The development and evaluation of a virtual, asynchronous, trauma-focused treatment program for adult survivors of childhood interpersonal trauma.

BACKGROUND: The long-term mental and physical health implications of childhood interpersonal trauma on adult survivors is immense, however, there is a lack of available trauma-focused treatment services that are widely accessible. This study, utilizing a user-centered design process, sought feedback on the initial design and development of a novel, self-paced psychoeducation and skills-based treatment intervention for this population. AIMS: To explore the views and perspectives of adult survivors of childhood interpersonal trauma on the first two modules of an asynchronous trauma-focused treatment program. METHODS: Fourteen participants from our outpatient hospital service who completed the modules consented to provide feedback on their user experience. A thematic analysis of the three focus groups was conducted. RESULTS: Four major themes emerged from the focus groups: (1) technology utilization, (2) module content, (3) asynchronous delivery, and (4) opportunity for interactivity. Participants noted the convenience of the platform and the use of multimedia content to increase engagement and did not find the modules to be emotionally overwhelming. CONCLUSIONS: Our research findings suggest that an asynchronous virtual intervention for childhood interpersonal trauma survivors may be a safe and acceptable way to provide a stabilization-focused intervention on a wider scale.

Blood flow restriction attenuates surface mechanomyography lateral and longitudinal, but not transverse oscillations during fatiguing exercise.

Objective. Surface mechanomyography (sMMG) can measure oscillations of the activated muscle fibers in three axes (i.e.X,Y, andZ-axes) and has been used to describe motor unit activation patterns (X-axis). The application of blood flow restriction (BFR) is common in exercise studies, but the cuff may restrict muscle fiber oscillations. Therefore, the purpose of this investigation was to examine the acute effects of submaximal, fatiguing exercise with and without BFR on sMMG amplitude in theX,Y, andZ-axes among female participants.Approach. Sixteen females (21 ± 1 years) performed two separate exercise bouts to volitional exhaustion that consisted of unilateral, submaximal (50% maximal voluntary isometric contraction [MVIC]) intermittent, isometric, leg extensions with and without BFR. sMMG was recorded and examined across percent time to exhaustion (%TTE) in 20% increments. Separate 2-way repeated measures ANOVA models were constructed: (condition [BFR, non-BFR]) × (time [20, 40, 60, 80, and 100% TTE]) to examine absolute (m·s-2) and normalized (% of pretest MVIC) sMMG amplitude in theX-(sMMG-X),Y-(sMMG-Y), andZ-(sMMG-Z) axes.Main results. The absolute sMMG-X amplitude responses were attenuated with the application of BFR (mean ± SD = 0.236 ± 0.138 m·s-2) relative to non-BFR (0.366 ± 0.199 m·s-2, collapsed across time) and for sMMG-Y amplitude at 60%-100% of TTE (BFR range = 0.213-0.232 m·s-2versus non-BFR = 0.313-0.445 m·s-2). Normalizing sMMG to pretest MVIC removed most, but not all the attenuation which was still evident for sMMG-Y amplitude at 100% of TTE between BFR (72.9 ± 47.2%) and non-BFR (98.9 ± 53.1%). Interestingly, sMMG-Z amplitude was not affected by the application of BFR and progressively decreased across %TTE (0.332 ± 0.167 m·s-2to 0.219 ± 0.104 m·s-2, collapsed across condition.)Significance. The application of BFR attenuated sMMG-X and sMMG-Y amplitude, although normalizing sMMG removed most of this attenuation. Unlike theXandY-axes, sMMG-Z amplitude was not affected by BFR and progressively decreased across each exercise bout potentially tracking the development of muscle fatigue.

Acute Effects of Sprint Interval Training and Blood Flow Restriction on Neuromuscular and Muscle Function.

