Dysphagia rehabilitation following acquired brain injury, including cerebral palsy, across the lifespan: a scoping review protocol

BACKGROUND: Swallowing impairment (dysphagia) following brain injury can lead to life-threatening complications such as dehydration, aspiration pneumonia and acute choking episodes. In adult therapeutic practice, there is research and clinical evidence to support the use of swallowing exercises to improve swallowing physiology in dysphagia; however, the use of these exercises in treating children with dysphagia is largely unexplored. Fundamental questions remain regarding the feasibility and effectiveness of using swallowing exercises with children. This review aims to outline the published literature on exercise-based treatment methods used in the rehabilitation of dysphagia secondary to an acquired brain injury across the lifespan. This will allow the range and effects of interventions utilised to be mapped alongside differential practices between adult and child populations to be formally documented, providing the potential for discussions with clinicians about which rehabilitative interventions might be appropriate for further trial in paediatrics. METHODS: This study will use a scoping review framework to identify and systematically review the existing literature using Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews (PRISMA) scoping review guidelines. Electronic databases (MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Allied and Complementary Medicine Database (AMED)), grey literature and the reference lists of key texts including systematic reviews will be searched. Information about the rehabilitation design, dosage and intensity of exercise programmes used as well as demographic information such as the age of participants and aetiology of dysphagia will be extracted. The number of articles in each area and the type of data source will be presented in a written and visual format. Comparison between the literature in adult and child populations will be discussed. DISCUSSION: This review is unique as it directly compares dysphagia rehabilitation in adults with that of a paediatric population in order to formally identify and discuss the therapeutic gaps in child dysphagia rehabilitation. The results will inform the next stage of research, looking into the current UK-based speech and language therapy practices when working with children with acquired dysphagia. SYSTEMATIC REVIEW REGISTRATION: Open science framework osf.io/ja4dr

Tulsa Oklahoma Oktoberfest Tent Collapse Report

Background. On October 17, 2007, a severe weather event collapsed two large tents and several smaller tents causing 23 injuries requiring evacuation to emergency departments in Tulsa, OK. Methods. This paper is a retrospective analysis of the regional health system's response to this event. Data from the Tulsa Fire Department, The Emergency Medical Services Authority (EMSA), receiving hospitals and coordinating services were reviewed and analyzed. EMS patient care reports were reviewed and analyzed using triage designators assigned in the field, injury severity scores, and critical mortality. Results. EMT's and paramedics from Tulsa Fire Department and EMSA provided care at the scene under unified incident command. Of the 23 patients transported by EMS, four were hospitalized, one with critical spinal injury and one with critical head injury. One patient is still in ongoing rehabilitation. Discussion. Analysis of the 2007 Tulsa Oktoberfest mass casualty incident revealed rapid police/fire/EMS response despite challenges of operations at dark under severe weather conditions and the need to treat a significant number of injured victims. There were no fatalities. Of the patients transported by EMS, a minority sustained critical injuries, with most sustaining injuries amenable to discharge after emergency department care

Too Hard to Find with Too Little Time: What School Social Workers Want in Online Resources for Evidence-Based Practice

School mental health practitioners, including social workers, are mandated through federal, state, and professional entities to provide evidence-based practices to students. Nevertheless, rates of use of evidence-based practices among mental health professionals in schools remain low, even as knowledge about effective practices increases. This study aimed to further knowledge about how to promote and support the use of evidence-based practices among school practitioners using online technology. School social workers attending a summer professional development event took part in focus groups exploring (a) their current perceptions of evidence-based practices, (b) their experiences finding evidence-based practice information online, and (c) their preferences for the formatting and content of online resources. Participants described a willingness to use evidence-based practice, efforts to find information, and difficulties encountered with online sources. Preferences for readily available, searchable, brief, and understandable online information were expressed. Implications for meeting the needs of school social workers with online resources are discussed

Pushing Moral Buttons: The Interaction Between Personal Force and Intention in Moral Judgment

In some cases people judge it morally acceptable to sacrifice one person’s life in order to save several other lives, while in other similar cases they make the opposite judgment. Researchers have identified two general factors that may explain this phenomenon at the stimulus level: (1) the agent’s intention (i.e. whether the harmful event is intended as a means or merely foreseen as a side-effect) and (2) whether the agent harms the victim in a manner that is relatively “direct” or “personal”. Here we integrate these two classes of findings. Two experiments examine a novel personalness/directness factor that we call personal force, present when the force that directly impacts the victim is generated by the agent’s muscles (e.g., in pushing). Experiments 1a and b demonstrate the influence of personal force on moral judgment, distinguishing it from physical contact and spatial proximity. Experiments 2a and b demonstrate an interaction between personal force and intention, whereby the effect of personal force depends entirely on intention. These studies also introduce a method for controlling for people’s real-world expectations in decisions involving potentially unrealistic hypothetical dilemmas.Psycholog

