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Emission estimates of carbon dioxide (CO2) and methane (CH4) and the meteorological factors affecting them are investigated over Sacramento, California, using an aircraft equipped with a cavity ring-down greenhouse gas sensor as part of the Alpha Jet Atmospheric eXperiment (AJAX) project. To better constrain the emission fluxes, we designed flights in a cylindrical pattern and computed the emission fluxes from two flights using a kriging method and Gauss's divergence theorem. Differences in wind treatment and assumptions about background concentrations affect the emission estimates by a factor of 1.5 to 7. The uncertainty is also impacted by meteorological conditions and distance from the emission sources. The vertical layer averaging affects the flux estimate, but the choice of raw wind or mass-balanced wind is more important than the thickness of the vertical averaging for mass-balanced wind for both urban and local scales. The importance of vertical mass transfer for flux estimates is examined, and the difference in the total emission estimate with and without vertical mass transfer is found to be small, especially at the local scale. The total flux estimates accounting for the entire circumference are larger than those based solely on measurements made in the downwind region. This indicates that a closed-shape flight profile can better contain total emissions relative to a one-sided curtain flight because most cities have more than one point source and wind direction can change with time and altitude. To reduce the uncertainty of the emission estimate, it is important that the sampling strategy account not only for known source locations but also possible unidentified sources around the city. Our results highlight that aircraft-based measurements using a closed-shape flight pattern are an efficient and useful strategy for identifying emission sources and estimating local- and city-scale greenhouse gas emission fluxes.

Background: Little is known about cancer surveillance (mammography, clinical breast examination, and pelvic examination) behaviors in long-term (9-16 years) breast cancer survivors. This report describes the relation of these behaviors to demographic and clinical characteristics, psychological symptoms, body satisfaction, and social support.Methods: Survivors who had participated in Cancer and Leukemia Group B treatment Trial 8541 completed a survey that included questions on breast cancer surveillance and pelvic examination, psychological well being, body satisfaction, and social support.Results: The participation rate was 78% and included 245 breast cancer survivors. Survivors (n = 107; 44%) reported completing breast cancer surveillance (mammography and clinical breast examination) and completing pelvic examination (n = 162; 68%) within recommended guidelines. There were no significant associations between breast cancer surveillance and breast cancer anxiety, depression, stressful life events, body satisfaction, social support, or demographic characteristics. Survivors within recommended guidelines for pelvic examinations were younger (P = .05), married (P = .003), had health insurance (P = .004), and had lower depression scores (P = .005) than survivors who underused or overused pelvic examination. In addition, survivors within recommended pelvic examination guidelines had significantly lower levels of breast cancer anxiety (P = .03) compared with survivors who underused pelvic examination.Conclusions: Many long-term breast cancer survivors were not within recommended cancer surveillance guidelines. Private health insurance was associated with following recommendations for pelvic examinations, although such a relation did not exist for breast cancer surveillance. The results of this study have implications for the development of educational programs to improve cancer surveillance among the growing population of long-term breast cancer survivors. [ABSTRACT FROM AUTHOR]

The current study tested the effectiveness of using National Alcohol Screening Day (NASD) to deliver personalized feedback via mail. At-risk NASD participants were assigned to either personalized or generic feedback conditions and attended a 4-week follow-up. Results failed to find any group differences on alcohol-related variables. However, participants in the personalized group reported a reduction in the maximum number of drinks consumed on one occasion. The personalized group also had a more accurate view of the amount of alcohol their peers consumed. NASD is a vehicle to efficiently deliver feedback to individuals about their alcohol use; however, more research is needed to determine the types of feedback that would be most effective. [ABSTRACT FROM AUTHOR]

Avian orthoreoviruses (ARV) are an emerging threat for the poultry industry, both in the United States (US) and globally. ARV infections in turkeys have been associated with arthritis, lameness and neurological disorders, and cost the US economy approximately USD 33 million per year. There is not a commercial vaccine available and the shortage of turkey ARV (TRV) genomic data hinders the efforts to explore the molecular epidemiology of this virus, although several studies suggest a close relationship between European TRVs and TRVs present in the US. This study shows a snapshot of the genomic diversity of Avian orthoreoviruses (ARV) circulating in Germany in the mid-2000s. Through a deep genomic analysis of 18 ARV isolates recovered from sick turkeys, we observed that co-infection was a common condition. 80% of the samples showed signs of a simultaneous infection with a TRV and a chicken ARV (CRV). We believe this is the first reported evidence of CRV and TRV naturally occurring co-infections in commercial turkeys. These co-infection events were identified due to the significant genomic diversity observed among ARV infecting various production bird species. Our phylogenetic analysis revealed a consistent host-associated ARV clustering, with three main clades: (i) a TRV clade, (ii) a CRV clade, and (iii) a Duck ARV (DRV)/Goose ARV (GRV) clade. Furthermore, our findings indicate that German TRVs have interacted with their European and American counterparts, suggesting active mobilization of the virus, likely through the commercial trading of live animals. However, we also consider the potential role of migratory birds in the international movement of ARV., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Inc.)

