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The design of specific material properties of aluminum alloys demands for a detailed understanding of clustering and precipitation processes occurring during heat treatments. Positron lifetime spectroscopy in combination with high-precision dilatometry measurements were taken, allowing for a comprehensive analysis of the aging mechanisms occurring on different timescales and in different temperature regimes, during artificial aging. From the results, unambiguous experimental evidence for the following three main steps of the precipitation process is obtained. In the first seconds of artificial aging, a competitive process of dissolution and growth of different cluster types occurs. Subsequently, clusters start to transform into coherent precipitates, which are mainly responsible for the hardening effect. For prolonged artificial aging, the number density of the coherent precipitates increases, while positron lifetime spectroscopy already reveals the simultaneous formation of less coherent precipitates.

A conceptual model was tested in which the effects of mentoring relationships on adolescents' academic outcomes were hypothesized to be mediated partially through improvements in parental relationships. The parameters of the model were compared with those of an alternative, in which improved parental relationships were treated as an outcome variable rather than a mediator. The study included 959 young adolescents (M age = 12.25 years), all of whom applied to Big Brothers Big Sisters programs. The adolescents were randomly assigned to either the treatment or control group and administered questions at baseline and 18 months later. The hypothesized model provided a significantly better explanation of the data than the alternative. In addition to improvements in parental relationships, mentoring led to reductions in unexcused absences and improvements in perceived scholastic competence. Direct effects of mentoring on global self-worth, school value, and grades were not detected but were instead mediated through improved parental relationships and scholastic competence. Implications of the findings for theory and research are discussed.

Calcific tendinitis of the shoulder is characterized by a reactive calcification that affects the rotator-cuff tendons. 1 Frequently, such calcifications are incidental radiographic findings in asymptomatic patients. In most cases, they are located 1 to 2 cm from the insertion of the supraspinatus tendon on the greater tuberosity. Approximately 50 percent of patients with calcific tendinitis have shoulder pain, 2 , 3 with acute or chronic painful restrictions of the range of motion of the shoulders and thus limitation of the activities of daily living. Treatments directed toward the calcium deposits, such as surgery and percutaneous needle aspiration, seem to reduce pain and . . .

Abstract Objective: To assess the efficacy of ultrasound treatment for mild to moderate idiopathic carpal tunnel syndrome. Design: Randomised, double blind, “sham” controlled trial with assessments at baseline, after 2 weeks' and 7 weeks' treatment, and at a follow up assessment 6 months later (8 months after baseline evaluation). Setting: Outpatient clinic of a university department of physical medicine and rehabilitation in Vienna. Subjects: 45 patients with mild to moderate bilateral carpal tunnel syndrome as verified by electroneurography. Intervention: 20 sessions of ultrasound (active) treatment (1 MHz, 1.0 W/cm2, pulsed mode 1:4, 15 minutes per session) applied to the area over the carpal tunnel of one wrist, and indistinguishable sham ultrasound treatment applied to the other. The first 10 treatments were performed daily (5 sessions/week); 10 further treatments were twice weekly for 5 weeks. Main outcome measures: Score of subjective symptom ratings assessed by visual analogue scale; electroneurographic measures (for example, motor distal latency and sensory antidromic nerve conduction velocity). Results: Improvement was significantly more pronounced in actively treated than in sham treated wrists for both subjective symptoms (P<0.001, paired t test) and electroneurographic variables (motor distal latency P<0.001, paired t test; sensory antidromic nerve conduction velocity P<0.001, paired t test). Effects were sustained at 6 months' follow up. Conclusion: Results suggest there are satisfying short to medium term effects due to ultrasound treatment in patients with mild to moderate idiopathic carpal tunnel syndrome. Findings need to be confirmed, and ultrasound treatment will have to be compared with standard conservative and invasive treatment options. Key messages Chronic entrapment of the median nerve at the wrist (the carpal tunnel syndrome) is probably the most common peripheral nerve lesion No satisfactory conservative treatment is available at present Twenty sessions of ultrasound treatment show good short and medium term efficacy in patients with bilateral, mild to moderate forms of the carpal tunnel syndrome Optimal treatment schedules of ultrasound treatment alone or in combination with other non-surgical treatments await elucidation