BFR) applied during sprint interval training (SIT) on performance and neuromuscular function. METHODS: Fifteen men completed a randomized bout of SIT with CBFR, IBFR, and without BFR (No-BFR), consisting of 2, 30-s maximal sprints on a cycle ergometer with a resistance of 7.5% of body mass. Concentric peak torque (CPT), maximal voluntary isometric contraction (MVIC) torque, and muscle thickness (MT) were measured before and after SIT, including surface electromyography (sEMG) recorded during the strength assessments. Peak and mean revolutions per minute (RPM) were measured during SIT and power output was examined relative to physical working capacity at the fatigue threshold (PWCFT). RESULTS: CPT and MVIC torque decreased from pre-SIT (220.3±47.6 Nm and 355.1±72.5 Nm, respectively) to post-SIT (147.9±27.7 Nm and 252.2±45.5 Nm, respectively, all P<0.05), while MT increased (1.77±0.31 cm to 1.96±0.30 cm). sEMG mean power frequency decreased during CPT (-12.8±10.5%) and MVIC (-8.7±10.2%) muscle actions. %PWCFT was greater during No-BFR (414.2±121.9%) than CBFR (375.9±121.9%). CONCLUSION: SIT with or without BFR induced comparable alterations in neuromuscular fatigue and sprint performance across all conditions, without affecting neuromuscular function.

Standing on shoulder of giants: the incredible legacy of the Judet family in orthopaedic surgery.

In orthopaedic surgery, as well as other areas in medicine, it is common for a surgical technique to carry the original authors' name describing the procedure. The Judet family represents a unique history, since several orthopaedic procedures are known as "Judet's technique". The aim of this historic review is to outline the genealogy of the orthopaedic arm of the Judet family, while crediting each surgical procedure to the specific family member that described the technique.

Silver Nanowire-Based Transparent Electrodes for V2O5 Thin Films with Electrochromic Properties.

The development of electrochromic systems, known for the modulation of their optical properties under an applied voltage, depends on the replacement of the state-of-the-art ITO (In2O3:Sn) transparent electrode (TE) as well as the improvement of electrochromic films. This study presents an innovative ITO-free electrochromic film architecture utilizing oxide-coated silver nanowire (AgNW) networks as a TE and V2O5 as an electrochromic oxide layer. The TE was prepared by simple spray deposition of AgNWs that allowed for tuning different densities of the network and hence the resistance and transparency of the film. The conformal oxide coating (SnO2 or ZnO) on AgNWs was deposited by atmospheric-pressure spatial atomic layer deposition, an open-air fast and scalable process yielding a highly stable electrode. V2O5 thin films were then deposited by radio frequency magnetron sputtering on the AgNW-based TE. Independent of the oxide's nature, a 20 nm protective layer thickness was insufficient to prevent the deterioration of the AgNW network during V2O5 deposition. On the contrary, crystalline V2O5 films were grown on 30 nm thick ZnO or SnO2-coated AgNWs, exhibiting a typical orange color. Electrochromic characterization demonstrated that only V2O5 films deposited on 30 nm thick SnO2-coated AgNW showed characteristic oxidation-reduction peaks in the Li+-based liquid electrolyte associated with a reversible orange-to-blue color switch for at least 500 cycles. The electrochromic key properties of AgNW/SnO2 (30 nm)/V2O5 films are discussed in terms of structural and morphological changes due to the AgNW network and the nature and thickness of the two protective oxide coatings.

To prove or improve? Examining how paradoxical tensions shape evaluation practices in accreditation contexts.

INTRODUCTION: Although programme evaluation is increasingly routinised across the academic health sciences, there is scant research on the factors that shape the scope and quality of evaluation work in health professions education. Our research addresses this gap, by studying how the context in which evaluation is practised influences the type of evaluation that can be conducted. Focusing on the context of accreditation, we critically examine the types of paradoxical tensions that surface as evaluation-leads consider evaluation ideals or best practices in relation to contextual demands associated with accreditation seeking. METHODS: Our methods were qualitative and situated within a critical realist paradigm. Study participants were 29 individuals with roles requiring responsibility and oversight on evaluation work. They worked across 4 regions, within 26 academic health science institutions. Data were collected using semi-structured interviews and analysed using framework and matrix analyses. RESULTS: We identified three overarching themes: (i) absence of collective coherence about evaluation practice, (ii) disempowerment of expertise and (iii) tensions as routine practice. Examples of these latter tensions in evaluation work included (i) resourcing accreditation versus resourcing robust evaluation strategy (performing paradox), (ii) evaluation designs to secure accreditation versus design to spur renewal and transformation (performing-learning paradox) and (iii) public dissemination of evaluation findings versus restricted or selective access (publicising paradox). Sub-themes and illustrative data are presented. DISCUSSION: Our study demonstrates how the high-stakes context of accreditation seeking surfaces tensions that can risk the quality and credibility of evaluation practices. To mitigate these risks, those who commission or execute evaluation work must be able to identify and reconcile these tensions. We propose strategies that may help optimise the quality of evaluation work alongside accreditation-seeking efforts. Critically, our research highlights the limitations of continually positioning evaluation purely as a method versus as a socio-technical practice that is highly vulnerable to contextual influences.

