Outpatient Physical Therapy Treatment of Patient with Spondylosis: A Case Study

Background and Purpose: In the United States low back pain (LBP) is one of the leading causes for individuals to reach out to health care professionals. LBP is often associated with a diagnosis of spondylosis. Spondylosis is present in about 80% of peoples in the United States. The prevalence of spondylosis continues to increase without a definite cure or form of treatment. Overall, exercise and intervention have proven to decrease symptoms of pain of those with spondylosis. However, success of treatment may see large variables in success. Further research into specific treatment interventions may be warranted to decrease chronic spondylosis in the United States. Case Description: This case involves a 72-year-old male diagnosed with spondylosis. The patient is a retired Top Gun Pilot for the United States Airforce and he participates in regular golf tournaments for recreation. He lives in a home with his wife. He began to feel pain in his low back when playing golf, walking up an incline, and bending over to carry groceries inside his home. He received imaging and was given the diagnosis of spondylosis and degenerative disc disease. Shortly after, he was referred to physical therapy for treatment of his symptoms. Intervention: Following evaluation and examination, directional preference was identified as well as mobility and strength deficits. Interventions and treatment were designed and implemented to compliment directional preferences and address strength DocuSign Envelope ID: 5958519C-66F8-46B0-8B47-200288084252 x and mobility deficits. Interventions included, but were not limited to, increasing thoracic and lumbar mobility, posterior chain strengthening, core stability interventions, manual therapy techniques and modalities. Outcomes: The patient felt significantly better following the eight weeks of treatment. Following the plan of care, the patient expressed he felt equipped to continue with his home exercise program to eliminate or decrease a return of symptoms. He expressed noticeable differences in his symptoms as well as noticeable increases in his strength and abilities within his normal daily activities following his treatment plan of care. Discussion: While interventions and manual therapy techniques were appropriate and delivered results for this patient, some research does not support or suggest just one approach being successful for all patients diagnosed with spondylosis. Further research should be done specifically on lumbar spondylosis as well as specific interventions to treat symptoms

Response of the Diatom Phaeodactylum tricornutum to Photooxidative Stress Resulting from High Light Exposure

The response of microalgae to photooxidative stress resulting from high light exposure is a well-studied phenomenon. However, direct analyses of photosystem II (PSII) D1 protein (the main target of photoinhibition) in diatoms are scarce. In this study, the response of the diatom model species Phaeodactylum tricornutum to short-term exposure to high light was examined and the levels of D1 protein determined immunochemically. Low light (LL) acclimated cells (40 µmol photons m−2 s−1) subjected to high light (HL, 1,250 µmol photons m−2 s−1) showed rapid induction of non-photochemical quenching (NPQ) and ca. 20-fold increase in diatoxanthin (DT) concentration. This resulted from the conversion of diadinoxanthin (DD) to DT through the activation of the DD-cycle. D1 protein levels under LL decreased about 30% after 1 h of the addition of lincomycin (LINC), a chloroplast protein synthesis inhibitor, showing significant D1 degradation and repair under low irradiance. Exposure to HL lead to a 3.2-fold increase in D1 degradation rate, whereas average D1 repair rate was 1.3-x higher under HL than LL, leading to decreased levels of D1 protein under HL. There were significant effects of both HL and LINC on P. tricornutum maximum quantum yield of PSII (Fv/Fm), showing a reduction of active PSII reaction centres. Partial recovery of Fv/Fm in the dark demonstrates the photosynthetic resilience of this diatom to changes in the light regime. P. tricornutum showed high allocation of total protein to D1 and an active D1-repair cycle to limit photoinhibition

Silencing of the Violaxanthin De-Epoxidase Gene in the Diatom Phaeodactylum tricornutum Reduces Diatoxanthin Synthesis and Non-Photochemical Quenching

Diatoms are a major group of primary producers ubiquitous in all aquatic ecosystems. To protect themselves from photooxidative damage in a fluctuating light climate potentially punctuated with regular excess light exposures, diatoms have developed several photoprotective mechanisms. The xanthophyll cycle (XC) dependent non-photochemical chlorophyll fluorescence quenching (NPQ) is one of the most important photoprotective processes that rapidly regulate photosynthesis in diatoms. NPQ depends on the conversion of diadinoxanthin (DD) into diatoxanthin (DT) by the violaxanthin de-epoxidase (VDE), also called DD de-epoxidase (DDE). To study the role of DDE in controlling NPQ, we generated transformants of P. tricornutum in which the gene (Vde/Dde) encoding for DDE was silenced. RNA interference was induced by genetic transformation of the cells with plasmids containing either short (198 bp) or long (523 bp) antisense (AS) fragments or, alternatively, with a plasmid mediating the expression of a self-complementary hairpin-like construct (inverted repeat, IR). The silencing approaches generated diatom transformants with a phenotype clearly distinguishable from wildtype (WT) cells, i.e. a lower degree as well as slower kinetics of both DD de-epoxidation and NPQ induction. Real-time PCR based quantification of Dde transcripts revealed differences in transcript levels between AS transformants and WT cells but also between AS and IR transformants, suggesting the possible presence of two different gene silencing mediating mechanisms. This was confirmed by the differential effect of the light intensity on the respective silencing efficiency of both types of transformants. The characterization of the transformants strengthened some of the specific features of the XC and NPQ and confirmed the most recent mechanistic model of the DT/NPQ relationship in diatoms

Light-induced responses of oxygen photoreduction, reactive oxygen species production and scavenging in two diatom species

Diatoms are frequently exposed to high light (HL) levels, which can result in photoinhibition and damage to PSII. Many microalgae can photoreduce oxygen using the Mehler reaction driven by PSI, which could protect PSII. The ability of Nitzschia epithemioides Grunow and Thalassiosira pseudonana Hasle et Heimdal grown at 50 and 300 μmol photons · m-2 · s-1 to photoreduce oxygen was examined by mass spectrometric measurements of 18O2. Both species exhibited significant rates of oxygen photoreduction at saturating light levels, with cells grown in HL exhibiting higher rates. HL-grown T. pseudonana had maximum rates of oxygen photoreduction five times greater than N. epithemoides, with 49% of electrons transported through PSII being used to reduce oxygen. Exposure to excess light (1,000 μmol photons · m-2 · s-1) produced similar decreases in the operating quantum efficiency of PSII (Fq'/Fm') of low light (LL)- and HL-grown N. epithemoides, whereas HL-grown T. pseudonana exhibited much smaller decreases in Fq'/Fm' than LL-grown cells. HL-grown T. pseudonana and N. epithemioides exhibited greater superoxide and hydrogen peroxide production, higher activities (in T. pseudonana) of superoxide dismutase (SOD) and ascorbate peroxidase (APX), and increased expression of three SOD- and one APX-encoding genes after 60 min of excess light compared to LL-grown cells. These responses provide a mechanism that contributes to the photoprotection of PSII against photodamage. © 2010 Phycological Society of America