Kevin Wilk

The incidence of knee injuries in sport, particularly involving the ACL, appears to be increasing yearly, especially in younger age athletes. Even more concerning is the frequency of ACL reinjury also appears to be increasing year after year. Improving the objective criteria and testing methods used to determine return to play (RTP) readiness following ACL surgery is one aspect of the rehabilitation process that can significantly help in reducing reinjury rates. Currently, the majority of clinicians are still using post operative time frames as their number one criterion for clearance to RTP...

Introduction of monovalent COVID-19 mRNA vaccines in late 2020 helped to mitigate disproportionate COVID-19-related morbidity and mortality in U.S. nursing homes (1); however, reduced effectiveness of monovalent vaccines during the period of Omicron variant predominance led to recommendations for booster doses with bivalent COVID-19 mRNA vaccines that include an Omicron BA.4/BA.5 spike protein component to broaden immune response and improve vaccine effectiveness against circulating Omicron variants (2). Recent studies suggest that bivalent booster doses provide substantial additional protection against SARS-CoV-2 infection and severe COVID-19-associated disease among immunocompetent adults who previously received only monovalent vaccines (3)...

BACKGROUND: Virtual care (VC) and remote patient monitoring programs were deployed widely during the COVID-19 pandemic. Deployments were heterogenous and evolved as the pandemic progressed, complicating subsequent attempts to quantify their impact. The unique arrangement of the Military Health System (MHS) enabled direct comparison between facilities that did, and did not, implement a standardized VC program. The VC program enrolled patients symptomatic for COVID-19, or at risk for severe disease...

No abstract text is available yet for this article.

By direct deposition of the drug at the local site of action, injectable depot formulations - intended for treatment of a local disease or for local intervention - are designed to limit the immediate exposure of the active principle at a systemic level and to reduce the frequency of administration. To overcome known drawbacks in the production of some marketed phospholipid-based depots, here we propose to manufacture drug-loaded negatively charged liposomes through conventional technologies and to control their aggregation mixing a solution of divalent cations prior to administration...

The growing concerns regarding the risks of transmitting the COVID-19 virus have intensified the job-related stressors commonly encountered by teachers in various cultural contexts. Evidence shows how the COVID-19 crisis has negatively impacted teachers' mental health outcomes such as stress, depression, and quality of life, which highlights the significance of designing psychological programs to boost teachers' well-being. This study examined the effects of a well-being intervention based on the Positivity, Relationship, Outcomes, Strength, Purpose, Engagement, and Resilience (PROSPER) framework on well-being outcomes among 76 in-service teachers (Mage  = 26...

BACKGROUND AND PURPOSE: Contrast therapy consists of alternating thermotherapy and cryotherapy repeatedly to assist in the management of acute, subacute, and chronic musculoskeletal conditions. This has been utilized for several decades with good to excellent subjective and objective results reported for patients with swelling (acute to chronic), pain, and loss of motion. Typically, the intervention is performed by either the use of a hot and cold whirlpool or by applying hot and cold packs which can be very time consuming and labor intensive...

BACKGROUND: Persistent immune activation is thought to contribute to heightened atherosclerotic cardiovascular disease (ASCVD) risk among people with HIV (PWH). METHODS: Participants (≥18 years) with versus without HIV and without history of clinical ASCVD were enrolled. We hypothesized that increased macrophage-specific arterial infiltration would relate to plaque composition and systemic immune activation among PWH. We applied a novel targeted molecular imaging approach [technetium-99  m (99mTc)-tilmanocept single photon emission computed tomography (SPECT)/CT] and comprehensive immune phenotyping...

BACKGROUND: Accurate and rapid measurement of the MRI volume of meningiomas is essential in clinical practice to determine the growth rate of the tumor. Imperfect automation and disappointing performance for small meningiomas of previous automated volumetric tools limit their use in routine clinical practice. PURPOSE: To develop and validate a computational model for fully automated meningioma segmentation and volume measurement on contrast-enhanced MRI scans using deep learning...

INTRODUCTION: Total knee arthroplasty (TKA) carries a high risk for significant blood loss due to bone cuts and extensive soft tissue involvement in the knee region. The use of tranexamic acid (TXA) or a tourniquet are two methods commonly employed to prevent significant blood loss and avoid the need for blood transfusion. TXA has been shown to reduce both intraoperative and postoperative bleeding as well as the probability that a patient will require a blood transfusion. The purpose of this study is to compare the efficacy of TXA and tourniquet use, both alone and in combination, in reducing blood loss during TKA...

