Effectiveness of Ultrasound (US) on Adults with Lateral Epicondylitis (LE)

Background: Individuals diagnosed with LE often present with increased pain and decreased functioning in daily activities. LE, commonly referred to as tennis elbow, which results from stress and pain to the lateral epicondyle or extensor carpi radialis brevis (ERCB). This can develop from a single incident, injury or trauma, which results in pain with gripping and lifting (Leadbetter, 2016). Ultrasound (US) utilizes wave production to cause thermal or nonthermal sound waves to stimulate tissue by increasing collagen extensibility and enabling the inflammatory process (Knight & Draper, 2013). Areas being treated by US require different depths; a 1.0 mHz sound head reaches a depth of 3-5 cm and a 3.0 mHZ sound head reaches a depth of 1-2 cm (Ledbetter, 2016)

The Luminous Convolution Model as an alternative to dark matter in spiral galaxies

The Luminous Convolution Model (LCM) demonstrates that it is possible to predict the rotation curves of spiral galaxies directly from estimates of the luminous matter. We consider two frame-dependent effects on the light observed from other galaxies: relative velocity and relative curvature. With one free parameter, we predict the rotation curves of twenty-three (23) galaxies represented in forty-two (42) data sets. Relative curvature effects rely upon knowledge of both the gravitational potential from luminous mass of the emitting galaxy and the receiving galaxy, and so each emitter galaxy is compared to four (4) different Milky Way luminous mass models. On average in this sample, the LCM is more successful than either dark matter or modified gravity models in fitting the observed rotation curve data. Implications of LCM constraints on populations synthesis modeling are discussed in this paper. This paper substantially expands the results in arXiv:1309.7370.Comment: Implications of LCM constraints on populations synthesis modeling are discussed in this paper. This paper substantially expands the results in arxiv:1309.737

Advance Care Planning as a Shared Endeavor: Completion of ACP Documents in a Multidisciplinary Cancer Program

Objective—We examined the roles of oncology providers in advance care planning (ACP) delivery in the context of a multidisciplinary cancer program. Methods—Semi-structured interviews were conducted with 200 women with recurrent and/or metastatic breast or gynecologic cancer. Participants were asked to name providers they deemed important in their cancer care and whether they had discussed and/or completed ACP documentation. Evidence of ACP documentation was obtained from chart reviews. Results—Fifty percent of participants self-reported completing an advance directive (AD) and 48.5% had named a healthcare power of attorney (HPA), 38.5% had completed both, and 39.0% had completed neither document. Among women who self-reported completion of the documents, only 24.0% and 14.4% of women respectively had documentation of an AD and HPA in their chart. Completion of an AD was associated with number (adjusted odds ratio [AOR] = 1.49) and percentage (AOR = 6.58) of providers with whom the participant had a conversation about end-of-life decisions. Participants who named a social worker or nurse practitioner were more likely to report having completed an AD. Participants who named at least one provider in common (e.g., named the same oncologist) were more likely to have comparable behaviors related to naming a HPA (AOR = 1.13, p = 0.011) and completion of an AD (AOR = 1.06, p = 0.114). Conclusions—Despite the important role of physicians in facilitating ACP discussions, involvement of other staff was associated with a greater likelihood of completion of ACP documentation. Patients may benefit from opportunities to discuss ACP with multiple members of their cancer care team

Use of the Delphi Method to Enhance Pharmacist Contraceptive Counseling Materials

Background: Many states have pharmacist contraceptive prescribing laws with several others in the process of enacting similar legislation. Little continuity or standardization exists across these programs, including development of counseling materials. Although the risk of unplanned pregnancy is greatest among adolescents and young adults, developed materials are not always sensitive to youth. Objective: To use a modified Delphi method to develop standardized youth-friendly counseling tools that are sensitive to pharmacy workflow during pharmacist contraceptive prescribing. Methods: A multidisciplinary expert panel of women's health pharmacists, community pharmacists, adolescent medicine pediatricians, obstetrician-gynecologists, and public health advocates was assembled and reviewed materials over 3 iterations. Comments were anonymized, summarized, and addressed with each iteration. A graphic designer assisted with visual representation of panel suggestions. Reviewer feedback was qualitatively analyzed for emergent themes. Results: The Delphi method produced 5 main themes of feedback integrated into the final materials including attention to work flow, visual appeal, digestible medical information, universal use of materials, and incorporating new evidence-based best practices. Final materials were scored at a Flesch-Kincaid grade of 5.1 for readability. Conclusions: The use of the Delphi method allowed for the efficient production of materials that are medically accurate, patient-centered, and reflect multiple disciplinary perspectives. Final materials were more robust and sensitive to the unique needs of youth

