Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools

In recent decades, there has been a call for change among all stakeholders involved in scoliosis management. Parents of children with scoliosis have complained about the so-called “wait and see” approach that far too many doctors use when evaluating children’s scoliosis curves between 10° and 25°. Observation, Physiotherapy Scoliosis Specific Exercises (PSSE) and bracing for idiopathic scoliosis during growth are all therapeutic interventions accepted by the 2011 International Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT). The standard features of these interventions are: 1) 3-dimension self-correction; 2) Training activities of daily living (ADL); and 3) Stabilization of the corrected posture. PSSE is part of a scoliosis care model that includes scoliosis specific education, scoliosis specific physical therapy exercises, observation or surveillance, psychological support and intervention, bracing and surgery. The model is oriented to the patient. Diagnosis and patient evaluation is essential in this model looking at a patient-oriented decision according to clinical experience, scientific evidence and patient’s preference. Thus, specific exercises are not considered as an alternative to bracing or surgery but as a therapeutic intervention, which can be used alone or in combination with bracing or surgery according to individual indication. In the PSSE model it is recommended that the physical therapist work as part of a multidisciplinary team including the orthopeadic doctor, the orthotist, and the mental health care provider - all are according to the SOSORT guidelines and Scoliosis Research Society (SRS) philosophy. From clinical experiences, PSSE can temporarily stabilize progressive scoliosis curves during the secondary period of progression, more than a year after passing the peak of growth. In non-progressive scoliosis, the regular practice of PSSE could produce a temporary and significant reduction of the Cobb angle. PSSE can also produce benefits in subjects with scoliosis other than reducing the Cobb angle, like improving back asymmetry, based on 3D self-correction and stabilization of a stable 3D corrected posture, as well as the secondary muscle imbalance and related pain. In more severe cases of thoracic scoliosis, it can also improve breathing function.This paper will discuss in detail seven major scoliosis schools and their approaches to PSSE, including their bracing techniques and scientific evidence. The aim of this paper is to understand and learn about the different international treatment methods so that physical therapists can incorporate the best from each into their own practices, and in that way attempt to improve the conservative management of patients with idiopathic scoliosis. These schools are presented in the historical order in which they were developed. They include the Lyon approach from France, the Katharina Schroth Asklepios approach from Germany, the Scientific Exercise Approach to Scoliosis (SEAS) from Italy, the Barcelona Scoliosis Physical Therapy School approach (BSPTS) from Spain, the Dobomed approach from Poland, the Side Shift approach from the United Kingdom, and the Functional Individual Therapy of Scoliosis approach (FITS) from Poland.     

An exploration of instructor perceptions of community college students’ attitudes towards evolution

Background

Faculty perception of student knowledge and acceptance of subject matter affects the choice of what to teach and how to teach it. Accurate assessment of student acceptance of evolution, then, is relevant to how the subject should be taught. To explore the accuracy of such assessment, we compared how community college instructors of life sciences courses perceive students’ attitudes towards evolution with those students’ actual attitudes towards evolution.

Results

The research had two components: (1) a survey of students of several biology classes at a community college about their acceptance of evolutionary theory and (2) interviews with the biology faculty teaching those classes about their perceptions of their students’ attitudes towards evolution. Results of the study indicate relatively high levels of acceptance of evolution among community college students at this West Coast institution. We also found that community college instructors of life sciences courses varied in accuracy of their perceptions of their students’ attitudes towards evolution–but not systematically. Although one professor assessed each class quite accurately, the other two professors frequently underestimated the acceptance of evolution among their students.

Conclusions

Errors in perception seemed independent of whether the class was composed of majors, nonmajors, or a combination. Clearly, in our sample there is much idiosyncrasy regarding community college instructor accuracy concerning student opinions about evolution.

     

Playing God? Synthetic biology as a theological and ethical challenge

In the ethical debate over synthetic biology the formula “playing god” is widely used in order to attack this new branch of biotechnology. The article analyses, contextualizes and criticises this usage with respect to the theological concepts of creation, sin and humans as created in the image of God. Against the background of these theological understandings an ethical corridor of how to responsibly cope with the societal challenges of synthetic biology is presented.     

Recruitment of young women to a trial of chlamydia screening – as easy as it sounds?

Background

In the United Kingdom (UK), there is an extensive market for the class 'A' drug heroin. Many heroin users spend time in prison. People addicted to heroin often require prescribed medication when attempting to cease their drug use. The most commonly used detoxification agents in UK prisons are buprenorphine, dihydrocodeine and methadone. However, national guidelines do not state a detoxification drug of choice. Indeed, there is a paucity of research evaluating the most effective treatment for opiate detoxification in prisons. This study seeks to address the paucity by evaluating routinely used interventions amongst drug using prisoners within UK prisons.

