Gait kinematics and kinetics in patients with chronic ankle instability and healthy controls: A statistical parametric mapping analysis.

BACKGROUND: Chronic ankle instability (CAI) is associated with changes in gait biomechanics which may be related to chronic dysfunction. Traditional statistical models may be limited in their ability to assess the complex 3D movement of the lower extremity during gait. Multivariate analysis of the lower extremity kinematics may reveal unique biomechanical differences associated with CAI. RESEARCH QUESTION: Do patients with CAI differ from healthy controls in their lower extremity biomechanics and GRF when comparing 3D biomechanics? METHODS: Thirty-nine young, active adults participated in this study. Data was collected using a 3D motion analysis system while patients walked and jogged. Statistical parametric mapping (SPM) was used to explore 3D GRF, kinematics and kinetics of the of the lower extremity of CAI and healthy patients. RESULTS: During walking, patients with CAI had greater inversion from 68-100% of gait cycle (p < 0.001, mean difference=3.2°). During jogging, patients with CAI had greater inversion from 20-92% (p < 0.001, mean difference=4.6°). Greater plantar flexion moments were found from 65-71% (p = 0.05, mean difference=347.4Nm/kg) and greater eversion moments were found from 95-100% (p = 0.03, mean difference=74.6Nm/kg) in the CAI group. No differences in GRF were found. SIGNIFICANCE: Greater inversion may present a potentially injurious position. A faulty position of the rearfoot may require greater muscle function in order to correct the position of the joint resulting in greater eversion moments at the ankle. However, this kinetic change does not appear to correct the ankle position.

Adaptation of sea turtles to climate warming: Will phenological responses be sufficient to counteract changes in reproductive output?

Sea turtles are vulnerable to climate change since their reproductive output is influenced by incubating temperatures, with warmer temperatures causing lower hatching success and increased feminization of embryos. Their ability to cope with projected increases in ambient temperatures will depend on their capacity to adapt to shifts in climatic regimes. Here, we assessed the extent to which phenological shifts could mitigate impacts from increases in ambient temperatures (from 1.5 to 3°C in air temperatures and from 1.4 to 2.3°C in sea surface temperatures by 2100 at our sites) on four species of sea turtles, under a "middle of the road" scenario (SSP2-4.5). Sand temperatures at sea turtle nesting sites are projected to increase from 0.58 to 4.17°C by 2100 and expected shifts in nesting of 26-43 days earlier will not be sufficient to maintain current incubation temperatures at 7 (29%) of our sites, hatching success rates at 10 (42%) of our sites, with current trends in hatchling sex ratio being able to be maintained at half of the sites. We also calculated the phenological shifts that would be required (both backward for an earlier shift in nesting and forward for a later shift) to keep up with present-day incubation temperatures, hatching success rates, and sex ratios. The required shifts backward in nesting for incubation temperatures ranged from -20 to -191 days, whereas the required shifts forward ranged from +54 to +180 days. However, for half of the sites, no matter the shift the median incubation temperature will always be warmer than the 75th percentile of current ranges. Given that phenological shifts will not be able to ameliorate predicted changes in temperature, hatching success and sex ratio at most sites, turtles may need to use other adaptive responses and/or there is the need to enhance sea turtle resilience to climate warming.

Patient function in serial assessments throughout the post-ACL reconstruction progression.

OBJECTIVE: To assess the changes in patient strength and function from 4- to 6-month assessments following ACLR, determine relationships between changes in strength to changes in subjective function, and identify factors that predict patients that fail to increase in strength. DESIGN: Prospective, Cohort Study. SETTING: Controlled Laboratory. PARTICIPANTS: Forty-seven patients(27 female, 24.3 ± 11.1 years) completed a battery of performance assessments at approximately 4- and 6-months following primary ACLR (4.03 ±0 .49 and 6.46 ±0 .68 months). MAIN OUTCOME MEASURES: Subjective scores and isokinetic knee flexor and extensor strength were compared across visits. Patients were categorized per their ability to increase in strength beyond a previously defined threshold(0.22 Nm/kg). Binary logistic regression models were used to determine predictors of patients that failed to meet strength changes. RESULTS: Patients demonstrated improvements in patient-reported outcomes and strength measures between visits(P's < 0.05). Higher age (B = -0.073, P = .039), lower pre-injury activity levels (B = 0.61, P = .022), and higher limb symmetry indexes (B = -0.044, P = .05) at 4-months were predictors of patients that did not achieve improvements in quadriceps strength between assessments. CONCLUSIONS: From 4- to 6-months post-ACLR, increases in subjective function, strength and symmetry were observed. High quadriceps symmetry at interim assessments without consideration of the magnitude of strength values could overestimate recovery of quadriceps function.

Chronic ankle instability patients exhibit higher variability in lower extremity joint-coupling variability during drop vertical jumps.

Chronic ankle instability (CAI) has been associated with biomechanical alterations during landing tasks. While joint coupling differences have been reported during gait in patients with CAI, there is no known research assessing joint coupling during a drop-vertical jumping (DVJ). Joint coupling variability measure may provide information on the sensorimotor health of these patients. The purpose of this study was to compare lower extremity joint coupling variability during a DVJ between patients with CAI and controls. Twenty-eight young, active individuals (CAI:n = 14, Control:n = 14) participated in the study. A 3D motion capture system was used to collect kinematics during 15 drop-vertical jump trials. A vector coding analysis was used to assess the variability in the following joint couples: knee sagittal-ankle frontal, knee sagittal-ankle sagittal, hip frontal-ankle frontal, and hip frontal-ankle sagittal. The CAI group had higher joint coupling variability in hip frontal-ankle sagittal, knee sagittal-ankle frontal and knee sagittal-ankle sagittal planes both prior to and following ground contact during the drop vertical jumps. These changes indicate potential adaptations to the constraint of CAI and the task of the DVJ. Higher variability may reflect an attempt by the subjects to explore alternate movement strategies or reflect poor sensorimotor control strategies. Clinicians should consider the challenges of DVJ during rehabilitation as they create a unique task constraint.

