Many upper gastrointestinal(GI) endoscopies worldwide are performed for inappropriate indications. This overuse of healthcare negatively affects healthcare quality and puts pressure on endoscopy services. Dyspepsia is...Many upper gastrointestinal(GI) endoscopies worldwide are performed for inappropriate indications. This overuse of healthcare negatively affects healthcare quality and puts pressure on endoscopy services. Dyspepsia is one of the most common inappropriate indications for upper GI endoscopy as diagnostic yield is low. Reasons for untimely referral are: unfamiliarity with dyspepsia guidelines,uncertainty about etiology of symptoms, and therapy failure. Unfiltered openaccess referrals feed upper GI endoscopy overuse. This review highlights strategies applied to diminish use of upper GI endoscopies for dyspepsia. First,we describe the impact of active guideline implementation. We found improved guideline adherence, but resistance was encountered in the process. Secondly, we show several forms of clinical assessment. While algorithm use reduced upper GI endoscopy volume, effects of referral assessment of individual patients were minor. A third strategy proposed Helicobacter pylori test and treat for all dyspeptic patients. Many upper GI endoscopies can be avoided using this strategy, but outcomes may be prevalence dependent. Lastly, empirical treatment with Proton pump inhibitors achieved symptom relief for dyspepsia and avoided upper GI endoscopies in about two thirds of patients. Changing referral behavior is complex as contributing factors are manifold. A collaboration of multiple strategies is most likely to succeed.展开更多
Chinese farmers are often accused of overusing pesticides that play a crucial role in enhancing crop yield by reducing losses to crop pests. Pesticide overuse has caused a series of negative health and environmental e...Chinese farmers are often accused of overusing pesticides that play a crucial role in enhancing crop yield by reducing losses to crop pests. Pesticide overuse has caused a series of negative health and environmental externalities. This paper quantiifes the productivity effect and the optimal amount of pesticides in rice, cotton and maize production in China from the economic perspective. Using survey data col ected in 2012 and 2013, both Cobb-Douglas and Weibul damage control speciifcations are used to estimate the production function. Results show that pesticides have statistical y signiifcant pro-ductivity effect on crop yield. On the condition of Weibul damage control speciifcations, the marginal products of 1 kg of the active ingredients of pesticides for rice, cotton and maize are 71.06, 22.73 and 98.45 kg, respectively. However, 57, 64 and 17%of the actual amount of pesticides are overused for rice, cotton and maize, respectively. Moreover, the productivity effect of pesticides would be overestimated using Cobb-Douglas speciifcation without incorporating a damage control agent.展开更多
Using a rabbit model leading to myositis in response to exercise-induced muscle overuse, we have previously observed that TNF-alpha is involved in the exercised muscle in early developing myositis as well as both ipsi...Using a rabbit model leading to myositis in response to exercise-induced muscle overuse, we have previously observed that TNF-alpha is involved in the exercised muscle in early developing myositis as well as both ipsiand contralaterally in the myositis which develops in response to a lengthened period of overuse. It is unknown if TNF-alpha can also be engaged contralaterally in early stages of myositis. The hypothesis was that this is the case. It was therefore evaluated whether the TNF-alpha system is early involved contralaterally. An experimental model of 1 week of overuse of the soleus muscle on one side leading to myositis was used, and in situ hybridization and immunohistochemistry were applied to study the expression patterns of TNF-alpha in the soleus muscle in the contralateral side. TNF-alpha was expressed in the myositis process which occurred contralaterally. There were thus TNF-alpha mRNA reactions in the cells of the inflammatory infiltrates, in blood vessel walls and in certain of the muscle fibers. Parts of the latter were necrotic fibers, whereas others were interpreted to be in a regenerative stage. TNF-alpha immunoreactions were seen for infiltrating white blood cells. The observations show that the TNF-alpha system is early involved in the cross-over effects that occur in response to unilateral muscle overuse leading to myositis bilaterally. TNF-alpha is likely to have pro-inflammatory and destructive effects but also to have effects in the muscle regenerative processes. The occurrence of an early involvement of the TNF-alpha system contralaterally to the injury side shows a new aspect of importance of this system in inflammation.展开更多
