Medicine and Health Sciences Commons^™

Gut Microbiome Dysbiosis In Antibiotic-Treated Covid-19 Patients Is Associated With Microbial Translocation And Bacteremia, Lucie Bernard-Raichon, Mericien Venzon, Jon Klein, Jordan E. Axelrad, Chenzhen Zhang, Alexis P. Sullivan, Grant A. Hussey, Arnau Casanovas-Massana, Maria G. Noval, Ana M. Valero-Jimenez, Juan Gago, Gregory Putzel, Alejandro Pironti, Evan Wilder, Yale Impact Research Team, Lorna E. Thorpe, Dan R. Littman, Meike Dittmann, Kenneth A. Stapleford, Bo Shopsin, Victor J. Torres, Albert I. Ko, Akiko Iwasaki, Ken Cadwell, Jonas Schluter, Abeer Obaid, Alice Lu-Culligan, Allison Nelson, Anderson Brito, Angela Nunez, Anjelica Martin, Annie Watkins, Bertie Geng, Chaney Kalinich, Christina Harden, Codruta Todeasa, Cole Jensen, Daniel Kim, David Mcdonald, Denise Shepard, Edward Courchaine, Elizabeth B. White, Eric Song, Erin Silva, Eriko Kudo, Giuseppe Deluliis, Harold Rahming, Hong-Jai Park, Irene Matos, Jessica Nouws, Jordan Valdez, Joseph R. Fauver, Joseph Lim, Kadi-Ann Rose, Kelly Anastasio, Kristina Brower, Laura Glick, Lokesh Sharma, Lorenzo Sewanan, Lynda Knaggs, Maksym Minasyan, Maria Batsu, Mary Petrone, Maxine Kuang, Maura Nakahata, Melissa Campbell, Melissa Linehan, Michael H. Askenase, Michael Simonov, Mikhail Smolgovsky, Nicole Sonnert, Nida Naushad

Journal Articles: Epidemiology

Although microbial populations in the gut microbiome are associated with COVID-19 severity, a causal impact on patient health has not been established. Here we provide evidence that gut microbiome dysbiosis is associated with translocation of bacteria into the blood during COVID-19, causing life-threatening secondary infections. We first demonstrate SARS-CoV-2 infection induces gut microbiome dysbiosis in mice, which correlated with alterations to Paneth cells and goblet cells, and markers of barrier permeability. Samples collected from 96 COVID-19 patients at two different clinical sites also revealed substantial gut microbiome dysbiosis, including blooms of opportunistic pathogenic bacterial genera known to include antimicrobial-resistant species. …

Standardized Emergency Behavioral Health Education Amongst Staff, Moriba Camara Adn, Rn, Nava Reed Adn, Rn, Stacy Long Adn, Rn, Alice Rivera Adn, Rn

Vizient/ AACN Nurse Residency Program™ EBP Projects

No abstract provided.

Agents Of Exposure Among Pediatric Transgender Patients: An Analysis Of The Toxicology Investigator’S Consortium (Toxic) Registry, William Nick Doyle Bs, Derek J. Fikse Do, Richard J. Mazzaccaro Md, Gillian A. Beauchamp Md, Marna R. Greenberg Do, Mph, Facep, Tasha Desai Do, Natalie E. Ebeling-Koning Do, Katelyn Mclain, Judith Sabino Mph, Cdp, Beth Careyva M.D., Alexandra Amaducci Do

Toxicology Division

No abstract provided.

Intentional Self-Harm Overdoses Before And During The Covid-19 Pandemic In Adolescents Managed By A Medical Toxicology Consultation Service, Samantha L. Gaetani Md, Natalie E. Ebeling-Koning Do, Nicholas S. Imperato, Katelyn Mclain, Derek J. Fikse Do, Gillian A. Beauchamp Md, Marna R. Greenberg Do, Mph, Facep, Alexandra Amaducci

Toxicology Division

No abstract provided.

The Importance Of Emphasizing Addiction Medicine During Medical Toxicology Fellowship Training: A Case Study Of A Tertiary Care Hospital System Toxicology Consultation Service, Nicholas S. Imperato, Chase Jones Do, Derek J. Fikse Do, Gillian A. Beauchamp Md, Katelyn Mclain, Marna R. Greenberg Do, Mph, Facep

Toxicology Division

No abstract provided.

