Pain Education Training in New York State Physical Therapy Programs: What We Do Well, Where the Gaps Are, and What Can Be Improved

Purpose: Essential pain education produces graduates who are competent in contemporary pain management. Despite various educational resources, surveys demonstrate minimal pain content in entry-level physical therapist education programs. This paper examines 1) the learning content of pain education and faculty expertise teaching core pain content, 2) whether pain education content is sufficient to prepare physical therapists to meet the needs of contemporary pain management, and 3) whether standardization of pain education in entry level Doctor of Physical Therapy (DPT) programs is advantageous. Methods: A pain education survey was developed and sent to all accredited DPT program directors in New York State. The survey included questions related to content and hours devoted to teaching 1) pain science, 2) pain education, 3) psychosocial factors, 4) biopsychosocial model, 5) cognitive-behavioral techniques, 6) advanced faculty training, and 7) challenges adding pain education to the curriculum. Results: In total, 10/15 programs responded. (1) 60% reported they do not have a class dedicated to pain science, (2) 60% reported \u3c 10 hours of pain education (3) 60% reported a class on psychosocial factors, (4) 50% reported \u3c 10 hours on the biopsychosocial model, (5) cognitive- behavioral techniques varied between 10-30 hours, (6) 70% of faculty received advanced training, and (7) challenges to adding pain education included time, a dense curriculum, and pain content is not part of NPTE exam questions. Conclusions and Recommendations: New York State accredited DPT programs include pain education, although content, time, and methods vary greatly. Increased standardization for pain education would create consistency across all U.S. DPT programs. Based on the findings from the study, an investigation should be undertaken to determine if more specific standards for pain education are advantageous for the entry level DPT curricula

Linear Reduced Order Model Predictive Control

Model predictive controllers leverage system dynamics models to solve constrained optimal control problems. However, computational requirements for real-time control have limited their use to systems with low-dimensional models. Nevertheless many systems naturally produce high-dimensional models, such as those modeled by partial differential equations that when discretized can result in models with thousands to millions of dimensions. In such cases the use of reduced order models (ROMs) can significantly reduce computational requirements, but model approximation error must be considered to guarantee controller performance. In this work a reduced order model predictive control (ROMPC) scheme is proposed to solve robust, output feedback, constrained optimal control problems for high-dimensional linear systems. Computational efficiency is obtained by leveraging ROMs obtained via projection-based techniques, and guarantees on robust constraint satisfaction and stability are provided. Performance of the approach is demonstrated in simulation for several examples, including an aircraft control problem leveraging an inviscid computational fluid dynamics model with dimension 998,930.Comment: This work has been submitted to the IEEE Transactions on Automatic Control for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl

Landmarking the brain for geometric morphometric analysis: An error study

Neuroanatomic phenotypes are often assessed using volumetric analysis. Although powerful and versatile, this approach is limited in that it is unable to quantify changes in shape, to describe how regions are interrelated, or to determine whether changes in size are global or local. Statistical shape analysis using coordinate data from biologically relevant landmarks is the preferred method for testing these aspects of phenotype. To date, approximately fifty landmarks have been used to study brain shape. Of the studies that have used landmark-based statistical shape analysis of the brain, most have not published protocols for landmark identification or the results of reliability studies on these landmarks. The primary aims of this study were two-fold: (1) to collaboratively develop detailed data collection protocols for a set of brain landmarks, and (2) to complete an intra- and inter-observer validation study of the set of landmarks. Detailed protocols were developed for 29 cortical and subcortical landmarks using a sample of 10 boys aged 12 years old. Average intra-observer error for the final set of landmarks was 1.9 mm with a range of 0.72 mm-5.6 mm. Average inter-observer error was 1.1 mm with a range of 0.40 mm-3.4 mm. This study successfully establishes landmark protocols with a minimal level of error that can be used by other researchers in the assessment of neuroanatomic phenotypes. © 2014 Chollet et al

