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Abstract Objective Topical corticosteroid irrigation plays critical role in the management of chronic rhinosinusitis (CRS). Yet, its efficacy can be highly variable. We sought to determine if personalized, 3‐dimensional (3D)‐printed nasal models can optimize head positioning and irrigation parameters, therefore improving patient outcomes. Study Design Randomized, single‐blinded clinical trial. Setting Tertiary medical center from November 2021 to July 2023. Methods Sixty‐two patients with CRS were randomized into either control (CG), backfill (BG), or model (MG) groups; daily 2 mg mometasone irrigations were then performed for 2 months with either standard head‐forward and natural side‐tilt position (CG), a head tilt of 90° to the side with fluid entering the lower nostril (BG), or in an optimized position as determined by a patient‐specific 3D printed irrigation model (MG), respectively. Results A total of 36 patients completed the trial (CG: N = 14/23; BG N = 11/23, MG: N = 11/16). Significant posttreatment improvement in Lund‐Mackay (LM) scoring was only observed in the MG (−3.73, 95% confidence interval = −5.71, −1.75; P

Following anterior cruciate ligament reconstruction (ACLR), patients exhibit abnormal walking mechanics and quadriceps dysfunction. Quadriceps dysfunction has been largely attributed to muscle atrophy and weakness. While important, these factors do not capture intrinsic properties of muscle that govern its ability to generate force and withstand load. While fascicle abnormalities after ACLR have been documented in early stages of recovery (<12 mo), long-term effects of ACLR on fascicle mechanics remain unexplored. We evaluated quadriceps fascicle mechanics during walking 3 years post-ACLR and examined the relationship with knee mechanics. Participants included 24 individuals with ACLR and 24 Controls. Linear mixed models compared the ACLR, Contralateral, and Controls limbs for (1) quadriceps strength, (2) fascicle architecture and mechanics, and (3) knee mechanics. No difference in strength or overall fascicle length excursions was found between limbs. The ACLR limb exhibited longer fascicles at heel strike and peak knee extension moment (P <.001–.004), and smaller fascicle angles at heel strike, peak knee extension moment, and overall suppressed fascicle angle excursions (P <.001–.049) relative to the Contralateral and/or Control limb. This indicates an abnormality in fascicle architecture and mechanics following ACLR and suggests abnormalities in contractile function that cannot be explained by muscle weakness and may contribute to long-term gait irregularities. [ABSTRACT FROM AUTHOR]

Abstract The Arctic is warming at a rate four times the global average, while also being exposed to other global environmental changes, resulting in widespread vegetation and ecosystem change. Integrating functional trait-based approaches with multi-level vegetation, ecosystem, and landscape data enables a holistic understanding of the drivers and consequences of these changes. In two High Arctic study systems near Longyearbyen, Svalbard, a 20-year ITEX warming experiment and elevational gradients with and without nutrient input from nesting seabirds, we collected data on vegetation composition and structure, plant functional traits, ecosystem fluxes, multispectral remote sensing, and microclimate. The dataset contains 1,962 plant records and 16,160 trait measurements from 34 vascular plant taxa, for 9 of which these are the first published trait data. By integrating these comprehensive data, we bridge knowledge gaps and expand trait data coverage, including on intraspecific trait variation. These data can offer insights into ecosystem functioning and provide baselines to assess climate and environmental change impacts. Such knowledge is crucial for effective conservation and management in these vulnerable regions.

