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Four hundred fifteen (67%) of the remaining 623 respondents reported they had not sustained a musculoskeletal injury within the last 2 years. The remaining 208 respondents (33%) reported they had sustained such an injury. Thirty-two percent of all PT respondents and 35% of all PTA respondents reported sustaining a musculoskeletal injury.

The PT and PTA respondents reported the highest level of occupational injury in the low back (62% and 56%, respectively). The PTs reported the upper back and the wrist and hand equally as their second most prevalent site of injury (23%). The PTAs also reported the upper back as their second most prevalent site of injury (28%) ( Fig. 1 ). The highest injury prevalence was seen in PTs and PTAs aged 21 to 30 years who worked between 41 and 50 hours per week. Years of experience had no effect on injury prevalence in PTs (χ 2 =8.13, P ≤.087) or PTAs (χ 2 =0.75, P ≤.94).

Figure 1
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Percentage of respondents who reported sustaining a musculoskeletal injury, missing work, and visiting a physician compared by anatomical area. Asterisk (*) indicates only those respondents reporting an injury (PTs=119, PTAs=88). PT=physical therapist, PTA=physical therapist assistant.

Figure 1
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Percentage of respondents who reported sustaining a musculoskeletal injury, missing work, and visiting a physician compared by anatomical area. Asterisk (*) indicates only those respondents reporting an injury (PTs=119, PTAs=88). PT=physical therapist, PTA=physical therapist assistant.

The prevalence of injury at a specific anatomical location varied with the practice setting. For example, PTs practicing in a rehabilitation environment at the time of injury reported more low back injuries (75%) than their colleagues reporting injuries in outpatient settings (64%), hospitals (63%), or skilled nursing facilities (SNFs) (52%). Physical therapist assistants injured in hospitals reported having the most low back injuries (65%) when compared with PTAs in SNFs (54%), outpatient settings (50%), or rehabilitation settings (36%). Practice setting proved to be an important factor for both PTs and PTAs who sustained wrist or hand injuries (χ 2 =11.11, P ≤.049 for PTs; χ 2 =25.29, P ≤.0001 for PTAs). Thirty-eight percent of PTs in an SNF and 32% of PTs in an outpatient setting reported sustaining a wrist or hand injury, as compared with only 13% of PTs injured in hospitals and 0% injured performing home-based care. Three PTAs, who account for all (100%) PTAs injured in private practice, reported sustaining an injury to the wrist or hand. This percentage is in comparison with the 6% of PTAs who reported sustaining a wrist or hand injury in an SNF (2 out of 31 PTAs).

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/ Abnormal Pap Smear

Women are encouraged to start getting yearly Pap smears at the ageof 21 or within 3 years of becoming sexually active. Pap smears are not diagnostictests, but they are screening tools used to find any abnormal cells or dysplasia in the cervix.

When women are faithful in having regular Pap smears,they increase their chances for early detection and treatment of anypotential problems.

What does an abnormal pap smear mean?

Being alarmed or worried is a completely normal reaction when toldyour Pap smear is abnormal. An abnormal Pap smear may indicate thatyou have an infection or abnormal cells called dysplasia . It’s important to remember that abnormal Pap smear results do notmean you have cancer.

These results just show that further testingshould be done to verify whether or not there is a problem.

An abnormal Pap smear may indicate any of the following:

A positive result indicates the presence of abnormalcells, also called an abnormal Pap . Remember that this is a test,not a diagnosis. A positive result does not prove that you have canceror even dysplasia (a pre-cancerous condition).

positive result

However, itusually means you should have further evaluation, such as another Pap smear, a colposcopy(using a microscope to look into the cervix) or a biopsy (removing asmall amount of tissue from the cervix). Your doctor will discussthe results with you.

One in ten Pap smears indicate some abnormality, though most arenot serious. Further testing will be required to determine if youhave infection, inflammation, a yeast infection , trichomoniasis, herpesor the Human Papilloma Virus (HPV).

HPV is the main risk factorfor cervical cancer , but most women who receive treatment for abnormal cells caused by HPV, do not develop cervical cancer.

In 2003, the FDA approved a screening test that can be done in conjunction with a Pap smear to determine if you have the HPV virus.The HPV DNA test can detect high risk types of HPV before any abnormal cells can be detected on the cervix. This screening is recommended for women over the age of 30, who are at an increased risk of an HPV infection turning into pre-cancerous cells.

Some Pap smears indicate an unsatisfactory sample because of recentsexual activity or use of vaginal creams and douches. Regardless ofthe reason, an abnormal Pap will require another Pap smear in a fewmonths.

If the abnormal cells are persisting, you may need further treatment, which may include the following:




Hydrogen atoms can be located accurately and precisely by x-ray crystallography

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27 May 2016: Vol. 2, no. 5, e1600192 DOI: 10.1126/sciadv.1600192
Magdalena Woińska
Biological and Chemical Research Centre, Chemistry Department, University of Warsaw, Zwirki i Wigury 101, 02-089 Warszawa, Poland.
Simon Grabowsky
Institut für Anorganische Chemie und Kristallographie, Fachbereich 2–Biologie/Chemie, Universität Bremen, Leobener Str. NW2, 28359 Bremen, Germany.
Paulina M. Dominiak
Biological and Chemical Research Centre, Chemistry Department, University of Warsaw, Zwirki i Wigury 101, 02-089 Warszawa, Poland.
Krzysztof Woźniak
Biological and Chemical Research Centre, Chemistry Department, University of Warsaw, Zwirki i Wigury 101, 02-089 Warszawa, Poland.
Dylan Jayatilaka
School of Chemistry and Biochemistry, University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia.

