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Old 09-03-2017, 09:09 PM   #901
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Your sole mission is to make that client happy and satisfied.
This has never been my sole mission and I believe it is what separates CAM from medically necessary treatments.

My mission is to provide sound medical advice, education, and explanations of NMSK conditions to patients in a manner they can understand. Followed by advice, education, explanations, and demonstrations on how they can rehabilitate their condition. I hope to make them happy, I hope their pain decreases, I hope they leave satisfied, but none of these can be predicted or assured in any reliable fashion, so I will control what i can control and let the rest fall where it may.
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Old 10-03-2017, 01:13 AM   #902
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I'd prefer that mine were happy and satisfied, but with my demographic quite a few start crying and others get angry when they realise how much they need to do out of their comfort zone.
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Old 10-03-2017, 02:02 AM   #903
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Default Brain is Ten Times More Active Than Previously Measured

http://neurosciencenews.com/brain-ac...obiology-6224/

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A new UCLA study could change scientists’ understanding of how the brain works — and could lead to new approaches for treating neurological disorders and for developing computers that “think” more like humans.

The research focused on the structure and function of dendrites, which are components of neurons, the nerve cells in the brain. Neurons are large, tree-like structures made up of a body, the soma, with numerous branches called dendrites extending outward. Somas generate brief electrical pulses called “spikes” in order to connect and communicate with each other. Scientists had generally believed that the somatic spikes activate the dendrites, which passively send currents to other neurons’ somas, but this had never been directly tested before. This process is the basis for how memories are formed and stored.

Scientists have believed that this was dendrites’ primary role.

But the UCLA team discovered that dendrites are not just passive conduits. Their research showed that dendrites are electrically active in animals that are moving around freely, generating nearly 10 times more spikes than somas. The finding challenges the long-held belief that spikes in the soma are the primary way in which perception, learning and memory formation occur.

“Dendrites make up more than 90 percent of neural tissue,” said UCLA neurophysicist Mayank Mehta, the study’s senior author. “Knowing they are much more active than the soma fundamentally changes the nature of our understanding of how the brain computes information. It may pave the way for understanding and treating neurological disorders, and for developing brain-like computers.”
Sensory enrichment is badly needed in many of our patients whose conditions can make them feel walled off. Hence the popularity, in my opinion, of the spa type "treatments" beloved by so many of our colleagues.

I still use touch in order to cue, but much of what I do is via verbal interaction. I give them a guided tour around their sensorium. It should lead to self efficacy and empowerment, but unfortunately there is still the potential to enhance guru status.

A similar situation can arise in us if we fall for a charismatic presenter. Woe betide them though if we find out that they have feet of clay. We discount much of the valid material we have gleaned because we feel tainted and want to excoriate them, we blame them for our gullibility.

Which brings us back to the patient, are we really doing them any favours when we collapse their house of cards by dissing those they have seen before.

I prefer to point out that current knowledge moves on and that the canon changes with each new discovery. Most patients feel comfortable with this. Some presenters don't, the clever ones, rather than directly accusing their critics of "trolling", unleash their acolytes to do it for them.
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Old 10-03-2017, 01:21 PM   #904
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https://www.sciencedaily.com/release...0309150634.htm



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The research is reported in the March 9 issue of the journal Science.

Scientists have generally believed that dendrites meekly sent currents they received from the cell's synapse (the junction between two neurons) to the soma, which in turn generated an electrical impulse. Those short electrical bursts, known as somatic spikes, were thought to be at the heart of neural computation and learning. But the new study demonstrated that dendrites generate their own spikes 10 times more often than the somas.

The researchers also found that dendrites generate large fluctuations in voltage in addition to the spikes; the spikes are binary, all-or-nothing events. The somas generated only all-or-nothing spikes, much like digital computers do. In addition to producing similar spikes, the dendrites also generated large, slowly varying voltages that were even bigger than the spikes, which suggests that the dendrites execute analog computation.

"We found that dendrites are hybrids that do both analog and digital computations, which are therefore fundamentally different from purely digital computers, but somewhat similar to quantum computers that are analog," said Mehta, a UCLA professor of physics and astronomy, of neurology and of neurobiology. "A fundamental belief in neuroscience has been that neurons are digital devices. They either generate a spike or not. These results show that the dendrites do not behave purely like a digital device. Dendrites do generate digital, all-or-none spikes, but they also show large analog fluctuations that are not all or none. This is a major departure from what neuroscientists have believed for about 60 years."