Introduction: Anterior cruciate ligament (ACL) injury is frequently accompanied by quadriceps muscle atrophy, a process closely linked to mitochondrial health and mitochondria-specific autophagy. However, the temporal progression of key quadricep atrophy-mediating events following ACL injury remains poorly understood. To advance our understanding, we conducted a longitudinal study to elucidate key parameters in quadriceps autophagy and mitophagy.Methods: Long-Evans rats were euthanized at 7, 14, 28, and 56 days after non-invasive ACL injury that was induced via tibial compression overload; controls were not injured. Vastus lateralis muscle was extracted, and subsequent immunoblotting analysis was conducted using primary antibodies targeting key proteins involved in autophagy and mitophagy cellular processes.Results: Our findings demonstrated dynamic changes in autophagy and mitophagy markers in the quadriceps muscle during the recovery period after ACL injury. The early response to the injury was characterized by the induction of autophagy at 14 days (Beclin1), indicating an initial cellular response to the injury. Subsequently, at 14 days we observed increase in the elongation of autophagosomes (Atg4B), suggesting a potential remodeling process. The autophagosome flux was also augmented between 14- and 28 days (LC3-II/LC3-I ratio and p62). Notably, at 56 days, markers associated with the elimination of damaged mitochondria were elevated (PINK1, Parkin, and VDAC1), indicating a possible ongoing cellular repair and restoration process.Conclusion: These data highlight the complexity of muscle recovery after ACL injury and underscore the overlooked but crucial role of autophagy and mitophagy in promoting the recovery process.

IntroductionAnterior cruciate ligament reconstruction (ACLR) is characterized by persistent involved limb functional deficits that persist for years despite rehabilitation. Previous research provides evidence of both peripheral and central nervous system adaptations following ACLR. However, no study has compared functional organization of the brain for involved limb motor control relative to the uninvolved limb and healthy controls. The purpose of this study was to examine sensorimotor cortex and cerebellar functional activity overlap and non-overlap during a knee motor control task between groups (ACLR and control), and to determine cortical organization of involved and uninvolved limb movement between groups.MethodsEighteen participants with left knee ACLR and 18 control participants performed a knee flexion/extension motor control task during functional magnetic resonance imaging (fMRI). A conjunction analysis was conducted to determine the degree of overlap in brain activity for involved and uninvolved limb knee motor control between groups.ResultsThe ACLR group had a statistically higher mean percent signal change in the sensorimotor cortex for the involved > uninvolved contrast compared to the control group. Brain activity between groups statistically overlapped in sensorimotor regions of the cortex and cerebellum for both group contrasts: involved > uninvolved and uninvolved > involved. Relative to the control group, the ACLR group uniquely activated superior parietal regions (precuneus, lateral occipital cortex) for involved limb motor control. Additionally, for involved limb motor control, the ACLR group displayed a medial and superior shift in peak voxel location in frontal regions; for parietal regions, the ACLR group had a more posterior and superior peak voxel location relative to the control group.ConclusionACLR may result in unique activation of the sensorimotor cortex via a cortically driven sensory integration strategy to maintain involved limb motor control. The ACLR group's unique brain activity was independent of strength, self-reported knee function, and time from surgery.

The authors comment on the article by B. Sonnery-Cottet and colleagues related to the incidence of and risk factors for arthrogenic muscle inhibition (AMI) following acute anterior cruciate ligament injuries. Topics covered include how the clinical assessment and intervention approaches suggested by the authors fail, the concern with the reliance on the Sonnery-Cottet classification for the purpose of diagnosing AMI, and the goal of AMI-based treatments.

Muscle weakness following anterior cruciate ligament reconstruction (ACLR) increases the risk of posttraumatic osteoarthritis (OA). However, focusing solely on muscle weakness overlooks other aspects like muscle composition, which could hinder strength recovery. Intramuscular fat is a non‐contractile element linked to joint degeneration in idiopathic OA, but its role post‐ACLR has not been thoroughly investigated. To bridge this gap, we aimed to characterize quadriceps volume and intramuscular fat in participants with ACLR (male/female = 15/9, age = 22.8 ± 3.6 years, body mass index [BMI] = 23.2 ± 1.9, time since surgery = 3.3 ± 0.9 years) and in controls (male/female = 14/10, age = 22.0 ± 3.1 years, BMI = 23.3 ± 2.6) while also exploring the associations between intramuscular fat and muscle volume with isometric strength. Linear mixed effects models assessed (I) muscle volume, (II) intramuscular fat, and (III) strength between limbs (ACLR vs. contralateral vs. control). Regression analyses were run to determine if intramuscular fat or volume were associated with quadriceps strength. The ACLR limb was 8%−11% smaller than the contralateral limb (p < 0.05). No between‐limb differences in intramuscular fat were observed (p = 0.091−0.997). Muscle volume but not intramuscular fat was associated with strength in the ACLR and control limbs (p < 0.001−0.002). We demonstrate that intramuscular fat does not appear to be an additional source of quadriceps dysfunction following ACLR and that muscle size only explains some of the variance in muscle strength. [ABSTRACT FROM AUTHOR]

