Aid In Recovery Research Articles

Application of Digital Orthopedic Technology in Orthopedic Trauma.

In order to solve the limitation of auxiliary treatment means in the process of orthopedic trauma surgery, and further improve the effective integration of orthopedic trauma clinical surgery and computer technology, a new orthopedic trauma auxiliary treatment means based on digital orthopedic technology was proposed with the aid of virtual digital technology. The method builds a 3D model of fracture fragments through 3D orthopedic modeling and obtains a high-quality 3D model through processing. Later clinical tests verify the feasibility of this auxiliary treatment method. The test results show that the precision of the 3D reconstruction model based on custom option fitting is higher than that based on optimal option fitting, and the precision difference is within 0.2%. This result also indicates that the 3D model obtained by 3D reconstruction has higher accuracy. The results show that three-dimensional finite element modeling technology can accurately simulate the stress of the spine of orthopedic patients and can reduce the incidence of complications through preoperative diagnosis, curative effect prediction, and trauma surgery, which has a good aid for postoperative recovery.

Trends in recovery aid concentration following Hurricane Florence in North Carolina: exploring the role of physical damage, community vulnerability, and Hurricane Matthew

ABSTRACT The intensity of extreme events like hurricanes is predicted to increase. As such, the role of federal disaster aid programmes in assisting community recovery will also grow, and potential inequities in these programmes could compound in an increasing disaster landscape. This study analyzes recovery efforts after Hurricane Florence (2018) to identify trends in areas that were targeted for recovery aid. Using a series of Ordinary Least Square (OLS) and spatial lag models, divergences in aid are investigated after controlling for physical damage and the study suggests that these divergences can be partially predicted by social and community factors, including characteristics that are typically associated with increased social vulnerability (such as high renter population, older housing stock, and high population of non-white residents). In addition, because North Carolina experienced two major hurricanes in the period of just two years (Hurricane Matthew in 2016), this study also analyzes the role of successive extremes in the outcomes of aid concentration and finds that communities successful in achieving aid after Hurricane Matthew were similarly successful after Hurricane Florence. Finally, the paper emphasises the importance of monitoring potential inequities in federal recovery aid payout, which can provide actionable opportunities for potential improvements to these programmes.

Pandemic to Endemic: A Review of Key Enablers of Small Medium Enterprise Resilience

The existence of various COVID-19 variants from Delta to Omicron has led to speculation that the spreading of the virus will continue; hence, the endless battle to fight it persists. The uncertainties in its progress from pandemic to endemic, renders it necessary to understand the applied mitigation and adaptation strategies amongst SMEs to build their future resilience as they are vulnerable and have limited resources. This study aims to develop a conceptual framework of the key enablers of SMEs’ resilience during the pandemic. Specifically, these enablers will be examined from the point of view of strategies and capabilities. A reviewed research articles from the Scopus database has been conducted focusing on selected keywords in 2020 and 2021. The findings reveal that financial resources, government support, embracing digital technologies and changing business approach are the key enablers for SMEs’ resilience. This study further provides a unique snapshot of business decisions and expectations particularly during this pandemic. It is suggested for the policy makers to consider designing recovery aids as they contemplate the scale of the required interventions. Significantly, this study also explores and provides deep understanding on the survival strategies; adaptive strategies and dynamic capabilities of SMEs during the pandemic and most importantly it directs and points out their path, present and in the future.

Maximizing the efficiency of transverse thermoelectric generators

Goniopolar materials and device geometry aid in generator waste heat recovery.