[The SCATTER project: computer-based simulation in the strategic transfer of intensive care patients]. / Das SCATTER-Projekt: Computerbasierte Simulation zur Unterstützung bei der strategischen Verlegung von Intensivpatienten.

BACKGROUND: The need for a concept for the nationwide strategic transfer of critical care patients in Germany was highlighted during the COVID-19 (coronavirus disease 2019) pandemic. Despite the cloverleaf concept developed specifically for this purpose, the transfer of large numbers of critical care patients represents a major challenge. With the help of a computer simulation, the SCATTER research project uses a fictitious example to test, develop, and recommend transfer strategies. METHOD: The simulation was programmed after collecting procedural and structural data on critical care transports within Germany. The simulation allows altering various parameters and testing different transfer scenarios. In a fictitious scenario, nationwide transfers starting from Schleswig-Holstein were simulated and evaluated using predetermined criteria. RESULTS: In the case of ground-based transfers, it became apparent that, depending on the selected target region, not all patients could be transferred due to the limited range of ground-based vehicles. Although a higher number of patients can be transferred by air, this is associated with additional gurney changes and potential risk to the patient. A distance-dependent transport strategy led to the identical results as purely air-bound transport, since air-bound transport was always chosen due to the long distances. DISCUSSION: The simulation can be used to develop recommendations and to draw important conclusions from different transfer strategies.

Exploring the degradation of silver nanowire networks under thermal stress by coupling in situ X-ray diffraction and electrical resistance measurements.

The thermal instability of silver nanowires (AgNWs) leads to a significant increase of the electrical resistance of AgNW networks. A better understanding of the relationship between the structural and electrical properties of AgNW networks is primordial for their efficient integration as transparent electrodes (TEs) for next-generation flexible optoelectronics. Herein, we investigate the in situ evolution of the main crystallographic parameters (i.e. integrated intensity, interplanar spacing and peak broadening) of two Ag-specific Bragg peaks, (111) and (200), during a thermal ramp up to 400 °C through in situ X-ray diffraction (XRD) measurements, coupled with in situ electrical resistance measurements on the same AgNW network. First, we assign the (111) and (200) peaks of χ-scans to each five crystallites within AgNWs using a rotation matrix model. Then, we show that the thermal transition of bare AgNW networks occurs within a temperature range of about 25 °C for the electrical properties, while the structural transition spans over 200 °C. The effect of a protective tin oxide coating (SnO2) on AgNW networks is also investigated through this original in situ coupling approach. For SnO2-coated AgNW networks, the key XRD signatures from AgNWs remain constant, since the SnO2 coating prevents Ag atomic surface diffusion, and thus morphological instability (i.e. spheroidization). Moreover, the SnO2 coating does not affect the strain of both (111) and (200) planes. The thermal expansion for bare and SnO2-coated AgNW networks appears very similar to the thermal expansion of bulk Ag. Our findings provide insights into the underlying failure mechanisms of AgNW networks subjected to thermal stress, helping researchers to develop more robust and durable TEs based on metallic nanowire networks.

Zoomification of medical education: can the rapid online educational responses to COVID-19 prepare us for another educational disruption? A scoping review.