Individuals with anterior cruciate ligament reconstruction (ACLR) often fail to return to their previous level of sport performance. Although multifaceted, this inability to regain preinjury performance may be influenced by impaired plyometric ability attributable to chronic quadriceps dysfunction. Whole-body vibration (WBV) acutely improves quadriceps function and biomechanics after ACLR, but its effects on jumping performance outcomes such as jump height, the reactive strength index (RSI), and knee work and power are unknown. To evaluate the acute effects of WBV on measures of jumping performance in those with ACLR. Crossover study design. Research laboratory. Thirty-six individuals with primary, unilateral ACLR. Participants stood on a WBV platform in a mini-squat position while vibration or no vibration (control) was applied during six 60-second bouts with 2 minutes of rest between bouts. Double-leg jumping tasks were completed preintervention and postintervention (WBV or control) and consisted of jumping off a 30-cm box to 2 force plates half the participant's height away. The jumping task required participants to maximally jump vertically upon striking the force plates. Whole-body vibration did not produce significant improvements in any of the study outcomes (ie, jump height, RSI, and knee work and power) in either limb (P =.053–.839). These results suggest that a single bout of WBV is insufficient for improving jumping performance in individuals with ACLR. As such, using WBV to acutely improve jumping performance post-ACLR is likely not warranted. Future research should evaluate the effects of repeated exposure to WBV in combination with other plyometric interventions on jumping performance. [ABSTRACT FROM AUTHOR]

Context: Arthrogenic muscle inhibition (AMI) continues to be a limiting factor in joint rehabilitation as the inability to volitionally activate muscle significantly dampens recovery. New evidence acquired at higher brain centers and in clinical populations continues to reshape our perspective of what AMI is and how to treat it. This review aims to stimulate discussion about the far-reaching effects of AMI by exploring the interconnected pathways by which it evolves. Objectives: To discuss how reflexive inhibition can lead to adaptations in brain activity, to illustrate how changes in descending motor pathways limit our ability to contract muscle following injury, and to summarize the emerging literature on the wide-reaching effects of AMI on other interconnected systems. Data Sources: The databases PubMed, SPORTDiscus, and Web of Science were searched for articles pertaining to AMI. Reference lists from appropriate articles were cross-referenced. Conclusion: AMI is a sequential and cumulative neurological process that leads to complex clinical impairments. Originating with altered afferent information arising from an injured joint, patients experience changes in afferent information, reflexive muscle inhibition, deficiencies in somatosensation, neuroplastic compensations in higher brain centers, and ultimately decreased motor output to the muscle surrounding the joint. Other aspects of clinical function, like muscle structure and psychological responses to injury, are also impaired and influenced by AMI. Removing, or reducing, AMI should continue to be a focus of rehabilitation programs to assist in the optimization of health after joint injury. [ABSTRACT FROM AUTHOR]

