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Background: Athletes at risk for anterior cruciate ligament (ACL) injury have concurrent deficits in visuocognitive function and sensorimotor brain functional connectivity. Purpose: This study aimed to determine whether visual perturbation neuromuscular training (VPNT, using stroboscopic glasses and external visual focus feedback) increases physical and cognitive training demand, improves landing mechanics, and reduces neural activity for knee motor control. Design: Controlled laboratory study. Methods: Eight right leg dominant healthy female athletes (20.4±1.1yrs; 1.6±0.1m; 64.4±7.0kg) participated in four VPNT sessions. Before and after VPNT, real-time landing mechanics were assessed with the Landing Error Scoring System (LESS) and neural activity was assessed with functional magnetic resonance imaging during a unilateral right knee flexion/extension task. Physical and cognitive demand after each VPNT session was assessed with Borg's Rating of Perceived Exertion (RPE) for both physical and cognitive perceived exertion and the NASA Task Load Index. Descriptives and effect sizes were calculated. Results: Following VPNT, LESS scores decreased by 1.5 ± 1.69 errors with a large effect size (0.78), indicating improved mechanics, and reductions in BOLD signal were observed in two clusters: 1) left supramarginal gyrus, inferior parietal lobule, secondary somatosensory cortex (p=.012, z=4.5); 2) right superior frontal gyrus, supplementary motor cortex (p<.01, z=5.3). There was a moderate magnitude increase of cognitive RPE between the first and last VPNT sessions. Conclusion: VPNT provides a clinically feasible means to perturbate visual processing during training that improves athletes' real-time landing mechanics and promotes neural efficiency for lower extremity movement, providing the exploratory groundwork for future randomized controlled trials. Level of evidence: Level 3 [ABSTRACT FROM AUTHOR]

Background: Carotenoids, found in vegetables and fruits, act as antioxidants and are a source of vitamin A. Carotenoids may play an important role in maternal and fetal health (e.g., eye health and brain development) and the prevention of pre-eclampsia, preterm birth, small for gestational age babies and/or intrauterine growth restriction. No studies have examined relationships among carotenoid concentrations, intake of vegetables and fruit, and weeks of gestation. Understanding of the stability of carotenoid concentrations across gestation, despite increasing demands placed on the body (e.g., increase in metabolic demands, body mass and volume), may help inform specific guidelines for vegetable and fruit intake during pregnancy. Aim: This study aimed to investigate the relationships of vegetable and fruit intake, body mass, volume, density and gestation with the carotenoid reflection score. Method: Carotenoid concentration in the fat of women throughout their pregnancy was assessed using a non-invasive Veggie Meter™ device which measures carotenoid reflection spectroscopy from the fingertip. Gestation and vegetable and fruit intake were self-reported. Body mass and body volume were measured via a 3D body scanner and force plate. Correlations between baseline visit measures, differences between visit I and II and repeated measures correlations (up to four visits) were analysed for all measures. Findings: Only nine of the 35 women (25.7%) in this study met the guideline of 7+ a day for vegetable and fruit intake. Carotenoid reflective scores tended to be lower for those with greater body mass (r = -0.48, 95% CI = -0.70, -0.18; p < 0.001) and volume (r = -0.50, 95% CI = -0.71, -0.20; p < 0.001). Although women increased their vegetable and fruit intake with increased gestation (rrm = 0.60, 95% CI = 0.2, 0.83; p = 0.01), their carotenoid reflective score did not increase (rrm = -0.29, 95% CI = -0.66, 0.19; p = 0.22). Conclusion: Supporting previous recommendations for the general population that vegetable and fruit intake should increase relative to body size, the current study findings suggest it may be advisable for women to progressively consume more vegetables and fruit to align with increases in body mass throughout pregnancy. [ABSTRACT FROM AUTHOR]