Introduction: In response to the COVID-19 pandemic, educators have increasingly shifted delivery of medical education to online/distance learning. Given the rapid and heterogeneous nature of adaptations; it is unclear what interventions have been developed, which strategies and technologies have been leveraged, or, more importantly, the rationales given for designs. Capturing the content and skills that were shifted to online, the type of platforms used for the adaptations, as well as the pedagogies, theories, or conceptual frameworks used to inform the adapted educational deliveries can bolster continued improvement and sustainability of distance/online education while preparing medical education for future large-scale disruptions. Methods: We conducted a scoping review to map the rapid medical educational interventions that have been adapted or transitioned to online between December 2019 and August 2020. We searched MEDLINE, EMBASE, Education Source, CINAHL, and Web of Science for articles pertaining to COVID-19, online (distance) learning, and education for medical students, residents, and staff. We included primary research articles and reports describing adaptations of previous educational content to online learning. Results: From an initial 980 articles, we identified 208 studies for full-text screening and 100 articles for data extraction. The majority of the reported scholarship came from Western Countries and was published in clinical science journals. Cognitive content was the main type of content adapted (over psychomotor, or affective). More than half of the articles used a video-conferencing software as the platform to pivot their educational intervention into virtual. Unfortunately, most of the reported work did not disclose their rationale for choosing a platform. Of those that did, the majority chose technological solutions based on availability within their institutions. Similarly, most of the articles did not report the use of any pedagogy, theory, or framework to inform the educational adaptations.

Introduction: En réponse à la pandémie de la COVID-19, l'enseignement médical a été progressivement déplacé vers l'espace virtuel. Compte tenu de la rapidité et de l'hétérogénéité des adaptations opérées, nous n'avons qu'une idée peu précise des activités éducatives élaborées, des stratégies et des technologies mobilisées et, plus important encore, des raisons avancées pour les motiver. Une meilleure connaissance du contenu et des compétences dont l'enseignement a été transféré en ligne, du type de plateformes utilisées pour le virage, ainsi que des pédagogies, des théories ou des cadres conceptuels utilisés pour guider les activités éducatives adaptées soutiendrait une amélioration continue et la pérennité de l'enseignement à distance, tout en préparant la formation médicale à de futures perturbations d'envergure. Méthodes: Nous avons effectué une revue exploratoire pour recenser les activités éducatives en médecine qui ont été expéditivement adaptées ou transposées en ligne entre décembre 2019 et août 2020. Nous avons interrogé les bases de données MEDLINE, EMBASE, Education Source, CINAHL et Web of Science à la recherche d'articles portant sur la COVID-19, sur l'apprentissage en ligne (à distance) et sur la formation des étudiants en médecine, des résidents et du personnel enseignant. Nous avons inclus des articles de recherche originale et d'autres décrivant l'adaptation de contenus éducatifs à l'apprentissage en ligne. Résultats: Des 980 articles trouvés, nous avons sélectionné 208 études pour un examen du texte intégral et 100 articles pour une extraction de données. La plupart des travaux provenaient de pays occidentaux et ont été publiés dans des revues médicales. Le type de contenu adapté était principalement cognitif, dans une moindre mesure psychomoteur ou affectif. Plus de la moitié des articles présentaient un logiciel de visioconférence comme plateforme utilisée pour transposer des activités éducatives en mode virtuel. Malheureusement, la plupart des études ne précisaient pas les raisons justifiant le choix de plateforme. Celles qui l'ont fait indiquaient majoritairement que les solutions technologiques avaient été choisies en fonction de leur disponibilité au sein de l'établissement. De la même manière, seulement une poignée d'articles font état de l'utilisation d'une pédagogie, d'une théorie ou d'un cadre pour guider les adaptations pédagogiques.

Assessing the Environmental Impact of Atomic Layer Deposition (ALD) Processes and Pathways to Lower It.

Due to concerns on resources depletion, climate change, and overall pollution, the quest toward more sustainable processes is becoming crucial. Atomic layer deposition (ALD) is a versatile technology, allowing for the precise coating of challenging substrates with a nanometer control over thickness. Due to its unique ability to nanoengineer interfaces and surfaces, ALD is widely used in many applications. Although the ALD technique offers the potential to tackle environmental challenges, in particular, considerations regarding the sustainability of renewable energy devices urge for greater efficiency and lower carbon footprint. Indeed, the process itself has currently a consequential impact on the environment, which should ideally be reduced as the technique is implemented in a wider range of products and applications. This paper reviews the studies carried out on the assessment of the environmental impact of ALD and summarizes the main results reported in the literature. Next, the principles of green chemistry are discussed, considering the specificities of the ALD process. This work also suggests future pathways to reduce the ALD environmental impact; in particular, the optimization of the reactor and processing parameters, the use of high throughput processes such as spatial ALD (SALD), and the chemical design of greener precursors are proposed as efficient routes to improve ALD sustainability.

Acute Effects of Continuous and Intermittent Blood Flow Restriction on Sprint Interval Performance and Muscle Oxygen Responses.

