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[(ge)13.9(ne)-372(ex)19.7(pr)15.1(es)19.9(si)20.9(on)20.8(.)-389.3(B)0(u)19.8(t)-381.4(cu)13.9(rr)20.9(en)19.7(t)-387.1(r)0(e)19.7(s)0(e)19.9(a)0(r)19.7(c)0(h)-377.7(o)0(n)-376.6(m)0(e)18.4(c)0(h)19.7(a)0(n)19.7(o)0(t)20.7(r)0(a)14(n)0(s)21(d)0(u)20.8(c)0(-)]TJ
T*
[(ti)14.8(on)-601.2(ha)13.9(s)-611.4(a)-618.5(we)18.8(ll)14.8(-r)20.9(ec)18.5(og)20.8(ni)20.7(ze)18.5(d)-617.4(l)0(i)20.6(m)0(i)19.5(t)0(a)13.8(t)0(i)20.6(o)0(n)20.8(:)-617.5(Al)19.8(mo)19.6(st)-606.9(al)19.6(l)-617.5(o)0(f)-606.9(i)0(t)20.6(s)]TJ
T*
[(kn)15.1(ow)20(le)19.6(dg)20.8(e)-376.6(i)0(s)-370.8(d)0(e)19.7(r)0(i)20.7(v)0(e)19.7(d)-375.5(fr)20.9(om)-372(cu)19.7(lt)20.6(ur)20.9(ed)-366.2(ce)18.5(ll)14.8(s.)-367.2(Ex)19.6(te)19.6(ns)21(io)20.7(n)-375.5(o)0(f)-370.8(t)0(h)20.7(i)0(s)]TJ
0 -1.1174 TD
[(wo)14.2(rk)-491.7(in)20.7(to)-497.7(wh)20(ol)20.7(e,)-495.3(li)14.8(ve)-492.9(ti)20.6(ss)15.5(ue)-492.9(ha)19.7(s)-507.8(r)0(e)19.7(s)0(u)21(l)0(t)14.8(e)0(d)-492.9(f)0(r)20.9(o)0(m)-498.8(s)0(t)20.9(u)0(d)20.8(i)0(e)19.6(s)-507.8(in)]TJ
0 -1.1116 TD
[(wh)14.2(ic)19.6(h)-283.3(t)0(h)20.7(e)-284.5(ac)18.5(up)20.8(un)20.8(ct)13.8(ur)20.9(e)-284.5(n)0(e)19.7(e)0(d)19.7(l)0(e)-274.2(p)0(r)20.9(o)0(v)15.1(i)0(d)20.7(e)0(s)-273.9(a)-284.5(me)18.4(th)20.7(od)-272.9(to)-278.8(de)19.7(li)20.6(ve)19.7(r)-283.3(a)]TJ
T*
[(pr)15.1(ec)18.5(is)20.9(e)-411.2(m)0(e)18.4(c)0(h)13.9(a)0(n)19.7(i)0(c)19.6(a)0(l)-400.9(s)0(i)15.1(g)0(n)20.8(a)0(l)-406.7(t)0(h)20.7(a)0(t)-400.9(c)0(a)18.5(n)-415.8(pr)20.9(od)20.8(uc)19.7(e)-417(d)0(o)20.8(s)0(e)19.9(-)0(d)15.1(e)0(p)19.7(e)0(n)19.7(d)0(e)19.7(n)0(t)]TJ
0 -1.1174 TD
[(re)14(sp)21(on)20.8(se)19.9(s)-467.4(i)0(n)-451.6(a)0(r)13.9(e)0(o)19.7(l)0(a)19.6(r)-461.8(co)19.7(nn)15.1(ec)18.5(ti)20.6(ve)-452.6(ti)14.8(ss)21.2(ue)-452.6(b)15.2(ro)20.9(bl)20.7(as)19.9(ts)15.2(.)]TJ
7.3823 0 0 6.5614 260.9007 641.877 Tm
[(32)24.7(,3)20.4(3)]TJ
9.843 0 0 9.843 281.7637 637.455 Tm
[(Su)21(s-)]TJ
-22.555 -1.1116 TD
[(ta)13.8(in)20.7(ed)-262.5(st)20.9(re)19.7(tc)19.5(hi)14.9(ng)-261.4(of)-261.4(ti)20.6(ss)21.2(ue)-268.3(is)-261.3(in)20.7(he)19.7(re)19.7(nt)-261.5(to)-261.5(th)15(is)-261.3(re)19.7(sp)21(on)15.1(se)-262.4(an)19.7(d)-271.8(h)0(a)19.7(s)]TJ
T*
[(be)13.9(en)-400.8(sh)15.3(ow)20(n)-415.8(t)0(o)-405.5(c)0(a)18.5(u)0(s)21(e)-417(lo)20.7(ca)18.5(l)-415.9(p)0(u)15.1(r)0(i)20.7(n)0(e)19.7(r)0(g)20.9(i)0(c)-406.7(s)0(i)20.9(g)0(n)15.1(a)0(l)19.5(i)0(n)20.7(g)-415.8(an)19.7(d)-415.8(a)0(c)18.5(t)0(i)20.6(v)0(e)19.7(,)]TJ
0 -1.1174 TD
[(ce)18.5(ll)14.8(-m)19.6(ed)19.7(ia)19.5(te)19.6(d)-225.7(t)0(i)20.6(s)0(s)15.5(u)0(e)-216.5(r)0(e)19.7(l)0(a)19.6(x)0(a)19.7(t)0(i)20.6(o)0(n)20.8(.)]TJ
7.3823 0 0 6.5614 179.8866 608.9951 Tm
(34)Tj
9.843 0 0 9.843 189.4109 604.5731 Tm
[(Be)18.6(fo)20.9(re)-216.4(ex)19.7(pe)19.7(ri)15(me)18.4(nt)20.7(s)-225.5(w)0(i)19.8(t)0(h)-215.4(t)0(h)20.7(e)]TJ
-13.1724 -1.1116 TD
[(ac)18.5(up)15.1(un)20.8(ct)19.5(ur)20.9(e)-411.2(n)0(e)19.7(e)0(d)19.7(l)0(e)19.6(,)-412.4(th)20.7(es)19.9(e)-411.2(f)0(u)20.9(n)0(c)19.7(t)0(i)14.8(o)0(n)20.8(s)-409.8(of)-399.6(b)21(ro)20.9(bl)20.7(as)14.1(ts)-399.5(we)18.8(re)-400.7(un)20.8(-)]TJ
T*
[(kn)15.1(ow)20(n.)-626.6(Th)19.6(us)21(,)-637(n)0(o)20.8(v)0(e)19.7(l)-634.8(in)20.7(si)15.1(gh)20.8(ts)-624.2(gl)20.7(ea)18.5(ne)13.9(d)-634.7(f)0(r)20.9(o)0(m)-625.5(a)0(c)18.5(u)0(p)20.8(u)0(n)15.1(c)0(t)19.5(u)0(r)20.9(e)0(-)]TJ
T*
[(re)14(la)19.6(te)19.6(d)-421.6(r)0(e)14(s)0(e)19.9(a)0(r)19.7(c)0(h)-418.1(h)0(a)19.7(v)0(e)-412.3(l)0(e)19.6(d)-427.3(to)-417(an)-412.3(im)19.5(pr)20.9(ov)15.1(ed)-412.3(un)20.8(de)13.9(rs)21.1(ta)19.5(nd)20.8(in)20.7(g)-427.3(o)0(f)]TJ
0 -1.1174 TD
[(ba)13.9(si)20.9(c)-324.8(m)0(e)18.4(c)0(h)19.7(a)0(n)19.7(o)0(b)20.8(i)0(o)20.7(l)0(o)20.7(g)0(y)15.1(.)]TJ
7.3823 0 0 6.5614 149.6693 565.1148 Tm
[(31)24.7(,3)20.4(5)16.2()0(3)24.7(7)]TJ
9.843 0 0 9.843 69.7323 549.8077 Tm
[(Acupuncture-related)-610.8(studies)-602(on)-595.4(connective)-603.4(tissue)-606.6(also)]TJ
-1.0137 -1.1116 TD
[(have)-530.9(contributed)-533.2(to)-526.5(a)-526.4(resurgence)-533.8(of)-526.3(interest)-529.7(and)-528.6(greater)]TJ
0 -1.1174 TD
[(understanding)-609.9(of)-601.2(connective)-603.4(tissue)-606.6(pathology)-604.6(associated)]TJ
0 -1.1116 TD
[(with)-293.5(chronic)-292.4(musculoskeletal)-293.3(pain)-293.7(and)-286.7(brotic)-291.2(diseases.)]TJ
7.3823 0 0 6.5614 282.2172 521.2912 Tm
[(38,3)-8.6(9)]TJ
9.843 0 0 9.843 59.7543 505.9841 Tm
[(The)-426.1(areolar)-426(connective)-430.6(tissue)-422.3(layers)-429.3(that)-420.5(wind)-425.9(around)-422.4(the)]TJ
0 -1.1174 TD
[(needle)-321.3(and)-315.5(respond)-319.7(to)-313.4(acupuncture)-322.1(needle)-315.5(manipulation)-316.8(are)]TJ
0 -1.1116 TD
[(the)-384.7(same)-382.1(layers)-383.2(that)-380.2(normally)-380.1(allow)-382.2(gliding)-382.5(between)-386.6(adja-)]TJ
T*
[(cent)-352.4(layers)-348.7(of)-347.7(fascia)-349.8(during)-346.5(normal)-343.2(movement)-353.6(and)-344.3(become)]TJ
0 -1.1174 TD
[(abnormal)-703.6(in)-699.3(musculoskeletal)-708(pain.)]TJ
7.3823 0 0 6.5614 208.6299 466.5258 Tm
(40)Tj
9.843 0 0 9.843 222.8598 462.1038 Tm
[(Recent)-708.2(ultrasound)]TJ
-16.5707 -1.1116 TD
[(studies)-348.6(have)-346.6(shown)-346(that)-345.6(the)-350.2(connective)-350(tissues)-348.4(surrounding)]TJ
T*
[(the)-361.7(muscles)-368.1(of)-359.3(the)-361.7(back)-358.1(are)-362.7(thicker)-367.4(in)-359.4(people)-360.4(with)-362.6(chronic)]TJ
T*
[(low)-522.7(back)-525.1(pain)-518.3(than)-524.1(in)-520.7(control)-521.7(participants)-529.6(without)-521.6(back)]TJ
0 -1.1174 TD
(pain)Tj
7.3823 0 0 6.5614 76.8189 422.6456 Tm
(41)Tj
9.843 0 0 9.843 84.1889 418.2802 Tm
[(;)-415.9(similar)-413.4(results)-411.9(have)-415.7(been)-415.7(reported)-414.4(in)-411.3(patients)-420.3(with)]TJ
-2.4824 -1.1116 TD
[(chronic)-338.4(pelvic)-337.5(pain.)]TJ
7.3823 0 0 6.5614 139.6346 411.7038 Tm
(42)Tj
9.843 0 0 9.843 69.7323 396.3968 Tm
[(These)-550.2(insights)-550.2(and)-551.6(new)-552.5(avenues)-552.4(of)-549.3(investigation)-552.8(into)]TJ
-1.0137 -1.1174 TD
[(mechanobiology)-331.4(and)-321.2(connective)-327(tissue)-324.4(pathophysiology)-323.2(are)]TJ
0 -1.1116 TD
[(not)-337.5(likely)-342.2(to)-336.4(have)-335(occurred)-340.5(without)-343(the)-332.9(initial)-343.6(research)-341.5(that)]TJ
T*
[(used)-327.9(acupuncture)-327.9(needles)-327.9(to)-324.9(interact)-329.4(specically)-327.8(with)-328.1(loose)]TJ
0 -1.1174 TD
[(connective)-338.5(tissue.)]TJ
/F9 1 Tf
8.9663 0 0 8.9663 59.7543 325.1338 Tm
[(Toward)-340(a)-333.2(better)-332.3(understanding)-332.8(of)-336.7(placebo)-328.4(effects)]TJ
/F5 1 Tf
9.843 0 0 9.843 69.7323 308.6928 Tm
[(Placebo)-293.4(effects,)-296.7(or)-290.1(nonspecic)-296.5(treatment)-297.2(effects,)-296.7(occur)-290(in)]TJ
-1.0137 -1.1116 TD
