Suchergebnisse

Patellar tendinopathy is a frequent overuse injury in sports that can cause significant pain and disability. It requires evidence-based guidelines on effective prevention and management. However, optimal treatments remain uncertain. We aimed to analyze available meta-analyses to summarize treatment recommendations, compare therapeutic modalities, examine included trials, and offer methodological suggestions to improve future systematic reviews. Meta-analyses were systematically searched for in PubMed (PROSPERO: CRD42023457963). A total of 21 meta-analyses were included. The AMSTAR-2 scale assessed study quality, which was low, with only 23.8% of the meta-analyses being of moderate quality, and none were considered to be of high quality. Heterogeneous outcomes are reported. Multiple platelet-rich plasma (PRP) injections appear superior to eccentric exercises and provide lasting improvements compared to eccentric exercises when conservative treatments fail. Extracorporeal shockwave therapy (ESWT) also seems superior to non-operative options and similar to surgery for patellar tendinopathy in the long term. However, evidence for eccentric exercise efficacy remains unclear due to inconclusive findings. Preliminary findings also emerged for genetic risk factors and diagnostic methods but require further confirmation. This review reveals a lack of high-quality evidence on optimal patellar tendinopathy treatments. While PRP and ESWT show promise, limitations persist. Further rigorous meta-analyses and trials are needed to strengthen the evidence base and guide clinical practice. Methodological enhancements are proposed to improve future meta-analyses.

Research on the issues and problems of the introduction of artificial intelligence into various spheres of life of a modern individual, the society, and the state are in the trend of scientific research at the present stage of information technology development. Artificial intelligence (AI) is being used now more than ever before, especially in the healthcare sector. Artificial intelligence has provided a more efficient way to automate routine work and other daily tasks, as well as manage patients and medical resources. The system can perform most of the tasks previously performed by humans, making it faster and cheaper. This significant advantage has facilitated the activities of interacting parties in the healthcare sector, doctors and patients. Artificial intelligence continues to gain momentum. Currently, there are modern machine learning solutions that can act, learn, understand, and predict. This is a step forward compared to robotic assistants in surgical interventions and the binding of genetic codes previously controlled by artificial intelligence. The article demonstrates that the development of artificial intelligence in healthcare involves some risks and problems — artificial intelligence systems expose patients to the risk of injury, and patient data for use in artificial intelligence systems involve the risk of privacy invasion. The article shows the advantages and disadvantages of the introduction of artificial intelligence in the field of healthcare, and the necessary conclusions are drawn.

Both weak muscle strength and impaired neuromuscular control has previous been suggested as risk factors for future traumatic knee injury. However, data on the relationship between these two factors are scarce. Thus, the aim of this study was to investigate the relationship and influence of the one repetition maximum (1RM) barbell squat strength on dynamic knee valgus in elite female and male handball players. In this cross-sectional study 22 elite handball players (7 females) were included. A unilateral drop jump (VDJ) test was used for the assessment of frontal plane dynamic knee valgus. Players also performed a one repetition maximum (1RM) barbell squat test, expressed relative to bodyweight (r1RM), to assess maximal strength, which were dichotomized to analyze 'weak' versus 'strong' players according to median. Correlations were noted between r1RM in squat and knee valgus angle for both the non-dominant (r = −0.54; p = 0.009) and dominant leg (r = −0.46, p = 0.03). The odds of knee valgus were eight times higher, for the dominant leg, in the weak group compared to the strong group (p = 0.03) and 27 times higher, for the non-dominant leg (p = 0.002). The outcome of the present study suggests that maximum squat strength plays an important role when it comes to neuromuscular control of the knee, and that weak handball players are at higher risk of knee valgus compared to strong players during jumping activity.

We assessed the training, work and Life Stress demands of a mixed gender group of 48 top amateur short-distance triathletes using an online retrospective epidemiological survey and the Life Events Survey for Collegiate Athletes. On superficial inspection, these mainly masters athletes appeared to undergo all the types of training that are recommended for the aging athlete. However, there were significant scheduling differences between their weekday vs. their weekend training, suggesting that age-groupers' outside sports commitments may affect their training efficacy. The triathletes claimed to periodize, to obtain feedback on and to modify their training plans when appropriate—and some evidence of this was obtained. Over the year preceding the ITU World Age-Group Championships, they averaged 53%, 33% and 14% of their combined swim, cycle and run training time, respectively, within intensity zones 1, 2 and 3. Although the triathletes specifically stated that their training was focused on preparation for the ITU World Age-Group Championships, the way that they modified their training in the month before the event suggested that this aim was not necessarily achieved. Sports-related stress accounted for most—42.0 ± 26.7%—of their total Life Stress over the preceding year (vs. 12.7 ± 18.6% for Relationship-, 31.3 ± 25.9% for Personal- and 14.0 ± 21.1% for Career-related Stress). It affected most athletes, and was overwhelmingly negative, when it related to failure to attain athletic goal(s), to injury and/or to illness.