Genetic fingerprinting reveals natal origins of male leatherback turtles encountered in the Atlantic Ocean and Mediterranean Sea

This paper is not subject to U.S. copyright. The definitive version was published in Marine Biology 164 (2017): 181, doi:10.1007/s00227-017-3211-0.Understanding population dynamics in broadly distributed marine species with cryptic life history stages is challenging. Information on the population dynamics of sea turtles tends to be biased toward females, due to their accessibility for study on nesting beaches. Males are encountered only at sea; there is little information about their migratory routes, residence areas, foraging zones, and population boundaries. In particular, male leatherbacks (Dermochelys coriacea) are quite elusive; little is known about adult and juvenile male distribution or behavior. The at-sea distribution of male turtles from different breeding populations is not known. Here, 122 captured or stranded male leatherback turtles from the USA, Turkey, France, and Canada (collected 1997–2012) were assigned to one of nine Atlantic basin populations using genetic analysis with microsatellite DNA markers. We found that all turtles originated from western Atlantic nesting beaches (Trinidad 55%, French Guiana 31%, and Costa Rica 14%). Although genetic data for other Atlantic nesting populations were represented in the assignment analysis (St. Croix, Brazil, Florida, and Africa (west and south), none of the male leatherbacks included in this study were shown to originate from these populations. This was an unexpected result based on estimated source population sizes. One stranded turtle from Turkey was assigned to French Guiana, while others that were stranded in France were from Trinidad or French Guiana breeding populations. For 12 male leatherbacks in our dataset, natal origins determined from the genetic assignment tests were compared to published satellite and flipper tag information to provide evidence of natal homing for male leatherbacks, which corroborated our genetic findings. Our focused study on male leatherback natal origins provides information not previously known for this cryptic, but essential component of the breeding population. This method should provide a guideline for future studies, with the ultimate goal of improving management and conservation strategies for threatened and endangered species by taking the male component of the breeding population into account.Sample collection in Nova Scotia, Canada, was supported by funding from Canadian Wildlife Federation, Environment Canada, Fisheries and Oceans Canada, George Cedric Metcalf Foundation, Habitat Stewardship Program for Species at Risk, National Fish and Wildlife Foundation (USA), National Marine Fisheries Service (USA), Natural Sciences and Engineering Research Council of Canada, and World Wildlife Fund Canada. Funding for US samples was provided by National Oceanic and Atmospheric Administration, Massachusetts Division of Marine Fisheries, National Fish and Wildlife Foundation, and Cape Cod Commercial Fisherman’s Alliance. Funding support for this analysis and for Kelly R. Stewart was provided by a Lenfest Ocean Program Grant

Root Traits of Perennial C\u3csub\u3e4\u3c/sub\u3e Grasses Contribute to Cultivar Variations in Soil Chemistry and Species Patterns in Particulate and Mineral-Associated Carbon Pool Formation

Recent studies have indicated that the C4 perennial bioenergy crops switchgrass (Panicum virgatum) and big bluestem (Andropogon gerardii) accumulate significant amounts of soil carbon (C) owing to their extensive root systems. Soil C accumulation is likely driven by inter- and intraspecific variability in plant traits, but the mechanisms that underpin this variability remain unresolved. In this study we evaluated how inter- and intraspecific variation in root traits of cultivars from switchgrass (Cave-in-Rock, Kanlow, Southlow) and big bluestem (Bonanza, Southlow, Suther) affected the associations of soil C accumulation across soil fractions using stable isotope techniques. Our experimental field site was established in June 2008 at Fermilab in Batavia, IL. In 2018, soil cores were collected (30 cm depth) from all cultivars. We measured root biomass, root diameter, specific root length, bulk soil C, C associated with coarse particulate organic matter (CPOM) and fine particulate organic matter plus silt- and clay-sized fractions, and characterized organic matter chemical class composition in soil using high-resolution Fourier-transform ion cyclotron resonance mass spectrometry. C4 species were established on soils that supported C3 grassland for 36 years before planting, which allowed us to use differences in the natural abundance of stable C isotopes to quantify C4 plant-derived C. We found that big bluestem had 36.9% higher C4 plant-derived C compared to switchgrass in the CPOM fraction in the 0–10 cm depth, while switchgrass had 60.7% higher C4 plant-derived C compared to big bluestem in the clay fraction in the 10–20 cm depth. Our findings suggest that the large root system in big bluestem helps increase POM-C formation quickly, while switchgrass root structure and chemistry build a mineral-bound clay C pool through time. Thus, both species and cultivar selection can help improve bioenergy management to maximize soil carbon gains and lower CO2 emissions