ANTIPLATELET AGGREGATION ASSAY OF HOMOGENATE OF EUTYPHOEUS GAMMIEI- A NATIVE EARTHWORM OF TRIPURA, NORTH-EAST, INDIA

For several years earthworms have been widely used in china, Japan, Indonesia, and the Far East to treat various chronic diseases. Intensive exploration has been made to reveal the use of earthworm as anti microbial anti inflammatory, anti pyretic and anti-cancer agents. Earthworm contains many compounds with potential medicinal properties and have been administered to treat inflammatory, hematological oxidative & nerve disease. It has been reported that medicinal activities of earthworm may vary depending on the species & living environment of that organism Cellular metabolism plays a vital role in the homeostasis of the bodyof any living organism. This metabolism is disturbed in conditions like thrombus that inhibits the blood supply to the body tissues leading to ischemia and finally necrosis of the cells. Hence, there is an urgent need for research in the field of antiplatelet and thrombolytic agents in order to prevent and cure thrombus thatleads to pathological conditions like Myocardial Infarction (MI), Hemiplegia and the like. It is essential to search for mineral medicines of similar nature which aid in a speedy recovery and are considered to be cost effective with a longer shelf life. The extract of Eutyphoeusgammiei (E.E.G) is used as a drug.As found in the literature, it is also used in cardiac ailments predominantly Angina and Mi for which thrombus is the reason behind the pathological condition. In this study, the extract of Eutyphoeusgammiei was evaluated for its in vitro antiplatelet aggregation and thrombolytic activity which proved effective at the dose of 65μl and 100μl respectively. Therefore, it can be concluded that Eutyphoeusgammiei (E.E.G) extract is an effective drug in the treatment of Cardiovascular diseases and Cerebrovascular accidents.

Effects of free-choice pasture access on lameness recovery and behavior of lame dairy cattle

Lameness is a common condition in dairy cows. Free-choice access to pasture may benefit lame cows by providing a softer and more comfortable lying and standing surface; however, the effects of this system on lameness have not yet been explored. We evaluated whether a 7-wk period of free-choice pasture access would improve lameness recovery and affect the lying behavior of lame dairy cows. Lactating Holstein cows, all clinically lame upon enrollment and housed inside a freestall barn, were pseudo-randomly allocated to 1 of 2 treatments (balancing for gait score, parity, and previous lameness history): free-choice access to pasture (n = 27; pasture) or indoor housing only (n = 27; indoor). Cows were gait scored weekly by an observer blind to treatment, using a 5-point numerical rating system (NRS 1 = sound, NRS 5 = severely lame), and hoof inspections were performed by professional trimmers at the start and end of the 7-wk period. Lying behavior was assessed using accelerometers. Cows were categorized as either having a sound period (NRS <2 over 2 consecutive weeks) or remaining lame. Cows spent, on average, 14.8 ± 10.0% (mean ± SD) of their total time on pasture, with much of this time spent outside at night. Over the 7-wk period, 42% of cows had at least one sound period (pasture: 55.6%, indoor: 26.9%), but this was more likely for cows with pasture access (odds ratio = 4.1; 95% confidence interval: 1.1-14.6%). Pasture cows also spent more total weeks sound compared with indoor cows (2.0 ± 0.34 vs. 0.81 ± 0.35 wk). Cows with pasture access lay down for less overall time than indoor cows (13.9 ± 0.29 vs. 12.7 ± 0.28 h/d) and spent more time standing on pasture (74%) than when indoors (47%). These results suggest that lame dairy cows will use pasture when provided with free-choice access, primarily at night, and that access to pasture aids in lameness recovery. We encourage future research to investigate longer-term effects on the recovery of hoof lesions and reoccurrence of lameness cases.

Psychological Factors Predicting Functional Ability and Participation After Hip Fracture.