[(preclinical)-351.3(research,)-350.7(clinical)-352.6(practice,)-345.4(and)-350(randomized)-349.9(con-)]TJ
T*
[(trolled)-447(clinical)-450.6(trials,)-443.3(with)-449(large)-445.7(effect)-447.9(sizes)-445.3(in)-445.8(functional)]TJ
0 -1.1174 TD
[(disorders)-569.4(such)-564.1(as)-567.6(chronic)-568.8(pain)]TJ
7.3823 0 0 6.5614 190.9984 280.1763 Tm
(43)Tj
9.843 0 0 9.843 203.981 275.8109 Tm
[(and)-563.2(depression.)]TJ
7.3823 0 0 6.5614 268.3842 280.1763 Tm
(44)Tj
9.843 0 0 9.843 281.3668 275.8109 Tm
(This)Tj
-22.5147 -1.1116 TD
[(section)-252(highlights)-247.5(how)-246.1(acupuncture)-253(research)-255.1(on)-244.1(chronic)-252(pain)]TJ
T*
[(has)-395.9(contributed)-400.7(to)-394(the)-396.3(understanding)-396.8(and)-396.1(potential)-392.9(clinical)]TJ
0 -1.1174 TD
[(use)-338.3(of)-330.5(placebo)-339.6(effects)-333.6(in)-336.4(biomedicine.)]TJ
1.0137 -1.1116 TD
[(Th)19.6(e)-347.8(u)0(s)21(e)-342.1(of)-336.2(th)20.7(e)-347.8(s)0(h)21(a)0(m)-332.9(a)0(c)12.8(u)0(p)20.8(u)0(n)20.8(c)0(t)19.5(u)0(r)20.9(e)-347.8(ne)19.7(ed)19.7(le)-337.6(as)-331.5(a)-347.8(u)0(n)20.8(i)0(q)20.7(u)0(e)-337.4(p)0(l)20.7(a)0(-)]TJ
-1.0137 -1.1116 TD
[(ce)18.5(bo)-647.3(de)19.7(vi)20.7(ce)-643.9(ha)13.9(s)-651.7(a)0(s)19.9(s)0(i)20.9(s)0(t)15.1(e)0(d)-642.7(r)0(e)19.7(s)0(e)19.9(a)0(r)14(c)0(h)19.7(e)0(r)19.7(s)-651.7(in)-647.4(id)20.7(en)19.7(ti)20.6(fy)20.9(in)15(g)-651.9(k)0(e)19.7(y)]TJ
0 -1.1174 TD
[(co)13.9(m)15(p)0(o)15.1(n)0(e)19.7(n)0(t)20.7(s)-536.6(of)-526.3(tr)20.7(ea)12.8(tm)19.5(en)19.7(t)-536.9(t)0(h)20.7(a)0(t)-527.6(m)0(a)18.4(y)-536.7(en)19.7(ha)19.7(nc)19.7(e)-537.9(t)0(h)20.7(e)-537.9(ef)14(fe)19.7(ct)-527.6(of)]TJ
0 -1.1116 TD
[(pl)14.9(ac)18.5(eb)19.7(o.)-286.8(In)-290.2(a)-296(s)0(e)19.9(m)0(i)13.7(n)0(a)19.7(l)-295(st)15.1(ud)20.8(y)-294.8(b)0(y)-290.2(K)0(a)18.8(p)0(t)20.7(c)0(h)19.7(u)0(k)-290.2(e)0(t)-291.5(a)0(l)19.5(.)13.9(,)-302.9(p)0(a)19.7(t)0(i)20.6(e)0(n)19.7(t)0(s)-290.1(w)0(i)19.8(t)0(h)]TJ
T*
[(ir)15(ri)20.7(ta)19.5(bl)20.7(e)-307.5(b)0(o)20.8(w)0(e)13(l)-306.5(sy)21(nd)20.8(ro)20.9(me)-298.3(re)14(po)20.8(rt)20.7(ed)-297.1(in)20.7(cr)14(ea)18.5(si)20.9(ng)-295.9(sy)21(mp)19.6(to)15(m)-307.6(r)0(e)19.7(l)0(i)20.6(e)0(f)]TJ
T*
[(wi)14.1(th)-388.2(es)19.9(ca)18.5(la)13.8(ti)20.6(ng)-388.1()56.5()0(d)20.9(o)0(s)21(e)0(s)19.9()56.5()-398.5(o)0(f)-393.8(p)0(l)20.7(a)0(c)18.5(e)0(b)19.7(o)0(:)-394(o)0(b)20.8(s)0(e)19.9(r)0(v)15.1(a)0(t)19.5(i)0(o)20.7(n)-398.5(al)13.8(on)20.8(e,)-391.6(ob)20.8(-)]TJ
0 -1.1174 TD
[(se)14.1(rv)20.9(at)19.5(io)20.7(n)-317.9(p)0(l)20.7(u)0(s)-301.5(s)0(h)21(a)0(m)-309.8(a)0(c)18.5(u)0(p)20.8(u)0(n)20.8(c)0(t)19.5(u)0(r)15.1(e)0(,)-299.4(a)0(n)13.9(d)-312.1(ob)20.8(se)19.9(rv)15.1(at)19.6(io)20.7(n)-312.1(p)0(l)20.7(u)0(s)-307.3(s)0(h)21(a)0(m)]TJ
0 -1.1116 TD
[(ac)18.5(up)15.1(un)20.8(ct)19.5(ur)20.9(e)-704.9(p)0(l)15(u)0(s)-693.2(p)0(o)20.8(s)0(i)20.9(t)0(i)14.8(v)0(e)-694.5(p)0(a)19.7(t)0(i)20.6(e)0(n)19.7(t)0(-)20.7(p)0(r)15.1(o)0(v)20.8(i)0(d)20.7(e)0(r)-694.5(r)0(e)19.7(l)0(a)13.8(t)0(i)20.6(o)0(n)20.8(s)0(h)21(i)0(p)20.7(.)]TJ
7.3823 0 0 6.5614 291.5716 159.6472 Tm
(45)Tj
9.843 0 0 9.843 59.7543 144.3401 Tm
[(Th)19.6(is)-318.9(st)20.9(ud)15.1(y)-323.6(h)0(a)19.7(s)-329.2(si)20.9(gn)20.8(i)15.1(ca)18.5(nt)20.7(ly)-319.1(af)19.7(fe)19.7(ct)19.5(ed)-320.1(th)20.7(e)-324.8()0(e)14.1(l)0(d)-313.3(o)0(f)-319(g)0(a)19.7(s)0(t)20.9(r)0(o)15.1(e)0(n)19.7(t)0(e)19.6(r)0(-)]TJ
0 -1.1174 TD
[(ol)14.9(og)20.8(y,)-401.9(en)19.7(ha)13.9(nc)19.7(in)20.7(g)-415.8(a)0(p)19.7(p)0(r)20.9(e)0(c)18.5(i)0(a)19.6(t)0(i)14.8(o)0(n)-405.4(o)0(f)-405.3(t)0(h)20.7(e)-417(do)20.8(ct)19.5(or)-405.3(as)-406.3(a)-417()62.3(w)14.2(al)19.6(ki)20.7(ng)]TJ
0 -1.1116 TD
[(pl)14.9(ac)18.5(eb)19.7(o,)18.5()62.3()]TJ
7.3823 0 0 6.5614 98.0787 126.7653 Tm
(46)Tj
9.843 0 0 9.843 109.8141 122.3999 Tm
[(an)19.7(d)-450.4(h)0(i)20.7(g)0(h)20.8(l)0(i)14.8(g)0(h)20.8(t)0(i)20.6(n)0(g)-439.9(t)0(h)20.7(e)-451.5(po)20.8(te)13.8(nt)20.7(ia)19.6(l)-450.5(t)0(h)20.7(a)0(t)-441.2(a)0(r)19.7(i)0(s)15.1(e)0(s)-440.9(f)0(r)20.9(o)0(m)]TJ
-5.0858 -1.1116 TD
[(pl)14.9(ac)18.5(eb)19.7(o)-346.7(r)0(e)19.7(s)0(e)19.9(a)0(r)19.7(c)0(h)-337.4(f)0(o)15.1(r)-346.6(pa)19.7(ti)20.6(en)19.7(ts)-336.2(wi)14.1(th)-336.4(ch)19.7(ro)20.9(ni)20.7(c)-347.8(a)0(b)19.7(d)0(o)15.1(m)15(in)15(al)-337.6(sy)21(mp)19.6(-)]TJ
0 -1.1174 TD
[(to)15(ms)19.8(.)]TJ
7.3823 0 0 6.5614 80.9008 104.8819 Tm
(47)Tj
9.843 0 0 9.843 91.6157 100.4598 Tm
[(Th)19.6(is)-336.2(sp)21(ec)18.5(i)20.9(c)-347.8(l)0(i)20.6(n)0(e)-331.7(o)0(f)-336.2(r)0(e)19.7(s)0(e)19.9(a)0(r)19.7(c)0(h)-337.4(i)0(n)-336.4(i)0(r)20.7(r)0(i)20.7(t)0(a)19.6(b)0(l)20.7(e)-347.8(bo)20.8(we)18.8(l)-346.8(s)0(y)21(n)0(-)]TJ
-3.237 -1.1116 TD
[(dr)15.1(om)19.6(e)-434.2(a)0(l)13.8(s)0(o)-428.2(s)0(e)19.9(t)-439(th)20.7(e)-440(s)0(t)20.9(a)0(g)19.7(e)-440(fo)20.9(r)-438.8(e)0(x)19.7(p)0(l)20.7(o)0(r)20.9(i)0(n)15(g)-433.1(ge)13.9(no)20.8(mi)19.5(c)-440(e)0(f)19.7(f)0(e)19.7(c)0(t)19.5(s)-438.6(on)]TJ
T*
[(pl)14.9(ac)18.5(eb)19.7(o)-473.4(r)0(e)19.7(s)0(p)15.3(o)0(n)20.8(s)0(e)19.9(,)]TJ
7.3823 0 0 6.5614 130.6771 82.9417 Tm
-.0162 Tc
(48)Tj
9.843 0 0 9.843 142.6393 78.5763 Tm
0 Tc
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[(an)19.7(d)]TJ
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[(protegerin)-387.9(and)-390.4(tumor)-392.7(necrosis)-391(factorrelated)-395.9(weak)-393.5(inducer)]TJ
T*
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(53)Tj
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[(as)-354.5(well)-358(as)-354.5(catecholamine)-362.8(O-methyl)-357.9(transfer-)]TJ
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(48)Tj
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[(In)-324.7(summary,)-331.3(acupuncture)-333.7(research)-335.8(has)-326.8(contributed)-331.6(to)-330.6(the)]TJ
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T*
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[(up)-353.5(to)-347.9(half)-357(of)-353.5(the)-355.9(participants)]TJ
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(52,54)Tj
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[(;)-352.6(\(2\))-354.6(the)-355.9(important)-352.5(role)-357(of)]TJ
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[(the)-309.9(provider-patient)-321(relationship)-315.3(in)-313.3(the)-309.9(therapeutic)-322.4(response)]TJ
T*
[(to)-572.5(placebo)]TJ
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(45,55)Tj
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[(;)-577.2(and)-574.7(\(3\))-579.2(identication)-577(of)-578.1(additional)-578.3(bio-)]TJ
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[(markers)-350.8(associated)-349.6(with)-345.4(placebo)-351.2(response.)]TJ
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[(53,5)-8.6(6)]TJ
