Normative Functional Performance Values in High School Athletes: The Functional Pre-Participation Evaluation Project

Context: The fourth edition of the Preparticipation Physical Evaluation recommends functional testing for the musculoskeletal portion of the examination; however, normative data across sex and grade level are limited. Establishing normative data can provide clinicians reference points with which to compare their patients, potentially aiding in the development of future injury-risk assessments and injury-mitigation programs. Objective: To establish normative functional performance and limb-symmetry data for high school-aged male and female athletes in the United States. Design: Cross-sectional study. Setting: Athletic training facilities and gymnasiums across the United States. Patients or Other Participants: A total of 3951 male and female athletes who participated on high school-sponsored basketball, football, lacrosse, or soccer teams enrolled in this nationwide study. Main Outcome Measure(s): Functional performance testing consisted of 3 evaluations. Ankle-joint range of motion, balance, and lower extremity muscular power and landing control were assessed via the weight-bearing ankle-dorsiflexion–lunge, single-legged anterior-reach, and anterior single-legged hop-for-distance (SLHOP) tests, respectively. We used 2-way analyses of variance and χ2 analyses to examine the effects of sex and grade level on ankle-dorsiflexion–lunge, single-legged anterior-reach, and SLHOP test performance and symmetry. Results: The SLHOP performance differed between sexes (males = 187.8% ± 33.1% of limb length, females = 157.5% ± 27.8% of limb length; t = 30.3, P \u3c .001). A Cohen d value of 0.97 indicated a large effect of sex on SLHOP performance. We observed differences for SLHOP and ankle-dorsiflexion–lunge performance among grade levels, but these differences were not clinically meaningful. Conclusions: We demonstrated differences in normative data for lower extremity functional performance during preparticipation physical evaluations across sex and grade levels. The results of this study will allow clinicians to compare sex- and grade-specific functional performances and implement approaches for preventing musculoskeletal injuries in high school-aged athletes

Linking forest cover, soil erosion and mire hydrology to late-Holocene human activity and climate in NW Spain

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).This article has been made available through the Brunel Open Access Publishing Fund.Forest clearance is one of the main drivers of soil erosion and hydrological changes in mires, although climate may also play a significant role. Because of the wide range of factors involved, understanding these complex links requires long-term multi-proxy approaches and research on the best proxies to focus. A peat core from NW Spain (Cruz do Bocelo mire), spanning the last ~3000 years, has been studied at high resolution by physical (density and loss on ignition (LOI)), geochemical (elemental composition) and palynological (pollen and non-pollen palynomorphs) analyses. Proxies related to mineral matter fluxes from the catchment (lithogenic tracers, Glomus and Entorrhiza), rainfall (Bromine), mire hydrology (HdV-18), human pressure (Cerealia-type, nitrophilous taxa and coprophilous fungi) and forest cover (mesophilous tree taxa) were the most useful to reconstruct the evolution of the mire and its catchment. Forest clearance for farming was one of the main drivers of environmental change from at least the local Iron Age (~2685 cal. yr BP) onwards. The most intense phase of deforestation occurred during Roman and Germanic times and the late Middle Ages. During these phases, the entire catchment was affected, resulting in enhanced soil erosion and severe hydrological modifications of the mire. Climate, especially rainfall, may have also accelerated these processes during wetter periods. However, it is noteworthy that the hydrology of the mire seems to have been insensitive to rainfall variations when mesophilous forest dominated. Abrupt changes were only detected once intense forest clearance commenced during the Iron Age/Roman transition (~2190 cal. yr BP) phase, which represented a tipping point in catchment's ability to buffer impacts. Overall, our findings highlight the importance of studying ecosystems' long-term trajectories and catchment-wide processes when implementing mire habitat protection measures.This work was funded by the projects CGL2010-20672 (Plan Nacional I+D+i, Spanish Ministry of Science and Innovation) and 10PXIB200182PR (General Directorate of I+D, Xunta de Galicia). N Silva-Sánchez and L López-Merino are currently supported by a FPU predoctoral scholarship (AP2010-3264) funded by the Spanish Government and a MINT postdoctoral fellowship funded by the Brunel Institute for the Environment, respectively

