Patient Outcomes Significantly Improve When Receiving Treatment by Athletic Therapy Students

Student-run clinics are beneficial and provide interactions between education and community. Treatment outcomes by students are rarely measured. To our knowledge, no studies evaluate student athletic therapist’s rehabilitation outcomes. The purpose of our study was to measure the improvement in function in injured patients seeking treatment at the student-run Athletic Therapy PERFORM Clinic. Main Outcomes and Measures: At baseline and at follow-up, student-treated patients completed one of three questionnaires to assess their injured level of function: Oswestry Disability Index (ODI) for low back injuries, Lower Extremity Functional Scale (LEFS) for lower extremity injuries and Disabilities of the Arm Shoulder and Hand (DASH) for upper extremity injuries. Results: On average, patients received 4.7 ± 1.8 treatments across 48.8 ± 16.1 days. Overall, patients experienced a statistically significant increase in function between assessment and follow-up (18.8% ± 20.3, p < 0.001). Patients with an acute injury improved more compared to patients with a chronic pain injury (p < 0.001). While there was no significant difference in function at baseline between patients with acute injuries and chronic pain/injuries, there was a trend towards patients with an acute injury being less functional (p = 0.051). Discussion: Improvements in function in injured patients at this student-run clinic are similar to the minimal clinically important difference respective to each questionnaire. The clinic offers an additional benefit to patients with a robust cost-effectiveness ratio. Our results suggest that Athletic Therapy education should investigate the different needs of chronic injury patients in order to maximize improvements in function

Athlete's Sleep and Performance Measures During The Competitive Season

Important information about the effect of sleep on sport-specific performance measures during different athletic seasons is lacking. Therefore, objective sleep and performance measures in football players were examined during two seasons. This was done using a single group, repeated measures design at a university lab and athletics practice facility. Twenty-four healthy male football players (age=21.6±1.6years, weight=99.7±18.9kg, height=183.8±5.6cm) participated in the study. Participants wore a wrist accelerometer, Actiwatch Score (AS), during 5 days in the off-season and the in-season, with the last recording being the night before a game. Sleep efficiency (SE) and total sleep time (TST) were calculated using wake-quiet activity from AS. All athletes also completed a self-report measures sleep diary before bedtime and upon awakening. Performance measures, including: reaction time test, handgrip strength, vertical jump, and the agility t-test, were recorded at the end of 5 days during the off-season and on the morning of game day during the in-season. There was no significant change in SE between off-season and in-season (77.6±7.2% and 77.5±7.9%, p=0.962). There was a trend toward an increase in in-season TST (375.2±70.2min and 409.3±72.4min, p=0.056). There was no significant changes in performance measures between seasons (p values: 0.190 to 0.872). There was no significant change in sleep measures between the off- season and in-season in university football players. However, the approximate 77% average of SE is alarmingly low. It is possible that student-athletes’ rigid schedules contribute to their poor sleep. Future studies are needed to determine the cause of poor sleep in football athletes

The Role of Visual Sensory Performance Outcomes in Concussions: Impact on Concussed Special Operations Forces Combat Soldiers and Possible Implications for the Future of Sports-Related Concussions

The Role of Visual Sensory Performance Outcomes in Concussions: Impact on Concussed Special Operations Forces Combat Soldiers and Possible Implications for the Future of Sports-Related Concussions Clara Soligon, BS, CAT(C) Concordia University, 2022 This thesis details the increased concern towards concussions in athletes and Soldiers as well as the role of visual sensory performance. More studies are showing the consequences, whether short term or long term, of concussions. The symptoms burden and multiple neurocognitive deficits faced by a concussed athlete are getting increasingly recognized by society, as well as healthcare professionals. Studies have shown how concussions can also cause visual sensory performance deficits, even when traditional assessments are normal, and the athletes are cleared to return to play. One big challenge with concussions is the lack of objective measures to diagnose a concussion, as well for medically clearing an athlete or Soldier to return to full activity. Even with the knowledge that visual deficits might be present after a concussion; most traditional assessments do not assess vision due to a lack of unified platform and test availability. Visual sensory performance is important for injury prevention and impact anticipation, as well as assuring peak occupational performance. We assessed US Special Operations Forces combat Soldiers’ visual sensory performance outcomes. Concussions are the most common traumatic injury in the US military since 2000. Visual sensory performance outcome deficits could prevent Soldiers to complete their missions and impact their safety. Finding visual sensory performance outcomes deficits could help prevent an early return to play or return to duty, an increased risk of re-injury as well as help guide rehabilitation in athletes and military alike