Several targeted upper extremity injury prevention programs have been developed to mitigate the risk of upper extremity overuse injuries among youth athletes in overhead sports;however,their effectiveness on performan...Several targeted upper extremity injury prevention programs have been developed to mitigate the risk of upper extremity overuse injuries among youth athletes in overhead sports;however,their effectiveness on performance outcome measures has not been investigated.This systematic review evaluated the effectiveness of existing upper extremity injury prevention programs that focused on modifying intrinsic risk factors,and performance outcome measures in overhead youth athletes.The secondary aim was to identify the training components of these programs.PubMed,Physiotherapy Evidence Database(PEDro),SPORTDiscus(via EBSCOhost),and Web of Science were searched from January 2000 to November 2020 for studies that implemented training programs or exercises for upper extremity injury prevention among youth athletes in overhead throwing or striking sports.An updated search was conducted from December 2020 to October 2022.A program was deemed effective for a performance outcome measure if significant improvements were observed in the intervention group as compared to the control group.Of the 1394 studies identified,five studies met the inclusion criteria.The effectiveness of the injury prevention programs on the identified performance outcome measures of strength,mobility,and sport-specific measures were 30.4%,28.6%,and 22.2%,respectively.The training components targeted were strength,mobility,and plyometrics.Strength was the most common training component and was also the most widely investigated performance outcome measure.Overall,current upper extremity injury prevention programs seem effective at improving performance outcome measures of strength,mobility,and sport-specific outcomes with training components of strength,mobility and plyometrics.Standardized protocols are required for the measurement and reporting of performance outcomes measures,and the reporting of training components.展开更多
Background:Internal tibial loading is influenced by modifiable factors with implications for the risk of stress injury.Runners encounter varied surface steepness(gradients)when running outdoors and may adapt their spe...Background:Internal tibial loading is influenced by modifiable factors with implications for the risk of stress injury.Runners encounter varied surface steepness(gradients)when running outdoors and may adapt their speed according to the gradient.This study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different gradients.Methods:Twenty recreational runners ran on a treadmill at 3 different speeds(2.5 m/s,3.0 m/s,and 3.5 m/s)and gradients(level:0%;uphill:+5%,+10%,and+15%;downhill:-5%,-10%,and-15%).Force and marker data were collected synchronously throughout.Bending moments were estimated at the distal third centroid of the tibia about the medial-lateral axis by ensuring static equilibrium at each 1%of stance.Stress was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ellipse.Two-way repeated-measures analysis of variance were conducted using both functional and discrete statistical analyses.Results:There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior stress.Higher running speeds resulted in greater tibial loading.Running uphill at+10%and+15%resulted in greater tibial loading than level running.Running downhill at-10%and-15%resulted in reduced tibial loading compared to level running.There was no difference between+5%or-5%and level running.Conclusion:Running at faster speeds and uphill on gradients≥+10%increased internal tibial loading,whereas slower running and downhill running on gradients≥-10%reduced internal loading.Adapting running speed according to the gradient could be a protective mechanism,providing runners with a strategy to minimize the risk of tibial stress injuries.展开更多
This study analyzes the the verbal humor in the movie series If You Are The One from the perspective of some pragmatic theories.The findings of the study provide explanations towards generative mechanism of humor,such...This study analyzes the the verbal humor in the movie series If You Are The One from the perspective of some pragmatic theories.The findings of the study provide explanations towards generative mechanism of humor,such as the violation of Cooperative Principle,avoiding face-threatening acts,and particularly,creatively reveal that special use of Politeness Principle can produce a humourous effect,too.展开更多
A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for t...A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for the wound, presented with MRSA infection. The patient was treated with linezolid for three days. Her pain and paresthesia resolved, and C-reactive protein decreased to normal.展开更多
It is found in the study that there is a big difference concerning the overall frequency of Do with Hong Kong students using much more DO in their writings than native speakers.Besides,Hong Kong university students te...It is found in the study that there is a big difference concerning the overall frequency of Do with Hong Kong students using much more DO in their writings than native speakers.Besides,Hong Kong university students tend to overuse the verbal operator DO,which is contrary to Qi Yan's study(2006).At the same time,they also misuse Do;When Do is used as de-lexical verb,Hong Kong students share the same characteristics with the study of Fu zhuqin(2006),that is,they allow more freedom to collocate with more Nouns,some of which are inappropriate collocates in native English.The potential reasons for these problems might be illustrated as overgeneralization,mother-tongue interference,and lack of vocabulary etc.Based on the findings,the paper presents two pedagogical implications about vocabulary teaching and learning:the content of vocabulary teaching should be extended and enriched,and the corpus-based vocabulary teaching methodology should be integrated into class practices.展开更多
Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm. Differential diagnosis must be carefully made, especially from D...Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm. Differential diagnosis must be carefully made, especially from De Quervain tendonsynovitis. Clinical examination provides with the necessary information for diagnosis, still magnetic resonance imaging scans and ultrasonography may assist in diagnosis. Treatment consists mainly of rest, use of a thumb spica splint, analgetic and oral nonsteroidal anti-inflammatory drugs and after 2-3 wk progressive stretching and muscle strengthening. Should symptoms persist beyond this time, corticosteroid injections adjacent to the site of injury may be useful. In refractory cases, surgical intervention is warranted.展开更多
Osteitis pubis(OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activi...Osteitis pubis(OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to pubis sympysis instability as the result of microtrauma caused by repetitive muscle strains on pubic bones. Diagnosis is based mainly on detailed sports history and a meticulous clinical examination, although occasionally is difficult to distinguish this nosological entity from other pathologies affecting the involved area which may occur concomitantly in the same patient. Radiologic examinations such as plain radiographs, magnetic resonance imaging and 3 phase bone isotope scanning may be helpful to differentiate from other clinical entities with similar clinical presentation. Most cases respond well to conservative treatment which includes several physical modalities and especially a progressive rehabilitation programmed individualized to each one of patients diagnosed with OP. Local injection therapies have been also been proposed as a non-operative therapeutic option for the efficient management of these patients. In refractory cases, surgical therapeutic strategies are warranted. These include several open or minimally invasive surgical interventions such as arthroscopic or open symphysis curettage, wedge or total resection of pubic sympysis, polypropylene mesh placement and pubic fusion. In this review a critical analysis of OP in elite athletes is performed with special focus on current concepts of diagnosis and management of this source of athletic groin pain.展开更多
We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume ...We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India. Although the final diagnosis of the skeletal tuberculosis like tubercular arthritis is made by bacteriological and histological studies, few demographic, clinical and radiological features might help making early diagnosis.展开更多
Instrument-assisted soft tissue mobilization is well researched and widely accepted to improve circulation, decrease pain, improve function, increase strength, and promote overall soft tissue health. However, the admi...Instrument-assisted soft tissue mobilization is well researched and widely accepted to improve circulation, decrease pain, improve function, increase strength, and promote overall soft tissue health. However, the administration of this intervention, in most cases, is limited to the brief amounts of time we spend mobilizing our soft tissue. SORxSOAP offers a pragmatic strategy by which one may mobilize their soft tissue while simultaneously showering or washing a specific part of their body. The purpose of this study is to demonstrate the effects SORxSOAP has on functional measures of upper extremity activity in the slicing hands of employees at a corporate deli franchise over the course of a one-month period. 31 employees of a corporate deli franchise were asked to participate in a study involving the use of SORxSOAP. The subjects were assigned to experimental and control groups rough random sampling. Twenty-one subjects in the experimental group were given a one month’s supply of SORxSOAP to use on a regular basis while showering. Ten subjects in the control group were not exposed to any independent variable. The subjects from both groups completed a questionnaire that asked the subjects to rate the level of ease at which specific job-related activities were for them to perform. Hand-strength/grip and range of motion measurements were also taken utilizing a handheld dynamometer and goniometer respectively by one evaluator both before and after a one-month duration of the experimental group’s exposure to SORxSOAP. Independent t-tests were performed to test the difference between pre and post-test values for the control and experimental groups. It was found that SORxSOAP significantly improves wrist flexion range of motion, results in significantly greater improvements