This paper focuses on the Health System Services, and how affects welfare and socio-economic growth, as an important sector to improve the socio-economic well-being of a developing country such as Kosovo. This study also provides key recommendations of some important policies to be undertaken by the government to improve the Health System Services with the aim for increasing social welfare and socio-economic growth of the country. Some of the different types of government policies and programs have been put in place reducing the Burden of Injury, to improve the health of the population. (Ganguli, I; Grawford, M L; Usadi, B; Mulligan, K L; O'Malley, A J; Yang, C W; Fisher, E S; Morden, N E;, 2023). In our paper we focused on secondary quantitative data collection. The data were provided by the annual health services report for 2022, Pristina Municipality related to the Family Medical Centers "FMC", for 2022. In our study we've used the descriptive method, and through tables and charts we've provided a comparative analysis, based on some statistics which are expressed in percentage (%) (Sejdiu, Rexha , & Deda, 2023). However, the main purpose is to show the employment structure of the Family Medical Centers "FMC", in Kosovo for 2022, according to the sectors: Primary Health Care and Dental Polyclinic.

Received: 29 July 2023 / Accepted: 19 October 2023 / Published: 5 November 2023

Executive Summary Will recipients of Deferred Action for Childhood Arrivals (DACA) leave the United States if a legal challenge succeeds in ending this important program? The fate of over 600,000 current DACA recipients may depend on answers to this question in one expert report and one online survey question, which a Texas District Court found to show "a quantifiable percentage" would leave. Had the District Court in its DACA ruling not credited these sources, Texas' lawsuit could have collapsed, and DACA would persist. The issue of whether DACA recipients will leave if DACA is ended will matter as this case is litigated, most likely to be decided by the Supreme Court. Drawing on research on immigrant return, DACA recipients, survey questions, priming, and intention-behavior gap, this paper argues that this expert report and the single online survey question used by the District Court cannot support the inferences regarding the return of DACA recipients to their birth countries. Rather, relevant research points toward DACA recipients staying in the United States, even if DACA were terminated. The paper recommends offering DACA recipients and long term undocumented residents a short path to legal status and citizenship, reassessing whether these two sources can support the conclusions drawn by the District Court; and analyzing the benefits accruing from DACA to Texas and all Texans, including US citizen children of DACA recipients, in assessing the claimed injury to the state.

Purpose
The purpose of this study was to provide proof of concept and evaluate the project for the development of a forensic service in safeguarding adults at risk of harm who may have suffered a non-accidental injury as a result of physical abuse or neglect.


Design/methodology/approach
This pilot project arising from a Safeguarding Adults Review was designed using an iterative process. Opinion from all partners of the Safeguarding Adults' Boards in two adjacent areas as well as using expert forensic advice from the Faculty of Forensic and Legal Medicine was sought.


Findings
All professionals recognised the need for a forensic service because at present decision-making around potential non-accidental injuries (NAI) may not be evidence based. The main barriers were seen as lack of knowledge and education combined with the area of work not being recognised as being needed and hence not commissioned. No similar service existed in England to aid the project being developed either academically or practically, other than reflecting what happens in children's safeguarding.


Practical implications
The knowledge and skills as well as the resources developed for this project will aid safeguarding professionals to make more informed decisions when working with adults at risk of harm who have sustained a potential NAI.


Originality/value
This project has high originality with no other area in England offering a similar service or in the process of developing a service at present.

The objective of this systematic review was to examine the effectiveness of flywheel training, which allows for the replication of specific sports movements, overloading both the concentric and eccentric phases. Inclusion criteria were injury prevention outcomes; ability in terms of strength, power, sprinting, jumping and change of direction; competitive athletes; and RCTs. Exclusion criteria were a lack of a control group and lack of baseline and/or follow-up data. The databases used were Web of Science, Scopus, PubMed, Cochrane Library, and Sage. The revised Cochrane risk-of-bias tool was used to assess the quality of the selected RCTs. The Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence was used. A PICOS (participants, intervention, comparators, study outcomes, and study design) approach was used to evaluate eligibility. A total of 21 RCTs with 8 to 54 participants in each study analyzed flywheel technology and its application in nine sports. The results showed that flywheel training is a good strategy to improve sports performance, providing variation in training methodologies and athletes' adherence. Further studies are needed to define guidelines on training modality, weekly frequency, volume, and inertia load. Only a few studies have applied the flywheel device directly to overload specific multidirectional movements at different joint angles. This method is not exempt from criticalities, such as the cost and the ability to carry out only individual training.

