Systematic Review of Physiotherapy during Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD)

In COPD patients, acute exacerbations are important events. Reviews of studies investigating treatment during AECOPD focus on medical management, with little discussion of physiotherapy. Therefore a systematic review was undertaken of the studies pertaining to physiotherapy during AECOPD. Methods: Studies were identified by searching databases and scanning reference lists. Appropriate studies were reviewed by two independent investigators. Data were extracted using a standardized form. Where possible, a score was assigned using the PEDro scale for assessment of study quality. HIll, K., Patman, S., & Brooks, D. (2008). Systematic review of physiotherapy during Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD). American Journal of Respiratory and Critical Care Medicine, 177, Abstracts Issue, A137. ISSN: 1073-449

Relationships Among Invasive Coqui Frogs, the Small Indian Mongoose and Rat Species in Hawaii

Non-native species are increasing globally, and with this increase, it is likely that there will be new, unique relationships found among non-natives as well as additional impacts on native species. Rats and mongooses have been introduced to islands throughout the world where they impact native species, including birds, reptiles, and amphibians. The coqui frog was introduced to Hawaii in the 1980’s, where there were already abundant rat and mongoose populations. Previous research suggests that the high densities of coqui frogs may provide enough of a new food source for mongooses and rats that their populations would grow larger than they would without coqui frogs, and that this would exacerbate the negative effects that these predators have on native birds. We investigated whether there are relationships between coqui presence, and the local abundance of introduced rats and mongoose on the island of Hawaii. We also investigated at these 12 sites whether there were indirect effects of coquis on bird nest predation rates using camera traps on artificial nests. Finally, we interpret our results in light of an analysis of the stomach contents of mongooses and rats, and data collected from remote cameras monitoring scavengers of dead coqui frogs. We compared abundances of mammals in coqui invaded plots and uninvaded plots. In areas where coquis were present, we found a greater number of mongooses, and less Pacific rats. Both predators consume coquis, but mongooses were more important consumers of live and dead coquis. Shifts in mongoose and rat diets were observed in coqui invaded and uninvaded plots. It may be that coqui frogs are competing with rats because we found more fruit in rat stomachs collected in coqui invaded compared to uninvaded plots. We did not observe any difference in nest predation rates with and without coquis. Our results show that the coqui may serve as novel prey and/or competitors to non-native mammals

Case Report: Sapho Syndrome Previously Mistaken for Paget\u27s Disease

SAPHO syndrome is a rare clinical entity, an acronym named for its frequent coincident clinical manifestations, synovitis, acne, pustulosis, hyperostosis, and osteitis. Its clinical phenotype is widely heterogeneous, which coupled with its rarity causes many misdiagnoses. Herein, we present a case of a patient that was previously diagnosed with Paget’s disease. After an MVA, the full extent of his disease was detected via incidental imaging, which demonstrated sclerosis and ankylosis of the lumbar spine, sclerosis of the clavicles, and the pathognomonic bull’s head configuration on bone scan. Upon further questioning, the patient also harbored intermittent palmar pustulosis, psoriasis, sternoclavicular pain and tenderness, and widespread morning joint stiffness that ameliorates with activity. A high index of suspicion, and knowledge of its variable manifestations are paramount to arrive at a SAPHO diagnosis and thereby provide appropriate therapy to the patient

Incidence and prevalence of falls in adults living with an intellectual disability living in the community: A systematic review

Review question/objective: The objective of this review is to synthesize the best available evidence to determine the incidence and prevalence of falls in adults with intellectual disability living in the community

Invasive Coqui Frogs Are Associated With Differences in Mongoose and Rat Abundances and Diets in Hawaii

With the increasing rate of species being introduced to areas outside of their native ranges, non-natives are likely to interact in ways that influence each other’s populations. The high densities of invasive coqui frogs (Eleutherodactylus coqui) in Hawaii have been hypothesized to increase non-native mongoose (Herpestes auropunctatus) and rat (Rattus spp.) abundances, and in turn increase bird nest depredation rates. We compared the relative abundances of rats and mongooses and artificial bird nest predation rates at 12 sites that had plots with similar habitat invaded and not invaded by coqui frogs across the island of Hawaii. We interpret our results considering mongoose and rat stomach analyses and camera trap data collected to monitor coqui scavengers. We found that coqui presence was associated with 30% greater mongoose abundance and 17% lower Pacific rat (R. exulans) abundance. Based on our diet analyses and scavenging data, both mongooses and rats consume coquis, but mongooses were the most important consumers of coquis, which may have contributed to their increase in coqui plots. We speculate that coquis are competing with rats for invertebrate prey due to reduced Pacific rat abundance and greater amounts of fruit in rat stomachs collected in coqui-invaded compared to uninvaded plots. We did not observe any difference in bird nest predation rates in coqui-invaded and uninvaded plots. Our results suggest that the coqui invasion may increase or decrease non-native mammal populations, and non-native amphibians may serve as both novel prey and competitors to non-native mammals

