Consistency and cost of dual-task gait balance measure in healthy adolescents and young adults.

Matched control data are commonly used to examine recovery from concussion. Limited data exist, however, examining dual-task gait data consistency collected over time in healthy individuals. The study purposes were to: 1) assess the consistency of single-task and dual-task gait balance control measures, 2) determine the minimal detectable change (MDC) of gait balance control measures, and 3) examine the extent to which age and task complexity affect dual-task walking costs in healthy adolescents and young adults.

Initial somatic symptoms are associated with prolonged symptom duration following concussion in adolescents.

Aim: To determine which initial postinjury symptom domains are independently associated with symptoms lasting >28 days in youth athletes who sustained sport-related concussions.

Methods: Patients who presented for care at a sport concussion clinic completed the postconcussion symptom scale. They were classified into two groups: those who reported symptom resolution within 28 days of injury and those who did not.

Examination of Age-Related Differences on Clinical Tests of Postural Stability.

Background: The modified Balance Error Scoring System (mBESS) and Y-Balance Test are common clinical measurements of postural control, but little is known about the effect of age on performance of these tasks. The purpose of this study was to examine how healthy child and adolescent athletes perform on 2 common clinical measurements of postural control.

Hypothesis: Younger athletes would demonstrate poorer postural control compared with older athletes.

In Vitro Expansion of Bone Marrow Derived Mesenchymal Stem Cells Alters DNA Double Strand Break Repair of Etoposide Induced DNA Damage.

Mesenchymal stem cells (MSCs) are of interest for use in diverse cellular therapies. Ex vivo expansion of MSCs intended for transplantation must result in generation of cells that maintain fidelity of critical functions. Previous investigations have identified genetic and phenotypic alterations of MSCs with in vitro passage, but little is known regarding how culturing influences the ability of MSCs to repair double strand DNA breaks (DSBs), the most severe of DNA lesions.

Single-leg postural stability deficits following anterior cruciate ligament reconstruction in pediatric and adolescent athletes.

The objective of this study was to compare the postural stability of pediatric and adolescent athletes without anterior cruciate ligament injury with those who underwent anterior cruciate reconstruction (ACLR). Postural stability ratings derived from a video-force plate system during the three stances of the modified Balance Error Scoring System were collected from pediatric and adolescent athletes who underwent ACLR (N=24; mean 1.2 years after surgery) and from uninjured controls (N=479).

Normative values for a video-force plate assessment of postural control in athletic children.

The objective of this study was to provide normative data for young athletes during the three stances of the modified Balance Error Scoring System (mBESS) using an objective video-force plate system. Postural control was measured in 398 athletes between 8 and 18 years of age during the three stances of the mBESS using a video-force plate rating system. Girls exhibited better postural control than boys during each stance of the mBESS.

Physical Activity Level and Symptom Duration Are Not Associated After Concussion.

Background: Physical rest after a concussion has been described as a key component in the management of the injury. Evidence supporting this recommendation, however, is limited.

Purpose: To examine the association between physical activity and symptom duration in a cohort of patients after a concussion.

The Relative Age Effect on Youth Sports Injuries.

Introduction/purpose: The relative age effect (RAE) has been described as the consequence of differences in ages between individuals within the same age group. In youth sports, relatively older children may have a physical and developmental advantage over younger children. The purpose of this study was to determine the relationship between relative age and sports injury in a cohort of pediatric athletes.

Myeloid Sarcoma of the Bladder in the Setting of Refractory Anemia with Excess Blasts-2 (RAEB-2).

Myeloid sarcoma is an extramedullary tumor consisting of immature hematopoietic cells of granulocytic or monocytic differentiation. While rare, it can be seen in a variety of clinical settings and is most commonly associated with acute myeloid leukemia (AML), myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN). We present a rare case of myeloid sarcoma occurring in the bladder of a 56 year old male.

A Randomized, Blinded Study to Validate the Merz Hand Grading Scale for Use in Live Assessments.

Background: The Merz Hand Grading Scale (MHGS) is a 5-point scale used to grade appearance of the dorsum of the hand. The MHGS has been previously validated for assessment of photographed hands but not for live assessment.

Objective: The purpose of this randomized, blinded study was to validate the MHGS for live assessment of the hands in the clinical setting.

Concussion Management Practice Patterns Among Sports Medicine Physicians.

Objective: The primary purpose of this study was to examine concussion management practice patterns among sports medicine physicians in the United States.

Design: Cross-sectional study using a web-based survey.

Participants: Members of the American Medical Society for Sports Medicine (AMSSM).

Assessing the Capacity of the US Health Care System to Use Additional Mechanical Ventilators During a Large-Scale Public Health Emergency.

Objective: A large-scale public health emergency, such as a severe influenza pandemic, can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use.