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[(These)-348.7(inno-)]TJ
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[(vative)-694.6(ndings)-692.9(provide)-694.4(a)-687.7(scientic)-698.8(basis)-691.8(for)-694.4(ethically)]TJ
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[(enhancing)-612.5(the)-609.4(placebo)-610.3(effect)-609.2(in)-607.1(the)-609.4(clinical)-611.8(setting)-613.8(by)]TJ
T*
[(strengthening)-460.3(the)-465.4(provider-patient)-465(relationship)-465.1(\(e.g.,)-458.2(com-)]TJ
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[(munications)-349.9(and)-350(clear)-348.9(explanation)-350.1(of)-347.7(possible)-349.7(benets)-355.4(of)-342(a)]TJ
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(treatment)Tj
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(46,54)Tj
9.843 0 0 9.843 364.9322 516.9258 Tm
[(\))-427.3(and)-424.9(by)-428.4(optimizing)-434.4(the)-425.1(therapeutic)-437.6(environ-)]TJ
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[(ment)-335.2(and)-332.8(rituals.)]TJ
7.3823 0 0 6.5614 378.5952 510.3495 Tm
(49)Tj
/F9 1 Tf
8.9663 0 0 8.9663 310.8472 482.2298 Tm
[(Acupuncture-related)-336(devices)-331.2(that)-332.1(have)-335.2(affected)]TJ
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(biomedicine)Tj
/F5 1 Tf
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[(The)-483.7(development)-495.2(of)-486(several)-489.2(currently)-490.5(used)-489.2(biomedical)]TJ
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[(devices)-276.1(has)-269.2(clear)-279.8(links)-270.5(to)-273(acupuncture-related)-282.8(research.)-275.8(This)]TJ
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[(section)-355.7(highlights)-356.9(two)-355.6(widely)-354.5(used)-356.7(devices:)-358(transcutaneous)]TJ
T*
[(electrical)-345.6(nerve)-341.9(stimulation)-337.5(\(TENS\))-343.7(units)-339.6(for)-343.1(analgesia)-342.9(and)]TJ
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[(acupressure)-338.9(bands)-334.8(for)-331.5(relief)-337.4(of)-336.2(nausea.)]TJ
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8.9663 0 0 8.9663 320.8251 387.2692 Tm
[(Acupuncture)-465.4(and)-462.2(TENS.)]TJ
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[(The)-454.9(modern)-458.2(TENS)-451(unit)-453.9(as)-452.4(a)]TJ
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[(means)-469.6(of)-468.7(pain)-472.2(relief)-475.7(was)-471.7(developed)-474.3(from)-466.3(a)-474.6(technique)-474.4(of)]TJ
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[(dorsal)-330.2(column)-337.4(electroanalgesia)-337.1(by)-330.5(C.)-333.9(Norman)-332.4(Shealy,)-334.9(MD,)]TJ
T*
[(in)-572.5(the)-580.6(early)-578.1(1970s.)]TJ
7.3823 0 0 6.5614 393.392 358.7527 Tm
(57,58)Tj
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[(According)-577.7(to)-578.3(Shealy,)-576.8()50.8()0(I)-578.1(began)]TJ
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[(stimulating)-233.8(acupuncture)-241.5(needles)-235.8(with)-235.9(electrical)-236.2(energy)-239.3(in)-232.7(the)]TJ
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[(mid)-471.2(60s.)-474.1(Later,)-479.1(without)-475.5(needles,)-481.1(I)-473.4(introduced)-474.4(TENS.)45.6()]TJ
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(59)Tj
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(60)Tj
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[(In)-474.5(the)-471.1(United)-481.2(States,)-478.8(TENS)-474(is)-474.4(a)-480.3(reimbursable)-478.7(medical)]TJ
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[(procedure)-238(for)-233.6(pain)-236.1(relief)-233.8(in)-232.7(both)-234.9(private)-234.9(and)-234.9(public)-238.4(insurance)]TJ
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T*
[(American)-388.9(Medical)-386.7(Association)-383.9(\(AMA\))-388.2(Current)-384.4(Procedural)]TJ
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[(Terminology)-263.6(\(CPT)-265.6(97014)-258.9(or)-261.4(64550\))-260(and)-263.6(in)-261.5(the)-263.8(public)-261.5(sector)]TJ
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[(based)-238(on)-232.6(the)-235(AMAs)-238.3(Healthcare)-242.6(Common)-234.7(Procedure)-237.8(Coding)]TJ
T*
[(System)-509.9(\(HCPCS-)-505.6(G0283\).)]TJ
7.3823 0 0 6.5614 419.981 249.1653 Tm
(61)Tj
9.843 0 0 9.843 432.34 244.8 Tm
[(The)-506.8(effect)-511.3(of)-503.3(TENS)-508.6(on)-509(the)]TJ
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[(medical)-375.6(eld)-368.4(at)-377.9(large)-370.8(is)-370.8(also)-374.1(reected)-376.3(in)-371(U.S.-based)-375.6(insur-)]TJ
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[(ance)-382.3(guidelines;)-383.4(for)-377.6(example,)-384.6(Blue)-381.1(CrossBlue)-382.6(Shield)-382.3(As-)]TJ
T*
[(sociation)-628.7(currently)-634.5(supports)-624.8(the)-632.4(use)-626.3(of)-630(this)-626.5(device)-632.3(for)]TJ
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[(chronic)-430.6(spinal)-434.1(pain)-437.7(\(neck)-434(or)-428.4(back\).)]TJ
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(62)Tj
9.843 0 0 9.843 468.5101 200.9196 Tm
[(TENS)-433.7(devices)-437.4(have)]TJ
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[(received)-508.9(U.S.)-510.9(Food)-505.3(and)-511.3(Drug)-506.3(Administration)-514.4(\(FDA\))-508.1(ap-)]TJ
T*
[(proval)-336.2(for)-331.5(both)-332.8(pain)-334(relief)-337.4(and)-332.8(the)-332.9(prevention)-341.9(of)-330.5(pain.)]TJ
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(63)Tj
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[(Acupuncture)-579.2(and)-588.6(acupressure)-579.4(bands.)]TJ
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[(Numerous)-564.8(acu-)]TJ
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[(pressure)-413.9(devic)-8(es)-412.1(\(e.g.,)-417.9(Sea-Band)]TJ
/F8 1 Tf
7.3823 0 0 6.5614 443.8487 148.7055 Tm
()Tj
/F5 1 Tf
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(,)Tj
9.843 0 0 9.843 455.6408 144.3401 Tm
[(Sea-Band)-416.3(Ltd.,)-420.4(Leices-)]TJ
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[(tershire,)-268(United)-262.3(Kingdom\))-264.4(are)-264.8(available)-268.4(on)-261.4(the)-263.8(open)-264.7(market,)]TJ
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[(most)-316.6(often)-323.6(sold)-321.1(as)-320(a)-319(means)-325.7(to)-319.1(relieve)-322.4(nausea)-326.7(and)-315.5(vomiting.)]TJ
T*
[(The)-472.2(history)-468.5(of)-468.7(these)-474.3(devices)-471.9(is)-474.4(inseparably)-470.7(linked)-474.6(to)-468.9(the)]TJ
T*
[(clinical)-335.4(practice)-342(of)-336.2(acupuncture)-339.4(and)-332.8(acupressure,)-342.3(with)-333.8(clin-)]TJ
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[(ical)-421.7(research)-422.1(reinforcing)-423.5(their)-421.6(acceptance.)-425.9(The)-420.4(earliest)-427.2(re-)]TJ
