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Background Research suggests that individuals with musculoskeletal injury may have difficulty negotiating physical tasks when they are combined with cognitive loads. Objective Our objective was to conduct a systematic review to understand the effects of increased cognitive demand on movement patterns among individuals with musculoskeletal injuries. Methods A comprehensive search of PubMed, MEDLINE, the Cumulative Index for Nursing and Allied Health Literature (CINAHL), and SPORTDiscus was conducted to find research reports that included a population that had previously experienced an ankle, knee, or low back injury, included an uninjured control group, and assessed a dual-task paradigm. Results Forty-five full-text research reports were assessed, of which 28 studies (six ankle injury, nine knee injury, and 13 low back pain studies) were included in the review. Included studies were assessed for methodological quality and the study design extracted for analysis including the participants, cognitive and physical tasks performed, as well as outcome measures (e.g., three-dimensional kinematics, center of pressure, etc.). All studies included were cross-sectional or case–control with methodological quality scores of 17.8 ± 2.2 out of a possible 22. Twenty-five of the 28 studies found changes in motor performance with dual-task conditions compared with single tasks. Furthermore, 54% of studies reported a significant group by task interaction effect, reporting at least one alteration in injured groups’ motor performance under dual-task conditions when compared with an uninjured group. Conclusion The results of this systematic review indicate that motor performance is further impaired by placing a cognitive load on individuals in populations with musculoskeletal injury. More demanding tasks such as gait appear to be more affected in injured individuals than simple balance tasks. Future investigators may want to consider the difficulty of the tasks included as well as the impact of dual-task paradigms on rehabilitation programs.

Purpose of Review Osteoarthritis (OA) affects a large percentage of older adults. Prevalence of OA in younger adults is growing due to traumatic joint injuries occurring through sport participation. The purpose of this review is to summarize the recent literature linking lower extremity musculoskeletal injuries to post-traumatic osteoarthritis (PTOA), summarize the biomechanical and movement strategy consequences of these injuries, and link these consequences with known metabolic risk factors associated with general OA specifically in the aging population. Recent Findings Approximately 30% of younger adults have radiographic OA within one year after traumatic knee injury. An estimated 50% of individuals with chronic ankle instability will suffer from PTOA. Injuries to lower limb joints can lead to alterations in movement patterns, which may result in detrimental joint loading. This may be contributing to this accelerated development of PTOA. Older age, independent of OA, is also associated with gait alterations as well as greater metabolic cost of movement and greater fatigability. It is hypothesized that individuals suffering from PTOA as younger adults may be at a greater risk for these metabolic consequences due to the accelerated timeframe of OA onset and associated functional declines of older age. Summary The potential consequences of PTOA in lower limb joints paired with advancing age may include gait abnormalities, greater metabolic cost of movement, greater fatigability, and reduced physical activity. Collectively, these factors may contribute to greater cardiometabolic risk and weight gain, and reduced quality of life with older age. Strategies to alleviate and/or delay the progression of OA in younger and middle-aged adults are necessary to help reduce this risk.

A Correction to this paper has been published: https://doi.org/10.1007/s13670-021-00353-x

Purpose: To measure the intra-rater and inter-rater reliability of three different bubble inclinometer placements on two different weight-bearing dorsiflexion range of motion (DFROM) stances in healthy patients. Methods: A novice examiner and an experienced examiner assessed weight-bearing DFROM measurements using a bubble goniometer on 18 healthy participants over 2 days. All participants performed knee straight and knee bent DFROM stances while the examiners used three different bubble inclinometer placements, tibial tuberosity, distal tibia, and aligned with the fibula. For each inclinometer placement, intra-rater and inter-rater reliabilities were calculated. Results: For both the knee straight and the knee bent stance, bubble inclinometer placement over the distal tibia provided the best overall reliability. Conclusions: Clinicians should place a bubble inclinometer over the distal tibia when performing weight-bearing DFROM. [Athletic Training & Sports Health Care. 2018;10(4):181–187.]