Background: Running is an extremely common exercise, both recreationally and competitively. Combined with clinical assessment, technology-driven biomechanical gait analysis can be used to examine markers of performance and injury risk in runners. Indications: The indication is to provide clinicians and sports science researchers a framework for using inertial measurement units (IMU) for data-driven, quantitative gait assessments. Technique Description: This video details practical application of IMU use in biomechanical gait assessments. Details on participant and equipment setup, in-session protocols, and selection of gait variables are included. Results: Following collection of demographic and anthropometric outcomes, IMUs should be placed on rigid segments of the lower extremity, sacrum, and trunk. In our model, we place IMUs on the foot, shank, thigh, sacrum, and lower thoracic spine. Following static anatomical calibration, running gait biomechanics are evaluated at multiple speeds using IMUs, 2-dimensional high-speed video cameras, and an instrumented treadmill. The high-speed video and IMU data are analyzed together at various parts of the gait cycle, including foot strike, mid-stance, toe-off, and flight. Many kinematic and kinetic variables (ie, unilateral discrete joint angles, joint excursions, joint moments, spatiotemporal outcomes, etc) can be selected for analysis, ideally via a collaboration between the sports science, athletic, and sports medicine teams. A collaborative approach should also be used to determine how this information will be used to alter training programs or influence injury risk in the running athlete. Discussion/Conclusion: This report details how to use a data-driven approach to evaluate running gait biomechanics using IMU technology. This framework for gait analysis is most applicable, and effective, when the team of researchers works in conjunction with coaches, sport scientists, and athletes. Utilizing this framework, training can be adapted based on the objective and clinical assessment to reduce injury risk and improve performance in the gait assessment.

The article focuses on the concept of "benign neglect" and its implications in addressing racial and social issues. Topics include the historical context of the term from a 1970 memo, its impact on civil rights, and the ongoing racial disparities in the criminal justice system, particularly regarding the treatment of opioid use disorder in jails.

IntroductionDespite rigorous rehabilitation aimed at restoring muscle health, anterior cruciate ligament (ACL) injury is often hallmarked by significant long-term quadriceps muscle weakness. Derangements in mitochondrial function are a common feature of various atrophying conditions, yet it is unclear to what extent mitochondria are involved in the detrimental sequela of quadriceps dysfunction after ACL injury. Using a preclinical, non-invasive ACL injury rodent model, our objective was to explore the direct effect of an isolated ACL injury on mitochondrial function, muscle atrophy, and muscle phenotypic transitions.MethodsA total of 40 male and female, Long Evans rats (16-week-old) were exposed to non-invasive ACL injury, while 8 additional rats served as controls. Rats were euthanized at 3, 7, 14, 28, and 56 days after ACL injury, and vastus lateralis muscles were extracted to measure the mitochondrial respiratory control ratio (RCR; state 3 respiration/state 4 respiration), mitochondrial reactive oxygen species (ROS) production, fiber cross sectional area (CSA), and fiber phenotyping. Alterations in mitochondrial function and ROS production were detected using two-way (sex:group) analyses of variance. To determine if mitochondrial characteristics were related to fiber atrophy, individual linear mixed effect models were run by sex.ResultsMitochondria-derived ROS increased from days 7 to 56 after ACL injury (30–100%, P < 0.05), concomitant with a twofold reduction in RCR (P < 0.05). Post-injury, male rats displayed decreases in fiber CSA (days 7, 14, 56; P < 0.05), loss of IIa fibers (day 7; P < 0.05), and an increase in IIb fibers (day 7; P < 0.05), while females displayed no changes in CSA or phenotyping (P > 0.05). Males displayed a positive relationship between state 3 respiration and CSA at days 14 and 56 (P < 0.05), while females only displayed a similar trend at day 14 (P = 0.05).ConclusionLong-lasting impairments in quadriceps mitochondrial health are present after ACL injury and play a key role in the dysregulation of quadriceps muscle size and composition. Our preclinical data indicate that using mitoprotective therapies may be a potential therapeutic strategy to mitigate alterations in muscle size and characteristic after ACL injury.

We describe a process for construction and use of a "dashboard" for monitoring the quality of in-person nonformal education programs. We followed the process to develop a 4-H special interest (SPIN) club dashboard, but the steps are applicable to any education program that includes instruction over multiple sessions. The dashboard construction process comprises selecting performance measures, choosing data collection strategies, designing the content and layout of the dashboard, collecting data, and populating the dashboard with performance metrics. Although these process steps are intuitive, specific decision options within each step can be complex. Our article includes discussion of these complexities in the context of our SPIN club application.

Black, Joel E. Structuring Poverty in the Windy City: Autonomy, Virtue, and Isolation in Post Fire Chicago. Lawrence: University Press of Kansas, 2019. 259 pages. Paperback, $24.95. In Structuring Poverty [...]