Circulating human leucine-rich a-2-glycoprotein 1 mRNA and protein levels to detect acute appendicitis in patients with acute abdominal pain

Background Elevated levels of circulating plasma and urine leucine-rich-2-glycoprotein-1 (LRG1) protein has been found in patients with acute appendicitis (AA) and may be useful for diagnosis. This study aimed to investigate whether combined tests including circulating LRG1 mRNA levels improve the early diagnosis of AA. Methods Between December 2011 and October 2012, a prospective study was conducted on patients aged 18 years or older presenting to the ED with acute abdominal pain (< 7 days of symptom onset). Levels of whole blood LRG1 mRNA and plasma LRG1 protein taken from these patients within 24 h of arrival (mean 12.4 h) were analyzed. The primary outcome was AA. Results Eighty-four patients (40 (47.6%) with AA and 44 (52.4%) without AA; mean age 35 years; 41.6% males) were recruited. Median whole blood LRG1 mRNA and plasma LRG1 levels were higher in AA patients than in non-AA. Of 40 AA patients, 13 (32.5%) were diagnosed as complicated AA. In ROC analysis of LRG1 mRNA (normalized to GAPDH), LRG1 protein and Alvarado score for discriminating AA and non-AA, the areas under the curve (AUC) were 0.723, 0.742 and 0.805 respectively. The AUC of combination of normalized LRG1 mRNA, LRG1 protein and Alvarado score was 0.845. Conclusion A combination of modified whole blood LRG1 mRNA levels, plasma LRG1 protein and Alvarado score at the ED may be useful to diagnose simple and complicated AA from other causes of abdominal pain

The Effects of Midfoot Strike Gait Retraining on Impact Loading and Joint Stiffness

Objective: To assess the biomechanical changes following a systematic gait retraining to modify footstrike patterns from rearfoot strike (RFS) to midfoot strike (MFS). Design: Pre-post interventional study. All participants underwent a gait retraining program designed to modify footstrike pattern to MFS. Setting: Research laboratory. Participants: Twenty habitual RFS male runners participated. Main Outcome Measures: Gait evaluations were conducted before and after the training. Footstrike pattern, loading rate (LR), ankle and knee joint stiffness were compared. Results: Participants’ footstrike angle was reduced (p<0.001, Cohen’s d=1.65) and knee joint stiffness was increased (p=0.003, Cohen’s d=0.69). No significant difference was found in the vertical loading rates (p>0.155). Further sub-group analyses were conducted on the respondents (n=8, 40% of participants) who exhibited MFS for over 80% of their footfalls during the post-training evaluation. Apart from the increased knee joint stiffness (p=0.005, Cohen’s d=1.14), respondents exhibited a significant reduction in the ankle joint stiffness (p=0.019, Cohen’s d=1.17) when running with MFS. Conclusions: Gait retraining to promote MFS was effective in reducing runners’ footstrike angle, but only 40% of participants responded to this training program. The inconsistent training effect on impact loading suggests a need to develop new training protocols in an effort to prevent running injuries

Difference in the running biomechanics between preschoolers and adults

Background: High vertical loading rate is associated with a variety of running-related musculoskeletal injuries. There is evidence supporting that non-rearfoot footstrike pattern, greater cadence, and shorter stride length may reduce the vertical loading rate. These features appear to be common among preschoolers, who seem to experience lower running injury incidence, leading to a debate whether adults should accordingly modify their running form. Objective: This study sought to compare the running biomechanics between preschoolers and adults. Methods: Ten preschoolers (4.2 ± 1.6 years) and ten adults (35.1 ± 9.5 years) were recruited Q3 and ran overground with their usual shoes at a self-selected speed. Vertical average (VALR) and vertical instantaneous loading rate (VILR) were calculated based on the kinetic data. Footstrike pattern and spatiotemporal parameters were collected using a motion capture system. Results: There was no difference in normalized VALR (p = 0.48), VILR (p = 0.48), running speed (p = 0.85), and footstrike pattern (p = 0.29) between the two groups. Preschoolers demonstrated greater cadence (p < 0.001) and shorter normalized stride length (p = 0.01). Conclusion: By comparing the kinetic and kinematic parameters between children and adults, our findings do not support the notion that adults should modify their running biomechanics according to the running characteristics in preschoolers for a lower injury risk. © 2020 Associac¸ao˜ Brasileira de Pesquisa e Pos-Graduac¸ ´ ao˜ em Fisioterapia. Published by Elsevier Editora Ltda. All rights reserved