A Five-Year Analysis Of The Toxicology Investigators Consortium (Toxic) Core Registry: Descriptive Differences Among Patients Who Identified As Transgender Compared To Cisgender, 2017-2021, Kristine Magnusson, Derek J. Fikse Do, Emily Glidden, Gillian A. Beauchamp Md, Kim Aldy, Desiree Mustaquim, Richard J. Mazzaccaro Md, Beth Careyva M.D., Judith Sabino Mph, Cdp, Marna R. Greenberg Do, Mph, Facep

Toxicology Division

No abstract provided.

Interactions Of International Pilots' Stress, Fatigue, Symptoms Of Depression, Anxiety, Common Mental Disorders And Wellbeing, Marion Venus, Martin Grosse Holtforth

International Journal of Aviation, Aeronautics, and Aerospace

Objective

This study Investigates more dimensions than previous studies simultaneously: pilots’ duty rosters, stress, sleep difficulties, fatigue levels, wellbeing, symptoms of depression, anxiety, and common mental disorders (CMD), and how they are interrelated.

Background

Several scientific studies have confirmed that fatigue can pose a significant risk to flight safety. Other studies reported positive depression screening results for more pilots, compared with the general population.

Method

A cross-sectional online survey was completed by 406 international pilots, who reported their duty rosters of the last two months. Pilots also self-assessed their stress-levels, sleep problems, fatigue, wellbeing, and mental health.

Results

Although pilots …

Modelling Air Quality In An Aircraft Passenger Cabin Using Health Care Standards, Bert Silich

International Journal of Aviation, Aeronautics, and Aerospace

The interest in aerosol contamination of aircraft passenger cabins has increased since the onset of the COVID-19 pandemic. Mathematical models have been developed to help describe how an aerosol behaves in a closed space. The number of infectious particles inhaled is of scientific interest because it can be related to the risk of getting ill from a pathogen. The data required to calculate these results is often difficult to obtain in real world settings. In fact, particle inhalation details are not obtained in the day-to-day routine of a health care environment and are they not required to maintain safety. Hospital …

Stroboscopic Augmented Reality As An Approach To Mitigate Gravitational Transition Effects During Interplanetary Spaceflight, Ethan Waisberg, Joshua Ong, Nasif Zaman, Sharif Amit Kamran, Andrew G. Lee, Alireza Tavakkoli

International Journal of Aviation, Aeronautics, and Aerospace

During interplanetary spaceflight, periods of extreme gravitational transitions will occur such as transitions between hypergravity, hypogravity, and microgravity. Following gravitational transitions, rapid sensorimotor adaptation or maladaptation may occur which can affect gaze control and weaken dynamic visual acuity in astronauts. A reduction in dynamic visual acuity during spaceflight could possibly impact or impair mission critical activities (e.g., control of extraterrestrial machinery/vehicles and other important tasks). Stroboscopic visual training is an emerging visual tool that has been terrestrially observed to enhance visual performance and perception by performing tasks under conditions of intermittent vision. This technique has also been seen to increase …

Outcomes Of Surgical Tracheostomy On Mechanically Ventilated Covid-19 Patients Admitted To A Private Tertiary Hospital In Tanzania, Nadeem Kassam, Ally Zain, Sajida Panjwani, Kamran Hameed, Samina Somji, Hanifa Mbithe, Fatma Bakshi, Bonvetura Mtega, Gloria Kinasa, Blessing Mathew, Harrison Chuwa

Internal Medicine, East Africa

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has resulted in an increase in the number of patients necessitating prolonged mechanical ventilation. Data on patients with COVID-19 undergoing tracheostomy indicating timing and outcomes are very limited. Our study illustrates outcomes for surgical tracheotomies performed on COVID-19 patients in Tanzania.

Methods: This was a retrospective observational study conducted at the Aga Khan Hospital in Dar es Salaam, Tanzania.