Older adults from underserved backgrounds experience chronic pain at a rate of 60% to 75%. Pharmacological treatments have limited efficacy and involve considerable risks. Mind-body interventions hold promise to improve pain outcomes but are typically not implemented in community clinics in which they are needed most, thus contributing to health disparities in chronic pain treatment. We conducted qualitative focus groups and interviews with 20 providers (eg, primary care doctors, nurses, administrators). We sought their perspectives on barriers and facilitators to implementing an evidence based mind-body activity program for older adults with chronic pain at an underserved community health clinic in Massachusetts. Subthemes were identified within 2 superordinate domains (barriers and facilitators) using a hybrid inductive-deductive thematic analysis approach following the Framework Method. Providers discussed facilitators (partner with clinic staff to facilitate referrals and buy-in, integrate referrals through the electronic medical record, offer groups in different languages, post and tailor advertisements) and barriers (limited staff bandwidth, scheduling challenges, inconsistent patient participation). These results will directly inform tailoring and subsequent effectiveness testing and implementation of the pain management program for older underserved adults with chronic pain in this community health care setting. [ABSTRACT FROM AUTHOR]

About 90% of the Texas High Plains area depends on the water supply from the Ogallala aquifer. The decline of the Ogallala water table raises a concern for the sustainability of producing the traditional irrigated field crops due to their high water demand. Thus, diversifying cropping systems may be a solution. However, about 70% of the irrigated cropland uses center pivots that may negatively impact specialty crop quality. Thus, a 3-year experiment was conducted to assess the potential of using mobile drip irrigation (MDI) to produce fresh watermelon compared to center pivot sprinkler irrigation using low-elevation spray application (LESA), and surface drip irrigation with plastic mulch (DI). The study evaluated the effects of irrigation systems on crop yield, fruit quality, physiological responses, water use efficiency (WUE), and irrigation use efficiency (IUE). On average, plants under MDI had higher yields (106 Mg ha−1) than those under DI (70 Mg ha−1) and LESA (68 Mg ha−1). Plants under MDI and DI also had more fruits per plant (1.9) than those under LESA (1.4). The higher yield was associated with higher biomass and photosynthetic function. In general, fruit quality was not affected by irrigation system. In addition, plants under MDI system showed a higher WUE and IUE, and less water stress than those under LESA and DI systems. Results of this study suggest that irrigating under an MDI system is a good alternative for growers in the Texas High Plains that aim to diversify their cropping system with high-value vegetable crops such as watermelon (Citrullus lanatus). [ABSTRACT FROM AUTHOR]

A hybrid surgical approach was utilized to address cor triatriatum sinister in a 10-month-old castrated male domestic shorthair cat. Prior to surgery, open-mouth breathing occurred with exertion. The procedure was guided by transesophageal echocardiography and fluoroscopy. A minithoracotomy was performed, and the left atrial membrane was accessed via an introducer placed through the left ventricular apex. Sequential balloon dilations were performed, and the mean transmembrane gradient under anesthesia was reduced from 16 mmHg to 2.23 mmHg. Four months after surgery, the transmembrane mean gradient remained lower than prior to intervention. The cat tolerated surgery well and remains free of clinical signs nine months after surgery. [ABSTRACT FROM AUTHOR]

Hereditary transthyretin amyloidosis (ATTRv) is associated with polyneuropathy, cardiomyopathy, or both. The effects of eplontersen on cardiac structure and function were assessed. NEURO-TTRansform was an open-label trial involving 144 adults with ATTRv polyneuropathy (49 patients [34%] with cardiomyopathy) receiving eplontersen throughout and compared with a historical placebo group (n = 60; 30 patients [50%] with cardiomyopathy) from the NEURO-TTR trial at week 65. Treatment effect (eplontersen vs placebo), presented as mean difference (95% confidence interval) was analyzed after adjusting for age, sex, region, baseline value, ATTRv disease stage, previous ATTRv treatment, and V30M transthyretin variant. There were notable differences at baseline between the eplontersen group and historical placebo. In the cardiomyopathy subgroup, 65 weeks of eplontersen treatment was associated with improvement from baseline relative to placebo in left ventricular ejection fraction of 4.3% (95% confidence interval 1.40–21.01; P =.049) and stroke volume 10.64 mL (95% confidence interval 3.99–17.29; P =.002) while the remainder of echocardiographic parameters remained stable. Eplontersen was associated with stable or improved measures of cardiac structure and function vs historical placebo in patients with ATTRv polyneuropathy and cardiomyopathy. Further investigation into eplontersen's effect on transthyretin amyloid cardiomyopathy is being conducted in the CARDIO-TTRansform trial. vATTR, variant transthyretin; LV, left ventricle; E/e′, ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity; NT-proBNP, N-terminal prohormone of brain natriuretic peptide. [Display omitted] [ABSTRACT FROM AUTHOR]