Because the dendrites are nearly 100 times larger in volume than the neuronal centers, Mehta said, the large number of dendritic spikes taking place could mean that the brain has more than 100 times the computational capacity than was previously thought.

Recent studies in brain slices showed that dendrites can generate spikes. But it was neither clear that this could happen during natural behavior, nor how often. Measuring dendrites' electrical activity during natural behavior has long been a challenge because they're so delicate: In studies with laboratory rats, scientists have found that placing electrodes in the dendrites themselves while the animals were moving actually killed those cells. But the UCLA team developed a new technique that involves placing the electrodes near, rather than in, the dendrites.
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Old 10-03-2017, 04:58 PM   #905
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Default Moving Toward Understanding Consciousness

http://www.npr.org/sections/13.7/201...ntent=20170305

Following on from posts #855 and #894

Quote:
If you stop and think about it, the idea that you could understand a complex system by detailed description of one its parts is crazy on the face of it.

You are unlikely to get too much insight into the principles organizing flocking behavior in birds by confining your attention to what is going on inside an individual bird. And you aren't very likely to figure out how birds fly in the first place by studying properties of the feather.
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Old 11-03-2017, 05:10 AM   #906
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Default Long-lasting antinociceptive effects of green light in acute and chronic pain in rats.

https://www.ncbi.nlm.nih.gov/pubmed/...?dopt=Abstract

Abstract
Quote:
Treatments for chronic pain are inadequate, and new options are needed. Nonpharmaceutical approaches are especially attractive with many potential advantages including safety. Light therapy has been suggested to be beneficial in certain medical conditions such as depression, but this approach remains to be explored for modulation of pain. We investigated the effects of light-emitting diodes (LEDs), in the visible spectrum, on acute sensory thresholds in naive rats as well as in experimental neuropathic pain. Rats receiving green LED light (wavelength 525 nm, 8 h/d) showed significantly increased paw withdrawal latency to a noxious thermal stimulus; this antinociceptive effect persisted for 4 days after termination of last exposure without development of tolerance. No apparent side effects were noted and motor performance was not impaired. Despite LED exposure, opaque contact lenses prevented antinociception. Rats fitted with green contact lenses exposed to room light exhibited antinociception arguing for a role of the visual system. Antinociception was not due to stress/anxiety but likely due to increased enkephalins expression in the spinal cord. Naloxone reversed the antinociception, suggesting involvement of central opioid circuits. Rostral ventromedial medulla inactivation prevented expression of light-induced antinociception suggesting engagement of descending inhibition. Green LED exposure also reversed thermal and mechanical hyperalgesia in rats with spinal nerve ligation. Pharmacological and proteomic profiling of dorsal root ganglion neurons from green LED-exposed rats identified changes in calcium channel activity, including a decrease in the N-type (CaV2.2) channel, a primary analgesic target. Thus, green LED therapy may represent a novel, nonpharmacological approach for managing pain.
What goes around comes around, there was interest in this as far back as the 1930s, possibly before. Should we be getting our patients into green lenses?
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Old 12-03-2017, 03:36 PM   #907
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Default Why do humans reason? Arguments for an argumentative theory

http://www.dan.sperber.fr/wp-content...mansreason.pdf

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Quote:
Reasoning is generally seen as a means to improve knowledge and make better decisions. However, much evidence shows that reasoning often leads to epistemic distortions and poor decisions. This suggests that the function of reasoning should be rethought. Our hypothesis is that the function of reasoning is argumentative. It is to devise and evaluate arguments intended to persuade. Reasoning so conceived is adaptive given the exceptional dependence of humans on communication and their vulnerability to misinformation. A wide range of evidence in the psychology of reasoning and decision making can be reinterpreted and better explained in the light of this hypothesis. Poor performance in standard reasoning tasks is explained by the lack of argumentative context. When the same problems are placed in a proper argumentative setting, people turn out to be skilled arguers. Skilled arguers, however, are not after the truth but after arguments supporting their views. This explains the notorious confirmation bias. This bias is apparent not only when people are actually arguing, but also when they are reasoning proactively from the perspective of having to defend their opinions. Reasoning so motivated can distort evaluations and attitudes and allow erroneous beliefs to persist. Proactively used reasoning also favors decisions that are easy to justify but not necessarily better. In all these instances traditionally described as failures or flaws, reasoning does exactly what can be expected of an argumentative device: Look for arguments that support a given conclusion, and, ceteris paribus, favor conclusions for which arguments can be found.
Keywords: argumentation; confirmation bias; decision making; dual process theory; evolutionary psychology; motivated reasoning; reason-based choice; reasoning

via @kvenere

Kinda wish I had printed this before reading , it would have been easier on the fingers.
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Old 12-03-2017, 03:59 PM   #908
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Default Why Reality Is Not A Video Game — And Why It Matters

http://www.npr.org/sections/13.7/201...why-it-matters

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Last week, Adam Gopnik of The New Yorker published a satirical essay, in which he wondered whether the strange reality we live in could be some kind of computer game played by an advanced intelligence (us in the future or alien).