Synthesis, antitubercular activity and mechanism of resistance of highly effective thiacetazone analogues

Defining the pharmacological target(s) of currently used drugs and developing new analogues with greater potency are both important aspects of the search for agents that are effective against drug-sensitive and drug-resistant Mycobacterium tuberculosis. Thiacetazone (TAC) is an anti-tubercular drug that was formerly used in conjunction with isoniazid, but removed from the antitubercular chemotherapeutic arsenal due to toxic side effects. However, several recent studies have linked the mechanisms of action of TAC to mycolic acid metabolism and TAC-derived analogues have shown increased potency against M. tuberculosis. To obtain new insights into the molecular mechanisms of TAC resistance, we isolated and analyzed 10 mutants of M. tuberculosis that were highly resistant to TAC. One strain was found to be mutated in the methyltransferase MmaA4 at Gly101, consistent with its lack of oxygenated mycolic acids. All remaining strains harbored missense mutations in either HadA (at Cys61) or HadC (at Val85, Lys157 or Thr123), which are components of the bhydroxyacyl-ACP dehydratase complex that participates in the mycolic acid elongation step. Separately, a library of 31 new TAC analogues was synthesized and evaluated against M. tuberculosis. Two of these compounds, 15 and 16, exhibited minimal inhibitory concentrations 10-fold lower than the parental molecule, and inhibited mycolic acid biosynthesis in a dose-dependent manner. Moreover, overexpression of HadAB HadBC or HadABC in M. tuberculosis led to high level resistance to these compounds, demonstrating that their mode of action is similar to that of TAC. In summary, this study uncovered new mutations associated with TAC resistance and also demonstrated that simple structural optimization of the TAC scaffold was possible and may lead to a new generation of TAC-derived drug candidates for the potential treatment of tuberculosis as mycolic acid inhibitors

Thiacetazone, an Antitubercular Drug that Inhibits Cyclopropanation of Cell Wall Mycolic Acids in Mycobacteria

Background. Mycolic acids are a complex mixture of branched, long-chain fatty acids, representing key components of the highly hydrophobic mycobacterial cell wall. Pathogenic mycobacteria carry mycolic acid sub-types that contain cyclopropane rings. Double bonds at specific sites on mycolic acid precursors are modified by the action of cyclopropane mycolic acid synthases (CMASs). The latter belong to a family of S-adenosyl-methionine-dependent methyl transferases, of which several have been well studied in Mycobacterium tuberculosis, namely, MmaA1 through A4, PcaA and CmaA2. Cyclopropanated mycolic acids are key factors participating in cell envelope permeability, host immunomodulation and persistence of M. tuberculosis. While several antitubercular agents inhibit mycolic acid synthesis, to date, the CMASs have not been shown to be drug targets. Methodology/Principle Findings. We have employed various complementary approaches to show that the antitubercular drug, thiacetazone (TAC), and its chemical analogues, inhibit mycolic acid cyclopropanation. Dramatic changes in the content and ratio of mycolic acids in the vaccine strainMycobacterium bovis BCG, as well as in the related pathogenic speciesMycobacterium marinum were observed after treatment with the drugs. Combination of thin layer chromatography, mass spectrometry and Nuclear Magnetic Resonance (NMR) analyses of mycolic acids purified fromdrug-treated mycobacteria showed a significant loss of cyclopropanation in both the a- and oxygenated mycolate sub-types. Additionally, High-Resolution Magic Angle Spinning (HR-MAS) NMR analyses on whole cells was used to detect cell wall-associated mycolates and to quantify the cyclopropanation status of the cell envelope. Further, overexpression of cmaA2, mmaA2 or pcaA in mycobacteria partially reversed the effects of TAC and its analogue on mycolic acid cyclopropanation, suggesting that the drugs act directly on CMASs. Conclusions/Significance. This is a first report on them echanism of action of TAC, demonstrating the CMASs as its cellular targets in mycobacteria. The implications of this study may be important for the design of alternative strategies for tuberculosis treatment

A survey for variable young stars with small telescopes – VIII. Properties of 1687 Gaia selected members in 21 nearby clusters