The objective was to assess how patellofemoral loads (joint force and stress) change while lunging with step length and step height variations. Sixteen participants performed a forward lunge using short and long steps at ground level and up to a 10-cm platform. Electromyography, ground reaction force, and 3D motion were captured, and patellofemoral loads were calculated as a function of knee angle. Repeated-measures 2-way analysis of variance (P < .05) was employed. Patellofemoral loads in the lead knee were greater with long step at the beginning of landing (10°-30° knee angle) and the end of pushoff (10°-40°) and greater with short step during the deep knee flexion portion of the lunge (50°-100°)...

A convergent approach for the total synthesis of calcipotriol (brand name: Dovonex), a proven vitamin D analog used for the treatment of psoriasis, and medicinally relevant synthetic analogs is described. A complete approach, not wedded to semisynthesis, toward both the A-ring and CD-ring is reported. From a retrosynthetic standpoint, hidden symmetry within the decorated A-ring is disclosed, which allowed for scalable quantities of this advanced intermediate. In addition, a radical retrosynthetic approach is described, which highlights an electrochemical reductive coupling as well as an intramolecular hydrogen atom transfer Giese addition to establish the 6,5-transcarbon skeleton found in the vitamin D family...

CONTEXT: Improper baseball pitching biomechanics are associated with increased stresses on the throwing elbow and shoulder as well as an increased risk of injury. EVIDENCE ACQUISITION: Previous studies quantifying pitching kinematics and kinetics were reviewed. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 5. RESULTS: At the instant of lead foot contact, the elbow should be flexed approximately 90° with the shoulder at about 90° abduction, 20° horizontal abduction, and 45° external rotation...

As human population growth has expanded in Southwest Florida, water quality has become degraded with an increased occurrence of harmful algal blooms (HABs). Red tide (Karenia brevis) originating offshore, intensifies in nearshore waters along Florida's Gulf Coast, and blue-green algae (Microcystis spp.) originating in Lake Okeechobee is discharged into the Caloosahatchee River. These HABs could be enhanced by anthropogenic nitrogen (N) and phosphorus (P) from adjacent watersheds. North Fort Myers is a heavily developed, low-lying city on the Caloosahatchee River Estuary serviced by septic systems with documented nutrient and bacterial pollution...

No abstract text is available yet for this article.

Mitral valve perforation is an uncommon aetiology of mitral regurgitation in the paediatric population. We present a case where 3-dimensional echocardiography assisted in the diagnosis of the source of mitral regurgitation and the surgical correlation.

Background: Forward and side lunge exercises strengthen hip and thigh musculature, enhance patellofemoral joint stability, and are commonly used during patellofemoral rehabilitation and training for sport. Hypothesis/Purpose: The purpose was to quantify, via calculated estimates, patellofemoral force and stress between two lunge type variations (forward lunge versus side lunge) and between two step height variations (ground level versus 10 cm platform). The hypotheses were that patellofemoral force and stress would be greater at all knee angles performing the bodyweight side lunge compared to the bodyweight forward lunge, and greater when performing the forward and side lunge at ground level compared to up a 10cm platform...

BACKGROUND: Depression is pleiotropic and influenced by diverse genetic, environmental, and pharmacological factors. Identifying patterns of circuit activity on which many of these factors converge would be important, because studying these patterns could reveal underlying pathophysiological processes and/or novel therapies. Depression is commonly assumed to involve changes within prefrontal circuits, and dopamine D2 receptor (D2R) agonists are increasingly used as adjunctive antidepressants...

The overhead throwing motion is an extremely stressful athletic movement. The high velocity and repetitive nature of this activity places immense pressure on the entire body, which can frequently result in injury to the throwing arm. Extensive literature exists with regards to the management of these injuries in the collegiate and professional level athlete; and it is well understood that a multiphasic approach is required to return an individual to prior level of play. However, there is a gap in the literature which fails to address the management of youth individuals...

BACKGROUND: The gap between treatment need and treatment availability is particularly wide for individuals seeking Dialectical Behavior Therapy (DBT), and mobile apps based on DBT may be useful in increasing access to care and augmenting in-person DBT. This review examines DBT based apps, with a specific focus on content quality and usability. METHODS: All apps referring to DBT were identified in Google Play and iOS app stores and were systematically reviewed for app content and quality...