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Many gait retraining studies use cues that promote internal focus of attention. However, the motor control literature clearly shows the beneficial effects of using cues that promote an external focus of attention (EFOA) when teaching new movements. This case report seeks to illustrate the outcomes of using an EFOA for running gait retraining. It also examines whether retrained mechanics transfer across different running speeds.

A 22-year-old female competitive runner with a history of tibial stress injuries was the participant.

Baseline assessments of flexibility, strength, and running biomechanics were performed after which an eight-session gait retraining protocol was implemented. Visual (mirror) and verbal feedback (EFOA) cues were provided during the retraining protocol. Outcomes showed improved hip, knee, and ankle kinematics, reduced ground reaction forces, and earlier onset and longer durations of muscle activity following retraining. These improvements transferred across running speeds.

In this participant, EFOA cues were effective for the gait retraining protocol and the benefits were transferable across running speeds. Clinicians should consider how EFOA cues may be incorporated to improve gait retraining outcomes.

In this participant, EFOA cues were effective for the gait retraining protocol and the benefits were transferable across running speeds. Clinicians should consider how EFOA cues may be incorporated to improve gait retraining outcomes.

The risk of developing severe COVID-19 illness despite completing vaccination for patients who have previously received immunosuppressive therapy is unclear.

We present three patients who received rituximab for treatment of autoimmune disorders who subsequently developed severe COVID-19 pneumonia post-vaccination requiring intensive care unit admission and found to have undetectable B cells.

While there have been concerns about the effectiveness of COVID-19 vaccines in this patient cohort, this is the first case series to report development of severe COVID-19 illness after completing vaccination in those who previously received rituximab. Guidelines for the optimal timing of COVID-19 vaccination in relation to immunosuppressive therapy have been recently published, albeit after many patients in this subpopulation have already been vaccinated.

This case series brings attention to the limited humoral response to vaccines in patients treated with rituximab, highlights existing guidelines and their limitations, and raises future considerations about the potential benefits to testing vaccine responsiveness.

This case series brings attention to the limited humoral response to vaccines in patients treated with rituximab, highlights existing guidelines and their limitations, and raises future considerations about the potential benefits to testing vaccine responsiveness.Dysbiosis of the gut microbiome is a hallmark of inflammatory bowel disease (IBD) and both, IBD risk and microbiome composition, have been found to be associated with genetic variation. Using data from families of IBD patients, we examined the association between genetic and microbiome similarity in a specific IBD context, followed by a genome-wide quantitative trait locus (QTL) linkage analysis of various microbiome traits using the same data. check details SNP genotypes as well as gut microbiome and phenotype data were obtained from the Kiel IBD family cohort (IBD-KC). The IBD-KC is an ongoing prospective study in Germany currently comprising 256 families with 455 IBD patients and 575 first- and second-degree relatives. Initially focusing upon known IBD risk loci, we noted a statistically significant (FDR less then 0.05) association between genetic similarity at SNP rs11741861 and overall microbiome dissimilarity among pairs of relatives discordant for IBD. In a genome-wide QTL analysis, 12 chromosomal regions were found to be linked to the abundance of one of seven microbial genera, namely Barnesiella (chromosome 4, region spanning 10.34 cM), Clostridium_XIVa (chr4, 3.86 cM; chr14, two regions spanning 7.05 and 13.02 cM respectively), Pseudoflavonifractor (chr7, 12.80 cM) Parasutterella (chr14, 8.26 cM), Ruminococcus (chr16, two overlapping regions spanning 8.01 and 16.87 cM, respectively), Roseburia (chr19, 7.99 cM), and Odoribacter (chr22, three regions spanning 0.89, 5.57 and 1.71 cM, respectively), as well as the Shannon index of α diversity (chr3, 1.47 cM). Our study thus shows that, in families of IBD patients, pairwise genetic similarity for at least one IBD risk locus is associated with overall microbiome dissimilarity among discordant pairs of relatives, and that hitherto unknown genetic modifiers of microbiome traits are located in at least 12 human genomic regions.

Physiotherapists are often important figures in the lives of people with physical disabilities and chronic conditions, yet gaps in understanding remain regarding how therapists promote physical activity and leverage existing community-based recreation programs.

We used qualitative methods to explore experiences of physiotherapists as well as individuals with disabilities and chronic conditions receiving physiotherapy, with a focus on strategies to promote physical activity and the extent that therapists leverage community-based resources and programs.

Semi-structured interviews were completed with nine physiotherapists (six American and three Canadian) and eight individuals with a physical disability (all Americans).

