A Randomized Controlled Trial Comparing Rehabilitation Efficacy in Chronic 1 Ankle Instability

There is minimal patient-oriented evidence regarding the effectiveness of interventions targeted to reduce symptoms associated with chronic ankle instability (CAI). Additionally, clinicians aiming to prioritize care by implementing only the most effective components of a rehabilitative program have very little evidence on comparative efficacy. The objective of this research report is to assess the comparative efficacy of two common ankle rehabilitation techniques [wobble board (WB) balance training and ankle strengthening using resistance tubing (RT)] using patient-oriented outcomes

An Update on the Use of Peer Tutoring and Students with Emotional and Behavioural Disorders

This article presents an update of the research on the use of peer tutoring and students with emotional and behavioural disorders (EBD). Nine studies from 2001 to 2007 were identified in which students with EBD served as tutors and/or tutees to teach their peers academic and social behaviours. Five of these studies included elementary students, two included middle school students, and two in-cluded high school students. Only one study (i.e., Tournaki & Criscitiello, 2003) was implemented in the general education classroom. Peer tutoring continues to be implemented across levels of schooling with the majority of research being conducted at the elementary level in reading with continued secondary interests on the effects of behavioural issues and social skills. Clearly, there is still a need for this intervention to be validated in the middle and secondary classrooms, but specifically, with students with EBD in the general education setting

Regulation of D-galacturonate metabolism in Caulobacter crescentus by HumR, a LacI-family transcriptional repressor

The oligotrophic freshwater bacterium Caulobacter crescentus encodes a cluster of genes (CC_1487 to CC_1495) shown here to be necessary for metabolism of D-galacturonate, the primary constituent of pectin, a major plant polymer. Sequence analysis suggests that these genes encode a version of the bacterial hexuronate isomerase pathway. A conserved 14 bp sequence motif is associated with promoter regions of three operons within this cluster, and is conserved in homologous gene clusters in related alpha-Proteobacteria. Embedded in the hexuronate gene cluster is a gene (CC_1489) encoding a member of the LacI family of bacterial transcription factors. This gene product, designated here as HumR (hexuronate metabolism regulator), represses expression of the uxaA and uxaC operon promoters by binding to the conserved operator sequence. Repression is relieved in the presence of galacturonate or, to a lesser extent, by glucuronate. Other genes potentially involved in pectin degradation and hexuronate transport are also under the control of HumR. Adoption of a LacI-type repressor to control hexuronate metabolism parallels the regulation of xylose, glucose, and maltose utilization in C. crescentus, but is distinct from the use of GntR-type repressors to control pectin and hexuronate utilization in gamma-Proteobacteria such as Escherichia coli

Standardised self-management kits for children with type 1 diabetes: pragmatic randomised trial of effectiveness and cost-effectiveness:pragmatic randomised trial of effectiveness and cost-effectiveness

Objective To estimate the effectiveness of standardised self-management kits for children with type 1 diabetes. Design Pragmatic trial with randomisation ratio of two intervention: one control. Qualitative process evaluation. Setting 11 diabetes clinics in England and Wales. Participants Between February 2010 and August 2011, we validly randomised 308 children aged 6–18 years; 201 received the intervention. Intervention We designed kits to empower children to achieve glycaemic control, notably by recording blood glucose and titrating insulin. The comparator was usual treatment. Outcome measures at 3 and 6 months Primary: Diabetes Pediatric Quality of Life Inventory (PedsQL). Secondary: HbA1c; General PedsQL; EQ-5D; healthcare resource use. Results Of the five Diabetes PedsQL dimensions, Worry showed adjusted scores significantly favouring self-management kits at 3 months (mean child-reported difference =+5.87; Standard error[SE]=2.19; 95% confidence interval [CI]) from +1.57 to +10.18; p=0.008); but Treatment Adherence significantly favoured controls at 6 months (mean child-reported difference=−4.68; SE=1.74; 95%CI from −8.10 to −1.25; p=0.008). Intervention children reported significantly worse changes between 3 and 6 months on four of the five Diabetes PedsQL dimensions and on the total score (mean difference=−3.20; SE=1.33; 95% CI from −5.73 to −0.67; p=0.020). There was no evidence of change in HbA1c; only 18% of participants in each group achieved recommended levels at 6 months. No serious adverse reactions attributable to the intervention or its absence were reported. Use of kits was poor. Few children or parents associated blood glucose readings with better glycaemic control. The kits, costing £185, alienated many children and parents. Conclusions Standardised kits showed no evidence of benefit, inhibited diabetes self-management and increased worry. Future research should study relationships between children and professionals, and seek new methods of helping children and parents to manage diabetes