The Eruption of the Candidate Young Star ASASSN-15qi

Outbursts on young stars are usually interpreted as accretion bursts caused by instabilities in the disk or the star-disk connection. However, some protostellar outbursts may not fit into this framework. In this paper, we analyze optical and near-infrared spectra and photometry to characterize the 2015 outburst of the probable young star ASASSN-15qi. The $\sim 3.5$ mag brightening in the $V$ band was sudden, with an unresolved rise time of less than one day. The outburst decayed exponentially by 1 mag for 6 days and then gradually back to the pre-outburst level after 200 days. The outburst is dominated by emission from $\sim10,000$ K gas. An explosive release of energy accelerated matter from the star in all directions, seen in a spectacular cool, spherical wind with a maximum velocity of 1000 km/s. The wind and hot gas both disappeared as the outburst faded and the source the source returned to its quiescent F-star spectrum. Nebulosity near the star brightened with a delay of 10-20 days. Fluorescent excitation of H$_2$ is detected in emission from vibrational levels as high as $v=11$, also with a possible time delay in flux increase. The mid-infrared spectral energy distribution does not indicate the presence of warm dust emission, although the optical photospheric absorption and CO overtone emission could be related to a gaseous disk. Archival photometry reveals a prior outburst in 1976. Although we speculate about possible causes for this outburst, none of the explanations are compelling

Antifungal activity of amphotericin B conjugated to nanosized magnetite in the treatment of paracoccidioidomycosis

This study reports on in vitro and in vivo tests that sought to assess the antifungal activity of a newly developed magnetic carrier system comprising amphotericin B loaded onto the surface of pre-coated (with a double-layer of lauric acid) magnetite nanoparticles. The in vitro tests compared two drugs; i.e., this newly developed form and free amphotericin B. We found that this nanocomplex exhibited antifungal activity without cytotoxicity to human urinary cells and with low cytotoxicity to peritoneal macrophages. We also evaluated the efficacy of the nanocomplex in experimental paracoccidioidomycosis. BALB/c mice were intratracheally infected with Paracoccidioides brasiliensis and treated with the compound for 30 or 60 days beginning the day after infection. The newly developed amphotericin B coupled with magnetic nanoparticles was effective against experimental paracoccidioidomycosis, and it did not induce clinical, biochemical or histopathological alterations. The nanocomplex also did not induce genotoxic effects in bone marrow cells. Therefore, it is reasonable to believe that amphotericin B coupled to magnetic nanoparticles and stabilized with bilayer lauric acid is a promising nanotool for the treatment of the experimental paracoccidioidomycosis because it exhibited antifungal activity that was similar to that of free amphotericin B, did not induce adverse effects in therapeutic doses and allowed for a reduction in the number of applications

The rich far-infrared water vapour spectrum of W Hya

We present an ISO Long Wavelength Spectrometer (LWS) grating spectrum of the oxygen-rich AGB star W Hya from 43-197μm. The spectrum is dominated by a forest of water vapour emission lines, confirming that H_2_O molecules are the dominant coolants of the winds of these stars. We have constructed an outflow model for the H_2_O spectrum of W Hya, which successfully matches the fluxes of most of the observed H_2_O lines, using an adopted wind temperature profile. These fits are sensitive to the mass loss rate, to the H_2_O abundance and to the inner radius of the H_2_O emitting region. The best fit parameters correspond to a mass loss rate of 6x10^-7^Msun_/yr, inner and outer radii for the emitting region of 1.5x10^14^ and 1x10^16^cm, and a H_2_O/H_2_ abundance of 8x10^-4^ for r <=4.5x10^14^cm and 3x10^-4^ at large radii. A decrease of the H_2_O/H_2_ abundance in the outer envelope is consistent with the predictions of photochemical models. The availability for the first time of observations of the line fluxes from the dominant coolant species should enable improved models of the wind temperature distribution to be produced