Results: Nineteen patients with COVID-19 underwent surgical tracheotomy between 16 th March and 31st December 2021. All surgical tracheostomies were performed in the operating theatre. The average duration of intubation prior to tracheotomy …

The Psychological Impact Of Isolation On Hospitalised Patients With Covid-19 Infection In The Uae, Nahida Nayaz Ahmed, Nirmin F. Juber, Reem Alkaabi, Fatema Alshehhi, Mohamed Alobeidli, Ahlam Salem, Alaa Galadari, Shamil Wanigaratne, Amar Ahmad

All Works

Infection prevention and control measures for COVID-19 may include immediate admission to an isolation facility for the infected. However, the mental health impact of this isolation worldwide is not fully documented. This study aims to contribute to global data on the psychological impact of COVID-19 and to be the first study to assess psychological distress among hospitalised patients with COVID-19 in the UAE. Using a cross-sectional study design on 132 hospitalised patients, we found that 90% of participants scored within the normal levels for psychological distress. The length of stay was associated with higher levels of psychological distress and those …

The Combinatory Effects Of Pediatric Obesity And Ontogeny On Monocarboxylate Transporter Expression In Tissues Of Drug Disposition, Michael Ng

University of the Pacific Theses and Dissertations

Proton-coupled and sodium-dependent monocarboxylate transporters are encoded by the SLC16A and SLC5A gene family of solute carriers, and are responsible for the transport of essential nutrients such as L-lactate, pyruvate, and ketone bodies. Basigin, or CD147, acts as an ancillary protein for MCT1 and MCT4, and is involved in membrane surface expression of transporters. MCT's are also involved in the shuttling of monocarboxylic xenobiotics across cell membranes, including the drugs valproate and gamma hydroxybutyrate. MCT’s are also important for normal mammalian development, particularly during embryogenesis and early neonatal life. Previous studies have shown that ketogenic diets increase MCT expression in …

Impact Of Covid-19 On The Diversity Of The Construction Workforce, Anil Baral, Yunping Liang, Mingshu Li, Marilyn Gonzalez, Mohsen Shahandashti, Baabak Ashuri

Durham School of Architectural Engineering and Construction: Faculty Publications

Construction industry employment has been severely impacted by the coronavirus (COVID-19) pandemic. This paper examines the impact of the COVID-19 pandemic in the US construction labor market. This study contributes to the state of knowledge by (1) revealing how the COVID-19 pandemic impacted construction employment across different demographic groups and geographic regions in the US, and (2) identifying vulnerable demographic groups (e.g., minorities, women, older workers) in the construction workforce that are disproportionally impacted by the pandemic. Employment data from the Current Population Survey and Current Employment Statistics (CES) programs, which are administered by the Bureau of Labor Statistics, are …

Quality Parameters Of Wet And Dry Aged Beef Loins From Cattle Fed High Doses Of Vitamin E, David M. Velazco, Joe A. Sonderman, Nicolas J. Herrera, Chris Calkins

Nebraska Beef Cattle Reports

The objective of this experiment was to determine if dietary supplementation of high doses of vitamin E (alpha-tocopherol; 2,200 IU per day for 100 days) can impact quality attributes of wet and dry-aged beef strip loins. Steaks from beef cattle supplemented with high doses of vitamin E exhibited less lipid oxidation after wet or dry aging, took longer time to discolor during retail display, and sustained redder color for a longer period under retail display conditions compared to controls. Free amino acids related to positive beef flavor attributes were higher for dry-aged loins compared to traditional wet aged samples loins. …

Beef Quality And Oxidative Stability From Cattle Fed High Levels Of Vitamin E, Nicolas J. Herrera, Joe A. Sonderman, David M. Velazco, Chris Calkins

Nebraska Beef Cattle Reports

Meat color is a major factor for consumer meat purchasing decisions. Aging beef, which can improve tenderness, has been shown to accelerate discoloration in fresh beef, shortening retail display time, and generating negative flavor attributes. The objective of this study was to evaluate supplementing cattle high levels (2,200 International Units/ day) of Vitamin E to sustain meat quality during prolonged retail display in beef strip loins after 2 or 14 days aging compared to commercially-produced loins selected as controls. Results showed a treatment x age effect for Warner-Bratzler shear force and free calcium content, primarily due to aging. A dietary …

Effect Of Feeding Cars On Digestibility And Fatty Acid Flow In Finishing Cattle Diets, John C. Gibbons, Mitchell M. Norman, Tyler J. Spore, Hannah C. Wilson, Kylie Butterfield, Andea K. Watson, Galen E. Erickson, Jonathan W. Wilson