Evolution and environment of the eastern linear pottery culture: A case study in the site of Polgár-Piócási-Dűlő

A salvage excavation preceding a major investment project was conducted in 2006–2007, during which associated settlement features of a Middle Neolithic, Eastern Linear Pottery Culture (Alföld Linearbandkeramik – ALBK) were uncovered in an area called Piócási-dűlő on the eastern outskirts of Polgár. The features of the ALBK settlement date from two periods. The cluster of multi-functional pits yielding a rich assortment of finds, the handful of post-holes and an unusual ritual well found in the southern part of the investigated area formed one unit from the earliest phase of the Middle Neolithic (ALBK I). The settlement’s other occupation can be assigned to the late phase of the Middle Neolithic (ALBK IV). Five houseplans representing the remains of timber-framed buildings outlined a distinct area with three multi-functional pits. Associated with the above features were 8 burials. The preliminary archaeobotanical results from Polgár–Piócási-dűlő are based on the plant material found within the sediments of 11 archaeological structures, which mainly represent pits and a welI. It can be stated that the natural environment offered habitats in which oak trees dominated in the local vegetation, forming floodplain forests and wooded steppes. They also provided food in the form of fruits and formed an optimal habitat for domestic animals. Arable fields were probably also established in the vicinity of the settlements, suggested by findings of macroscopic plant remains that represented cultivated species. In both settlement phases lithic production activities are manifested both by the local on-site lithic production and – most importantly – by the presence of imported, mainly mesolocal, raw materials that point to contacts with deposit areas, or off-site preliminary working of obsidian and limnoquartzites. The kit of harvesting tools and a large number of grinding stones – especially in the younger phase – for the preparation of plant food suggest a major role of plant cultivation

Intensive enteral nutrition is ineffective for individuals with severe alcoholic hepatitis treated with corticosteroids.

peer reviewedBACKGROUND & AIMS: Severe alcoholic hepatitis (AH) is a lifethreatening disease for which adequate oral nutritional support is recommended. We performed a randomized controlled trial to determine whether the combination of corticosteroid and intensive enteral nutrition therapy is more effective than corticosteroid therapy alone in patients with severe AH. METHODS: We enrolled 136 heavy consumers of alcohol (age, 18–75 y) with recent onset of jaundice and biopsy-proven severe AH in our study, performed at 18 hospitals in Belgium and 2 in France, from February 2010 through February 2013. Subjects were assigned randomly (1:1) to groups that received either intensive enteral nutrition plus methylprednisolone or conventional nutrition plus methylprednisolone (controls). In the intensive enteral nutrition group, enteral nutrition was given via feeding tube for 14 days. The primary end point was patient survival for 6 months. RESULTS: In an intention-to-treat analysis, we found no significant difference between groups in 6-month cumulative mortality: 44.4% of patients died in the intensive enteral nutrition group (95% confidence interval [CI], 32.2%–55.9%) and 52.1% of controls died (95% CI, 39.4%– 63.4%) (P ¼ .406). The enteral feeding tube was withdrawn prematurely from 48.5% of patients, and serious adverse events considered to be related to enteral nutrition occurred in 5 patients. Regardless of group, a greater proportion of patients with a daily calorie intake less than 21.5 kcal/kg/day died (65.8%; 95% CI, 48.8–78.4) than patients with a higher intake of calories (33.1%; 95% CI, 23.1%–43.4%) (P < .001). CONCLUSIONS: In a randomized trial of patients with severe AH treated with corticosteroids, we found that intensive enteral nutrition was difficult to implement and did not increase survival. However, low daily energy intake was associated with greater mortality, so adequate nutritional intake should be a main goal for treatment

Searching for regularities of slope modelling by extreme events (diversity of rainfall intensity – duration and physical properties of the substrate)

