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Objective: To determine the time needed to heat hot packs to water temperature (73-75 degrees C) in 4- and 8-pack HYDROCOLLATOR units. Design and Setting: A 2 x 2 factorial design, with heating unit (4- or 8-pack) and number of packs added (1 or 3/7) as independent variables. Dependent variables were hot-pack and Hydrocollator-water temperatures. Measurements: Temperatures were measured with type T thermocouples interfaced with a 16-channel ISOTHERMEX. Hydrocollator temperatures were measured with 2 thermocouples, and hot-pack temperatures, with 6 thermocouples inserted in 6 cells of a hydrated, 10- by 12-in Hydrocollator pack. Temperature was measured every 30 s for 5 min before and 45 min after pack immersion. Results: Packs warmed rapidly from approximately 18 to 65-68 degrees C by 10 min and to 72.5-75 degrees C by 20 min. Heating slowed by approximately 5% when 7 packs were added to the large unit. Water temperatures decreased approximately 2 degrees C (from approximately 75 degrees C) after 7 packs were immersed and returned to preimmersion temperatures by 20 min. Conclusions: Rewarming is quicker than commonly believed (20-150 min) and might be a function of the number of packs being simultaneously warmed. [ABSTRACT FROM AUTHOR]

Problem: Isokinetic contractions are thought to be superior to isotonic contractions for developing strength because resistance during them is greater. Because isokinetic resistance is accommodating, however, it decreases with fatigue. It is constant during multiple repetitions, so an aggressive isotonic procedure should produce more force as the muscle fatigues, which would be an advantage in strength development. Purpose: To compare force production in isokinetic and isotonic muscle contractions at the beginning and end of a set of fatiguing repetitions. Methods: Sub-jects performed 25 maximal-effort iso-kinetic knee extensions at 60¡/s. After 25-72 hours, they performed maximal repetitions isotonically using 70% of the isokinetic peak torque with speed set at a maximum of 300¡/s. Results: Peak force during the first 3 repetitions was greater isokinetically, but average force was similar. During the last 3 repeti-tions, isotonic force was higher than isokinetic force. Conclusion: Muscle is more active as it nears fatigue during an isotonic contraction. These data support the hypothesis that isotonic contractions re-cruit extra motor units at the point of fatigue. [ABSTRACT FROM AUTHOR]

Constant compression is essential during immediate care when the goal is to prevent edema.Intermittent compression is best when the goal is remove edema.Elastic wraps should be applied over ice bags.It is recommended that elastic wraps be stretched to 75% of their capacity when applied with one-third to one-half overlap. [ABSTRACT FROM AUTHOR]

Context: Therapeutic modality control variables are thought to be thermal neutral, a term sometimes used interchangeably with room temperature. We question this common assumption. Objective: To determine thermal neutrality of common therapeutic modality control variables. Design: We performed 5 laboratory experiments, including (1) water temperature over 3 weeks in 3 different containers (glass, plastic, and polystyrene); (2) water temperature and volume of 4 beakers (2 insulated, 2 uninsulated) over 4 weeks, with 1 beaker of each type covered by polyethylene; and skin interface temperature of (3) a dry, nonheated hydrocollator pack held against the chest, (4) kitty litter applied to the knee, and (5) room-temperature ultrasound gel to the forearm. Setting: Therapeutic modalities laboratory. Patients or Other Participants: College student volunteers were subjects in experiments 3, 4, and 5. Main Outcome Measure(s): We measured temperature and volume change. Data were evaluated using descriptive and interferential statistics. Results: Water temperature plateaued significantly below room temperature. Temperatures significantly increased in all but the open, insulated container. Open containers plateaued at approximately 2°C below room temperature and lost significant amounts of water; closed containers plateaued at room temperature with negligible water loss. In experiments 3 through 5, skin temperatures rose significantly during hydrocollator pack, kitty litter, and ultrasound gel application. Conclusions: Room-temperature water baths, dry hydrocollator packs, kitty litter, and ultrasound gel were not thermally neutral. Room temperature should not be used synonymously with thermal neutral. Care must be taken to ensure that control variables truly are controlled. [ABSTRACT FROM AUTHOR]

Context: The amount of retained ankle flexibility gains and the effects of diathermy on those gains are unclear. Objective: To determine the retention of flexibility 3 weeks after an 18-day stretching regime and the effect of pulsed, shortwave diathermy on that retention. Design: We used a 2x4 factorial with repeated measures on day (1, 19, 24, and 39). The other independent variable was treatment (stretch only versus diathermy and stretch). The dependent variable was ankle-dorsiflexion angular displacement as measured on a digital inclinometer. Setting: Therapeutic Modality Research Laboratory. Patients or Other Participants: 23 healthy college-aged volunteers (8 males, 15 females; age = 22.7 +/- 2.1 years, height = 171.1 +/- 8.8 cm, mass = 70.4 +/- 13.5 kg). Interventions: All subjects performed 3 weeks (not including weekends) of low-load, prolonged, long-duration stretching. One group performed stretching only; the other group also received diathermy. Main Outcome Measure(s): After an 18-day stretching regime and 7-day retention study, subjects returned 14 days later for the 3-week retention measure. The angle of inclination from the posterior Achilles tendon to the sole of the shoe near the heel was measured on each treatment and test day. Results: Regardless of group (F(1,21) = 0.74, P = 0.40), the flexibility gained between days 1 (99.7 +/- 4.0 degrees), 19 (102.9 +/- 5.8 degrees ), and 24 (105.0 +/- 6.2 degrees) were maintained at day 39 (104.8+/- 7.2 degrees) (P < .05). Conclusions: Flexibility gains in normal ankles with 3 weeks of training were retained for at least 3 weeks after training ceased. The application of pulsed, shortwave diathermy during stretching did not appear to influence the chronic retention of flexibility gains in normal subjects. [ABSTRACT FROM AUTHOR]