L'ozono troposferico (O3) è uno dei principali inquinanti atmosferici e può arrecare gravi danni agli ecosistemi forestali a causa del suo elevato potenziale fitotossico. Il monitoraggio dell'O3 in foresta è, pertanto, fondamentale per poterne studiare l'effetto nocivo sulla vegetazione e stabilire i livelli critici per la protezione del patrimonio boschivo. In questo lavoro sono riportati i risultati dell'applicazione di innovative stazioni di monitoraggio attivo in foresta, installate nell'ambito del progetto europeo LIFE MOTTLES (MOnitoring ozone injury for seTTing new critical LEvelS). Le aree sperimentali sono state selezionate all'interno della rete CON.ECO.FOR, e in esse sono stati stimati due diversi indici cumulati basati sull'esposizione all'O3 in atmosfera (AOT40) e sul flusso stomatico di O3 (PODY), poi correlati ad indicatori di salute della vegetazione quali sintomi visibili fogliari e defogliazione della chioma, valutati sia all'interno (ITP) che lungo il margine della foresta (LESS), per derivare i livelli critici basati sull'esposizione (CLec) e sul flusso (CLef). I risultati suggeriscono CLec e CLef rispettivamente di 17000 e 19000 ppb h AOT40 e 12 e 5 mmol m-2 POD1 per conifere e latifoglie. Il monitoraggio attivo consente di poter definire e aggiornare regolarmente livelli critici e standard legislativi per la protezione delle foreste ed inoltre, rispetto al tradizionale monitoraggio passivo, è risultato essere anche maggiormente sostenibile da un punto di vista ambientale, economico e sociale sul lungo periodo.

Background Odontoid C2 fractures account for 9% to 15% of adult cervical spine fractures. The aim of this study is to report the incidence of a previous described Y-shaped trabecular bone structure (TBS) in the odontoid process in a larger sample of patients who performed a CT cervical scan following a cervical trauma to investigate if its absence can increase the risk of the odontoid process fracture of the axis.
Methods A retrospective review of 245 patients who performed a CT cervical scan in our University Hospital, as results of cervical spine injury, was performed during a 12-month period between May 2020 and May 2021.
Results The presence of a Y-shaped TBS at the odontocentral synchondrosis level was observed in 165 patients that is 67.3% of whole population included in this study. Eighteen patients (7.3%) reported an odontoid type II C2 fracture. Among patients with odontoid type II C2 fracture, the Y-shaped TBS at the odontocentral synchondrosis level was observed in 8 (44.4%) of them. The presence of the Y-shaped TBS at the odontocentral synchondrosis level was statistically more frequently observed in patients without odontoid process fracture (69.2% Vs 30.8%) compared to patients who developed odontoid process fracture (44.4 % Vs 55.6%) after a cervical trauma (p = 0.03).
Conclusions This study showed the crucial role of this Y-shaped TBS in biomechanical structural dynamics of the C1-C2 joint and its significant clinical relevance in odontoid fractures of the axis.

AbstractBisphenol
A (BPA) is one of the chemicals that is firmly accompanied by hippocampal neuronal injury. As oxidative stress appears to be a major contributor to neurotoxicity induced by BPA, antioxidants with remarkable neuroprotective effects can play a valuable protective role. Around the world, ( −)-epigallocatechin-3-gallate (EGCG) was one of the most popular antioxidants that could exert a beneficial neuroprotective role. Here, we examined the potential efficiency of EGCG against neurotoxicity induced by BPA in the hippocampal CA3 region of the rat model. This study revealed that EGCG was unable to abrogate the significant decrease in circulating adiponectin level and hippocampal superoxide dismutase activity as well as an increase in hippocampal levels of nitric oxide and malondialdehyde. Notably, EGCG failed to antagonize the oxidative inhibitory effect of BPA on hippocampal neurotransmission and its associated cognitive deficits. In addition, the histopathological examination with immunohistochemical detection of caspase-3 and NF-kB/p65 emphasized that EGCG failed to protect hippocampal CA3 neurons from apoptotic and necrotic effects induced by BPA. Our study revealed that EGCG showed no protective role against the neurotoxic effect caused by BPA, which may be attributed to its failure to counteract the BPA-induced oxidative stress in vivo. The controversial effect is probably related to EGCG's ability to impede BPA glucuronidation and thus, its detoxification. That inference requires further additional experimental and clinical studies.
Graphical abstract

