Top tips for social media use in sports and exercise medicine: doing the right thing in the digital age

Sports and exercise (SEM) clinicians need thick skin and a nimble brain to juggle the plethora of competing professional responsibilities; from athlete clinical care, to work/life pressures, all while developing professional knowledge and skills. In recent years there has also been an assertion that SEM clinicians need to develop/maintain a social media presence, and many working in amateur and elite sport now have Facebook, Twitter and Instagram profiles. Although professional bodies have provided social media guidance (see web appendix for additional reading) there is no explicit SEM specific social media guidance

Endothelium-Derived Netrin-4 Supports Pancreatic Epithelial Cell Adhesion and Differentiation through Integrins α2β1 and α3β1

BACKGROUND: Netrins have been extensively studied in the developing central nervous system as pathfinding guidance cues, and more recently in non-neural tissues where they mediate cell adhesion, migration and differentiation. Netrin-4, a distant relative of Netrins 1-3, has been proposed to affect cell fate determination in developing epithelia, though receptors mediating these functions have yet to be identified. METHODOLOGY/PRINCIPAL FINDINGS: Using human embryonic pancreatic cells as a model of developing epithelium, here we report that Netrin-4 is abundantly expressed in vascular endothelial cells and pancreatic ductal cells, and supports epithelial cell adhesion through integrins α2β1 and α3β1. Interestingly, we find that Netrin-4 recognition by embryonic pancreatic cells through integrins α2β1 and α3β1 promotes insulin and glucagon gene expression. In addition, full genome microarray analysis revealed that fetal pancreatic cell adhesion to Netrin-4 causes a prominent down-regulation of cyclins and up-regulation of negative regulators of the cell cycle. Consistent with these results, a number of other genes whose activities have been linked to developmental decisions and/or cellular differentiation are up-regulated. CONCLUSIONS/SIGNIFICANCE: Given the recognized function of blood vessels in epithelial tissue morphogenesis, our results provide a mechanism by which endothelial-derived Netrin-4 may function as a pro-differentiation cue for adjacent developing pancreatic cell populations expressing adhesion receptors α2β1 and α3β1 integrins

Complete Genome Sequence of the N2-Fixing Broad Host Range Endophyte Klebsiella pneumoniae 342 and Virulence Predictions Verified in Mice

We report here the sequencing and analysis of the genome of the nitrogen-fixing endophyte, Klebsiella pneumoniae 342. Although K. pneumoniae 342 is a member of the enteric bacteria, it serves as a model for studies of endophytic, plant-bacterial associations due to its efficient colonization of plant tissues (including maize and wheat, two of the most important crops in the world), while maintaining a mutualistic relationship that encompasses supplying organic nitrogen to the host plant. Genomic analysis examined K. pneumoniae 342 for the presence of previously identified genes from other bacteria involved in colonization of, or growth in, plants. From this set, approximately one-third were identified in K. pneumoniae 342, suggesting additional factors most likely contribute to its endophytic lifestyle. Comparative genome analyses were used to provide new insights into this question. Results included the identification of metabolic pathways and other features devoted to processing plant-derived cellulosic and aromatic compounds, and a robust complement of transport genes (15.4%), one of the highest percentages in bacterial genomes sequenced. Although virulence and antibiotic resistance genes were predicted, experiments conducted using mouse models showed pathogenicity to be attenuated in this strain. Comparative genomic analyses with the presumed human pathogen K. pneumoniae MGH78578 revealed that MGH78578 apparently cannot fix nitrogen, and the distribution of genes essential to surface attachment, secretion, transport, and regulation and signaling varied between each genome, which may indicate critical divergences between the strains that influence their preferred host ranges and lifestyles (endophytic plant associations for K. pneumoniae 342 and presumably human pathogenesis for MGH78578). Little genome information is available concerning endophytic bacteria. The K. pneumoniae 342 genome will drive new research into this less-understood, but important category of bacterial-plant host relationships, which could ultimately enhance growth and nutrition of important agricultural crops and development of plant-derived products and biofuels

The use of the dual-task paradigm in detecting gait performance deficits following a sports-related concussion a systematic review and meta-analysis /

The purpose of this systematic review was to determine the viability of the dual-task paradigmin the evaluation of a sports-related concussion

Evidence of sensorimotor deficits in functional ankle instability: a systematic review with meta-analysis

