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Additional file 1. Table S1: Mean changes in core temperature, iBAT temperature, heart rate and mean arterial pressure for the present study (Sievers et al.) and Van Schaik et al. (2). A t-test was used to assess statistical difference between means. Mean change in temperatures are represented in the centre column. P-values are reported in the right-most column. n = 6���8.Table S2: Animal research: Reporting of in vivo experiments (ARRIVE) checklist.

Additional file 2: Figure S1. Individual changes in temperature (�� Temperature ��C) of interscapular brown adipose tissue (iBAT) and core, in male rats following injection (time = zero) of estrogen or vehicle. Temperature of iBAT following A IP injection or B ICV injection. Core temperature following C IP injection or D ICV injection. n = 6 for IPcontrol; n = 7 for IP-estrogen and ICV-control; n = 8 for ICV-estrogen. One rat was excluded from the IP-control group due to a procedural error. Two rats were excluded from the ICV-estrogen group due to prolonged (< 7 h) surgical complications experienced.

Additional file 3: Figure S2. Individual changes in heart rate (�� Heart Rate) and mean arterial pressure (�� MAP), in male rats following injection (time = zero) of estrogen or vehicle. Heart rate following A IP injection or B ICV injection. Mean arterial pressure following C IP injection or D ICV injection. n = 6 for IP-control; n = 7 for IP-estrogen and ICV-control; n = 8 for ICV-estrogen. One rat was excluded from the IP-control group due to a procedural error. Two rats were excluded from the ICV-estrogen group due to prolonged (< 7 h) surgical complications experienced.

Additional file 4: Figure S3. Number of cFos immunoreactive (cFos-ir) cells within thalamic and hypothalamic nuclei. n = 3 for all treatment groups. One rat was considered one experimental unit. VMH = ventromedial nucleus of the hypothalamus; Arc = arcuate nucleus of the hypothalamus; LH = lateral nucleus of the hypothalamus; PVN = Paraventricular nucleus of the hypothalamus; PVT = paraventricular nucleus of the thalamus; CM = centromedian nucleus of the thalamus; DMH = dorsomedial nucleus of the hypothalamus.

The objective of this analysis is to evaluate the necessity of large clinical trials using FLOW trial data. The FLOW pilot study and definitive trial were factorial trials evaluating the effect of different irrigation solutions and pressures on re-operation. To explore treatment effects over time, we analyzed data from the pilot and definitive trial in increments of 250 patients until the final sample size of 2447 patients was reached. At each increment we calculated the relative risk (RR) and associated 95% confidence interval (CI) for the treatment effect, and compared the results that would have been reported at the smaller enrolments with those seen in the final, adequately powered study. The pilot study analysis of 89 patients and initial incremental enrolments in the FLOW definitive trial favored low pressure compared to high pressure (RR: 1.50, 95% CI: 0.75–3.04; RR: 1.39, 95% CI: 0.60–3.23, respectively), which is in contradiction to the final enrolment, which found no difference between high and low pressure (RR: 1.04, 95% CI: 0.81–1.33). In the soap versus saline comparison, the FLOW pilot study suggested that re-operation rate was similar in both the soap and saline groups (RR: 0.98, 95% CI: 0.50–1.92), whereas the FLOW definitive trial found that the re-operation rate was higher in the soap treatment arm (RR: 1.28, 95% CI: 1.04–1.57). Our findings suggest that studies with smaller sample sizes would have led to erroneous conclusions in the management of open fracture wounds. NCT01069315 (FLOW Pilot Study) Date of Registration: February 17, 2010, NCT00788398 (FLOW Definitive Trial) Date of Registration: November 10, 2008.

Irrespective of national guidelines for medical fitness to drive, this study investigated the cumulative expert wisdom of clinicians regarding minimum periods of driving cessation required for patients suffering from conditions that can impair driver capability. Occupational Physicians (196) and Psychiatrists (103) completed an online questionnaire. For private motorists, the modal response for anxiety and depression favoured clinical discretion, followed by three month cessations for hypomania, acute psychosis, schizophrenia and alcohol dependence and six weeks for alcohol misuse/dependence. For professional drivers the modal value for anxiety and depression was three months, rising to six months for hypomania, psychosis and schizophrenia and 12 months for both alcohol misuse/dependence. Chi-square test results indicated statistically significant differences in clinical opinion between Occupational Physicians and Psychiatrists regarding driving cessation times for drivers suffering from psychiatric and alcohol misuse conditions except for alcohol dependence. Further studies are warranted to investigate these issues in more depth.