Methods: We identified key components of the health care system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (ie, conventional, contingency, and crisis), and determined the constraining key component at each capacity level.

Identification of multiple dityrosine bonds in materials composed of the protein Ultrabithorax.

The recombinant protein Ultrabithorax (Ubx), a Hox transcription factor, self-assembles into biocompatible materials that are remarkably extensible and strong. Here, we demonstrate that the strength of Ubx materials is due to intermolecular dityrosine bonds. Ubx materials auto-fluoresce blue, a characteristic of dityrosine, and bind dityrosine-specific antibodies.

Variability in phenotype induced by the podocin variant R229Q plus a single pathogenic mutation.

Background: Mutations in podocin (NPHS2) are the most common cause of childhood onset autosomal recessive steroid-resistant nephrotic syndrome (SRNS). The disease is characterized by early-onset proteinuria, resistance to immunosuppressive therapy and rapid progression to end-stage renal disease. Compound heterozygous changes involving the podocin variant R229Q combined with another pathogenic mutation have been associated with a mild phenotype with disease onset often in adulthood.

Return to Physical Activity Timing and Dual-Task Gait Stability Are Associated 2 Months Following Concussion.

Objective: The effect of physical activity resumption on functional recovery following concussion is poorly understood. We sought to examine the relationship between physical activity resumption timing and gait stability 2 months following concussion.

Setting: Motion analysis laboratory.

Monitoring recovery of gait balance control following concussion using an accelerometer.

Despite medical best-practice recommendations, no consistent standard exists to systematically monitor recovery from concussion. Studies utilizing camera-based systems have reported center-of-mass (COM) motion control deficits persisting in individuals with concussion up to two months post-injury. The use of an accelerometer may provide an efficient and sensitive method to monitor COM alterations following concussion that can be employed in clinical settings.

In vivo Modeling Implicates APOL1 in Nephropathy: Evidence for Dominant Negative Effects and Epistasis under Anemic Stress.

African Americans have a disproportionate risk for developing nephropathy. This disparity has been attributed to coding variants (G1 and G2) in apolipoprotein L1 (APOL1); however, there is little functional evidence supporting the role of this protein in renal function. Here, we combined genetics and in vivo modeling to examine the role of apol1 in glomerular development and pronephric filtration and to test the pathogenic potential of APOL1 G1 and G2.

A blinded, randomized, split-face pilot study of bruising and pain with hyaluronic acid for correction of perioral lines using no lidocaine, lidocaine alone, and lidocaine and epinephrine.

Background: Hyaluronic acid (HA) fillers are sometimes mixed with lidocaine to mitigate pain. Whether the addition of epinephrine to lidocaine provides greater benefits in bruising and pain has not been fully reported.

Objectives: The investigators explored the severity of bruising and pain in patients treated with the cohesive polydensified matrix HA (CPMHA) in 3 different preparations: CPMHA (Belotero Balance [BEL]), CPMHA with lidocaine (BEL-L), and CPMHA with lidocaine and epinephrine (BEL-LE).

Ultrastructural analysis of 3 hyaluronic acid soft-tissue fillers using scanning electron microscopy.

Background: Although hyaluronic acid (HA) specifications such as molecular weight and particle size are fairly well characterized, little information about HA ultrastructural and morphologic characteristics has been reported in clinical literature.

Objective: To examine uniformity of HA structure, the effects of extrusion, and lidocaine dilution of 3 commercially available HA soft-tissue fillers.

Materials And Methods: Using scanning electron microscopy and energy-dispersive x-ray analysis, investigators examined the soft-tissue fillers at various magnifications for ultrastructural detail and elemental distributions.

Adolescents demonstrate greater gait balance control deficits after concussion than young adults.

Background: Age has been described as a factor that affects recovery after concussion. The recommended management protocol is to treat adolescents in a more cautious manner than adults. However, few studies have prospectively and longitudinally assessed the way these age groups perform on motor tasks after concussion.

Detecting acute distress and risk of future psychological morbidity in critically ill patients: validation of the intensive care psychological assessment tool.

Introduction: The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units.

Regional changes in elastic fiber organization and transforming growth factor β signaling in aortas from a mouse model of marfan syndrome.

In Marfan Syndrome (MFS), development of thoracic aortic aneurysms (TAAs) is characterized by degeneration of the medial layer of the aorta, including fragmentation and loss of elastic fibers, phenotypic changes in the smooth muscle cells, and an increase in the active form of transforming growth factor-β (TGFβ), which is thought to play a major role in development and progression of the aneurysm. We hypothesized that regional difference in elastic fiber fragmentation contributes to TGFβ activation and hence the localization of aneurysm formation. The fibrillin-1-deficient mgR/mgR mouse model of MFS was used to investigate regional changes in elastin fiber fragmentation, TGFβ activation and changes in gene expression as compared to wild-type littermates.