Nebraska Beef Cattle Reports

An experiment was conducted to evaluate the impact of a liquid feed, Condensed Algal Residue Solubles (CARS) on diet digestibility and fatty acid flow to the small intestine. Three treatments included CARS at 0, 2.5, and 5% of the diet dry matter, replacing steam-flaked corn. The base diet included 73, 70.5, or 68% steam flaked corn, 15% dried distillers grains plus solubles, 8% alfalfa haylage, and 4% supplement. Inclusion of CARS in the diet did not affect dry matter or organic matter intake or digestibility of dry matter, organic matter or neutral detergent fiber. Amount of fatty acid flowing to …

Evaluation Of Green Grass On Nutrient Digestibility And Fatty Acid Flow In Cattle Finishing Diets, Aksel R. Wiseman, Tyler J. Spore, Mitchell M. Norman, Hannah C. Wilson, J. C. Macdonald, Andrea K. Watson, Galen E. Erickson

Nebraska Beef Cattle Reports

Six ruminally and duodenally cannulated steers were utilized in a 3 × 3 replicated Latin square experiment to test 0, 15, and 30% dietary inclusion of Green Grass (Sunseo Omega 3; Chungcheong Duk-Do, South Korea), a feed comprised of sesame meal, giant kelp, cassava, and sorghum (not currently approved to be fed in the US). Dry matter and fiber intake increased linearly with increased Green Grass inclusion. Dry matter and organic matter digestibility were not affected by Green Grass inclusion. Concentration of saturated fatty acids at the duodenum were similar for Green Grass 0 and Green Grass 15 with a …

Effect Of Biochar As A Feedlot Pen Surface Amendment On Manure Nutrient Capture, J. L. Sperber, Braden C. Troyer, Mitchell M. Norman, Levi J. Mcphillips, Heather Nobert, Andrea K. Watson, Galen E. Erickson

Nebraska Beef Cattle Reports

Two mass balance experiments were conducted during winter and summer seasons to evaluate the effect of spreading biochar on the feedlot pen surface on manure nutrient retention. The winter experiment (Dec to June) evaluated three treatments including biochar spread to pen surface (approximately 54 lb of biochar per steer), hydrated lime spread to pen surface (cooperation with UNL Environmental Engineering; approximately 68 lb per steer) and negative control (no treatment applied). The summer experiment (June to Nov) evaluated biochar treatment (approximately 68 lb of biochar per steer) against negative control. Biochar utilized in winter and summer was unprocessed and sourced …

Interaction Of Sweet Bran Inclusion And Corn Processing Method In Beef Finishing Diets, Rebecca L. Sjostrand, Levi J. Mcphillips, Braden C. Troyer, Maggie Youngers, Rick Stock, J. C. Macdonald, Galen E. Erickson

Nebraska Beef Cattle Reports

The effects of corn processing method and Sweet Bran concentration on finishing cattle performance and carcass characteristics were evaluated in steam-flaked corn or a blend of high-moisture and dry-rolled corn-based diets. Sweet Bran was included at 0, 20, or 40% of diet dry matter. When cattle were fed 0% Sweet Bran, feeding steam-flaked corn resulted in a 11.7% improvement in feed conversion and heavier hot-carcass weight compared to feeding high-moisture/ dry-rolled corn. As Sweet Bran increased in the diet, there was a linear improvement in feed conversion for high-moisture/dry-rolled corn-fed steers and no change in feed conversion for steam-flaked corn-fed …

Effect Of Rapeseed Inclusion In Late-Summer Planted Oat Pasture On Growing Performance Of Beef Steers, Devin A. Jakub, Hannah E. Riley, Kristin E. Hales, Steven D. Shackelford, Harvey C. Freetly, M. E. Drewnoski

Nebraska Beef Cattle Reports

An oat monoculture was planted in late summer at 100 lb/ac and compared to oats planted at 50 lb/ac with rapeseed included at 3 lb/ac. Seed cost of the oat monoculture ($20/ac) was greater than the mix ($15/ac). Initial forage yield was not affected by the inclusion of rapeseed with fall oat. Calf gain was significantly greater and cost of gain was significantly decreased when rapeseed was included due to the combination of greater gains and lesser seed cost. Including rapeseed in late summer planted oats may be beneficial for producers who want to graze growing calves in the fall.