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[(search)-326.6(trials)-330.5(were)-324.4(initiated)-329.7(in)-324.9(Ireland)-326.9(by)-324.7(J.W.)-327.9(Dundee,)-330(who)]TJ
T*
[(had)-304(observ)-7.5(ed)-302.9(physicians)-312.7(in)-307.6(China)-307.3(teaching)-312.1(patients)-310.8(to)-307.6(press)]TJ
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[(on)-520.6(acupuncture)-523.7(point)-518.4(PC6,)-520.2(located)-524.1(on)-514.8(the)-523(inner)-519.4(wrist.)]TJ
7.3823 0 0 6.5614 542.551 61.0583 Tm
(64)Tj
/F4 1 Tf
8.9663 0 0 8.9663 59.7543 749.7069 Tm
[(THE)-335.2(IMPACT)-336.8(OF)-337.5(ACUPUNCTURE)-340.1(RESEARCH)]TJ
54.1178 0 TD
(3)Tj
ET
endstream
endobj
55 0 obj
<>stream
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BT
/F5 1 Tf
9.843 0 0 9.843 62.022 725.1588 Tm
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[(Dundee)-510.9(and)-511.3(colleagues)-516.8(were)-508.7(among)-509(the)-511.4(rst)-511(to)-509.2(conduct)]TJ
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[(randomized)-396(controlled)-393.8(trials)-399.6(to)-388.2(demonstrate)-397(the)-396.3(antiemetic)]TJ
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[(effectiveness)-555.6(of)-543.6(acupuncture,)]TJ
7.3823 0 0 6.5614 183.3448 707.5841 Tm
(65)Tj
9.843 0 0 9.843 196.1007 703.2188 Tm
[(a)-543.7(nding)-548(replicated)-551.7(with)]TJ
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[(manual)-378.9(acupressure)-379.2(using)-374.1(a)-376.6(wristband)-374.8(device.)]TJ
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(66)Tj
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(Numerous)Tj
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[(subsequent)-496.9(acupuncture)-494.9(and)-494(acupressure)-500.1(trials)-497.5(have)-490.5(been)]TJ
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[(evaluated)-429.5(in)-422.8(systematic)-430.4(reviews)-431.3(of)-422.6(nausea)-424.6(and)-424.9(emesis)-430.4(as-)]TJ
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[(sociated)-288.8(with)-282(postoperative)-288.7(recovery)]TJ
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(67)Tj
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[(and)-280.9(chemotherapy.)]TJ
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(68)Tj
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[(The)-478(1997)-482.5(NIH)-477.3(Consensus)-483.8(Conference)-483.2(on)-480.3(Acupuncture)]TJ
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[(reported)-587.2(promising)-587.1(results)-584.7(from)-581.5(stimulation)-585.2(of)-583.9(PC6)-585.9(for)]TJ
0 -1.1116 TD
[(postoperative)-369.3(and)-367.3(chemotherapy-related)-371.5(nausea)-367(and)-367.3(vomit-)]TJ
T*
(ing.)Tj
7.3823 0 0 6.5614 77.1023 619.9368 Tm
(11)Tj
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[(Several)-523.8(PC6)-522.5(acupressure)-523.2(stimulation)-521.8(devices)-523.8(have)]TJ
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[(received)-537.7(FDA)-529(approval)-535.4(for)-533.1(nausea)-534(control)-533.2(and)-534.4(are)-529.7(now)]TJ
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[(available)-337.5(on)-336.3(the)-332.9(open)-333.9(market.)]TJ
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(69)Tj
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[(The)-287.9(common)-292.5(use)-292.3(of)-290.2(these)-290(acupressure)-298.5(devices,)-291(combined)]TJ
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[(with)-529.7(clinical)-531.2(research)-531.6(results,)-524.8(has)-528.4(translated)-533(into)-528.8(several)]TJ
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[(international)-698.1(clinical)-698.2(guidelines)-698.9(within)-693.3(biomedicine)-696.9(re-)]TJ
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[(commending)-344.2(acupressure.)-342.3(Such)-345.2(guidelines)-341.8(include)-344.4(those)-340.7(of)]TJ
T*
[(the)-379(Society)-384.5(of)-376.5(Obstetrics)-382.8(&)-376.7(Gynecology)-383(of)-376.5(Canada)-385.5(on)-376.6(the)]TJ
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[(management)-479(of)-480.2(nausea)-476.4(and)-476.8(vomiting)-477(in)-474.6(pregnancy,)]TJ
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(70)Tj
9.843 0 0 9.843 289.0204 527.8676 Tm
(the)Tj
-23.0619 -1.1116 TD
[(U.S.)-257.4(Agency)-263.2(for)-262.4(Healthcare)-265.6(Research)-261.9(and)-257.9(Quality,)]TJ
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(71)Tj
9.843 0 0 9.843 272.2393 516.9258 Tm
[(and)-257.9(the)]TJ
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[(United)-446.6(Kingdoms)-449.7(National)-450.1(Institute)-449.1(for)-446.7(Health)-453.6(and)-442.2(Care)]TJ
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[(Excellence)-340.8(\(NICE\).)]TJ
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[(72,7)-8.6(3)]TJ
/F9 1 Tf
8.9663 0 0 8.9663 62.022 467.603 Tm
[(Pragmatic)-337.4(clinical)-337.2(trials)]TJ
/F5 1 Tf
9.843 0 0 9.843 72 451.1621 Tm
[(The)-322.4(evolution)-322.5(of)-318.9(clinical)-329.6(research)-324.2(in)-319.1(biomedicine)-328.3(toward)]TJ
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[(more)-231.4(pragmatic)-233.7(randomized)-234.7(controlled)-238.3(trials,)-230.2(a)-232.6(method)-228(often)]TJ
T*
[(encouraged)-562.8(in)-555.3(comparative)-559.6(effectiveness)-561.4(research,)]TJ
7.3823 0 0 6.5614 272.9763 433.644 Tm
(74)Tj
9.843 0 0 9.843 285.8456 429.2786 Tm
(was)Tj
-22.7393 -1.1174 TD
[(informed)-431.7(by)-422.7(earlier)-431.8(research)-433.7(involving)-425(pragmatic)-435.3(trials)-428.4(of)]TJ
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[(acupuncture)-656.2(for)-654.1(chronic)-655.2(pain)-650.8(conditions)-651.7(in)-653.2(the)-655.4(United)]TJ
T*
[(Kingdom)-321(with)-316.6(recruitmen)-10.2(t)-318(starting)-321.2(in)-319.1(1999)]TJ
7.3823 0 0 6.5614 235.1054 400.7621 Tm
(75,76)Tj
9.843 0 0 9.843 254.8913 396.3968 Tm
[(and)-315.5(in)-319.1(Ger-)]TJ
-19.5945 -1.1174 TD
[(many)-283.3(starting)-286.6(in)-284.6(2001.)]TJ
7.3823 0 0 6.5614 151.8236 389.7637 Tm
(28)Tj
9.843 0 0 9.843 161.9716 385.3983 Tm
[(The)-287.9(need)-283.2(for)-285.5(a)-284.5(more)-283.2(pragmatic)-285.6(ap-)]TJ
-10.1544 -1.1116 TD
[(proach)-417.8(was)-414.1(supported)-414.2(in)-417(2003)-413.3(by)-411.1(Tunis)-415.6(and)-413.4(colleagues,)]TJ
7.3823 0 0 6.5614 293.7259 378.8219 Tm
(77)Tj
9.843 0 0 9.843 62.022 363.5149 Tm
[(who)-367(argued)-366(that)-368.7(there)-370.8(was)-368(a)-365.1(paucity)-367.4(of)-365(published)-368.2(research)]TJ
0 -1.1174 TD
[(designed)-206.9(to)-203.9(directly)-207.3(answer)-205.4(questions)-206.8(faced)-204.8(by)-203.8(policymakers,)]TJ
0 -1.1116 TD
[(clinicians,)-317.8(and)-315.5(patients.)-314.3(Most)-316.3(trials,)-316.6(they)-316.7(observed,)-313.9(used)-316.4(ef-)]TJ