Context: Neoprene sleeves are alleged to increase heat in skeletal muscle, but no published research supports this belief. Objectives: To quantify anterior thigh skin and intramuscular temperature changes in varsity athletes wearing a neoprene thigh sleeve. Design: A 2 x 2 x 3 x 5 factorial design with replicated measures on 3 variables. Independent variables included sex (male or female), neoprene sleeve (yes or no), exercise intensity (control, 50% intensity bicycle, 70% intensity bicycle), and exercise phase (5 minutes pre-exercise, 15 minutes of exercise, 0-10 minutes postexercise, 11-20 minutes postexercise, 21- 30 minutes postexercise). Setting: Research laboratory. Patients or Other Participants: 12 male (23 +/- 0.95 years) and 12 female (20.59 +/- 1.44 years) National Collegiate Athletic Association Division I collegiate athletes actively engaged in offseason strength and conditioning programs. Intervention(s): We sampled skin and muscle temperatures every 10 seconds for 50 minutes with a telethermometer interfaced to a personal computer. Each 60-minute session included 15 minutes pre-exercise (temperatures recorded during the last 5 minutes), 15 minutes of exercise (control, 50% intensity, and 70% intensity), and 30 minutes postexercise. Skin temperature was measured on the anterior aspect of the thigh using surface thermocouples. Intramuscular temperature was measured in the vastus lateralis muscle at a depth of 2 cm below the subcutaneous fat using implantable thermocouples. Main Outcome Measure(s): Skin and intramuscular temperature. Results: Skin temperature was greater when subjects were wearing neoprene sleeves (1.4 degrees C during control, 3.1 degrees C during 70% exercise). Wearing a thigh sleeve had no effect on intramuscular temperature before or during exercise, but postexercise temperatures averaged 0.5 degrees C higher. Exercise intensity showed 1.3 degrees C to 2.0 degrees C increases in temperature with the sleeve. Females had higher intramuscular temperatures than males when wearing sleeves (1.4 degrees C during control, 1 degrees C during 50% exercise, and 0.8 degrees C during 70% exercise). Males had higher skin temperatures than females (0.8 degrees C during 50% exercise, 1 degrees C during 70% exercise). Conclusions: Neoprene sleeves are effective in maintaining intramuscular temperature after 15 minutes of exercise and in increasing skin temperature during and after exercise. These results may be attributable to the insulating effects of the neoprene sleeve. [ABSTRACT FROM AUTHOR]

Context: Data from electrothermometers are used to determine therapeutic modality usage, but the value of experimental results is only as good as the data collected.Objective: To determine the reliability and validity of 3 electrothermometers from 2 manufacturers.Design: A 3 x 4 x 17 factorial with repeated measures on 2 factors. Independent variables were trial (1, 2, 3), thermometer (mercury thermometer, Iso-Thermex calibrated from -50 degreesC to 50 degreesC, Iso-Thermex calibrated from -20 degreesC to 80 degreesC, and Data-logger), and time (17).Setting: Human Performance Research Center.Intervention(s): Eighteen thermocouples were inserted through the wall of a foamed polystyrene cooler, and 6 were connected to each of the 3 electrothermometers. The cooler was positioned on a stir plate and filled with room-temperature water (18.4 degreesC). A mercury thermometer was immersed into the water bath. Measurements of the water bath were taken every 10 seconds for three 3-minute trials.Main Outcome Measure(s): The temperature variability of 3 electrothermometers was taken from a calibrated mercury thermometer.Results: The Iso-Thermex electrothermometers did not differ statistically from each other in uncertainty (validity error +/- reliability error = 0.06 degreesC +/- 0.03 degreesC +/- 0.03 degreesC +/- 0.02 degreesC, P < .05), but both differed from the Datalogger (0.64 degreesC +/- 0.20 degreesC, P < .05). The Datalogger temperature was consistently higher than the mercury thermometer temperature.Conclusions: The Iso-Thermex electrothermometers were more stable than the Datalogger, and values were within the published uncertainty (+/-0.1 degreesC) when used with PT-6 thermocouples. The Datalogger we used had an uncertainty of measurement greater than that indicated in the user's manual (approximately +/-0.52 degreesC). Uncertainty of +/-0.84 degreesC can significantly influence the interpretation of results when intramuscular temperature changes are usually less than 5 degreesC. [ABSTRACT FROM AUTHOR]

Objective: To review the 44-year history of the Journal of Athletic Training. Description: We examined the 179 issues of the Journal and selected 9 years (every 5 years beginning in 1957) for a page-by-page analysis of content. We interviewed 8 former Editors and Editors-in-Chief and drew upon our own experiences during a combined 56 years of association with the Journal. The Journal has undergone significant changes in both structure and quality; its growth mirrors the growth of the athletic training profession. During its infancy, the Journal relied greatly on reprints from other journals. Now, most authors are certified athletic trainers, sharing the results of their own scholarship. Conclusions: The Journal, like the athletic training profession, is alive and strong. It has become an independent leader in the dissemination of athletic health care information. [ABSTRACT FROM AUTHOR]

