Montero, S; Carter, A A; Carter, J R; Carvalho, J; Casadei, D; Casado, M P; Cascella, M; Castaneda Hernadez, A M; Castaneda Miranda, E; Castillo Gimenez, V; Castro, N; Cataldi, G; Catinaccio, A; Catmore, J R; Cattai, A; Cattani, G; Caughron, S; Cauz, D; Cavalleri, P; Cavalli, D; Cavalli-Sforza, M; Cavasinni, V; Ceradini, F; Cerqueira, A S; Cerri, A; Cerrito, L; Cerutti, F; Cetin, S A; Cevenini, F; Chafaq, A; Chakraborty, D; Chan, K; Chapman, J D; Chapman, J W; Chareyre, E; Charlton, D G; Chatterjii, S; Cheatham, S; Chekanov, S; Chekulaev, S V; Chelkov, G A; Chen, H; Chen, S; Chen, X; Cheplakov, A; Chepurnov, V F; Cherkaoui El Moursli, R; Chernyatin, V; Chesneanu, D; Cheu, E; Cheung, S L; Chevalier, L; Chevallier, F; Chiarella, V; Chiefari, G; Chikovani, L; Childers, J T; Chilingarov, A; Chiodini, G; Chizhov, M; Chouridou, S; Christidi, I A; Christov, A; Chromek-Burckhart, D; Chu, M L; Chudoba, J; Ciapetti, G; Ciftci, A K; Ciftci, R; Cindro, V; Ciobotaru, M D; Ciocca, C; Ciocio, A; Cirilli, M; Citterio, M; Clark, A; Cleland, W; Clemens, J C; Clement, B; Clement, C; Clements, D; Coadou, Y; Cobal, M; Coccaro, A; Cochran, J; Coggeshall, J; Cogneras, E; Cole, B; Colijn, A P; Collard, C; Collins, N J; Collins-Tooth, C; Collot, J; Colon, G; Conde Muino, P; Coniavitis, E; Consonni, M; Constantinescu, S; Conta, C; Conventi, F; Cook, J; Cooke, M; Cooper, B D; Cooper-Sarkar, A M; Cooper-Smith, N J; Copic, K; Cornelissen, T; Corradi, M; Corriveau, F; Corso-Radu, A; Cortes-Gonzalez, A; Cortiana, G; Costa, G; Costa, M J; Costanzo, D; Costin, T; Cote, D; Coura Torres, R; Courneyea, L; 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Quayle, W B; Quinonez, F; Raas, M; Radeka, V; Radescu, V; Radics, B; Rador, T; Ragusa, F; Rahal, G; Rahimi, A M; Rahm, D; Rajagopalan, S; Rauscher, F; Rauter, E; Raymond, M; Read, A L; Rebuzzi, D M; Redelbach, A; Redlinger, G; Reece, R; Reeves, K; Reinherz, E; Reinsch, A; Reisinger, I; Reljic, D; Rembser, C; Ren, Z L; Renkel, P; Rescia, S; Rescigno, M; Resconi, S; Resende, B; Reznicek, P; Rezvani, R; Richards, A; Richards, R A; Richter, D; Richter, R; Richter-Was, E; Ridel, M; Rieke, S; Rijpstra, M; Rijssenbeek, M; Rimoldi, A; Rinaldi, L; Rios, R R; Riu, I; Rizatdinova, F; Rizvi, E R; Roa Romero, D A; Robertson, S H; Robichaud-Veronneau, A; Robinson, D; Robinson, M; Robson, A; Rocha de Lima, J G; Roda, C; Rodriguez, D; Rodriguez, Y; Roe, S; Rohne, O; Rojo, V; Rolli, S; Romaniouk, A; Romanov, V M; Romeo, G; Romero Maltrana, D; Roos, L; Ros, E; Rosati, M; Rosati, S; Rosenbaum, G A; Rosenberg, E I; Rosselet, L; Rossi, L P; Rotaru, M; Rothberg, J; Rottlaender, I; Rousseau, D; Royon, C R; Rozanov, A; Rozen, Y; Ruckert, B; Ruckstuhl, N; Rud, V I; Rudolph, G; Ruehr, F; Ruggieri, F; Ruiz-Martinez, A; Rumyantsev, L; Rusakovich, N A; Rutherfoord, J P; Ruwiedel, C; Ruzicka, P; Ryabov, Y F; Ryan, P; Rybin, A M; Rybkin, G; Rzaeva, S; Saavedra, A F; Sadrozinski, H F-W; Sadykov, R; Sakamoto, H; Salamanna, G; Salamon, A; Saleem, M; Salihagic, D; Salnikov, A; Salt, J; Salvachúa Ferrando, B M; Salvatore, D; Salvatore, F; Salvucci, A; Salzburger, A; Sampsonidis, D; Samset, B H; Sandaker, H; Sander, H G; Sandhoff, M; Sandstroem, R; Sandvoss, S; Sankey, D P C; Sanny, B; Sansoni, A; Santamarina Rios, C; Santoni, C; Santonico, R; Santos, D; Santos, J; Saraiva, J G; Sarangi, T; Saremi, S; Sarkisyan-Grinbaum, E; Sarri, F; Sasaki, O; Sasao, N; Satsounkevitch, I; Sauvage, G; Savard, P; Savine, A Y; Savinov, V; Sawyer, L; Saxon, D H; Says, L P; Sbarra, C; Sbrizzi, A; Scannicchio, D A; Schaarschmidt, J; Schacht, P; Schaefer, U; Schaetzel, S; Schaffer, A C; Schaile, D; Schamberger, R D; Schamov, A G; Schegelsky, V A; Schernau, M; Scherzer, M I; Schiavi, C; Schieck, J; Schioppa, M; Schlenker, S; Schmid, P; Schmitt, C; Schmitz, M; Schott, M; Schouten, D; Schovancova, J; Schram, M; Schreiner, A; Schroeder, C; Schroer, N; Schroers, M; Schultes, J; Schultz-Coulon, H-C; Schumacher, J; Schumacher, M; Schumm, B A; Schune, Ph; Schwanenberger, C; Schwartzman, A; Schwemling, Ph; Schwienhorst, R; Schwierz, R; Schwindling, J; Scott, W G; Searcy, J; Sedykh, E; Segura, E; Seidel, S C; Seiden, A; Seifert, F; Seixas, J M; Sekhniaidze, G; Seliverstov, D M; Sellden, B; Semprini-Cesari, N; Serfon, C; Serin, L; Seuster, R; Severini, H; Sevior, M E; Sfyrla, A; Shan, L Y; Shank, J T; Shao, Q T; Shapiro, M; Shatalov, P B; Shaw, K; Sherman, D; Sherwood, P; Shibata, A; Shimojima, M; Shin, T; Shmeleva, A; Shochet, M J; Shupe, M A; Sicho, P; Sidoti, A; Siegrist, J; Sijacki, Dj; Silbert, O; Silva, J; Silverstein, D; Silverstein, S B; Simak, V; Simic, Lj; Simion, S; Simmons, B; Simonyan, M; Sinervo, P; Sinev, N B; Sipica, V; Siragusa, G; Sisakyan, A N; Sivoklokov, S Yu; Sjoelin, J; Sjursen, T B; Skubic, P; Slater, M; Slavicek, T; Sliwa, K; Sloper, J; Sluka, T; Smakhtin, V; Smirnov, S Yu; Smirnov, Y; Smirnova, L N; Smirnova, O; Smith, B C; Smith, D; Smith, K M; Smizanska, M; Smolek, K; Snesarev, A A; Snow, S W; Snow, J; Snuverink, J; Snyder, S; Soares, M; Sobie, R; Sodomka, J; Soffer, A; Solans, C A; Solar, M; Solfaroli Camillocci, E; Solodkov, A A; Solovyanov, O V; Soluk, R; Sondericker, J; Sopko, V; Sopko, B; Sosebee, M; Sosnovtsev, V