Objective: The use of some forms of hormone therapy (HT) is associated with an increase in mammographic density-a major risk factor for breast cancer. The role of isoflavones, however, is unclear. Here, we quantify the prevalence of HT and isoflavone use among postmenopausal Spanish women, determine associated risk factors, and explore the relationship between these therapies and mammographic density. Methods: This cross-sectional study included 2,754 postmenopausal women who underwent breast cancer screening in seven geographical areas. Mammographic density was evaluated using Boyd's semiquantitative scale. Multinomial logistic regression models were adjusted to assess risk factors associated with both therapies. Ordinal regression models were fitted to study the association between HT and isoflavone consumption with mammographic density. Results: The prevalence of ever-use of HT was 12%, whereas that of the current use was 2.3%. Isoflavone lifetime prevalence was 3.7%, and current use was 1.7%. The most common HT types were tibolone and estrogens. Surgical menopause, oral contraceptive use, educational level, population density, and years since menopause were positively associated with HT, whereas body mass index and parity were inversely associated. Mammographic density was not associated with current or past HT use. However, women who reported having consumed isoflavones in the past and those who started their use after menopause had a higher mammographic density when compared with never-users (odds ratio 1.98, 95% CI 1.21-3.25, P = 0.007; and odds ratio 1.60, 95% CI 1.01-2.53, P = 0.045 respectively). Conclusions: Our results show a low prevalence of HT and isoflavone use in postmenopausal Spanish women. In this population, HT use was not associated with mammographic density, whereas some categories of isoflavone users had higher density.

Human skin is a remarkable organ that sustains insult and injury throughout life. The ability of skin to expeditiously repair wounds is paramount to survival. With an aging global population, coupled with a rise in the prevalence of conditions such as diabetes, chronic wounds represent a significant biomedical burden. Mesenchymal stem cells (MSC), a progenitor cell population of the mesoderm lineage, have been shown to be significant mediators in inflammatory environments. Preclinical studies of MSC in various animal wound healing models point towards a putative therapy. This review examines the body of evidence suggesting that MSC accelerate wound healing in both clinical and preclinical studies and also the possible mechanisms controlling its efficacy. The delivery of a cellular therapy to the masses presents many challenges from a safety, ethical, and regulatory point of view. Some of the issues surrounding the introduction of MSC as a medicinal product are also delineated in this review.

M.Tech. (Chiropractic) PURPOSE: The aim of the study was to compare the effectiveness of treating inter-scapular pain with either chiropractic adjustments delivered to the costovertebral joints, with ischaemic compression of the myofascial trigger points of the rhomboid muscles, or using a combination treatment protocol in order to determine which of the three treatment protocols was superior. DESIGN: This study was a comparative study consisting of three groups of ten participants each. Participants were between the ages of eighteen and forty-five and there was an equal male to female ratio. Prior to becoming a participant in this study individuals were assessed according to the inclusion and exclusion criteria. A McGill Pain Questionnaire, numerical pain rating scale, a clinical case history, full physical examination, a cervical regional examination were completed. The method of treatment for each participant was determined by random group allocation. Group 1 received chiropractic adjustments to the costovertebral joints, Group 2 received ischaemic compression to the myofascial trigger points of the rhomboid muscles. Group 3 received a combination treatment involving both chiropractic adjustments to the costovertebral joints together with ischaemic compression of the rhomboid trigger points. Subjective and objective readings were based on the above treatment protocols. All participants received a total of six treatments over a three week period. MEASUREMENTS: Subjective measurements were obtained by the Numerical Pain Rating Scale and the McGill Pain Questionnaire. Objective measurements were obtained using the hand-held pressure algometer. The data was collected on the first, fourth and seventh consultations. OUTCOME: With regards to the subjective readings, the results from the McGill Pain Questionnaire for the intragroup analysis indicated that the ischaemic compression group showed the greatest improvement over time (84.06%). No statistically significant differences were noted for the intergroup analysis. The intragroup analysis of the Numerical Pain Rating Scale indicated that the adjustment group showed the greatest improvement over time (78.70%). The intergroup analysis indicated that there were no statistically significant differences. With regards to the objective measurements, the intragroup analysis of the pressure algometer readings indicated that the ischaemic compression group showed the greatest improvement over time (35.44%). Once again, there were no statistically significant differences with the intergroup analysis. CONCLUSION: Based on the results of this study, it showed that all three treatment groups were effective in decreasing inter-scapular pain and disability. Although all three treatment protocols have shown to be effective, and have shown similar improvement, intergroup analysis indicates that statistically there is no treatment protocol that is seen to be more superior or more effective in treating inter-scapular pain.