T*
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T*
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[(gues)-339.4(Clin)-333.6(Neurosci.)-335.4(2006;8:335344.)]TJ
-1.2503 -1.1223 TD
[(3.)-500.4(Vickers)-304.6(AJ,)-299.9(Cronin)-306.3(AM,)-300.1(Maschino)-300.1(AC,)-305.6(et)-296.7(al.)-302.9(Acupuncture)]TJ
1.2503 -1.1284 TD
[(for)-590.6(chronic)-590.6(pain:)-589.3(individual)-588.9(patient)-587.1(data)-593.9(meta-analysis.)]TJ
0 -1.1223 TD
[(Arch)-338(Intern)-332.4(Med)-333.3(2012;172:14441453.)]TJ
-1.2503 -1.1284 TD
[(4.)-500.4(Napadow)-598.1(V,)-587.3(Webb)-594.7(JM,)-590.4(Pearson)-593.2(N,)-587.3(Hammerschlag)-599.6(R.)]TJ
1.2503 -1.1223 TD
[(Neurobiological)-364.1(correlates)-368.5(of)-356.4(acupuncture:)-367.4(November)-360.7(17)]TJ
0 -1.1284 TD
[(18,)-335.8(2005.)-330(J)-334.7(Altern)-337.2(Complement)-335.9(Med.)-333.3(2006;12:931935.)]TJ
-1.2503 -1.1223 TD
[(5.)-500.4(Colquhoun)-414.2(D,)-410.4(Novella)-412.4(SP.)-408.7(Acupuncture)-414(is)-413.6(theatrical)-414.8(pla-)]TJ
1.2503 -1.1284 TD
[(cebo.)-338.4(Anesth)-334.6(Analg)-335.3(2013;116:13601363.)]TJ
-1.2503 -1.1284 TD
[(6.)-500.4(Wang)-332.4(S-M,)-328.2(Harris)-333.1(RE,)-330.3(Lin)-325(Y-C,)-332.4(Gan)-329.5(T-J.)-327.1(Acupuncture)-334.7(in)]TJ
1.2503 -1.1223 TD
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0 -1.1284 TD
[(Anesth)-334.6(Analg)-335.3(2013;116:13561359.)]TJ
-1.2503 -1.1223 TD
[(7.)-500.4(Han)-329.5(JS.)-325.6(Acupuncture)-328.6(and)-327.9(endorphins.)-323.8(Neurosci)-329.2(Lett)-328.8(2004;)]TJ
1.2503 -1.1284 TD
(361:258261.)Tj
-1.2503 -1.1223 TD
[(8.)-500.4(Pomeranz)-439.4(B.)-438(Scientic)-438.8(research)-436.5(into)-438.6(acupuncture)-441(for)-432(the)]TJ
1.2503 -1.1284 TD
[(relief)-336(of)-338.1(pain.)-333.6(J)-334.7(Altern)-331.1(Complement)-335.9(Med)-339.4(1996;2:5360.)]TJ
-1.2503 -1.1223 TD
[(9.)-500.4(Fields)-396.3(HL.)-394.2(Pain)-397.5(II:)-394.8(new)-396.6(approaches)-397.9(to)-396.2(management.)-395.1(Ann)]TJ
1.2503 -1.1284 TD
[(Neurol)-337.8(1981;9:101106.)]TJ
-1.7505 -1.1223 TD
[(10.)-500.5(Ulett)-425.6(GA.)-418.3(Acupuncture)-420.1(treatments)-428.1(for)-419.8(pain)-419(relief.)-421.5(JAMA)]TJ
1.7505 -1.1284 TD
(1981;245:768769.)Tj
-1.7505 -1.1223 TD
[(11.)-500.5(National)-790.1(Institutes)-790.7(of)-789.4(Health.)-784.4(Consensus)-794.4(Conference.)]TJ
1.7505 -1.1284 TD
[(Acupuncture.)-340.9(JAMA)-331.5(1998;280:15181524.)]TJ
-1.7505 -1.1223 TD
[(12.)-500.5(Dhond)-502.4(RP,)-496(Kettner)-500.1(N,)-501.9(Napadow)-500.5(V.)-495.8(Neuroimaging)-500.4(acu-)]TJ
1.7505 -1.1284 TD
[(puncture)-328.5(effects)-327.9(in)-329.1(the)-321.2(human)-327.8(brain.)-330(J)-322.5(Altern)-325(Complement)]TJ
0 -1.1223 TD
[(Med)-339.4(2007;13:603616.)]TJ
-1.7505 -1.1284 TD
[(13.)-500.5(Harris)-278.2(RE,)-281.5(Zubieta)-278.5(JK,)-275.5(Scott)-281.1(DJ,)-275.5(Napadow)-280.9(V,)-276.3(Gracely)-279.2(RH,)]TJ
1.7505 -1.1223 TD
[(Clauw)-474.3(DJ.)-476.8(Traditional)-469.4(Chinese)-476.3(acupuncture)-477.6(and)-474.3(placebo)]TJ
0 -1.1284 TD
[(\(sham\))-215.8(acupuncture)-215.4(are)-212.4(differentiated)-212.6(by)-213.8(their)-207.4(effects)-218.1(on)]TJ
/F8 1 Tf
22.5367 0 TD
(++)Tj
/F5 1 Tf
1.104 0 TD
(-)Tj
-23.6406 -1.1223 TD
[(opioid)-207.1(receptors)-206.2(\()-81.7(MORs\).)-203(Neuroimage)-206(2009;47:10771085.)]TJ
-1.7505 -1.1284 TD
[(14.)-500.5(Martikainen)-361.7(IK,)-351.9(Pecin)]TJ
10.4846 .0122 TD
()Tj
.4147 -.0122 TD
[(a)-358.1(M)0(,)-353.2(Love)-354.3(TM,)-355.3(et)-357.7(al.)-357.7(Alterations)-358.4(in)]TJ
-9.1489 -1.1223 TD
[(endogenous)-527.4(opioid)-524.3(functional)-528.9(measures)-526.2(in)-524.2(chronic)-523.5(back)]TJ
0 -1.1284 TD
[(pain.)-333.6(J)-334.7(Neurosci)-335.3(2013;33:1472914737.)]TJ
-1.7505 -1.1223 TD
[(15.)-500.5(DosSantos)-288.2(MF,)-283.1(Martikainen)-288.5(IK,)-290.9(Nascimento)-287.7(TD,)-284.4(et)-284.5(al.)-284.6(Re-)]TJ
1.7505 -1.1284 TD
[(duced)-369(basal)-367.5(ganglia)-362(mu-opioid)-368(receptor)-365.5(availability)-370.8(in)-359.6(tri-)]TJ
0 -1.1223 TD
[(geminal)-190.8(neuropathic)-198.4(pain:)-186.8(a)-193.4(pilot)-188.1(study.)-188.4(Mol)-194.3(Pain)-190.1(2012;8:74.)]TJ
-1.7505 -1.1284 TD
[(16.)-500.5(Napadow)-476.1(V,)-477.5(Liu)-477.5(J,)-469(Li)-477.3(M,)-475.2(et)-473.6(al.)-473.6(Somatosensory)-482.4(cortical)]TJ
1.7505 -1.1223 TD
[(plasticity)-250.1(in)-237.6(carpal)-247(tunnel)-241.8(syndrome)-244.2(treated)-246.6(by)-244.3(acupuncture.)]TJ
0 -1.1284 TD
[(Hum)-337(Brain)-334.7(Mapp)-333.4(2007;28:159171.)]TJ
25.263 70.9158 TD
[(17.)-500.5(Nataraj)-345.7(R,)-340.5(Evans)-347.5(PJ,)-337.8(Seitz)-346.3(WH,)-341.7(Li)-343.2(Z-M.)-345.5(Effects)-343.8(of)-344.2(carpal)]TJ
1.7505 -1.1223 TD
[(tunnel)-241.8(syndrome)-244.2(on)-244.3(reach-to-pinch)-244.2(performance.)-250.7(PLoS)-240(One)]TJ
0 -1.1284 TD
(2014;9:e92063.)Tj
-1.7505 -1.1223 TD
[(18.)-500.5(Zhang)-366.7(W,)-370.5(Johnston)-364.8(JA,)-367(Ross)-369.5(MA,)-367.2(et)-369.9(al.)-369.9(Effects)-368.3(of)-368.6(carpal)]TJ
1.7505 -1.1283 TD
[(tunnel)-345.5(syndrome)-347.9(on)-341.8(dexterous)-346(manipulation)-349(are)-346.6(grip)-343.9(type-)]TJ
0 -1.1223 TD
[(dependent.)-336.7(PLoS)-331.5(One)-335.6(2013;8:e53751.)]TJ
-1.7505 -1.1284 TD
[(19.)-500.5(Schwenkreis)-580.7(P,)-576.4(Scherens)-579.2(A,)-575.1(Ro)]TJ
15.303 .0244 TD
()Tj
.4208 -.0244 TD
[(nnau)-578.1(A-K,)-573.2(Ho)]TJ
5.9224 .0244 TD
()Tj
.4147 -.0244 TD
[(ffken)-576.8(O,)]TJ
-20.3105 -1.1223 TD
[(Tegenthoff)-479.4(M,)-481.3(Maier)-485.9(C.)-480.7(Cortical)-478.5(disinhibition)-485.5(occurs)-480.4(in)]TJ
0 -1.1284 TD
[(chronic)-432(neuropathic,)-430.2(but)-432.9(not)-426.8(in)-426.7(chronic)-432(nociceptive)-437.6(pain.)]TJ
0 -1.1223 TD
[(BMC)-332.5(Neurosci)-335.3(2010;11:73.)]TJ
-1.7505 -1.1284 TD
[(20.)-500.5(Napadow)-396.8(V,)-398.2(LaCount)-395.6(L,)-392.5(Park)-400.3(K,)-398.2(As-Sanie)-393.1(S,)-399.6(Clauw)-395(DJ,)]TJ
1.7505 -1.1223 TD
[(Harris)-430.7(RE.)-427.9(Intrinsic)-428.4(brain)-433.6(connectivity)-426.8(in)-432.8(bromyalgia)-428.4(is)]TJ
0 -1.1284 TD
[(associated)-558.2(with)-556(chronic)-554(pain)-559.2(intensity.)-557.4(Arthritis)-559.4(Rheum)]TJ
T*
(2010;62:25452555.)Tj
-1.7505 -1.1223 TD
[(21.)-500.5(Napadow)-384.6(V,)-386(Kim)-385.3(J,)-389.7(Clauw)-382.8(DJ,)-385.3(Harris)-388(RE.)-391.3(Decreased)-391.3(in-)]TJ
1.7505 -1.1284 TD
[(trinsic)-242.8(brain)-250.6(connectivity)-243.8(is)-248.9(associated)-247.1(with)-251.1(reduced)-247.7(clinical)]TJ
0 -1.1223 TD
[(pain)-297(in)-298.6(bromyalgia.)-300.4(Arthritis)-297.1(Rheum)-295.9(2012;64:23982403.)]TJ
-1.7505 -1.1284 TD
[(22.)-500.5(Lee)-413.3(MC,)-413.1(Tracey)-420.2(I.)-411.2(Imaging)-415.2(pain:)-412.4(a)-413(potent)-418.7(means)-416.5(for)-413.7(in-)]TJ
1.7505 -1.1223 TD
