Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors

Patellofemoral Pain Syndrome (PFPS), a common cause of anterior knee pain, is successfully treated in over 2/3 of patients through rehabilitation protocols designed to reduce pain and return function to the individual. Applying preventive medicine strategies, the majority of cases of PFPS may be avoided if a pre-diagnosis can be made by clinician or certified athletic trainer testing the current researched potential risk factors during a Preparticipation Screening Evaluation (PPSE). We provide a detailed and comprehensive review of the soft tissue, arterial system, and innervation to the patellofemoral joint in order to supply the clinician with the knowledge required to assess the anatomy and make recommendations to patients identified as potentially at risk. The purpose of this article is to review knee anatomy and the literature regarding potential risk factors associated with patellofemoral pain syndrome and prehabilitation strategies. A comprehensive review of knee anatomy will present the relationships of arterial collateralization, innervations, and soft tissue alignment to the possible multifactoral mechanism involved in PFPS, while attempting to advocate future use of different treatments aimed at non-soft tissue causes of PFPS

Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy.

PURPOSE: The medial patellofemoral ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. METHODS: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3 February 2016. All papers investigating the anatomy of the MPFL were eligible. Methodological quality was assessed using a modified CASP tool. A narrative analysis approach was adopted to synthesise the findings. RESULTS: After screening and review of 2045 papers, a total of 67 studies investigating the relevant anatomy were included. From this, the origin appears to be from an area rather than (as previously reported) a single point on the medial femoral condyle. The weighted average length was 56 mm with an 'hourglass' shape, fanning out at both ligament ends. CONCLUSION: The MPFL is an hourglass-shaped structure running from a triangular space between the adductor tubercle, medial femoral epicondyle and gastrocnemius tubercle and inserts onto the superomedial aspect of the patella. Awareness of anatomy is critical for assessment, anatomical repair and successful surgical patellar stabilisation. LEVEL OF EVIDENCE: Systematic review of anatomical dissections and imaging studies, Level IV

Social media and sensemaking patterns in new product development: demystifying the customer sentiment

Artificial intelligence by principle is developed to assist but also support decision making processes. In our study, we explore how information retrieved from social media can assist decision-making processes for new product development (NPD). We focus on consumers’ emotions that are expressed through social media and analyse the variations of their sentiments in all the stages of NPD. We collect data from Twitter that reveal consumers’ appreciation of aspects of the design of a newly launched model of an innovative automotive company. We adopt the sensemaking approach coupled with the use of fuzzy logic for text mining. This combinatory methodological approach enables us to retrieve consensus from the data and to explore the variations of sentiments of the customers about the product and define the polarity of these emotions for each of the NPD stages. The analysis identifies sensemaking patterns in Twitter data and explains the NPD process and the associated steps where the social interactions from customers can have an iterative role. We conclude the paper by outlining an agenda for future research in the NPD process and the role of the customer opinion through sensemaking mechanisms

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Productivity of determinate growth tomato lines tolerant to heat under the organic system Produtividade de linhagens de tomate rasteiro tolerantes ao calor sob o sistema orgânico

The objective of the present work was to evaluate the productive response of heat tolerant lines of determinate growth tomato under the organic production system. The experiment was carried out in the Instituto de Ciências Agrárias of UFMG, Montes Claros, Minas Gerais state, Brazil. The experimental design was of randomized complete blocks with eight treatments and four replications. The treatments consisted of eight heat tolerant processing type tomato lines obtained from the Asian Vegetable Research and Development Center (AVRDC), China: CLN1621L, CLN1621F, CLN1621E, CLN1466P, CLN2026E, CLN2026D, CLN2026C and CLN2001C. There was an inverse relationship between the average weight of the fruits and the number of fruits per plant. The highest average fruit weight of some lines was compensated by the lowest quantity of fruits, in such a way that there were no significant differences among the lines. Symptoms of nutritional deficiency and incidences of pests and diseases were not verified in any of the studied lines. All lines presented potential for genetic improvement research and cultivation using organic production systems under higher temperature conditions.<br>O objetivo do presente trabalho foi avaliar o desempenho produtivo de linhagens de tomate rasteiro tolerantes ao calor sob o sistema orgânico de produção. O experimento foi realizado no Núcleo de Ciências Agrárias da UFMG, Montes Claros-MG. Foi utilizado o delineamento em blocos casualizados com oito tratamentos e quatro repetições. Os tratamentos consistiram de oito linhagens de tomate do tipo rasteiro tolerantes ao calor obtidos na Asian Vegetable Research and Development Center (AVRDC), China: CLN1621L, CLN1621F, CLN1621E, CLN1466P, CLN2026E, CLN2026D, CLN2026C e CLN2001C. Houve uma relação inversa entre o peso médio dos frutos e o número de frutos produzidos por planta. O maior peso médio de frutos de algumas linhagens foi compensado pelo menor número de frutos, de tal forma que não houve diferenças significativas entre as linhagens. Não foram constatados sintomas de deficiência nutricional e incidências de pragas e doenças nas linhagens estudadas. Todas as linhagens apresentam potencial para pesquisas de melhoramento genético e cultivo em sistemas orgânicos de produção em condições de temperatura mais elevada