Continuous Passive Motion nach Knietotalendoprothese : Effektivität bei spezifischen Subgruppen

Einführung: Nach Implantierung einer Knietotalendoprothese wird die Behandlung mittels einer motorisierten Bewegungsmaschine als Zusatz zur physiotherapeutischen Behandlung im stationären Setting vielerorts routinegemäss durchgeführt. Der effektive Nutzen der Durchführung wird jedoch von vielen Autoren in Frage gestellt. Ziel: Es soll eine evidenzbasierte Empfehlung für die Anwendung der motorisierten Bewegungsmaschine an die Praxis abgegeben werden können. Dabei soll aufgezeigt werden, welche Subgruppe von Patienten mit einer Knietotalendoprothese von der Anwendung der motorisierten Bewegungsmaschine postoperativ profitiert, bezogen auf die ROM und die Schmerzangaben. Methode: Es wurde eine Literaturrecherche im NEBIS-Katalog sowie in den Datenbanken PubMed, Medline via OvidSP, Cinahl Database, Google Scholar und Pedro durchgeführt. Des Weiteren wurde Fachliteratur aus den Hochschulbibliotheken sowie aus dem NEBIS-Katalog, den bereits erwähnten Datenbanken und aus dem Internet gesucht. Ergebnisse: Mit Ausnahme von einer Studie konnten keine statistisch signifikante Unterschiede der Schmerzangaben beziehungsweise der ROM im Vergleich zwischen der Kontroll- und der Experimentalgruppen aufgezeigt werden. Schlussfolgerung: Zur Garantierung der evidenzbasierten Physiotherapie ist es von grosser Wichtigkeit, dass Praxis und Forschung eng miteinander arbeiten und dasselbe Ziel verfolgen. Die Autorinnen raten von der postoperativen Anwendung der motorisierten Bewegungsmaschine zugunsten von einem vergrösserten Bewegungsausmass oder der Schmerzreduktion ab

Collaborative Practices in Special Education: An Exploratory Study

Objective: This exploratory survey study examined collaborative practices of professionals working in special education. The basis for the survey was the Conceptual Model of Collaboration (CMC), created by Hess and colleagues (2017). Methods: 27 professionals who work in special education participated. Cross tabulation tests and Pearson\u27s correlation tests were run to determine relationships between the variables. Results: The findings indicated that the majority of participants value collaboration for student outcomes and professional development. Most participants agreed on common facilitators and barriers to collaboration. Collaboration primarily takes place in IEP meetings, through email and text messaging and is frequent in all classroom types and age ranges. Frequent collaboration has supported prioritization of sensory-motor programming for both the student and the classroom equally

Collaborative Practices in Special Education: An Exploratory Study

Professional collaboration in special education is essential for student success (Barnes & Turner, 2000). However, IDEA legislation does not guide how such collaboration should take place (Pub. L. 108–446). The Conceptual Model for Collaboration (CMC) created by Czuleger and colleagues (2016) described professional collaborative practices of a transdisciplinary team at a special education center. The purpose of this study was to examine the CMC in a broader context.https://scholar.dominican.edu/ug-student-posters/1058/thumbnail.jp

Extracellular matrix remodeling following myocardial infarction influences the therapeutic potential of mesenchymal stem cells

INTRODUCTION: Although stem cell therapy is a promising treatment for myocardial infarction, the minimal functional improvements observed clinically limit its widespread application. A need exists to maximize the therapeutic potential of these stem cells by first understanding what factors within the infarct microenvironment affect their ability to regenerate the necrotic tissue. In this study, we assessed both differentiation capacity and paracrine signaling as a function of extracellular matrix remodeling after myocardial infarction. METHODS: Mechanical and compositional changes to the decellularized infarcted myocardium were characterized to understand how the extracellular environment, specifically, was altered as a function of time after coronary artery ligation in Sprague–Dawley rats. These alterations were first modeled in a polyacrylamide gel system to understand how the variables of composition and stiffness drive mesenchymal stem cell differentiation towards a cardiac lineage. Finally, the paracrine secretome was characterized as a function of matrix remodeling through gene and protein expression and conditioned media studies. RESULTS: The decellularized infarct tissue revealed significant alterations in both the mechanical and compositional properties of the ECM with remodeling following infarction. This altered microenvironment dynamically regulates the potential for early cardiac differentiation. Whereas Nkx2.5 expression is limited in the presence of chronic remodeled matrix of increased stiffness, GATA4 expression is enhanced. In addition, the remodeled matrix promotes the expression of several proangiogenic, prosurvival, antifibrotic, and immunomodulatory growth factors. In particular, an increase in HGF and SDF1 expression and secretion by mesenchymal stem cells can rescue oxidatively stressed cardiomyocytes in vitro. CONCLUSIONS: This study demonstrated that decellularization of diseased tissue allows for the exclusive analysis of the remodeled matrix and its ability to influence significantly the cellular phenotype. Characterization of cell fate as a function of myocardial remodeling following infarction is critical in developing the ideal strategy for cell implantation to maximize tissue regeneration and to ultimately reduce the prevalence and severity of heart failure

