The identification of risk factors associated with overuse injuries, specifically Medial Tibial Stress Syndrome (MTSS) and Tibial Stress Fractures (TSF), may help professionals with management and prevention of these injuries. The purpose of this study was to identify risk factors associated with MTSS and TSF in female intercollegiate athletes. This study used a mulitifactorial, prospective design for 13-26 weeks. Thirty-nine Division I intercollegiate female student-athletes in volleyball, soccer, and track were examined. Anatomical, physiological (eating disorder and menstrual history), and training (duration and recovery time) characteristics were examined as possible risk factors. Only two injuries were reported during the study; therefore, analysis for risk factors was not possible. Descriptive statistics for the dependent variables were calculated, and comparisons across sport were performed. Differences in leg length values and dorsiflexion ROM were observed across sports. No conclusions could be drawn regarding possible risk factors for MTSS and TSF in this population.

This study investigates whether there are certain age groups in college that are more susceptible to eating problems and the contributing factors for eating disorders. The participants were 144 college women divided into traditional and non-traditional age groups. The EDI-2, BSI, RSE, and additional items were administered. The results show that non-traditional age college women were as likely to have eating disorder symptoms and more likely to possess body dissatisfaction than traditional age college students. The data support body dissatisfaction, aging concerns, perfectionism, depression, anxiety, and having children as potential risk factors for eating disturbances. This study suggests that there are high prevalence rates of eating disturbances in all college female age groups, but that the highest prevalence may actually be in older women. It is imperative that clinicians and others working in colleges realize these issues can affect students of all ages.

No description available.

Patients with common variable immunodeficiency (CVID) are occasionally recognized to have a concurrent noncaseating granulomatous disease. The granulomatous disease (GD) associated with CVID shares many clinical properties typical of sarcoidosis. Some investigators speculate that the GD-CVID is actually sarcoidosis that is expressed atypically because of the patient's immunodeficiency. Clinical differences, however, have led other investigators to speculate that the GD-CVID is a distinct "sarcoid-like" granulomatous process.

The anticardiolipin antibody syndrome is relatively uncommon. It should be suspected mostly in young people with unexplained embolic or thrombotic events. A young patient with an abnormal prothrombin time, partial thromboplastin time, or venereal disease research lab test with one of the above noted vascular events would be a suspect for this disorder. Though an antibody test that will qualitatively and quantitatively measure antiphospholipid antibodies is available, its clinical application is not entirely clear. The presence of the antibody will support a diagnosis but cannot be used alone for diagnosis or treatment.

We are reporting an unusual case of cat-scratch disease in a young adolescent girl presenting with recurrent ascites. The illness started with nonspecific symptoms followed by ascites and an axillary lymph node enlargement. She had recurrent ascites for 18 months associated with constrictive pericarditis. Following pericardiectomy, she had a resolution of ascites and was back to her normal life. This is a first documented report of a constrictive pericarditis following cat scratch diseases in English literature.

No description available.

Traumatic brain injury (TBI) is a prevalent condition worldwide with 1.7 million incidences in the U.S. alone. A range of clinical outcomes have been reported post TBI, including dementia, memory loss, and impaired balance and coordination. The lack FDA approved treatments for TBI drives the need for improved prevention and therapeutic strategies. Finite element (FE) models of brain injury mechanics can be used to advance these efforts. These computational models require appropriate constitutive properties in order to predict accurate brain tissue response to injury loading. Suitable experimental models need to be implemented to match the resolution and computational power of FE models. The first aim of this thesis was to characterize the mechanical properties of brain tissue. Here, human, porcine, and rat brain tissue mechanical responses to multistep indentation of increasing strains up to 30% strain were recorded. We tested whether the quasilinear theory of viscoelasticity (QLV) was required to capture the mechanical behavior of brain tissue, but observed that linear viscoelasticity was sufficient under the loading condition applied. Using this fitting model, brain tissue stiffness was found to be dependent on anatomical region, loading direction, age, sex and species to varying degrees. This analysis elucidated factors that affect brain tissue injury mechanics and can be used to improve the accuracy of FE models of brain tissue deformation to predict a biofidelic response to TBI. There is growing evidence linking TBI to pathologies leading to increased risk of neurodegeneration, like tauopathies. However better understanding of these underlying mechanisms is still needed. In our study, we utilized a custom shock tube design to induce blast TBI (bTBI). To isolate the effect of bTBI-induced tau pathology, tau was extracted from sham and shockwave exposed mice 24 hours post injury, referred to as sham and blast tau respectively. We showed that bTBI increased phosphorylation of tau and its propensity to oligomerize. Treatment with blast tau resulted in impaired behavior in mice as well as reduced long term potentiation (LTP) in acute hippocampal slices. Treatment with brain isolate from shockwave exposed tau knockout mice did not exhibit altered behavior or LTP response, eliminating the possibility that any confounding factor in the blast tau preparation was responsible for the impaired outcome. Administration of de-oligomerized blast tau prevented these cognitive impairments, suggesting that toxic effect of blast tau was attributed to its oligomeric form. Here we showed that blast injury can initiate cascades in tau pathology and exposure to this progression results in worsened neurological outcome. Tau phosphorylation is mainly regulated by protein phosphatase 2A (PP2A), whose activity can be altered by leucine carboxyl methyltransferase 1 (LCMT-1) and protein phosphatase methylesterase 1 (PME-1). We sought to leverage this mechanism by infusing LCMT-1 and PME-1 transgenic mice with sham and blast tau. LCMT-1 overexpression prevented behavior and LTP deficits induced by oligomeric blast tau. Furthermore, PME-1 overexpression worsened behavior and LTP response at subthreshold doses of oligomeric blast tau. Together, this illustrated the ability of these two enzymes to regulate the response to exposure of bTBI-induced pathogenic forms of tau. This study indicates the potential of targeting PP2A activity as a viable strategy for therapeutic intervention. In conclusion, this research expands our understanding of the complexity of brain tissue injury mechanics to inform computational models of TBI, illustrates the deleterious effect of pathogenic forms of tau induced by blast injury on cognitive function, and presents a potential target mechanism for the investigation of therapeutic strategies.