Objective: To outline the essential elements of scholarship, identify its role in the development of the athletic training profession, and encourage athletic trainers to increase scholarly activities. Background: In the process of writing 2 manuscripts for the Journal of Athletic Training about how to write journal manuscripts, we felt something needed to be said concerning why one should write such manuscripts and how individual manuscripts should tie together to advance knowledge. This led us to search the scientific literature for information concerning scholarship and its attainment. Finding no comprehensive discussion on the topic, we then began to investigate components of scholarship and activities that lead to its attainment. Description: Scholarship, knowledge, truth, and theory are defined. The attributes or characteristics of a scholar delineated and discussed include seeking to establish truth and develop new knowledge, developing and refining theory, being focused in one's work, being honest about one's work, communicating ideas and stirring thinking, being open minded, and recognizing the difference between scholarship and pseudoscholarship. It is important to promote scholarship among undergraduate and graduate students; numerous suggestions are outlined. Application: Scholarship is essential to our survival as a profession. The guidelines presented here will help individuals examine and improve their scholarship. [ABSTRACT FROM AUTHOR]

Objective: Most of the research on cold applications has been performed on nonexercising supine subjects during a single cold pack application. Most athletic injuries occur during exercise, which increases skin temperature. Exercise before ice application will also increase ankle skin temperature during the rewarming phase. The purpose of this study was to examine the effects of activity on subsequent ice pack applications and rewarming using standard immediate care procedures. Design and Setting: Three experimental conditions (20-, 30-, and 40-minute ice pack applications) were applied to 12 subjects in a repeated measures design. Subjects rode a bicycle ergometer for 15 minutes before ice application to the ankle and opposite thigh, and were active (walking with crutches, simulated showering and dressing) for 20 minutes following application. Subjects rested with the limb elevated for an additional 40 minutes. Ice packs were then reapplied for the appropriate time (20, 30, or 40 minutes) followed by 60 minutes of rest with the limb elevated. Subjects: Twelve (8 males, 4 females) college-aged volunteers. Only subjects with good-to-high fitness levels were accepted for this study. Measurements: Ankle skin, thigh skin, and atmospheric temperatures were measured every minute using an Isothermex (Columbus Instruments, Columbus, OH). Results: Thigh temperature changes during the first ice application were greater during the 30- and 40-minute conditions than the 20-minute condition. Ankle and thigh temperature changes during the first ice application and rewarming, and for the entire trial were greater during the 40-minute condition than the 20- or 30-minute conditions. Throughout the first ice application and rewarming, and the entire trial, thigh temperature changes were greater during the 30-minute condition than the 20-minute condition. Conclusions: During immediate care procedures following injury, ice packs should be reapplied immediately following showering, changing clothes, and returning home. [ABSTRACT FROM AUTHOR]

Objective: To share with potential authors tips for communicating their ideas more clearly in a scholarly manuscript. Description: Communicating scientific, technical, or medical information so that readers can understand its meaning requires logical organization and proper use of language. These 30 tips review basic English grammar and suggest ways authors can clearly and concisely present their material. We admonish authors to avoid common errors such as writing in the passive voice, overusing abbreviations, and emphasizing unimportant facts. Conclusion: Attention to matters of writing style enhances clear communication, which must be the prime objective of scientific writing. [ABSTRACT FROM AUTHOR]