V; Soukharev, A; Spagnolo, S; Spano, F; Spencer, E; Spighi, R; Spigo, G; Spila, F; Spiwoks, R; Spousta, M; Spreitzer, T; Spurlock, B; Denis, R D; Stahl, T; Stamen, R; Stancu, S N; Stanecka, E; Stanek, R W; Stanescu, C; Stapnes, S; Starchenko, E A; Stark, J; Staroba, P; Stastny, J; Staude, A; Stavina, P; Steinbach, P; Steinberg, P; Stekl, I; Stelzer, B; Stelzer, H J; Stenzel, H; Stevenson, K; Stewart, G; Stockton, M C; Stoicea, G; Stonjek, S; Strachota, P; Stradling, A; Straessner, A; Strandberg, J; Strandberg, S; Strandlie, A; Strassler, M J; Strauss, M; Strizenec, P; Stroehmer, R; Strom, D M; Stroynowski, R; Stugu, B; Su, D A; Su, D; Suchkov, S I; Sugaya, Y; Sugimoto, T; Suhr, C; Sulin, V V; Sultansoy, S; Sun, X; Sundermann, J E; Suruliz, K; Sushkov, S; Susinno, G; Sutton, M R; Suzuki, T; Suzuki, Y; Sykora, I; Sykora, T; Szymocha, T; Sánchez, J; Ta, D; Taffard, A; Tafirout, R; Taga, A; Takahashi, Y; Takai, H; Takashima, R; Takeda, H; Takeshita, T; Talby, M; Talyshev, A; Tamsett, M C; Tanaka, J; Tanaka, R; Tanaka, S; Tanaka, S; Tapprogge, S; Tardif, D; Tarem, S; Tarrade, F; Tartarelli, G F; Tas, P; Tasevsky, M; Tassi, E; Taylor, C; Taylor, F E; Taylor, G N; Taylor, R P; Taylor, W; Teixeira-Dias, P; Ten Kate, H; Teng, P K; Terada, S; Terashi, K; Terron, J; Terwort, M; Testa, M; Teuscher, R J; Tevlin, C M; Thananuwong, R; Thioye, M; Thoma, S; Thomas, J P; Thomas, T L; Thompson, E N; Thompson, P D; Thompson, P D; Thompson, R J; Thompson, A S; Thomson, E; Thun, R P; Tic, T; Tikhomirov, V O; Tikhonov, Y A; Tipton, P; Tique Aires Viegas, F J; Tisserant, S; Toczek, B; Todorov, T; Todorova-Nova, S; Tojo, J; Tokar, S; Tokushuku, K; Tomasek, L; Tomasek, M; Tomasz, F; Tomoto, M; Tompkins, D; Tompkins, L; Toms, K; Tonoyan, A; Topfel, C; Topilin, N D; Torrence, E; Torro Pastor, E; Toth, J; Touchard, F; Tovey, D R; Tovey, S N; Trefzger, T; Tremblet, L; Tricoli, A; Trigger, I M; Trincaz-Duvoid, S; Tripiana, M F; Triplett, N; Trischuk, W; Trivedi, A; Trocme, B; Troncon, C; Trzupek, A; Tsarouchas, C; Tseng, J C-L; Tsiakiris, M; Tsiareshka, P V; Tsipolitis, G; Tsiskaridze, V; Tskhadadze, E G; Tsukerman, I I; Tsulaia, V; Tsuno, S; Turecek, D; Turk Cakir, I; Turlay, E; Tuts, P M; Twomey, M S; Tylmad, M; Tyndel, M; Tzanakos, G; Uchida, K; Ueda, I; Uhrmacher, M; Ukegawa, F; Unal, G; Underwood, D G; Undrus, A; Unel, G; Unno, Y; Urbaniec, D; Urkovsky, E; Urquijo, P; Urrejola, P; Usai, G; Vacavant, L; Vacek, V; Vachon, B; Vahsen, S; Valenta, J; Valente, P; Valentinetti, S; Valkar, S; Vallecorsa, S; Valls Ferrer, J A; van der Graaf, H; van der Kraaij, E; van der Poel, E; Van Der Ster, D; van Eldik, N; van Gemmeren, P; van Kesteren, Z; van Vulpen, I; VanBerg, R; Vandelli, W; Vaniachine, A; Vankov, P; Vannucci, F; Vari, R; Varnes, E W; Varouchas, D; Vartapetian, A; Varvell, K E; Vassilakopoulos, V I; Vassilieva, L; Vazeille, F; Veillet, J J; Vellidis, C; Veloso, F; Veneziano, S; Ventura, A; Ventura, D; Venturi, M; Venturi, N; Vercesi, V; Verducci, M; Verkerke, W; Vermeulen, J C; Vetterli, M C; Vichou, I; Vickey, T; Viehhauser, G H A; Villa, M; Villani, E G; Villaplana Perez, M; Villate, J; Vilucchi, E; Vincter, M G; Vinogradov, V B; Viret, S; Virzi, J; Vitale, A; Vitells, O V; Vivarelli, I; Vives Vaques, F; Vlachos, S; Vlasak, M; Vlasov, N; Vokac, P; Volpi, M; von der Schmitt, H; von Loeben, J; von Radziewski, H; von Toerne, E; Vorobel, V; Vorobiev, A P; Vorwerk, V; Vos, M; Voss, R; Voss, T T; Vossebeld, J H; Vranjes, N; Vranjes Milosavljevic, M; Vrba, V; Vreeswijk, M; Vu Anh, T; Vudragovic, D; Vuillermet, R; Vukotic, I; Wagner, P; Wahlen, H; Walbersloh, J; Walder, J; Walker, R; Walkowiak, W; Wall, R; Wang, C; Wang, J; Wang, S M; Ward, C P; Warsinsky, M; Watkins, P M; Watson, A T; Watts, G; Watts, S; Waugh, A T; Waugh, B M; Webel, M; Weber, J; Weber, M D; Weber, M; Weber, M S; Weber, P; Weidberg, A R; Weingarten, J; Weiser, C; Wellenstein, H; Wells, P S; Wemans, A; Wen, M; Wenaus, T; Wendler, S; Wengler, T; Wenig, S; Wermes, N; Werner, M; Werner, P; Werthenbach, U; Wessels, M; Whalen, K; Wheeler-Ellis, S J; White, A; White, M J; White, S; Whiteson, D; Whittington, D; Wicek, F; Wicke, D; Wickens, F J; Wiedenmann, W; Wielers, M; Wienemann, P; Wiglesworth, C; Wildauer, A; Wildt, M A; Wilkens, H G; Williams, E; Williams, H H; Willocq, S; Wilson, J A; Wilson, M G; Wilson, A; Wingerter-Seez, I; Winklmeier, F; Wittgen, M; Wolter, M W; Wolters, H; Wosiek, B K; Wotschack, J; Woudstra, M J; Wraight, K; Wright, C; Wright, D; Wrona, B; Wu, S L; Wu, X; Wulf, E; Xella, S; Xie, S; Xu, N; Yamada, M; Yamamoto, A; Yamamoto, S; Yamamura, T; Yamanaka, K; Yamaoka, J; Yamazaki, T; Yamazaki, Y; Yan, Z; Yang, H; Yang, U K; Yang, Z; Yao, W-M; Yao, Y; Yasu, Y; Ye, J; Ye, S; Yilmaz, M; Yoosoofmiya, R; Yorita, K; Yoshida, R; Young, C; Youssef, S P; Yu, D; Yu, J; Yuan, J; Yuan, L; Yurkewicz, A; Zaidan, R; Zaitsev, A M; Zajacova, Z; Zambrano, V; Zanello, L; Zarzhitsky, P; Zaytsev, A; Zeitnitz, C; Zeller, M; Zema, P F; Zemla, A; Zendler, C; Zenis, T; Zenonos, Z; Zenz, S; Zerwas, D; Zevi della Porta, G; Zhan, Z; Zhang, H; Zhang, J; Zhang, Q; Zhang, X; Zhao, L; Zhao, T; Zhao, Z; Zhemchugov, A; Zhong, J; Zhou, B; Zhou, N; Zhou, Y; Zhu, C G; Zhu, H; Zhu, Y; Zhuang, X; Zhuravlov, V; Zimmermann, R; Zimmermann, S; Ziolkowski, M; Zitoun, R; Zivkovic, L; Zobernig, G; Zoccoli, A; zur Nedden, M