His point was that if it is, the "programmers" are messing up, given the absurdity of current events: the incredible faux-pas at the Oscars, where the wrong best picture was announced; Donald Trump, the most outsider president ever elected in U.S. history; the strange comeback by the New England Patriots at the Super Bowl. These events, claims Gopnik, are not just weird; they point to a glitch in the "Matrix," the program that runs us all.

For most people trying to make a living, pay bills or fighting an illness, to spend time considering that our reality is not the "real thing" but actually a highly-sophisticated simulation sounds ridiculous. Someone close to me said, "I wish smart people would focus on real world problems and not on this nonsense." I confess that despite being a scientist that uses simulations in my research, I tend to sympathize with this. To blame the current mess on powers beyond us sounds like a major cop out.
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Old 12-03-2017, 04:19 PM   #909
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Default What Makes Science Science?

http://www.npr.org/sections/13.7/201...cience-science
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Old 13-03-2017, 04:17 PM   #910
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Default Spine Surgeon Gets Almost 20-Year Prison Sentence for Fraud

http://www.medscape.com/viewarticle/874210

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Aria Sabit, MD, a spinal surgeon who admitted to unnecessary as well as fake operations, was sentenced today to a prison term of 235 months — almost 20 years — in a federal district court in Detroit, Michigan.

Federal prosecutors had sought a long sentence for the 43-year-old surgeon to deter other Detroit-area physicians from committing fraud.

"As this court is well aware, the Eastern District of Michigan has a particular problem with corrupt physicians willing to sell their licenses and judgment in pursuit of personal gain, sometimes at the expense of their patients," prosecutors told US District Judge Paul Borman in a sentencing memorandum in 2015. "In the past six years, more than 60 doctors in this district have been charged with misuse and abuse of their licenses in a variety of healthcare fraud, drug distribution, and/or kickback cases."
via @SimonGandevia

There will always be those who use a qualification in health care as a licence to maximise income. One of my interview questions decades ago was "Would you feel compelled to do this work if you weren't being paid for it?" I doubt that I'd be allowed to ask it nowadays.
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Old 14-03-2017, 01:53 PM   #911
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Default The body is the missing link for truly intelligent machines

https://aeon.co/ideas/the-body-is-th...55567-69418129

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It’s tempting to think of the mind as a layer that sits on top of more primitive cognitive structures. We experience ourselves as conscious beings, after all, in a way that feels different to the rhythm of our heartbeat or the rumblings of our stomach. If the operations of the brain can be separated out and stratified, then perhaps we can construct something akin to just the top layer, and achieve human-like artificial intelligence (AI) while bypassing the messy flesh that characterises organic life.

I understand the appeal of this view, because I co-founded SwiftKey, a predictive-language software company that was bought by Microsoft. Our goal is to emulate the remarkable processes by which human beings can understand and manipulate language. We’ve made some decent progress: I was pretty proud of the elegant new communication system we built for the physicist Stephen Hawking between 2012 and 2014. But despite encouraging results, most of the time I’m reminded that we’re nowhere near achieving human-like AI. Why? Because the layered model of cognition is wrong. Most AI researchers are currently missing a central piece of the puzzle: embodiment.
Ectodermalists may wish to avert their eyes.
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Old 14-03-2017, 03:58 PM   #912
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Old 14-03-2017, 11:31 PM   #913
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Default Doctor knows best....by Dave Nicholls

http://criticalphysio.net/2017/03/15/doctor-knows-best/

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Not so long ago, physiotherapists had a very close, perhaps paternalistic, relationship with the medical profession. But it seems now that our quest for professional autonomy is pushing us further away from physicians and surgeons. There are few in the profession, I think, that would dispute the obvious benefits of greater independence for physiotherapists, but this is a critical ideas blog, so I’m going to do just that.