This article explores current global research on voluntarily stopping eating and drinking (VSED) and presents a detailed, deidentified case study of a patient who elected VSED in a hospice setting in the Southeastern United States. It highlights the collaborative efforts of health care professionals in effectively supporting the patient and family, sharing multiple perspectives from various health care team members who cared for the patient and family. It offers evidence-based recommendations to guide health care teams through the ethical, medical, and emotional challenges of VSED, ensuring compassionate and competent care. The article emphasizes the importance of structured protocols and empathetic care in hospice settings, advocating for the education and preparation of health care teams and families to address the complex challenges associated with VSED. By promoting open communication, interdisciplinary collaboration, and comprehensive support, hospices can respect the autonomy of patients and families choosing VSED, ensuring a compassionate and dignified end-of-life experience., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 by The Hospice and Palliative Nurses Association. All rights reserved.)

Background: Imbalances in soft tissue stiffness (STS) of the pectoralis and common wrist extensors (CWEs) can adversely alter upper extremity function. Shear wave elastography (SWE) has the capacity to provide precise, repeatable, objective data on STS. The purpose of this study was to determine the between-day intrarater reliability for the pectoralis and CWE tendon stiffness as measured by SWE., Methods: STS measured by the shear wave modulus (kilopascals (kPa)) was captured bilaterally on the pectoralis major, pectoralis minor, and CWE tendon using 2D SWE ultrasound imaging (GE Logiq S8, 9 L transducer) on two separate days. Within examiner intraclass correlation coefficients (ICC (3, 3)) with 95% confidence intervals, standard error of the measure, and minimal detectable changes were calculated., Results: The investigators recruited 10 healthy participants (mean age = 23.50  ±  1.43). Between day intrarater reliability values were obtained for the dominant pectoralis major ICC  =  0.70 (-0.15, -0.93), nondominant pectoralis major ICC  =  0.63 (-0.30, -0.91), dominant pectoralis minor ICC  = 0 .72(-0.04, -0.93), nondominant pectoralis minor ICC  = 0.75(0.08, -0.94), dominant CWE tendon ICC  =  0.75(-0.08, -0.94), and nondominant CWE tendon ICC  =  0.75(-0.12, -0.94)., Discussion: Our data demonstrate acceptable reliability but future studies should include methods that control for variables known to effect STS., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Deep convection in the Asian summer monsoon is a significant transport process for lifting pollutants from the planetary boundary layer to the tropopause level. This process enables efficient injection into the stratosphere of reactive species such as chlorinated very-short-lived substances (Cl-VSLSs) that deplete ozone. Past studies of convective transport associated with the Asian summer monsoon have focused mostly on the south Asian summer monsoon. Airborne observations reported in this work identify the East Asian summer monsoon convection as an effective transport pathway that carried record-breaking levels of ozone-depleting Cl-VSLSs (mean organic chlorine from these VSLSs ~500 ppt) to the base of the stratosphere. These unique observations show total organic chlorine from VSLSs in the lower stratosphere over the Asian monsoon tropopause to be more than twice that previously reported over the tropical tropopause. Considering the recently observed increase in Cl-VSLS emissions and the ongoing strengthening of the East Asian summer monsoon under global warming, our results highlight that a reevaluation of the contribution of Cl-VSLS injection via the Asian monsoon to the total stratospheric chlorine budget is warranted., Competing Interests: Competing interests statement:The authors declare no competing interest.

Context: Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players., Design: Cross-sectional study., Methods: The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues., Results: Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC > .78 for the pectoralis musculature) and excellent (ICC > .94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, -22.8 to 252.5 kPa for the dominant arm [P = .039]). Mean pectoralis major and minor stiffness differences were not significant (P > .214)., Conclusions: Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected.

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most common class of drugs utilized for a variety of disorders, including headaches, pain states, fever, and other common conditions. In recent years, a link between NSAIDs and adverse effects has been identified, including renal, heart, and liver disease, bleeding, and increased mortality. NSAID-mediated renal disease is associated with interference with the cyclooxygenase enzyme. Literature evaluating NSAID renal effects has indicated that a number of factors are associated with acute and chronic kidney injury (AKI). Early diagnosis can identify changes in renal function and allow for cessation of NSAID use, limiting the risk for long-term chronic renal disease and in some cases reversal of renal injury. Alternative medications should be considered in those patients identified with morbidity linked to NSAID use. Nephrotoxicity is increased in the elderly population and in hypovolemia, high dose exposure, use of vasoconstrictors such as calcineurin inhibitors, and use of renin-angiotensin-aldosterone system (RAAS) inhibitors or diuretics. Careful risk/benefit considerations from healthcare professionals can limit the incidence and degree of morbidity and mortality, including in NSAID-mediated renal disease. Selective NSAID cyclooxygenase-2 inhibitors also possess risks and therefore clinicians should always recommend short-term courses of this class of drugs versus long-term dosing because of the risk of morbidity and mortality. Given that these drugs are available over the counter as well by prescribing, clinicians must communicate the risks and benefits of NSAIDs and provide sound recommendations to their patients regarding use short and long term., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Although often described as a self-limiting condition and likely to resolve on its own, high recurrence rates and extended sick leave frame a need for effective non-surgical treatment for people with lateral elbow tendinopathy. The interrelationship of histological and structural changes to the tendon, the associated impairments in motor control, and potential changes in pain processing may all drive symptoms. This clinical practice guideline covers the epidemiology, functional anatomy and pathophysiology, risk factors, clinical course, prognosis, differential diagnosis, tests and measures, and interventions for managing lateral elbow tendinopathy in the physical therapy clinic. J Orthop Sports Phys Ther 2022;52(12):CPG1-CPG111. doi:10.2519/jospt.2022.0302 .