Objective: To share with potential authors tips for constructing a scholarly manuscript and for organizing information in various types of scholarly manuscripts: experimental reports, literature reviews, case reports, and clinical techniques. Description: The goal of writing a scientific/technical/medical article is to communicate new information that hopefully has clinical relevance and will improve health care. This information must be organized and presented clearly and logically. We present 66 tips for organizing a scholarly manuscript. We tell not only what goes where in the manuscript but also how to construct each of the elements so as to logically communicate the author's message. The tips are numbered to facilitate referencing. Conclusion: By becoming familiar with these tips, potential authors can avoid making mistakes that may hinder publication of their manuscripts. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To measure tissue-temperature rise in the lateral aspect of the ankle during 10-minute ultrasound treatments with ultrasound gel (gel), a gel pad with a thin layer of ultrasound gel on the top (gel/pad), and a gel pad with a thin layer of ultrasound gel on the top and the bottom coated with ultrasound gel (gel/pad/gel). DESIGN AND SETTING: We used a 1 x 3 repeated-measures, crossover design. The dependent variables were tissue-temperature change and time to peak temperature. The independent variable was the type of ultrasound coupling medium. Treatment orders were randomly assigned, and all possible orders were assigned 3 times. A thermocouple was inserted through a 32-mm catheter at a depth of 1 cm into the target-tissue space, the posterior lateral aspect of the left ankle, halfway between the lateral malleolus and the Achilles tendon. Each treatment consisted of ultrasound delivered topically at 1 W/cm(2), 3 MHz, in the continuous mode for 10 minutes. SUBJECTS: Eighteen healthy, college-aged student volunteers (13 women, 5 men), with no history of ankle injury in the previous 6 months. MEASUREMENTS: Intratissue temperature, measured every 30 seconds for 10 minutes. RESULTS: Intratissue temperature increases during the 10-minute treatments were significantly greater for the ultrasound gel (7.72 degrees C +/- 0.52 degrees C) and the gel/pad/gel (6.68 degrees C +/- 0.52 degrees C) than for the gel/pad (4.98 degrees C +/- 0.52 degrees C). CONCLUSIONS: When ultrasound is applied over bony prominences, a gel pad should be covered with ultrasound gel on both sides to ensure optimal heating. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of low-load, short-duration stretching with or without high-intensity, pulsed short-wave diathermy on hamstring flexibility.Design and Setting: We used a single-blind, repeated-measures design (pretest and posttest for all treatments) that included a placebo. The 3 independent variables were treatment mode, pretest and posttest measurements, and day. Treatment mode had 3 levels: diathermy and stretching, stretching alone, and control. The dependent variable was range of motion. Subjects were randomly assigned to the diathermy and stretching, stretching-only, or control group. Subjects were treated and tested each day (at approximately the same time) for 5 days, with a follow-up test administered 72 hours later. Hamstring flexibility was tested using a sit-and-reach box before and after each treatment. Diathermy and stretching subjects received a 15-minute diathermy treatment on the right hamstring at a setting of 7000 pulses per second, with an average pulse width of 95 microsec. Stretching-only subjects received a 15-minute sham diathermy treatment. Both diathermy and stretching and stretching-only subjects then performed three 30-second stretches (short duration) before being retested. Control subjects lay prone for 15 minutes before being retested.Subjects: Thirty-seven healthy college students (11 men, 26 women, age = 20.46 +/- 1.74 years) volunteered.Measurements: Hamstring flexibility was measured using a sit-and-reach box before and after each treatment.Results: The average increases in hamstring flexibility over the 5 treatment days for the diathermy and stretching, stretching-only, and control groups were 6.06 cm (19.6%), 5.27 cm (19.7%), and 3.38 cm (10.4%), respectively. Three days later (after no treatment), the values for the diathermy and stretching, stretching-only, and control groups were 8.27 cm (26.7%), 6.83 cm (25.3%), and 4.15 cm (14.2%), respectively. No significant differences in hamstring flexibility were noted among the groups.Conclusions: Diathermy and short-duration stretching were no more effective than short-duration stretching alone at increasing hamstring flexibility. The effects of diathermy with longer stretching times need to be researched. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of 3 treatments on ankle dorsiflexion range of motion: prolonged long-duration stretching, pulsed shortwave diathermy followed by stretching, and pulsed shortwave diathermy, stretching, and ice combined.Design and Setting: A 2 x 5 x 15 repeated-measures (on 2 factors) design guided this study. Range-of-motion change in triceps surae flexibility was the dependent variable. The 3 independent variables were treatment group, pretest and posttest measurements, and day. Treatment group had 4 levels: control, stretching (10 minutes of stretching via the weight and pulley), diathermy and stretching (20 minutes of diathermy and 10 minutes of stretching), and diathermy, stretching, and ice (20 minutes of diathermy, 10 minutes of stretching applied after 15 minutes of diathermy, and 5 minutes of ice applied during the last 5 minutes of stretching). Each subject received 14 treatments throughout 3 weeks, with a follow-up measurement taken 6 days after the last treatment.Subjects: Forty-four healthy college-student volunteers not involved in any flexibility program.Measurements: We measured ankle dorsiflexion using a digital inclinometer before and after treatment.Results: After 14 days of treatment, the range-of-motion increase was greater after heat and stretching than after stretching alone. After 6 additional days of rest, the heat and stretching range-of-motion increase was greater than that for stretching alone.Conclusion: Pulsed shortwave diathermy application before prolonged long-duration static stretching was more effective than stretching alone in increasing flexibility throughout 3 weeks. After 14 treatments, prolonged long-duration stretching combined with pulsed shortwave diathermy followed by ice application caused greater immediate and net range-of-motion increases than prolonged long-duration stretching alone. [ABSTRACT FROM AUTHOR]

Objective: To compare tissue temperature rise and decay after 20-minute diathermy and ultrasound treatments. Design and Setting: We inserted 3 26-gauge thermistor microprobes into the medial aspect of the anesthetized triceps surae muscle at a depth of 3 cm and spaced 5 cm apart. Eight subjects received the diathermy treatment first, followed by the ultrasound treatment. This sequence was reversed for the remaining 8 subjects. The diathermy was applied at a frequency of 27.12 MHz at the following settings: 800 bursts per second, 400-microsecond burst duration, 850-microsecond interburst interval, peak root mean square amplitude of 150 W per burst, and an average root mean square output of 48 W per burst. The ultrasound was delivered at a frequency of 1 MHz and an intensity of 1.5 W/cm2 in the continuous mode for 20 minutes over an area of 40 times the effective radiating area. The study was performed in a ventilated research laboratory. Subjects: Sixteen (11 men, 5 women) healthy subjects (mean age = 23.56 +/- 4.73 years) volunteered to participate in this study. Measurements: We recorded baseline, final, and decay temperatures for each of the 3 sites. Results: The average temperature increases over baseline temperature after pulsed short-wave diathermy were 3.02 degrees C 1.02 degrees C in site 1, 4.58 degrees C +/- 0.87 degrees C in site 2, and 3.28 degrees C +/- 1.64 degrees C in site 3. The average temperature increases over baseline temperature after ultrasound were only 0.17 degrees C +/- 0.40 degrees C, 0.09 degrees C +/- 0.56 degrees C, and -0.43 degrees C +/- 0.41 degrees C in sites 1, 2, and 3, respectively. The temperature dropped only 1 degree C in 7.65 +/- 4.96 minutes after pulsed short-wave diathermy. Conclusions: We conclude that pulsed short-wave diathermy was more effective than 1-MHz ultrasound in heating a large muscle mass and resulted in the muscles' retaining heat longer. [ABSTRACT FROM AUTHOR]

