Multimodal Physical Therapy Management of a 24 Year-Old Male with Chronic Retrocalcaneal Pain: A Case Report

Background and Purpose: The multimodal approach reflects the type of individualized treatment commonly used in the clinical setting, in which many different interventions are available to the physical therapist. The purpose of this case report is to describe the physical therapy management process for a patient with chronic retrocalcaneal pain using a multimodal intervention approach. Case Description: The patient was a 24 year-old male with chronic left retrocalcaneal pain. The patient’s impairments included decreased left ankle dorsiflexion, decreased left talocrural joint mobility, left ankle swelling, and gait deviations. The patient’s functional limitations included decreased ability to stand and walk for prolonged periods of time secondary to pain. Outcomes: Left ankle dorsiflexion passive range of motion increased from 0-10⁰ to 0-14⁰. Numeric Pain Rating Scale (NPRS) scores decreased from 8/10 to 3/10. Gait deviations were normalized. The patient reported improved functional mobility in school and work activities. Discussion: Even though the specific etiology of retrocalcaneal pain could not be determined in clinic, positive outcomes were seen through a selection of interventions that addressed the patient’s impairments and functional limitations

Age-specific mortality during the 1918 influenza pandemic: unravelling the mystery of high young adult mortality.

The worldwide spread of a novel influenza A (H1N1) virus in 2009 showed that influenza remains a significant health threat, even for individuals in the prime of life. This paper focuses on the unusually high young adult mortality observed during the Spanish flu pandemic of 1918. Using historical records from Canada and the U.S., we report a peak of mortality at the exact age of 28 during the pandemic and argue that this increased mortality resulted from an early life exposure to influenza during the previous Russian flu pandemic of 1889-90. We posit that in specific instances, development of immunological memory to an influenza virus strain in early life may lead to a dysregulated immune response to antigenically novel strains encountered in later life, thereby increasing the risk of death. Exposure during critical periods of development could also create holes in the T cell repertoire and impair fetal maturation in general, thereby increasing mortality from infectious diseases later in life. Knowledge of the age-pattern of susceptibility to mortality from influenza could improve crisis management during future influenza pandemics

Using a virtual reality cricket simulator to explore the effects of pressure, competition anxiety on batting performance in cricket

Virtual reality (VR) has created opportunities to innovatively re-imagine the way we examine the relations between pressure, competition anxiety and performance. This study aimed to determine the efficacy of VR as a means of measuring the effects of competition anxiety when pressure manipulations are applied while participants bat in a cricket batting VR simulator. The twenty-eight male participants who took part in two experiments were divided into a high (14, mean age: 22.94, SD: 5.4) and a low skill group (14; mean age: 23.55, SD: 9.9). The aim of the first experiment was to validate the VR simulator as a tool that could capture differences in batting performance between a high and low skilled group. The results showed that high skill participants not only scored significantly higher run rates than low skill participants, but they outperformed the low skill group in all performance measures including higher incidences of correct foot placements that reflect better anticipatory responses. Having established the VR batting simulator as being a reliable tool for capturing batting dynamics, experiment 2 aimed to explore the effects of a pressure manipulation on competition anxiety and batting performance. All measures of competition anxiety were significantly greater for both groups in the high-pressure condition compared to the two low-pressure conditions (p &lt; 0.001). The magnitude of this effect was greater in the low skill group for cognitive (0.59) and somatic (0.794) anxiety. Despite anxiety levels significantly increasing in the high-pressure condition, no significant negative changes to batting performance were found for either group, with both groups actually demonstrating performance improvements. Overall, the findings show how a cricket batting virtual reality simulator can be used as a tool to measure the effects of pressure on competition anxiety and batting performance in tasks involving dynamic skill execution.</p

Determinants of Influenza Mortality Trends: Age-Period-Cohort Analysis of Influenza Mortality in the United States, 1959-2016.