Interaction Of Urea With Frequency And Amount Of Distillers Grains Supplementation On Growing Steer Rumen Digestion Parameters, Haley F. Linder, Joshua E. Sebade, Tyler J. Spore, M. E. Drewnoski, J. C. Macdonald

Nebraska Beef Cattle Reports

Ruminally cannulated steers were used in 8 × 6 row-column design with 8 animals and 6 periods. Treatment design was a 2 × 2 × 2 factorial, with factors including amount of supplementation, frequency of supplementation, and inclusion of urea. Hay dry matter intake was reduced by increased amount of supplementation and by decreased frequency of supplementation. Total VFA concentration did not differ among treatments. Rumen ammonia-N concentration was impacted by an interaction of amount of supplementation and inclusion of urea but there was no effect of supplementation frequency. In situ NDF disappearance did not differ between daily and alternate …

Comparison Of Partially Confined And Traditional Cow-Calf Systems, Zac E. Carlson, Levi J. Mcphillips, Galen E. Erickson, M. E. Drewnoski, J. C. Macdonald

Nebraska Beef Cattle Reports

Production of cow-calf pairs and grow/finish performance of calves from a partially-confined, fall-calving, intensive cow-calf system were compared to a traditional, spring-calving, extensive cow-calf system. Body condition was lower at breeding and weaning for the fall-calving alternative system compared to the traditional, spring-calving system. Conception, calving, and weaning rates were not different among treatments. Weaning weights were lower for the fall-calving alternative system than traditional, spring-calving system. Following weaning, calves were grown for 117 d and then subsequently finished to the same target fatness for both systems. In the grower phase, gain was greater and feed conversion improved for the …

Factors Leading To High Intraocular Pressure In Intraocular Device-Associated Uveitis (Idau): A Nested Case Control Study, Jakkrit Juhong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Purpose: To describe the clinical pattern of uveitis–glaucoma–hyphaema (UGH) syndrome and to evaluate the risk factors leading to high intraocular pressure among intraocular device-associated uveitis (IDAU) patients using the Chulalongkorn University Uveitis Cohort (CU2C) database. Methods: A retrospective nested case‒control study was conducted in a cohort of 375 subjects who were followed up in a uveitis clinic at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, from 2014 to 2022. Thirty subjects with IDAU with increased intraocular pressure (IOP) were included in the case group, and 60 subjects with IDAU without increased intraocular pressure were selected from the CU2C database as …

Photochemical Reaction Of Renieramycins And Evaluation Of Cytotoxicity Against Lung Cancer Cells, Suwimon Sinsook

Chulalongkorn University Theses and Dissertations (Chula ETD)

Lung cancer causes more deaths than any other type of cancers, with the majority of patients diagnosed with non-small cell lung cancer (NSCLC). Lung cancer is a difficult disease to treat because of the drug resistant problem. Therefore, there is an immediate need for effective, safe, and easily accessible anti-lung cancer drug. Ecteinascidin 743 (Trabectedin or Yondelis®), a marine-derived tetrahydroisoquinoline alkaloid, is an approved drug for treating human lung cancer. This research was studied on the semi-syntheses of new renieramycins derivatives with similar structures to above drug for discovery and development of potent NSCLC cytotoxic agents. Renieramycins was extracted from …

Anti-Inflammatory Compounds In Human Peripheral Blood Mononuclear Cells From Dendrobium Species, Virunh Kongkatitham

Chulalongkorn University Theses and Dissertations (Chula ETD)

In these studies, four new compounds including three phenanthrene derivatives (dendrocrumenols A, B and D) and one fluorenone (dendrocrumenol C) and four known compounds including gigantol, 3,7-dihydroxy-2,4,8-trimethoxyphenanthrene, densiflorol B and cypripedin were isolated from Dendrobium crumenatum Sw. Each structure of isolated compounds from D. crumenatum was elucidated by spectroscopic data. These isolated compounds were then evaluated for anti-inflammatory effects in human peripheral blood mononuclear cells (PBMCs). Among the tested compounds, dendrocrumenols B and D showed the most promising anti-inflammatory effects through inhibition of tumor necrosis factor tumor (TNF) and interleukin-2 (IL-2) in monocytes and T cells. The deep immune profiling …

