Trunk muscle activity during drop jump performance in adolescent athletes with back pain

It was with great interest we read the recently published article “Trunk Muscle Activity during Drop Jump Performance in Adolescent Athletes with Back Pain.” Investigating back pain (BP) in adolescents is commendable as there is growing evidence that for many, an experience of BP as early as 14 years of age may relate to ongoing pain in adulthood (Coenen et al., 2017). Indeed, the conventional narrative is changing as individual physical factors such as posture, use of schoolbags, and hypermobility are only weakly associated with adolescent BP. Rather, factors which predict BP at a young age are considered to be multi-dimensional and include gender, negative BP beliefs and poor mental health (O\u27Sullivan et al., 2017; Smith et al., 2017). Mueller et al. (2017) have focused on a single physical factor (trunk muscle activation patterns) drawing inferences regarding BP prevention and treatment. This article prompts consideration of three essential aspects regarding research design and interpretation of findings: 1. Interpreting results from cross-sectional designs 2. Interpreting pain-related differences in motor behavior 3. Translating and conveying scientific results to the end-user (patients, healthcare professionals and policy makers)

Unobtrusive Observation of Team Learning Attributes in Digital Learning

This article presents a new framework for unobtrusive observation analytics of knowledge and skills-in-action through continuous collection of data from individuals while they interact with digital assets either as individuals or on problem-solving teams. The framework includes measures of the skill and knowledge areas of collaboration, creativity, personal learning, problem solving, and global sustainability, which are observed during natural production and use of communications, intentional artifacts, and resources in a digital learning space designed for self-directed and team-based learning challenges. The article describes the digital context for data collection and shows some example data and analyses

The Warwick Hip Trauma Evaluation One - an abridged protocol for the WHiTE One Study AN EMBEDDED RANDOMISED TRIAL COMPARING THE X-BOLT WITH SLIDING HIP SCREW FIXATION IN EXTRACAPSULAR HIP FRACTURES

Fractures of the proximal femur are one of the greatest challenges facing the medical community, constituting a heavy socioeconomic burden worldwide. Controversy exists regarding the optimal treatment for patients with unstable trochanteric proximal femoral fractures. The recognised treatment alternatives are extramedullary fixation usually with a sliding hip screw and intramedullary fixation with a cephalomedullary nail. Current evidence suggests that best results and lowest complication rates occur using a sliding hip screw. Complications in these difficult fractures are relatively common regardless of type of treatment. We believe that a novel device, the X-Bolt dynamic plating system, may offer superior fixation over a sliding hip screw with lower reoperation risk and better function. We therefore propose to investigate the clinical effectiveness of the X-bolt dynamic plating system compared with standard sliding hip screw fixation within the framework of a the larger WHiTE (Warwick Hip Trauma Evaluation) Comprehensive Cohort Study. Cite this article: Bone Joint Res 2013;2:206–9

Residual strength of equine bone is not reduced by intense fatigue loading: Implications for stress fracture

Fatigue or stress fractures are an important clinical problem in humans as well as racehorses. An important question in this context is, when a bone experiences. fa!igue damage ~uring e~treme use, how much is it weakened compared to its original state? Since there are very ltmtted data on thts quesuon and stress fractures are common in racehorses, we sought to determine the effect of fatigue loading on the monotonic l:trength of equine cortical bone. Beams were machined from the dorsal, medial and lateral cortices of the third metacarpal bones of six thoroughbred racehorses. Beams from left and right bones were assigned to control and fatigue groups. respectively (N- 18 each). The fatigue group was cyclicully loaded in three-point bending at 2Hz for 100,000 cycles at 0- 5000 microstrain while submerged in saline at 37°C. These beams. as well as those in the control group. were then monotonically loaded to failure in three-point bending. The monotonic load-deflection curves were analyzed for differences using three-factor (fatigue loading, ~natotni~ region. and horse)_ analysis o_f variance .. The mean failure load was 3% less in the fatigue group, but thts reduction was only margmally stgmficant. Netther elastic modulus nor yield strength was significantly affected by the fatigue loading. The principal effects of fatigue loading were on post-yield behavior (yield being based on a 0.02% offset criter!on). The work don~ and the load increase between yield and failure were both significantly reduced. All the vanables except post-yteld deflecuon were significantly affected by anatomic region. In summary, loading equivalent to a lifetime of racing does not significantly weaken equine cortical bone ex vivo. The clinical implication of this may be that the biological repair of fatigue damage can actually contribute to stress fracture if pressed too far

