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A profound need for rehabilitation services exists, especially in developing countries. This article highlights the role of the epidemiology of disability in addressing this critical need. The article concludes that national and global disability epidemiology statistics inform stakeholder development of rehabilitation policies and programs necessary to meet the global need for rehabilitation, directly supporting the World Health Organization Rehabilitation 2030: Call for Action and United Nations Sustainable Development Goal 3 to "ensure healthy lives and promote well-being for all at all ages."

The methylation of myo-inositol forms O-methyl inositol (D-ononitol) when plants are under abiotic stress in a reaction catalyzed by myo-inositol methyltransferase (IMT). D-Ononitol can serve as an osmoprotectant that prevents water loss in plants. We isolated the IMT cDNA from Glycine max and found by RT-PCR analysis that GmIMT transcripts are induced by drought and salinity stress treatments in the leaves of soybean seedlings. We confirmed the protein product of GmIMT and its substrate using a recombinant system in E. coli. Transgenic Arabidopsis plants over-expressing GmIMT displayed improved tolerance to dehydration stress treatment and to a lesser extent high salinity stress treatment. These results indicate that GmIMT is functional in heterologous Arabidopsis plants.

Purpose To provide the wound care practitioner with a review of the assessment, prevention, and management of pressure ulcers in pediatric patients with spinal cord injury. Target audience This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. Objectives After reading this article and taking this test, the reader should be able to

To provide wound care practitioners with information about the effects of smoking on wound healing.This continuing education activity is intended for physicians and nurses with an interest in wound care.After reading this article and taking this test, the reader should be able to: 1. Describe the physiologic relationship between smoking and wound healing. 2. Discuss the phenomenon of smoking addiction and both pharmacologic and behavioral approaches to smoking cessation.

Objectives: The purpose of this study was to compare the biomechanical properties of posterolateral antiglide plating and lateral locked plating for fixation of displaced short oblique fractures of the fibula in osteoporotic bone. Methods: Short oblique fractures of the distal fibula at the level of the syndesmosis were simulated with a fibular osteotomy and ligamentous sectioning in 18 paired fresh frozen ankles. The fractures were fixed with either a lateral locking plate with an independent lag screw or a posterolateral antiglide plate with a lag screw through the plate. The specimens were tested under a torsional load to failure. The torque to failure, angular rotation at failure, and construct stiffness of the two groups were compared. Results: The torque to failure and construct stiffness were significantly greater on the side with the posterolateral antiglide plate than on the side with the the lateral locking plate (P = 0.01 and 0.005, respectively). Conclusions: The posterolateral antiglide plate demonstrated improved biomechanical stability as compared to the lateral locking plate in osteoporotic bone. In situations where fixation needs to be optimized, use of an antiglide plate may be favored over a lateral locking plate construct.

The heel is a frequent site of pressure ulcer formation, in particular, the development of suspected deep tissue injury. This article reviews the epidemiology, pathophysiology and prevention of heel pressure ulcers. Also, the related concept of purple heel, a not-well-recognized entity, is introduced.

This work presents a finite element analysis of anterior cruciate ligament (ACL) impingement against the intercondylar notch during tibial external rotation and abduction, as a mechanism of noncontact ACL injuries. Experimentally, ACL impingement was measured in a cadaveric knee in terms of impingement contact pressure and six degrees-of-freedom tibiofemoral kinematics. Three-dimensional geometries of the ACL, femur and tibia were incorporated into the finite element model of the individual knee specimen. A fiber-reinforced model was adopted, which accounts for the anisotropy, large deformation, nonlinearity and incompressibility of the ACL. With boundary conditions specified based on the experimental tibiofemoral kinematics, the finite element analysis showed that impingement between the ligament and the lateral wall of intercondylar notch could occur when qthe knee at 45 degrees was externally rotated at 29.1 degrees and abducted at 10.0 degrees . Strong contact pressure and tensile stress occurred at the impinging and nonimpinging sides of the ligament, respectively. The impingement force and contact area estimated from the model matched their counterparts from the corresponding cadaver experiment. The modeling and experimental approach provides a useful tool to characterize potential ACL impingement on a knee-specific basis, which may help elucidate the ACL injury mechanism and develop more effective treatments.

To provide the wound care practitioner with an overview of new methodologies for measuring and documenting chronic wounds.This continuing education activity is intended for physicians and nurses with an interest in wound care and related disorders.After reading this article and taking this test, the reader should be able to: 1. Recognize the importance of thorough wound assessment. 2. Describe the new aspects of chronic wound assessment. 3. Identify the technologies and methods to measure and document wounds.

Research targeting the pathophysiology, prevention, and treatment of pressure ulcers (PrUs) continue to be a significant priority for clinical and basic science research. Spinal cord injury patients particularly benefit from PrU research, because the prevalence of chronic wounds in this category is increasing despite standardized medical care. Because of practical, ethical, and safety considerations, PrUs in the human environment are limited to studies involving patients with pre-existing ulcers. Therefore, we are limited in our basic knowledge pertaining to the development, progression, and healing environment in this devastating disease.This review provides a synopsis of literature and a discussion of techniques used to induce PrUs in animal models. The question of what animal model best mimics the human PrU environment has been a subject of debate by investigators, peer review panels, and editors. The similarities in wound development and healing in mammalian tissue make murine models a relevant model for understanding the causal factors as well as the wound healing elements. Although we are beginning to understand some of the mechanisms of PrU development, a key dilemma of what makes an apparently healthy tissue develop a PrU waits to be solved.No single method of induction and exploring PrUs in animals can address all the aspects of the pathology of chronic wounds. Each model has its particular strengths and weaknesses. Certain types of models can selectively identify specific aspects of wound development, quantify the extent of lesions, and assess outcomes from interventions. The appropriate interpretation of these methods is significant for proper study design, an understanding of the results, and extrapolation to clinical relevance.

Purpose To update the practitioner with causes, diagnosis, and treatment options for necrotizing fasciitis. Target audience This continuing education activity is intended for physicians and nurses with an interest in better understanding the pathophysiology, diagnosis, and treatment of necrotizing fasciitis. Objectives After reading this article and taking this test, the reader should be able to: 1. Identify the risk factors and causes of necrotizing fasciitis (NF). 2. Describe the clinical presentation and diagnosis of NF. 3. Explain the treatment options for NF.