Objective: Although ankle braces supposedly protect the ankle by providing mechanical support of the joint and enhancing proprioceptive input, their proprioceptive effects are unclear. Measuring the center of pressure during posture provides a reasonably well-controlled evaluation of proprioceptive input at the ankle. We, therefore, compared the changes in the center of pressure resulting from wearing ankle braces and wearing no brace (control). Design and Setting: Center-of-pressure variables were measured during a one-legged modified Romberg test with six variations. The six test conditions systematically altered the three sensory modalities that control posture: visual input, vestibular input, and proprioceptive input. Subjects performed three 16-second trials of each Romberg variation for each brace condition. Subjects: Twenty-four male volunteers (age = 18 to 26 yr) with no history of ankle injuries in the past 5 years and no difficulty with balance. Measurements: Center of pressure, transmitted through the bottom of the foot, was monitored during each trial and transformed into total distance traveled, anterior-posterior (AP) position, and medial-lateral (ML) position. Results: Average AP and ML center-of-pressure positions were increased only during brace wearing when all sensory modalities were functioning normally (control condition). Total center-of-pressure distance was the same for all three brace conditions. Conclusions: Our results do not support or refute the concept that bracing enhances proprioception. The fact that subjects relocated their center of pressure only during the control condition is perplexing. If braces were to enhance proprioception, one would expect to see lower average ML and average AP center-of-pressure values when comparing the braced with the unbraced conditions. Alternatively, the relocated position may represent a more stable position resulting from enhanced proprioception. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of tape, with and without prewrap, on dynamic ankle inversion before and after exercise. Design and Setting: Doubly multivariate analyses of variance were used to compare the taping and exercise conditions. Subjects were randomly assigned to a fixed treatment order as determined by a balanced latin square. The independent variables were tape application (no tape, tape with prewrap, tape to skin) and exercise (before and after). The dependent variables were average inversion velocity, total inversion, maximum inversion velocity, and time to maximum inversion. Subjects: Thirty college-age male and female students (17 males, 13 females; mean age = 24.9 +/- 4.3 years, range, 19 to 39 years) were tested. Subjects were excluded from the study if they exhibited a painful gait or painful range of motion or had a past history of ankle surgery or an ankle sprain within the past 4 weeks. Measurements: We collected data using electronic goniometers while subjects balanced on the right leg on an inversion platform tilted about the medial-lateral axis to produce 15 degrees of plantar flexion. Sudden ankle inversion was induced by pulling the inversion platform support, allowing the platform support base to rotate 37 degrees. Ten satisfactory trials were recorded on the inversion platform before and after a prescribed exercise bout. We calculated total inversion, time to maximum inversion, average inversion velocity, and maximum inversion velocity after sudden inversion. Results: We found no significant differences between taping to the skin and taping over prewrap for any of the variables measured. There were significant differences between both taping conditions and no-tape postexercise for average inversion velocity, maximum inversion, maximum inversion velocity, and time to maximum inversion. The total inversion mean for no-tape postexercise was 38.8 degrees +/- 6.3 degrees, whereas the means for tape and skin and for tape and prewrap were 28.3 degrees +/- 4.6 degrees and 29.1 degrees +/- 4.7 degrees, respectively. After exercise, inversion increased by 1.0 degrees +/- 2.8 degrees for the no-tape condition, whereas the tape-to-skin and tape-over-prewrap inversion increased by 2.1 degrees +/- 3.2 degrees and 1.7 degrees +/- 2.2 degrees, respectively. Conclusions: There was no difference in the amount of inversion restriction when taping with prewrap was compared with taping to the skin. Tape and tape with prewrap significantly reduced the average inversion velocity, maximum inversion, maximum inversion velocity, and the time to maximum inversion. Both taping conditions offered residual restriction after exercise. [ABSTRACT FROM AUTHOR]

Objective: Therapeutic ultrasound is an effective deep heating modality commonly applied alone or after cooling or heating of the treatment area. The purpose of this study was to examine the tissue temperature rise in the human triceps surae muscle group after ultrasound with prior heating via a silicate gel hot pack. Design and Setting: This study was designed as a 2 x 2 x 3 factorial with repeated measures on two factors (depth and time). Independent variables were temperature of pack (hot and room temperature), depth of measurement (1 cm and 3 cm), and time (beginning, after pack application, and after ultrasound). The dependent variable was tissue temperature. Subjects were assigned to one of two treatment groups: ultrasound preceded by a 15-minute hot pack treatment or ultrasound preceded by a 15-minute application with a silicate gel pack at room temperature. Measurements were taken while subjects were treated in a university training room. Subjects: Twenty-one uninjured male and female college student volunteers were randomly assigned to one of the two pack groups. Measurements: The hot packs were stored in 75 degrees C water. A 1-MHz ultrasound treatment was administered for 10 minutes at an intensity of 1.5 W/cm2 . Tissue temperature was measured every 30 seconds using 23-gauge hypodermic microprobes interfaced with a telethermometer and inserted 1 and 3 cm below the surface of anesthetized triceps surae muscle. Results: At both tissue depths, there was a 0.8 degrees C greater increase in tissue temperature with hot packs and ultrasound. At 1 cm, ultrasound increased temperature 3.5 degrees C after a 0.5 degrees C rise during the room temperature-pack application, but only 0.6 degrees C after a 3.8 degrees C increase during hot-pack application. At 3 cm, ultrasound increased temperature 3.85 degrees C following a slight (-0.26 degrees C) decrease during the room temperature-pack application and 3.68 degrees C after a 0.74 degrees C increase during hot-pack application. Conclusions: Vigorous increases in deep muscle temperature (>/= 4 degrees C) can be reached with 2 to 3 minutes less total sonation time when preheated with a hot pack. Thus, ultrasound and hot packs have an additive effect on intramuscular temperature, but the characteristics of the additive effect are different, primarily because there appears to be a tissue temperature plateau. [ABSTRACT FROM AUTHOR]