Objective: To evaluate the long-term effects of postoperative comprehensive physiotherapy starting one week after lumbar disc surgery. Design: Twelve-year follow-up of a three-armed, randomized, controlled, single-blinded clinical trial. Setting: Department of Physical Medicine & Rehabilitation. Participants: Of 111 patients following first-time, uncomplicated lumbar disc surgery who participated in the original study and completed the treatment originally allocated, 74 ((67%; 29 (73%) physiotherapy, 22 (58%) sham therapy, 23 (68%) no therapy) completed a 12-year follow-up examination. Interventions: In the original study, patients had been randomly assigned to comprehensive physiotherapy, sham intervention (neck massage), or no therapy. Measures: Low Back Pain Rating Scale; best score 0, worst score 130 points). Results: At 12 years after surgery, the group participating in comprehensive physiotherapy had significantly better functional outcomes, as rated on the Low Back Pain Rating Score, than the untreated group (mean difference: −13.2 (95% CI: (−25.4; −1.0)). Equally, there was a clinically relevant, non-significant difference between the sham therapy and no therapy (mean difference: −12.5 (95%CI: −26.1; 1.1)). Consequently, the Low Back Pain Rating Score outcome did not differ between physiotherapy and sham therapy (mean difference: −0.7 (95%CI: −14.2; 12.8)). Conclusions: Participating in a comprehensive physiotherapy program following lumbar disc surgery may be associated with better long-term health benefits over no intervention, but may not be superior to sham therapy.

The relevance of calcium (Ca2+), an essential bone mineral, to the prevention and treatment of osteoporosis is well established. However, a good deal of evidence casts doubt on the validity of current RDAs (recommended daily allowance), i.e., 800-1000 mg/day. New guidelines consistently advocate higher daily intakes (up to 1500 mg/day), a goal that may be difficult to achieve for many patients. Environmental as well as individual behavioral factors may limit the consumption of dairy products, whereas calcium supplements require a high level of compliance and cause additional costs. Calcium-rich mineral waters may offer a promising alternative. A systematic literature search was performed (Medline, years 1966-1998) to identify experimental studies on the bioavailability of calcium-rich mineral waters. First, all publications on calcium absorption from mineral waters were identified, and, in a second step, studies comparing calcium absorption from mineral waters with that from dairy products. Four studies fulfilled all inclusion criteria. A meta-analysis based on published p values indicated calcium absorption from mineral waters was significantly higher (p = 0.03) than that from dairy products. Although only few studies with a relatively small number of subjects are available to date, the bioavailability of calcium from calcium-rich mineral waters thus seems to be at least comparable to, and possibly better than, that from dairy products. These results are in keeping with the assumption that calcium-rich mineral water is a useful calcium source to achieve new, higher recommended daily allowances of calcium.

Abstract Some essential oils (EO) are known for having antimicrobial, antiviral, antifungal, and antioxidant characteristics that may be a feedlot antibiotic alternative to replace monensin sodium (M) and tylosin (T). Four-hundred cross-bred steers (BW 368.7 ± 11.0 kg) were blocked by initial BW and cattle source and randomly assigned to 1 of 5 treatments (8 pens/trt; 10 steers/pen) to evaluate an EO blend (EOB). Treatments were: 1) Control: no additives added to the steam-flaked corn-based finishing total mixed ration (TMR); 2) EOB: proprietary essential oil blend (Ralco Nutrition, Marshall, MN) added at 3 g/d; 3) EOB + M + T: EOB added at 3 g/d plus M and T (Huvepharma, Peachtree City, GA) at 42.4 and 8.5 g/ton, respectively; 4) M + T: M and T added at 42.4 and 8.5 g/ton, respectively; and 5) EOB + M: EOB and M added at 3 g/d and 42.4 g/ton. Individual BW were measured on two consecutive d at the start and conclusion and every 28 d during the experiment. Equal treatment pen replicates were transported to a commercial abattoir on 160, 174, and 182 d, respectively for collecting carcass data. Initial, interim 28-d periods, and final BW were similar (P > 0.50) among treatments However, during the 1st 3 28-d time-period steers fed EOB along or in combination demonstrated greater average daily gain (ADG) compared with steers fed the remaining treatments. The study remaining time-periods and overall study ADG were similar (P > 0.10) for all treatments. Steers fed Control consumed greater (P < 0.05) overall study DMI compared with steers fed M + T with steers fed the remaining treatments being intermediate but different (P < 0.05) or similar (P > 0.05). Overall, study feed efficiency was lowest (P < 0.05) for steers fed Control compared with steers fed the remaining treatments being similar (P > 0.10). Dressing percentages were greater (P < 0.05) for steers fed EOB compared with steers fed the remaining treatments. Steers fed M + T demonstrated the lowest (P < 0.05) liver abscesses compared with steers fed Control and EOB with steers fed EOB + M + T being intermediate and similar (P > 0.10). Feeding finishing steers an EOB improved early growth rate and dressing percentage with similar feed conversions to M and T, but did not impact liver abscess incidences. A propriety essential oil blend having antimicrobial, antiviral, antifungal, and antioxidant characteristics may be a potential antibiotic alternative for feeding feedlot steers. Feeding finishing steers an essential oil blend improved early feedlot growth rates and dressing percentages with similar feed conversions compared with monensin and tylosin. Lay Summary A propriety essential oil blend (EOB) having antimicrobial, antiviral, antifungal, and antioxidant characteristics was evaluated as an antibiotic alternative for feeding feedlot steers. Four-hundred cross-bred steers (BW 368.7 ± 11.0 kg) were blocked by BW and cattle source and randomly assigned to 1 of 5 treatments (8 pens/trt; 10 steers/pen) using a randomized complete block design to evaluate an EOB, monensin sodium (M), or Tylosin (T) fed alone or in combination for influencing finishing beef cattle performance and carcass characteristics. Initial, 28 d time-periods, and final BW were similar among all treatments. However, during the 1st 3 28-d time-period steers fed EOB along or in combination demonstrated greater average daily gain (ADG) compared with steers fed the remaining treatments. But, the overall experiment ADG was similar for steers fed all treatments. Overall, experiment dry mater intake was greater for Control fed steers. Steers fed EOB demonstrated greater dressing percentages. Feeding finishing steers an EOB improved early feedlot growth rates and dressing percentages with similar feed conversions compared with M and T, but did not impact incidence of liver abscesses. The feeding of an EOB provides an alternative to feeding antibiotics to feedlot steers.