This study examines the roles of age, period, and cohort in influenza mortality trends over the years 1959-2016 in the United States. First, we use Lexis surfaces based on Serfling models to highlight influenza mortality patterns as well as to identify lingering effects of early-life exposure to specific influenza virus subtypes (e.g., H1N1, H3N2). Second, we use age-period-cohort (APC) methods to explore APC linear trends and identify changes in the slope of these trends (contrasts). Our analyses reveal a series of breakpoints where the magnitude and direction of birth cohort trends significantly change, mostly corresponding to years in which important antigenic drifts or shifts took place (i.e., 1947, 1957, 1968, and 1978). Whereas child, youth, and adult influenza mortality appear to be influenced by a combination of cohort- and period-specific factors, reflecting the interaction between the antigenic experience of the population and the evolution of the influenza virus itself, mortality patterns of the elderly appear to be molded by broader cohort factors. The latter would reflect the processes of physiological capital improvement in successive birth cohorts through secular changes in early-life conditions. Antigenic imprinting, cohort morbidity phenotype, and other mechanisms that can generate the observed cohort effects, including the baby boom, are discussed

Why not just Google it? An assessment of information literacy skills in a biomedical science curriculum

<p>Abstract</p> <p>Background</p> <p>Few issues in higher education are as fundamental as the ability to search for, evaluate, and synthesize information. The need to develop information literacy, the process of finding, retrieving, organizing, and evaluating the ever-expanding collection of online information, has precipitated the need for training in skill-based competencies in higher education, as well as medical and dental education.</p> <p>Methods</p> <p>The current study evaluated the information literacy skills of first-year dental students, consisting of two, consecutive dental student cohorts (n = 160). An assignment designed to evaluate information literacy skills was conducted. In addition, a survey of student online search engine or database preferences was conducted to identify any significant associations. Subsequently, an intervention was developed, based upon the results of the assessment and survey, to address any deficiencies in information literacy.</p> <p>Results</p> <p>Nearly half of students (n = 70/160 or 43%) missed one or more question components that required finding an evidence-based citation. Analysis of the survey revealed a significantly higher percentage of students who provided incorrect responses (n = 53/70 or 75.7%) reported using Google as their preferred online search method (p < 0.01). In contrast, a significantly higher percentage of students who reported using PubMed (n = 39/45 or 86.7%) were able to provide correct responses (p < 0.01). Following a one-hour intervention by a health science librarian, virtually all students were able to find and retrieve evidence-based materials for subsequent coursework.</p> <p>Conclusions</p> <p>This study confirmed that information literacy among this student population was lacking and that integration of modules within the curriculum can help students to filter and establish the quality of online information, a critical component in the training of new health care professionals. Furthermore, incorporation of these modules early in the curriculum may be of significant value to other dental, medical, health care, and professional schools with similar goals of incorporating the evidence base into teaching and learning activities.</p

Pandemic Paradox: Early Life H2N2 Pandemic Influenza Infection Enhanced Susceptibility to Death during the 2009 H1N1 Pandemic.

Recent outbreaks of H5, H7, and H9 influenza A viruses in humans have served as a vivid reminder of the potentially devastating effects that a novel pandemic could exert on the modern world. Those who have survived infections with influenza viruses in the past have been protected from subsequent antigenically similar pandemics through adaptive immunity. For example, during the 2009 H1N1 "swine flu" pandemic, those exposed to H1N1 viruses that circulated between 1918 and the 1940s were at a decreased risk for mortality as a result of their previous immunity. It is also generally thought that past exposures to antigenically dissimilar strains of influenza virus may also be beneficial due to cross-reactive cellular immunity. However, cohorts born during prior heterosubtypic pandemics have previously experienced elevated risk of death relative to surrounding cohorts of the same population. Indeed, individuals born during the 1890 H3Nx pandemic experienced the highest levels of excess mortality during the 1918 "Spanish flu." Applying Serfling models to monthly mortality and influenza circulation data between October 1997 and July 2014 in the United States and Mexico, we show corresponding peaks in excess mortality during the 2009 H1N1 "swine flu" pandemic and during the resurgent 2013-2014 H1N1 outbreak for those born at the time of the 1957 H2N2 "Asian flu" pandemic. We suggest that the phenomenon observed in 1918 is not unique and points to exposure to pandemic influenza early in life as a risk factor for mortality during subsequent heterosubtypic pandemics.IMPORTANCE The relatively low mortality experienced by older individuals during the 2009 H1N1 influenza virus pandemic has been well documented. However, reported situations in which previous influenza virus exposures have enhanced susceptibility are rare and poorly understood. One such instance occurred in 1918-when those born during the heterosubtypic 1890 H3Nx influenza virus pandemic experienced the highest levels of excess mortality. Here, we demonstrate that this phenomenon was not unique to the 1918 H1N1 pandemic but that it also occurred during the contemporary 2009 H1N1 pandemic and 2013-2014 H1N1-dominated season for those born during the heterosubtypic 1957 H2N2 "Asian flu" pandemic. These data highlight the heretofore underappreciated phenomenon that, in certain instances, prior exposure to pandemic influenza virus strains can enhance susceptibility during subsequent pandemics. These results have important implications for pandemic risk assessment and should inform laboratory studies aimed at uncovering the mechanism responsible for this effect