Positive psychological factors have been related to better outcomes among adults with various health conditions. To predict functional ability and participation in older adults who had experienced a hip fracture on the basis of data at admission to acute (inpatient) rehabilitation. We measured physical factors, as well as positive and negative psychological factors, at three time points. Prospective and cross-sectional cohort study. Data collection occurred during admission, at discharge, and 6 mo after rehabilitation. Inpatient geriatric rehabilitation center and follow-up at home. Seventy-one older adults (M age = 78.58 yr, SD = 6.09) who had sustained a hip fracture because of a fall and who attended acute rehabilitation; 55 completed follow-up assessments 6 mo after discharge from rehabilitation. Participants completed the Adult Hope Scale, Life Orientation Test, Positive Affect Questionnaire, Geriatric Depression Scale (at admission only), hand-grip strength measures, Numeric Pain Rating Scale, and FIM® Motor domain (mFIM) before and after acute rehabilitation and after 6 mo. The Activity Card Sort (ACS) was administered only at follow-up. Outcome measures were the mFIM and ACS. At 6-mo follow-up, functional ability was correlated more with optimism than with age, gender, or hand-grip strength measured at admission. Participation was predicted by age, the hope-agency component, and pain in walking at admission; however, the hope-agency component was only marginally significant. At discharge, functional ability was strongly predicted by age, hand-grip strength, and mFIM scores at admission. Optimism and hope played a role in explaining rehabilitation outcomes at 6-mo follow-up. Occupational therapy evaluation should address positive psychological factors, and intervention should aim to strengthen these factors as powerful aids in older adults' recovery from hip fractures. What This Article Adds: This study reflects the philosophy of occupational therapy, which places great emphasis on the connection between clients' mind-body-spirit and their participation in daily life occupations.

Vaccination modulates pulmonary eosinophil subsets upon breakthrough influenza infection.

Abstract Eosinophils play a critical role in mucosal tissue homeostasis, anti-helminth responses, and allergy. Lung eosinophilia is associated with aberrant T cell responses to respiratory viral infection and is also a consequence of vaccine-associated enhanced respiratory disease (VAERD). A growing body of literature has demonstrated there are different phenotypic subsets of eosinophils and, depending on subset, can play a protective role and aid in lung recovery following infection. Previous work by Choi et al. showed recruitment of eosinophils to the lung in BALB/c mice vaccinated with alum-adjuvanted trivalent inactivated influenza vaccine (TIV) following a sub-lethal H1N1 (A/New Caledonia/20/1999; NC99) influenza challenge. In this study, flow cytometric analysis of the lung showed an increase in total lung eosinophil numbers in all NC99-challenged mice compared to controls. Furthermore, in TIV-vaccinated then challenged mice, flux of inflammatory eosinophil (iEos) and resident eosinophil (rEos) numbers at 7 days post-infection (DPI) resulted in iEos/rEos ratios similar to that of OVA-sensitized allergic control mice; this effect was independent of alum adjuvant. Treatment groups with increased lung eosinophil numbers did not show signs of enhanced morbidity or inflammatory cytokine signatures compared to unvaccinated mice. Unsupervised clustering using CATALYST confirmed findings from manual gating analysis and revealed differences in eosinophil activation status based on surface expression levels of MHC Class II. Our findings provide a starting point for more sophisticated phenotypic characterization of eosinophil subsets and their distinct functional contributions to vaccine- and infection-induced immunity. This research was partly funded by NIAID T32 Virus-Host Interactions Training Grant (5T32AI007647-22) and CRIP (Center for Research for Influenza Pathogenesis), a NIAID supported Center of Excellence for Influenza Research and Surveillance (CEIRS, contract # HHSN272201400008C).

Impact of timing of multimodal analgesia in enhanced recovery after cesarean delivery protocols on postoperative opioids: A single center before-and-after study

Study objectiveEnhanced recovery after cesarean delivery (ERAC) programs aim to decrease maternal morbidity and aid in maternal recovery and return to baseline. Multimodal analgesia is an important element of ERAC protocols, but no consensus exists on the timing of medication administration. We compared maternal pain outcomes following scheduled cesarean delivery with modification of the timing of administration of multimodal analgesia with non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. DesignBefore-and-after study. SettingLabor and delivery unit at a single academic institution. InterventionNSAIDs and acetaminophen were administered as a fixed-interval alternating regimen every 3 h for the initial ERAC group (ERAC 1) and fixed-interval combined regimen every 6 h for the modified ERAC group (ERAC 2). ERAC 1 and ERAC 2 groups were compared to historical controls (Pre-ERAC). Patients520 women undergoing scheduled cesarean delivery (Pre-ERAC n = 179, ERAC 1 n = 179, and ERAC 2 n = 162). MeasurementsThe primary outcomes were postoperative total and daily opioid utilization as measured in morphine milligram equivalents (MME). Secondary outcomes included postoperative length of stay, maximum pain scores, and racial disparities in care. Main resultsThe modified schedule of non-opioid analgesics involving combined administration (ERAC 2) versus alternating administration (ERAC 1) of multimodal analgesia resulted in decreased total postoperative opioid utilization (median = 26.3 vs 52.5 MME, Bonferroni corrected P = 0.002). Total postoperative opioid utilization among the ERAC 2 group was also significantly reduced compared to the Pre-ERAC group (median = 26.3 vs 105.0 MME, Bonferroni corrected P < 0.0001). ConclusionsMultidisciplinary teams developing or modifying ERAC protocols for scheduled cesarean delivery should consider a combined administration at fixed intervals of NSAIDs and acetaminophen throughout the hospital stay to optimize postoperative pain management.

