The Management of Chronic Myofascial Thoracolumbar Pain with Dry Needling, Spinal Manipulation, Cognitive Behavioral Therapy and Exercise: A Case Report

Background & Purpose: Chronic pain suffers have been shown to be comorbid with psychosocial impairments such as anxiety, depression and pain catastrophizing. Cognitive Behavioral Therapy (CBT) is a popular non-pharmacological treatment that has shown efficacious outcomes in reducing pain and disability levels in chronic pain suffers. Myofascial pain syndrome is a pain condition within the soft tissue that is perpetrated by myofascial trigger points (MTrP). MTrPs are associated with greater disability, poorer sleep quality and altered muscle activation patterns. MTrPs are also correlated with the development of central sensitization and chronic pain syndromes. Dry needling (DN) and Spinal Manipulative Therapy (SMT) have shown to reduce pain and disability in MTrP. The purpose of this case report is to provide a treatment rationale and documentation of the efficacy of combining CBT, DN, SMT and exercise in the management of an individual with chronic myofascial pain syndrome. Case Description: A 33-year-old male veteran was referred to therapy with a chief complaint of a constant, dull burning mid-scapular ache extending down to his lower back and up to his trapezius on the right side. He described this pain as 6/10 at current and constant, 5/10 at best with rest and pain medication and 10/10 at worst that occurs intermittently with prolonged sitting, walking and particularly forward-bending. Physical impairments included decreased and painful active range of motion, thoracic spine and rib hypomobility, and lumbar spine hypermobility with a positive prone instability test. MTrPs were identified along the T6-8 paraspinals, rhomboids at the medial border of the right scapula and lumbar segments L1-2 and L4-5. The patient was treated for nine 30-minute treatment sessions following a one-hour initial evaluation. DN was performed in 4/10 sessions; CBT, SMT and exercise were performed in every session. Outcomes: Pain intensity and catastrophizing were measured by the Numeric Pain Rating Scale (NPRS) and Pain Catastrophizing Scale (PCS). Disability was measured by the Oswestry Disability Index (ODI) and the Patient Specific Functional Scale (PSFS). Active functional movement was measured using the Selective Functional Movement Assessment (SFMA). Following ten treatments, NPRS improved from 7/10 to 3/10, PCS improved from 31/52 to 16/52, and ODI improved from 72% to 8%. PSFS to return to golfing improved from a perceived ability of as a 7/10 ability and return to CrossFit activities as 8/10. SFMA multi-segmental flexion and rotation and overhead squat improved to functional painful while single leg stance improved to functional non-painful. Thoracic spine and rib mobility improved to a grade 3 without pain. Discussion: Pain intensity, catastrophizing, disability and functional movement were all improved following nine treatment sessions. The outcomes of this case report suggest a multimodal treatment approach of DN, SMT, CBT and exercise may be beneficial for individuals with chronic myofascial pain

Designing Haptic Interfaces to Uncover Gestural Patterns in Children

Children with sensory processing differences such as Autism Spectrum Disorder (ASD) may have different gestural patterns compared to their neurotypical peers. However, the evaluation of sensory differences is complicated and subjective, especially when it\u27s related to the tactile sense. Haptic interfaces (i.e., tools that transmit information through touch) allow changing vibrotactile patterns to stimulate children\u27s tactile senses, affecting how children interact with the interface. Therefore, haptic interfaces can be used to collect data on how users interact with them and uncover their gestural patterns. However, it is unclear how to design active haptic interfaces vibration using touch (e.g., mobile phone), wearables (e.g., smartwatch), or ultrasonic (e.g., Stratos) to support the data collection of gesture interaction. As the first step in this work, we proposed the design of Feel and Touch, a haptic game that could be developed for different haptic interfaces, such as mobile, wearable, and ultrasonic. In future work, we proposed to develop the game in the three interfaces and evaluate their usefulness and effectiveness in collecting gestural data, especially for children with ASD. We would like to thank: Ivonne Monarca and Monica Tentori from CICESE Research center

Twice as Nice or Double Trouble: Examination of IVF Twins relative to IVF Singletons and their Families' Outcomes in Adolescence