The aim of this study is to determine the acute effects of resistance and plyometric training on sprint and change of direction (COD) performance in healthy adults and adolescents. A systematic literature search was conducted via Medline, Cinahl, Scopus and SportDiscus databases for studies that investigated: 1) healthy male, female adults, or adolescents; and 2) measured sprint or change of direction performance following resistance and plyometric exercises. Studies were excluded if: 1) resistance or plyometric exercises was not used to induce muscle damage; 2) conducted in animals, infants, elderly; 3) sprint performance and/or agility performance was not measured 24 h post muscle damaging protocol. Study appraisal was completed using the Kmet Quality Scoring for Quantitative Study tool. Forest plots were generated to quantitatively analyse data and report study statistics for statistical significance and heterogeneity. The included studies (n = 20) revealed sprint and COD performance was significantly impaired up to 72 hr following resistance and plyometric exercises; both protocols significantly increased creatine kinase (CK), delayed-onset muscle soreness (DOMS) and decreased countermovement jump (CMJ) up to 72 hr. The systematic review of 20 studies indicated that resistance and plyometric training significantly impaired sprint and COD performance up to 72 hours post-exercise. Both training protocols elevated exerciseinduced muscle damage (EIMD) markers (CK, DOMS) and decreased CMJ performance within the same timeframe. [ABSTRACT FROM AUTHOR]

Recent attention to reports of racial bias and the vestiges of slavery and segregation on Ivy Leagues campuses raises concerns about physical and psychological safety of Students of Color attending these elite colleges and universities. This qualitative study centers the voices of 14 Black students attending five different Ivy League Institutions and contextualizes the impact of experiencing racism and racially motivated incidents on students' sense of belonging. Findings illustrate the ways students' experiences traversing the campus physical environment and engaging with others in academic and communal campus spaces, continue to be influenced by racist campus histories and racial bias against Black people. Consequently, students navigated experiences of "everyday racism" and grappled with institutional responses that served to invalidate their experiences and undermine their sense of belonging on campus. Institutional leaders must continue to establish specific, timely strategies to acknowledge, assess, and address racialized tensions within the collegiate environment in order to achieve the true benefits of racial diversity in higher education. [ABSTRACT FROM AUTHOR]

Shared decision-making (SDM) aims to create a context in which patients and surgeons work together to explore treatment options and goals of care. The objective of the current study was to characterize demographic factors, behaviors, and perceptions of patient involvement among surgeons relative to SDM. Using a cross-sectional survey methodology, surgeon demographics, behaviors, and perceptions of patient involvement were assessed. Surgeon approaches to SDM were measured using a 100-point scale ranging from 'patient-led' (0) to 'surgeon-led' (100). Among 241 respondents, most were male (n = 123, 67.2%) and White (n = 124, 69.3%); roughly one-half of surgeons had been in practice ≥10 years (n = 120, 52.4%). Surgeon approaches to SDM ranged from 0 to 81.0, with a median rating of 50.0 (IQR: 35.5, 62.0). Reported approaches to SDM were associated with years in practice, sharing information, and perceptions of patient involvement. Surgeons in practice 10 + years most frequently utilized a 'Shared, Patient-led' approach to SDM (27.5%), while individuals with less experience more often employed a 'Shared, Surgeon-led' approach (33.3%, p = 0.031). Surgeons with a 'Patient-led' approach perceived patient involvement as most important (M = 3.82, SD = 0.16), while respondents who had a 'Surgeon-led' approach considered this less important (M = 3.57, SD = 0.38; p < 0.001). Surgeon factors including demographics, behaviors, and perceptions of patient involvement influenced SDM approaches. SDM between patients and surgeons should strive to be more dynamic and tailored to each specific patient's needs to promote optimal patient-centered care. [ABSTRACT FROM AUTHOR]