Renal Biopsy Device with Bleeding Control

Final report and team photo for Project 22 of ME450, Fall 2010 semester.This project will develop a novel biopsy needle device that adds a 3rd stage to the standard biopsy process to deploy a hemostatic agent to control bleeding at the time of biopsy.William Weitzel (Nephrology, U of M); Grant Kruger (Mechanical Engineering, U of M)http://deepblue.lib.umich.edu/bitstream/2027.42/86249/1/ME450 Fall2010 Final Report - Project 22 - Renal Biopsy Device with Bleeding Control.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/86249/2/ME450 Fall2010 Team Photo - Project 22 - Renal Biopsy Device with Bleeding Control.jp

The fission yeast DNA structure checkpoint protein Rad26(ATRIP/LCD1/UVSD )accumulates in the cytoplasm following microtubule destabilization

BACKGROUND: DNA structure checkpoints are conserved eukaryotic signal transduction pathways that help preserve genomic integrity. Upon detecting checkpoint signals such as stalled replication forks or double-stranded DNA breaks, these pathways coordinate appropriate stress responses. Members of the PI-3 kinase related kinase (PIKK) family are essential elements of DNA structure checkpoints. In fission yeast, the Rad3 PIKK and its regulatory subunit Rad26 coordinate the detection of checkpoint signals with pathway outputs. RESULTS: We found that untreated rad26Δ cells were defective for two microtubule-dependent processes: chromosome segregation and morphogenesis. Interestingly, cytoplasmic accumulation of Rad26-GFP occurred following treatment with microtubule destabilizing drugs, but not during treatment with the genotoxic agent Phleomycin. Cytoplasmic accumulation of Rad26-GFP depended on Rad24, a 14-3-3 protein also required for DNA structure checkpoints and morphogenesis. Results of over expression and epistasis experiments confirm that Rad26 and Rad24 define a response to microtubule destabilizing conditions. CONCLUSION: Two DNA structure checkpoint proteins with roles in morphogenesis define a response to microtubule destabilizing conditions

Death Penalty in America: Perceptions, Reflection, and Reform

The “Death Penalty Reform” Panel was presented by Thomas Sullivan, Erik Lillquist, and John Cunningham. Thomas Sullivan was a senior partner at Jenner Block LLP, former United States Attorney for the Northern District of Illinois, co-chair of the Illinois Governor George H. Ryan\u27s Commission on Capital Punishment, and served as chairman of the Illinois Capital Punishment Reform Study Committee. Erik Lillquist was Professor of Law at Seton Hall School of Law where he was Director of the Institute of Law, Science and Technology. John Cunningham was a Senior Trial Attorney with the Employment Litigation Section of the Civil Rights Division at the United States Department of Justice. This panel was moderated by Corinna Lain, Professor of Law at the University of Richmond School of Law. The “Current Issues in Capital Cases” Panel was presented by Michael Herring, the Commonwealth Attorney for the City of Richmond; Matthew Geary, the Chief Deputy of the Commonwealth\u27s Attorney Office in the City of Richmond; and Craig Cooley, one of the region’s most respected trial attorneys. This panel was moderated by John Douglass, Professor of Law at the University of Richmond School of Law