University of Minnesota Ph.D. dissertation. 2016. Major: Family Social Science. Advisor: Martha Rueter. 1 computer file (PDF); 79 pages.The two presented studies examine outcomes of in vitro fertilization (IVF)-conceived twins relative to IVF singletons and their families in adolescence (Study 1: n = 194 families, Study 2: n = 192 families). Study 1 used nested ANCOVAs to examine differences in family environment and adolescent adjustment outcomes among 11 – 17 year-old IVF twins and IVF singletons and their families. Despite notable statistical power, there were no differences between adolescent-aged IVF twins and IVF singletons and their families. This suggests IVF twins and their families function well into adolescence. Study 2 tested two autoregressive path models that propose parental conformity expectations have differential effects on twins’ and singletons’ parent-adolescent relationship satisfaction, which indirectly accounts for relative changes in twins’ and singletons’ adjustment over time. Despite the developmental need for increased autonomy in adolescence, results indicate high conformity expectations play a positive role for adolescent-aged twins and their families. These studies suggest that, while adolescent IVF twins and IVF singletons and their families function well, research on singletons should not be universally applied to understand twins and their families

Cases of Forced Labor and Policy Responses Regarding Human Trafficking Legislation at Mega Sporting Events

International mega sporting events require large construction and infrastructure projects to be completed in short amounts of time. Unfortunately, labor trafficking has become a means to complete these projects for the Olympic Games and World Cup. My research question asks whether or not certain types of governments (1) condone labor trafficking in order to appear developed by producing ostentatious mega sporting events or (2) use these international sporting events to strengthen their human rights platform. The importance of this topic stems from reports published by Human Rights Watch and several other NGOs. These organizations have found incidences of labor trafficking and severe exploitation of construction workers at Olympic and World Cup venue sites. There is also an overwhelming lack of research focused solely on labor trafficking at mega sporting events. In this thesis, I conduct a comparative case study analysis examining the rhetoric of the Brazilian, Russian, and Chinese legislation and compare it against investigative reports by NGOs at the 2008 Beijing Summer Olympics, the 2014 Sochi Winter Olympics, and the 2014 Brazilian World Cup. This paper does not have available empirical data to analyze; however, it represents an analysis of contrasting narratives and relies on information from human rights organizations, journal articles, newspaper reports, and legal documents from each country. I find that authoritarian governments condone human trafficking in order to appear more developed, while democratic countries use mega-sporting events to strengthen human rights in their country

Flood-inundation Maps for a 12.5-mile Reach of Big Papillion Creek at Omaha, Nebraska

Digital flood-inundation maps for a 12.5-mile reach of the Big Papillion Creek from 0.6 mile upstream from the State Street Bridge to the 72nd Street Bridge in Omaha, Nebraska, were created by the United States Geological Survey (USGS) in cooperation with the Papio-Missouri River Natural Resources District. The flood-inundation maps, which can be accessed through the USGS Flood Inundation Mapping Science Web site at http://water.usgs.gov/osw/flood_inundation/, depict estimates of the areal extent and depth of flooding corresponding to selected water levels (stages) at the USGS streamgage on the Big Papillion Creek at Fort Street at Omaha, Nebraska (station 06610732). Near-real-time stages at this streamgage may be obtained on the Internet from the USGS National Water Information System at http://waterdata.usgs.gov/ or the National Weather Service Advanced Hydrologic Prediction Service at http:/water.weather.gov/ahps/, which also forecasts flood hydrographs at this site. Flood profiles were computed for the 12.5-mile reach by means of a one-dimensional step-backwater model. The model was calibrated by using the current (2015) stage-discharge relation at streamgages for the Big Papillion Creek at Fort Street at Omaha, Nebraska, and the Big Papillion Creek at Q Street at Omaha, Nebraska. The hydraulic model was then used to compute 15 water-surface profiles for flood stages at 1-foot (ft) intervals referenced to the streamgage datum for the Big Papillion Creek at Fort Street and ranging from 18 ft (or near bankfull) to 32 ft, which exceeds the “major flood stage” as defined by the National Weather Service. The simulated water-surface profiles were then combined with a Geographic Information System digital elevation model (derived from light detection and ranging data having a 1.18-ft vertical accuracy and 3.28-ft horizontal resolution) to delineate the area flooded at each flood stage (water level). The availability of these flood-inundation maps, along with Internet information regarding current stage from the USGS streamgage and forecasted high-flow stages from the National Weather Service, will provide emergency management personnel and residents with information that is critical for flood response activities such as evacuations and road closures, as well as for postflood recovery efforts