Psychologists have been applying neurorehabilitation models of care for many years. These practitioners come from different training backgrounds and use a variety of titles to refer to themselves despite considerable overlap in practice patterns, professional identification, and salary. Titles like 'neurorehabilitation psychologist' and 'rehabilitation neuropsychologist' are sometimes used by practitioners in the field to indicate their specialty area, but are not formally recognized by the American Psychological Association, the American Board of Professional Psychology, or by training councils in clinical neuropsychology (CN) or rehabilitation psychology (RP). Neither the CN or RP specialties alone fully address or define the competencies, skill sets, and clinical experiences required to provide high quality, comprehensive neurorehabilitation psychology services across settings. Therefore, irrespective of practice setting, we believe that both clinical neuropsychologists and rehabilitation psychologists should ideally have mastery of specific, overlapping competencies and a philosophical approach to care that we call neurorehabilitation psychology in this paper. Trainees and early career professionals who aspire to practice in this arena are often pressured to prioritize either CN or RP pathways over the other, with anxiety about perceived and real potential for falling short in their training goals. In the absence of an explicit training path or formal guidelines, these professionals emerge only after the opportunity, privilege, or frank luck of working with specific mentors or in exceptional patient care settings that lend themselves to obtaining integrated competencies in neurorehabilitation psychology. This paper reflects the efforts of 7 practitioners to preliminarily define the practice and philosophies of neurorehabilitation psychology, the skill sets and competencies deemed essential for best practice, and essential training pathway elements. We propose competencies designed to maximize the integrity of training and provide clear guideposts for professional development. [ABSTRACT FROM AUTHOR]

Objective: Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation. Method: Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they seeking treatment. ACE scores were calculated, and age of substance use initiation was recorded. A Cox proportional hazard model was used to examine the effect of ACE score on age of substance use initiation. Results: A total of 107 participants completed the study. An average number of 2.3 ACEs (SD = 2.2) were endorsed with 24% of participants reporting 4 or more ACEs. Higher ACE scores were associated with cigarette smoking and non-medical prescription opioid use onset (hazard ratio (HR) = 1.14, 95% CI=1.02–1.28, p = 0.02, and HR=1.19, 95% CI = 1.04–1.37, p = 0.01, respectively. Conclusions: A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use, consistent with prior research. Primary prevention of ACEs, screening for ACEs during childhood, and interventions for ACEs if detected, may help to reduce the risk of substance use/SUD in adulthood. [ABSTRACT FROM AUTHOR]

An 11-year-old spayed female domestic shorthaired cat was diagnosed with severe dilated cardiomyopathy (DCM) and congestive heart failure. The cat had been eating cat foods that were high in pulses (e.g. peas, lentils, chickpeas). Neither plasma nor whole blood taurine concentrations were deficient. Primary treatment included furosemide, pimobendan, and clopidogrel, and changing to diets that did not contain pulses (a taurine supplements was not administered). The cat's clinical signs improved, high-sensitivity cardiac troponin I concentrations decreased, and echocardiographic measurements stayed relatively stable for over one year after initiating cardiac medications and changing the diet. Ultimately, the cat was euthanized for worsening congestive heart failure 374 days after the diagnosis of DCM. Infectious disease testing during the time of clinical surveillance was negative. Routine histopathology of the heart was unremarkable, but electron microscopy of the left ventricle showed large numbers of mitochondria of variable size and structure. A moderate number of lamellar bodies and autophagic vacuoles also were noted. This case report illustrates an unusual case of a cat with DCM unrelated to taurine deficiency. The relative roles of diet change, cardiac medications, and a dedicated owner are unclear, but this cat's relatively long survival time is similar to that seen after diet change in dogs and cats with DCM eating high-pulse diets. [ABSTRACT FROM AUTHOR]

