Medial collateral ligament injuries of the knee: current treatment concepts

The medial collateral ligament is one of the most commonly injured ligaments of the knee. Most injuries result from a valgus force on the knee. The increased participation in football, ice hockey, and skiing has all contributed to the increased frequency of MCL injuries. Prophylactic knee bracing in contact sports may prevent injury; however, performance may suffer. The majority of patients who sustain an MCL injury will achieve their pre-injury activity level with non-operative treatment alone; however, those with combined ligamentous injuries may require acute operative care. Accurate characterization of each aspect of the injury will help to determine the optimum treatment plan

Larval parasitoids and pathogens of the groundnut leaf miner, Aproaerema modicella (Lep.: Gelechiidae), in India

Natural enemies of the groundnut leaf miner,Aproaerema modicella (Deventer), were studied at the International Crops Research Institute for the Semi-Arid Tropics (ICRISAT) located near Hyderabad in peninsular India. Hymenopterous parasitoids attacking leaf miner larvae were the most important group of natural enemies. Nine primary and eight secondary parasitoids emerged from host larvae, and killed up to 50% of the leaf miner larvae sampled. The trophic relationships between primary and secondary parasitoids are incompletely understood. The influence of pathogens of this species is reported for the first time. These pathogens killed up to 30% of the leaf miner larvae. The combined effects of all mortality agents killed up to 95% of the leaf miner larvae per sample period. However, use of insecticides in sprayed plots reduced the efficacy of parasitoids. The impact of predators on larval populations was not studied and may explain underestimates of leaf miner mortality rate

Intradialytic Modified Tai Chi Exercise among End-Stage Renal DiseasePatients Undergoing Hemodialysis: An Exploratory Pilot Study

International audienc

280 Enhancing Nephrology Care Access: Development and Implementation of a Telenephrology Dashboard Through Human-Centered Design

OBJECTIVES/GOALS: Our objective is to develop a Telenephrology dashboard for the 150,000 Veterans that obtain care through the Iowa City Veterans Affairs Health Care System. Our goal is to create a comprehensive and user-friendly tool for monitoring kidney health and facilitating remote nephrology consultations. METHODS/STUDY POPULATION: We structured our intervention according to the five stages of human-centered design: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype and (5) Test. During the empathy stage, the principal investigator spent 10 hours immersed in the clinical setting observing how nephrologists approach a remote nephrology consultation. These observations were augmented by unstructured interviews with clinicians and patients to better understand the process and dynamics. Following this, a rapid ideation workshop was convened to generate creative solutions that balance technical requirements with the needs of clinicians and patients. These led to rapid prototyping and testing to identify what elements of the prototypes worked and which needed improvement. RESULTS/ANTICIPATED RESULTS: Through the empathy and define stages, three needs were identified: (1) clarity in visualizing data, (2) accuracy of information, and (3) balancing standardization with individualization. During the rapid ideation workshop, the concept of a four-frame dashboard was settled upon. This led to the creation of five prototypes, which were tested. These were reconciled and modified to make a final product. This final product, the Telenephrology Dashboard, contains 5 elements that support nephrologists and supporting staff: (1) a graph of kidney function over time, (2) tables synthesizing lab data, (3) options to drill down events to specific times, (4) customization of views, and (5) integration of kidney disease progression models. DISCUSSION/SIGNIFICANCE: A Telenephrology dashboard was created to facilitate remote nephrology consultations through a Human-Centered Design process. Our next steps include determining if this dashboard may improve end-user satisfaction, referring clinician satisfaction, access to specialist care, and patient outcomes