2-Deoxy-D-Glucose and its Derivatives for the COVID-19 Treatment: An Update.

Treatment choices for the “severe acute respiratory syndrome‐related coronavirus‐2 (SARS‐CoV‐2)” are inadequate, having no clarity on efficacy and safety profiles. Currently, no established intervention has lowered the mortality rate in the “coronavirus disease 2019 (COVID‐19)” patients. Recently, 2-deoxy-D-glucose (2-DG) has evaluated as a polypharmacological agent for COVID-19 therapy owing to its influence on the glycolytic pathway, interaction with viral proteins, and anti-inflammatory action. In May 2020, the Indian drug regulatory authority approved 2-DG as an emergency adjunct therapy in mild to severe COVID-19 patients. Clinical studies of 2-DG corroborate that it aids in faster recovery of hospitalized patients and decreases supplemental oxygen. Herein, we describe the development process, synthesis, mechanism of viral eradication, and preclinical and clinical development of 2-DG and its derivatives as molecularly targeted therapeutics for COVID-19 treatment.

Overblown? Analyzing Wind Speed in the Hurricane Warning Response System

The role of wind speed in determining the impacts of hurricanes is examined via statistical analysis of Cate- gory 2-5 hurricanes that made landfall in the U.S. Atlantic basin coastline, including Puerto Rico’s coast, from 1970-2020. The results indicate a positive yet statistically insignificant correlation between wind speed and hurricane deaths, cost of damages and federally obligated recovery aid. Other factors, such as storm surge, rainfall, and inland inundation, may be more strongly correlated with these impacts. The results are contextualized by a wealth of literature pointing to the role of social, political, and economic factors in determining the destructiveness of hurricanes. Finally, alternative indices to the popular Saffir-Simpson hurricane hazard scale – which relies on wind speed – are examined. As climate change advances and hurricanes become in- creasingly frequent and severe, more comprehensive hazard-rating scales may provide the basis for a more effective warning-response system, ultimately bolstering the resilience of coastal areas.

Pemulihan Trauma Pasca Bencana pada Tokoh Anak dalam Buku Cerita Bergambar (E Hon)

This study aimed to know the form of trauma recovery for child survivors after the 2011 T?hoku Tsunami, in the picture book (e hon) entitled Minna de Utau be! by Mari Mitsuoka. The method used in this research is descriptive analysis. Theories used in this research are Sigmund Freud's theory of Literature Psychology and Resilience theory by Masten (2014). The analysis results showed that child characters in e hon are described as having characteristics of mild trauma that can recover quickly through appropriate trauma recovery support. Those types of recovery support were affected by protective factors that interconnect and complement each other, such as the characteristics of child survivors, family support, and psychological support activities in the school and community environment. The effectiveness of appropriate recovery aid enhances children's resilience in the trauma recovery process, so they can recover and thrive after experiencing a natural disaster.