    2009-01-01

    Neutral particles with long decay paths that decay to many-particle final states represent, from an experimental point of view, a challenge both for the trigger and for the reconstruction capabilities of the ATLAS apparatus. The Hidden Valley scenario serves as an excellent setting for the purpose of exploring the challenges to the trigger posed by long-lived particles.

  9. OnabotulinumtoxinA injections in chronic migraine, targeted to sites of pericranial myofascial pain: an observational, open label, real-life cohort study.

    Science.gov (United States)

    Ranoux, Danièle; Martiné, Gaelle; Espagne-Dubreuilh, Gaëlle; Amilhaud-Bordier, Marlène; Caire, François; Magy, Laurent

    2017-12-01

    OnabotulinumtoxinA has proven its efficacy in reducing the number of headache days in chronic migraine (CM) patients. The usual paradigm includes 31 pericranial injection sites with low dose (5 U) per site. The aim of this study is to present the results obtained using a simpler injection protocol of onabotulinumtoxinA, with injection sites targeted to pericranial myofascial sites of pain. Observational, open label, real-life, cohort study. We enrolled 63 consecutive patients fulfilling the diagnostic criteria of CM, and refractory to conventional treatments. The patients were injected using a "follow-the-pain" pattern into the corrugator and/or temporalis and/or trapezius muscles. The doses per muscle were fixed. According to the number of muscles injected, the total dose could vary from 70 to 150 U per session. Patients were considered responders if they had a ≥ 50% decrease in number of headache days in at least two consecutive injection cycles. Forty one patients (65.1% in intention to treat analysis) responded to treatment. In 70.7% of responders, the effect size was even higher, with a reduction ≥70% in the number of headache days. The associated cervical pain and muscle tenderness, present in 33 patients, was reduced by ≥50% in 31 patients (94%). Triptan consumption dramatically decreased (81%) in responders. The trapezius was the most frequently injected muscle. We observed no serious adverse event. The mean patient satisfaction rate was 8.5/10. This study provides additional robust evidence supporting the efficacy of onabotulinumtoxinA injections in CM. Furthermore, the paradigm we used, with reduced number of injection sites targeted to pericranial myofascial sites of pain, may provide evidence in favor of the implication of myofascial trigger points in migraine chronicization. ClinicalTrials.gov Protocol Record I17022 ClinicalTrials.gov Identifier: NCT03175263 . Date of registration: June 7, 2017. Retrospectively registered.

  10. A FLUX ROPE ERUPTION TRIGGERED BY JETS

    International Nuclear Information System (INIS)

    Guo Juan; Zhang Hongqi; Deng Yuanyong; Lin Jiaben; Su Jiangtao; Liu Yu

    2010-01-01

    We present an observation of a filament eruption caused by recurrent chromospheric plasma injections (surges/jets) on 2006 July 6. The filament eruption was associated with an M2.5 two-ribbon flare and a coronal mass ejection (CME). There was a light bridge in the umbra of the main sunspot of NOAA 10898; one end of the filament was terminated at the region close to the light bridge, and recurrent surges were observed to be ejected from the light bridge. The surges occurred intermittently for about 8 hr before the filament eruption, and finally a clear jet was found at the light bridge to trigger the filament eruption. We analyzed the evolutions of the relative darkness of the filament and the loaded mass by the continuous surges quantitatively. It was found that as the occurrence of the surges, the relative darkness of the filament body continued growing for about 3-4 hr, reached its maximum, and kept stable for more than 2 hr until it erupted. If suppose 50% of the ejected mass by the surges could be trapped by the filament channel, then the total loaded mass into the filament channelwill be about 0.57x10 16 g with a momentum of 0.57x10 22 g cm s -1 by 08:08 UT, which is a non-negligible effect on the stability of the filament. Based on the observations, we present a model showing the important role that recurrent chromospheric mass injection play in the evolution and eruption of a flux rope. Our study confirms that the surge activities can efficiently supply the necessary material for some filament formation. Furthermore, our study indicates that the continuous mass with momentum loaded by the surge activities to the filament channel could make the filament unstable and cause it to erupt.

  11. Stress triggering and the Canterbury earthquake sequence

    Science.gov (United States)

    Steacy, Sandy; Jiménez, Abigail; Holden, Caroline

    2014-01-01

    The Canterbury earthquake sequence, which includes the devastating Christchurch event of 2011 February, has to date led to losses of around 40 billion NZ dollars. The location and severity of the earthquakes was a surprise to most inhabitants as the seismic hazard model was dominated by an expected Mw > 8 earthquake on the Alpine fault and an Mw 7.5 earthquake on the Porters Pass fault, 150 and 80 km to the west of Christchurch. The sequence to date has included an Mw = 7.1 earthquake and 3 Mw ≥ 5.9 events which migrated from west to east. Here we investigate whether the later events are consistent with stress triggering and whether a simple stress map produced shortly after the first earthquake would have accurately indicated the regions where the subsequent activity occurred. We find that 100 per cent of M > 5.5 earthquakes occurred in positive stress areas computed using a slip model for the first event that was available within 10 d of its occurrence. We further find that the stress changes at the starting points of major slip patches of post-Darfield main events are consistent with triggering although this is not always true at the hypocentral locations. Our results suggest that Coulomb stress changes contributed to the evolution of the Canterbury sequence and we note additional areas of increased stress in the Christchurch region and on the Porters Pass fault.

  12. Epidural injections for back pain

    Science.gov (United States)

    ESI; Spinal injection for back pain; Back pain injection; Steroid injection - epidural; Steroid injection - back ... pillow under your stomach. If this position causes pain, you either sit up or lie on your ...

  13. Managing the Risk of Triggered Seismicity: Can We Identify (and Avoid) Potentially Active Faults? - A Practical Case Study in Oklahoma

    Science.gov (United States)

    Zoback, M. D.; Alt, R. C., II; Walsh, F. R.; Walters, R. J.