Persistent low back pain (LBP) is a common complaint among women during and after pregnancy, and its effects on quality of life can be disabling. To evaluate the effectiveness of osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) in women with persistent LBP and functional disability after childbirth. A pragmatic randomized controlled trial was conducted among a sample of women with a history of pregnancy-related LBP for at least 3 months after delivery. Participants were identified from the general population in Germany. By means of external randomization, women were allocated to an OMTh group and a waitlist control group. Osteopathic manipulative therapy was provided 4 times at intervals of 2 weeks, with a follow-up after 12 weeks. The OMTh was tailored to each participant and based on osteopathic principles. The participants allocated to the control group did not receive OMTh during the 8-week study; rather, they were put on a waiting list to receive OMTh on completion of the study. Further, they were not allowed to receive any additional treatment (ie, medication, physical therapy, or other sources of pain relief) during the study period. The main outcome measures were pain intensity as measured by a visual analog scale and the effect of LBP on daily activities as assessed by the Oswestry Disability Index (ODI). A total of 80 women aged between 23 and 42 years (mean [SD], 33.6 [4.5] years) were included in the study, with 40 in the OMTh group and 40 in the control group. Pain intensity decreased in the OMTh group from 7.3 to 2.0 (95% CI, 4.8-5.9; <.001) and in the control group from 7.0 to 6.5 (95% CI, -0.2 to -0.9; =.005). The between-group comparison of changes revealed a statistically significant improvement in pain intensity in the OMTh group (between-group difference of means, 4.8; 95% CI, 4.1-5.4; <.001) and level of disability (between-group difference of means, 10.6; 95% CI, 9.9-13.2; <.005). The follow-up assessment in the OMTh group (n=38) showed further improvement. During 8 weeks, OMTh applied 4 times led to clinically relevant positive changes in pain intensity and functional disability in women with postpartum LBP. Further studies that include prolonged follow-up periods are warranted. (German Clinical Trials Register: DRKS00006280.)

We often and wrongly equate the response seen in the placebo arm of a clinical trial with the placebo effect. In order to obtain the true placebo effect, other non-specific effects can be identified by including an untreated control group in clinical trials. A review of the literature shows that most authors confuse the perceived placebo effect with the true placebo effect. The true placebo effect is highly variable, depending on several factors that are not fully understood. A distinction between the perceived and the true placebo effects would be helpful in understanding the complex phenomena involved in a placebo response.

OBJECTIVE To determine the effectiveness of acupuncture for smoking cessation and to examine whether any individual aspect of trials is associated with an effect. DATA SOURCES All randomised controlled trials of acupuncture for smoking cessation that were listed in computerised databases or reference lists of relevant articles. STUDY SELECTION All randomised single-blind studies that compared acupuncture with sham acupuncture. DATA EXTRACTION Methodological data were extracted for quality assessment. Outcome data were extracted for rates of total smoking cessation at three intervals: early after treatment and after six and 12 months follow up. DATA SYNTHESIS Results were expressed as odds ratios of success over failure in intervention over control groups. The combined odds ratio for all studies was calculated. Repeated meta-analyses were subsequently performed on subsets of studies combined according to defined characteristics: acupuncture technique, number of attendances, country of origin, status of journal, and control procedure. The overall quality of studies was poor. The combined odds ratio for smoking cessation calculated for the earliest results after the end of treatment was 1.20 (95% confidence intervals (95% CIs) = 0.98 to 1.48). The combined odds ratio for smoking cessation after six months was 1.29 (95% CI = 0.82 to 2.01), and after 12 months was 1.03 (95% CI = 0.73 to 1.46). There were no significant effects of relevance among subsets of studies grouped according to defined characteristics. CONCLUSIONS Acupuncture was not superior to sham acupuncture for smoking cessation; no particular aspect of acupuncture technique was associated with a positive effect. The conclusions are limited by methodological inadequacies of studies and by the absence of testable hypotheses; design of future trials should avoid these deficiencies.