[(vestigating)-580.2(pain)-583.6(mechanisms)-584.2(in)-579.1(patients.)-580.4(Br)-580.7(J)-578.7(Anaesth)]TJ
0 -1.1284 TD
(2013;111:6472.)Tj
-1.7505 -1.1223 TD
[(23.)-500.5(Gerdle)-518.8(B,)-511.2(Ghafouri)-517.3(B,)-517.3(Ernberg)-518(M,)-517.9(Larsson)-513.9(B.)-517.3(Chronic)]TJ
1.7505 -1.1284 TD
[(musculoskeletal)-654.9(pain:)-656.4(review)-653(of)-649.1(mechanisms)-657.4(and)-657.3(bio-)]TJ
0 -1.1223 TD
[(chemical)-662.9(biomarkers)-665.2(as)-668.4(assessed)-662.9(by)-665.1(the)-662.8(microdialysis)]TJ
0 -1.1284 TD
[(technique.)-336.1(J)-334.7(Pain)-330.4(Res)-337.9(2014;7:313326.)]TJ
-1.7505 -1.1223 TD
[(24.)-500.5(Wiech)-421.6(K,)-422.6(Tracey)-426.3(I.)-423.4(Pain,)-421.9(decisions,)-427.7(and)-419.4(actions:)-427.8(a)-419.1(moti-)]TJ
1.7505 -1.1284 TD
[(vational)-331.1(perspective.)-342(Front)-334.7(Neurosci)-335.3(2013;7:46.)]TJ
-1.7505 -1.1223 TD
[(25.)-500.5(Barnes)-363.2(PM,)-362.4(Bloom)-364.4(B,)-364.9(Nahin)-365.8(RL.)-360.8(Complementary)-367.3(and)-364.5(al-)]TJ
1.7505 -1.1284 TD
[(ternative)-368.3(medicine)-366(use)-369.7(among)-364.4(adults)-369(and)-364.5(children:)-370.2(United)]TJ
0 -1.1223 TD
[(States,)-333.5(2007.)-336.1(Natl)-334.6(Health)-333(Stat)-335.9(Report)-334.9(2008;\(12\):123.)]TJ
-1.7505 -1.1284 TD
[(26.)-500.5(Robinson)-425.3(N,)-428.7(Lorenc)-428.2(A,)-428.7(Ding)-428.5(W,)-425.4(Jia)-430.1(J,)-426.3(Bovey)-424.5(M,)-426.4(Wang)]TJ
1.7505 -1.1223 TD
-.0208 Tc
[(X)-20.8(M)-20.8(.)-327(Exploring)-307.6(p)-2.6(ractice)-311.8(c)-.7(haracter)]TJ
13.1134 0 TD
-.0203 Tc
[(istics)-306.2(and)-307.1(r)1.6(esearch)-307.1(priorities)]TJ
-13.1134 -1.1284 TD
0 Tc
[(of)-295.4(practitioners)-302.6(of)-301.5(traditional)-302.2(acupuncture)-306.8(in)-298.6(China)-295.8(and)-303.5(the)]TJ
0 -1.1223 TD
[(EU-A)-331.2(survey.)-335.9(J)-334.7(Ethnopharmacol.)-340.6(2012;140:604613.)]TJ
-1.7505 -1.1284 TD
[(27.)-500.5(Hopton)-422.7(AK,)-418.3(Curnoe)-426.9(S,)-417.9(Kanaan)-423.7(M,)-426.4(MacPherson)-420.2(H.)-422.6(Acu-)]TJ
1.7505 -1.1223 TD
[(puncture)-444.4(in)-438.9(practice:)-445.7(mapping)-443.4(the)-443.2(providers,)-441.8(the)-443.2(patients)]TJ
0 -1.1284 TD
[(and)-370.6(the)-370(settings)-367.8(in)-371.8(a)-370.3(national)-373.8(cross-sectional)-373(survey.)-372.5(BMJ)]TJ
0 -1.1223 TD
[(Open)-335.7(2012;2:e000456.)]TJ
-1.7505 -1.1284 TD
[(28.)-500.5(Cummings)-448.9(M.)-456.9(Modellvorhaben)-454.2(Akupunktura)-454.7(summary)]TJ
1.7505 -1.1223 TD
[(of)-277.1(the)-278.5(ART,)-283.2(ARC)-279.9(and)-279.1(GERAC)-277.6(trials.)-285.4(Acupunct)-279(Med)-278.4(2009;)]TJ
0 -1.1284 TD
(27:2630.)Tj
-1.7505 -1.1223 TD
.0171 Tc
[(2)17.1(9)17.1(.)-483.4(Fed)4.8(e).6(ral)-488.7(J)5.7(oi)5.3(nt)-488.7(Co)4.8(mm)5.2(it)5.3(tee)-487.4(\()2.4(German)4.8(y\).)-483.1(T)-3.2(rag)4.8(e).6(n)4.8(d)-1.3(e)-487.4(G)3.2(ru)]TJ
23.8114 .0061 TD
0 Tc
()Tj
.433 -.0061 TD
.0123 Tc
[(nd)-6.1(e)]TJ
-22.494 -1.1284 TD
.0153 Tc
[(zum)-289.4(B)-1.8(eschluss)-288.9(des)-288.9(G)1.4(emeinsam)]TJ
13.0768 0 TD
.0163 Tc
[(en)-288.8(Bundesauss)4.9(chuss)4.9(e)-.2(s)-287.9(z)-.2(ur)]TJ
-13.0768 -1.1223 TD
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[(Ak)4.3(up)4.3(un)4.3(kt)4.8(ur.)-520.2(F)1.4(e)6.2(d)-1.8(eral)-519.7(J)5.1(o)-1.8(i)4.8(n)-1.8(t)-519.7(C)-.5(o)4.3(m)-1.4(m)4.7(i)-1.3(t)4.8(t)-1.3(ee)-518.4(\(Ge)6.2(r)-4.2(m)4.7(a).1(n)4.3(y)-1.8(\).)-520.2(Apr)]TJ
0 -1.1284 TD
0 Tc
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0 -1.1223 TD
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[(40-268-71/2006-04-18_Akupunkt)-5.3(ur-TGr.pdf,)-1006(a)-3.9(cces)-4.9(sed)]TJ
0 -1.1284 TD
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-1.7505 -1.1284 TD
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1.7505 -1.1223 TD
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[(di)-4.2(s)-3.9(eas)-3.8(es)-3.9(?)-381(R)-3.4(he)-8.9(um)-4.3(at)-4.2(ol)-4.2(o)-4.7(g)1.4(i)-4.2(s)-3.8(t.)-382.8(M)-4(a)-2.8(rc)-8.9(h)-376.8(1)-4.7(,)-382.8(2)-4.7(01)-4.7(4.)-382.8(O)-6.3(n)1.4(l)-4.2(i)-4.2(n)1.4(e)-387.1(d)1.4(o)-4.7(c)-2.8(u)-4.7(-)]TJ
0 -1.1284 TD
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9.2951 0 0 9.2951 327.118 212.5983 Tm
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(role-does-fascia-play-in-rheum)Tj
11.7288 0 TD
[(atic-diseases/,)-372.2(a)1.6(ccessed)-366.2(J).6(anu)5.9(a)-4.4(ry)]TJ
-11.7288 -1.1284 TD
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[(4,)-329.3(2016.)]TJ
-1.7505 -1.1223 TD
0 Tc
[(31.)-500.5(Jahed)-410.8(Z,)-416.8(Shams)-415.2(H,)-416.5(Mehrbod)-415.5(M,)-408.1(Mofrad)-417.6(MRK.)-414.8(Mechan-)]TJ
1.7505 -1.1284 TD
[(otransduction)-369.9(pathways)-375.7(linking)-371.3(the)-370(extracellular)-379(matrix)-371.8(to)]TJ
0 -1.1223 TD
[(the)-333.4(nucleus.)-337.4(Int)-331.5(Rev)-332.7(Cell)-337.8(Mol)-334.6(Biol)-333.6(2014;310:171220.)]TJ
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[(32.)-500.5(Langevin)-279.3(HM,)-281.8(Bouffard)-285.5(NA,)-284.1(Badger)-278.7(GJ,)-281.6(Iatridis)-288(JC,)-278.7(Howe)]TJ
1.7505 -1.1223 TD
[(AK.)-393.9(Dynamic)-394.3(broblast)-393(cytoskeletal)-393.5(response)-394.4(to)-396.2(subcuta-)]TJ
0 -1.1284 TD
[(neous)-284.6(tissue)-288.8(stretch)-284.2(ex)-285.1(vivo)-286.7(and)-285.2(in)-286.4(vivo.)-280.6(Am)-288.1(J)-285.9(Physiol)-282.4(Cell)]TJ
0 -1.1223 TD
[(Physiol.)-331.3(2005;288:C747756.)]TJ
-1.7505 -1.1284 TD
[(33.)-500.5(Langevin)-486.6(HM,)-489.1(Bouffard)-486.8(NA,)-485.4(Churchill)-492.7(DL,)-485.7(Badger)-486(GJ.)]TJ
1.7505 -1.1223 TD
[(Connective)-286.1(tissue)-288.8(broblast)-283.2(response)-284.6(to)-286.4(acupuncture:)-288.1(dose-)]TJ
0 -1.1284 TD
[(dependent)-385.4(effect)-389.6(of)-386.9(bidirectional)-386(needle)-385(rotation.)-390.3(J)-383.5(Altern)]TJ
0 -1.1223 TD
[(Complement)-335.9(Med)-333.3(2007;13:355360.)]TJ
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[(3)21.8(4)21.8(.)-478.7(Langevin)-594.4(HM,)-594.3(F).5(ujita)-592.5(T)-4.6(,)-594.3(B)4.7(ouffard)-594.4(NA,)-594.3(et)-593.8(al.)-594.3(F).5(ibro-)]TJ
1.7505 -1.1223 TD
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0 Tc
[(THE)-335.2(IMPACT)-336.8(OF)-337.5(ACUPUNCTURE)-340.1(RESEARCH)]TJ
54.1178 0 TD
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[(35.)-500.5(Ingber)-662.3(DE.)-662.5(Mechanobiology)-665.4(and)-657.3(diseases)-669.3(of)-661.3(mechan-)]TJ
1.7505 -1.1223 TD
[(otransduction.)-339.5(Ann)-331.4(Med)-333.3(2003;35:564577.)]TJ
-1.7505 -1.1283 TD
[(36.)-500.5(Lammerding)-384.7(J.)-377.5(Mechanics)-381.9(of)-380.8(the)-376.1(nucleus.)-386.2(Compr)-379.5(Physiol)]TJ
1.7505 -1.1223 TD
(2011;1:783807.)Tj
-1.7505 -1.1284 TD
[(37.)-500.5(Van)-451.5(Gerwen)-453.9(DJ,)-452.4(Dankelman)-453.6(J,)-450.7(van)-449.9(den)-449.9(Dobbelsteen)-452.9(JJ.)]TJ
1.7505 -1.1223 TD