in hand-grip strength compared to control, and significantly improves wrist extension range of motion over a one-month period. Improvements in the ease of job-related activities also appear to be correlated to the use of SORxSOAP for items #1, 2, 3, 4, 5, 6, 7, and 9. Significant differences were also found between the slicing and non-slicing hands for pre-test wrist extension range of motion measurements, indicating the presence of possible over-use injury in occupations and activities placing excessive demand on certain body regions. This provides isolated evidence that supports the notion that SORxSOAP could be a viable option for preventing the steady decline of wrist extension range of motion and actually promoting and maintaining soft tissue and overall joint health, making it clear how further investigation into the effects of SORxSOAP can not only improve joint and soft tissue health, but prevent the emergence of joint and soft tissue impairment entirely. Clinical Bottom Line: The use of SORxSOAP has the potential to significantly improve muscle and soft tissue performance and function over a period of one month.展开更多
This paper studied the fertilizer rate(FR), fertilizer use efficiency(FUE) and fertilizer overuse rate(FOR) of rice, corn and wheat in China from 1998 to 2018 and briefly analysed the reasons why farmers were willing ...This paper studied the fertilizer rate(FR), fertilizer use efficiency(FUE) and fertilizer overuse rate(FOR) of rice, corn and wheat in China from 1998 to 2018 and briefly analysed the reasons why farmers were willing to apply more fertilizers.(1) The FR of grain in China reached 373.7 kg/ha in 2018, an increase of 26.8% compared to that in 1998. In 2018, the FR for corn was the highest, at 411.2 kg/ha, compared to the values of 338.3 kg/ha for rice and 371.7 kg/ha for wheat.(2) In recent years, the FUE of grain in China has obviously improved, with values of 32.9% in 1998, 36.7% in 2008, and 39.3% in 2018. In 2018, the FUE for rice was the highest(41.2%), followed by that for corn(39.9%), and the FUE for wheat was the lowest(36.0%).(3) By 2018, fertilizer was overused in all zones of rice, corn and wheat. In 2018, the average FOR for wheat reached 69.0%, which was 35.9% higher than that for corn and 42.8% higher than that for rice.(4) The lower price of chemical fertilizers was the main reason leading to overapplication.(5) Establishing market mechanisms and adjusting regional planting structures can be effective in reducing the application of chemical fertilizers.展开更多
文摘Many upper gastrointestinal(GI) endoscopies worldwide are performed for inappropriate indications. This overuse of healthcare negatively affects healthcare quality and puts pressure on endoscopy services. Dyspepsia is one of the most common inappropriate indications for upper GI endoscopy as diagnostic yield is low. Reasons for untimely referral are: unfamiliarity with dyspepsia guidelines,uncertainty about etiology of symptoms, and therapy failure. Unfiltered openaccess referrals feed upper GI endoscopy overuse. This review highlights strategies applied to diminish use of upper GI endoscopies for dyspepsia. First,we describe the impact of active guideline implementation. We found improved guideline adherence, but resistance was encountered in the process. Secondly, we show several forms of clinical assessment. While algorithm use reduced upper GI endoscopy volume, effects of referral assessment of individual patients were minor. A third strategy proposed Helicobacter pylori test and treat for all dyspeptic patients. Many upper GI endoscopies can be avoided using this strategy, but outcomes may be prevalence dependent. Lastly, empirical treatment with Proton pump inhibitors achieved symptom relief for dyspepsia and avoided upper GI endoscopies in about two thirds of patients. Changing referral behavior is complex as contributing factors are manifold. A collaboration of multiple strategies is most likely to succeed.
基金financial support from the National Natural Science Foundation of China (71173014 and 71210004)the China Scholarship Council (201306030053)
文摘Chinese farmers are often accused of overusing pesticides that play a crucial role in enhancing crop yield by reducing losses to crop pests. Pesticide overuse has caused a series of negative health and environmental externalities. This paper quantiifes the productivity effect and the optimal amount of pesticides in rice, cotton and maize production in China from the economic perspective. Using survey data col ected in 2012 and 2013, both Cobb-Douglas and Weibul damage control speciifcations are used to estimate the production function. Results show that pesticides have statistical y signiifcant pro-ductivity effect on crop yield. On the condition of Weibul damage control speciifcations, the marginal products of 1 kg of the active ingredients of pesticides for rice, cotton and maize are 71.06, 22.73 and 98.45 kg, respectively. However, 57, 64 and 17%of the actual amount of pesticides are overused for rice, cotton and maize, respectively. Moreover, the productivity effect of pesticides would be overestimated using Cobb-Douglas speciifcation without incorporating a damage control agent.