Purpose: Humeral retroversion alters range of motion and has been linked to injury risk. Clinically,palpation of the bicipital groove is used to quantify humeral torsion, but the accuracy of this procedure has not been fully examined. The purpose of this study was to investigate the relationship between clinical and diagnostic ultrasound (US) assessment of humeral torsion while considering shoulder position of the participant and clinical expertise of the examiner., Methods: Seventeen participants (34 shoulders, 16/17 right handed, 10/17 history of throwing) were recruited. US was assessed by an experienced assessor. Two clinical assessments of humeral torsion were performed by two assessors of different experience (expert and novice). Humeral torsion was assessed at 90 degrees shoulder abduction (Palp90) and 45 degrees shoulder abduction (Palp45). Within assessor intraclass correlation coefficients (ICC (3, 1) were calculated. Correlation coefficients (Pearson's) were generated to determine relationship between clinical and US examination findings., Results: Intra-rater reliability for clinical tests were good (ICCs .73 - .92) for both raters. Of the palpation tests, only the expert assessor was significantly correlated to the US measurement (p<.001) at Palp45 (r = .64) and Palp90 (r = .62). For the expert, there was a significantly lower angle calculated for Palp45 compared to Palp90 (p<.001)., Conclusion: The accuracy of both palpation methods for assessing humeral retrotorsion may depend on the training background of the assessor. Further, the glenohumeral position of the patient during palpation should be consistent for the purposes of repeated testing.

17β-Hydroxysteroid dehydrogenase type 3 (17β-HSD3) is expressed at high levels in testes and seminal vesicles; it is also present in prostate tissue and involved in gonadal and non-gonadal testosterone biosynthesis. The enzyme is membrane-bound, and a crystal structure is not yet available. Selective aryl benzylamine-based inhibitors were designed and synthesised as potential agents for prostate cancer therapeutics through structure-based design, using a previously built homology model with docking studies. Potent, selective, low nanomolar IC 50 17β-HSD3 inhibitors were discovered using N -(2-([2-(4-chlorophenoxy)phenylamino]methyl)phenyl)acetamide ( 1 ). The most potent compounds have IC 50 values of approximately 75 nM. Compound 29 , N -[2-(1-Acetylpiperidin-4-ylamino)benzyl]- N -[2-(4-chlorophenoxy)phenyl]acetamide, has an IC 50 of 76 nM, while compound 30 , N -(2-(1-[2-(4-chlorophenoxy)-phenylamino]ethyl)phenyl)acetamide, has an IC 50 of 74 nM. Racemic C -allyl derivative 26 (IC 50 of 520 nM) was easily formed from 1 in good yield and, to determine binding directionality, its enantiomers were separated by chiral chromatography. Absolute configuration was determined using single crystal X-ray crystallography. Only the S -(+)-enantiomer ( 32 ) was active with an IC 50 of 370 nM. Binding directionality was predictable through our in silico docking studies, giving confidence to our model. Importantly, all novel inhibitors are selective over the type 2 isozyme of 17β-HSD2 and show <20% inhibition when tested at 10 µM. Lead compounds from this series are worthy of further optimisation and development as inhibitors of testosterone production by 17β-HSD3 and as inhibitors of prostate cancer cell growth.

Turkey coronavirus (TCoV) can cause a highly contagious enteric disease in turkeys with severe economic losses in the global turkey industry. To date, no commercial vaccines are available for control of the disease. In the present study, we isolated a field strain (NC1743) of TCoV and evaluated its pathogenicity in specific-pathogen-free (SPF) turkey poults to establish a TCoV disease model. The results showed that the TCoV NC1743 isolate was pathogenic to turkey poults with a minimal infectious dose at 10 6 EID 50 /bird. About 50 % of one-day-old SPF turkeys infected with the virus's minimal infectious dose exhibited typical enteric disease signs and lesions from 6 days post-infection (dpi) to the end of the experiment (21 dpi). In contrast, fewer than 20 % of older turkeys (1- or 2-week-old) infected with the same amount of TCoV displayed enteric disease signs, which disappeared after 15-18 dpi. Although all infected turkeys, regardless of age, shed TCoV, the older turkeys shed less virus than the younger birds, and 50 % of the 2-week-old birds even cleared the virus at 21 dpi. Furthermore, the viral infection caused day-old turkeys more body-weight-gain reduction than older birds. The overall data demonstrated that the TCoV NC1743 isolate is a highly pathogenic strain and younger turkeys are more susceptible to TCoV infection than older birds. Thus, one-day-old turkeys infected with the minimal infectious dose of TCoV NC1743 could be used as a TCoV disease model to study the disease pathogenesis, and the TCoV NC1743 strain could be used as a challenge virus to evaluate a vaccine protective efficacy., (Published by Elsevier B.V.)