Circulating mannose-binding lectin (MBL) plays an important role in the progression of tissue damage caused by ischemic events, an account of its high-affinity, multivalent binding to carbohydrate arrays exposed on damaged endothelium (damage-associated molecular patterns, DAMPS). MBL inhibitors have therefore been proposed as a novel protective therapeutic strategy to prevent secondary injury. We developed a new, convenient, robust surface plasmon resonance (SPR) assay for in vitro screening of compounds interfering with the binding of native human MBL to an appropriate chip surface functionalized with a pattern of sugar moieties mimicking DAMPS. We also characterized the procedure to regenerate the chip surface after each experimental session, accomplished by sequential cleaning with piranha solution followed by UV exposure. The SPR assay detects the specific binding of human recombinant MBL and native MBL present in human serum, and can identify inhibitors of this binding. We observed inhibitory effects of mannose (IC50 5 mM), of a nine mannose residues carrying glycan (IC50 0.33 mg/mL, corresponding to ~ 175 mu M), and mainly mannose-coated gold nanoparticles (IC50 1.1 mu g /mL). These in vitro results serve as a basis for testing the protective properties of these molecules/nanoparticles later inthe more expensive and time-consuming studies in cells and animal models of MBL mediated-injuries. ; This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 814236.

Pakistan has witnessed the rise of a range of Islamic forces that claim to be defending Islam from what they imagine to be a deluge of incidents of blasphemy, a veritable moral panic organized around a set of blasphemy laws pertaining to the regulation and protection of Islam. The violence of blasphemy politics, which is disproportionately directed at sectarian and religious minorities, is predicated on the claim that is the duty and mandate of the state to enforce the blasphemy laws, and where the state fails, the onus falls on ordinary Muslims to fulfill the demands of Islam. In this article, I focus on the response to this blasphemy politics by Pakistani Tablighis, practitioners of the transnational Islamic piety movement the Tablighi Jamaat. Like other Islamic groups in Pakistan, Tablighis consider blasphemy to be a grave sin and a deep threat to the Islamic community, but Tablighis believe that the solution to the growing incidence of blasphemy is to spread virtue through their distinct form of face-to-face preaching (dawat). I show that these different ethical responses to blasphemy reflect different approaches to the relationship between Islam and state sovereignty. Specifically, I argue that blasphemy politics presupposes the sacralization of the state but Islamic piety among Pakistani Tablighis provides an alternative ethical framework for addressing the moral injury of blasphemy. (Asian Aff/GIGA)

Chronic low-level blast exposure has been linked with neurological alterations and traumatic brain injury (TBI) biomarkers. Impaired smooth-pursuit eye movements (SPEM) are often associated with TBI. The purpose of this study was to determine whether long-term operators of low-level blast exposure or high-caliber weapons use displayed oculomotor behaviors that differed from controls. Twenty-six members of an elite military unit performed a computerized oculomotor testing task using an eye tracker and completed a concussion assessment questionnaire. The participants were split into a blast exposure group and control group. The blast exposure group had a history of exposure to low-level blasts or high-caliber weapon use. The results revealed significant differences in SPEM, saccades, and fixations between the blast exposure group and control group. The blast exposure group's eye movements were slower, stopped at more frequent points when following a target, traveled further from the target in terms of both speed and direction, and showed higher rates of variation and inefficiency. Poor oculomotor behavior correlated with a higher symptom severity on the concussion assessment questionnaire. Military special operators exposed to long-term low-level blasts or high-caliber weapons usage displayed an impaired oculomotor behavior in comparison to controls. These findings further our understanding of the impact of long-term low-level blast exposure on the oculomotor behavior of military special operators and may inform practical implications for military training.

This paper aims to better understand the resilience and further entrenchment of food aid through food banks in the context of the COVID-19 pandemic. During the first months of the pandemic in the Netherlands, concerns quickly rose about the number of people falling into conditions of food insecurity. Adding insult to injury, food banks reported problems in their operations. The analysis shows that after some adaptations to initial problems, food banks were largely able to continue their service. This ability was partly based on organizational flexibility. However, in order to understand the resilience of food aid through food banks, it is imperative to understand food banks as part of a system of food aid that extends beyond the organizational boundaries. This system includes a range of other actors and resources, including donors, public support and governmental backing that contributed to the resilience of the food aid system. While this embeddedness in a system as well as broad public support were essential for the resilience of food aid through food banks, both factors also indicate the further entrenchment of food banks in the understanding and practices of ensuring food security for people in poverty. Ultimately, when the root causes of a need for food aid are not addressed, a resilient system of food aid through food banks can eventually prove detrimental to societal resilience, specifically the ability to ensure dignified access to adequate food.