ABSTRACT: Wizenberg, AM, Gonzalez-Rojas, D, Rivera, PM, Proppe, CE, Laurel, KP, Stout, JR, Fukuda, DH, Billaut, F, Keller, JL, and Hill, EC. Acute effects of continuous and intermittent blood flow restriction on sprint interval performance and muscle oxygen responses. J Strength Cond Res 37(10): e546-e554, 2023-This investigation aimed to examine the acute effects of continuous and intermittent blood flow restriction (CBFR and IBFR, respectively) during sprint interval training (SIT) on muscle oxygenation, sprint performance, and ratings of perceived exertion (RPE). Fifteen men (22.6 ± 2.4 years; 176 ± 6.3 cm; 80.0 ± 12.6 kg) completed in random order a SIT session with CBFR, IBFR (applied during rest), and no blood flow restriction (NoBFR). Each SIT session consisted of two 30-second all-out sprint tests separated by 2 minutes. Peak power (PP), total work (TW), sprint decrement score (S dec ), RPE, and muscle oxygenation were measured during each sprint. A p value ≤0.05 was considered statistically significant. PP decreased to a greater extent from sprint 1 to sprint 2 during CBFR (25.5 ± 11.9%) and IBFR (23.4 ± 9.3%) compared with NoBFR (13.4 ± 8.6%). TW was reduced similarly (17,835.6 ± 966.2 to 12,687.2 ± 675.2 J) from sprint 1 to sprint 2 for all 3 conditions, but TW was lower (collapsed across time) for CBFR (14,320.7 ± 769.1 J) than IBFR (15,548.0 ± 840.5 J) and NoBFR (15,915.4 ± 771.5 J). There were no differences in S dec (84.3 ± 1.7%, 86.1 ± 1.5%, and 87.2 ± 1.1% for CBFR, IBFR, and NoBFR, respectively) or RPE, which increased from sprint 1 (8.5 ± 0.3) to sprint 2 (9.7 ± 0.1). Collective muscle oxygenation responses increased across time and were similar among conditions, whereas increases in deoxy[heme] and total[heme] were greatest for CBFR. Applying BFR during SIT induced greater decrements in PP, and CBFR resulted in greater decrements in work across repeated sprints. The larger increases in deoxy[heme] and total[heme] for CBFR suggested it may induce greater metabolite accumulation than IBFR and NoBFR when combined with SIT.

Acute effects of low load blood flow restricted and non restricted exercise on muscle excitation, neuromuscular efficiency, and average torque.

OBJECTIVES: The purpose of this investigation was to examine the acute effects of low-load blood flow restriction (LLBFR) and low-load (LL) resistance exercise on muscle excitation, neuromuscular efficiency, and average torque. METHODS: Eleven men (age±SD=22±3yrs) randomly performed LLBFR and LL that consisted of 30 unilateral leg extensions at 30% of one-repetition maximum while surface electromyography (sEMG) and torque were simultaneously assessed. Polynomial regression analyses and slope comparisons were performed to examine patterns of responses and rates of change. RESULTS: sEMG amplitude increased for LLBFR (9 of 11) and LL (8 of 11) and between composite responses (R2=0.939-0.981). For LLBFR, sEMG amplitude increased to a greater extent for 5 of the 11 individual and for the composite responses. Similarly, neuromuscular efficiency decreased for LLBFR (8 of 11) and LL (5 of 11) as well as the composite responses r2=0.902-0.929, but the decrease was larger for LLBFR than LL for the individual (4 of 11) responses. For average submaximal concentric torque, there were individual increases, decreases, and no changes for the composite responses (R2=0.198-0.325). CONCLUSION: LLBFR elicited greater fatigue-induced increases in muscle excitation and decreases in neuromuscular efficiency than LL, but neither LLBFR nor LL affected average submaximal concentric torque.

Power/knowledge: A sociomaterial perspective on a new accreditation process during COVID-19.