Study Design: This is an observational study., Introduction: Because isometric wrist extension minimizes the effects of other muscles, the sensitivity of wrist extension strength testing on patients with lateral elbow tendinopathy (LET) should be evaluated., Purpose of the Study: The purpose of the study was to compare the effects of the elbow position on wrist extension and grip strength in patients with LET., Methods: Patients were screened for at least 2 of 5 clinical tests for LET. Between-day intraclass correlation coefficients (ICC 3, 1 ) for healthy individuals were examined for both grip and wrist extension strength at 0° and 90°. To compare the effects of elbow position on wrist extension strength to grip strength, a repeated measure analysis of variance was run using 2 within-group factors, test angles (0° and 90°), and the test type (wrist extension and grip)., Results: Nineteen patients with LET and twenty-one healthy participants were included. The between-day intrarater reliability for both wrist extension and grip strength was excellent for the healthy subjects across the 0° and 90° positions (ICC > .95). The analysis of variance yielded a significant interaction between the type of test and the angle of testing (P = .00)., Discussion: Both wrist extension strength and grip strength are reliable between-day measures. For patients with LET, there was a significant decrease in grip strength when testing at 0° compared with 90°., Conclusion: In patients with LET, clinicians can expect wrist extension strength at 0° and 90° to be similar. Grip strength testing may be a more relevant clinical test at the initial evaluation., (Copyright © 2020 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

Introduction: Individuals with shoulder and upper extremity pathology often present with altered scapular motion. Few studies have looked at variations in scapular acceleration as a way of quantifying scapular motion. The purpose was to determine the effectiveness of wireless accelerometers for detecting changes in acceleration in individuals with scapular dyskinesis., Materials/methods: Twenty-seven asymptomatic college students (mean age 24 (SD ± 1.54), 65% female, 93% right handed) were visually screened for scapular dyskinesis using previously described criteria. Of the students recruited, fifteen students were determined to have scapular dyskinesis. After securing a wireless accelerometer (MyoResearch 3D DTS) on the dominate scapula, the participants performed five repetitions of standing scaption from 0 to 140°. Linear scapular accelerations along three orthogonal axes (frontal-y, transverse-z, and sagittal-x) were collected. Intraclass correlation coefficients (ICC 3, k ) were used to determine the between day intra-rater reliability while a one-way analysis of variance was used to determine differences in acceleration between those with and without dyskinesis., Results: There was good between day intra-rater reliability for the average of all three axes (ICC = 0.79) and for the x and y axes (ICC > 0.78). Reliability was poor (ICC = 0.31) for the z-axis. There was a significant increase in overall acceleration of the scapula in those with dyskinesis (p = .039). There was also a significant increase in acceleration along the y-axis for those with dyskinesis (p = .003) but not for the other axes (p > .16)., Conclusion: Wireless accelerometers reliably quantify scapular acceleration in healthy individuals. In a healthy population with dyskinesis, the overall magnitude of scapular acceleration was greater when compared to a healthy group without dyskinesis., Competing Interests: Declaration of competing interest None., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Natural aerosols in pristine regions form the baseline used to evaluate the impact of anthropogenic aerosols on climate. Sea spray aerosol (SSA) is a major component of natural aerosols. Despite its importance, the abundance of SSA is poorly constrained. It is generally accepted that wind-driven wave breaking is the principle governing SSA production. This mechanism alone, however, is insufficient to explain the variability of SSA concentration at given wind speed. The role of other parameters, such as sea surface temperature (SST), remains controversial. Here, we show that higher SST promotes SSA mass generation at a wide range of wind speed levels over the remote Pacific and Atlantic Oceans, in addition to demonstrating the wind-driven SSA production mechanism. The results are from a global scale dataset of airborne SSA measurements at 150 to 200 m above the ocean surface during the NASA Atmospheric Tomography Mission. Statistical analysis suggests that accounting for SST greatly enhances the predictability of the observed SSA concentration compared to using wind speed alone. Our results support implementing SST into SSA source functions in global models to better understand the atmospheric burdens of SSA., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)

Context: There is a lack of consensus on the best management approach for lateral elbow tendinopathy (LET). Recently, scapular stabilizer strength impairments have been found in individuals with LET., Objective: The purpose of this study was to compare the effectiveness of local therapy (LT) treatment to LT treatment plus a scapular muscle-strengthening (LT + SMS) program in patients diagnosed with LET., Design: Prospective randomized clinical trial., Setting: Multisite outpatient physical therapy., Patients: Thirty-two individuals with LET who met the criteria were randomized to LT or LT + SMS., Interventions: Both groups received education, a nonarticulating forearm orthosis, therapeutic exercise, manual therapy, and thermal modalities as needed. Additionally, the LT + SMS group received SMS exercises., Main Outcome Measure: The primary outcome measure was the patient-rated tennis elbow evaluation; secondary outcomes included global rating of change (GROC), grip strength, and periscapular muscle strength. Outcomes were reassessed at discharge, 6, and 12 months from discharge. Linear mixed-effect models were used to analyze the differences between groups over time for each outcome measure., Results: The average duration of symptoms was 10.2 (16.1) months, and the average total number of visits was 8.0 (2.2) for both groups. There were no significant differences in gender, age, average visits, weight, or height between groups at baseline (P > .05). No statistical between-group differences were found for any of the outcome measures. There were significant within-group improvements in all outcome measures from baseline to all follow-up points (P < .05)., Conclusion: The results of this pilot study suggest that both treatment approaches were equally effective in reducing pain, improving function, and increasing grip strength at discharge as well as the 6- and 12-month follow-ups. Our multimodal treatment programs were effective at reducing pain and improving function up to 1 year after treatment in a general population of individuals with LET.