Nitrogen increases soil organic carbon accrual and alters its functionality

Nitrogen (N) availability has been considered as a critical factor for the cycling and storage of soil organic carbon (SOC), but effects of N enrichment on the SOC pool appear highly variable. Given the complex nature of the SOC pool, recent frameworks suggest that separating this pool into different functional components, for example, particulate organic carbon (POC) and mineral-associated organic carbon (MAOC), is of great importance for understanding and predicting SOC dynamics. Importantly, little is known about how these N-induced changes in SOC components (e.g., changes in the ratios among these fractions) would affect the functionality of the SOC pool, given the differences in nutrient density, resistance to disturbance, and turnover time between POC and MAOC pool. Here, we conducted a global meta-analysis of 803 paired observations from 98 published studies to assess the effect of N addition on these SOC components, and the ratios among these fractions. We found that N addition, on average, significantly increased POC and MAOC pools by 16.4% and 3.7%, respectively. In contrast, both the ratios of MAOC to SOC and MAOC to POC were remarkably decreased by N enrichment (4.1% and 10.1%, respectively). Increases in the POC pool were positively correlated with changes in aboveground plant biomass and with hydrolytic enzymes. However, the positive responses of MAOC to N enrichment were correlated with increases in microbial biomass. Our results suggest that although reactive N deposition could facilitate soil C sequestration to some extent, it might decrease the nutrient density, turnover time, and resistance to disturbance of the SOC pool. Our study provides mechanistic insights into the effects of N enrichment on the SOC pool and its functionality at global scale, which is pivotal for understanding soil C dynamics especially in future scenarios with more frequent and severe perturbations

Effect of growth temperature on photosynthetic capacity and respiration in three ecotypes of Eriophorum vaginatum

Ecotypic differentiation in the tussock‐forming sedge Eriophorum vaginatum has led to the development of populations that are locally adapted to climate in Alaska\u27s moist tussock tundra. As a foundation species, E. vaginatum plays a central role in providing topographic and microclimatic variation essential to these ecosystems, but a changing climate could diminish the importance of this species. As Arctic temperatures have increased, there is evidence of adaptational lag in E. vaginatum, as locally adapted ecotypes now exhibit reduced population growth rates. Whether there is a physiological underpinning to adaptational lag is unknown. Accordingly, this possibility was investigated in reciprocal transplant gardens. Tussocks of E. vaginatum from sites separated by ~1° latitude (Coldfoot: 67°15′N, Toolik Lake: 68°37′, Sagwon: 69°25′) were transplanted into the Toolik Lake and Sagwon sites and exposed to either an ambient or an experimental warming treatment. Five tussocks pertreatment combination were measured at each garden to determine photosynthetic capacity (i.e., Vcmax and Jmax) and dark respiration rate (Rd) at measurement temperatures of 15, 20, and 25°C. Photosynthetic enhancements or homeostasis were observed for all ecotypes at both gardens under increased growth temperature, indicating no negative effect of elevated temperature on photosynthetic capacity. Further, no evidence of thermal acclimation in Rd was observed for any ecotype, and there was little evidence of ecotypic variation in Rd. As such, no physiological contribution to adaptational lag was observed given the increase in growth temperature (up to ~2°C) provided by this study. Despite neutral to positive effects of increased growth temperature on photosynthesis in E. vaginatum, it appears to confer no lasting advantage to the species

Effect of growth temperature on photosynthetic capacity and respiration in three ecotypes of Eriophorum vaginatum