基金Financial support has been obtained from the Faculty of Medicine,Umea University,and the J.C.Kempe and Seth M.Kempe Memorial Foundations,Ornskoldsvik
文摘Using a rabbit model leading to myositis in response to exercise-induced muscle overuse, we have previously observed that TNF-alpha is involved in the exercised muscle in early developing myositis as well as both ipsiand contralaterally in the myositis which develops in response to a lengthened period of overuse. It is unknown if TNF-alpha can also be engaged contralaterally in early stages of myositis. The hypothesis was that this is the case. It was therefore evaluated whether the TNF-alpha system is early involved contralaterally. An experimental model of 1 week of overuse of the soleus muscle on one side leading to myositis was used, and in situ hybridization and immunohistochemistry were applied to study the expression patterns of TNF-alpha in the soleus muscle in the contralateral side. TNF-alpha was expressed in the myositis process which occurred contralaterally. There were thus TNF-alpha mRNA reactions in the cells of the inflammatory infiltrates, in blood vessel walls and in certain of the muscle fibers. Parts of the latter were necrotic fibers, whereas others were interpreted to be in a regenerative stage. TNF-alpha immunoreactions were seen for infiltrating white blood cells. The observations show that the TNF-alpha system is early involved in the cross-over effects that occur in response to unilateral muscle overuse leading to myositis bilaterally. TNF-alpha is likely to have pro-inflammatory and destructive effects but also to have effects in the muscle regenerative processes. The occurrence of an early involvement of the TNF-alpha system contralaterally to the injury side shows a new aspect of importance of this system in inflammation.
文摘Several targeted upper extremity injury prevention programs have been developed to mitigate the risk of upper extremity overuse injuries among youth athletes in overhead sports;however,their effectiveness on performance outcome measures has not been investigated.This systematic review evaluated the effectiveness of existing upper extremity injury prevention programs that focused on modifying intrinsic risk factors,and performance outcome measures in overhead youth athletes.The secondary aim was to identify the training components of these programs.PubMed,Physiotherapy Evidence Database(PEDro),SPORTDiscus(via EBSCOhost),and Web of Science were searched from January 2000 to November 2020 for studies that implemented training programs or exercises for upper extremity injury prevention among youth athletes in overhead throwing or striking sports.An updated search was conducted from December 2020 to October 2022.A program was deemed effective for a performance outcome measure if significant improvements were observed in the intervention group as compared to the control group.Of the 1394 studies identified,five studies met the inclusion criteria.The effectiveness of the injury prevention programs on the identified performance outcome measures of strength,mobility,and sport-specific measures were 30.4%,28.6%,and 22.2%,respectively.The training components targeted were strength,mobility,and plyometrics.Strength was the most common training component and was also the most widely investigated performance outcome measure.Overall,current upper extremity injury prevention programs seem effective at improving performance outcome measures of strength,mobility,and sport-specific outcomes with training components of strength,mobility and plyometrics.Standardized protocols are required for the measurement and reporting of performance outcomes measures,and the reporting of training components.
