Upper extremity pain and overuse injuries in fly-fishing: A North American cross-sectional survey and implications for injury prevention

Background: Fly-fishing requires rhythmic, coordinated movements to successfully cast a fly line. Previous studies have shown that the biomechanical demands of fly-casting may cause some individuals to develop upper extremity pain or injuries. Purpose: To report the rates, trends, and contributing factors of upper extremity pain and overuse injuries in a sample of North American recreational fly-fishers. Study Design: Descriptive epidemiology study. Methods: Participants were reached via 3 popular online fly-fishing forums in April 2019. Each consenting North American participant over 18 years of age was given a link to a unique survey that recorded his or her demographic and orthopaedic histories, fly-fishing experience, equipment, casting techniques, upper extremity pain after fly-fishing, and chronic outcomes. Results: The 162 fly-fishers included were 63.3 (± 11.5) years of age, and 95.1% were men. In total, 59 (36.4%) reported experiencing upper extremity pain immediately after fly-fishing. Pain was rated a 4.0 (interquartile range, 3.0-6.0) on a 10-point Likert scale, commonly lasting less than 1 day (45.0%) or between 1 day and 1 week (45.0%). The majority (62.7%) reported not needing to see a medical provider for their pain/soreness. Those who did most commonly received diagnoses of elbow or rotator cuff tendinitis. Pain/soreness was associated with casting in an elliptical/sidearm fashion, compared with overhead or 2-handed casting ( Conclusion: In this sample of recreational fly-fishers, no aspects of fly-fishing were associated with long-term upper extremity disability, and only a little more than a third reported having transient pain immediately after fishing. Casting style, using weighted lines or added weight, and grip style were all associated with pain. These are modifiable risk factors that can be adjusted to reduce the risk of upper extremity pain immediately after fly-fishing

Pediatric open long-bone fracture and subsequent deep infection risk: The importance of early hospital care

The purpose of the current study was to identify risk factors for deep infection after an open long-bone fracture in pediatric patients. Systematic billing queries were utilized to identify pediatric patients who presented to a level I trauma center from 1998 to 2019 with open long-bone fractures. There were 303 open long-bone fractures, and 24 (7.9%) of these became infected. Fractures of the tibia/fibula

Antibiotics for preventing recurrent urinary tract infection: Systematic review and meta-analysis

Recurrent urinary tract infections are a common health problem. The only comprehensive synthesis on antibiotic prophylaxis in the last 15 years has been a guideline-embedded meta-analysis. We conducted a systematic review and meta-analysis of randomized controlled trials published up to October 13, 2020, evaluating patients age ≥12 years with either ≥2 episodes of lower urinary tract infection (UTI) within 6 months or ≥3 in the past year. Placebo or antibiotics were allowed as comparators. Study quality was low. In the 11 placebo-controlled trials, the risk for developing UTI was 85% lower with prophylaxis in comparison with placebo (risk ratio [RR], 0.15; 95% CI, 0.08-0.29). In the 9 head-to-head trials, the efficacy of the antibiotic agents appeared similar: The pooled RR indicated no difference between nitrofurantoin and comparators (RR, 1.01; 95% CI, 0.74-1.37), nor trimethoprim (+/- sulfamethoxazole; RR, 1.34; 95% CI, 0.89-2.03) or norfloxacin and comparators (RR, 1.17; 95% CI, 0.43-1.70). Studies comparing intermittent (postcoital) with continuous strategies revealed intermittent application to be equally effective

Antibiotics for Preventing Recurrent Urinary Tract Infection: Systematic Review and Meta-analysis.

Recurrent urinary tract infections are a common health problem. The only comprehensive synthesis on antibiotic prophylaxis in the last 15 years has been a guideline-embedded meta-analysis. We conducted a systematic review and meta-analysis of randomized controlled trials published up to October 13, 2020, evaluating patients age ≥12 years with either ≥2 episodes of lower urinary tract infection (UTI) within 6 months or ≥3 in the past year. Placebo or antibiotics were allowed as comparators. Study quality was low. In the 11 placebo-controlled trials, the risk for developing UTI was 85% lower with prophylaxis in comparison with placebo (risk ratio [RR], 0.15; 95% CI, 0.08-0.29). In the 9 head-to-head trials, the efficacy of the antibiotic agents appeared similar: The pooled RR indicated no difference between nitrofurantoin and comparators (RR, 1.01; 95% CI, 0.74-1.37), nor trimethoprim (+/- sulfamethoxazole; RR, 1.34; 95% CI, 0.89-2.03) or norfloxacin and comparators (RR, 1.17; 95% CI, 0.43-1.70). Studies comparing intermittent (postcoital) with continuous strategies revealed intermittent application to be equally effective

Give us a game : evaluating the opportunities that exist for English footballers to play in the English Premier League