Correlation functions for extended mass galaxy clusters

The phenomenon of clustering of galaxies on the basis of correlation functions in an expanding Universe is studied by using equation of state, taking gravitational interaction between galaxies of extended nature into consideration. The partial differential equation for the extended mass structures of a two-point correlation function developed earlier by Iqbal, Ahmad and Khan is studied on the basis of assigned boundary conditions. The solution for the correlation function for extended structures satisfies the basic boundary conditions, which seem to be sufficient for understanding the phenomena, and provides a new insight into the gravitational clustering problem for extended mass structures.Comment: 3 pages, no figure

Clinical validation of expert consensus statements for respiratory physiotherapy management of invasively ventilated adults with community-acquired pneumonia: A qualitative study

Objectives: To conduct multidisciplinary peer-review of expert consensus statements for respiratory physiotherapy for invasively ventilated adults with community-acquired pneumonia, to determine clinical acceptability for development into a clinical practice guideline. Research methodology: A qualitative study was undertaken using focus groups (n = 3) conducted with clinician representatives from five Australian states. Participants were senior intensive care physiotherapists, nurses and consultants. Thematic analysis was used, with a deductive approach to confirm clinical validity, and inductive analysis to identify new themes relevant to the application of the 38 statements into practice. Setting: Adult intensive care. Findings: Senior intensive care clinicians from physiotherapy (n = 16), medicine (n = 6) and nursing (n = 4) participated. All concurred that the consensus statements added valuable guidance to practice; twenty-nine (76%) were deemed relevant and applicable for the intensive care setting without amendment, with modifications suggested for remaining nine statements to enhance utility. Overarching themes of patient safety, teamwork and communication and culture were identified as factors influencing clinical application. Cultural differences in practice, particularly related to patient positioning, was evident between jurisdictions. Participants raised practicality and safety concerns for two statements related to the use of head-down patient positioning. Conclusion: Multidisciplinary peer-review established clinical validity of expert consensus statements for implementation with invasively ventilated adults with community-acquired pneumonia

Exploration Space Suit Architecture and Destination Environmental-Based Technology Development

This paper continues forward where EVA Space Suit Architecture: Low Earth Orbit Vs. Moon Vs. Mars [1] left off in the development of a space suit architecture that is modular in design and could be reconfigured prior to launch or during any given mission depending on the tasks or destination. This paper will address the space suit system architecture and technologies required based upon human exploration extravehicular activity (EVA) destinations, and describe how they should evolve to meet the future exploration EVA needs of the US human space flight program.1, 2, 3 In looking forward to future US space exploration to a space suit architecture with maximum reuse of technology and functionality across a range of mission profiles and destinations, a series of exercises and analyses have provided a strong indication that the Constellation Program (CxP) space suit architecture is postured to provide a viable solution for future exploration missions4. The destination environmental analysis presented in this paper demonstrates that the modular architecture approach could provide the lowest mass and mission cost for the protection of the crew given any human mission outside of low-Earth orbit (LEO). Additionally, some of the high-level trades presented here provide a review of the environmental and non-environmental design drivers that will become increasingly important the farther away from Earth humans venture. This paper demonstrates a logical clustering of destination design environments that allows a focused approach to technology prioritization, development, and design that will maximize the return on investment, independent of any particular program, and provide architecture and design solutions for space suit systems in time or ahead of need dates for any particular crewed flight program in the future. The approach to space suit design and interface definition discussion will show how the architecture is very adaptable to programmatic and funding changes with minimal redesign effort such that the modular architecture can be quickly and efficiently honed into a specific mission point solution if required. Additionally, the modular system will allow for specific technology incorporation and upgrade as required with minimal redesign of the system