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This study evaluated the effects of a 10-month neuromuscular training (NMT) intervention on muscle architecture, isometric force production, and stretch-shortening cycle (SSC) function. Thirty-seven girls aged 6-12 years were placed into gymnastics + NMT (gNMT; n = 15), gymnastics only (GYM; n = 10), or maturity-matched control (CON; n = 12) groups. The gNMT group followed a 10-month NMT program in addition to gymnastics training, whereas the GYM group only participated in gymnastics training. Isometric midthigh pull (IMTP) and drop jump (DJ) kinetics were measured, in addition to muscle thickness, fascicle length, and pennation angle of the gastrocnemius medialis at baseline and at 4, 7, and 10 months. A3 x 4 (group x time) repeated-measures ANCOVA (covariate, % predicted adult height) was used to evaluate within-group changes. Significance level was set at p < 0.05. Significant interaction effects were observed in muscle thickness, absolute (PFabs) and relative peak force (PFrel) in the IMTP and various DJ variables. The gNMT group demonstrated improvements in muscle thickness, IMTP PFabs and PFrel, and DJ kinetics, most commonly evidenced from 7 months onward. The GYM group's muscle thickness also significantly improved, accompanied by improvements in some DJ kinetics. The CON group did not experience any desirable changes. Overall, NMT elicited positive changes in muscle thickness, PFabs and PFrel, and SSC function to a greater extent than gymnastics training alone or growth and maturation. As most adaptations took 7 months, longer-term NMT programs should be implemented with youth female gymnasts. [ABSTRACT FROM AUTHOR]

Objective: To provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases. Background: Adrenal glands are a common site of metastases in many malignancies. Diagnosis of adrenal metastases is on the rise, leading to an increasing number of patient candidates for surgery without consensual management. Methods: We conducted a population-based study between January 2012 and December 2022 using the French National Health Data System (SNDS) and the Eurocrine registry (NCT03410394). The first database exhaustively covers all procedures carried out in France, while the second provides more clinical information on procedures and tumor characteristics, based on the experience of 11 specialized centers. Results: From the SNDS, we extracted 2515 patients who underwent adrenalectomy for secondary malignancy and 307 from the Eurocrine database. The most common primary malignancies were lung cancer (n = 1203, 47.8%) and renal cancer (n = 555, 22.1%). One-year survival was 84.3% (n = 2120). Thirty-day mortality and morbidity rates were, respectively, 1.3% (n = 32) and 29.9% (n = 753, including planned intensive care unit - stays). Radiotherapy within the year before adrenalectomy was significantly associated with higher 30-day major complication rates (P = 0.039). In the Eurocrine database, the proportion of laparoscopic procedures reached 85.3% without impairing resection completeness (R0: 92.9%). Factors associated with poor overall survival were the presence of extra-adrenal metastases (hazard ratio = 0.64; P = 0.031) and incomplete resection ( ≥R1; hazard ratio = 0.41; P = 0.015). Conclusions: The number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery. [ABSTRACT FROM AUTHOR]

Study Design. Systematic review and meta-analysis. Objective. Describe the impact of endplate coverage on HO in cervical disc replacement (CDR). Summary of Background Data. CDR is a motion-sparing alternative to anterior cervical discectomy and fusion. However, the high prevalence of heterotopic ossification threatens to diminish range of motion and limit this benefit associated with CDR. Materials and Methods. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EMBASE and PubMed databases were queried. Results were deduplicated and screened. Relevant studies were included. All metrics that were reported in ≥3 studies were aggregated for analysis. SPSS was used to perform the meta-analysis. Results. A total of 10 studies were included in the systematic review. Endplate coverage was assessed using a wide variety of measurements, including anteroposterior implant depth (ID), endplate depth (ED), exposed endplate depth (EED), implant depth to endplate depth ratio (ID:ED), EED to ED ratio (EED: ED), implant width (IW) to endplate width (EW) ratio (IW:EW), and the implant area (IA) to endplate area (EA) ratio (IA:EA). No evidence has linked ID (three studies) to HO. Mixed evidence has linked ID:ED (3/5) and IW:ED (1/2) to HO. All available evidence has linked ED (2), EED (4), EED:ED (2), and IA:EA (1) to HO. In our meta-analysis, ID was not found to be a significant risk factor for HO. However, EED and ID:ED were found to be significant risk factors for HO formation. Conclusions. Exposed endplate, especially as assessed by EED and ID:ED, is a significant risk factor for HO. Surgeons should focus on preoperative planning and intraoperative implant selection to maximize endplate coverage. While optimizing technique and implant selection is crucial, improved implant design may also be necessary to ensure that appropriate implant-endplate footprint matching is possible across the anatomic spectrum. [ABSTRACT FROM AUTHOR]

Exercise-induced bronchospasm (EIB) is a problem encountered by many people, and although it can be controlled, it is often overlooked or attributed to deconditioning. Children and elite athletes tend to have an increased incidence of EIB, but this condition is also encountered in others. Unfortunately, many who must deal with this disease tend to limit the level of exercise that provokes symptoms or avoid exercise altogether. EIB can occur alone or in association with underlying asthma. This article discusses EIB, its management, and strategies for nurses when caring for patients with EIB. [ABSTRACT FROM AUTHOR]

Telementoring is a valuable workforce development resource that connects subject matter experts with healthcare providers via videoconferencing. This technology can deliver training, education, and ongoing technical support to build workforce capacity. Arizona State University (ASU) has leveraged a widely used telementoring platform, Project ECHO, to disseminate best practices in palliative medicine. The model has increased clinician knowledge and confidence, and the learning network may provide protective factors for clinician wellness. The replicable and inclusive nature of telementoring platforms creates educational opportunities to align learners across the didactic and clinical years of medical training, as well as into early- and midcareer for physician associates/assistants (PAs). Telementoring programs can be used across the PA learning continuum, including in PA training programs. [ABSTRACT FROM AUTHOR]