Background: Intrinsic factors including altered joint motion in the upper extremity may lead to altered biomechanics in tennis players and could result in symptoms of lateral elbow tendinopathy., Purpose: To compare upper extremity passive motion and elbow carrying angle between three groups of women: recreational tennis players with LET, non-symptomatic recreational tennis players, and a control group of non-tennis players., Study Design: Cross-sectional., Methods: A convenience sample of 63 women was recruited and placed into one of the three groups: non-symptomatic tennis players (NSTP), symptomatic tennis players (STP), and a control group. Elbow carrying angle, passive range of motion of the shoulder, elbow, forearm, and wrist were measured during a single session., Results: A significant difference was found between the groups for wrist flexion ( p < 0.00), forearm pronation ( p = 0.002), elbow flexion ( p = 0.020) and extension ( p = 0.460), as well as shoulder internal rotation ( p < 0.00). No significant differences were found in other motions or carrying angle between the three groups ( p =0.059). Post-hoc comparisons indicated that shoulder internal rotation and wrist flexion was less in both STP and NSTP groups compared with the control group. Elbow flexion and forearm pronation were greater in STP than the other two groups., Conclusion: Impairments including loss of shoulder internal rotation and wrist flexion and greater motion at the elbow and forearm were found in the UE of symptomatic tennis players. Evaluation of passive motion and muscle length should be performed prior to establishing a rehabilitation plan for symptomatic tennis players., Levels of Evidence: 3., (© 2020 by the Sports Physical Therapy Section.)

Scapular muscle weakness in patients with lateral elbow tendinopathy is an identified impairment and is part of a multimodal rehabilitation approach. The published literature provides little information regarding specific rehabilitation guidelines that address both the proximal scapular muscle weakness and local elbow/wrist dysfunctions common in patients with lateral elbow tendinopathy. The purpose of this clinical commentary is to describe a comprehensive rehabilitation strategy for individuals with lateral elbow tendinopathy. This program emphasizes a phased therapeutic strategy that addresses proximal and local dysfunction along the kinetic chain. This clinical protocol is currently being tested for efficacy as part of a randomized controlled trial. The information in this commentary is intended to provide clinicians with sufficient detail to comprehensively guide the rehabilitation of a patient with lateral elbow tendinopathy., Level of Evidence: 5., (© 2019 by the Sports Physical Therapy Section.)

Interprofessional Education Collaborative (IPEC) core competencies are widely accepted as a guide to prepare healthcare professionals. Two competency domains, values/ethics and roles and responsibilities, have specific relevance when investigating the effectiveness of a transcultural interprofessional experience. Participants were University of South Alabama students from the Colleges of Allied Health Professions, Medicine, and Nursing, who volunteered for a 7-day service learning experience in Trinidad. A convergent mixed methods research design was used. Students completed two Likert scale surveys, the Interprofessional Education Collaborative Competency Survey (IPECC) and the Transcultural Self-Efficacy Tool- Multidisciplinary Healthcare Provider Version (TSET-MHP), prior to and following the experience. A Wilcoxon Sign Test was used to analyze quantitative data. Qualitative data, guided by the Critical Incident Technique, was obtained from diary entries during the trip and a selected member focus group post-trip. There was a significant improvement in all three cultural competency domains of the TSET-MHP (p < .001). The most frequently reported IPEC sub-competencies were the ability to work in cooperation with those who receive, provide, and support care; and the ability to engage diverse healthcare providers to complement one's own professional expertise. Based on participant report, an international interprofessional clinical experience appears to be effective in enhancing health care competencies.

Background: Adolescent idiopathic scoliosis (AIS) refers to a spinal curvature of an unknown origin diagnosed in otherwise healthy children. A conservative treatment approach includes physiotherapy scoliosis-specific exercises (PSSE) with or without corrective bracing in preventing further spinal column deviation. However, several PSSE types have been developed to facilitate a positive patient outcome and/or preclude surgical remediation. Based on other reviews, there has been insufficient evidence published on the efficacy of PSSEs. In addition, the superiority of PSSE over no intervention or compared to other exercise modes has yet to be determined., Methods: A comprehensive search of AIS literature, inception through February 2018, was conducted to reveal relevant PSSE articles. Only studies using commonly reported PSSEs were included. Examined databases included PubMed, Scopus, CINAHL Complete, and Physiotherapy Evidence Database (PEDro). Google Scholar search engine was also examined. Article types included randomized or clinical control trials. All articles were published in English or were of English translation. Search parameters were collectively defined by the reviewers and subsequently used to determine included studies. Individual PSSE study methodology quality was determined by the PEDro scale. Effect sizes (Hedge's g) and their 95% confidence intervals were calculated for Cobb angle between group changes., Results: Of the initial 24 articles recovered only eight (33%) met the established search criteria. Patient ages from these sources ranged from 11.4-16.2 including both males and females. Examined papers included two Schroth method and six specifying the Scientific Exercise Approach to Scoliosis (SEAS) method. All articles demonstrated positive between group effect sizes for PSSEs. There were no studies that compared one PSSE to another. Determined PEDro scores indicated an overall moderate quality of these studies., Conclusions: There is insufficient evidence to suggest that both Schroth and SEAS methods can effectively improve Cobb angles in patients with AIS compared to no intervention. There is limited evidence that the SEAS method is more effective at reducing Cobb angles compared to traditional exercises in treating AIS. Overall, this review revealed a noticeable lack of contemporary studies that could be used in answering our questions. Evidence-based medicine (EBM) supplies clinicians with verifiable results from well-designed and managed research studies. Consequently, more and varied studies of higher quality are needed before any definitive determination can be made as to the effectiveness of any PSSE let alone the one offering better patient outcomes., Competing Interests: Competing interestsThe authors declare that they have no competing interests.

