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Background: An Achilles tendon rupture (ATR) is known to cause persistent biomechanical deficits such as decreased muscle strength in end-range plantar flexion and reduced tendon stiffness. Purpose/Hypothesis: This study aimed to examine whether sustained asymmetries were present in dynamic stiffness and kinematic and kinetic variables in gait and single-leg balance at 4.5-year follow-up in conservatively treated patients recovering from an ATR. We hypothesized that patients who had recovered from ATRs exhibit a midterm increase in peak ankle dorsiflexion, a decrease in concentric work, and decreased dynamic stiffness during the stance phase of gait, along with increased single-leg standing sway in the injured leg compared with the uninjured leg. Study Design: Case series; Level of evidence, 4. Methods: This study was a cross-sectional medium-term follow-up of conservatively treated patients recovering from ATRs. A total of 34 patients who underwent nonoperative treatment were included for testing 4.5 years after a rupture. The Achilles tendon length was measured using ultrasound. Standard instrumented 3-dimensional (3D) gait analysis and single-leg standing balance were performed using 3D motion capture. Kinematic and kinetic ankle parameters were calculated during gait, and quasi-stiffness was calculated as the moment change per the change in the degree of dorsiflexion during the second (ankle) rocker of the gait cycle. Center of pressure displacement (sway length), along with rambling and trembling, was calculated for the single-leg balance task. Results: Peak dorsiflexion in stance was 13.4% larger in the injured leg than the uninjured leg (16.9° ± 3.1° vs 14.9° ± 0.4°, respectively; P ≤ .001). Peak dorsiflexion was not associated with the normalized Achilles tendon length (B = 0.052; P = .775). Total positive work in the plantar flexors was 23.9% greater in the uninjured leg than the injured leg (4.71 ± 1.60 vs 3.80 ± 0.79 J/kg, respectively; P = .001). Quasi-stiffness was greater in the uninjured leg than the injured leg during the initial (0.053 ± 0.022 vs 0.046 ± 0.020 N·m/kg/deg, respectively; P = .009) and late (0.162 ± 0.110 vs 0.139 ± 0.041 N·m/kg/deg, respectively; P = .005) phases of eccentric loading. No difference was found in sway length during single-leg stance between the injured and uninjured legs (1.45 ± 0.4 vs 1.44 ± 0.4 m, respectively; P = .955). Conclusion: Patients treated conservatively have a small increase in peak dorsiflexion, decreased total concentric plantar flexor power, and decreased quasi-stiffness in initial and end-range dorsiflexion in the injured leg. These deviations could not be directly associated with the measured tendon elongation. Registration: NCT02760784 (ClinicalTrials.gov).

ObjectiveExtremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital.Study designBlinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age.ResultsWe assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56–2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001).Difficulty recruiting TR patients at 2 years extended the study by 14 months and affected their demographics.ConclusionImpairment rates among EP infants appear to be substantially underestimated from Bayley III norms. These rates may be best assessed by comparison with healthy term infants followed with minimal attrition from birth in the same centers.ClinicalTrials.gov IDTerm Reference (under the Generic Database Study): NCT00063063

Cellulose is the most abundant naturally occurring polysaccharide. Its inherent mechanical stability, biocompatibility, biodegradability, and polyhydroxy functional groups make it desirable for various applications such as conductive fibers. Cellulose acetate (CA) – an acetate ester of cellulose – has a good fiber-forming property using a variety of solvents. Fiber-based materials offers good mechanical and thermal stability. Electrospinning is one of the emerging technologies in producing fibers in the nanoscale range. A polymer solution is fed through a spinneret and is collected on a metallic plate where both surfaces are attached to a high voltage supply. As the solution traverses the distance from the needle to the plate, the material stretches and gradually solidifies into superfine fibers. Polyaniline (PANI) is a conductive polymer that is popular for its high chemical stability, nontoxicity, good processability, and stable intrinsic redox state. This study explored the fabrication of a conductive PANI/CA nanocomposite through electrospinning. Working conditions, electrospinning variables and solution parameters were optimized to produced characterizable PANI/CA nanofibers. The effects of varying CA concentration, amount of PANI, molecular weight of CA, and feed flowrate on the morphology of the nanofibers were investigated.

ObjectiveThis study evaluates the 24-month follow-up for the NICHD Neonatal Research Network (NRN) Inositol for Retinopathy Trial.Study designBayley Scales of Infants Development-III and a standardized neurosensory examination were performed in infants enrolled in the main trial. Moderate/severe NDI was defined as BSID-III Cognitive or Motor composite score <85, moderate or severe cerebral palsy, blindness, or hearing loss that prevents communication despite amplification were assessed.ResultsPrimary outcome was determined for 605/638 (95%). The mean gestational age was 25.8 ± 1.3 weeks and mean birthweight was 805 ± 192 g. Treatment group did not affect the risk for the composite outcome of death or survival with moderate/severe NDI (60% vs 56%, p = 0.40).ConclusionsTreatment group did not affect the risk of death or survival with moderate/severe NDI. Despite early termination, this study represents the largest RCT of extremely preterm infants treated with myo-inositol with neurodevelopmental outcome data.