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Precise and accurate structural information on hydrogen atoms is crucial to the study of energies of interactions important for crystal engineering, materials science, medicine, and pharmacy, and to the estimation of physical and chemical properties in solids. However, hydrogen atoms only scatter x-radiation weakly, so x-rays have not been used routinely to locate them accurately. Textbooks and teaching classes still emphasize that hydrogen atoms cannot be located with x-rays close to heavy elements; instead, neutron diffraction is needed. We show that, contrary to widespread expectation, hydrogen atoms can be located very accurately using x-ray diffraction, yielding bond lengths involving hydrogen atoms (A–H) that are in agreement with results from neutron diffraction mostly within a single standard deviation. The precision of the determination is also comparable between x-ray and neutron diffraction results. This has been achieved at resolutions as low as 0.8 Å using Hirshfeld atom refinement (HAR). We have applied HAR to 81 crystal structures of organic molecules and compared the A–H bond lengths with those from neutron measurements for A–H bonds sorted into bonds of the same class. We further show in a selection of inorganic compounds that hydrogen atoms can be located in bridging positions and close to heavy transition metals accurately and precisely. We anticipate that, in the future, conventional x-radiation sources at in-house diffractometers can be used routinely for locating hydrogen atoms in small molecules accurately instead of large-scale facilities such as spallation sources or nuclear reactors.

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial license , which permits use, distribution, and reproduction in any medium, so long as the resultant use is not for commercial advantage and provided the original work is properly cited.

Science Advances

Vol 2, No. 506 May 2016

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Hydrogen atoms can be located accurately and precisely by x-ray crystallography

By Magdalena Woińska , Simon Grabowsky , Paulina M. Dominiak , Krzysztof Woźniak , Dylan Jayatilaka

For acute treatment of abdominal migraine attacks, medications used for other forms of migraine are often employed. These include hydration therapy (particularly if there has been significant vomiting), NSAIDs, antinausea medication and the triptans. The choice of medications is somewhat affected by the age of the patient. When abdominal migraines are frequent, preventive therapies used for other forms of migraines can be explored. These include pizotifen, flunarazine, propranolol, cyproheptadine and topiramate.

Abdominal migraine is a sub-type of migraine seen mainly in children. It consists of episodes of abdominal pain with nausea, vomiting, loss of appetite or pallor. Between episodes, there should be no symptoms. Children with abdominal migraine generally go on to develop migraine headaches later in life. People suspected of having abdominal migraine should be carefully assessed by their doctor for an underlying cause as certain gastrointestinal, urogenital or metabolic conditions may mimic abdominal migraine.

The International Headache Society.

Gelfand AA. Episodic syndromes that may be associated with migraine: A.K.A. “the childhood periodic syndromes”. Headache . 2015;55(10):1358-1364.

Evans RW, Whyte C. Cyclic vomiting syndrome and abdominal migraine in adults and children. Headache . 2013;53(6):984-993.

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curtis June 29, 2018

The American Migraine Foundation responds to recent article with a letter to Elle Magazine Editor In the United States alone, more than 37 million...

In the United States alone, more than 37 million people have migraine and approximately 6 million live with symptoms almost every day. One in five women experience migraine and it is the single most disabling disease for women under the age of 49 years, worldwide. This week, just days before the end of National Migraine and Headache Awareness Month, Elle USA published this article , highlighting fashion influencers’ use of the “migraine pose.” According to the article, the pose is trending because it tightens the face, emphasizes cheekbones and draws attention to manicures. The article has generated outrage in the community from people and patients whose lives have been seriously impacted in almost every way imaginable by this invisible and highly misunderstood disease—a disease that historically has had few options for treatment. “Women who are in a critical time of their lives, trying to get an education, build careers and start and raise families are especially impacted by migraine,” says David Dodick, MD, FAHS, Chairman of the American Migraine Foundation. “To make matters worse, women with migraine are at a significantly increased risk of other diseases – including chronic pain syndromes, depression, anxiety, stroke, epilepsy, just to name a few.” In response to this article, the American Migraine Foundation has sent a formal letter to the Editor-in-Chief of Elle Magazine. We invited the publication to join us and to use its reach and influence to demonstrate compassion and understanding for the millions of women around the world fighting to live a normal a life, while dealing with a devastating illness. “We are hoping to use this as an opportunity to change the conversation about migraine and put an end to the stigma surrounding this disabling disease,” says Dodick. While we begin the dialogue, we ask that you continue to respectfully advocate for those living with migraine by sharing photos of what a migraine attack really looks like by sharing personal photos using the hashtag #truemigrainepose. Please tag the American Migraine Foundation so we can share your posts. We want you to know that the American Migraine Foundation and its partners stand with the almost one billion people who experience migraine. We humbly ask that you use this incident as an opportunity to take action. Together we’re as relentless as migraine.

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