The purpose of this study was to provide a detailed, large-scale retrospective analysis of the number of English footballers that have been developed to play in the English Premier League (EPL) over twenty seasons. Unlike previous research, we examined appearance data as opposed to percentage of squad data enabling a more accurate representation of English players appearing in the EPL. The findings revealed a steady decline in the number and proportion of appearances made by English players in the EPL throughout the twenty season period. However, the results also indicated that the rate of decline had abated since the inception of UEFA's home-grown rule. The results support the view that opportunities for indigenous players have diminished since the EPL's inception. Given the short-term, results-focused culture that prevails in the EPL, this would appear to present a major challenge for governing bodies, particularly those working in elite player development. Discussion surrounding how these challenges might be met is presented

Variation resources at UC Santa Cruz

The variation resources within the University of California Santa Cruz Genome Browser include polymorphism data drawn from public collections and analyses of these data, along with their display in the context of other genomic annotations. Primary data from dbSNP is included for many organisms, with added information including genomic alleles and orthologous alleles for closely related organisms. Display filtering and coloring is available by variant type, functional class or other annotations. Annotation of potential errors is highlighted and a genomic alignment of the variant's flanking sequence is displayed. HapMap allele frequencies and linkage disequilibrium (LD) are available for each HapMap population, along with non-human primate alleles. The browsing and analysis tools, downloadable data files and links to documentation and other information can be found at

Gluteus maximus transfer for hip abductor deficiency

Hip abductor deficiency resulting from gluteus medius and minimus pathology is increasingly recognized as a generator of lateral-sided hip pain. In the setting of a failed gluteus medius repair or in patients with irreparable tears, transfer of the anterior portion of the gluteus maximus muscle can be performed to treat gluteal abductor deficiency. The classic description of the gluteus maximus transfer technique relies solely on bone tunnel fixation. This article describes a reproducible technique that incorporates the addition of a distal row to the tendon transfer, which may improve fixation by both compressing the tendon transfer to the greater trochanter and providing improved biomechanical strength to the transfer

Snapshots during the catalytic cycle of a histidine acid phytase reveal an induced fit structural mechanism

Highly engineered phytases, which sequentially hydrolyze the hexakisphosphate ester of inositol known as phytic acid, are routinely added to the feeds of monogastric animals to improve phosphate bioavailability. New phytases are sought as starting points to further optimize the rate and extent of dephosphorylation of phytate in the animal digestive tract. Multiple inositol polyphosphate phosphatases (MINPPs) are clade 2 histidine phosphatases (HP2P) able to carry out the stepwise hydrolysis of phytate. MINPPs are not restricted by a strong positional specificity making them attractive targets for development as feed enzymes. Here, we describe the characterization of a MINPP from the Gram-positive bacterium Bifidobacterium longum (BlMINPP). BlMINPP has a typical HP2P-fold but, unusually, possesses a large a-domain polypeptide insertion relative to other MINPPs. This insertion, termed the U-loop, spans the active site and contributes to substrate specificity pockets underpopulated in other HP2Ps. Mutagenesis of U-loop residues reveals its contribution to enzyme kinetics and thermostability. Moreover, four crystal structures of the protein along the catalytic cycle capture, for the first time in an HP2P, a large ligand-driven a-domain motion essential to allow substrate access to the active site. This motion recruits residues both downstream of a molecular hinge and on the U-loop to participate in specificity subsites, and mutagenesis identified a mobile lysine residue as a key determinant of positional specificity of the enzyme. Taken together, these data provide important new insights to the factors determining stability, substrate recognition, and the structural mechanism of hydrolysis in this industrially important group of enzymes

cis sequence effects on gene expression

<p>Abstract</p> <p>Background</p> <p>Sequence and transcriptional variability within and between individuals are typically studied independently. The joint analysis of sequence and gene expression variation (genetical genomics) provides insight into the role of linked sequence variation in the regulation of gene expression. We investigated the role of sequence variation in <it>cis </it>on gene expression (<it>cis </it>sequence effects) in a group of genes commonly studied in cancer research in lymphoblastoid cell lines. We estimated the proportion of genes exhibiting <it>cis </it>sequence effects and the proportion of gene expression variation explained by <it>cis </it>sequence effects using three different analytical approaches, and compared our results to the literature.</p> <p>Results</p> <p>We generated gene expression profiling data at N = 697 candidate genes from N = 30 lymphoblastoid cell lines for this study and used available candidate gene resequencing data at N = 552 candidate genes to identify N = 30 candidate genes with sufficient variance in both datasets for the investigation of <it>cis </it>sequence effects. We used two additive models and the haplotype phylogeny scanning approach of Templeton (Tree Scanning) to evaluate association between individual SNPs, all SNPs at a gene, and diplotypes, with log-transformed gene expression. SNPs and diplotypes at eight candidate genes exhibited statistically significant (p < 0.05) association with gene expression. Using the literature as a "gold standard" to compare 14 genes with data from both this study and the literature, we observed 80% and 85% concordance for genes exhibiting and not exhibiting significant <it>cis </it>sequence effects in our study, respectively.</p> <p>Conclusion</p> <p>Based on analysis of our results and the extant literature, one in four genes exhibits significant <it>cis </it>sequence effects, and for these genes, about 30% of gene expression variation is accounted for by <it>cis </it>sequence variation. Despite diverse experimental approaches, the presence or absence of significant <it>cis </it>sequence effects is largely supported by previously published studies.</p