Bibliographic record
Abstract
I would like to thank the authors of the letter to the editor for their interest and constructive criticism of our work. The stretching of vertebral arteries (VA) during spinal manipulations (SMTs) of the neck has become an important clinical problem since the coroner's inquest into the death of Lana Lewis. The first scientific research aimed at directly measuring VA strains during neck SMTs was performed 8 years ago1Symons B Leonar T Herzog W Internal forces sustained by the vertebral artery during spinal manipulative therapy.J Manipulative Physiol Ther. 2002; 25: 504-510Abstract Full Text PDF PubMed Scopus (79) Google Scholar and demonstrated that VA strains distal to C1 and proximal to C6 were much smaller than strains encountered during everyday movements of the neck/head. For technical reasons, we could not measure the strains of VA in segments C1 to C6, which was rectified in our recent work.2Wuest S Symons B Leonard T Herzog W Preliminary report: biomechanics of vertebral artery segments C1-C6 during cervical spine manipulation.J Manipulative Physiol Ther. 2010; 33: 273-278Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar The findings of this study were essentially the same as those found in the study of Symons et al,1Symons B Leonar T Herzog W Internal forces sustained by the vertebral artery during spinal manipulative therapy.J Manipulative Physiol Ther. 2002; 25: 504-510Abstract Full Text PDF PubMed Scopus (79) Google Scholar supporting the idea that VA strains during SMTs were smaller than strains encountered during normal head and neck movements. The basic criticism in the letter to the editor was that the placement of our piezoelectric crystals does not allow measurement of VA strains between adjacent foramina, and the authors go on suggesting that our strain measurements were inaccurate because they were made across foramina and that tensile forces would not be fully transmitted across foramina. Although we agree that tensile forces are likely not fully transmitted across foramina, we must point out that strains are measurements of length changes and that the accuracy of these measurements is independent of force transmission across foramina. Furthermore, strains experienced by segments between adjacent foramina (the measurements suggested by the authors) are contained in the strains of the adjacent distal and proximal segments made in our study. In other words, the total strain along the entire VA is independent of the placement of the strain transducers, and thus, the average total strains for our setup and that suggested by the authors of the letter would be identical. It was also suggested that local compression of VA at C2 was not accounted for in our study. Again, that is correct. However, accounting for this effect would likely not change the conceptual results of our study for 2 reasons: first, arteries exposed to compressive stresses are reinforced at the places of compression; thus, compressive stresses would likely not translate into great compressive strains. Second, VA is much more strained during everyday movements than during chiropractic neck SMTs; therefore, tensile strains caused by local VA compression would likely be greater for everyday movements than neck SMTs. Finally, the authors of the letter criticize the choice of the Diversified Technique. A quick inquiry revealed that the Diversified Technique is the main technique taught at the Canadian Memorial Chiropractic College; it is used by 96% of all chiropractors, and it is the primary technique taught at many US-based chiropractic colleges.3National Board of Chiropractic Examiners.in: Christensen MG Job Analysis of Chiropractic. 2000Google Scholar Therefore, we felt that our decision was feasible, probably more so than the hypothenar occiput technique mentioned by the authors of the letter. In any case, the hypothenar occiput technique requires full rotation of the patient's head, which goes against the Best Practice Guidelines that suggest minimizing neck rotations during cervical SMTs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".