BACKGROUND: HIF (hypoxia inducible factor) regulates many aspects of cardiac function. We and others previously showed that chronic HIF activation in the heart in mouse models phenocopies multiple features of ischemic cardiomyopathy in humans, including mitochondrial loss, lipid accumulation, and systolic cardiac dysfunction. In some settings, HIF also causes the loss of peroxisomes. How, mechanistically, HIF promotes cardiac dysfunction is an open question. METHODS: We used mice lacking cardiac pVHL (von Hippel-Lindau protein) to investigate how chronic HIF activation causes multiple features of ischemic cardiomyopathy, such as autophagy induction and lipid accumulation. We performed immunoblot assays, RNA sequencing, mitochondrial and peroxisomal autophagy flux measurements, and live cell imaging on isolated cardiomyocytes. We used CRISPR-Cas9 gene editing in mice to validate a novel mediator of cardiac dysfunction in the setting of chronic HIF activation. RESULTS: We identify a previously unknown pathway by which cardiac HIF activation promotes the loss of mitochondria and peroxisomes. We found that DEPP1 (decidual protein induced by progesterone 1) is induced under hypoxia in a HIF-dependent manner and localizes inside mitochondria. DEPP1 is both necessary and sufficient for hypoxia-induced autophagy and triglyceride accumulation in cardiomyocytes ex vivo. DEPP1 loss increases cardiomyocyte survival in the setting of chronic HIF activation ex vivo, and whole-body Depp1 loss decreases cardiac dysfunction in hearts with chronic HIF activation caused by VHL loss in vivo. CONCLUSIONS: Our findings identify DEPP1 as a key component in the cardiac remodeling that occurs with chronic ischemia. [ABSTRACT FROM AUTHOR]

Introduction: The definition of excellence in physical therapy (PT) education is evolving, yet the role of postprofessional residency education remains uncertain. Arguments in favor of required residency have emerged through the re-visioning of PT education across the continuum. Yet, little evidence exists whether residency education further develops clinical skills, clinical knowledge, and clinical reasoning abilities. Review of literature: Previous studies have explored the development of the novice physical therapist in the first 2 years of practice; however, there is little evidence about the outcomes of PT residency education. Thus, this study looked to explore the development of learners through their residency education and to identify the critical elements of the teaching and learning environment in residency education. Subjects: Eleven PT residency programs and 13 residents participated in a qualitative study to explore the learner development through residency. Each residency program consisted of a residency program director, one or more mentors identified by the residency program director, and at least one physical therapist resident. Semistructured interviews were conducted with program participants, and journal entries were collected from residents. Methods: Using a purposeful sample of convenience, an exploratory, multiple-site/specialty area qualitative case study design was conducted. Results: Three emerging themes were identified including growth of self, becoming a member of the community of practice, and facilitation of learning through mentoring. Through the transformative journey of residency education, there are critical elements of the learning environment supporting deep learning within the community of practice. These elements include the provision of opportunities and adequate time and space for learning to occur. Discussion and conclusion: The intentional design of the community of practice through residency education facilitates the development of the novice clinician to experienced clinician in an accelerated period of time. In addition, residency graduates develop characteristics similar to adaptive learners through planned teaching and learning opportunities. Finally, the structure of residency education mattered to the resident participants such that the learning environment enhanced peer learning and the development of professional relationships. [ABSTRACT FROM AUTHOR]

Relationships between force-generating capabilities and weightlifting performance (e.g., snatch, clean and jerk [C&J], and combined total) have previously been explored in adult weightlifters; however, associations in young athletes are unknown. The purpose of this study was twofold: (a) to examine the relationships between countermovement jump (CMJ) and isometric midthigh pull (IMTP) kinetics and weightlifting performance in young weightlifters and (b) to determine the proportion of weightlifting performance that could be accounted for by CMJ and IMTP kinetics using principal component analysis (PCA). Thirty-seven young weightlifters (12-18 years of age) completed 3 trials of CMJ and 2 trials of the IMTP assessments on dual force plates. Recent competition maximum loads, obtained within 2 weeks of the data collection, for the C&J and snatch were also recorded. Pearson's zero-order correlation coefficients demonstrated moderate to very high correlations (r = 0.359-0.801; all p ≤ Benjamini-Hochberg critical values [B-Hα]) between CMJ kinetic variables, including jump height, average braking force, average braking velocity, absolute and relative braking net impulse, absolute and relative force at minimum displacement, absolute and relative propulsive force, absolute and relative propulsive net impulse and average propulsive velocity, and weightlifting performance. High to very high correlations were evident between IMTP peak force and relative peak force and all weightlifting performance metrics (snatch, C&J, combined total, combined total [kg]/body mass [kg-0.67], and Sinclair's total; r = 0.538-0.796; p ≤ B-Hα). Components from the PCA were used to conduct stepwise, multiple, linear regression analyses. Moderate (45.8-52.9%) and large percentages (79.1-81.3%) of variance in absolute measures of weightlifting performance were explained by IMTP peak force variables and CMJ propulsive variables, respectively. These novel findings indicate that IMTP peak force variables and CMJ propulsive variables could provide valuable insight for talent identification and long-term athletic development in junior weightlifting pathways. [ABSTRACT FROM AUTHOR]

This article proposes a conceptual framework to optimize clinical decision making during patient selection for knee arthroplasty. It discusses why a clearer conceptualization of patient selection is needed for knee arthroplasty. It states that the proposed conceptual framework serves to organize existing factors and potential new factor that may emerge in the future.