[(Needle-tissue)-318(interaction)-319.2(forcesa)-316.5(survey)-317.6(of)-313.7(experimental)]TJ
0 -1.1284 TD
[(data.)-337.9(Med)-333.3(Eng)-331.7(Phys.)-332(2012;34:665680.)]TJ
-1.7505 -1.1223 TD
[(38.)-500.5(Tr)19.9(av)19.9(er)17.6(so)-273.9(S.)-277.6(M)12.8(e)0(c)15.7(h)0(a)19.9(n)0(i)18.6(c)0(a)15.7(l)-280.1(si)19.5(gn)18(al)20.5(li)19.2(ng)-274.8(in)-274.2(ti)19.2(ss)19.8(ue)13.8(s)-279.8(a)0(n)13.8(d)-280.7(it)19.2(s)-285.9(p)0(o)18(s)12.9(si)19.5(bl)18.6(e)]TJ
1.7505 -1.1284 TD
[(ro)21.8(le)-315(in)-316.9(no)24.1(ci)14.4(c)14(e)0(p)13.8(t)12.6(io)18.6(n.)-311.3(Th)16.1(eo)19.9(re)17.6(t)-322.8(B)13.4(io)18.6(l)-322.8(F)0(o)15.1(r)0(u)21.8(m)12.5(.)-323.3(2)0(0)18(1)0(1)18(;)12.6(10)18(4:)18.6(75)24.1(8)18(4.)]TJ
-1.7505 -1.1223 TD
[(39.)-500.5(Benjamin)-329.9(M.)-334.9(The)-329.8(fascia)-331.5(of)-332(the)-327.3(limbs)-333.7(and)-327.9(backa)-330.8(review.)]TJ
1.7505 -1.1284 TD
[(J)-334.7(Anat)-335.1(2009;214:118.)]TJ
-1.7505 -1.1284 TD
[(40.)-500.5(Langevin)-407.3(HM,)-409.9(Fox)-405.9(JR,)-406.8(Koptiuch)-408.3(C,)-407.5(et)-412.6(al.)-406.5(Reduced)-408.8(thor-)]TJ
1.7505 -1.1223 TD
[(acolumbar)-393.4(fascia)-398.6(shear)-388.7(strain)-395.7(in)-390.1(human)-394.9(chronic)-395.4(low)-391.8(back)]TJ
0 -1.1284 TD
[(pain.)-333.6(BMC)-338.6(Musculoskelet)-333.5(Disord.)-338.8(2011;12:203.)]TJ
-1.7505 -1.1223 TD
[(41.)-500.5(Langevin)-315.9(HM,)-312.3(Stevens-Tuttle)-317.4(D,)-312.9(Fox)-308.3(JR,)-315.3(et)-315(al.)-309(Ultrasound)]TJ
1.7505 -1.1284 TD
[(evidence)-438.3(of)-441.7(altered)-435.6(lumbar)-439.4(connective)-444.1(tissue)-435.2(structure)-445.4(in)]TJ
0 -1.1223 TD
[(human)-443.6(subjects)-439.7(with)-446.2(chronic)-444.2(low)-440.6(back)-442(pain.)-443.4(BMC)-442.3(Mus-)]TJ
0 -1.1284 TD
[(culoskelet)-334.7(Disord)-338.8(2009;10:151.)]TJ
-1.7505 -1.1223 TD
[(42.)-500.5(Whittaker)-392.8(JL,)-391.7(Warner)-396.4(MB,)-394.8(Stokes)-390.8(M.)-389.8(Comparison)-395.1(of)-393(the)]TJ
1.7505 -1.1284 TD
[(sonographic)-456.1(features)-462.2(of)-460(the)-455.4(abdominal)-459.5(wall)-456.6(muscles)-458(and)]TJ
0 -1.1223 TD
[(connective)-364.8(tissues)-361.3(in)-365.7(individuals)-362.5(with)-360.9(and)-364.5(without)-360.7(lumbo-)]TJ
0 -1.1284 TD
[(pelvic)-337.5(pain.)-333.6(J)-334.7(Orthop)-333.6(Sports)-334(Phys)-331.9(Ther)-338.4(2013;43:1119.)]TJ
-1.7505 -1.1223 TD
[(43.)-500.5(Dworkin)-573.1(RH,)-574(Turk)-572(DC,)-567.9(Peirce-Sandner)-578.1(S,)-570.3(et)-577.2(al.)-571.2(Con-)]TJ
1.7505 -1.1284 TD
[(siderations)-356.5(for)-352.7(improving)-355.8(assay)-355(sensitivity)-361(in)-353.5(chronic)-352.7(pain)]TJ
0 -1.1223 TD
[(clinical)-523.8(trials:)-528.9(IMMPACT)-525.3(recommendations.)-524.8(Pain)-525.5(2012;)]TJ
0 -1.1284 TD
(153:11481158.)Tj
-1.7505 -1.1223 TD
[(44.)-500.5(Khan)-384.5(A,)-386(Schwartz)-386(K.)-386(Study)-381.2(designs)-387.1(and)-382.8(outcomes)-391.9(in)-384(an-)]TJ
1.7505 -1.1284 TD
[(tidepressant)-391.3(clinical)-389.6(trials.)-389.1(Essent)-388.9(Psychopharmacol)-394.4(2005;)]TJ
0 -1.1223 TD
(6:221226.)Tj
-1.7505 -1.1284 TD
[(45.)-500.5(Kaptchuk)-254.5(TJ,)-257.5(Kelley)-253.7(JM,)-254.9(Conboy)-249.6(LA,)-260(et)-254(al.)-254.1(Components)-252.5(of)]TJ
1.7505 -1.1223 TD
[(placebo)-318(effect:)-322.1(randomised)-321.4(controlled)-315.4(trial)-316.6(in)-316.9(patients)-324.1(with)]TJ
0 -1.1284 TD
[(irritable)-335.3(bowel)-335.3(syndrome.)-335.8(BMJ)-332.9(2008;336:9991003.)]TJ
-1.7505 -1.1223 TD
[(46.)-500.5(Jubb)-469.3(J,)-475.1(Bensing)-472.1(JM.)-468.4(The)-470.1(sweetest)-476(pill)-474.6(to)-469.4(swallow:)-475.6(how)]TJ
1.7505 -1.1284 TD
[(patient)-257.8(neurobiology)-257.2(can)-258.9(be)-254.6(harnessed)-258.4(to)-255.9(maximise)-256.8(placebo)]TJ
0 -1.1223 TD
[(effects.)-340.1(Neurosci)-335.3(Biobehav)-337(Rev)-332.7(2013;37:27092720.)]TJ
-1.7505 -1.1284 TD
[(47.)-500.5(Schmid)-372.9(J,)-371.4(Langhorst)-368.1(J,)-371.4(Ga)-372.2(F,)-375.2(et)-369.9(al.)-369.9(Placebo)-375.8(analgesia)-376(in)]TJ
1.7505 -1.1223 TD
[(patients)-549.8(with)-549.9(functional)-553.3(and)-547.5(organic)-554(abdominal)-551(pain:)-546.6(a)]TJ
0 -1.1284 TD
[(fMRI)-338.6(study)-328.6(in)-335.2(IBS,)-339.9(UC)-329.9(and)-340.1(healthy)-331.5(volunteers.)-339.6(Gut)-336.9(2015;)]TJ
0 -1.1223 TD
(64:418427.)Tj
-1.7505 -1.1284 TD
[(48.)-500.5(Hall)-352.9(KT,)-351.5(Kaptchuk)-352.1(TJ.)-355.1(Genetic)-355.6(biomarkers)-354.2(of)-350.3(placebo)-354.6(re-)]TJ
1.7505 -1.1223 TD
[(sponse:)-454.2(what)-457.1(could)-455.7(it)-450.5(mean)-453.8(for)-456.4(future)-454.4(trial)-456.9(design?)-453.2(Clin)]TJ
0 -1.1284 TD
[(Investig)-335(\(Lond\).)-336.8(2013;3:311314.)]TJ
-1.7505 -1.1223 TD
[(49.)-500.5(Finniss)-366.9(DG,)-369.5(Kaptchuk)-370.4(TJ,)-373.4(Miller)-370.9(F,)-363(Benedetti)-376.8(F.)-363(Biologi-)]TJ
1.7505 -1.1284 TD
[(cal,)-240.1(clinical,)-237.2(and)-236.4(ethical)-243.7(advances)-236.7(of)-240.5(placebo)-238.7(effects.)-236.5(Lancet)]TJ
T*
(2010;375:686695.)Tj
-1.7505 -1.1223 TD
[(50.)-500.5(Kaptchuk)-486.3(TJ,)-483.2(Friedlander)-490.2(E,)-483.9(Kelley)-485.4(JM,)-486.7(et)-485.8(al.)-485.8(Placebos)]TJ
1.7505 -1.1284 TD
[(without)-269.2(deception:)-268.5(a)-266.6(randomized)-271.6(controlled)-272.7(trial)-267.8(in)-268.1(irritable)]TJ
0 -1.1223 TD
[(bowel)-335.3(syndrome.)-335.8(PloS)-335.1(One)-329.5(2010;5:e15591.)]TJ
-1.7505 -1.1284 TD
[(51.)-500.5(Wechsler)-250.8(ME,)-239.4(Kelley)-247.6(JM,)-248.8(Boyd)-243.2(IOE,)-244.2(et)-241.8(al.)-248(Active)-247.6(albuterol)]TJ
1.7505 -1.1223 TD
[(or)-240.5(placebo,)-244.9(sham)-241.3(acupuncture,)-245.9(or)-246.6(no)-238.2(intervention)-248(in)-237.6(asthma.)]TJ
0 -1.1284 TD
[(N)-331.1(Engl)-337.4(J)-334.7(Med)-333.3(2011;365:119126.)]TJ
-1.7505 -1.1223 TD
[(52.)-500.5(Benedetti)-437.8(F,)-430.1(Frisaldi)-434.9(E.)-435.2(Creating)-436.4(placebo)-433.9(responders)-433.6(and)]TJ
1.7505 -1.1284 TD
[(nonresponders)-513.3(in)-512(the)-510.3(laboratory:)-519.2(boons)-512.2(and)-510.9(banes.)-514.6(Pain)]TJ
0 -1.1223 TD
[(Manag)-337.8(2014;4:165167.)]TJ
-1.7505 -1.1284 TD
[(53.)-500.5(Kokkotou)-362(E,)-368.1(Conboy)-365.5(LA,)-363.7(Ziogas)-365.4(DC,)-366.6(et)-363.8(al.)-363.8(Serum)-369.6(corre-)]TJ
1.7505 -1.1223 TD
[(lates)-507.2(of)-502.7(the)-510.3(placebo)-507.1(effect)-505.5(in)-505.9(irritable)-506.1(bowel)-506.1(syndrome.)]TJ
0 -1.1284 TD
[(Neurogastroenterol)-342.5(Motil)-333.7(2010;22:285281.)]TJ
-1.7505 -1.1223 TD
[(54.)-500.5(Klinger)-282.4(R,)-279.5(Colloca)-287.5(L,)-282.7(Bingel)-283.2(U,)-276.3(Flor)-285.8(H.)-282.4(Placebo)-278.2(analgesia:)]TJ
1.7505 -1.1284 TD
[(clinical)-334.7(applications.)-340.6(Pain)-336.5(2014;155:10551058.)]TJ
-1.7505 -1.1223 TD
[(55.)-500.5(Kelley)-394(JM,)-383(Lembo)-390.6(AJ,)-391.4(Ablon)-386(JS,)-392.7(et)-388.2(al.)-388.2(Patient)-388.8(and)-388.9(prac-)]TJ
1.7505 -1.1284 TD