Study Design: Systematic review., Introduction: No consensus exists as to which are the most effective methods to treat the symptoms associated with lateral elbow tendinopathy (LET). Research has suggested that joint mobilizations may assist in the recovery of patients with LET., Purpose of the Study: To determine if joint mobilizations are effective in improving pain, grip strength, and disability in adults with LET., Methods: Searches in 3 databases were performed to identify relevant clinical trials. Reviewers independently extracted data and assessed the methodological quality. Summary measures of quantitative data were extracted or calculated where possible. Appropriate data were pooled for meta-analysis using a random-effects model., Results: A total of 20 studies met the inclusion criteria; 7 were included in the meta-analysis. Studies were broadly classified into 3 groups: mobilization with movement (MWM), Mill's manipulation, and regional mobilization techniques. Pooled data across all time periods demonstrated a mean effect size of 0.43 (95% confidence interval [CI]: 0.15-0.71) for MWM on improving pain rating, and 0.31 (95% CI: 0.11-0.51) for MWM on improving grip strength, 0.47 (95% CI: 0.11-0.82) for Mill's manipulation on improving pain rating. A mean effect size of -0.01 (95% CI: -0.27 to -0.26) shows Mill's manipulation did not improve pain free grip strength. Functional outcomes varied considerably among studies. Pain, grip strength, and functional outcomes were improved with regional mobilizations., Conclusion: There is compelling evidence that joint mobilizations have a positive effect on both pain and/or functional grip scores across all time frames compared to control groups in the management of LET., (Copyright © 2018 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.)

In this study, we isolated a novel avian reovirus (ARV) strain, K738/14, from a broiler chicken with viral arthritis in South Korea. Genome sequence comparisons showed relatively low nucleotide identity with previously identified ARV strains. Phylogenetic analyses suggested multiple reassortment events between reovirus strain S1133 and reoviruses of Hungarian, Chinese, and US origin had occurred. In addition, recombination analyses showed evidence of intra-segmental recombination in the M2 and S2 genes. Based on our genetic analyses, multiple reassortment events, intra-segmental recombination, and accumulation of point mutations have possibly contributed to the emergence of this novel genotype of ARV, identified in Korea.

Clinical Scenario: Lateral elbow tendinopathy (LE) is a common musculoskeletal condition that often results in pain and disability. An array of conservative interventions have been shown to improve patient outcomes in outpatient rehabilitation clinics. However, with the rise in health care costs, patients and rehabilitation specialists have opted to reduce the number of in-house visits and focus on home exercise programs (HEPs). As a result, many rehabilitation specialists and patients now depend on HEPs as the primary intervention to treat LE. Focused Clinical Question: For individuals with LE, is there evidence to suggest that HEPs are as effective as traditional on-site rehabilitation for reducing pain and disability? Summary of Search, Best Evidence Appraised, and Key Findings: The literature was searched for studies comparing HEP to on-site rehabilitation in the management of LE. Two clinical controlled trials (CCTs) were included. No studies suggested that HEPs demonstrated equal or improved outcomes in pain or disability. Both studies concluded that on-site rehabilitation services were more effective at reducing pain and disability in the short term. More research is needed to compare the cost effectiveness of both HEP and on-site rehabilitation. Clinical Bottom Line: Based on 2 CCTs, it can be concluded that there is moderate evidence to suggest that patients with LE experience decreased pain and disability scores with on-site rehabilitation compared to a guided HEP in the short term. The authors could not draw a conclusion regarding long-term effects of treatments or cost effectiveness of the 2 approaches. Strength of Recommendation: Based on the Centre for Evidence Based Medicine, there is level B evidence that a HEP only was not as effective as on-site rehabilitation services in patients with LE.

New tungsten isotope data for modern ocean island basalts (OIB) from Hawaii, Samoa, and Iceland reveal variable 182 W/ 184 W, ranging from that of the ambient upper mantle to ratios as much as 18 parts per million lower. The tungsten isotopic data negatively correlate with 3 He/ 4 He. These data indicate that each OIB system accesses domains within Earth that formed within the first 60 million years of solar system history. Combined isotopic and chemical characteristics projected for these ancient domains indicate that they contain metal and are repositories of noble gases. We suggest that the most likely source candidates are mega-ultralow-velocity zones, which lie beneath Hawaii, Samoa, and Iceland but not beneath hot spots whose OIB yield normal 182 W and homogeneously low 3 He/ 4 He., (Copyright © 2017, American Association for the Advancement of Science.)