Graft-versus-host disease (GVHD) is a primary and often lethal complication of allogenic hematopoietic stem cell transplantation (HSCT). Prophylactic regimens for GVHD are given as standard pretransplantation therapy; however, up to 50% of these patients develop acute GVHD (aGVHD) and require additional immunosuppressive intervention. Using a mouse GVHD model, we previously showed that injecting mice with exopolysaccharide (EPS) from Bacillus subtilis prior to GVHD induction significantly increased 80-day survival after transplantation of complete allogeneic major histocompatibility complex-mismatched cells. To ask whether EPS might also inhibit GVHD in humans, we used humanized NSG-HLA-A2 mice and induced GVHD by i.v. injection of A2 neg human peripheral blood mononuclear cells (PBMCs). Because we could not inject human donors with EPS, we transferred EPS-pretreated dendritic cells (DCs) to inhibit aGVHD. We derived these DCs from CD34 + human cord blood cells, treated them with EPS, and then injected them together with PBMCs into the NSG-HLA-A2 mice. We found that all mice that received untreated DCs were dead by day 35, whereas 25% of mice receiving EPS-treated DCs (EPS-DCs) survived. This DC cell therapy could be readily translatable to humans, because we can generate large numbers of human EPS-DCs and use them as an "off the shelf" treatment for patients undergoing HSCT., (Copyright © 2023 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)

Introduction: Many well-known risk factors for breast cancer are associated with dysbiosis (an aberrant microbiome). However, how bacterial products modulate cancer are poorly understood. In this study, we investigated the effect of an exopolysaccharide (EPS) produced by the commensal bacterium Bacillus subtilis on breast cancer phenotypes. Although B. subtilis is commonly included in probiotic preparations and its EPS protects against inflammatory diseases, it was virtually unknown whether B. subtilis -derived EPS affects cancer., Methods: This work investigated effects of EPS on phenotypes of breast cancer cells as a cancer model. The phenotypes included proliferation, mammosphere formation, cell migration, and tumor growth in two immune compromised mouse models. RNA sequencing was performed on RNA from four breast cancer cells treated with PBS or EPS. IKKβ or STAT1 signaling was assessed using pharmacologic or RNAi-mediated knock down approaches., Results: Short-term treatment with EPS inhibited proliferation of certain breast cancer cells (T47D, MDA-MB-468, HCC1428, MDA-MB-453) while having little effect on others (MCF-7, MDA-MB-231, BT549, ZR-75-30). EPS induced G1/G0 cell cycle arrest of T47D cells while increasing apoptosis of MDA-MB-468 cells. EPS also enhanced aggressive phenotypes in T47D cells including cell migration and cancer stem cell survival. Long-term treatment with EPS (months) led to resistance in vitro and promoted tumor growth in immunocompromised mice. RNA-sequence analysis showed that EPS increased expression of pro-inflammatory pathways including STAT1 and NF-κB. IKKβ and/or STAT1 signaling was necessary for EPS to modulate phenotypes of EPS sensitive breast cancer cells., Discussion: These results demonstrate a multifaceted role for an EPS molecule secreted by the probiotic bacterium B. subtilis on breast cancer cell phenotypes. These results warrant future studies in immune competent mice and different cancer models to fully understand potential benefits and/or side effects of long-term use of probiotics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Nguyen, Ma, Wyatt, Knight and Osipo.)

Intestinal inflammatory diseases affect millions of people worldwide, and one class of drugs showing promise toward treatment of several inflammatory diseases is probiotics. Numerous studies have been performed using probiotics to prevent and treat intestinal inflammatory diseases. Most of these studies used intact bacteria, and neither the active molecule nor the molecular mechanisms by which they affect immune responses are known. We have shown that the probiotic Bacillus subtilis is anti-inflammatory and can protect mice from acute colitis induced by the enteric pathogen Citrobacter rodentium. We identified and purified the active molecule, exopolysaccharide (EPS), and showed that it protects mice from C. rodentium-induced colitis by inducing anti-inflammatory M2 macrophages or inhibitory dendritic cells (DCs), both of which inhibit excessive T cell responses. We showed previously that EPS affects macrophages and DCs in a TLR4-dependent manner, and in the current study we asked how EPS induces these anti-inflammatory cells and how they function to inhibit T cells. By investigating the signaling downstream of TLR4 that leads to acquisition of inhibitory properties of macrophages and DCs, we found that EPS induces expression of the inhibitory molecule IDO in bone marrow-derived DCs, and that inhibition of T cell proliferation by IDO-expressing bone marrow-derived DCs utilizes the kynurenine/aryl hydrocarbon receptor circuit. Furthermore, unlike LPS, EPS does not induce inflammatory cytokines upon injection in vivo, directly demonstrating different outcomes induced by two different TLR4 agonists., (Copyright © 2023 by The American Association of Immunologists, Inc.)

Regulating B cell death is essential for generating antibodies and maintaining immune tolerance. B cells can die by apoptosis, and we report that human tonsil B cells, but not peripheral blood B cells also die by NETosis. This cell death is density-dependent, characterized by the loss of cell and nuclear membrane integrity, release of reactive oxygen species, and chromatin decondensation. Tonsil B cells secrete high levels of TNF, and inhibiting TNF prevented chromatin decondensation. By in situ fluorescence microscopy, B cell NETosis, as identified by the hyper citrullination of Histone-3, was localized to the light zone (LZ) of germinal centers in normal tonsil and overlapped with the B cell marker CD19/IgM. We propose a model in which stimulation of B cells in the LZ induces NETosis, driven in part by TNF. We also provide evidence that NETosis of tonsil B cells may be inhibited by an unidentified factor in tonsil. The results describe a previously unidentified form of B cell death and suggest a new mechanism to maintain B cell homeostasis during immune responses., (© 2023. The Author(s).)