Compare single-leg aerobic capacity and strength differences between the surgically repaired ACL leg (injured) and the uninjured leg. Cross-sectional study. Laboratory. Eight participants (5 female, 3 male, age = 23 ± 3.5 y, mass = 72.3 ± 17.3 kg, height = 169.7 ± 9.4 cm) that returned to play from ACL surgery between six and 18 months. Participants performed an aerobically-based, single-leg cycling protocol to determine maximum oxygen consumption, ventilatory threshold, heart rate, rating of perceived exertion, and maximal watts cycled. Participants also performed isokinetic knee flexion and extension on a dynamometer to assess peak torque, total work, work fatigue, and power. There were no statistical differences in single-leg aerobic capacity or strength outcomes between the injured and uninjured legs. Individuals who have had an ACL surgically repaired six to 18 months after return to play do not appear to have aerobic capacity or strength deficits between the injured leg and uninjured leg. •To our knowledge, single-leg aerobic capacity has yet to be investigated in a surgically repaired ACL population.•There were no differences in single-leg aerobic capacity/ strength outcomes in individuals with surgically repaired ACLs.•More research is necessary to determine the role single-leg aerobic capacity could play in rehabilitation/return to play.

Industrial experimental design is an iterative process beginning with small screening experiments. After the screening design, the experimenter often needs to perform additional augmentation runs to clarify the model. Design augmentation strategies to clarify different alias structures in resolution III and IV fractional factorial designs are presented and evaluated. Response surface design augmentation is also evaluated. For response surface designs, augmentations are performed and evaluated to fit a full cubic model and a reduced cubic model. Design comparisons are performed for different augmentation scenarios for a given model using variance dispersion graphs, variance inflation factors, G-efficiency and D-efficiency. Recommendations based on the evaluations are also presented.

Making processes transparent is a prerequisite for sustainable and cost reduction. The purpose of process transparency is to let the processes speak to capture the ‘‘voice of the process.” This chapter discusses what that means, and two steps are recommended for achieving that goal. Company must use a supplier‐input‐process‐output‐customer (SIPOC) map to help scope the effort and create a value stream map (VSM) to capture the workflow in detail, along with relevant process data. The chapter focuses on the use of VSMs in the context of an identified project. Creating a value stream map will allow the company and top managements to understand which activities are happening, in what order, and at what levels of performance from end to end. Data monitoring will help to evaluate process performance in terms of throughput, cycle time, setup time, wait time, WIP waiting to be worked on, process downtime/uptime, defect/rework rates, and so on.

There is a gourmet olive oil and vinegar shop, for example, and a specialty coffee shop within a couple of storefronts. 3. Data can be drawn from the point of sale (POS) database, which includes all wine purchases. Sales data are collected along with the sale date, club membership, grape varietal, vineyard and vintage. 4. In his seminal work, Semiology of Graphics, Bertin cataloged a system of graphical variables that are determined by the human eye's ability to detect differences (Figure 2, p. 28).2 Used in isolation, the variables can make the viewer focus on key features.

Improve the customer experience with customer Journey maps Wouldn't it be nice to have a document that showed your process or product from the customer's point of view? A single page on which the customer journey is recorded alongside the customer's underlying thoughts and feelings at critical touchpoints? A document that's easy to understand and explain to stakeholders? Start with what you have-past customer surveys, customer service data, warranty data, sales data and social media comments, for example. Understanding customer thinking and feeling will help with detailed measurement criteria, and operational definitions and tolerances during the map's design phase. New process and product development roadmaps, technology roadmaps, process improvement projects and marketing plans now can be aligned to create the ultimate customer journey.

The source and dynamics of persistent HIV-1 during long-term combinational antiretroviral therapy (cART) are critical to understanding the barriers to curing HIV-1 infection. To address this issue, we isolated and genetically characterized HIV-1 DNA from naïve and memory T cells from peripheral blood and gut-associated lymphoid tissue (GALT) from eight patients after 4–12 y of suppressive cART. Our detailed analysis of these eight patients indicates that persistent HIV-1 in peripheral blood and GALT is found primarily in memory CD4 ⁺ T cells [CD45RO ⁺/CD27(⁺/⁻)]. The HIV-1 infection frequency of CD4 ⁺ T cells from peripheral blood and GALT was higher in patients who initiated treatment during chronic compared with acute/early infection, indicating that early initiation of therapy results in lower HIV-1 reservoir size in blood and gut. Phylogenetic analysis revealed an HIV-1 genetic change between RNA sequences isolated before initiation of cART and intracellular HIV-1 sequences from the T-cell subsets after 4–12 y of suppressive cART in four of the eight patients. However, evolutionary rate analyses estimated no greater than three nucleotide substitutions per gene region analyzed during all of the 4–12 y of suppressive therapy. We also identified a clearly replication-incompetent viral sequence in multiple memory T cells in one patient, strongly supporting asynchronous cell replication of a cell containing integrated HIV-1 DNA as the source. This study indicates that persistence of a remarkably stable population of infected memory cells will be the primary barrier to a cure, and, with little evidence of viral replication, this population could be maintained by homeostatic cell proliferation or other processes.