The Hunting Outbursting Young Stars (HOYS) project performs long-term, optical, multi-filter, high cadence monitoring of 25 nearby young clusters and star forming regions. Utilising Gaia DR3 data we have identified about 17000 potential young stellar members in 45 coherent astrometric groups in these fields. Twenty one of them are clear young groups or clusters of stars within one kiloparsec and they contain 9143 Gaia selected potential members. The cluster distances, proper motions and membership numbers are determined. We analyse long term (≈ 7 yr) V, R, and I-band light curves from HOYS for 1687 of the potential cluster members. One quarter of the stars are variable in all three optical filters, and two thirds of these have light curves that are symmetric around the mean. Light curves affected by obscuration from circumstellar materials are more common than those affected by accretion bursts, by a factor of 2 – 4. The variability fraction in the clusters ranges from 10 to almost 100 percent, and correlates positively with the fraction of stars with detectable inner disks, indicating that a lot of variability is driven by the disk. About one in six variables shows detectable periodicity, mostly caused by magnetic spots. Two thirds of the periodic variables with disk excess emission are slow rotators, and amongst the stars without disk excess two thirds are fast rotators – in agreement with rotation being slowed down by the presence of a disk

A survey for variable young stars with small telescopes: VIII — Properties of 1687 Gaia selected members in 21 nearby clusters

The Hunting Outbursting Young Stars (HOYS) project performs long-term, optical, multi- filter, high cadence monitoring of 25 nearby young clusters and star forming regions. Utilising Gaia DR3 data we have identified about 17000 potential young stellar members in 45 coherent astrometric groups in these fields. Twenty one of them are clear young groups or clusters of stars within one kiloparsec and they contain 9143 Gaia selected potential members. The cluster distances, proper motions and membership numbers are determined. We analyse long term ( 7 yr) V, R, and I-band light curves from HOYS for 1687 of the potential cluster members. One quarter of the stars are variable in all three optical filters, and two thirds of these have light curves that are symmetric around the mean. Light curves affected by obscuration from circumstellar materials are more common than those affected by accretion bursts, by a factor of 2 – 4. The variability fraction in the clusters ranges from 10 to almost 100 percent, and correlates positively with the fraction of stars with detectable inner disks, indicating that a lot of variability is driven by the disk. About one in six variables shows detectable periodicity, mostly caused by magnetic spots. Two thirds of the periodic variables with disk excess emission are slow rotators, and amongst the stars without disk excess two thirds are fast rotators – in agreement with rotation being slowed down by the presence of a disk

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population

Duration of androgen deprivation therapy with postoperative radiotherapy for prostate cancer: a comparison of long-course versus short-course androgen deprivation therapy in the RADICALS-HD randomised trial

Background Previous evidence supports androgen deprivation therapy (ADT) with primary radiotherapy as initial treatment for intermediate-risk and high-risk localised prostate cancer. However, the use and optimal duration of ADT with postoperative radiotherapy after radical prostatectomy remains uncertain. Methods RADICALS-HD was a randomised controlled trial of ADT duration within the RADICALS protocol. Here, we report on the comparison of short-course versus long-course ADT. Key eligibility criteria were indication for radiotherapy after previous radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to add 6 months of ADT (short-course ADT) or 24 months of ADT (long-course ADT) to radiotherapy, using subcutaneous gonadotrophin-releasing hormone analogue (monthly in the short-course ADT group and 3-monthly in the long-course ADT group), daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as metastasis arising from prostate cancer or death from any cause. The comparison had more than 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 75% to 81% (hazard ratio [HR] 0·72). Standard time-to-event analyses were used. Analyses followed intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov , NCT00541047 . Findings Between Jan 30, 2008, and July 7, 2015, 1523 patients (median age 65 years, IQR 60–69) were randomly assigned to receive short-course ADT (n=761) or long-course ADT (n=762) in addition to postoperative radiotherapy at 138 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 8·9 years (7·0–10·0), 313 metastasis-free survival events were reported overall (174 in the short-course ADT group and 139 in the long-course ADT group; HR 0·773 [95% CI 0·612–0·975]; p=0·029). 10-year metastasis-free survival was 71·9% (95% CI 67·6–75·7) in the short-course ADT group and 78·1% (74·2–81·5) in the long-course ADT group. Toxicity of grade 3 or higher was reported for 105 (14%) of 753 participants in the short-course ADT group and 142 (19%) of 757 participants in the long-course ADT group (p=0·025), with no treatment-related deaths. Interpretation Compared with adding 6 months of ADT, adding 24 months of ADT improved metastasis-free survival in people receiving postoperative radiotherapy. For individuals who can accept the additional duration of adverse effects, long-course ADT should be offered with postoperative radiotherapy. Funding Cancer Research UK, UK Research and Innovation (formerly Medical Research Council), and Canadian Cancer Society

Reliability of inversion and eversion peak- and average-torque measurements from the Biodex System 3 dynamometer

Fiabilité des mesures de la force concentrique, excentrique et isocinétique au niveau des muscles de la cheville et du pied