© The Author(s), 2018. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Ecology and Evolution 8 (2018): 3711-3725, doi:10.1002/ece3.3939.Ecotypic differentiation in the tussock‐forming sedge Eriophorum vaginatum has led to the development of populations that are locally adapted to climate in Alaska's moist tussock tundra. As a foundation species, E. vaginatum plays a central role in providing topographic and microclimatic variation essential to these ecosystems, but a changing climate could diminish the importance of this species. As Arctic temperatures have increased, there is evidence of adaptational lag in E. vaginatum, as locally adapted ecotypes now exhibit reduced population growth rates. Whether there is a physiological underpinning to adaptational lag is unknown. Accordingly, this possibility was investigated in reciprocal transplant gardens. Tussocks of E. vaginatum from sites separated by ~1° latitude (Coldfoot: 67°15′N, Toolik Lake: 68°37′, Sagwon: 69°25′) were transplanted into the Toolik Lake and Sagwon sites and exposed to either an ambient or an experimental warming treatment. Five tussocks pertreatment combination were measured at each garden to determine photosynthetic capacity (i.e., Vcmax and Jmax) and dark respiration rate (Rd) at measurement temperatures of 15, 20, and 25°C. Photosynthetic enhancements or homeostasis were observed for all ecotypes at both gardens under increased growth temperature, indicating no negative effect of elevated temperature on photosynthetic capacity. Further, no evidence of thermal acclimation in Rd was observed for any ecotype, and there was little evidence of ecotypic variation in Rd. As such, no physiological contribution to adaptational lag was observed given the increase in growth temperature (up to ~2°C) provided by this study. Despite neutral to positive effects of increased growth temperature on photosynthesis in E. vaginatum, it appears to confer no lasting advantage to the species.Division of Polar Programs Grant Numbers: 1417645, 1417763, 1418010; West Chester University, Department of Biolog

A community partnership to evaluate the feasibility of addressing food insecurity among adult patients in an urban healthcare system

BACKGROUND: Food insecurity (FI) is a significant public health problem. Possible sequelae of prolonged food insecurity include kidney disease, obesity, and diabetes. Our objective was to assess the feasibility of a partnership between Henry Ford Health System (HFHS) and Gleaners Community Foodbank of Southeastern Michigan to implement and evaluate a food supplementation intervention initiated in a hospital outpatient clinic setting. METHODS: We established a protocol for using the Hunger Vital Signs to screen HFHS internal medicine patients for food insecurity and established the data sharing infrastructure and agreements necessary for an HFHS-Gleaners partnership that would allow home delivery of food to consenting patients. We evaluated the food supplementation program using a quasi-experimental design and constructing a historical comparison group using the electronic medical record. Patients identified as food insecure through screening were enrolled in the program and received food supplementation twice per month for a total of 12 months, mostly by home delivery. The feasibility outcomes included successful clinic-based screening and enrollment and successful food delivery to consenting patients. Our evaluation compared healthcare utilization between the intervention and historical comparison group during a 12-month observation period using a difference-in-differences (DID) analysis. RESULTS: Of 1691 patients screened, 353 patients (20.9%) met the criteria for FI, of which 340/353 (96.3%) consented, and 256/340 (75.3%) were matched and had data sufficient for analysis. Food deliveries were successfully made to 89.9% of participant households. At follow-up, the intervention group showed greater reductions in emergency department visits than the comparison group, -41.5% and -25.3% reduction, respectively. Similar results were observed for hospitalizations, -55.9% and -17.6% reduction for intervention and control groups, respectively. DID regression analysis also showed lower trends in ED visits and hospitalizations for the intervention group compared to the comparison group. CONCLUSIONS: Results suggest that community-health system partnerships to address patient-reported food insecurity are feasible and potentially could reduce healthcare utilization in these patients. A larger, randomized trial may be the next step in fully evaluating this intervention, perhaps with more outcomes (e.g., medication adherence), and additional covariates (e.g., housing insecurity and financial strain)

How enlightened self-interest guided global vaccine sharing benefits all: a modelling study

Background: Despite the consensus that vaccines play an important role in combating the global spread of infectious diseases, vaccine inequity is still rampant with deep-seated mentality of self-priority. This study aims to evaluate the existence and possible outcomes of a more equitable global vaccine distribution and explore a concrete incentive mechanism that promotes vaccine equity. Methods: We design a metapopulation epidemiological model that simultaneously considers global vaccine distribution and human mobility, which is then calibrated by the number of infections and real-world vaccination records during COVID-19 pandemic from March 2020 to July 2021. We explore the possibility of the enlightened self-interest incentive mechanism, i.e., improving one's own epidemic outcomes by sharing vaccines with other countries, by evaluating the number of infections and deaths under various vaccine sharing strategies using the proposed model. To understand how these strategies affect the national interests, we distinguish the imported and local cases for further cost-benefit analyses that rationalize the enlightened self-interest incentive mechanism behind vaccine sharing. ...Comment: Accepted by Journal of Global Healt

Exploring the Feasibility, Validity, and Reliability of DIGEST after Maxillectomy

https://openworks.mdanderson.org/sumexp23/1016/thumbnail.jp