Analysis of Speech-to-Text Algorithms in Recognizing Down Syndrome Conversations

Introduction: Speech-to-text technology has become key in supporting technologies such as voice assistants (e.g., Alexa, Siri). Unfortunately, some individuals with speech differences, such as accents, female voices, children, or individuals with disabilities such as Down Syndrome, are not well recognized, creating issues in inclusivity. The first step toward making it more inclusive is to figure out where the errors or weaknesses are in speech-to-text algorithms (YouTube, IBM, Zoom, and Azure) in recognizing dialogs from diverse populations. Methods: We analyze 10 videos from the ‘Special Books by Special Kids’ YouTube channel. Videos include 15 people with Down Syndrome and 6 Neurotypicals. To compare how algorithms perform, we developed a python script to compute the word error rate, mismatch, insertion, and deletion. Results: Each algorithm did better for Neurotypicals than individuals with Down Syndrome by almost 40%. Overall, the most accurate algorithm was Azure for both Down Syndrome (46%) and Neurotypicals (87%). In general, all algorithms struggled the most with mismatching words, then deleting words, and the least common mistake was inserting words. Conclusion: Even though Azure is doing better than other algorithms, it still does not work well for Down Syndrome. To further understand the limitations and potential improvement of these algorithms, we propose a phonetic analysis to identify key sounds that prove difficult to detect in each algorithm. The end goal is to determine the best algorithm for analyzing speech from individuals with Down Syndrome and to ultimately provide an inclusive and more accurate algorithm. We are also planning to use estate of the art AI algorithms such as OpenAI and AssemblyAI. Acknowledgments: The first three authors equally contributed to this paper. We also thank Dr. Vivian Genaro Motti for her contributions to this research

Hydrographic Surveys at Seven Chutes and Three Backwaters on the Missouri River in Nebraska, Iowa, and Missouri, 2011-13

The United States Geological Survey (USGS) cooperated with the United States Army Corps of Engineers (USACE), Omaha District, to complete hydrographic surveys of seven chutes and three backwaters on the Missouri River yearly during 2011–13. These chutes and backwaters were constructed by the USACE to increase the amount of available shallow water habitat (SWH) to support threatened and endangered species, as required by the amended “2000 Biological Opinion” on the operation of the Missouri River main-stem reservoir system. Chutes surveyed included Council chute, Plattsmouth chute, Tobacco chute, Upper Hamburg chute, Lower Hamburg chute, Kansas chute, and Deroin chute. Backwaters surveyed included Ponca backwater, Plattsmouth backwater, and Langdon backwater. Hydrographic data from these chute and backwater surveys will aid the USACE to assess the current (2011–13) amount of available SWH, the effects river flow have had on evolving morphology of the chutes and backwaters, and the functionality of the chute and backwater designs. Chutes and backwaters were surveyed from August through November 2011, June through November 2012, and May through October 2013. During the 2011 surveys, high water was present at all sites because of the major flooding on the Missouri River. The hydrographic survey data are published along with this report in comma-separated-values (csv) format with associated metadata.Hydrographic surveys included bathymetric and Real-Time Kinematic Global Navigation Satellite System surveys. Hydrographic data were collected along transects extending across the channel from top of bank to top of bank. Transect segments with water depths greater than 1 meter were surveyed using a single-beam echosounder to measure depth and a differentially corrected global positioning system to measure location. These depth soundings were converted to elevation using water-surface-elevation information collected with a Real-Time Kinematic Global Navigation Satellite System. Transect segments with water depths less than 1 meter were surveyed using Real-Time Kinematic Global Navigation Satellite Systems. Surveyed features included top of bank, toe of bank, edge of water, sand bars, and near-shore areas.Discharge was measured at chute survey sites, in both the main channel of the Missouri River upstream from the chute and the chute. Many chute entrances and control structures were damaged by floodwater during the 2011 Missouri River flood, allowing a larger percentage of the total Missouri River discharge to flow through the chute than originally intended in the chute design. Measured discharge split between the main channel and the chute at most chutes was consistent with effects of the 2011 Missouri River flood damages and a larger percent of the total Missouri River discharge was flowing through the chute than originally intended. The US Army Corps of Engineers repaired many of these chutes in 2012 and 2013, and the resulting hydraulic changes are reflected in the discharge splits

Ticks and Tick-Borne Pathogens in Domestic Animals, Wild Pigs, and Off-Host Environmental Sampling in Guam, USA