    2014-12-01

    It is well known that throughout the central and eastern U.S. there has been a marked increase in seismicity since 2009, at least some of which appears to increased wastewater injection. No area has seen a greater increase in seismicity than Oklahoma. In this paper, we utilize newly available information on in situ stress orientation and relative magnitudes, the distribution of high volume injection wells and knowledge of the intervals used for waste water disposal to identify the factors potentially contributing to the occurrence of triggered seismicity. While there are a number of sites where in situ stress data has been successfully used to identify potentially active faults, we are investigating whether this methodology can be implemented throughout a state utilizing the types of information frequently available in areas of oil and gas development. As an initial test of this concept, we have been compiling stress orientation data from wells throughout Oklahoma provided by private industry. Over fifty new high quality data points, principally drilling-induced tensile fractures observed in image logs, result in a greatly improved understanding of the stress field in much of the state. A relatively uniform ENE direction of maximum compressive stress is observed, although stress orientations (and possibly relative stress magnitudes) differ in the southern and southwestern parts of the state. The proposed methodology can be tested in the area of the NE-trending fault that produced the M 5+ earthquakes in the Prague, OK sequence in 2011, and the Meers fault in southwestern OK, that produced a M~7 reverse faulting earthquake about 1100 years ago. This methodology can also be used to essentially rule out slip on other major faults in the area, such as the ~N-S trending Nemaha fault system. Additional factors leading to the occurrence of relatively large triggered earthquakes in Oklahoma are 1) the overall increase in injection volumes throughout the state in recent

  14. Trigger electronics for the ALICE PHOS detector

    CERN Document Server

    Müller, H; Musa, L; Yin, Z; Röhrich, D; Skaali, B; Sibiryak, Yu; Budnikov, D L

    2004-01-01

    The Photon Spectrometer of ALICE consists of 5 identical modules of 56 multiplied by 64 PWO crystals with a total of 100 degree azimuthal coverage of the barrel. The electronics required for implementing both the L0 trigger for high luminosity p-p physics and the L1 trigger for high p//T Pb+Pb physics has been studied. A full integration of the trigger logic into the detector's enclosure is based on analog transmission of fast trigger sums between stacks of front-end boards and trigger-router units. The latter contain 112 digitizer channels of 10bit, which are mapped into a single FPGA per trigger unit, covering areas of 24 multiplied by 16 crystals. The running modes allow for Level-0 trigger at 800ns and Level-1 at 6200ns trigger latencies. The design and status of the PHOS trigger electronics are outlined.

  15. Injection moulding antireflective nanostructures

    DEFF Research Database (Denmark)

    Christiansen, Alexander Bruun; Clausen, Jeppe Sandvik; Mortensen, N. Asger

    We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used in an inject......We present a method for injection moulding antireflective nanostructures on large areas, for high volume production. Nanostructured black silicon masters were fabricated by mask-less reactive ion etching, and electroplated with nickel. The nickel shim was antistiction coated and used...... in an injection moulding process, to fabricate the antireflective surfaces. The cycle-time was 35 s. The injection moulded structures had a height of 125 nm, and the visible spectrum reflectance of injection moulded black polypropylene surfaces was reduced from 4.5±0.5% to 2.5±0.5%. The gradient of the refractive...

  16. SQL injection detection system

    OpenAIRE

    Vargonas, Vytautas

    2017-01-01

    SQL injection detection system Programmers do not always ensure security of developed systems. That is why it is important to look for solutions outside being reliant on developers. In this work SQL injection detection system is proposed. The system analyzes HTTP request parameters and detects intrusions. It is based on unsupervised machine learning. Trained by regular request data system detects outlier user parameters. Since training is not reliant on previous knowledge of SQL injections, t...

  17. Study of Pellet Injection Effects on Transport Barrier Formation and Pedestal Width Using Bifurcation Concept

    International Nuclear Information System (INIS)

    Wihakhaphirom, K.; Chatthong, B.; Picha, R.; Poolyarat, N.; Onjun, T.

    2014-01-01

    This work focuses on the effects of pellet injection on the L-H transition phenomenon in tokamak plasmas based on bifurcation concept. Thermal and particle transport equations with both neoclassical and turbulent contributions included are solved simultaneously. In this study, the investigated transport suppression mechanism is flow shear, which is assumed to affect only the turbulent channel. The flow shear, coupling both transport equations via pres- sure and density gradients, can be calculated from the force balance equation. The pedestal formation can be seen when some operation points reach the second branch of bifurcation curve. As a result, the pedestal region can be determined. The pellet injection is modeled as a Gaussian profile of the particle source function. The centroid of the Gaussian shape repre- sents the location of the maximum pellet penetration depth, which is taken to be proportional to the pellet's initial velocity. Moreover, the duration that the pellet has effects on transport barrier formation and pedestal width in the plasma is proportional to its diameter. The two transport equations are solved both analytically and numerically using MATLAB to study the possibility of L-H transition triggering using pellet injection and its effects on pedestal width.

  18. Joint and Soft Tissue Injections

    Science.gov (United States)

    ... Injections Joint and Soft Tissue Injections Share Print What is a joint and soft tissue injection? Joint and soft tissue injections are shots ... many injections do I need and how often? What restrictions do I have after an ... tissue injection, treatment April 1, 2004 Copyright © American Academy ...

  19. Piezoelectric Injection Systems

    Science.gov (United States)

    Mock, R.; Lubitz, K.

    The origin of direct injection can be doubtlessly attributed to Rudolf Diesel who used air assisted injection for fuel atomisation in his first self-ignition engine. Although it became apparent already at that time that direct injection leads to reduced specific fuel consumption compared to other methods of fuel injection, it was not used in passenger cars for the moment because of its disadvantageous noise generation as the requirements with regard to comfort were seen as more important than a reduced specific consumption.

  20. CMS High Level Trigger for boosted $t\\bar{t}$ events

    CERN Document Server

    Celli, Federico

    2016-01-01

    In this work we studied the efficiency of a new CMS high level trigger path for boosted topology $t\\bar{t}$ events, available during the 2016 LHC run at 13 TeV. We found out that this trigger was affected by a prescale factor bug that did not allow us to register about 18.4% of candidate $t\\bar{t}$ events, leading to an apparent loss in the trigger efficiency. This work has also pointed out that as soon as this issue is solved we will be able to use the new trigger path with good performances, increasing the statistics in future measurements.

  1. Triggers and Their Influence on Health Behaviors.

    Science.gov (United States)

    Gipson, Christine S

    2017-05-01

    This article provides a conceptual definition of the concept trigger within the context of health behaviors and applies it to the highly significant health issue of obesity. Healthy behaviors are essential to life and happiness, but they do not just happen. They are triggered, and an inner drive keeps them alive. To help patients gain and retain optimal health, nurses must understand the triggers of healthy behaviors. Walker and Avant's (2011) method of concept analysis is used as the basis for defining the concept of trigger. The antecedents, defining attributes, and consequences of trigger are identified. Findings suggest that nurses can play a role in triggering health behavior change through simple motivational efforts.

  2. Muon Trigger for Mobile Phones

    Science.gov (United States)

    Borisyak, M.; Usvyatsov, M.; Mulhearn, M.; Shimmin, C.; Ustyuzhanin, A.

    2017-10-01

    The CRAYFIS experiment proposes to use privately owned mobile phones as a ground detector array for Ultra High Energy Cosmic Rays. Upon interacting with Earth’s atmosphere, these events produce extensive particle showers which can be detected by cameras on mobile phones. A typical shower contains minimally-ionizing particles such as muons. As these particles interact with CMOS image sensors, they may leave tracks of faintly-activated pixels that are sometimes hard to distinguish from random detector noise. Triggers that rely on the presence of very bright pixels within an image frame are not efficient in this case. We present a trigger algorithm based on Convolutional Neural Networks which selects images containing such tracks and are evaluated in a lazy manner: the response of each successive layer is computed only if activation of the current layer satisfies a continuation criterion. Usage of neural networks increases the sensitivity considerably comparable with image thresholding, while the lazy evaluation allows for execution of the trigger under the limited computational power of mobile phones.