Bird damage has plagued orchardists since the earliest times of cultivation. In a matter of minutes, a flock of birds can literally strip a tree of all harvestable fruit or render hanging fruit unmarketable. While this level of damage is rare, signifi- cant economic impact can occur to those orchards where birds select to forage. Crop protection techniques available to orchardists are primarily limited to hazing (scarecrows, propane cannons, flagging) and physical exclusion (netting). Given the propensity of birds to habituate to hazing techniques, hazing methods offer limited protection for crops. Although exclusion devices may offer the best protection from birds, they are expensive to purchase, install, and maintain. As a consequence, orchardists have sought a chemical means of protecting their crops from bird damage. Repellents are, by design, not toxic to the target organism. They may, however, still have undesirable impacts on humans and the environment. Consequently, repellents are subject to the same general registration requirements as traditional agricultural chemicals. As with any chemical application to a food or feed crop, a major hurdle for expanding the use to fruit crops is the establishment of a residue tolerance for applications made during the ripening period. Between 1972 and 1991, fruit (cherry and blueberry) producers in 10 states were allowed to use methiocarb (as Mesurol) to combat avian damage. In 1987, the United States Environmental Protection Agency (US EPA) published the Registration Standard (US EPA 1987), summarizing the data available to support continued use of methiocarb as an avian repellent in corn fields and fruit orchards, and for slugs and snails in ornamental plantings, lawns, turf and ginseng. The US EPA's review concluded that additional product chemistry, residue chemistry, ecological effects, environmental fate, toxicology and occupational/residential exposure data were needed to continue these uses. Because of the cost associated with generating these data, registrants voluntarily cancelled all uses of methiocarb as a avian repellent and EPA subsequently waived the residue chemistry data requirements for the remaining uses (US EPA 1992). Thus, the primary hurdle facing product registration of an avian repellent for agricultural crops is the establishment of a residue tolerance when applications must be made late in the growing season to protect ripening crops. The time between application and harvest is most often insufficient for desired residue decline before reaching the consumer. Since 1992, new chemical repellents have been actively sought to protect agricultural crops, but only one (a.i., methyl anthranilate) has been fully registered with the US EPA. Methyl anthranilate is a GRAS-listed (Generally Recognized As Safe) food additive which is commonly used as grape flavoring. It has been demonstrated to be repellent to birds when consumed (Clark et al. 1991) and currently has 8 active product registrations with the US EPA. In 2002, the US EPA exempted methyl anthranilate from the requirement of a residue tolerance (Federal Register: August 7, 2002 (Volume 67, Number 152)). It is registered for bird control on structures, airports, ornamental plantings, turf, fruit crops (berries, grapes, pomes, stonefruit), and grain crops (corn, barley, rice, sorghum, millet, wheat, oats, sunflower), and can be applied in baits, broadcast application or as a fog. Although methyl anthranilate is currently registered as an avian repellent for use in a variety of food crops, independent research has shown that bird damage did not differ between methyl anthranilate-treated versus untreated blueberries (Cummings et al. 1995, Avery et al. 1996). Additionally, it was not effective for repelling blackbirds from ripening rice and sunflower fields. This paper presents the data requirements and cost considerations for US EPA product registration of a chemical repellent for protecting fruit crops (e.g., cherries, blueberries) from bird damage. Four approaches to product registration for a food use are presented: 1) development of a new active ingredient; 2) registering an existing avian repellent for use in fruit; 3) registering an existing pesticide formulation as an avian repellent for use in fruit crops; and 4) registering a new formulation of an existing pesticide product as a avian repellant on fruit crops.

Harmful algal blooms often occurred in the East China Sea (ECS) and the German coastal waters of the North Sea but Karlodinium veneficum had not been taxonomically reported. Two strains of Karlodinium (LAMB090611 and LAMB010601) were isolated from the two areas in 2009. The morphological characteristics and molecular phylogeny of two strains are compared on the basis of observation of a light microscope, a scanning electron microscope (SEM), a laser scanning microscope (LSM) and an internal transcribed spacer (ITS) sequence data. The mean cell length of strain LAMB090611 is (14.2±1.8) µm (range 11.1–18.7 µm) and mean width is (10.8±1.5) µm (range 8.2–14.7 µm). The mean cell length of strain LAMB010601 is (15.1±1.2) µm (range 12.7–17.9 µm) and the mean width is (11.4±1.1) µm (range 9.1–14.7 µm), respectively. The two strains are similar in morphological characteristics, including a straight apical groove, distinct ventral pore, sulcal extension, cingulum displacement, two or four irregular shaped chloroplasts within the cell and almost equal sized epicone and hypocone. The large and round nucleus is located at the center or at the hypocone of the cell. The sequence length of the ECS strain LAMB090611 and the German strain LAMB010601 is 640 and 646 bp, respectively. The GC content is 49%. The nucleotide similarity of the two strains is 98.1%. The sequence divergence is 0.003. Both strains are confirmed as Karlodinium veneficum (D. Ballantine) J. Larsen and this is the first taxonomic report from China and Germany coastal waters. The population dynamics of this toxic species in the ECS and German coastal waters needs to be investigated in the near future.

Introduction This lessons learned paper provides recommendations for novice investigators to consider when writing a research protocol; specifically when it involves clinical staff with varying levels of research experience, multiple departments, and is conducted at a non-academic medical center. It further explores each specific lesson with generalizability to help future novice investigators successfully develop and implement their own research study. Methods There were several lessons learned during the development and implementation of the research teams’ original study. These lessons include: (1) Conduct feasibility assessments; (2) Assess external factors; (3) Partner with stakeholder(s); (4) Develop tools that promote transparency; (5) Coordinate with Information Technology personnel; and (6) Engage and educate stakeholders. Conclusion The aim of this study was to determine if unrestricted oral intake of low fat, low residue foods during labor impacts maternal and neonatal outcomes, with the goal of contributing an adequately powered study to the current literature. Due to the challenges experienced in executing this study, the findings were not able to be generalized. However, the challenges encountered are not specific to the original focus of the researchers’ study. Each of the lessons are generalizable and can be applied to nursing research. As nurses begin to develop clinical research protocols, utilizing the lessons learned in this paper may help ensure successful implementation and completion of their research.