Chuck-will's-widow (Antrostomus carolinensis) are a caprimulgid that breeds in the southeastern United States. Understanding the behavior of this critically understudied species is essential to ensuring its conservation, but few studies have attempted to identify breeding, movements, and interactions. Part of this understanding is predicated on successful capture of individuals so that demographic and other information can be collected. Given that Chuck-will's-widow are relatively large birds, their size and mass limit the utility of traditional methods in capturing them. We captured Chuck-will's-widow in east-central Mississippi using a fabricated decoy with speaker playback to draw individuals towards the trapping area, and modified trammel loops affixed to a 60-mm mist net that reduced the likelihood of birds striking and bouncing out of the net. Using a latex hose allowed the net to flex upon the impact of fast-flying Chuck-will's-widow targeting the decoy. A decoy was incorporated with conspecific playback to draw individuals to each erected mist net. This net modification, coupled with the decoy and audio lure, resulted in the capture of 80% of targeted Chuck-will's-widow, compared to a 0% capture rate for all other attempted methods. This is the first known study specifically designed to evaluate capture methods for Chuck-will's-widow and can be used for studies targeting comparable species. [ABSTRACT FROM AUTHOR]

Introduction. Validly and reliably assessing conceptual change is essential for evaluating the effectiveness of pain science education for physiotherapy students. We aimed to 1) evaluate concept of pain before and after a 14-week pain science education university subject, 2) assess structural validity of the Concept of Pain Inventory for Adults (COPI-Adult) in postgraduate entry-level physiotherapy students, and 3) explore possible relationships between baseline variables and baseline COPI-Adult scores. Review of Literature. As the COPI-Adult is a newly developed questionnaire, there is a lack of data regarding its psychometric properties. Subjects. Of 129 enrolled students at an Australian university, 124 (96%) and 114 (88%) completed the baseline and follow-up questionnaires, respectively. Methods. In this prospective cohort study, students who commenced the degree in 2020 or 2021 completed online questionnaires, including the COPI-Adult, at the start and end of their first semester. This semester included a 14-week pain science education subject and other physiotherapy-related subjects. Higher COPI-Adult scores (range = 0–52) indicate better alignment with contemporary pain science. We 1) compared differences in concept of pain before and after the semester, 2) performed a confirmatory factor analysis on the COPI-Adult, and 3) performed exploratory regression analyses. Results. Concept of Pain Inventory for Adults scores increased from baseline (median [interquartile range]: 39 [36–44]) to follow-up (48 [44–51]). The COPI-Adult retained its 1-factor structure, with acceptable internal consistency (Cronbach's alpha = 0.80). Exploratory analysis showed that previously completing a subject on pain was related to higher COPI-Adult baseline scores. Age, gender, and mental health diagnosis did not relate to baseline COPI-Adult scores. Discussion and Conclusion. Following a 14-week pain science education subject embedded within a physiotherapy degree, students improved their concept of pain. The COPI-Adult maintains a 1-factor structure in this population. Completing a previous subject on pain was associated with higher COPI-Adult scores. [ABSTRACT FROM AUTHOR]