  3. ATLAS Level-1 Topological Trigger

    CERN Document Server

    Zheng, Daniel; The ATLAS collaboration

    2018-01-01

    The ATLAS experiment has introduced and recently commissioned a completely new hardware sub-system of its first-level trigger: the topological processor (L1Topo). L1Topo consist of two AdvancedTCA blades mounting state-of-the-art FPGA processors, providing high input bandwidth (up to 4 Gb/s) and low latency data processing (200 ns). L1Topo is able to select collision events by applying kinematic and topological requirements on candidate objects (energy clusters, jets, and muons) measured by calorimeters and muon sub-detectors. Results from data recorded using the L1Topo trigger will be presented. These results demonstrate a significantly improved background event rejection, thus allowing for a rate reduction without efficiency loss. This improvement has been shown for several physics processes leading to low-pT leptons, including H->tau tau and J/Psi->mu mu. In addition to describing the L1Topo trigger system, we will discuss the use of an accurate L1Topo simulation as a powerful tool to validate and optimize...

  4. Industrial accidents triggered by lightning.

    Science.gov (United States)

    Renni, Elisabetta; Krausmann, Elisabeth; Cozzani, Valerio

    2010-12-15

    Natural disasters can cause major accidents in chemical facilities where they can lead to the release of hazardous materials which in turn can result in fires, explosions or toxic dispersion. Lightning strikes are the most frequent cause of major accidents triggered by natural events. In order to contribute towards the development of a quantitative approach for assessing lightning risk at industrial facilities, lightning-triggered accident case histories were retrieved from the major industrial accident databases and analysed to extract information on types of vulnerable equipment, failure dynamics and damage states, as well as on the final consequences of the event. The most vulnerable category of equipment is storage tanks. Lightning damage is incurred by immediate ignition, electrical and electronic systems failure or structural damage with subsequent release. Toxic releases and tank fires tend to be the most common scenarios associated with lightning strikes. Oil, diesel and gasoline are the substances most frequently released during lightning-triggered Natech accidents. Copyright © 2010 Elsevier B.V. All rights reserved.

  5. Stimulus conflict triggers behavioral avoidance.

    Science.gov (United States)

    Dignath, David; Eder, Andreas B

    2015-12-01

    According to a recent extension of the conflict-monitoring theory, conflict between two competing response tendencies is registered as an aversive event and triggers a motivation to avoid the source of conflict. In the present study, we tested this assumption. Over five experiments, we examined whether conflict is associated with an avoidance motivation and whether stimulus conflict or response conflict triggers an avoidance tendency. Participants first performed a color Stroop task. In a subsequent motivation test, participants responded to Stroop stimuli with approach- and avoidance-related lever movements. These results showed that Stroop-conflict stimuli increased the frequency of avoidance responses in a free-choice motivation test, and also increased the speed of avoidance relative to approach responses in a forced-choice test. High and low proportions of response conflict in the Stroop task had no effect on avoidance in the motivation test. Avoidance of conflict was, however, obtained even with new conflict stimuli that had not been presented before in a Stroop task, and when the Stroop task was replaced with an unrelated filler task. Taken together, these results suggest that stimulus conflict is sufficient to trigger avoidance.

  6. ATLAS FTK: Fast Track Trigger

    CERN Document Server

    Volpi, Guido; The ATLAS collaboration

    2015-01-01

    An overview of the ATLAS Fast Tracker processor is presented, reporting the design of the system, its expected performance, and the integration status. The next LHC runs, with a significant increase in instantaneous luminosity, will provide a big challenge to the trigger and data acquisition systems of all the experiments. An intensive use of the tracking information at the trigger level will be important to keep high efficiency in interesting events, despite the increase in multiple p-p collisions per bunch crossing (pile-up). In order to increase the use of tracks within the High Level Trigger (HLT), the ATLAS experiment planned the installation of an hardware processor dedicated to tracking: the Fast TracKer (FTK) processor. The FTK is designed to perform full scan track reconstruction at every Level-1 accept. To achieve this goal, the FTK uses a fully parallel architecture, with algorithms designed to exploit the computing power of custom VLSI chips, the Associative Memory, as well as modern FPGAs. The FT...

  7. Electron beam manipulation, injection and acceleration in plasma wakefield accelerators by optically generated plasma density spikes

    Energy Technology Data Exchange (ETDEWEB)

    Wittig, Georg; Karger, Oliver S.; Knetsch, Alexander [Institute of Experimental Physics, University of Hamburg, 22761 Hamburg (Germany); Xi, Yunfeng; Deng, Aihua; Rosenzweig, James B. [Particle Beam Physics Laboratory, UCLA, Los Angeles, CA 90095 (United States); Bruhwiler, David L. [RadiaSoft LLC, Boulder, CO 80304 (United States); RadiaBeam Technologies LLC (United States); Smith, Jonathan [Tech-X UK Ltd, Daresbury, Cheshire WA4 4FS (United Kingdom); Sheng, Zheng-Ming; Jaroszynski, Dino A.; Manahan, Grace G. [Physics Department, SUPA, University of Strathclyde, Glasgow G4 0NG (United Kingdom); Hidding, Bernhard [Institute of Experimental Physics, University of Hamburg, 22761 Hamburg (Germany); Physics Department, SUPA, University of Strathclyde, Glasgow G4 0NG (United Kingdom)

    2016-09-01

    We discuss considerations regarding a novel and robust scheme for optically triggered electron bunch generation in plasma wakefield accelerators [1]. In this technique, a transversely propagating focused laser pulse ignites a quasi-stationary plasma column before the arrival of the plasma wake. This localized plasma density enhancement or optical “plasma torch” distorts the blowout during the arrival of the electron drive bunch and modifies the electron trajectories, resulting in controlled injection. By changing the gas density, and the laser pulse parameters such as beam waist and intensity, and by moving the focal point of the laser pulse, the shape of the plasma torch, and therefore the generated trailing beam, can be tuned easily. The proposed method is much more flexible and faster in generating gas density transitions when compared to hydrodynamics-based methods, and it accommodates experimentalists needs as it is a purely optical process and straightforward to implement.

  8. [Anesthesia unrelated triggering of a fatal malignant hyperthermia crisis].

    Science.gov (United States)

    Olthoff, D; Vonderlind, C

    1997-12-01

    For incidents of malignant hyperthermia (MH) outside the hospital, a high number of unrecorded cases must be reckoned with because of an insufficient knowledge of emergency services and poor identification and documentation that make it impossible to classify acute situations under the diagnosis of malignant hyperthermia crisis. As a result, there are no statistical data in this field, and only case reports with a broad spectrum of suspected trigger mechanisms have been published. The case described in this report is a proved example of a non-anesthesia-related triggering of MH in a 21-year-old man who had had an anesthetic-induced MH manifestation in childhood, which was confirmed with an in vitro contracture test. After visiting a restaurant, he became unconscious and convulsive after consuming a high level of alcohol (2.9/1000). The first cardiocirculatory arrest occurred directly before hospitalization. After admission, the patient showed a full-blown MH episode whose subsequent fatality was unavoidable in spite of adapted and optimal therapy. Suspected trigger mechanisms seem to be multifactoral (excessive alcohol consumption, over-heating, mental stress) as a forensic investigation did not point to any particular signs of typical trigger substances. The case demonstrates again that an MH attack might be triggered under certain non-anaesthesia-related situations. For patients with an MH disposition, additional information on their behavior outside the hospital is required.

  9. Electron injection in microtron

    International Nuclear Information System (INIS)

    Axinescu, S.