“A Descriptive Study to Assess the Knowledge Regarding Ebola Virus Disease among Nursing Students in Selected College of Nursing, Haridwar, Uttarakhand in a View to Develop Information Booklet”

One of the true tests of headship is the skill to identify a problem before it becomes an emergency. Ebola virus also called Ebola hemorrhagic fever is rare but fatal illness. Ebola is named after the Ebola River in Zaire. It earliest emerged in Sudan and Zaire. These viruses are to be found in sun- Saharan Africa. This spreads through human to human transmission. It is transmitted to human population from wild animals such as fruit bats, chimpanzees, and monkeys. Often blood or body fluids of infected animals contains this virus and contact with it makes human vulnerable to Ebola virus disease (EVD). No vaccine as such available to combat this deadly disease. On the other hand, early detection of case and symptomatic treatment aid in fast recovery. The aim of the study was (1) to assess the knowledge regarding Ebola virus among nursing students, (2) to find association between knowledge score and demographic characteristics, and (3) to develop an information booklet on EVD based on knowledge of nursing students. Quantitative approach and descriptive design were used in the study. The study was conducted in Arihant College of Nursing, Haridwar. Convenient sampling technique was used to collect data from 60 subjects. Based on findings of the study, it was concluded that the mean knowledge score was 07.42 ± 2.28. A majority of subjects, 54 (90%) were having poor knowledge and 6 (10%) were having average knowledge regarding EVD. No subjects were having good knowledge regarding EVD. This study concluded that there is a need of upgrading knowledge and awareness regarding EVD among nursing students. Although it is not a disease of Asian region, chances of international spread are always there.

Transient nuclear lamin A/C accretion aids in recovery from vapor nanobubble-induced permeabilisation of the plasma membrane

Vapor nanobubble (VNB) photoporation is a physical method for intracellular delivery that has gained significant interest in the past decade. It has successfully been used to introduce molecular cargo of diverse nature into different cell types with high throughput and minimal cytotoxicity. For translational purposes, it is important to understand whether and how photoporation affects cell homeostasis. To obtain a comprehensive view on the transcriptional rewiring that takes place after VNB photoporation, we performed a longitudinal shotgun RNA-sequencing experiment. Six hours after photoporation, we found a marked upregulation of LMNA transcripts as well as their protein products, the A-type lamins. At the same time point, we observed a significant increase in several heterochromatin marks, suggesting a global stiffening of the nucleus. These molecular features vanished 24 h after photoporation. Since VNB-induced chromatin condensation was prolonged in LMNA knockout cells, A-type lamins may be required for restoring the nucleus to its original state. Selective depletion of A-type lamins reduced cell viability after VNB photoporation, while pharmacological stimulation of LMNA transcription increased the percentage of successfully transfected cells that survived after photoporation. Therefore, our results suggest that cells respond to VNB photoporation by temporary upregulation of A-type lamins to facilitate their recovery.

Paraquat poisoning: Death after oral intake

This case study describes an Indian male patient's death caused by paraquat after oral consumption. A 20-year-old male patient attended the emergency department. He had a major complaint of stomach disorders, vomiting, fatigue, and hypothermia. It was confirmed that he was transferred from a nearby hospital after evaluating the situation. It was reported that paraquat poison had a systemic effect, and during the healing process, he was subject to multiple dialysis. This study will help doctors and clinicians to respond quickly to paraquat poisoning and aid in the early recovery and maintenance of poisoning.

Effect of osteopathic manipulation on gait asymmetry.