Methods/Design

The Leeds Evaluation of Efficacy of Detoxification Study (LEEDS) Prisons Pilot Study will use randomised controlled trial methodology to compare the open use of buprenorphine and dihydrocodeine for opiate detoxification, given in the context of routine care, within HMP Leeds. Prisoners who are eligible and give informed consent will be entered into the trial. The primary outcome measure will be abstinence status at five days post detoxification, as determined by a urine test. Secondary outcomes during the detoxification and then at one, three and six months post detoxification will be recorded.     

Microalgae as a source of bioactive molecules – experience from cyanophyte research

Detrimental and beneficial properties of prokaryoticand eukaryotic microalgae may be qualifications givingthem posibillities for their biotechnologicalutilization. Phycotoxins and related products mayserve as material for useful drugs. Cyanotoxins arean example. Bioassay screening methods are used todetect specific biological activity (e.g. antibioticeffects). A study demonstrating antibacterialproperties among cyanophytes showed that these effectswere caused by substances produced by both toxigenicand non-toxigenic strains. Differences inbiosynthetic activity are influenced by the type ofclones and by the culture conditions (genetic andbiochemical variation). Experience of recentscreening (1997–1998) of compounds from cyanophytes –including 25 species from 14 genera – display thediscovery of more than 30 different antibioticsubstances. The further isolation of newpharmaceuticals from natural resources is becomingdifficult, if not uncommon species of producerorganisms are taken into consideration.     

On the tensions of universities as a social institution – developing a comparative sociology of higher education

This review of Natasha Warikoo’s timely and insightful intervention on the relationship between race, social mobility and elite university institutions argues that education has always presented a profoundly contested terrain for debates about race, racism and inclusion but that for too long those debates were confined to pre-eighteen education. The review argues that this study, with its revelatory, comparative U.S./U.K. lens, reveals the complex tensions, ambitions, achievements, identifications, anxieties, limits of diversity, and denials that shape the experiences and perspectives of those students who are part of the population of elite universities. It concludes that Warikoo’s work makes an original and important contribution to the emergent and much needed sociology of higher education.     

Adaptive Timing as a Component of a Mosquito-Eating predator’s Specialization Profile

Evarcha culicivora, a salticid spider from East Africa, is a mosquito specialist which feeds indirectly on vertebrate blood by actively choosing blood-carrying mosquitoes as preferred prey and by actively choosing Anopheles as preferred mosquitoes. Here we investigate for the first time whether specialization by this predator is also expressed in the timing of its predatory activity. With data from field sampling and from systematically observing E. culicivora under semi-field conditions, we show that instances of predation tend to be most common in the early morning hours, this being when especially many night-feeding anthropophilic anopheline mosquitoes are resting while digesting blood acquired during the night. Experimental data show that E. culicivora is significantly more responsive to prey in the morning than in the afternoon, where ‘responsive’ includes being significantly more inclined to eat living prey, choose the preferred prey, approach a source of prey odor in the absence of visible prey and approach lures made from dead prey that can be seen but not touched or smelled. We found no significant diel pattern in E. culicivora’s inclination to mate and, although mate, plant and human odors are all known to be salient to E. culicivora, we found no significant diel pattern in response to any of these odors. Our findings suggest that E. culicivora’s innate pattern of predatory activity is adaptively adjusted in a way that facilitates predation on its preferred prey.     

Association of a common TLR-6 polymorphism with coronary artery disease – implications for healthy ageing?

Background

The pro-inflammatory status of the elderly triggers most of the age-related diseases such as cancer and atherosclerosis. Atherosclerosis, the leading cause world wide of morbidity and death, is an inflammatory disease influenced by life-style and genetic host factors. Stimuli such as oxLDL or microbial ligands have been proposed to trigger inflammation leading to atherosclerosis. It has recently been shown that oxLDL activates immune cells via the Toll-like receptor (TLR) 4/6 complex. Several common single nucleotide polymorphisms (SNPs) of the TLR system have been associated with atherosclerosis. To investigate the role of TLR-6 we analyzed the association of the TLR-6 SNP Pro249Ser with atherogenesis.

Results

Genotyping of two independent groups with CAD, as well as of healthy controls revealed a significant association of the homozygous genotype with a reduced risk for atherosclerosis (odds ratio: 0.69, 95% CI 0.51-0.95, P?=?0.02). In addition, we found a trend towards an association with the risk of restenosis after transluminal coronary angioplasty (odds ratio: 0.53, 95% CI 0.24-1.16, P?=?0.12). In addition, first evidence is presented that the frequency of this protective genotype increases in a healthy population with age. Taken together, our results define a role for TLR-6 and its genetic variations in modulating the inflammatory response leading to atherosclerosis.