Adolescents’ Perceptions of Contraception Access through Pharmacies

Adolescent pregnancy is an important public health issue, and pharmacist prescribing has the potential to expand contraceptive access and decrease unintended pregnancy. However, little is known about acceptability and uptake of pharmacist prescribing among adolescents, particularly among youth in socially and politically conservative regions of the country. The study objective was to identify how young women in Indiana perceive pharmacist contraceptive prescribing. Participants were recruited from clinics and completed a simulated pharmacist contraception-prescribing encounter; a demographic and behavioral questionnaire; and an in-depth qualitative interview focused on adolescent perspectives on pharmacist prescribing. Data were analyzed using thematic analysis. Sixty young women aged 14–21 years (mean age 17.0 ± 1.7 years) completed in-depth interviews. The majority expressed interest in pharmacist contraceptive prescribing (n = 33, 55.9%). Three overarching themes were identified, focusing on accessibility; quality of care; and pharmacist knowledge and youth friendliness. Subthemes highlighted the need for improved confidential access; a desire for additional pharmacist training in contraception; and interactions with a pharmacist that can relate to the young person. Increased awareness of the perceptions of young people can inform state policies and pharmacy protocols. Pharmacists, because of their accessibility, are well poised and equipped to assist in this public health concern

A Census of Early-phase High-mass Star Formation in the Central Molecular Zone

We present new observations of the C-band continuum emission and masers to assess high-mass (>8 ${M}_{\odot }$) star formation at early evolutionary phases in the inner 200 pc of the Central Molecular Zone (CMZ) of the Galaxy. The continuum observation is complete to free–free emission from stars above 10–11 ${M}_{\odot }$ in 91% of the covered area. We identify 104 compact sources in the continuum emission, among which five are confirmed ultracompact H ii regions, 12 are candidates of ultracompact H ii regions, and the remaining 87 sources are mostly massive stars in clusters, field stars, evolved stars, pulsars, extragalactic sources, or of unknown nature that is to be investigated. We detect class ii CH3OH masers at 23 positions, among which six are new detections. We confirm six known H2CO masers in two high-mass star-forming regions and detect two new H2CO masers toward the Sgr C cloud, making it the ninth region in the Galaxy that contains masers of this type. In spite of these detections, we find that current high-mass star formation in the inner CMZ is only taking place in seven isolated clouds. The results suggest that star formation at early evolutionary phases in the CMZ is about 10 times less efficient than expected from the dense gas star formation relation, which is in line with previous studies that focus on more evolved phases of star formation. This means that if there will be any impending, next burst of star formation in the CMZ, it has not yet begun

Little Things

We present LITTLE THINGS (Local Irregulars That Trace Luminosity Extremes, The HI Nearby Galaxy Survey) that is aimed at determining what drives star formation in dwarf galaxies. This is a multi-wavelength survey of 37 Dwarf Irregular and 4 Blue Compact Dwarf galaxies that is centered around HI-line data obtained with the National Radio Astronomy Observatory (NRAO) Very Large Array (VLA). The HI-line data are characterized by high sensitivity (less than 1.1 mJy/beam per channel), high spectral resolution (less than or equal to 2.6 km/s), and high angular resolution (~6 arcseconds. The LITTLE THINGS sample contains dwarf galaxies that are relatively nearby (less than or equal to 10.3 Mpc; 6 arcseconds is less than or equal to 300 pc), that were known to contain atomic hydrogen, the fuel for star formation, and that cover a large range in dwarf galactic properties. We describe our VLA data acquisition, calibration, and mapping procedures, as well as HI map characteristics, and show channel maps, moment maps, velocity-flux profiles, and surface gas density profiles. In addition to the HI data we have GALEX UV and ground-based UBV and Halpha images for most of the galaxies, and JHK images for some. Spitzer mid-IR images are available for many of the galaxies as well. These data sets are available on-line.Comment: In press in A

Local erythropoietin and endothelial progenitor cells improve regional cardiac function in acute myocardial infarction

<p>Abstract</p> <p>Background</p> <p>Expanded endothelial progenitor cells (eEPC) improve global left ventricular function in experimental myocardial infarction (MI). Erythropoietin beta (EPO) applied together with eEPC may improve regional myocardial function even further by anti-apoptotic and cardioprotective effects. Aim of this study was to evaluate intramyocardial application of eEPCs and EPO as compared to eEPCs or EPO alone in experimental MI.</p> <p>Methods and Results</p> <p>In vitro experiments revealed that EPO dosed-dependently decreased eEPC and leukocyte apoptosis. Moreover, in the presence of EPO mRNA expression in eEPC of proangiogenic and proinflammatory mediators measured by TaqMan PCR was enhanced. Experimental MI was induced by ligation and reperfusion of the left anterior descending coronary artery of nude rats (n = 8-9). After myocardial transplantation of eEPC and EPO CD68+ leukocyte count and vessel density were enhanced in the border zone of the infarct area. Moreover, apoptosis of transplanted CD31 + TUNEL + eEPC was decreased as compared to transplantation of eEPCs alone. Regional wall motion of the left ventricle was measured using Magnetic Resonance Imaging. After injection of eEPC in the presence of EPO regional wall motion significantly improved as compared to injection of eEPCs or EPO alone.</p> <p>Conclusion</p> <p>Intramyocardial transplantation of eEPC in the presence of EPO during experimental MI improves regional wall motion. This was associated with an increased local inflammation, vasculogenesis and survival of the transplanted cells. Local application of EPO in addition to cell therapy may prove beneficial in myocardial remodeling.</p