Movement and loading asymmetry are associated with an increased risk of musculoskeletal injury, disease progression, and suboptimal recovery. Osteopathic structural screening can be utilized to determine areas of somatic dysfunction that could contribute to movement and loading asymmetry. Osteopathic manipulation treatments (OMTs) targeting identified somatic dysfunctions can correct structural asymmetries and malalignment, restoring the ability for proper compensation of stresses throughout the body. Little is currently known about the ability for OMTs to reduce gait asymmetries, thereby reducing the risk of injury, accelerated disease progression, and suboptimal recovery. To demonstrate whether osteopathic screening and treatment could alter movement and loading asymmetry during treadmill walking. Forty-two healthy adults (20 males, 22 females) between the ages of 18 and 35 were recruited for this prospective intervention. Standardized osteopathic screening exams were completed by a single physician for each participant, and osteopathic manipulation was performed targeting somatic dysfunctions identified in the screening exam. Three-dimensional (3-D) biomechanical assessments, including the collection of motion capture and force plate data, were performed prior to and following osteopathic manipulation to quantify gait mechanics. Motion capture and loading data were processed utilizing Qualisys Track Manager and Visual 3D software, respectively. Asymmetry in the following temporal, kinetic, and kinematic measures was quantified utilizing a limb symmetry index (LSI): peak vertical ground reaction force, the impulse of the vertical ground reaction force, peak knee flexion angle, step length, stride length, and stance time. A 2-way repeated-measures analysis of variance model was utilized to evaluate the effectsof time (pre/post manipulation) and sex (male/female) on each measure of gait asymmetry. Gait asymmetry in the peak vertical ground reaction force (-0.6%, p=0.025) and the impulse of the vertical ground reaction force (-0.3%, p=0.026) was reduced in males following osteopathic manipulation. There was no difference in gait asymmetry between time points in females. Osteopathic manipulation did not impact asymmetry in peak knee flexion angle, step length, stride length, or stance time. Among the participants, 59.5% (25) followed the common compensatory pattern, whereas 40.5% (17) followed the uncommon compensatory pattern. One third (33.3%, 14) of the participants showed decompensation at the occipitoatlantal (OA) junction, whereas 26.2% (11), one third (33.3%, 14), and 26.2% (11) showed decompensation at the cervicothoracic (CT), thoracolumbar (TL), and lumbosacral (LS) junctions, respectively. Somatic dysfunction at the sacrum, L5, right innominate, and left innominate occurred in 88.1% (37), 69.0% (29), 97.6% (41), and 97.6% (41) of the participants, respectively. Correcting somatic dysfunction can influence gait asymmetry in males; the sex-specificity of the observed effects of osteopathic manipulation on gait asymmetry is worthy of further investigation. Osteopathic structural examinations and treatment of somatic dysfunctions may improve gait symmetry even in asymptomatic individuals. These findings encourage larger-scale investigations on the use of OMT to optimize gait, prevent injury and the progression of disease, and aid in recovery after surgery.

Cannabidiol Does Not Impact Acute Anabolic or Inflammatory Signaling in Skeletal Muscle In Vitro.

Background:Cannabidiol (CBD) is becoming increasingly popular for the treatment of clinical conditions including as an aid for muscle recovery. Previous work demonstrated that CBD exhibited mild effects on skeletal muscle, with a tendency to increase anabolic signaling and decrease inflammatory signaling.Methods:To gain mechanistic insight and extend these findings, we conducted a set of experiments using C2C12 myotubes.Results:Increasing the dose of CBD (1–5 μM) provided with insulin-like growth factor 1 (IGF-1) showed no effect on anabolic signaling through mTORC1 (S6K1 [Thr389], p=0.27; rpS6 [Ser240/244], p=0.81; or 4E-BP1 [Thr37/46], p=0.87). Similarly, inflammatory signaling through nuclear factor kappa B (NF-κB) (p105, p=0.88; p50, p=0.93; or phosphorylated p65 [Ser536], p=0.84) in response to tumor necrosis factor α (TNFα) was unaffected by CBD (2.5 μM), whereas dioscin, a natural product that blocks NF-κB signaling, reduced p105 and phosphorylated p65 (Ser536) compared with the TNFα and the TNFα + CBD condition (p<0.01 and p<0.05, respectively). Finally, cannabinoid receptor type 1 (CB1) receptor levels were measured in C2C12 cells, murine skeletal muscle, cortex, and hippocampus. Although CB1 was not detectable in muscle cells or muscle tissue, high levels were observed in brain tissue.Conclusion:In conclusion, CBD does not directly modulate anabolic or inflammatory signaling in myotubes in vitro, which can likely be explained by the lack of functional receptors.