Participants reflected on the salience of physical activity promotion throughout physiotherapy but also highlighted barriers. Three themes explored idealized and problematic experiences with physical activity promotion in therapy 1) individualized promotion of physical activity; 2) increarstanding the extent that these strategies align with the scope of physiotherapy practice in varying contexts.Ulcerative colitis (UC) is a complex immune-mediated disease in which the gut microbiota plays a central role, and may determine prognosis and disease progression. We aimed to assess whether a specific microbiota profile, as measured by a machine learning approach, can be associated with disease severity in patients with UC. In this prospective pilot study, consecutive patients with active or inactive UC and healthy controls (HCs) were enrolled. Stool samples were collected for fecal microbiota assessment analysis by 16S rRNA gene sequencing approach. A machine learning approach was used to predict the groups' separation. Thirty-six HCs and forty-six patients with UC (20 active and 26 inactive) were enrolled. Alpha diversity was significantly different between the three groups (Shannon index p-values active UC vs HCs = 0.0005; active UC vs inactive UC = 0.0273; HCs vs inactive UC = 0.0260). In particular, patients with active UC showed the lowest values, followed by patients with inactive UC, and HCs. At species level, we found high levels of Bifidobacterium adolescentis and Haemophilus parainfluenzae in inactive UC and active UC, respectively. A specific microbiota profile was found for each group and was confirmed with sparse partial least squares discriminant analysis, a machine learning-supervised approach. The latter allowed us to observe a perfect class prediction and group separation using the complete information (full Operational Taxonomic Unit table), with a minimal loss in performance when using only 5% of features. A machine learning approach to 16S rRNA data identifies a bacterial signature characterizing different degrees of disease activity in UC. Follow-up studies will clarify whether such microbiota profiling are useful for diagnosis and management.

Repeated serosurveys in the same population provide more accurate estimates of the frequency of SARS-CoV-2 infection and more comparable data over time than notified cases. We aimed to estimate the incidence of SARS-CoV-2 infection, identify associated factors, and assess time trends in the ratio of serological/molecular diagnosis in a cohort of university workers.

Participants had a serological rapid test for SARS-CoV-2 immunoglobulins M and G, and completed a questionnaire, in May-July 2020 (

 = 3628) and November 2020-January 2021 (

 = 2661); 1960 participated in both evaluations and provided data to compute the incidence proportion and the incidence rate. Crude and adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) were computed using generalized linear models with Poisson regression.

The incidence rate was 1.8/100 person-months (95% CI 1.5-2.0), and the 6 months' cumulative incidence was 10.7%. The serological/molecular diagnosis ratio was 101 in the first evaluation and 31 in the second. Considering newly identified seropositive cases at the first (

 = 69) and second evaluation (

 = 202), 29.0% and 9.4% never reported symptoms, respectively, 14.5% and 33.3% reported contact with a confirmed case and 82.6%, and 46.0% never had a molecular test. Males (aIRR 0.61; 95% CI 0.44-0.85) and 'high-skilled white-collar' workers (aIRR 0.74, 95% CI 0.53-1.04) had lower risk of infection.

University workers presented a high SARS-CoV-2 incidence while restrictive measures were in place. The time decrease in the proportion of undiagnosed cases reflected the increased access and awareness to testing, but opportunities continued to be missed, even in the presence of COVID-19-like symptoms.

University workers presented a high SARS-CoV-2 incidence while restrictive measures were in place. The time decrease in the proportion of undiagnosed cases reflected the increased access and awareness to testing, but opportunities continued to be missed, even in the presence of COVID-19-like symptoms.Esophageal squamous cell carcinoma (ESCC) is an aggressive form of human squamous cell carcinomas with extremely aggressive pathological features. This study explores the functions of microRNA-149 (miR-149) and its interacted molecules in ESCC. The ESCC-related miRNA and messenger RNA (mRNA) datasets were applied to identify aberrantly expressed genes in ESCC. Forty-two patients with ESCC were included and their tissue samples were collected. miR-149 was poorly expressed whereas DNA methyltransferase 3 beta (DNMT3B) and ring finger protein 2 (RNF2) were abundantly expressed in ESCC tumor samples. Overexpression of miR-149 suppressed growth and invasiveness of ESCC cells in vitro and in vivo. DNMT3B bound to the promoter region of miR-149 to trigger its promoter methylation and downregulation. RNF2 mRNA was a target of miR-149. RNF2 overexpression blocked the inhibitory effect of miR-149 on ESCC cell growth. RNF2 activated the Wnt/β-catenin pathway to promote ESCC development. In conclusion, this study found that DNMT3B downregulates miR-149 level through methylation modification of the miR-149 promoter, while miR-149 suppresses RNF2 expression and inactivates the Wnt/β-catenin pathway to suppress growth of ESCC cells.Dupuytren's disease is a progressive fibrotic condition of the hand that causes contracture of fingers in later stages. Our previous in vitro studies suggest that the transformation of fibroblasts to myofibroblasts induced by transforming growth factor-beta can be inhibited by the addition of the antifibrotic drug, pirfenidone (PFD). We hypothesize that the local delivery of PFD directly to nodules can potentially prevent the progression to cords and, furthermore, that injection of PFD after the resection of cords can limit the recurrence of the disease. The purpose of this research was to develop a PFD injectable solution and to assess its safety in mice. Based on preformulation observations, a sterile solution containing up to 8 mg/0.4 mL of PFD was prepared in a phosphate buffer with and without 15%v/v N-methyl-2-pyrrolidone. Accelerated stability studies suggested that the product should be kept at refrigerated temperature (2-8 °C) for long-term storage. Safety studies involving subcutaneous administration to mice showed that 2-4 mg of PFD in 0.