    1977-01-01

    A review of the methods of injecting electrons in the microtron is presented. A special attention is paid to efficient injection systems developed by Wernholm and Kapitza. A comparison of advantages and disadvantages of both systems is made in relation to the purpose of the microtron. (author)

  10. Glenohumeral Joint Injections

    Science.gov (United States)

    Gross, Christopher; Dhawan, Aman; Harwood, Daniel; Gochanour, Eric; Romeo, Anthony

    2013-01-01

    Context: Intra-articular injections into the glenohumeral joint are commonly performed by musculoskeletal providers, including orthopaedic surgeons, family medicine physicians, rheumatologists, and physician assistants. Despite their frequent use, there is little guidance for injectable treatments to the glenohumeral joint for conditions such as osteoarthritis, adhesive capsulitis, and rheumatoid arthritis. Evidence Acquisition: We performed a comprehensive review of the available literature on glenohumeral injections to help clarify the current evidence-based practice and identify deficits in our understanding. We searched MEDLINE (1948 to December 2011 [week 1]) and EMBASE (1980 to 2011 [week 49]) using various permutations of intra-articular injections AND (corticosteroid OR hyaluronic acid) and (adhesive capsulitis OR arthritis). Results: We identified 1 and 7 studies that investigated intra-articular corticosteroid injections for the treatment of osteoarthritis and adhesive capsulitis, respectively. Two and 3 studies investigated the use of hyaluronic acid in osteoarthritis and adhesive capsulitis, respectively. One study compared corticosteroids and hyaluronic acid injections in the treatment of osteoarthritis, and another discussed adhesive capsulitis. Conclusion: Based on existing studies and their level of evidence, there is only expert opinion to guide corticosteroid injection for osteoarthritis as well as hyaluronic acid injection for osteoarthritis and adhesive capsulitis. PMID:24427384

  11. Tolerability of hypertonic injectables.

    Science.gov (United States)

    Wang, Wei

    2015-07-25

    Injectable drug products are ideally developed as isotonic solutions. Often, hypertonic injectables may have to be marketed for a variety of reasons such as product solubilization and stabilization. A key concern during product formulation development is the local and systemic tolerability of hypertonic products upon injection. This report reviews and discusses the tolerability in terms of local discomfort, irritation, sensation of heat and pain, along with other observed side effects of hypertonicity in both in-vitro systems and in-vivo animal and human models. These side effects clearly depend on the degree of hypertonicity. The sensation of pain among different injection routes seems to follow this order: intramuscular>subcutaneous>intravenous or intravascular. It is recommended that the upper osmolality limit should be generally controlled under 600 mOsm/kg for drug products intended for intramuscular or subcutaneous injection. For drug products intended for intravenous or intravascular injection, the recommended upper limit should be generally controlled under 1,000 mOsm/kg for small-volume injections (≤ 100 mL) and 500 mOsm/kg for large-volume injections (>100mL). Several options are available for minimization of hypertonicity-induced pain upon product administration. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Performance of the CMS Regional Calorimeter Trigger

    CERN Document Server

    Klabbers, P; Dasu, S; Efron, J; Fobes, R; Gorski, T; Grogg, K; Grothe, M; Lazaridis, C; Leonard, J; Savin, A; Smith, W H; Weinberg, M

    2009-01-01

    The CMS Regional Calorimeter Trigger (RCT) receives eight-bit energies and a data quality bit from the HCAL and ECAL Trigger Primitive Generators (TPGs). The RCT uses these trigger primitives to find e/γ candidates and calculate regional calorimeter sums that are sent to the Global Calorimeter Trigger (GCT) for sorting and further processing. The RCT hardware consists of one clock distribution crate and 18 double-sided crates containing custom boards, ASICs, and backplanes. The RCT electronics have been completely installed since 2007. The RCT has been integrated into the CMS Level-1 Trigger chain. Regular runs, triggering on cosmic rays, prepare the CMS detector for the restart of the LHC. During this running, the RCT control is handled centrally by CMS Run Control and Monitor System communicating with the Trigger Supervisor. Online Data Quality Monitoring (DQM) evaluates the performance of the RCT during these runs. Offline DQM allows more detailed studies, including trigger efficiencies. These and other r...

  13. Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats.

    Science.gov (United States)

    Meng, Fei; Ge, Hong-You; Wang, Yong-Hui; Yue, Shou-Wei

    2015-01-01

    Myofascial trigger points (MTrPs) are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human) of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P MPTs) of MTrSs were lower than those of non-MTrSs (P MPTs of MTrSs significantly (P MPTs of non-MTrSs first decreased (P 0.05). 30 min after the injection, MPTs at MTrSs were significantly lower than those of non-MTrSs (P < 0.01). Therefore, we concluded that proliferated myelinated afferents existed at MTrSs, which were closely related to pathology of SEA and mechanical hyperalgesia of MTrSs.

  14. Effect of the Ethanol Injection Moment During Compression Stroke on the Combustion of Ethanol - Diesel Dual Direct Injection Engine

    Science.gov (United States)

    Liang, Yu; Zhou, Liying; Huang, Haomin; Xu, Mingfei; Guo, Mei; Chen, Xin

    2018-01-01

    A set of GDI system is installed on a F188 single-cylinder, air-cooled and direct injection diesel engine, which is used for ethanol injection, with the injection time controlled by the crank angle signal collected by AVL angle encoder. The injection of ethanol amounts to half of the thermal equivalent of an original diesel fuel. A 3D combustion model is established for the ethanol - diesel dual direct injection engine. Diesel was injected from the original fuel injection system, with a fuel supply advance angle of 20°CA. The ethanol was injected into the cylinder during compression process. Diesel injection began after the completion of ethanol injection. Ethanol injection starting point of 240°CA, 260°CA, 280°CA, 300°CA and 319.4°CA were simulated and analyzed. Due to the different timing of ethanol injection, the ignition of the ethanol mixture when diesel fires, results in non-uniform ignition distribution and flame propagation rate, since the distribution and concentration gradients of the ethanol mixture in the cylinder are different, thus affecting the combustion process. The results show that, when ethanol is injected at 319.4°CA, the combustion heat release rate and the pressure rise rate during the initial stage are the highest. Also, the maximum combustion pressure, with a relatively advance phase, is the highest. In case of later initial ethanol injection, the average temperature in the cylinder during the initial combustion period will have a faster rise. In case of initial injection at 319.4°CA, the average temperature in the cylinder is the highest, followed by 240°CA ethanol injection. In the post-combustion stage, the earlier ethanol injection will result in higher average temperature in the cylinder and more complete fuel combustion. The injection of ethanol at 319.4°CA produces earlier and highest NOX emissions.

  15. A Hardware Track Trigger (FTK) for the ATLAS Trigger

    CERN Document Server

    Zhang, J; The ATLAS collaboration

    2014-01-01

    The design and studies of the performance for the ATLAS hardware Fast TracKer (FTK) are presented. The existing trigger system of the ATLAS experiment is deployed to reduce the event rate from the bunch crossing rate of 40 MHz to < 1 KHz for permanent storage at the LHC design luminosity of 10^34 cm^-2 s^-1. The LHC has performed exceptionally well and routinely exceeds the design luminosity and from 2015 is due to operate with higher still luminosities. This will place a significant load on the High Level trigger (HLT) system, both due to the need for more sophisticated algorithms to reject background, and from the larger data volumes that will need to be processed. The Fast TracKer is a custom electronics system that will operate at the full Level-1 accepted rate of 100 KHz and provide high quality tracks at the beginning of processing in the HLT. This will be performing by track reconstruction using hardware with massive parallelism using associative memories (AM) and FPGAs. The availability of the full...