Volatile element and compound abundances vary widely in planets and were set during the earliest stages of solar system evolution. Experiments or natural analogs approximating these early conditions are limited. Using silicate glass formed from arkosic sands during the first nuclear detonation at the Trinity test site, New Mexico, we show that the isotopes of zinc were fractionated during evaporation. The green silicate glasses, termed "trinitite," show +0.5 ± 0.1‰/atomic mass unit isotopic fractionation from ~200 m to within 10 m of ground zero of the detonation, corresponding to an α fractionation factor between 0.999 and 0.9995. These results confirm that Zn isotopic fractionation occurs through evaporation processes at high temperatures. Evidence for similar fractionations in lunar samples consequently implies a volatile-depleted bulk Moon, with evaporation occurring during a giant impact or in a magma ocean.

Recent metagenomic analyses of the enteric viromes in turkeys and chickens have revealed complex viral communities comprised of multiple viral families. Of particular significance are the novel avian picobirnaviruses (family Picobirnaviridae), multiple genera of tailed phages (family Siphoviridae), and undescribed avian enteric picornaviruses (family Picornaviridae). In addition to these largely undescribed-and therefore relatively poorly understood-poultry enteric viral families, these metagenomic analyses have also revealed the presence of well-known groups of enteric viruses such as the chicken and turkey astroviruses (family Astroviridae) and the avian rotaviruses and reoviruses (family Reoviridae). The order Picornavirales is a group of viruses in flux, particularly among the avian picornaviruses, since several new genera have been described recently based upon community analysis of enteric viromes from poultry and other avian species worldwide. Our previous investigation of the turkey enteric picornaviruses suggests the avian enteric picornaviruses may contribute to the enteric disease syndromes and performance problems often observed in turkeys in the Southeastern United States. This report describes our recent phylogenetic analysis of turkey and chicken enteric samples archived at the Southeast Poultry Research Laboratory from 2004 to present and is a first step in placing these novel avian picornaviruses within the larger Picornaviridae family.

In this study all currently known chicken picornaviruses including a novel one (chicken phacovirus 1, KT880670) were identified by viral metagenomic and RT-PCR methods from a single specimen of a diarrheic chicken suffering from a total of eight picornavirus co-infections, in Hungary. The complete genomes of six picornaviruses were determined and their genomic and phylogenetic characteristics and UTR RNA structural models analyzed in details. Picornaviruses belonged to genera Sicinivirus (the first complete genome), Gallivirus, Tremovirus, Avisivirus and "Orivirus" (two potential genotypes). In addition, the unassigned phacoviruses were also detected in multiple samples of chickens in the USA. Multiple co-infections promote and facilitate the recombination and evolution of picornaviruses and eventually could contribute to the severity of the diarrhea in chicken, in one of the most important food sources of humans., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Study Design: Descriptive, laboratory-based, cross-sectional study., Objectives: To describe scapular musculature strength, endurance, and change in thickness in individuals with unilateral lateral epicondylalgia (LE) compared to the uninvolved limb and the corresponding limb of a matched comparison group., Background: Reported poor long-term outcomes for the nonsurgical management of individuals with LE suggest a less-than-optimal rehabilitation process. Knowledge of scapular muscle function in a working population of individuals with LE may help to further refine conservative management of this condition., Methods: Twenty-eight patients with symptomatic LE and 28 controls matched by age and sex were recruited to participate in the study. Strength of the middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) was measured with a handheld dynamometer. A scapular isometric muscle endurance task was performed in prone. Changes in muscle thickness of the SA and LT were measured with ultrasound imaging. Analysis-of-variance models were used to determine within- and between-group differences., Results: The involved side of the group with LE had significantly lower values for MT strength (P = .031), SA strength (P<.001), LT strength (P = .006), endurance (P = .003), and change in SA thickness (P = .028) when compared to the corresponding limb of the control group. The involved side of the group with LE had significantly lower strength of the LT (P = .023) and SA (P = .016) when compared to the uninvolved limb; however, these differences were small and of potentially limited clinical significance., Conclusion: When compared to a matched comparison group, there were impairments of scapular musculature strength and endurance in patients with LE, suggesting that the scapular musculature should be assessed and potentially treated in this population. Cause and effect cannot be established, as the weakness of the scapular musculature could be a result of LE.

Previous research into the viral community in the poultry gastrointestinal tract has revealed a number of novel and partially described enteric viruses. It is evident that the poultry gut viral community remains minimally characterized and incompletely understood. Investigations into the microbiome of the poultry gut have provided some insight into the geographical distribution and the rapidly evolving taxonomy of the avian enteric picornaviruses. The present investigation was undertaken to produce a comparative metagenomic analysis of the gut virome from a healthy turkey flock versus a flock placed in the field. This investigation revealed a number of enteric picornavirus sequences that were present in the commercial birds in the field that were completely absent in the healthy flock. A novel molecular diagnostic assay was used to track the shedding of field strains of turkey enteric picornavirus in commercial poults inoculated with picornavirus-positive intestinal homogenates prepared from turkeys that were experiencing moderate enteric disease. The propagation of this novel enteric picornavirus in commercial poults resulted in significant reduction in weight gain, and suggests that this common inhabitant of the turkey gut may result in performance problems or enteric disease in the field.