The GlobalFiler™ PCR Amplification Kit is one of the most sensitive kits that exist today that makes the PCR amplification of human DNA possible. PCR amplification using this specific kit makes millions of copies of 24 specific target sequences in the DNA, called markers or loci. This kit is a 6-dye, short tandem repeat (STR) multiplex assay kit that has a synthetic mix of primers and single-stranded oligonucleotides that are combined with DNA samples and then subjected to 29 or 30 cycles of denaturing, annealing, and extension, as per laboratory protocol. Methods for instrument operation will vary depending on the thermal cycler instrument model that is used. Nevertheless, the GlobalFiler™ PCR Amplification Kit has proven to be a very useful tool to DNA analysts, amplifying extremely low quantities of DNA, making it possible to detect partial, if not full, genetic profiles from a wide range of sample types. This chapter discusses the typical preparation and PCR amplification of human forensic DNA samples, using the GlobalFiler™ PCR Amplification Kit., (© 2023. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Following the isolation of deoxyribonucleic acid (DNA) from biological samples, the quantitation of amplifiable human DNA is a critical next step in the process of DNA analysis. The Quantifiler ® Trio kit provides a simple way to accurately estimate the quantity of human and male DNA with concentrations as low as 5 pg/μL or less. Not only can the Quantifiler ® Trio kit determine the quantity of human DNA present, but it can also give an indication of the quality of the sample, which is essential information to have in the decision-making process regarding any downstream testing being done. In this chapter, we describe how to prepare and process quantitation reactions using the Quantifiler ® Trio kit. We also provide basic information on how to interpret the results., (© 2023. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

The fetal and neonatal immune systems are uniquely poised to generate tolerance to self, maternal and environmental antigens encountered in the womb and shortly after birth. However, the tolerogenic nature of fetal and neonatal immunity can be detrimental in the context of pathogens, leading to overwhelming bacterial infections or chronic viral infections. A variety of mechanisms contribute to fetal and neonatal tolerance, including a propensity to generate Foxp3 + regulatory T cells (Treg cells). However, the mechanism(s) of fetal Foxp3 + T-cell differentiation, the specific antigen-presenting cells required and factors that inhibit Treg generation after the neonatal period are poorly understood. Here, we demonstrate that a subset of CD14 + monocytes expressing the scavenger molecule, CD36, can generate CD4 + and CD8 + T cells that coexpress Foxp3 and T-bet from both umbilical cord blood. These Foxp3 + T-bet + T cells potently suppress T-cell proliferation and ameliorate xenogeneic graft-versus-host disease. CD14 +  CD36 + monocytes provide known Treg-inducing signals: membrane-bound transforming growth factor-beta and retinoic acid. Unexpectedly, adult peripheral blood monocytes are also capable of inducing Foxp3 + T cells from both cord blood and adult peripheral naïve T cells. The induction of Foxp3 + T cells in umbilical cord blood by monocytes was inhibited by the lymphoid fraction of adult peripheral blood cells. These studies highlight a novel immunoregulatory role of monocytes and suggest that antigen presentation by CD36 hi monocytes may contribute to the peripheral development of Foxp3 + T-bet + T cells with regulatory functions in both neonates and adults., (© 2021 John Wiley & Sons Ltd.)

Acute graft-versus-host disease (aGvHD) is a severe, often lethal, complication of hematopoietic stem cell transplantation, and although prophylactic regimens are given as standard pretransplantation therapy, up to 60% of these patients develop aGvHD, and require additional immunosuppressive intervention. We treated mice with a purified probiotic molecule, exopolysaccharide (EPS) from Bacillus subtilis, shortly before and after induction of aGvHD and found that, whereas only 10% of control mice survived to day 80, 70% of EPS-treated mice survived to 80 d. EPS treatment of donor-only mice resulted in ∼60% survival. Using a biosensor mouse model to assess inflammation in live mice during aGvHD, we found that EPS prevented the activation of alloreactive donor T cells. In vitro, EPS did not affect T cells directly but, instead, induced bone marrow-derived dendritic cells (BMDCs) that displayed characteristics of inhibitory dendritic cells (DCs). Development of these BMDCs required TLR4 signaling through both MyD88 and TRIF pathways. Using BMDCs derived from IDO knockout mice, we showed that T cell inhibition by EPS-treated BMDCs was mediated through the suppressive effects of IDO. These studies describe a bacterial molecule that modulates immune responses by inducing inhibitory DCs in a TLR4-dependent manner, and these cells have the capacity to inhibit T cell activation through IDO. We suggest that EPS or EPS-treated DCs can serve as novel agents for preventing aGvHD., (Copyright © 2021 by The American Association of Immunologists, Inc.)

Fatty liver is the earliest and most common response of the liver to consumption of excessive alcohol. Steatosis can predispose the fatty liver to develop progressive liver damage. Chief among the many mechanisms involved in development of hepatic steatosis is dysregulation of insulin-mediated adipose tissue metabolism. Particularly, it is the enhanced adipose lipolysis-derived free fatty acids and their delivery to the liver that ultimately results in hepatic steatosis. The adipose-liver axis is modulated by hormones, particularly insulin and adiponectin. In recent studies, we demonstrated that an alcohol-induced increase in serum ghrelin levels impairs insulin secretion from pancreatic β-cells. The consequent reduction in circulating insulin levels promotes adipose lipolysis and mobilization of fatty acids to the liver to ultimately contribute to hepatic steatosis. Because many tissues, including adipose tissue, express ghrelin receptor we hypothesized that ghrelin may directly affect energy metabolism in adipocytes. We have exciting new preliminary data which shows that treatment of premature 3T3-L1 adipocytes with ghrelin impairs adipocyte differentiation and inhibits lipid accumulation in the tissue designed to store energy in the form of fat. We further observed that ghrelin treatment of differentiated adipocytes significantly inhibited secretion of adiponectin, a hepatoprotective hormone that reduces lipid synthesis and promotes lipid oxidation. These results were corroborated by our observations of a significant increase in serum adiponectin levels in ethanol-fed rats treated with a ghrelin receptor antagonist verses the un-treated ethanol-fed rats. Interestingly, in adipocytes, ghrelin also increases secretion of interleukin-6 (IL-6) and CCL2 (chemokine [C-C motif] ligand 2), cytokines which promote hepatic inflammation and progression of liver disease. To summarize, the alcohol-induced increase in serum ghrelin levels dysregulates adipose-liver interaction and promotes hepatic steatosis by increasing the free fatty acid released from adipose for hepatic uptake, and by altering adiponectin and cytokine secretion. Taken together, our data indicates that targeting the activity of ghrelin may be a powerful treatment strategy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020. Published by Elsevier B.V.)