Conclusions

These results may lead to a better risk stratification, and potentially to an improved prophylactic treatment of high-risk populations. Furthermore, the protective effect of this polymorphism may lead to an increase of this genotype in the healthy elderly and may therefore be a novel genetic marker for the well-being during aging.

     

6,6’-Dihydroxythiobinupharidine as a poison of human type II topoisomerases

A number of natural products with medicinal properties increase DNA cleavage mediated by type II topoisomerases. In an effort to identify additional natural compounds that affect the activity of human type II topoisomerases, a blind screen of a library of 341 Mediterranean plant extracts was conducted. Extracts from Nuphar lutea, the yellow water lily, were identified in this screen. N. lutea has been used in traditional medicine by a variety of indigenous populations. The active compound in N. lutea, 6,6’-dihydroxythiobinupharidine, was found to enhance DNA cleavage mediated by human topoisomerase IIα and IIβ ∼8-fold and ∼3-fold, respectively. Mechanistic studies with topoisomerase IIα indicate that 6,6’-dihydroxythiobinupharidine is a “covalent poison” that acts by adducting the enzyme outside of the DNA cleavage-ligation active site and requires the N-terminal domain of the protein for its activity. Results suggest that some of the medicinal properties of N. lutea may result from the interactions between 6,6’-dihydroxythiobinupharidine and the human type II enzymes.     

Pre-service teachers’ perceptions of sluggish cognitive tempo

Sluggish cognitive tempo (SCT) is characterized by a passive form of inattention that may not overtly disrupt classroom goals. Due to the nature of these symptoms, children with SCT may be “falling through the cracks” in schools. The current study examined pre-service teachers’ perceptions of SCT in the classroom. Undergraduate education majors (n = 161) read vignettes describing fictitious fourth-grade boys presenting with symptoms of SCT, attention-deficit/hyperactivity disorder (ADHD), or a non-ADHD-related control: social anxiety disorder (SA), and rated each of the vignettes in terms of their perceptions of the boy described. Results were analyzed using repeated measures ANOVAs and paired-sample t tests. Pre-service teachers viewed all three sets of symptoms as concerning, but viewed ADHD behaviors as the most problematic. These results are promising, as they suggest that pre-service teachers are concerned about both hyperactive (i.e., ADHD) and non-hyperactive behavioral problems (i.e., SCT and SA). Implications and future directions are discussed.     

Echocardiographic markers of dyssynchrony as predictors of super-response to cardiac resynchronisation therapy – a pilot study

Background

Some patients with congestive heart failure have greater improvement of cardiac remodelling after cardiac resynchronisation therapy (CRT) and they are identified as super-responders (SRs). It remains unclear if echocardiographic markers of dyssynchrony could accuratelly predict super-response to CRT. The aim of this study is to evaluate potential echocardiographic predictors associated with super-response to CRT.

Methods

Fifthy nine CRT patients (mean age 52.9?±?9.0 years, 88% men) with congestive heart failure (54% ischaemic and 46% non-ischaemic aetiology) II-IV NYHA functional class were enrolled. To assess mechanical dyssynchrony we evaluated interventricular mechanical delay, the maximum delay between peak systolic velocities of the septal and posterior walls of left ventricle, duration of left ventricular pre-ejection period (LVPEP), left ventricular and interventricular dyssynchrony by tissue Doppler imaging and systolic dyssynchrony index by 3D echocardiography. After six months the patients were assessed for response and classified as SRs (reduction in left ventricular end-systolic volume (LVESV) ≥30%, n?=?20) and non-SRs (reduction in LVESV <?30%, n?=?39) and baseline data were analyzed to identify the predictors.

Results

Both groups demonstrated significant improvement in NYHA functional class, increase in left ventricular ejection fraction and reduction in LVESV. All parameters of mechanical dyssynchrony at baseline were significantly higher in SR group. Multiple logistic regression analysis showed that LVPEP (HR 1.031; 95% CI 1.007–1.055; p?=?0.011) was an independent predictor for CRT super-response. In ROC curve analysis LVPEP with a cut-off value of 147 ms demonstrated 73.7% sensitivity and 75% specificity (AUC?=?0.753; p?=?0.002) for the prediction of super-response to CRT.

Conclusion

Greater mechanical dyssynchrony is associated with super-response to CRT in patients with congestive heart failure. It is probable that an LVPEP >?147 ms can be used as independent predictor of super-response.