Association of soybean-based food with the prevalence of anemia among reproductive aged men and women in rural Central Java, Indonesia

OBJECTIVE: To assess the association between soybean consumption and anemic status in Central Java, Indonesia. DESIGN: As part of an overarching sanitation improvement intervention in Central Java, Indonesia, we conducted a cross-sectional study in four rural villages. The study consisted of a 24-hour food recall, anthropometric measurements, blood hemoglobin measurement and stool sampling to test for soil-transmitted helminth (STH) infection status. A binary logistic regression model was fitted to test the association between soybean consumption and anemic status after adjusting for socio-demographic factors, STH infection, dietary diversity and anthropometric status. SETTING: This study took place in four rural villages of Wonosobo regency, Central Java, Indonesia. PARTICIPANTS: Participants were rural villagers aged between 15 and 49 years. RESULTS: A total sample size of 763 was attained, of which 231 were anemic. The prevalence of anemia was 30.2% among men and women of reproductive age, and highest among young males. Consumption of soybean was high (79.8%). After adjusting for covariates, the protective association between soybean consumption and anemia was statistically significant (AOR = 0.53, 95% CI = 0.30-0.95, p<0.05). There was a positive association with anemia among underweight (AOR = 2.75, 95% CI = 1.13-6.69, p<0.05) and those with high diet diversity (AOR = 1.40, 95% CI = 1.00-1.97, p<0.05). CONCLUSIONS: Our results were consistent with studies from other countries finding a protective association between soybean consumption and anemia. This association appeared stronger for tofu than for tempeh. The prevalence of anemia in rural Central Java is relatively consistent with nationwide statistics indicating that interventions targeting anemia are still largely required

Development of a Robotic Assembly for Analyzing the Instantaneous Axis of Rotation of the Foot Ankle Complex

Ankle instantaneous axis of rotation (IAR) measurements represent a more complete parameter for characterizing joint motion. However, few studies have implemented this measurement to study normal, injured, or pathological foot ankle biomechanics. A novel testing protocol was developed to simulate aspects of in vivo foot ankle mechanics during mid-stance gait in a human cadaveric specimen. A lower leg was mounted in a robotic testing platform with the tibia upright and foot flat on the baseplate. Axial tibia loads (ATLs) were controlled as a function of a vertical ground reaction force (vGRF) set at half body weight (356 N) and a 50% vGRF (178 N) Achilles tendon load. Two specimens were repetitively loaded over 10 degrees of dorsiflexion and 20 degrees of plantar flexion. Platform axes were controlled within 2 microns and 0.008 degrees resulting in ATL measurements within ±2 N of target conditions. Mean ATLs and IAR values were not significantly different between cycles of motion, but IAR values were significantly different between dorsiflexion and plantar flexion. A linear regression analysis showed no significant differences between slopes of plantar flexion paths. The customized robotic platform and advanced testing protocol produced repeatable and accurate measurements of the IAR, useful for assessing foot ankle biomechanics under different loading scenarios and foot conditions

The Samurai Project: verifying the consistency of black-hole-binary waveforms for gravitational-wave detection

We quantify the consistency of numerical-relativity black-hole-binary waveforms for use in gravitational-wave (GW) searches with current and planned ground-based detectors. We compare previously published results for the $(\ell=2,| m | =2)$ mode of the gravitational waves from an equal-mass nonspinning binary, calculated by five numerical codes. We focus on the 1000M (about six orbits, or 12 GW cycles) before the peak of the GW amplitude and the subsequent ringdown. We find that the phase and amplitude agree within each code's uncertainty estimates. The mismatch between the $(\ell=2,| m| =2)$ modes is better than $10^{-3}$ for binary masses above $60 M_{\odot}$ with respect to the Enhanced LIGO detector noise curve, and for masses above $180 M_{\odot}$ with respect to Advanced LIGO, Virgo and Advanced Virgo. Between the waveforms with the best agreement, the mismatch is below $2 \times 10^{-4}$. We find that the waveforms would be indistinguishable in all ground-based detectors (and for the masses we consider) if detected with a signal-to-noise ratio of less than $\approx14$, or less than $\approx25$ in the best cases.Comment: 17 pages, 9 figures. Version accepted by PR