Coherent population trapping with controlled interparticle interactions.

We investigate coherent population trapping in a strongly interacting ultracold Rydberg gas. Despite the strong van der Waals interactions and interparticle correlations, we observe the persistence of a resonance with subnatural linewidth at the single-particle resonance frequency as we tune the interaction strength. This narrow resonance cannot be understood within a mean-field description of the strong Rydberg-Rydberg interactions. Instead, a many-body density matrix approach, accounting for the dynamics of interparticle correlations, is shown to reproduce the observed spectral features.

Use and abuse of licit and illicit substances: prevalence and risk factors among students in Lebanon.

OBJECTIVE: This study aims at examining the patterns of 'substance' use in Lebanon among an 'at risk' population, the university students. METHOD: A stratified cluster sample of 1,851 students from two major universities was included in the study and the Diagnostic Interview Schedule (version 3) was administered. RESULTS: The prevalence of nicotine users in the sample was 18.3% and of ever consuming alcohol 49.4%. 2.1% of the sample were alcohol abusers and 2.4% alcohol dependents according to DSM-III criteria. For the remaining substances, tranquilizers were found to have the highest rate of ever use (10.2%), whereas heroin had the lowest rate (0.4%); the rates of abuse and dependence in these categories (other than alcohol and nicotine) following DSM-III criteria ranged from 0.1 to 0.8%. CONCLUSION: University students in Lebanon in this study have relatively low rates of use and abuse of substances but this might be changing.

Prevention of coronary artery disease.

The magnitude of cardiovascular disease is enormous. When the risk factors that predispose a patient to heart disease are recognized early and the appropriate intervention is instituted, the incidence of morbidity and mortality from coronary heart disease can be reduced. Lifestyle modification and the judicious use of medications can improve the complications of heart disease and prevent its onset.

The War Events Questionnaire.

BACKGROUND: The measurement of exposure to war in large epidemiological studies necessitates the use of easily administered and reliable questionnaires that cover a range of war events. The War Event Questionnaire (WEQ) was designed by our group to address these issues and has proved to be quite easy to administer. The aim of this study is to establish the inter-rater reliability of the WEQ. METHOD: Two trained interviewers alternated in administering parts I and II of the WEQ. RESULTS: The Kappa statistics used to calculate the degree of agreement between the two raters ranged from 0.281 to 0.774 for part I events and from 0.189 to 1.000 for part II events. CONCLUSION: The WEQ has proved to be a useful instrument that addresses both objective and the subjective war experiences; it is a fairly reliable instrument and has helped us avoid tautological assessment of the mental health effects of war.

PTSD: how frequently should the symptoms occur? The effect on epidemiologic research.

The definition of posttraumatic stress disorder (PTSD), like most other psychiatric disorders, relies on descriptive methodology; the formulation of the criteria needed to establish a diagnosis is based on clinical and research findings. We used our data from a community study in Beirut, Lebanon to look at the effect that the frequency of occurrence of individual PTSD symptoms might have on the total PTSD prevalence. We found that the prevalence of PTSD decreased by half if symptoms were required to have occurred at least twice per week. This phenomenon was true whether we considered war or nonwar traumata and was true for the DSM-III-R and the DSM-IV definitions of PTSD.

Extrarectal colonic carcinoma: analysis of 138 cases with long-term follow-up.

To identify factors that determine long-term survival after resection of extrarectal colonic cancer, we analyzed 138 such patients operated upon in a five-year period. Because rectal tumors have lower survival rates, they were excluded hoping to enhance the prognostic accuracy of the study. The sigmoid colon was the most common location of the tumor (59%) followed by the ascending (19%), the transverse (15%), and the descending colon (9%). In 95 patients (69%), operation was curative. In 12 patients (9%), a resection even with palliative aims could not be done. The five-year survival rates were 87% for 23 patients with Dukes' A and B lesions, 62% for 32 patients with Dukes' B2 lesions, 36% for 42 patients with Dukes' C1 lesions, and 0% for 34 patients with Dukes' C2 or higher. The overall five-year survival rate was 42%. These results emphasize the prognostic reliability of pathologic staging methods and bring into focus the importance of enhancing efforts for detecting extrarectal colonic cancers at early stages of development when curative resection offers maximal chances for cure.

[Value of amineptin in the treatment of different depressive states. Apropos of 112 cases treated as part of a national multi-centric study]. / Intérêt de l'amineptine dans le traitement des différents états dépressifs. A propos de 112 observations traitées dans le cadre d'une étude multicentrique nationale.

Amineptine is a new tricyclic compound with a grafted long aliphatic chain active on Dopamine synaptic release and as such more desinhibitor, safer and short acting. The study was coordinated by a national and 13 local counsellors. It was an open study. Inclusions criteria and results are examined, making obvious that patients responded well according to the Hamilton rating scale for depression (17 item version--16.4 points dropped at day 7th in 43%) and that it is an efficaceous antidepressant.