INTRODUCTION: The COVID-19 pandemic had significant impacts on many aspects of health care and education, including the accreditation of medical education programmes. As a community of international educators, it is important that we study changes that resulted from the pandemic to help us understand educational processes more broadly. As COVID-19 unfolded in Canada, a revised format of undergraduate medical accreditation was implemented, including a shift to virtual site visits, a two-stage visit schedule, a focused approach to reviewing standards and the addition of a field secretary to the visit team. Our case study research aimed to evaluate the sociomaterial implications of these changes in format on the process of accreditation at two schools. METHODS: We interviewed key informants to understand the impacts, strengths and limitations of changes made to the accreditation format. We used an abductive approach to analyse transcripts and applied a sociomaterial lens in looking for interconnections between the material and social changes that were experienced within the accreditation system. RESULTS: Stakeholders within the accreditation system did not anticipate that changes to the accreditation format would have significant impacts on how accreditation functioned or on its overall outcomes. However, key informants described how the revised format of accreditation reconstructed how power was distributed and how knowledge was produced. The revised format contributed to changes in who held power within each of the programmes, within each of the visiting teams and between site members and visiting team members. As power shifted across stakeholders in response to material changes to the accreditation format, key informants described changes in how knowledge was produced. CONCLUSIONS: Our findings suggest that the most powerful knowledge about any given programme might best be obtained through individualised tools, technologies and voices that are most meaningful to the unique context of each programme. Deliberate attention to how knowledge and power are influenced by the interactions between material and social processes within accreditation may help educators and leaders see the effects of change.

Can We Rationally Design and Operate Spatial Atomic Layer Deposition Systems for Steering the Growth Regime of Thin Films?

Fine control over the growth of materials is required to precisely tailor their properties. Spatial atomic layer deposition (SALD) is a thin-film deposition technique that has recently attracted attention because it allows producing thin films with a precise number of deposited layers, while being vacuum-free and much faster than conventional atomic layer deposition. SALD can be used to grow films in the atomic layer deposition or chemical vapor deposition regimes, depending on the extent of precursor intermixing. Precursor intermixing is strongly influenced by the SALD head design and operating conditions, both of which affect film growth in complex ways, making it difficult to predict the growth regime prior to depositions. Here, we used numerical simulation to systematically study how to rationally design and operate SALD systems for growing thin films in different growth regimes. We developed design maps and a predictive equation allowing us to predict the growth regime as a function of the design parameters and operation conditions. The predicted growth regimes match those observed in depositions performed for various conditions. The developed design maps and predictive equation empower researchers in designing, operating, and optimizing SALD systems, while offering a convenient way to screen deposition parameters, prior to experimentation.

Neuromuscular Responses to Failure vs Non-Failure During Blood Flow Restriction Training in Untrained Females.

Applying blood flow restriction (BFR) during resistance exercise is a potent stimulus of muscular adaption, but there is little direct comparison of its effect on neuromuscular function. The purpose of this investigation was to compare surface electromyography amplitude and frequency responses during a 75 (1 × 30, 3 × 15) repetition bout (BFR-75) of BFR to 4 sets to failure (BFR-F). Twelve women (mean ± SD age = 22 ± 4 years; body mass = 72 ± 14.4 kg; height = 162.1 ± 4.0 cm) volunteered for the investigation. One leg was randomly assigned to complete BFR-75 and the other to BFR-F. Each leg performed isokinetic, unilateral, concentric-eccentric, leg extension at 30% of maximal strength while surface electromyographic (sEMG) data was recorded. More repetitions (p = 0.006) were completed during set 2 for BFR-F (21.2 ± 7.4) than BFR-75 (14.7 ± 1.2), but there were no other between condition differences for set 1 (29.8 ± 0.9 vs 28.9 ± 10.1), set 3 (14.4 ± 1.4 vs 17.1 ± 6.9), or set 4 (14.8 ± 0.9 vs 16.3 ± 7.0). Collapsed across condition, normalized sEMG amplitude increased (p = 0.014, 132.66 ± 14.03% to 208.21 ± 24.82%) across the first three sets of exercise then plateaued, while normalized sEMG frequency decreased (p = 0.342, 103.07 ± 3.89% to 83.73 ± 4.47%) across the first two sets then plateaued. The present findings indicated that BFR-75 and BFR-F elicited similar acute neuromuscular fatigue responses. The plateau in amplitude and frequency suggested that maximal motor unit excitation and metabolic buildup may be maximized after two to three sets of BFR-75 and BFR-F.

75-repetition versus sets to failure of blood flow restriction exercise on indices of muscle damage in women.