M.Tech. (Chiropractic) Background: In sporting activity, especially rugby, soccer, cricket and hockey, re-occurring hamstring injuries are a common sight that suggests that there is an opening for an improvement in the treatment and management of these injuries. This can be debilitating to any sportsman as it results in recurrent time away from his/her sporting activity. A study by Fyfer, Yelverton and Sher (2005), found that sacroiliac manipulation alone had a positive effect in the treatment of recurrent hamstring injuries. Cibuklka, Rose, Delitto and Sinacore (1986), proposed a possible link between hamstring muscle injuries and sacroiliac joint dysfunction. A study conducted by Donahue, Docherty and Schrader (2010), on the effects of Graston technique on pressure pain threshold, revealed a significant improvement in the patient’s pain threshold due to the fact that the instrument assisted technique effectively broke down scar tissue and correct fascial restrictions. The FAKTR approach to soft tissue dysfunction combines instrument-assisted soft tissue mobilization (Graston Technique) with proprioceptive (functional) techniques to reduce pain and return to function (Hyde and Doerr, 2012). Objective: This blinded, randomised pilot study was done to investigate the effects of sacroiliac joint manipulative therapy versus functional and kinetic treatment with rehabilitation on hamstring flexibility in previously injured hamstring muscle. Design: The study consisted of 30 participants recruited from the University of Johannesburg by word of mouth and posters, which met the inclusion criteria. They were equally and randomly divided into 2 groups. Group 1 received chiropractic therapy of the sacroiliac joint. Group 2 received functional and kinetic treatment with rehabilitation. Objective measurements consisted of digital inclinometer which measured the flexibility and range of motion of the hamstring muscle. The pressure algometry was used to measure pain pressure threshold. Procedure: Both group participants hamstring flexibility and ranges of motion were tested. Group 1 participants were motion palpated to determine sacroiliac joint dysfunction and treated with a high velocity, low amplitude trust to restricted segment, group 2 received functional and kinetic treatment with rehabilitation. Results: The statistical results should be viewed with regards that this study only represent a small group of thirty participants and therefore no assumption can be made with respect to whole population. The p-value was set at 0.05 and represents the level of significance of the results. If the p-value was less or equal to 0.05 (p≤0.05) there was a statistical significance finding. If the p-value is greater than 0.05 (p>0.05) vi there was no statistical finding. Statistical significance only means that a given result is unlikely to have occurred by chance. Analysis included demographic data analysis of age and gender. Objective data were collected using Digital Inclinometer and Pressure Algometry. Intra-group and inter-group analysis was done on straight leg raise, passive knee extension, hip extension, lateral rotation of the hip and medial rotation of the hip. The Shapiro-Wilk test was performed to determine normality. As normality could not be assumed, non-parametric testing were used to do intra-group analysis. The Non-parametric Friedman test was used to determine if a change occurred over time. As change did occur over time the Wilcoxon Signed Rank Test was use to determined where the change within each group occurred. The Mann-Whitney U test was also used to determine if any difference between the groups were present at any given time. At the end of the study both test groups showed significant clinical as well as statistical improvement over the three week course of the study. Conclusion: The FAKTR treatment did clinically have the greatest improvement, however the changes seen was not statistically superior to those seen with the sacroiliac joint manipulation treatment. A statistical significant improvement was seen in both treatment protocols, concluding that both the spinal manipulative therapy and the functional and kinetic treatment with rehabilitation could be proficient protocols in treating hamstring flexibility.