文摘Background:Internal tibial loading is influenced by modifiable factors with implications for the risk of stress injury.Runners encounter varied surface steepness(gradients)when running outdoors and may adapt their speed according to the gradient.This study aimed to quantify tibial bending moments and stress at the anterior and posterior peripheries when running at different speeds on surfaces of different gradients.Methods:Twenty recreational runners ran on a treadmill at 3 different speeds(2.5 m/s,3.0 m/s,and 3.5 m/s)and gradients(level:0%;uphill:+5%,+10%,and+15%;downhill:-5%,-10%,and-15%).Force and marker data were collected synchronously throughout.Bending moments were estimated at the distal third centroid of the tibia about the medial-lateral axis by ensuring static equilibrium at each 1%of stance.Stress was derived from bending moments at the anterior and posterior peripheries by modeling the tibia as a hollow ellipse.Two-way repeated-measures analysis of variance were conducted using both functional and discrete statistical analyses.Results:There were significant main effects for running speed and gradient on peak bending moments and peak anterior and posterior stress.Higher running speeds resulted in greater tibial loading.Running uphill at+10%and+15%resulted in greater tibial loading than level running.Running downhill at-10%and-15%resulted in reduced tibial loading compared to level running.There was no difference between+5%or-5%and level running.Conclusion:Running at faster speeds and uphill on gradients≥+10%increased internal tibial loading,whereas slower running and downhill running on gradients≥-10%reduced internal loading.Adapting running speed according to the gradient could be a protective mechanism,providing runners with a strategy to minimize the risk of tibial stress injuries.
文摘This study analyzes the the verbal humor in the movie series If You Are The One from the perspective of some pragmatic theories.The findings of the study provide explanations towards generative mechanism of humor,such as the violation of Cooperative Principle,avoiding face-threatening acts,and particularly,creatively reveal that special use of Politeness Principle can produce a humourous effect,too.
文摘A one-year-old baby girl with one-month history of recurrent pus fluid exuding from her left preauricular sinus orifice, who failed multiple courses of surgical drainage of the abscess and persistent debridement for the wound, presented with MRSA infection. The patient was treated with linezolid for three days. Her pain and paresthesia resolved, and C-reactive protein decreased to normal.
文摘It is found in the study that there is a big difference concerning the overall frequency of Do with Hong Kong students using much more DO in their writings than native speakers.Besides,Hong Kong university students tend to overuse the verbal operator DO,which is contrary to Qi Yan's study(2006).At the same time,they also misuse Do;When Do is used as de-lexical verb,Hong Kong students share the same characteristics with the study of Fu zhuqin(2006),that is,they allow more freedom to collocate with more Nouns,some of which are inappropriate collocates in native English.The potential reasons for these problems might be illustrated as overgeneralization,mother-tongue interference,and lack of vocabulary etc.Based on the findings,the paper presents two pedagogical implications about vocabulary teaching and learning:the content of vocabulary teaching should be extended and enriched,and the corpus-based vocabulary teaching methodology should be integrated into class practices.
文摘Intersection syndrome is a rare sports overuse injury occurring through friction at the intersection of the first and second compartment of the forearm. Differential diagnosis must be carefully made, especially from De Quervain tendonsynovitis. Clinical examination provides with the necessary information for diagnosis, still magnetic resonance imaging scans and ultrasonography may assist in diagnosis. Treatment consists mainly of rest, use of a thumb spica splint, analgetic and oral nonsteroidal anti-inflammatory drugs and after 2-3 wk progressive stretching and muscle strengthening. Should symptoms persist beyond this time, corticosteroid injections adjacent to the site of injury may be useful. In refractory cases, surgical intervention is warranted.
文摘Osteitis pubis(OP) is a debilitating overuse syndrome characterizing by pelvic pain and local tenderness over the pubic symphysis commonly encountered in athletes often involved in kicking, twisting and cutting activities in sports such as soccer and rugby and to a lesser degree distance running. It is a common source of groin pain in elite athletes attributable to pubis sympysis instability as the result of microtrauma caused by repetitive muscle strains on pubic bones. Diagnosis is based mainly on detailed sports history and a meticulous clinical examination, although occasionally is difficult to distinguish this nosological entity from other pathologies affecting the involved area which may occur concomitantly in the same patient. Radiologic examinations such as plain radiographs, magnetic resonance imaging and 3 phase bone isotope scanning may be helpful to differentiate from other clinical entities with similar clinical presentation. Most cases respond well to conservative treatment which includes several physical modalities and especially a progressive rehabilitation programmed individualized to each one of patients diagnosed with OP. Local injection therapies have been also been proposed as a non-operative therapeutic option for the efficient management of these patients. In refractory cases, surgical therapeutic strategies are warranted. These include several open or minimally invasive surgical interventions such as arthroscopic or open symphysis curettage, wedge or total resection of pubic sympysis, polypropylene mesh placement and pubic fusion. In this review a critical analysis of OP in elite athletes is performed with special focus on current concepts of diagnosis and management of this source of athletic groin pain.