Functional ankle instability (FAI) has been associated with impaired sensorimotor function; however individual studies have produced conflicting results. In an attempt to reduce this ambiguity, a systematic review with meta-analysis was undertaken to determine which sensorimotor deficits exist with FAI. Fifty-three studies assessing sensorimotor factors in subjects with FAI were included from 465 identified articles. Studies were rated for methodological quality and data were pooled for peroneal reaction time, joint position sense, and postural sway during single-leg stance and time to stabilisation from a single-leg jump. Data on joint movement sense were unable to be pooled. When subjects with unstable ankles were compared to healthy controls, sensorimotor impairments were demonstrated for passive joint position sense (mean difference (MD) = 0.7°, 95% confidence interval (CI): 0.2–1.2°, p = 0.004), active joint position sense (MD = 0.6°, 95% CI: 0.2–1.0°, p = 0.002), postural sway in single-leg stance (standardised MD (SMD) = 0.6, 95% CI: 0.2–1.0, p = 0.002), the star excursion balance test (SMD = 0.4, 95% CI: 0.1–0.7, p = 0.009), and time to stabilisation from a single-leg jump in a medio-lateral (MD = 0.6 ms, 95% CI: 0.4–0.8, p \u3c 0.0001) and an antero-posterior direction (MD = 0.7 ms, 95% CI: 0.4–1.0, p \u3c 0.0001). Peroneal reaction time was not affected. Sensorimotor deficits occur for joint position sense and postural control in subjects with FAI. Deficits in peroneal muscle reaction time following perturbation are not evident

Does a standardised exercise protocol incorporating a cognitive task provoke postconcussion-like symptoms in healthy individuals?

Objectives: To explore whether an exercise protocol, alone and in combination with two selected cognitivetasks related to working memory, provokes postconcussion-like symptoms in healthy individuals. Design: Prospective single cohort semi-randomised crossover repeated measures (time×condition)design

Utilization of low back pain patient reported outcome measures within chiropractic literature: A descriptive review

Schneiders, AG ORCiD: 0000-0002-1583-3879© 2018 Objective: The purpose of this review was to determine the most commonly reported and utilized low back pain (LBP) Patient Reported Outcome Measures (PROMs) within the chiropractic literature and to investigate their temporal and methodological publication characteristics. Methods: A systematic search of English-language publications in 5 electronic databases (PubMed, Cochrane [CENTRAL], CINAHL/EBSCO, PsycINFO, and Index to Chiropractic Literature) was conducted for articles published from the inception of each database through June 2016. Results: One hundred forty-four articles were retrieved that utilized 75 different LBP PROMs. The 4 most commonly used LBP PROMs in the chiropractic literature were the Oswestry Disability Index, Numeric Rating Scale, Visual Analogue Scale, and Roland Morris Questionnaire. Conclusions: This research has created a unique list of the most commonly used LBP PROMs within the chiropractic literature

Rest and return-to-sport recommendations following sport-related concussion (PEDro synthesis)

Schneiders, AG ORCiD: 0000-0002-1583-3879The aim of the systematic review was to synthesise the literature related to rest and RTS/activity recommendations following sport-related concussion

Clinical tests to diagnose lumbar segmental instability: a systematic review

Study Design: Systematic literature review. Objectives: To evaluate the diagnostic accuracy of clinical tests used to diagnose patients with structural lumbar segmental instability (LSI). Backround: Patients with structural LSI represent an important, identifiable subgrouping of individuals with low back pain. Numerous clinical tests have been proposed to diagnose structural LSI; however, data on the diagnostic accuracy of these tests have not yet been evaluated through a systematic review of the literature. Methods: A systematic review was conducted in 6 electronic databases for diagnostic accuracy studies, published between January 1950 and March 2010, that evaluated clinical tests against radiological diagnosis of structural LSI. The diagnostic accuracy of the clinical tests from the retrieved articles was independently evaluated, reviewed, and quality scored using the QUADAS tool. Results: Four articles and a total of 11 clinical tests used in the diagnosis of structural LSI met the study inclusion criteria. The majority of tests had high specificity but low sensitivity, with positive likelihood ratios ranging from very small to moderate. QUADAS scores ranged from 16 to 25 out of a possible 26. The passive lumbar extension test was the most accurate clinical test, with high sensitivity (84%), specificity (90%), and a positive likelihood ratio of 8.8 (95% CI: 4.5, 17.3), indicating that this clinical test may be useful in the differential diagnosis of structural LSI. Conclusion: This systematic review found that the majority of clinical tests routinely employed to diagnose structural LSI demonstrated only limited ability to do so. The results do, however, indicate that the passive lumbar extension test may be useful in orthopaedic clinical practice to diagnose structural LSI. Additional research is required to further validate its use for diagnosing structural LSI in all populations of those with low back pain