Effects of deceptive footwear condition on subjective comfort and running biomechanics

Comfort is a major criterion for footwear selection. Previous studies have suggested that physical properties were not enough to predict comfort and psychological factors could also affect the perception. To understand comfort, this study examined the effect of controlled shoe description and price cue on the perception of comfort. Furthermore, this study also examined the running biomechanics in response to footwear conditions of differing comfort. Fifteen runners completed treadmill running tests in two conditions: Shoe A and Shoe B. The same pair of neutral running shoes was used in both conditions, yet, Shoe B was described to be the “latest model designed to maximize comfort” and more expensive than Shoe A. Comfort assessment was conducted after the running trial of each condition. Participants reported significantly greater comfort in Shoe B than Shoe A (p=0.011, Cohen’s d=0.70). There were no significant differences found among the temporal-spatial parameters (p>0.916) and the vertical loading rates (p>0.161) when comparing the more and less comfortable conditions. In conclusion, runners exhibited a biased perception of footwear comfort when presented with different shoe description and price information. However, such a difference in perceived comfort alone is not likely to affect running biomechanics

Ad hoc influenza vaccination during years of significant antigenic drift in a tropical city with 2 seasonal peaks

We evaluated the acceptability of an additional ad hoc influenza vaccination among the health care professionals following seasons with significant antigenic drift. Self-administered, anonymous surveys were performed by hard copy questionnaires in public hospitals, and by an on-line platform available to all healthcare professionals, from April 1st to May 31st, 2015. A total of 1290 healthcare professionals completed the questionnaires, including doctors, nurses, and allied health professionals working in both the public and private systems. Only 31.8% of participating respondents expressed an intention to receive the additional vaccine, despite that the majority of them agreed or strongly agreed that it would bring benefit to the community (88.9%), save lives (86.7%), reduce medical expenses (76.3%), satisfy public expectation (82.8%), and increase awareness of vaccination (86.1%). However, a significant proportion expressed concern that the vaccine could disturb the normal immunization schedule (45.5%); felt uncertain what to do in the next vaccination round (66.0%); perceived that the summer peak might not occur (48.2%); and believed that the summer peak might not be of the same virus (83.5%). Furthermore, 27.8% of all respondents expected that the additional vaccination could weaken the efficacy of previous vaccinations; 51.3% was concerned about side effects; and 61.3% estimated that there would be a low uptake rate. If the supply of vaccine was limited, higher priority groups were considered to include the elderly aged ≥65 years with chronic medical conditions (89.2%), the elderly living in residential care homes (87.4%), and long-stay residents of institutions for the disabled (80.7%). The strongest factors associated with accepting the additional vaccine included immunization with influenza vaccines in the past 3 years, higher perceived risk of contracting influenza, and higher perceived severity of the disease impact. The acceptability to an additional ad hoc influenza vaccination was low among healthcare professionals. This could have a negative impact on such additional vaccination campaigns since healthcare professionals are a key driver for vaccine acceptance. The discordance in perceived risk and acceptance of vaccination regarding self versus public deserves further evaluation

Gait Retraining for the Reduction of Injury Occurrence in Novice Distance Runners: 1-Year Follow-up of a Randomized Controlled Trial

Background: The increasing popularity of distance running has been accompanied by an increase in running-related injuries, such that up to 85% of novice runners incur an injury in a given year. Previous studies have used a gait retraining program to successfully lower impact loading, which has been associated with many running ailments. However, softer footfalls may not necessarily prevent running injury. Purpose: To examine vertical loading rates before and after a gait retraining program and assess the effectiveness of the program in reducing the occurrence of running-related injury across a 12-month observation period. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 320 novice runners from the local running club completed this study. All the participants underwent a baseline running biomechanics evaluation on an instrumented treadmill with their usual running shoes at 8 and 12 km/h. Participants were then randomly assigned to either the gait retraining group or the control group. In the gait retraining group (n = 166), participants received 2 weeks of gait retraining with real-time visual feedback. In the control group (n = 154), participants received treadmill running exercise but without visual feedback on their performance. The training time was identical between the 2 groups. Participants’ running mechanics were reassessed after the training, and their 12-month posttraining injury profiles were tracked by use of an online surveillance platform. Results: A significant reduction was found in the vertical loading rates at both testing speeds in the gait retraining group (P 0.99), whereas the loading rates were either similar or slightly increased in the control group after training (P = .001 to 0.461, Cohen’s d = 0.03 to −0.14). At 12-month follow-up, the occurrence of running-related musculoskeletal injury was 16% and 38% in the gait retraining and control groups, respectively. The hazard ratio between gait retraining and control groups was 0.38 (95% CI, 0.25-0.59), indicating a 62% lower injury risk in gait-retrained runners compared with controls. Conclusion: A 2-week gait retraining program is effective in lowering impact loading in novice runners. More important, the occurrence of injury is 62% lower after 2 weeks of running gait modification. Registration: HKUCTR-1996 (University of Hong Kong Clinical Trials Registry)