  16. The D OE software trigger

    International Nuclear Information System (INIS)

    Linnemann, J.T.; Michigan State Univ., East Lansing, MI

    1992-10-01

    In the D OE experiment, the software filter operates in a processor farm with each node processing a single event. Processing is data-driven: the filter does local processing to verify the candidates from the hardware trigger. The filter code consists of independent pieces called ''tools''; processing for a given hardware bit is a ''script'' invoking one or more ''tools'' sequentially. An offline simulator drives the same code with the same configuration files, running on real or simulated data. Online tests use farm nodes parasiting on the data stream. We discuss the performance of the system and how we attempt to verify its correctness

  17. Laser-triggered vacuum switch

    Science.gov (United States)

    Brannon, Paul J.; Cowgill, Donald F.

    1990-01-01

    A laser-triggered vacuum switch has a material such as a alkali metal halide on the cathode electrode for thermally activated field emission of electrons and ions upon interaction with a laser beam, the material being in contact with the cathode with a surface facing the discharge gap. The material is preferably a mixture of KCl and Ti powders. The laser may either shine directly on the material, preferably through a hole in the anode, or be directed to the material over a fiber optic cable.

  18. The ALICE high level trigger

    Energy Technology Data Exchange (ETDEWEB)

    Alt, T [Kirchhoff Institute for Physics, University of Heidelberg (Germany); Grastveit, G [Department of Physics and Technology, University of Bergen (Norway); Helstrup, H [Faculty of Engineering, Bergen University College (Norway); Lindenstruth, V [Kirchhoff Institute for Physics, University of Heidelberg (Germany); Loizides, C [Institute for Nuclear Physics, University of Frankfurt (Germany); Roehrich, D [Department of Physics and Technology, University of Bergen (Norway); Skaali, B [Department of Physics, University of Oslo (Norway); Steinbeck, T [Kirchhoff Institute for Physics, University of Heidelberg (Germany); Stock, R [Institute for Nuclear Physics, University of Frankfurt (Germany); Tilsner, H [Kirchhoff Institute for Physics, University of Heidelberg (Germany); Ullaland, K [Department of Physics and Technology, University of Bergen (Norway); Vestboe, A [Faculty of Engineering, Bergen University College (Norway); Vik, T [Department of Physics, University of Oslo (Norway); Wiebalck, A [Kirchhoff Institute for Physics, University of Heidelberg (Germany)

    2004-08-01

    The ALICE experiment at LHC will implement a high-level trigger system for online event selection and/or data compression. The largest computing challenge is posed by the TPC detector, which requires real-time pattern recognition. The system entails a very large processing farm that is designed for an anticipated input data stream of 25 GB s{sup -1}. In this paper, we present the architecture of the system and the current state of the tracking methods and data compression applications.

  19. Ischemia Reperfusion Injury Triggers TNFα Induced-Necroptosis in Rat Retina.

    Science.gov (United States)

    Kim, Cho Rong; Kim, Jie Hyun; Park, Hae-Young Lopilly; Park, Chan Kee

    2017-05-01

    A recent study revealed a novel form of cell death, termed necroptosis, or programmed necrosis. Previous research indicated that after ischemia-reperfusion (IR) injury to the retina, Tumor Necrosis Factor α (TNFα) is increased, which may activate necroptosis. This study observed macroglial cell activation, and in particular, astrocyte activation, after the release of TNFα and other necroptosis factors in the rat retina due to IR. IR was induced in the retinas of adult male Sprague-Dawley rats by increasing the intraocular pressure to 160 mmHg and then allowing reperfusion. In addition, to inhibit necroptosis, Nec-1 (necrostatin-1) was injected intravitreally after IR. Rats were sacrificed after reperfusion at 12 hours, 1, 3, and 5 days, and 1 and 2 weeks. Retinas from each time point were analyzed by immunohistochemistry (IHC) and Western blotting (WB) to identify the initiator of necroptosis, TNFα, the expression of necroptosis factors, such as receptor interacting protein (RIP) 1, 3, and inactive caspase 8, and Brn3a. Cell death in the IR-injured retinas was identified by cell counting. We found decreased retinal cell numbers in the inner and outer nuclear layers (INL and ONL), as well as in the ganglion cell layer (GCL). Increased glial cell activation was detected by using glial fibrillary acidic protein (GFAP) IHC. TNFα, RIP1, RIP3, and inactive caspase 8 were mainly expressed in the GCL after IR, as determined by IHC and WB. Nec-1 inhibited RIP1, a necroptosis factor, indicating protection against retinal cell loss after IR injury. We showed that IR injury triggered increases in both activation of astrocytes and the expression of TNFα. In addition, TNFα, which was activated by IR, triggered the release of necroptosis factors, particularly, in GCL. Inhibition of necroptosis using Nec-1 decreased the level of RIP1 and retinal cell loss in IR-injured retinas.

  20. THE RHIC INJECTION SYSTEM.

    Energy Technology Data Exchange (ETDEWEB)

    FISCHER,W.; GLENN,J.W.; MACKAY,W.W.; PTITSIN,V.; ROBINSON,T.G.; TSOUPAS,N.

    1999-03-29

    The RHIC injection system has to transport beam from the AGS-to-RHIC transfer line onto the closed orbits of the RHIC Blue and Yellow rings. This task can be divided into three problems. First, the beam has to be injected into either ring. Second, once injected the beam needs to be transported around the ring for one turn. Third, the orbit must be closed and coherent beam oscillations around the closed orbit should be minimized. We describe our solutions for these problems and report on system tests conducted during the RHIC Sextant test performed in 1997. The system will be fully commissioned in 1999.

  1. Triggering for charm, beauty, and truth

    International Nuclear Information System (INIS)

    Appel, J.A.

    1982-02-01

    As the search for more and more rare processes accelerates, the need for more and more effective event triggers also accelerates. In the earliest experiments, a simple coincidence often sufficed not only as the event trigger, but as the complete record of an event of interest. In today's experiments, not only has the fast trigger become more sophisticated, but one or more additional level of trigger processing precedes writing event data to magnetic tape for later analysis. Further search experiments will certainly require further expansion in the number of trigger levels required to filter those rare events of particular interest

  2. Configuration of the ATLAS Trigger System

    CERN Document Server

    Elsing, M; Armstrong, S; Baines, J T M; Bee, C P; Biglietti, M; Bogaerts, A; Boisvert, V; Bosman, M; Brandt, S; Caron, B; Casado, M P; Cataldi, G; Cavalli, D; Cervetto, M; Comune, G; Corso-Radu, A; Di Mattia, A; Díaz-Gómez, M; Dos Anjos, A; Drohan, J; Ellis, Nick; Epp, B; Etienne, F; Falciano, S; Farilla, A; George, S; Ghete, V M; González, S; Grothe, M; Kaczmarska, A; Karr, K M; Khomich, A; Konstantinidis, N P; Krasny, W; Li, W; Lowe, A; Luminari, L; Ma, H; Meessen, C; Mello, A G; Merino, G; Morettini, P; Moyse, E; Nairz, A; Negri, A; Nikitin, N V; Nisati, A; Padilla, C; Parodi, F; Pérez-Réale, V; Pinfold, J L; Pinto, P; Polesello, G; Qian, Z; Rajagopalan, S; Resconi, S; Rosati, S; Scannicchio, D A; Schiavi, C; Segura, E; De Seixas, J M; Shears, T G; Sivoklokov, S Yu; Smizanska, M; Soluk, R A; Stanescu, C; Tapprogge, Stefan; Touchard, F; Vercesi, V; Watson, A; Wengler, T; Werner, P; Wheeler, S; Wickens, F J; Wiedenmann, W; Wielers, M; Zobernig, G; CHEP 2003 Computing in High Energy Physics

    2003-01-01

    In this paper a conceptual overview is given of the software foreseen to configure the ATLAS trigger system. Two functional software prototypes have been developed to configure the ATLAS Level-1 emulation and the High-Level Trigger software. Emphasis has been put so far on following a consistent approach between the two trigger systems and on addressing their requirements, taking into account the specific use-case of the `Region-of-Interest' mechanism for the ATLAS Level-2 trigger. In the future the configuration of the two systems will be combined to ensure a consistent selection configuration for the entire ATLAS trigger system.