Disrupted Peyer’s Patch Microanatomy in COVID-19 Including Germinal Centre Atrophy Independent of Local Virus

Confirmed SARS-coronavirus-2 infection with gastrointestinal symptoms and changes in microbiota associated with coronavirus disease 2019 (COVID-19) severity have been previously reported, but the disease impact on the architecture and cellularity of ileal Peyer’s patches (PP) remains unknown. Here we analysed post-mortem tissues from throughout the gastrointestinal (GI) tract of patients who died with COVID-19. When virus was detected by PCR in the GI tract, immunohistochemistry identified virus in epithelium and lamina propria macrophages, but not in lymphoid tissues. Immunohistochemistry and imaging mass cytometry (IMC) analysis of ileal PP revealed depletion of germinal centres (GC), disruption of B cell/T cell zonation and decreased potential B and T cell interaction and lower nuclear density in COVID-19 patients. This occurred independent of the local viral levels. The changes in PP demonstrate that the ability to mount an intestinal immune response is compromised in severe COVID-19, which could contribute to observed dysbiosis

Driven vortices in 3D layered superconductors: Dynamical ordering along the c-axis

We study a 3D model of driven vortices in weakly coupled layered superconductors with strong pinning. Above the critical force $F_c$, we find a plastic flow regime in which pancakes in different layers are uncoupled, corresponding to a pancake gas. At a higher $F$, there is an ``smectic flow'' regime with short-range interlayer order, corresponding to an entangled line liquid. Later, the transverse displacements freeze and vortices become correlated along the c-axis, resulting in a transverse solid. Finally, at a force $F_s$ the longitudinal displacements freeze and we find a coherent solid of rigid lines.Comment: 4 pages, 3 postscript figure

The Cosmic Origins Spectrograph

The Cosmic Origins Spectrograph (COS) is a moderate-resolution spectrograph with unprecedented sensitivity that was installed into the Hubble Space Telescope (HST) in May 2009, during HST Servicing Mission 4 (STS-125). We present the design philosophy and summarize the key characteristics of the instrument that will be of interest to potential observers. For faint targets, with flux F(sub lambda) approximates 1.0 X 10(exp -14) ergs/s/cm2/Angstrom, COS can achieve comparable signal to noise (when compared to STIS echelle modes) in 1-2% of the observing time. This has led to a significant increase in the total data volume and data quality available to the community. For example, in the first 20 months of science operation (September 2009 - June 2011) the cumulative redshift pathlength of extragalactic sight lines sampled by COS is 9 times that sampled at moderate resolution in 19 previous years of Hubble observations. COS programs have observed 214 distinct lines of sight suitable for study of the intergalactic medium as of June 2011. COS has measured, for the first time with high reliability, broad Lya absorbers and Ne VIII in the intergalactic medium, and observed the HeII reionization epoch along multiple sightlines. COS has detected the first CO emission and absorption in the UV spectra of low-mass circumstellar disks at the epoch of giant planet formation, and detected multiple ionization states of metals in extra-solar planetary atmospheres. In the coming years, COS will continue its census of intergalactic gas, probe galactic and cosmic structure, and explore physics in our solar system and Galaxy

Convective distribution of tropospheric ozone and tracers in the Central American ITCZ region: Evidence from observations during TC4

During the Tropical Composition, Clouds and Climate Coupling (TC4) experiment that occurred in July and August of 2007, extensive sampling of active convection in the ITCZ region near Central America was performed from multiple aircraft and satellite sensors. As part of a sampling strategy designed to study cloud processes, the NASA ER-2, WB-57 and DC-8 flew in stacked “racetrack patterns” in convective cells. On July 24, 2007, the ER-2 and DC-8 probed an actively developing storm and the DC-8 was hit by lightning. Case studies of this flight, and of convective outflow on August 5, 2007 reveal a significant anti-correlation between ozone and condensed cloud water content. With little variability in the boundary layer and a vertical gradient, low ozone in the upper troposphere indicates convective transport. Because of the large spatial and temporal variability in surface CO and other pollutants in this region, low ozone is a better convective indicator. Lower tropospheric tracers methyl hydrogen peroxide, total organic bromine and calcium substantiate the ozone results. OMI measurements of mean upper tropospheric ozone near convection show lower ozone in convective outflow. A mass balance estimation of the amount of convective turnover below the tropical tropopause transition layer (TTL) is 50%, with an altitude of maximum convective outflow located between 10 and 11 km, 4 km below the cirrus anvil tops. It appears that convective lofting in this region of the ITCZ is either a two-stage or a rapid mixing process, because undiluted boundary layer air is never sampled in the convective outflow