Effects of Physical Therapy and Dalfampridine on Function and Quality of Life in Nonambulatory Individuals With Multiple Sclerosis: A Randomized Controlled Trial.

Background: Decreases in mobility, quality of life (QOL) and cognition are commonly seen in people with multiple sclerosis (MS). Physical therapy (PT) and exercise have been shown to improve many symptoms in ambulatory individuals with MS; however, evidence in nonambulatory people with MS is lacking. Dalfampridine is a US Food and Drug Administration-approved medication for MS that treats impaired ambulation by enhancing nerve conduction.

Adults are not older adolescents: comparing physical therapy findings among adolescents, young adults and older adults with persistent post-concussive symptoms.

Objective: Individuals with persistent post-concussive symptoms (PPCS) may present with a myriad of physical symptoms. There is limited research available comparing the presence of examination findings among individuals with PPCS from different age groups.

Methods: Retrospective case-control chart review of 481 patients with PPCS and 271 non-trauma controls.

Feasibility and safety of a robotic approach to diverticular disease: a retrospective series of short-term outcomes.

Backgrounds: Robotic colorectal surgery is a method of performing complex surgery in a minimally invasive manner. In diverticular disease, chronic inflammation obscures tissues planes and increases difficulty of resection. This study aims to assess feasibility and safety of application of a robotic approach to diverticular disease, by reviewing short-term outcomes from a series of diverticular resections.

A prospective study to validate the expanded timed get-up-and-go in a population with multiple sclerosis.

Background: Timed 25-foot walk (T25FW) test serves as gold standard in care of persons with multiple sclerosis (PwMS) and as walking measure of regulatory trials.

Objective: To validate and determine the clinical utility of Expanded Timed Get-Up and Go (ETGUG) as a disability measure in MS.

Methods: ETGUG intra-rater and inter-rater reproducibility was determined in 65 PwMS that were examined twice in two centres over 1-week.

Three-Day Dietary Manipulation in Multiple Sclerosis: Exercise and Fatigue Outcomes.

Background: In persons with multiple sclerosis (MS), the effect of nutrition on exercise performance and fatigue remains unknown. The objective was to determine whether a 3-day diet high in triglycerides (FAT) compared with a 3-day diet high in carbohydrates (CARB) would improve fatigue and exercise performance in persons with MS.

Methods: A randomized controlled crossover design was incorporated to study FAT versus CARB on submaximal cycling endurance (60% of peak oxygen consumption), substrate utilization, and fatigue in 12 persons with mild-to-moderate MS (Expanded Disability Status Scale score, 2.

Persistent Postoperative Opioid Prescription Fulfillment and Peripheral Nerve Blocks for Ambulatory Shoulder Surgery: A Retrospective Cohort Study.

Background: There is need to identify perioperative interventions that decrease chronic opioid use. The authors hypothesized that receipt of a peripheral nerve block would be associated with a lower incidence of persistent postoperative opioid prescription fulfillment.

Methods: This was a retrospective population-based cohort study examining ambulatory shoulder surgery patients in Ontario, Canada.

Rehabilitation of Concussion and Persistent Postconcussive Symptoms.

Concussion and persistent postconcussive symptoms (PPCS) are encountered by clinicians in sports medicine, pediatrics, neurology, physiatry, emergency medicine, and primary care. Clinical management may require a multidisciplinary approach. This article presents a structured method for the diagnosis of concussion and PPCS in the outpatient setting, which includes a history, physical examination, and additional tests as clinically indicated to help identify underlying symptom generators.

Breast ultrasound in breast cancer surveillance; incremental cancers found at what cost?

Purpose: To determine the diagnostic parameters of breast ultrasound (US) in the setting of routine radiological surveillance after a diagnosis of breast cancer and evaluate costs of the inclusion of breast US as well as any survival benefit of US detected cases of recurrence in surveillance.

Methods: 622 patients underwent breast cancer surgery and follow up at Austin Health from July 2009 to December 2015. Retrospective data analysis was performed to determine; diagnostic parameters, financial costs of US and survival outcomes of US detected cases of recurrence.

"First Do No Harm": Significance of Delays from Diagnosis to Surgery in Patients with Non-metastatic Breast Cancer.

Background: The majority of patients with non-metastatic breast cancer will undergo surgery. This involves complex decisions that inevitably increase time from diagnosis to surgery beyond the currently recommended 30 days. This study aims to analyse factors that increase time to surgery and establish whether it is justifiable in the context of improved individualised breast cancer management.

Investigation and management of a large community mumps outbreak among young adults in Toronto, Canada, January 2017-February 2018.

Background: In 2017, a mumps outbreak was identified in a cohort of 18-34 year olds in Toronto, Canada.

Objective: To describe a large community mumps outbreak in an urban centre from January 2017 to February 2018 among young adults.

Methods: A broad range of interventions were implemented in an attempt to reach the target audience; including case and contact management, vaccination clinics at schools and clinicians' offices, school exclusions, bar inspections, traditional communication strategies (including health care provider updates and posters) and newer communication strategies (including three sequential social media campaigns).

Impact of Nutritional Intake on Function in People with Mild-to-Moderate Multiple Sclerosis.