[(titioner)-371.3(inuences)-369.1(on)-366.2(the)-370(placebo)-372.9(effect)-371.3(in)-365.7(irritable)-371.9(bowel)]TJ
0 -1.1223 TD
[(syndrome.)-335.8(Psychosom)-335.6(Med)-333.3(2009;71\):789797.)]TJ
25.2569 70.8975 TD
[(56.)-500.5(Hall)-822.5(KT,)-821.1(Lembo)-817.6(AJ,)-818.4(Kirsch)-824.8(I,)-819.8(et)-815.1(al.)-821.3(Catechol-O-)]TJ
1.7505 -1.1223 TD
[(methyltransferase)-514.5(val158met)-508.3(polymorphism)-501.3(predicts)-510(pla-)]TJ
0 -1.1284 TD
[(cebo)-283.5(effect)-279.8(in)-280.3(irritable)-280.4(bowel)-280.4(syndrome.)-280.9(PLoS)-276.6(One)-280.7(2012;7:)]TJ
0 -1.1223 TD
(e48135.)Tj
-1.7505 -1.1283 TD
[(57.)-500.5(Shealy)-572.7(CN,)-574(Mortimer)-568.8(JT,)-568.6(Hagfors)-571.7(NR.)-574(Dorsal)-568.6(column)]TJ
1.7505 -1.1223 TD
[(electroanalgesia.)-342(J)-334.7(Neurosurg)-334.1(1970;32:560564.)]TJ
-1.7505 -1.1284 TD
[(58.)-500.5(Shealy)-365.4(CN.)-360.5(Transcutaneous)-362.3(electrical)-364.1(stimulation)-361.5(for)-358.8(con-)]TJ
1.7505 -1.1223 TD
[(trol)-337.2(of)-332(pain.)-333.6(Clin)-333.6(Neurosurg)-340.2(1974;21:269277.)]TJ
-1.7505 -1.1284 TD
[(59.)-500.5(Shealy)-383.7(CN.)-384.9(Shealy)-377.6(wellness.)-386.5(September)-384.1(29,)-378.5(2014.)-384.9(Online)]TJ
1.7505 -1.1223 TD
[(document)-484.3(at:)-485.3(www.normshealy.com/the-sacred-rings/,)-489.8(ac-)]TJ
0 -1.1284 TD
[(cessed)-341.1(January)-334.1(4,)-335.7(2016.)]TJ
-1.7505 -1.1223 TD
[(60.)-500.5(Maurer)-751.2(D.)-745.9(Transcutaneous)-746.5(stimulator)-748.5(and)-748.7(stimulation)]TJ
1.7505 -1.1284 TD
[(method.)-339.6(US)-334.1(patent)-331.4(36733979.)-336.7(1974.)]TJ
-1.7505 -1.1284 TD
[(61.)-500.5(Abraham)-464.2(M,)-463(American)-468(Medical)-463.1(Association.)-465.6(CPT)-461.3(2014:)]TJ
1.7505 -1.1223 TD
[(Current)-880.2(Procedural)-874.9(Terminology.)-874.6(Chicago:)-879.3(American)]TJ
0 -1.1284 TD
[(Medical)-341.1(Association,)-337.5(2015.)]TJ
-1.7505 -1.1223 TD
[(62.)-500.5(Bl)19.9(ue)-413.1(C)13.4(r)0(o)15.7(s)12.9(s)12.9()0(B)19.3(l)0(u)18.6(e)-419.1(Sh)21.2(i)12.6(e)0(l)20.5(d)-421(As)17.3(s)12.9(o)0(c)19.9(i)0(a)20.5(t)0(i)19.2(o)0(n)24.1(.)-420.9(Tr)19.9(an)19.9(sc)20.8(ut)18.6(a)14(n)0(e)19.9(o)0(u)18(s)-420.1(el)20.5(ec)21.8(-)]TJ
1.7505 -1.1284 TD
[(tr)16.3(i)12.6(c)0(a)21.8(l)-347.2(ne)19.9(rv)21.8(e)-352(s)12.9(ti)19.2(m)12.5(u)0(l)18.6(a)0(t)20.5(o)0(r)-338.1(\()0(T)19.9(E)0(N)20.7(S)15.3(\).)-338(Ju)18.9(ne)-333.8(1,)-341.8(20)24.1(15)24.1(.)-347.7(O)0(n)16.4(l)12.6(i)12.6(n)0(e)-339.9(d)0(o)24.1(c)0(u)19.9(-)]TJ
0 -1.1223 TD
[(me)20.3(nt)-402.3(at)20.5(:)-414.3(w)0(w)21(w)0(.)22.6(b)0(c)19.9(b)0(s)18.9(m)12.5(s)12.9(.)0(c)20(o)0(m)18.5(/)12.6(co)19.9(m)12.5(/)0(b)18.6(c)0(b)19.9(s)12.9(ms)19.3(/)12.6(a)0(p)19.9(p)0(s)18.9(/)12.6(Po)21.2(li)19.2(cy)19.9(Se)23.1(ar)17.6(ch)19.9(/)]TJ
0 -1.1284 TD
[(v)-6.2(i)0(e)-10(ws/)-12.7(Vi)-7.4(ew)-12.2(Po)-9.3(lic)-9.6(y)-6.2(.)0(p)-6.3(h)-6.2(p?&)-10.3(n)-6.2(o)0(p)-6.4(r)0(i)-8.1(n)-6.2(t=y)-11.1(es)-9.7(&pa)-10.3(th)-11.9(=/p)-11(o)-6.2(lic)-9.6(y)-6.2(/)0(e)-10(m)0(e)-10.2(d)0(/)]TJ
0 -1.1223 TD
[(T)-8.1(ran)-13.1(sc)-9.7(uta)-10.2(n)-6.2(e)0(o)-10.6(us_)-11.7(El)-7.7(ec)-8.7(_)-6.2(Ner)-14.6(ve_)-10.7(St)-8.7(im_)-11.6(\(T)-10.6(EN)-9.8(S\).)-11.7(htm)-11.6(l,)-335.1(ac)-8.7(ce)-8.7(ss)-10.7(ed)]TJ
0 -1.1284 TD
.0062 Tc
[(J)6.2(a)-3.5(nua)6.2(r)6.2(y)-336.2(4,)-329.3(20)6.2(16.)]TJ
-1.7505 -1.1223 TD
0 Tc
[(63.)-500.5(U.S.)-377(Food)-375.5(and)-376.7(Drug)-376.5(Administration.)-378.1(FDA)-372.4(Center)-375.7(for)-377.1(De-)]TJ
1.7505 -1.1284 TD
[(vices)-288.2(and)-285.2(Radiological)-285.2(Health.)-290.4(Guidance)-283.2(documents)-288.4(-)-283(draft)]TJ
0 -1.1223 TD
[(guidance)-177.9(for)-169.7(industry)-178.3(and)-169.3(FDA)-171.2(staff:)-178.5(Class)-172(II)-175.7(special)-176.3(controls)]TJ
0 -1.1284 TD
[(guidance)-336.5(document:)-337.5(transcutaneous)-335.4(electrical)-339.7(nerve)-334.7(stimu-)]TJ
0 -1.1223 TD
[(lator)-366(for)-358.8(pain)-364.1(relief)-360.4(intended.)-362.3(September)-365.8(30,)-360.2(2014.)-360.5(Online)]TJ
0 -1.1284 TD
-.0245 Tc
[(document)-274.1(a)-4.4(t:)-280.2(www.fda.gov/MedicalDevices/DeviceRegulation)]TJ
0 -1.1223 TD
-.0238 Tc
[(andGuidance/GuidanceDocuments/ucm198645.h)-5.6(tm,)-633.8(a)2.3(ccess)-4.7(ed)]TJ
0 -1.1284 TD
-.0243 Tc
[(J)-5.3(une)-260.4(22,)-262.2(2015.)]TJ
-1.7505 -1.1223 TD
0 Tc
[(64.)-500.5(Dundee)-352.4(JW,)-351.5(Chestnutt)-349.3(WN,)-347.9(Ghaly)-353.6(RG,)-348.3(Lynas)-353.6(AG.)-345.1(Tradi-)]TJ
1.7505 -1.1284 TD
[(tional)-241.2(Chinese)-238.4(acupuncture:)-245.4(a)-236.1(potentially)-238.9(useful)-237.7(antiemetic?)]TJ
0 -1.1223 TD
[(Br)-336.7(Med)-333.3(J)-334.7(\(Clin)-336(Res)-331.8(Ed\))-334(1986;293:583584.)]TJ
-1.7505 -1.1284 TD
[(65.)-500.5(Dundee)-358.5(JW.)-357.6(Belfast)-362.2(experience)-359.7(with)-360.9(P6)-356.9(acupuncture)-361.7(anti-)]TJ
1.7505 -1.1223 TD
[(emesis.)-335.9(Ulster)-336.3(Med)-339.4(J)-328.6(1990;59:6370.)]TJ
-1.7505 -1.1284 TD
.0156 Tc
[(6)15.6(6)15.6(.)-484.9(Hyde)-690.2(E.)-692(Acupressure)-696.3(therapy)-692(f).9(or)-688.3(morning)-692(s)-1.9(ickness.)]TJ
1.7505 -1.1223 TD
.0127 Tc
[(A)-434.3(c)-3.8(o)-5.7(n).4(t)-5.2(r)-2(ol)-5.2(led)-432.7(c)-3.8(l)-5.2(i)-5.2(n).4(ical)-438.2(tri)-5.2(a)-3.8(l.)-432.6(J)-437.9(N)-1.2(u)-5.7(r)-2(se)-436.9(M)-5(i).9(d)-5.7(w)-1.2(if)-8.1(er)-8.1(y)-432.7(1).4(9)-5.7(89;)-5.2(34)-5.7(:)]TJ
0 -1.1284 TD
.0184 Tc
[(17)6.1(1)6.1(17)6.1(8)6.1(.)]TJ
9.2951 0 0 9.2951 313.0582 327.6849 Tm
0 Tc
[(67.)-500.5(Lee)-315.7(A,)-312.9(Fan)-312.5(LT.)-309.1(Stimulation)-316.5(of)-307.6(the)-315.1(wrist)-313.6(acupuncture)-312.9(point)]TJ
1.7505 -1.1284 TD
[(P6)-363(for)-358.8(preventing)-358.7(postoperative)-361.9(nausea)-360.3(and)-358.4(vomiting.)-358.9(Co-)]TJ
0 -1.1223 TD
[(chrane)-339.1(Database)-335.3(Syst)-337.5(Rev)-332.7(2009;CD003281.)]TJ
-1.7505 -1.1284 TD
[(68.)-500.5(Ezzo)-346.3(JM,)-340.3(Richardson)-344.9(MA,)-342.8(Vickers)-341.2(A,)-343.4(et)-339.4(al.)-345.5(Acupuncture-)]TJ
1.7505 -1.1223 TD
[(point)-359.4(stimulation)-355.4(for)-358.8(chemotherapy-induced)-360.6(nausea)-360.3(or)-350.3(vo-)]TJ
0 -1.1284 TD
[(miting.)-334.3(Cochrane)-338(Database)-341.4(Syst)-331.4(Rev)-332.7(2006;:CD002285.)]TJ
-1.7505 -1.1223 TD
[(69.)-500.5(U.S.)-480.6(Food)-473.1(and)-474.3(Drug)-480.2(Administration.)-475.7(FDA)-482.2(approved)-475.4(de-)]TJ
1.7505 -1.1284 TD
[(vices:)-367.1(AcuBand.)-369.6(June)-363.8(1,)-366.2(2015.)-360.5(Online)-365.4(document)-368.4(at:)-363.3(www)]TJ
T*
[(.accessdata.fda.gov/cdrh_docs/pdf5/K053509.pdf,)-361.4(accessed)]TJ
0 -1.1223 TD
[(January)-340.2(4,)-329.6(2016.)]TJ
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[(70.)-500.5(Arsenault)-615.4(M-Y,)-613.6(Lane)-614.7(CA,)-610.5(MacKinnon)-619.9(CJ,)-608.1(et)-613.8(al.)-613.9(The)]TJ
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