Chyle leaks are a common post-operative complication following solid-tumor resection in pediatric patients. Current treatments for persistent chyle leaks are limited, leading many patients to experience prolonged hospitalization, nutritional deficits and/or delays in cancer therapies. Lymphatic embolization is an emerging treatment option for chyle leaks, however, limited reports exist of its use in pediatric populations. We conducted a retrospective review of pediatric patients (<18) who underwent lymphangiogram with intent for lymphatic embolization for the management of chyle leaks following solid-tumor resection between 2017 and 2022. Seven patients underwent a total of 11 attempted lymphatic embolization procedures after current standard of care treatments failed to resolve the leak. Lymphangiograms identified a chyle leak in 6 of 7 patients and embolization had a technical success rate of 73%. The complication rate was 9% and complications were limited to one episode of inadvertent gastric wall perforation that did not result in a gastric leak. Lymphatic embolization was ultimately associated with chyle leak resolution in 100% of patients within a median of 24 days, however, repeat embolization was required in 5 of 7 patients (83%). Lymphatic embolization appears to be a safe and effective treatment for persistent chyle leaks in pediatric patients, leads to a direction reduction in chyle output, and has high rates of technical and clinical success. Complete resolution of the chyle leak may require multiple embolization procedures. Further work is needed to determine whether earlier intervention may offer benefit for the management of pediatric chyle leaks. IV. [ABSTRACT FROM AUTHOR]

Background: High-quality nurse-physician communication during family-centered rounds (FCRs) can increase patient safety. Local Problem: In our hospital, interdisciplinary team members perceived that nurse-physician communication during FCRs declined during the COVID-19 pandemic. Methods: Using quality improvement methodology, we measured nurses' perceived awareness of components of the shared mental model, nurses' attendance during FCRs, compliance with completing FCR summaries, and average time spent per FCR encounter. Interventions: A structured resident huddle took place prior to an FCR. Residents used a tool to send individualized alerts to bedside nurses to prepare them for an FCR. Residents developed comprehensive summaries after each FCR encounter and sent a summary text to nurses who were unable to attend the FCR. Results: We assessed 40 FCRs over 16 weeks. Nurses' perceived awareness increased from 70% to 87%. Nurse attendance increased from 53% to 75%. Conclusions: We successfully piloted multiple interventions to improve nurse perceived awareness after an FCR. [ABSTRACT FROM AUTHOR]

Today's ambulatory care providers face numerous challenges as they try to practice efficient, patient-centered medicine. This article explains how community health workers (CHWS) can be engaged to address many patient- and system-related barriers currently experienced in ambulatory care practices. Community health workers are frontline public health workers who serve as a trusted bridge between community members and health care providers. Among their varied roles, CHWs can educate and support patients in managing their risk factors and diseases and link these patients to needed resources. As shown in this overview (CHW 101), including CHWs as members of multidisciplinary care teams has the potential to strengthen both current and emerging models of health care delivery. [ABSTRACT FROM AUTHOR]

During the evolution of the COVID-19 pandemic, health care entities had to adapt to rapidly changing research and best practices in disease prevention and treatment to maintain the delivery of high-quality patient care. Prompt interdisciplinary efforts amongst physician, pharmacist, nursing, and information technology teammates are needed to develop robust centralized strategies to allocate and administer COVID-19 therapies in the ambulatory setting. The objective of this analysis is to demonstrate the impact of a system-wide, centralized workflow on referral times and treatment outcomes for COVID-19 infected patients in the ambulatory setting. Upon release of monoclonal antibodies for the treatment of COVID-19, a centralized approach for patient treatment referrals to the University of North Carolina Health Virtual Practice team was developed due to the limited supply. Collaboration with infectious disease colleagues played a pivotal role in the rapid application of therapeutic guidance and creation of treatment prioritization levels. From November 2020 through February 2022, the centralized workflow team facilitated the administration of over 17,000 COVID-19 treatment infusions. The median time from treatment referral to infusion was 2 days from a positive COVID-19 test result. From January through February 2022, 514 oral COVID-19 treatment courses were dispensed from the health system's outpatient pharmacies. The median time from referral to treatment was 1 day from diagnosis. Given the ongoing strain and demand of COVID-19 on the health care system, a centralized, multidisciplinary team of experts allowed for efficient delivery of COVID-19 therapies through one provider touchpoint. The collaboration between outpatient pharmacies, infusion sites, and Virtual Practice culminated in a sustainable, centralized treatment approach that supported widespread reach, and equitable dose distribution, to the most vulnerable patient populations. [ABSTRACT FROM AUTHOR]