Background: We sought to assess the associations between nutrition and ambulation, daily activity, quality of life (QOL), and fatigue in individuals with mild-to-moderate disability with multiple sclerosis (MS).

Methods: This cross-sectional pilot study included 20 ambulatory adult volunteers with MS (14 women and 6 men; mean ± SD age, 57.9 ± 10.

Humanitarian applications of machine learning with remote-sensing data: review and case study in refugee settlement mapping.

The coordination of humanitarian relief, e.g. in a natural disaster or a conflict situation, is often complicated by a scarcity of data to inform planning.

Validity and Reliability of Four Clinical Gait Measures in Patients with Multiple Sclerosis.

Background: The gold standards for assessing ambulation are the Expanded Disability Status Scale (EDSS) and the Timed 25-Foot Walk (T25FW) test. In relation with these measures, we assessed the reliability and validity of four clinical gait measures: the Timed Up and Go (TUG) test, the Dynamic Gait Index (DGI), the 2-Minute Walk Test (2MWT), and the 6-Minute Walk Test (6MWT). Patient self-report of gait was also assessed using the 12-item Multiple Sclerosis Walking Scale (MSWS-12).

Prescribing smoked cannabis for chronic noncancer pain: preliminary recommendations.

Objective: To offer preliminary guidance on prescribing smoked cannabis for chronic pain before the release of formal guidelines.

Quality Of Evidence: We reviewed the literature on the analgesic effectiveness of smoked cannabis and the harms of medical and recreational cannabis use. We developed recommendations on indications, contraindications, precautions, and dosing of smoked cannabis, and categorized the recommendations based on levels of evidence.

Effects of sleep restriction on the human plasma metabolome.

This study examined the effects of recurrent sleep restriction on the plasma metabolome of adults with familial risk of type 2 diabetes. Eleven healthy adults (6M/5F; mean [SD] age: 26 [3]years; BMI 23.5 [2.

Sleep restriction decreases the physical activity of adults at risk for type 2 diabetes.

Study Objective: To test the hypothesis that recurrent sleep curtailment will result in decreased physical activity in adults at risk for type 2 diabetes.

Design: Two-condition 2-period randomized crossover study.

Setting: University General Clinical Research Center.

Reduced physical activity in adults at risk for type 2 diabetes who curtail their sleep.

Adults with parental history of type 2 diabetes have high metabolic morbidity, which is exacerbated by physical inactivity. Self-reported sleep <6 h/day is associated with increased incidence of obesity and diabetes, which may be mediated in part by sleep-loss-related reduction in physical activity. We examined the relationship between habitual sleep curtailment and physical activity in adults with parental history of type 2 diabetes.

Sleep and eating behavior in adults at risk for type 2 diabetes.

Insufficient quantity and quality of sleep may modulate eating behavior, everyday physical activity, overall energy balance, and individual risk of obesity and type 2 diabetes. We examined the association of habitual sleep quantity and quality with the self-reported pattern of eating behavior in 53 healthy urban adults with parental history of type 2 diabetes (30 F/23 M; mean (s.d.

Changes in insulin secretion and action in adults with familial risk for type 2 diabetes who curtail their sleep.

Objective: Experimental sleep deprivation is accompanied by changes in glucose regulation. However, the effects of chronic sleep insufficiency on insulin secretion and action in populations at high risk for type 2 diabetes are not known. This study examined the relationship between objectively documented habitual sleep curtailment and measures of insulin sensitivity, insulin secretion, and oral glucose tolerance in free-living adults with parental history of type 2 diabetes.

Acute and chronic effects of ketamine on semantic priming: modeling schizophrenia?

Acute administration of the N-methyl-D-aspartate receptor antagonist ketamine induces schizophrenia-like symptoms in healthy volunteers; furthermore, a window on ketamine's chronic effects is provided by regular recreational users. The current study utilized both acute ketamine administration in healthy volunteers and chronic ketamine abusers to investigate semantic processing, one of the key cognitive deficits in schizophrenia. Semantic processing was examined using a semantic priming paradigm.

The incidence of unpleasant dreams after sub-anaesthetic ketamine.

Rationale: Ketamine is an N-methyl-D: -aspartate (NMDA) receptor antagonist with psychotogenic effects and for which there are diverse reports of whether pleasant or unpleasant dreams result during anaesthesia, post-operatively or after sub-anaesthetic use.

Objective: To assess in healthy volunteers the incidence of unpleasant dreams over the three nights after receiving a sub-anaesthetic dose of ketamine, in comparison to placebo, and with retrospective home nightmare frequency as a covariate.

Method: Thirty healthy volunteers completed questionnaires about retrospective home dream recall and were then given either ketamine (n = 19, males = 9, mean age = 23.

Unlabeled probes for the detection and typing of herpes simplex virus.

Background: Unlabeled probe detection with a double-stranded DNA (dsDNA) binding dye is one method to detect and confirm target amplification after PCR. Unlabeled probes and amplicon melting have been used to detect small deletions and single-nucleotide polymorphisms in assays where template is in abundance. Unlabeled probes have not been applied to low-level target detection, however.