(1) Problem: Previous evidence showed that parenting programs effectively reduce externalizing problems and disorders in children living in high-income countries. However, there was less evidence about the effectiveness of parenting programs in low- and middle-income countries (LMICs). In addition, there is a need for more studies that assess how parenting practices and family characteristics mediate the effects of parenting programs. The overall goal of this dissertation was to contribute to closing the gap in the evidence regarding the efficacy of parenting programs in and low- and middle-income countries. Also, this dissertation intended to increase the evidence regarding how parenting practice (i.e., supervision, parent child communication, and punishment) meditate the effects of parenting programs high-income and low- and middle-income countries. (2) Materials and methods: First, in chapter 2, I conducted a systematic review to synthesize the evidence regarding how parenting practices and family variables mediated the parenting programs effects. In chapter 3, I assessed the effect of Pilas program on child’s oppositional and conduct problems and aggressive behaviors. Also, I examined the mediating mechanism though parent-child communication, supervision, and punishment. Pilas was a multimodal program designed and implemented in Medellin Colombia. The program was evaluated through a cluster randomized control trial, including children aged 6-11 who were followed at baseline, 1-, and 3-year assessments. In chapter 4, I assessed how parent-child communication and supervision mediated the effect of Fast Track Project (FTP) on antisocial behaviors at grade 7 and 9, exploring the mediating mechanism of FTP in the early- and middle-adolescence. FTP is a multimodal intervention that aim to reduce conduct problem in childhood in four communities of the USA (Durham, NC, Nashville, TN, rural PA, and Seattle, WA.). (3) Results and conclusions: In the chapters 2, the systematic review showed that positive parenting and parental discipline had been the most studied mediators of parenting programs. However, there was limited evidence or methodological problems regarding other mechanisms (i.e., supervision, family functioning, parent-child relationships, harsh parenting, and ineffective discipline). In addition, few articles studied the medium (3-5 years follow-up) and long-term (more than 5 years) mediating mechanisms, and no articles assessed mediation mechanisms in low- and middle-income countries. Among, the most important methodological problems were the lack of control for confounding in the Mediator-Outcome pathway (M-Y pathway) and underreporting of the mediating results. In chapter 3, I presented the Pilas effects and mediated mechanisms. Children exposed to Pilas had 22% fewer conduct problems, 32% fewer oppositional problems, 36% less indirect aggression, 15% less total aggressive behaviors, and 22% less direct aggression. On the other hand, there were not program effects on child behaviors based on caregivers' reports. In addition, after three years of follow-up, Pilas reduced the number of psychological and psychical punishments reported by the children, but it did not have an effect on punishment as reported by caregivers. Pilas improved parent-restricted topics and role orienting reported by the caregivers. However, the Pilas effects were not mediated through the target mediators (supervision, parent-child communication, and punishment) so the mediation mechanisms remain unknown. Chapter 4 presented the medium- and long-term mediating mechanism of Fast-track project. I found that parent-child communication and supervision were not mediators of FTP effects on antisocial behaviors during early- and middle- adolescence. However, FTP improved antisocial behavior in early- and middle-adolescents and improve parenting practices such as parent-child communication and supervision. FTP reduced child antisocial behaviors in grades 7 and 9 and improved child communication and total communication and supervision variables, such as daily discussion of activities and curfew time. Finally, chapter 5 presented the most important dissertation findings and conclusions. There is evidence about the mediating mechanism of parenting programs. However, the evidence available is not conclusive and had multiple methodological weakness and underreporting. Pilas programs improved children’s conduct problems, oppositional problems and aggressive behavior and reduces punishment against the children. However, the program effect was not mediated through parenting practices. Regarding FTP, the program effects of antisocial behaviors were not mediated through parent-child communication and supervision during early- and middle- adolescence. Further studies should be conducted to enlarge the evidence about the effects of parenting programs on LMIC and research about how parent-child communication meditate the effects of parenting programs in both LMIC and HIC.

Staphylococcus aureus is a pulmonary pathogen associated with substantial morbidity and mortality. It is a common complication of influenza and SARS CoV2 infection, chronic obstructive pulmonary disease, cystic fibrosis and is a major cause of ventilator associated pneumonia. The prevalence of this specific organism as a respiratory pathogen has been attributed to its many gene products that thwart innate immunity. However, vaccines targeting virulence determinants have failed to be protective in humans, suggesting that other bacterial or host factors are also critical in pathogenesis. We postulated that S. aureus that are able to persist in the lung must adapt to substrates that are especially abundant. Here we show that among the many potential carbon sources in the infected airway, S. aureus is directed by carbon catabolite repression (CCR) to utilize proline. By following transcriptomic and metabolomic changes over the initial course of infection by human clinical isolates of S. aureus, we established that CcpA and CcpE upregulate expression of the S. aureus collagenase (scpA) and proline transporter (putP). In response to infection, airway fibroblasts synthesize collagen, of which proline is a major component. Host-adapted S. aureus is thus poised to ingest and metabolize newly available proline which fuels oxidative metabolism via the TCA cycle, outcompeting strains that have not made this metabolic transition. Thus, clinical settings characterized by airway repair processes and fibrosis provide a milieu that is intrinsically supportive of S. aureus infection.