Light-Front Approach for Pentaquark Strong Decays

Assuming the two diquark structure for the pentaquark state as advocated in the Jaffe-Wilczek model, we study the strong decays of light and heavy parity-even pentaquark states using the light-front quark model in conjunction with the spectator approximation. The narrowness of the Theta width is ascribed to the p-wave configuration of the diquark pair. Taking the Theta width as a benchmark, we estimate the rates of the strong decays Xi_{3/2}-- to Xi- pi-, Sigma- K-, Sigma_{5c}0 to D_s- p, D_{s0}*- p and Xi_{5c}0 to D_s- Sigma+, D_{s0}^{*-} Sigma+ with Sigma_{5c} Xi_{5c} being antisextet charmed pentaquarks and D_{s0}* a scalar strange charmed meson. The ratio of Gamma(P_c to Baryon D_{s0}*)/Gamma(P_c to Baryon D_s) is very useful for verifying the parity of the antisextet charmed pentaquark P_c. It is expected to be of order unity for an even parity P_c and much less than one for an odd parity pentaquark.Comment: 24 pages, 2 figure

Impact loading during distracted running before and after auditory gait retraining.

Visual feedback gait retraining has been reported to successfully reduce impact loading in runners, even when the runners were distracted. However, auditory feedback is more feasible in real life application. Hence, this study compared the peak positive acceleration (PPA), vertical average (VALR) and instantaneous (VILR) loading rate during distracted running before and after a course of auditory feedback gait retraining in 16 runners. The runners were asked to land with softer footfalls with and without auditory feedback. Low or high sound pitch was generated according to the impact of particular footfall, when compared with the preset target. Runners then received a course of auditory gait retraining, and after the gait retraining, runners completed a reassessment. Runners before gait retraining exhibited lower PPA, VALR and VILR with augmented auditory feedback (p0.104). A small effect of auditory feedback on VILR in runners after gait retraining was observed (p=0.032). Real time auditory feedback gait retraining is effective in impact loading reduction, even when the runners were distracted

Effect of minimalist and maximalist shoes on impact loading and footstrike pattern in habitual rearfoot strike trail runners: an in-field study

Running-related injuries among trail runners are very common and footwear selection may modulate the injury risk. However, most previous studies were conducted in a laboratory environment. The objective of this study was to examine the effects of two contrasting footwear design, minimalist (MIN) and maximalist shoes (MAX), on the running biomechanics of trail runners during running on a natural trail. Eighteen habitual rearfoot strike trail runners completed level, uphill and downhill running at their preferred speeds in both shod conditions. Peak tibial acceleration, strike index and footstrike pattern were compared between the two footwear and slopes. Interactions of footwear and slope were not detected for all the selected variables. There was no significant effect from footwear (F=1.23, p=0.27) and slope (F=2.49, p=0.09) on peak tibial acceleration and there was no footwear effect on strike index (F=3.82, p=0.056). A significant main effect of slope on strike index (F=13.24, p<0.001) was found. Strike index during uphill running was significantly greater (i.e., landing with a more anterior foot strike) when compared with level (p<0.001, Cohen’s d=1.72) or downhill running (p<0.001, Cohen’s d=1.44) in either MIN or MAX. The majority of habitual rearfoot strike runners switched to midfoot strike during uphill running while maintaining a rearfoot strike pattern during level or downhill running. In summary, wearing either one of the two contrasting footwear (MIN or MAX) demonstrated no effect on impact loading and footstrike pattern in habitual rearfoot strike trail runners running on a natural trail with different slopes