ABSTRACTThere is conflicting evidence regarding the prevalence and magnitude of exercise-induced muscle damage (EIMD) following low-load resistance exercise with blood flow restriction (LL + BFR) that may be related to exercise protocols. The purpose of this investigation was to examine the effects of 75-repetition (BFR-75) (1 × 30, 3 × 15) and 4 sets to failure (BFR-4x) protocols on indices of EIMD among untrained women. Thirteen women completed this investigation. One leg was randomly assigned to BFR-75 and the other to BFR-4x. Each leg performed isokinetic, unilateral, concentric-eccentric, leg extension muscle actions at 30% of maximal strength. Indices of EIMD (muscle soreness, range of motion [ROM], limb circumference, pain pressure threshold [PPT], and maximal voluntary isometric contraction [MVIC]) were recorded before exercise, 0-, 24-, 48-, 72-, and 96-hours post-exercise. There were no changes for ROM, circumference, or PPT. Muscle soreness increased similarly in both conditions 0-, 24-, and 48-hours post-exercise and MVIC increased 24-, 48-, 72-, and 96-hours post-exercise. These findings suggested BFR-75 and BFR-4x were not associated with EIMD and elicited similar physiological responses. The increases in muscle soreness may be due to metabolic stress associated with LL + BFR protocols apart from EIMD.

HighlightsThere was no evidence of significant exercise-induced muscle damage following low-load resistance exercise with blood flow restriction completed failure and non-failure.Muscle function was not impaired 24-96 h post-exercise for either protocol.Low-load resistance exercise with blood flow restriction using a 75-repetition and 4 sets to volitional failure protocol resulted in similar physiological responses to exercise.There may be higher levels of metabolic stress which may increase muscle soreness following low-load resistance exercise with blood flow restriction.

Effects of load matched isokinetic versus isotonic blood flow restricted exercise on neuromuscular and muscle function.

The purpose of this investigation was to examine neuromuscular function, muscle fatigue, rating of perceived exertion (RPE), and muscle swelling between isokinetic and isotonic leg extensions with blood flow restriction (BFR). Fourteen (21 ± 2years; 160cm ± 3.8; 61kg ± 9.1) trained women performed 75 (1 × 30,3 × 15) submaximal (30% of maximal strength), unilateral, isokinetic and isotonic leg extensions with BFR (60% of total arterial occlusion pressure). Before and after exercise, subjects performed maximal voluntary isometric contractions (MVIC) and muscle thickness (MT) was assessed with ultrasound. RPE was recorded across all sets and surface electromyography (EMG) was assessed during the MVIC muscle actions. Separate repeated measures ANOVAs were used to examine MVIC, MT, RPE and neuromuscular function. There were greater reductions in MVIC torque and EMG mean power frequency following isotonic (46.2 ± 17.1%; 16.4 ± 7.9%) than isokinetic (17.9 ± 10.9%;6.5 ± 6.3%). RPE was also higher during isotonic (7.5 ± 2.2), than isokinetic (5.7 ± 1.9). There were no differences in EMG amplitude or MT increases (20 ± 2.1%) between conditions. Isotonic BFR elicited greater fatigue-induced decreases in muscular strength and greater RPE than isokinetic BFR, but similar MT and muscle excitation responses for both conditions. Therefore, both isokinetic and isotonic may induce similar acute physiological responses, but isotonic BFR was associated with greater muscle fatigue and perceived effort.HighlightsExercise modality affects the fatigue and perceptual responses when applying blood flow restriction.Despite greater utility, isotonic blood flow restriction was associated greater fatigue and perceived effort.Isotonic and isokinetic blood flow restriction elicited comparable neural changes.

Efficacy of Cefazolin Versus Vancomycin Antibiotic Cement Spacers.