Background: Guam, a United States of America (USA) island territory in the Pacific Ocean, is known to have large populations of ticks; however, it is unclear what the risk is to wildlife and humans living on the island. Dog (Canis familiaris), cat (Felis catus), and wild pig (Sus scrofa) sentinels were examined for ticks, and environmental sampling was conducted to determine the ticks present in Guam and the prevalence of tick-borne pathogens in hosts. Methods and Results: From March 2019-November 2020, ticks were collected from environmental sampling, dogs, cats, and wild pigs. Blood samples were also taken from a subset of animals. A total of 99 ticks were collected from 27 environmental samples and all were Rhipicephalus sanguineus, the brown dog tick. Most ticks were collected during the dry season with an overall sampling success rate of 63% (95% CI: 42.4–80.6). 6,614 dogs were examined, and 12.6% (95% CI: 11.8–13.4) were infested with at least one tick. One thousand one hundred twelve cats were examined, and six (0.54%; 95% CI: 0.20–1.1) were found with ticks. Sixty-four wild pigs were examined and 17.2% (95% CI: 9.5–27.8) had ticks. In total, 1,956 ticks were collected and 97.4% of ticks were R. sanguineus. A subset of R. sanguineus were determined to be the tropical lineage. The other tick species found were Rhipicephalus microplus (0.77%), Amblyomma breviscutatum (0.77 %), and a Haemaphysalis sp. (0.51%). Blood samples from 136 dogs, four cats, and 64 wild pigs were tested using polymerase chain reaction (PCR) and DNA sequencing methods. Five different tick-borne pathogens with the following prevalences were found in dogs: Anaplasma phagocytophilum 5.9% (95% CI: 2.6–11.3); Anaplasma platys 19.1% (95% CI: 12.9–26.7); Babesia canis vogeli 8.8% (95% CI: 4.6–14.9); Ehrlichia canis 12.5% (95% CI: 7.5–19.3); Hepatozoon canis 14.7% (95% CI: 9.2–28.8). E. canis was detected in one cat, and no tick-borne pathogens were detected in wild pigs. Overall, 43.4% (95% CI: 34.9–52.1) of dogs had at least one tick-borne pathogen. Serological testing for antibodies against Ehrlichia spp. and Anaplasma spp. showed prevalences of 14.7% (95% CI: 9.2–28.8) and 31.6% (95% CI: 23.9–40), respectively. Conclusion: Four different tick species were found in Guam to include a Haemaphysalis sp., which is a previously unreported genus for Guam. Dogs with ticks have a high prevalence of tick-borne pathogens which makes them useful sentinels

Process Evaluation of Healthy Habits, Healthy U: A School-Based Cancer Prevention Program

In the U.S., approximately one­third of cancer deaths are a result of poor nutrition and sedentary behaviors (ACS, 2015) and since 2008, cancer has been the leading cause of death in Idaho (CCAI, 2014). The American Institute of Cancer Research (2015) indicates about 50% of the most common cancers could be prevented by reducing negative health habits or by adopting positive ones. The topic of cancer is only briefly mentioned in the Boise School District\u27s eighth­grade health curriculums, thus the motivation behind the Healthy Habits Healthy U (HHHU) program. The program was designed to inform students about the relationship between cancer risks and nutrition, physical activity, and sugar sweetened beverages. After the HHHU program, teachers administered surveys to the students to determine the program\u27s impact on their knowledge of health habits related to decreasing cancer risks and measure their behavioral intent when it came to changing negative health habits. After analyzing the Fall 2015 data, it was found that there was a 71.06% increase in knowledge when identifying cancer risks and a 75.48% increase when identifying ways to prevent cancer risk

Leveraging Case Study Research: A Mechanism to Measure Teaching Effectiveness

This article shares findings from a descriptive, multiple case study assessing graduate outcomes 2.5 years after the completion of a teacher education program. Case study was used as an alternative to value-added measures to holistically examine complex attributes of effective teaching. Mixed methods data collection included graduate and supervisor surveys, self and supervisor evaluation of skills and dispositions, interviews, and classroom observations. Results indicated participants effectively applied the knowledge, skills, and dispositions the program was designed to achieve in the areas of Learner and Learning, Content, Instructional Practice, and Professional Responsibility. Three major recommendations emerged: 1) the necessity to develop established proficiency levels for new teachers related to diverse learners, 2) the need for shared responsibility of outcomes and targeted induction support, and 3) support for supervisor evaluation as a viable mechanism for education program accountability of teaching effectiveness of graduates