Staphylococcus aureus is a Gram-positive opportunistic pathogen that causes a variety of diseases. Bloodstream infection is the most severe, with mortality rates reaching 20 to 50%. Exopolysaccharide (EPS) from the probiotic Bacillus subtilis reduces bacterial burden and inflammation during S. aureus bloodstream infection in mice. Protection is due, in part, to hybrid macrophages that restrict S. aureus growth through reactive oxygen species and to limiting superantigen-induced T cell activation and interferon gamma (IFN-γ) production during infection. A decrease in IFN-γ production was observed within 24 h after infection, and here, we investigated how EPS abrogates its production. We discovered that S. aureus uses a rapid, superantigen-independent mechanism to induce host IFN-γ and that this is mediated by interleukin-12 (IL-12) activation of NK cells. Furthermore, we found that EPS limits IFN-γ production by modulating host immunity in a Toll-like receptor 4 (TLR4)-dependent manner, a signaling pathway that is required for EPS-mediated protection from S. aureus infection in vivo We conclude that EPS protects hosts from acute bloodstream S. aureus infection not only by inducing macrophages that restrict S. aureus growth and inhibit superantigen-activated T cells but also by limiting NK cell production of IFN-γ after S. aureus infection in a TLR4-dependent manner., (Copyright © 2020 American Society for Microbiology.)

Vitiligo is impacted by environmental triggers. We studied the contribution of the microbiome in FH mice, in which depigmentation is mediated by tyrosinase-reactive T cells. The mice received oral antibiotics and were monitored for depigmentation. The microbiome was studied in fecal and skin samples using 16S rRNA analysis. The resulting T-cell distributions were evaluated. In untreated mice, pigment loss did not expand to the pelage, whereas mice in the ampicillin group were approximately 1/3 depigmented at 30 weeks. In contrast to models of autoimmunity that are less dependent on IFN-γ, ampicillin but not neomycin treatment correlated with accelerated disease and reduced bacteria in the fecal pellets. Modified cytokine patterns in the tissue and serum suggest a response that transcends the gut. Ampicillin-induced depigmentation was accompanied by gut but not skin dysbiosis, and reduced T cell numbers in both sites. Neomycin induced a redistribution of gut T cells and an accumulation of skin regulatory T cells. This treatment spurred a Bacteroides-dominated population of fecal bacteria. Reduced diversity is prominent particularly after ampicillin treatment, when the gut is dominated by Pseudomonas species. In line with current concepts relating the microbiome and the immune system, we predict that dietary measures might promote skin health and delay vitiligo onset., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Inflammasomes are multiprotein complexes that coordinate cellular inflammatory responses and mediate host defense. Following recognition of pathogens and danger signals, inflammasomes assemble and recruit and activate caspase-1, the cysteine protease that cleaves numerous downstream targets, including pro-IL-1β and pro-IL-18 into their biologically active form. In this study, we sought to develop a biosensor that would allow us to monitor the initiation, progression, and resolution of inflammation in living animals. To this end, we inserted a known caspase-1 target sequence into a circularly permuted luciferase construct that becomes bioluminescent upon protease cleavage. This biosensor was activated in response to various inflammatory stimuli in human monocytic cell lines and murine bone marrow-derived macrophages. Next, we generated C57BL/6 transgenic mice constitutively expressing the caspase-1 biosensor. We were able to monitor the spatiotemporal dynamics of caspase-1 activation and onset of inflammation in individual animals in the context of a systemic bacterial infection, colitis, and acute graft-versus-host disease. These data established a model whereby the development and progression of inflammatory responses can be monitored in the context of these and other mouse models of disease., (Copyright © 2019 by The American Association of Immunologists, Inc.)

Objective: The aim was to assess a standardized order set for perioperative pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery., Methods: This retrospective chart review evaluated a pain order set in highly opioid-tolerant patients undergoing elective total knee or total hip arthroplasty from January 2010 through August 2012. Based on the date of the surgery, patients were allocated into preimplementation or postimplementation order set groups. The primary outcome assessed whether an adjustment in daily opioid dosage was required within the first 48 hours postoperatively. Secondary outcomes included pain scores, length of hospitalization, and safety outcomes., Results: Sixty patients were included in the analysis. An adjustment to postoperative opioid therapy occurred in 62% of the patients in the preimplementation group and in 56% of postimplementation group patients (P = 0.786). There were no differences in median pain scores 48 hours postoperatively (P = 0.348). Cumulative toxicity was increased after order set implementation compared with previous patients (44% versus 5%, P < 0.005); however, opioid doses held for sedation was the only individual toxicity to reach statistical significance (P = 0.011)., Conclusions: This study is the first to evaluate a standardized order set for pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery. The order set demonstrated similar efficacy to previous treatment modalities, but opioid-induced sedation was of concern with the order set. After the initial analysis, the order set was modified to minimize opioid-induced sedation. Continual safety analysis is warranted for quality improvement to enhance perioperative pain management in highly opioid-tolerant patients.