OBJECTIVE: Cefazolin is a heat-labile antibiotic that is not usually added to polymethylmethacrylate (PMMA) cement spacers because it is believed to be inactivated by the high polymerization temperatures. The purpose of this study was to compare cefazolin versus vancomycin high-dose antibiotic cement spacers. METHODS: High-dose antibiotic PMMA spacers with either cefazolin or vancomycin were fabricated. Setting time, compressive strength, and compression modulus of spacers were measured. Spacers were emerged in saline, and the eluent was tested on days 1, 2, 3, 7, 14, and 30 to determine the zone of inhibition of methicillin-sensitive Staphylococcus aureus and estimate the cumulative antibiotic released. RESULTS: Cefazolin, compared with vancomycin-loaded spacers, had significantly shorter setting time [mean difference (MD) -1.8 minutes, 95% confidence interval (CI), -0.6 to -3.0], greater compressive strength (MD 20.1 megapascal, CI, 15.8 to 24.5), and compression modulus (MD 0.15 megapascal, CI, 0.06 to 0.23). The zone of inhibition of eluent from PMMA-C spacers was significantly greater than PMMA-V spacers at all time points, an average of 11.7 ± 0.8 mm greater across time points. The estimated cumulative antibiotic released from cefazolin spacers was significantly greater at all time points ( P < 0.0001). CONCLUSIONS: Cefazolin was not inactivated by PMMA polymerization and resulted in spacers with superior antimicrobial and biomechanical properties than those made with vancomycin, suggesting that cefazolin could play a role in the treatment of infected bone defects with high-dose antibiotic PMMA spacers.

Investigating the experiences of medical students quarantined due to COVID-19 exposure.

Background: The COVID-19 pandemic profoundly impacted medical education systems worldwide. Between March 2020 and December 2021, 111 MD students at the University of Toronto completed two-week quarantines due to hospital or community exposures and experienced disrupted clinical instruction. We explored the experiences, barriers, and supports of these quarantined medical students to identify program development opportunities and improve student supports. Methods: We used a qualitative descriptive approach to explore experiences of clerkship students quarantined due to COVID-19 exposure. Methods included an online survey with open-ended questions and an audio-recorded interview. We analysed the demographic survey responses using descriptive statistics. Subsequently, we conducted descriptive thematic analysis of the narrative survey responses and transcribed interview recordings. Results: Concerns reported in surveys (n = 23, response rate 20.7%) and interviews (n = 5) included themes of illness uncertainty, racial tensions, confidentiality of COVID-19 status, unclear academic expectations, and financial burden. Supports included friends, family, and MD program administration. Recommendations related to communication, administration, equity considerations, supports, confidentiality/privacy, and academics. Conclusion: Supporting student wellbeing and learning is at the core of medical training. Enhanced understanding of health profession trainee needs during COVID can improve institutional supportive responses to students routinely and during times of crisis.

Contexte: La pandémie de la COVID-19 a eu des répercussions importantes sur les systèmes d'éducation médicale dans le monde entier. Entre mars 2020 et décembre 2021, 111 étudiants en médecine de l'Université de Toronto ont été contraints à l'auto-isolement pour une période de deux semaines après une exposition au virus à l'hôpital ou dans la collectivité, voyant du même coup leur apprentissage clinique perturbé. Nous avons exploré les expériences, les obstacles et les types de soutien que ces étudiants ont eus alors qu'ils étaient en quarantaine pour en tirer des leçons afin d'améliorer notre programme et de mieux soutenir nos étudiants. Méthodes: Nous avons utilisé une approche qualitative descriptive pour explorer le vécu des étudiants à l'externat mis en quarantaine en raison d'une exposition à la COVID-19. Les méthodes comprenaient une enquête en ligne avec des questions ouvertes et une interview enregistrée. Nous avons analysé les données démographiques à l'aide de méthodes statistiques descriptives. Par la suite, nous avons effectué une analyse thématique descriptive des réponses narratives à l'enquête en ligne et des transcriptions des entretiens. Résultats: Les préoccupations signalées dans les réponses à l'enquête en ligne (n=23, taux de réponse de 20,7 %) et les entretiens (n=5) touchaient à l'incertitude face à la maladie, aux tensions raciales, à la confidentialité du fait d'avoir été infecté , au manque de clarté quant aux attentes académiques, et au fardeau financier. Les sources de soutien citées comprenaient les amis, la famille et l'administration du programme d'études. Les recommandations concernaient la communication, l'administration, les considérations d'équité, le soutien, la confidentialité et les études. Conclusion: Le soutien au bien-être et à l'apprentissage des étudiants est au cœur de la formation médicale. Une meilleure compréhension des besoins des stagiaires des professions de la santé à l'occasion d'une infection par la COVID-19 peut améliorer le soutien institutionnel qui leur est offert en temps normal et en temps de crise.