Physiotherapy has, for much of its history, been wedded to medicine. Indeed, the modern physiotherapy profession only survived and later prospered because its founders made subservience to medicine a condition of entry. Memberhip of the Society of Trained Masseuses (STM) – formed in 1894 and the forerunner of all physiotherapy professional bodies around the world – required that everyone sat the STM’s stringent examination. Doing so cost a lot of money and effort, at a time when anyone could practice as a masseuse with just half-a-day’s training. So why did people submit to the Society’s exam? The answer is that the STM had secured the patronage of many esteemed medical men, so that members of the Society could be assured of legitimate ‘health’ cases to treat, and could distance themselves from quacks and prostitutes (see Nicholls and Cheek, 2006).

Medical patronage served the profession well during both World Wars; the epidemics, economic depressions and medical advanced of the inter-war years; and the birth of the welfare state, but by the 1970s, people within the profession wanted more control over their own professional affairs. Moving training from national health budgets into higher education and the growth of profession-specific research hastened the separation, and now, today, physiotherapy finds itself at something of a crossroads.
Quote:
Certainly moves to ‘share’ in the work of medicine (as in this, for example), illustrate that physiotherapists still see themselves as primarily biomechticians (a new word I think I might have just invented). So perhaps now might be a good time to rethink our separatist agenda, and look to our past to find new ways to align ourselves with biomedicine in order that we can secure the profession’s future for the next century or more?
The example above refers to one of the British physiotherapists who is doing orthopaedic surgical proceedures, It's good that those who want to can take this route.

It isn't for me and never was.

Had I been able to cope with managers I would still be working within the NHS. As it is, I spend much of my time mopping up patients who have fallen through the cracks in the protocols provided by the service. Thousands of pounds of tax payers money have been spent and key features of uncomplicated clinical presentations have been missed, leading to delays in getting people moving and loading.
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Old 15-03-2017, 01:56 PM   #914
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Default U.K. scientists prepare for impending break with European Union

http://www.sciencemag.org/news/2017/...et_cid=1216040



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For months after the United Kingdom voted last June to leave the European Union, many British scientists clung to hopes of a “soft Brexit,” which would not cut them off from EU funding and collaborators. But Prime Minister Theresa May, who is expected to trigger the 2-year process of exiting the European Union in coming days, has signaled the break will be sharp. U.K. researchers are now facing up to the prospect that they won’t be able to apply for EU funding or easily recruit students and colleagues from the rest of Europe.
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The stakes are high for the United Kingdom, which is a scientific powerhouse and a magnet for talent. Between 2007 and 2013, U.K. researchers brought home more than €7 billion in EU research funding, second only to Germany. Cash from Brussels made up nearly 10% of research funding at U.K. universities in 2013, an increase of 68% since 2009. The United Kingdom’s prominence as an international hub was made clear this week when a new analysis of mobility of high-skill professionals, published in the Journal of the Royal Society Interface, found that the country was four times more highly networked than the average for Europe.
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Old 15-03-2017, 11:05 PM   #915
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Default Changing pain thresholds with classical conditioning

http://www.bodyinmind.org/pain-thres...ody+in+Mind%29
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Old 16-03-2017, 09:40 AM   #916
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Default Preventing opioid-induced nausea and vomiting: Rest your head and close your eyes?

http://journals.plos.org/plosone/art...l.pone.0173925

Quote:
Nausea during remifentanil administration was triggered by movement and avoided by rest in all subjects independently of visual input. This suggests that vision is not the major cause for an inter-sensory mismatch with semicircular canal input during head motion.

Remifentanil reversibly affects vestibulo-ocular reflex function, as measured by the VOR gain of the horizontal semicircular canals [9,10]. This altered information could clash with neck proprioception or other vestibular sensory information. An intra-vestibular mismatch between reduced horizontal semicircular canals [9] and not accordingly altered otolith signals seems likely. Such an intra-vestibular mismatch is acknowledged as a causative factor for seasickness (for review, see Bertolini&Straumann, 2016 [16]) and also seems to provoke space sickness where altered otolith signals in weightlessness clash with regular semicircular canal input.
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Old 16-03-2017, 10:02 AM   #917
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Default Is the headache in patients with vestibular migraine attenuated by vestibular rehabilitation?

