Physical therapy in the Emergency Department: A prospective cohort study from an Alternatives to Opioids program.

Objective: Musculoskeletal pain complaints are common in the emergency department (ED). The objective of this study was to determine the impact of physical therapy (PT) in the ED on pain and ED return. Methods: A prospective cohort study was performed with those presenting to the ED or Urgent Care at a single academic center for musculoskeletal pain between November 2020 and December 2022. All patients were referred to outpatient PT. During business hours, PT was available to begin treatment in the ED. Long-term follow-up was performed using the electronic health records. Statistical analyses included descriptive and non-parametric pairwise comparisons, Fisher's exact test, and multiple logistic regression. Results: A total of 974 patients were included in the study with 553 completing optional surveys. Back pain was most common. Pain was reduced at ED discharge for all patients, but pain was significantly improved if patients saw PT in the ED. Patients in the ED were less likely to keep their outpatient PT appointments than others, but importantly, patients who saw PT in the ED were less likely to return to the ED for the same complaint up to 1 year later. Those who kept PT appointments were likely to establish or maintain healthcare outside emergency services later. Conclusions: Initiating PT in this ED reduces pain at ED discharge. However, patients who utilized PT were more likely to later utilize health care resources outside of emergency services. Those who saw PT in this ED were less likely to return to the ED for the same complaint up to 1 year later.

Graded alarm call behavior in wild fox squirrels (Sciurus niger).

Distress or alarm calls are vocalizations made when animals are in stressful situations or faced with a predator. Squirrels (Sciuridae) are known for being very vocal; however, most studies on alarm vocalizations are limited to ground squirrels. We investigated the acoustic behavior of the arboreal fox squirrel (Sciurus niger) under different conditions. Specifically, we tested the hypothesis that fox squirrels modify acoustic alarm behavior in response to different perceived threat levels and that this response is affected by sex and individual experience. Squirrels were trapped, and acoustic data were collected during periods in which the squirrels were alone, approached by humans, manipulated in traps, and handled by humans. Calls were categorized based on acoustic features, and we quantified the call rate (calls/s) across conditions. Threat level significantly affected vocal rate, with squirrels producing more calls overall when alone but shifting the proportion of emitted call types as threat level increased. Sex, capture history, and individual had no effect on call rate. These results suggest that fox squirrels use a graded alarm call response system to respond to threatening situations.

Different demographic responses of three species of container Aedes (Diptera: Culicidae) larvae to timing of extrinsic mortality.

Mortality imposed on a population can interact with negatively density-dependent mortality to produce overcompensation, wherein added mortality results in more survivors. Experimental mortality can cause overcompensation in mosquito larvae, which would be counterproductive if it resulted from mosquito control in nature. We tested for different demographic responses to mortality among 3 container Aedes species when impacted by density dependence. We imposed 48.2% mortality on cohorts of larvae 2, 6, or 8 days after hatching and compared adult production, development times, and female size to those variables for controls without mortality. Mortality significantly increased adult production compared to controls, but the 3 species varied in the details of that response. Aedes albopictus (Skuse) produced more adults with mortality on day 2 primarily because of greater production of males. Aedes triseriatus (Say) yielded more adults with mortality on day 2 primarily because of greater production of females. Aedes aegypti (L.) adult production was not significantly affected by mortality, but development times for both sexes were significantly shorter with mortality on day 8. There were no effects of mortality on female wing length. None of our mortality treatments yielded significant reductions of adults for any species. These species responses to mortality are not the same, despite their similar ecologies and life histories. Thus, we cannot assume that killing almost half the larvae present in a dense population will reduce adult production, nor can we assume that different Aedes species will respond to mortality in the same way.