  3. Power Distribution for the ATLAS LAr Trigger Digitizer Board

    CERN Document Server

    Lazzaroni, Massimo; The ATLAS collaboration

    2015-01-01

    The research activity for the design of the power distribution section of the ATLAS LAr Trigger Digitizer Board board (LTDB) will be presented. Many aspects concerning the radiation hardness and the ability to operate Point-of-load converters even in presence of high magnetic fields will be covered. Devices designed by CERN have been used and their capability for implementation on the ATLAS LTDB has been exploited with the aim to have a power distribution section with the required performances.

  4. The Database Driven ATLAS Trigger Configuration System

    CERN Document Server

    Martyniuk, Alex; The ATLAS collaboration

    2015-01-01

    This contribution describes the trigger selection configuration system of the ATLAS low- and high-level trigger (HLT) and the upgrades it received in preparation for LHC Run 2. The ATLAS trigger configuration system is responsible for applying the physics selection parameters for the online data taking at both trigger levels and the proper connection of the trigger lines across those levels. Here the low-level trigger consists of the already existing central trigger (CT) and the new Level-1 Topological trigger (L1Topo), which has been added for Run 2. In detail the tasks of the configuration system during the online data taking are Application of the selection criteria, e.g. energy cuts, minimum multiplicities, trigger object correlation, at the three trigger components L1Topo, CT, and HLT On-the-fly, e.g. rate-dependent, generation and application of prescale factors to the CT and HLT to adjust the trigger rates to the data taking conditions, such as falling luminosity or rate spikes in the detector readout ...

  5. Minimum Bias Interaction Triggers in ATLAS

    CERN Document Server

    Kwee, R E; The ATLAS collaboration

    2010-01-01

    Since the restart of the LHC in November 2009, ATLAS has collected inelastic ppcollisions to perform first measurements on charged particle densities. These measurements will help to constrain various models describing phenomenologically soft parton interactions. Understanding the trigger efficiencies for different event types are therefore crucial to minimize any possible bias in the event selection. ATLAS uses two main minimum bias triggers, featuring complementary detector components and trigger levels. While a hardware based first trigger level situated in the forward regions with 2.2 < |eta| < 3.8 has been proven to select pp-collisions very efficiently, the Inner Detector based minimum bias trigger uses a random seed on filled bunches and central tracking detectors for the event selection. Both triggers were essential for the analysis of kinematic spectra of charged particles. Their performance and trigger efficiency measurements as well as studies on possible bias sources will be presente...

  6. Nicotine plus a high-fat diet triggers cardiomyocyte apoptosis.

    Science.gov (United States)

    Sinha-Hikim, Indrani; Friedman, Theodore C; Falz, Mark; Chalfant, Victor; Hasan, Mohammad Kamrul; Espinoza-Derout, Jorge; Lee, Desean L; Sims, Carl; Tran, Peter; Mahata, Sushil K; Sinha-Hikim, Amiya P

    2017-04-01

    Cigarette smoking is an important risk factor for diabetes, cardiovascular disease and non-alcoholic fatty liver disease. The health risk associated with smoking can be aggravated by obesity. Smoking might also trigger cardiomyocyte (CM) apoptosis. Given that CM apoptosis has been implicated as a potential mechanism in the development of cardiomyopathy and heart failure, we characterize the key signaling pathways in nicotine plus high-fat diet (HFD)-induced CM apoptosis. Adult C57BL6 male mice were fed a normal diet (ND) or HFD and received twice-daily intraperitoneal (IP) injections of nicotine (0.75 mg/kg body weight [BW]) or saline for 16 weeks. An additional group of nicotine-treated mice on HFD received twice-daily IP injections of mecamylamine (1 mg/kg BW), a non-selective nicotinic acetylcholine receptor antagonist, for 16 weeks. Nicotine when combined with HFD led to a massive increase in CM apoptosis that was fully prevented by mecamylamine treatment. Induction of CM apoptosis was associated with increased oxidative stress and activation of caspase-2-mediated intrinsic pathway signaling coupled with inactivation of AMP-activated protein kinase (AMPK). Furthermore, nicotine treatment significantly (P nicotine, when combined with HFD, triggers CM apoptosis through the generation of oxidative stress and inactivation of AMPK together with the activation of caspase-2-mediated intrinsic apoptotic signaling independently of FGF21 and SIRT1.

  7. Hadronic triggers and trigger object-level analysis at ATLAS

    CERN Document Server

    Zaripovas, Donatas Ramilas; The ATLAS collaboration

    2017-01-01

    Hadronic signatures are critical to the high energy physics analysis program at the Large Hadron Collider (LHC), and are broadly used for both Standard Model measurements and searches for new physics. These signatures include generic quark and gluon jets, as well as jets originating from b-quarks or the decay of massive particles (such as electroweak bosons or top quarks). Additionally missing transverse momentum from non-interacting particles provides an interesting probe in the search for new physics beyond the Standard Model. Developing trigger selections that target these events is a huge challenge at the LHC due to the enormous event rates associated with these signatures. This challenge is exacerbated by the amount of pile-up activity, which continues to grow. In order to address these challenges, several new techniques have been developed during the past year in order to significantly improve the potential of the 2017 dataset and overcome the limiting factors, such as storage and computing requirements...

  8. Hadronic Triggers and trigger-object level analysis at ATLAS

    CERN Document Server

    Zaripovas, Donatas Ramilas; The ATLAS collaboration

    2017-01-01

    Hadronic signatures are critical to the high energy physics analysis program, and are broadly used for both Standard Model measurements and searches for new physics. These signatures include generic quark and gluon jets, as well as jets originating from b-quarks or the decay of massive particles (such as electroweak bosons or top quarks). Additionally missing transverse momentum from non-interacting particles provides an interesting probe in the search for new physics beyond the Standard Model. Developing trigger selections that target these events is a huge challenge at the LHC due to the enormous rates associated with these signatures. This challenge is exacerbated by the amount of pile-up activity, which continues to grow. In order to address these challenges, several new techniques have been developed during the past year in order to significantly improve the potential of the 2017 dataset and overcome the limiting factors to more deeply probing for new physics, such as storage and computing requirements f...

  9. Global Review of Induced and Triggered Earthquakes

    Science.gov (United States)

    Foulger, G. R.; Wilson, M.; Gluyas, J.; Julian, B. R.; Davies, R. J.

    2016-12-01

    ongoing at the time of the relevant earthquakes, e.g., oil production and brine injections. We present a first analysis of the data in our database and comment on some related issues with which scientists are currently grappling. Figure: Induced or triggered seismicity world-wide in Mollweide projection, centered on the Greenwich meridian.

  10. Parathyroid Hormone Injection

    Science.gov (United States)

    ... the blood in people with certain types of hypoparathyroidism (condition in which the body does not produce ... are taking this medication.Parathyroid hormone injection controls hypoparathyroidism but does not cure it. Continue to use ...

  11. Collagenase Clostridium Histolyticum Injection

    Science.gov (United States)

    ... disease (a thickening of tissue [plaque] inside the penis t