文摘We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India. Although the final diagnosis of the skeletal tuberculosis like tubercular arthritis is made by bacteriological and histological studies, few demographic, clinical and radiological features might help making early diagnosis.
文摘Instrument-assisted soft tissue mobilization is well researched and widely accepted to improve circulation, decrease pain, improve function, increase strength, and promote overall soft tissue health. However, the administration of this intervention, in most cases, is limited to the brief amounts of time we spend mobilizing our soft tissue. SORxSOAP offers a pragmatic strategy by which one may mobilize their soft tissue while simultaneously showering or washing a specific part of their body. The purpose of this study is to demonstrate the effects SORxSOAP has on functional measures of upper extremity activity in the slicing hands of employees at a corporate deli franchise over the course of a one-month period. 31 employees of a corporate deli franchise were asked to participate in a study involving the use of SORxSOAP. The subjects were assigned to experimental and control groups rough random sampling. Twenty-one subjects in the experimental group were given a one month’s supply of SORxSOAP to use on a regular basis while showering. Ten subjects in the control group were not exposed to any independent variable. The subjects from both groups completed a questionnaire that asked the subjects to rate the level of ease at which specific job-related activities were for them to perform. Hand-strength/grip and range of motion measurements were also taken utilizing a handheld dynamometer and goniometer respectively by one evaluator both before and after a one-month duration of the experimental group’s exposure to SORxSOAP. Independent t-tests were performed to test the difference between pre and post-test values for the control and experimental groups. It was found that SORxSOAP significantly improves wrist flexion range of motion, results in significantly greater improvements in hand-grip strength compared to control, and significantly improves wrist extension range of motion over a one-month period. Improvements in the ease of job-related activities also appear to be correlated to the use of SORxSOAP for items #1, 2, 3, 4, 5, 6, 7, and 9. Significant differences were also found between the slicing and non-slicing hands for pre-test wrist extension range of motion measurements, indicating the presence of possible over-use injury in occupations and activities placing excessive demand on certain body regions. This provides isolated evidence that supports the notion that SORxSOAP could be a viable option for preventing the steady decline of wrist extension range of motion and actually promoting and maintaining soft tissue and overall joint health, making it clear how further investigation into the effects of SORxSOAP can not only improve joint and soft tissue health, but prevent the emergence of joint and soft tissue impairment entirely. Clinical Bottom Line: The use of SORxSOAP has the potential to significantly improve muscle and soft tissue performance and function over a period of one month.
基金The Second Tibetan Plateau Scientific Expedition and Research Program,No.2019QZKK0603Strategic Priority Research Program of Chinese Academy of Sciences,No.XDA20040000,No.XDA20090000。
文摘This paper studied the fertilizer rate(FR), fertilizer use efficiency(FUE) and fertilizer overuse rate(FOR) of rice, corn and wheat in China from 1998 to 2018 and briefly analysed the reasons why farmers were willing to apply more fertilizers.(1) The FR of grain in China reached 373.7 kg/ha in 2018, an increase of 26.8% compared to that in 1998. In 2018, the FR for corn was the highest, at 411.2 kg/ha, compared to the values of 338.3 kg/ha for rice and 371.7 kg/ha for wheat.(2) In recent years, the FUE of grain in China has obviously improved, with values of 32.9% in 1998, 36.7% in 2008, and 39.3% in 2018. In 2018, the FUE for rice was the highest(41.2%), followed by that for corn(39.9%), and the FUE for wheat was the lowest(36.0%).(3) By 2018, fertilizer was overused in all zones of rice, corn and wheat. In 2018, the average FOR for wheat reached 69.0%, which was 35.9% higher than that for corn and 42.8% higher than that for rice.(4) The lower price of chemical fertilizers was the main reason leading to overapplication.(5) Establishing market mechanisms and adjusting regional planting structures can be effective in reducing the application of chemical fertilizers.