http://journal.frontiersin.org/artic...00124/abstract

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Background: Vestibular rehabilitation is the most effective treatment for dizziness due to vestibular dysfunction. Given the biological relationship between vestibular symptoms and headache, headache in patients with vestibular migraine (VM) could be improved by vestibular rehabilitation that leads to the improvement of dizziness. This study aimed to compare the effects of vestibular rehabilitation on headache and other outcomes relating to dizziness, and the psychological factors in patients with VM patients, patients with dizziness and tension-type headache, and patients without headache.
Methods: Our participants included 251 patients with dizziness comprising 28 patients with VM, 79 patients with tension-type headache, and 144 patients without headache. Participants were hospitalized for 5 days and taught to conduct a vestibular rehabilitation program. They were assessed using the Dizziness Handicap Inventory (DHI), Headache Impact Test (HIT-6), Hospital Anxiety and Depression Scale (HADS), and Somatosensory Catastrophizing Scale (SCSS), and underwent center of gravity fluctuation measurement as an objective dizziness severity index before, 1 month after, and 4 months after their hospitalization.
Results: The VM and tension-type headache groups demonstrated a significant improvement in the HIT-6 score with improvement of the DHI, HADS, SCSS, and a part of the objective dizziness index that also shown in patients without headache following vestibular rehabilitation. The change in HIT-6 during rehabilitation in the VM group was positively correlated with changes in the DHI and anxiety in the HADS. Changes in the HIT-6 in tension-type headache group positively correlated with changes in anxiety and SCSS.
Conclusions: Vestibular rehabilitation contributed to improvement of headache both in patients with VM and patients with dizziness and tension-type headache, in addition to improvement of dizziness and psychological factors. Improvement in dizziness following vestibular rehabilitation could be associated with the improvement of headache more prominently in VM compared with comorbid tension-type headache.
Keywords: Vestibular Diseases, Migraine Disorders, Rehabilitation, Treatment, vestibular rehablitation, headache impact, dizziness handicap

I find this interesting in that I have rarely been able to affect the nature of migraine pain although patients have found reduction in vestibular symptoms and frequency of migraine episodes helpful.
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Old 16-03-2017, 10:21 AM   #918
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Default Dynamic Shaping of the Defensive Peripersonal Space through Predictive Motor Mechanisms: When the “Near” Becomes “Far”

http://www.jneurosci.org/content/37/...ampaign=buffer

Abstract

Quote:
The hand blink reflex is a subcortical defensive response, known to dramatically increase when the stimulated hand is statically positioned inside the defensive peripersonal space (DPPS) of the face. Here, we tested in a group of healthy human subjects the hand blink reflex in dynamic conditions, investigating whether the direction of the hand movements (up-to/down-from the face) could modulate it. We found that, on equal hand position, the response enhancement was present only when the hand approached to (and not receded from) the DPPS of the face. This means that, when the hand is close to the face but the subject is planning to move the hand down, the predictive motor system can anticipate the consequence of the movement: the “near” becomes “far.” We found similar results both in passive movement condition, when only afferent (visual and proprioceptive) information can be used to estimate the final state of the system, and in motor imagery task, when only efferent (intentional) information is available to predict the consequences of the movement. All these findings provide evidence that the DPPS is dynamically shaped by predictive mechanisms run by the motor system and based on the integration of feedforward and sensory feedback signals.

SIGNIFICANCE STATEMENT The defensive peripersonal space (DPPS) has a crucial role for survival, and its modulation is fundamental when we interact with the environment, as when we move our arms. Here, we focused on a defensive response, the hand blink reflex, known to increase when a static hand is stimulated inside the DPPS of the face. We tested the hand blink reflex in dynamic conditions (voluntary, passive, and imagined movements) and we found that, on equal hand position, the response enhancement was present only when the hand approached to (and not receded from) the DPPS of the face. This suggests that, through the integration of efferent and afferent signals, the safety boundary around the body is continuously shaped by the predictive motor system.
via @neuroconscience
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Old 17-03-2017, 03:31 AM   #919
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Default Stories from neuroanatomy: ascending thoracic nerve roots

https://noijam.com/2017/03/17/storie...c-nerve-roots/
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"Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi
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Old 17-03-2017, 06:58 PM   #920
Jo Bowyer
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Default Posts awaiting moderation.............................

won't stop me reading


Update.

It has happened in the past that a user name, rather than posts from certain journals has triggered automatic moderation. I have had nothing back via the Contact Us button. Having lost a few posts which makes it difficult to curate subject threads, I won't be posting until I know more.
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Jo Bowyer
Chartered Physiotherapist Registered Osteopath.
"Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

Last edited by Jo Bowyer; Today at 10:33 AM. Reason: update
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