Loneliness, social relations and health and wellbeing in deprived communities

There is growing policy concern about the extent of loneliness in advanced societies, and its prevalence among various social groups. This study looks at loneliness among people living in deprived communities, where there may be additional barriers to social engagement including low incomes, fear of crime, poor services and transient populations. The aim was to examine the prevalence of loneliness, and also its associations with different types of social contacts and forms of social support, and its links to self-reported health and wellbeing in the population group. The method involved a cross-sectional survey of 4,302 adults across 15 communities, with the data analysed using multinomial logistic regression controlling for sociodemographics, then for all other predictors within each domain of interest. Frequent feelings of loneliness were more common among those who: had contact with family monthly or less; had contact with neighbours weekly or less; rarely talked to people in the neighbourhood; and who had no available sources of practical or emotional support. Feelings of loneliness were most strongly associated with poor mental health, but were also associated with long-term problems of stress, anxiety and depression, and with low mental wellbeing, though to a lesser degree. The findings are consistent with a view that situational loneliness may be the product of residential structures and resources in deprived areas. The findings also show that neighbourly behaviours of different kinds are important for protecting against loneliness in deprived communities. Familiarity within the neighbourhood, as active acquaintance rather than merely recognition, is also important. The findings are indicative of several mechanisms that may link loneliness to health and wellbeing in our study group: loneliness itself as a stressor; lonely people not responding well to the many other stressors in deprived areas; and loneliness as the product of weak social buffering to protect against stressors

Effect on health-related quality of life of the X-Bolt dynamic plating system versus the sliding hip screw for the fixation of trochanteric fractures of the hip in adults: the WHiTE Four randomized clinical trial

Aims Surgical treatment of hip fracture is challenging; the bone is porotic and fixation failure can be catastrophic. Novel implants are available which may yield superior clinical outcomes. This study compared the clinical effectiveness of the novel X-Bolt Hip System (XHS) with the sliding hip screw (SHS) for the treatment of fragility hip fractures. Methods We conducted a multicentre, superiority, randomized controlled trial. Patients aged 60 years and older with a trochanteric hip fracture were recruited in ten acute UK NHS hospitals. Participants were randomly allocated to fixation of their fracture with XHS or SHS. A total of 1,128 participants were randomized with 564 participants allocated to each group. Participants and outcome assessors were blind to treatment allocation. The primary outcome was the EuroQol five-dimension five-level health status (EQ-5D-5L) utility at four months. The minimum clinically important difference in utility was pre-specified at 0.075. Secondary outcomes were EQ-5D-5L utility at 12 months, mortality, residential status, mobility, revision surgery, and radiological measures. Results Overall, 437 and 443 participants were analyzed in the primary intention-to-treat analysis in XHS and SHS treatment groups respectively. There was a mean difference of 0.029 in adjusted utility index in favour of XHS with no evidence of a difference between treatment groups (95% confidence interval -0.013 to 0.070; p = 0.175). There was no evidence of any differences between treatment groups in any of the secondary outcomes. The pattern and overall risk of adverse events associated with both treatments was similar. Conclusion Any difference in four-month health-related quality of life between the XHS and SHS is small and not clinically important. There was no evidence of a difference in the safety profile of the two treatments; both were associated with lower risks of revision surgery than previously reported

Chemoenzymatic Synthesis of Triazololactams Structurally Related to Pancratistatin

Four tricyclic lactams that structurally resemble alkaloids with the pancratistatin skeleton were synthetized from bromobenzene by a chemoenzymatic strategy. The sequence involved enzymatic dihydroxylation, efficient stereodirected oxidation of double bonds, inter- or intramolecular Huisgen cycloaddition, and a solvent-free cyclization. The complex structures were obtained in high chemical and optical purity and may be good candidates for biological testing.Fil: de la Sovera, Victoria. Universidad de la República. Facultad de Química. Departamento de Química Orgánica; UruguayFil: Suescun, Leopoldo. Universidad de la República. Laboratorio de Cristalografía, Estado Sólido y Materiales; UruguayFil: Bellomo Peraza, Ana Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Bionanociencias ; ArgentinaFil: González, David. Universidad de la República. Facultad de Química. Departamento de Química Orgánica; Urugua

Calcium buffering is required to maintain bone stiffness in saline solution

This work determined whether mineral dissolution due to prolonged testing or storage of bone s~\u27imens in normal salint: would alter Lheir elastic modulus. In one experiment, small pieces of equine third metacarpal bone were soaked in normal saline supplemented with varying amounts of CaCI1. Changing Ca ion concentrations in the bath were monitored and the equilibrium concentration was determined. In a second experiment, the elastic moduli of twenty 4 x 10 x 100 mm equine third metacarpal beams were determined non-destructively in four-point bending. Half the beams were then soaked for 10 days in normal saline, and the other half in saline buffered to the bone mineral equilibrium point with Ca ions. Modulus measurements were repeated at 6 and 10 days. The oquilibrium Ca ion con.centration for bone specimens was found to be 57.5 mgl - •. The modulus of bone specimens soaked in normal saline significantly diminished 2.4%, whereas the modulus of those soaked in calcium-buffered saline did not change significantly