Bible Journaling as a Spiritual Aid in Addiction Recovery

Bible Journaling is a trend of the past decade whereby readers make creative, visual interventions in their Bibles, using coloured pens and pencils, watercolours, stickers and stencils, highlighting texts of particular resonance. Journaling, in its more conventional written forms, has long been recognised as a pathway to spiritual development. Significantly, Bible journaling is almost exclusively practiced by women and has a high level of interpersonal interaction attached to it, through open and mutual sharing of these creations, through various online social media fora. Gleaned from the sharing of women who journal for spiritual support, this article examines the role Bible journaling plays in aiding recovery from drug addiction. Multimodal analysis is a methodological approach that provides a structured semiotic framework in which to closely examine every feature of a creation such as a journaled page of a Bible, to examine how the journaler has made meaning of a text through their interventions on the page. Appreciating every mark, choice and placement of image, colour, typography as a motivated sign revealing the interest of the creator, the sign-maker, a detailed multimodal analysis is conducted of one page of a recovered drug-user’s journaled Bible. As shall be demonstrated, profound insights into the appropriation of sacred texts for the spiritual life of a recovering addict can be gleaned in this process. Bible journaling reveals itself to be a highly valuable spiritual practice for those in addiction recovery. This interdisciplinary paper uniquely brings a methodological approach from the field of semiotics to the field of spirituality. Both the methodological approach and the subject of sacred text journaling may be of particular interest to spiritual directors, across many religions with a foundational sacred text, as a means whereby adherents can engage with a text in a deep, contemplative and creative practice that is personally, spiritually sustaining and motivating during a difficult phase of life.

A Comprehensive Review of the Pathogenesis, Diagnosis, and Management of Diabetic Foot Infections.

To review an approach to diabetic foot infections (DFIs), including acute osteomyelitis, while also discussing current practices and the challenges in diagnosis and management. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant will1. Identify the risk factors for developing DFIs.2. Outline diagnostic techniques for assessing DFIs.3. Select the assessment techniques that support a diagnosis of osteomyelitis.4. Choose the appropriate pharmacologic and nonpharmacologic treatment options for patients who have DFIs. Diabetic foot ulcers result from a combination of peripheral neuropathy, vascular compromise, and repetitive trauma. Approximately 50% of individuals with diabetic foot ulcers will develop a diabetic foot infection (DFI), and 20% of individuals with a DFI will develop osteomyelitis. Herein, the authors review an approach to DFIs including acute osteomyelitis and discuss current practices and challenges in diagnosis and management.The diagnosis of a skin and soft tissue DFI is based on clinical criteria. A bone biopsy is considered the criterion standard for diagnosis of osteomyelitis; however, biopsy is not always feasible or available. Consequently, diagnosis can be made using a combination of clinical, biochemical, and radiographic findings. X-ray is the recommended imaging modality for initial evaluation; however, because of its lower relative sensitivity, advanced imaging may be used when clinical suspicion remains after negative initial testing.The microbiology of skin and soft tissue DFIs and osteomyelitis is similar. Staphylococcus aureus and other Gram-positive cocci are the most common pathogens identified. Deep cultures are preferred in both DFI and osteomyelitis to identify the etiologic pathogens implicated for targeted antimicrobial therapy. Management also requires a multidisciplinary approach. Surgical debridement in those with deep or severe infections is necessary, and surgical resection of infected bone is curative in cases of osteomyelitis. Finally, appropriate wound care is critical, and management of predisposing factors, such as peripheral neuropathy, peripheral arterial disease, tinea, and edema, aids in recovery and prevention.

The Piano Press: A Cable-Actuated Glove for Assistive Piano Playing

As the need for physical therapists for rheumatoid arthritis is rising, novel technologies are emerging to aid in physical therapy and motor recovery for rheumatoid arthritis patients. However, many of the existing techniques pose questions of practicality and use in the real world as multiple patients report being distracted or bored by their physical therapy sessions. To combat this problem, our project Piano Press aims to create a smart wearable glove that combines musical and physical therapy through assistive piano playing. The glove can amplify a user’s force when pressing on a piano key and help arthritic pianists develop muscle memory. We built Piano Press with three main modules, the conversion from sheet music to MIDI files and fingering positions on a virtual piano, the overall glove design and the rings around the hand, and the hardware components such as the microcontroller and servo motors. We simulated the finger movement in Rhino 7 with Grasshopper and compared the actuation time and distance to an experienced piano player’s. By utilizing cable actuation and MIDI files to control finger movement, the piano glove would use music to ease symptoms of arthritis while making physical therapy exercises enjoyable.