Inoculation of specific-pathogen-free chickens and turkeys with five chicken parvoviruses (ChPV) and five turkey parvoviruses (TuPV) resulted in productive virus replication only in the homologous host species. A phylogenetic tree based on nucleotide sequences of the VP1 gene segment revealed a host-specific clustering of the virus strains. These results suggest that the VP1 gene plays an essential role in host specificity of ChPV and TuPV strains and could be a relevant target sequence for strain classification.

There is a great deal of interest in characterizing the complex microbial communities in the poultry gut, and in understanding the effects of these dynamic communities on poultry performance, disease status, animal welfare, and microbes with human health significance. Investigations characterizing the poultry enteric virome have identified novel poultry viruses, but the roles these viruses play in disease and performance problems have yet to be fully characterized. The complex bacterial community present in the poultry gut influences gut development, immune status, and animal health, each of which can be an indicator of overall performance. The present metagenomic investigation was undertaken to provide insight into the colonization of specific pathogen free chickens by enteric microorganisms under field conditions and to compare the pre-contact intestinal microbiome with the altered microbiome following contact with poultry raised in the field. Analysis of the intestinal virome from contact birds ("sentinels") placed on farms revealed colonization by members of the Picornaviridae, Picobirnaviridae, Reoviridae, and Astroviridae that were not present in pre-contact birds or present in proportionally lower numbers. Analysis of the sentinel gut bacterial community revealed an altered community in the post-contact birds, notably by members of the Lachnospiracea/Clostridium and Lactobacillus families and genera. Members of the avian enteric Reoviridae and Astroviridae have been well-characterized and have historically been implicated in poultry enteric disease; members of the Picobirnaviridae and Picornaviridae have only relatively recently been described in the poultry and avian gut, and their roles in the recognized disease syndromes and in poultry performance in general have not been determined. This metagenomic analysis has provided insight into the colonization of the poultry gut by enteric microbes circulating in commercial broiler flocks, and has identified enteric viruses and virus communities that warrant further study in order to understand their role(s) in avian gut health and disease.

There are a growing number of reports of antibiotic resistance (ATBR) in bacteria living in wildlife. This is a cause for concern as ATBR in wildlife represents a potential public health threat. However, little is known about the factors that might determine the presence, abundance and dispersion of ATBR bacteria in wildlife. Here, we used culture and molecular methods to assess ATBR in bacteria in fecal samples from howler monkeys (Alouatta palliata), spider monkeys (Ateles geoffroyi), tapirs (Tapirus bairdii) and felids (jaguars, Panthera onca; pumas, Puma concolor; jaguarundis, Puma yagouaroundi; and ocelots, Leopardus pardalis) living freely in two regions of the Mexican state of Veracruz under different degrees of human influence. Overall, our study shows that ATBR is commonplace in bacteria isolated from wildlife in southeast Mexico. Most of the resistances were towards old and naturally occurring antibiotics, but we also observed resistances of potential clinical significance. We found that proximity to humans positively affected the presence of ATBR and that ATBR was higher in terrestrial than arboreal species. We also found evidence suggesting different terrestrial and aerial routes for the transmission of ATBR between humans and wildlife. The prevalence and potential ATBR transfer mechanisms between humans and wildlife observed in this study highlight the need for further studies to identify the factors that might determine ATBR presence, abundance and distribution.

The Moon is depleted in volatile elements relative to the Earth and Mars. Low abundances of volatile elements, fractionated stable isotope ratios of S, Cl, K and Zn, high μ ((238)U/(204)Pb) and long-term Rb/Sr depletion are distinguishing features of the Moon, relative to the Earth. These geochemical characteristics indicate both inheritance of volatile-depleted materials that formed the Moon and planets and subsequent evaporative loss of volatile elements that occurred during lunar formation and differentiation. Models of volatile loss through localized eruptive degassing are not consistent with the available S, Cl, Zn and K isotopes and abundance data for the Moon. The most probable cause of volatile depletion is global-scale evaporation resulting from a giant impact or a magma ocean phase where inefficient volatile loss during magmatic convection led to the present distribution of volatile elements within mantle and crustal reservoirs. Problems exist for models of planetary volatile depletion following giant impact. Most critically, in this model, the volatile loss requires preferential delivery and retention of late-accreted volatiles to the Earth compared with the Moon. Different proportions of late-accreted mass are computed to explain present-day distributions of volatile and moderately volatile elements (e.g. Pb, Zn; 5 to >10%) relative to highly siderophile elements (approx. 0.5%) for the Earth. Models of early magma ocean phases may be more effective in explaining the volatile loss. Basaltic materials (e.g. eucrites and angrites) from highly differentiated airless asteroids are volatile-depleted, like the Moon, whereas the Earth and Mars have proportionally greater volatile contents. Parent-body size and the existence of early atmospheres are therefore likely to represent fundamental controls on planetary volatile retention or loss., (© 2014 The Author(s) Published by the Royal Society. All rights reserved.)