     

‘Minority’ as a sociological concept

This article considers how a Muslim cultural discourse of ‘propriety’ has influenced Muslim Arab Sudanese ethnic identity in two locations and time periods in an expanding diaspora. Focusing in particular on women and their embodied practices of whitening and propriety in Egypt in the nineties and the United Kingdom a decade later, I argue that the recent turn towards Muslim expressions of Sudaneseness is a form of resistance to racial labelling. While Sudanese have rejected being labelled ‘black’ in Egypt and in the UK, their renegotiation of a Muslim religious identity in the diaspora nevertheless confirms a racialized Sudanese ethnicity. This study contributes to the rethinking of ethnicity in a transnational space where ethnic nationalism and globalized Islamic discourse intersect with local histories and hierarchies of race and gender.     

Scute’s polymorphism as a source of evolutionary development of the turtle shell

The scute mosaic (pholidosis) of the turtle shell is a complex correlated system of the modular type. Horny scutes are separate morphological elements partially closely connected with each other and partially relatively autonomous in development. The last feature causes high variability of scutes in the shape, size, rate and direction of growth, and provides the basis of transformation of the entire mosaic. In the evolution of turtles, the horny shell changed towards a decrease in the number of elements composing it. The process of oligomerization developed through reduction and fusion of scutes or their anlages. The traces of these transformations are observed in the ontogeny of living turtles. The scutes undergoing reduction display the following developmental deviations: (1) a decrease in size of the scute anlage, (2) the temporal shift in initiation to later embryonic stages, (3) absence of an anlage of a own furrow (the boundaries of the scute are formed by the furrows of neighboring scutes), and (4) a decrease in size of the zone and rate of the scute growth. The fusion of horny scutes follows two patterns: (1) fusion of scute anlages and (2) reduction of horny furrows separating scutes before. Secondary polymerization of the scute mosaic by the appearance of additional elements usually results from abnormal development and is infrequently fixed in evolution. The main mechanism of evolutionary changes in turtle pholidosis was heterochrony, i.e., the time shift in initiation and developmental rate of scutes. The heterotopies, i.e., changes in the position of scute anlages, played a minor role in the evolution of turtles; they usually caused only scute abnormalities, which was frequently asymmetrical.     

Bhattacharyya’s distance measure as a precursor of genetic distance measures

In Population Genetics, two populations are distinguished from each other on the basis of the differences in the distributions of the alleles at the locus or loci under consideration. These differences are measured by a “genetic distance” between the two populations (not to be confused with genetic distance between two loci, which is based on recombination fractions) and they play a major role in inferences at the population level. Several measures of genetic distance have been proposed by different authors (Sanghvi 1953; Cavalli-Sforza and Edwards 1967; Jukes and Cantor 1969; Nei 1972; Kimura 1980; Reynoldset al 1983; reviews in Felsenstein 1991; Nei and Kumar 2000). Most of these measures are actually dissimilarity measures and not mathematically true distance measures (B-Rao and Majumdar 1999). Independently, and much before the geneticists, statisticians too were concerned with the idea of distinguishing between two (statistical) populations. In order to discriminate between two populations on the basis of one or more characters, divergence measures like “Mahalanobis’D ² statistic” or “Mahalanobis’ generalized distance” (1936) and “Bhattacharyya’s distance” (1943, 1946), Kullback-Leibler’s divergence measure (1951) etc. have been proposed by statisticians. Mukherjee and Chattopadhyaya (1986) have mentioned measures based on distances, association between two attributes and discrimination function. There are similarities between the distance measures defined by applied scientists and by theoreticians. Felsenstein (1985) shows that three of the allele frequency-based genetic distance measures were anticipated by Bhattacharyya (1946). Nei and Takezaki (1994) have also studied the effectiveness of several genetic distance measures in the context of phylogenetic analysis, including Bhattacharyya’s distance measure.     

Identification of protegrin-1 as a stable and nontoxic scaffold among protegrin family – a computational approach

Achieving both, nontoxicity and stability in antimicrobial peptides (AMP) is a challenge. This study predicts a structurally stable, nontoxic scaffold among the protegrin family, for future therapeutic peptide analogs. Protegrins (PG) are a class of pharmaceutically approved, in demand AMPs, which require further improvement in terms of nontoxicity and stability. Out of five protegrins viz., PG1, PG2, PG3, PG4 and PG5, PG1 has been predicted as best scaffold. Prediction was based upon sequential elimination of other protegrins, using computational methods to assess the extracellular bacterial membrane penetrability, nontoxicity and structural stability by geometric observables. Initially, PG2 and PG4 showing the lowest membrane penetrability and highest toxicity respectively, were screened out. Among the remaining three protegrins, PG1 displayed both lowest root mean square deviation and radius of gyration, with a considerable occupancy of seven H-bonds and established uniform secondary structure profile throughout its ensembles. Therefore, the authors claim the superiority of PG1 as a nontoxic stable scaffold among its family.

Communicated by Ramaswamy H. Sarma