Titania Nanosheets Induce Anticancer Activityin Human Non-Small Cell Lung Cancer Cells, Rapeepun Soonnarong

Chulalongkorn University Theses and Dissertations (Chula ETD)

Metal nanomaterials can enhance the efficacy of current cancer therapies. Here, we show that Ti0.8O2 nanosheets cause cytotoxicity in several lung cancer cells but not in normal cells. The nanosheet-treated cells showed certain apoptosis characteristics. Protein analysis further indicated the activation of the p53-dependent death mechanism. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) analyses revealed the cellular uptake of the nanosheets and the induction of cell morphological change. Ti0.8O2 nanosheets induce apoptosis through a molecular mechanism involving peroxynitrite (ONOO−) generation. As peroxynitrite is known to be a potent inducer of S-nitrosylation, we further found that the nanosheets mediated …

Chemical Constituents And Nitric Oxide Inhibitory Activity Of Capparis Micracantha And Maerua Siamensis, Sasiwimon Nukulkit

Chulalongkorn University Theses and Dissertations (Chula ETD)

The chemical investigation of two plants in Capparaceae family, which are Capparis micracantha and Maerua siamensis, leads to the isolation of 13 compounds. The structures of the isolates were elucidated using spectroscopy techniques and comparison of the previous reports. Of five known compounds from the stems of C. micracantha were an indole alkaloid (methyl 6-methoxy-3-indolecarbonate), a benzoic acid derivative (vanillic acid), a lignan [(−)-syringaresinol], and two stilbene dimers [(+)-ampelopsin A and (−)-pauciflorol E]. In addition, eight new indole alkaloids named (+)-maeruanitrile A, maeruanitrile B, maeroximes A-C and maeruabisindoles A-C were isolated from the roots of M. siamensis,. All isolates were …

Neuroprotective Effect Of Intranasal Delivery Of Asiatic Acid Against Amyloid Beta1-42-Induced Alzheimer's Disease In Mice, Ridho Islamie

Chulalongkorn University Theses and Dissertations (Chula ETD)

Asiatic acid (AA) is an active natural compound that can be derived from Centella asiatica extract. Several pharmacological studies were reported that AA has potential as neuroprotector in the central nervous system disorders. AA penetration in the brain was limited due to its low bioavailability. Nasal delivery system of solid lipid nanoparticles (SLNs) loaded-AA was developed to increase AA penetration in the brain. The current study aimed to investigate neuroprotective effect and protective mechanisms of AA in SLNs by nasal-to-brain delivery technique against Aβ1–42 induced memory impairment by in vivo study. Male ICR mice were divided into six groups (n=11-12/group); …

Prevalence Of Musculoskeletal Disorders And Ergonomic Risk Factors Among Firefighters, Hamza Farooq

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Injury to the musculoskeletal system or the human body's ability to move is known as a musculoskeletal disorder (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels, etc.). Firefighting is a physically hard and dangerous job. Firefighters carry out emergencies and prevent fire and respond to disaster. Workers who deal with fireworks often have musculoskeletal disorders. Objective: To investigated the prevalence of musculoskeletal disorders and ergonomic risk factors among firefighters. Methodology: Nordic musculoskeletal questionnaire was used to report musculoskeletal disorders in 106 firefighters and quick exposure check (QEC) questionnaire was used in 20 firefighters for 3 different tasks to evaluated …

Effects Of Lower Extremity Muscle Strengthening Exercise And Foot Orthoseson Medial Longitudinal Arch Height In Individuals With Flexible Flatfoot, Phoomchai Engkananuwat

Chulalongkorn University Theses and Dissertations (Chula ETD)

Background: Foot orthoses and lower extremity exercises have been widely recommended to improve medial longitudinal arch (MLA) height in adults with flexible flatfoot. However, there is little evidence to guide the choice between foot orthoses or lower extremity exercises. Objectives: This study comprised two separate studies. Study 1 aimed to establish the more effective exercise protocol by comparing the MLA height in groups performing foot exercises with and without gluteus medius (GMed) muscle strengthening exercise. Study 2 compared the established exercise protocol in Study 1 with foot orthoses to determine the actual effectiveness of each intervention. Main outcome measures: Navicular …