In the last decades, research into slope transformation, especially transformation caused by debris flows and shallow landslides has set great store by the establishment of thresholds based on the relation of mean rainfall intensity to its duration. The present author is no exception. In the 1970s, after examining that relationship he distinguished three main types of extreme rainfalls (heavy downpours, continuous rains and rainy seasons). In this paper, while noting the great diversity of extreme events in space and time, he stresses the function of extremely high rainfall intensity in triggering off the slope transformation. Taking into account the role of such parameters as the effect of substrate, relief and land use on the distribution of precipitation into overland flow, subsurface runoff, and ground water storage, he proposes several models that connect geomorphic processes with different types of extreme rainfalls. In critical comments to the establishment of thresholds based only on mean daily rainfall and mean rainfall intensity he follow the opinion on limitation of factors to standart climatic and hydrologic and hydrologic data presented earlier by T. Dunne and A. Freeze. This analysis also notes the role of clusterings of events in various climatic zones and stresses the need of continuous monitoring of rainfall intensity and any other aspects of water circulation on slopes. All of those elements are indispensable for the construction of a more diversified pattern of thresholds

Złożoność reagowania systemu fluwialnego na zmiany hydrologiczne w holocenie (na przykładzie dorzecza Wisły)

Hydrological changes during the Holocene are expressed in the variable frequency of extreme events and reflected in fluvial sediments and landforms. The diversity of fluvial system response depends on rainfall and runoff-sediment load regime, but is specifically related to the landscape type, size of catchment, and connectivity of valley reaches in the long profile, as well as to increasing human impact. This diversity is exemplified by the Vistula River catchment, investigated in detail during the last decades, providing a basis for demonstrating how various fluvial sequences are expressing palaeohydrological changes. Various types of flood events, ranging from those connected with heavy downpours to continuous rains and to snowmelt floods, play a leading role in catchments of various size and landscape type. Three main models of Holocene transformation of valley floors were distinguished: an incisional one in the mountain headwaters, an aggradational one in low-gradient river valleys, and transitional one reflecting phases of various frequency of extreme events (and their clusters) represented in sequences of cuts and fills. This last transitional type should characterise the middle valley courses, but is best developed slightly upstream on the direct foreland of the Carpathians, where the greatest fluctuations in the river discharge, bed load and suspended load are observed. The presence of many gaps in alluvial sequences requires a better recognition of Holocene hydrological changes and it is recommended to correlate fluvial data with other palaeorecords.Zmiany hydrologiczne w holocenie wyrażone są w różnej częstotliwości powodzi i zapisane w osadach i formach fluwialnych. Różna reakcja systemu fluwialnego zależy od reżimu opadu, odpływu i transportu rumowiska, które wiążą się z typem krajobrazu, wielkością zlewni, położeniem w profilu podłużnym rzeki, jak i narastającą ingerencją człowieka. Szczegółowe badania dolin dorzecza Wisły w ostatnich dziesięcioleciach stanowiły podstawę określenia, jak różne sekwencje osadów rzecznych odzwierciedlają zmiany paleohydrologiczne. W różnych typach rzeźby i zlewniach różnej wielkości istotną rolę odgrywają lokalne ulewy, albo opady rozlewne lub wezbrania roztopowe. Wyróżniono trzy zasadnicze modele przekształceń den dolin w holocenie: pogłębiania erozyjnego w zlewniach górskich, agradacyjny w dolinach o małym spadku i przejściowy, zapisany w szeregu rozcięć i włożeń, odzwierciedlających fazy o różnej częstotliwości wezbrań. Ten ostatni winien charakteryzować środkowe biegi rzek, ale jest najlepiej rozwinięty na bezpośrednim przedpolu Karpat o największych wahaniach przepływów i transportu rumowiska. Częste występowanie wielu przerw w sekwencjach aluwialnych wymaga spojrzenia całościowego na zmiany hydrologiczne i korelacji środowisk fluwialnych z zapisem zmian w ewolucji szaty roślinnej, osadach jeziornych, stokowych i innych

Temporal and spatial complexity of extreme rainfalls : their geomorphological effects and ways of counteract them

W ocenie geomorfologicznych efektów ekstremalnych opadów istotne są zarówno złożoność czasowa, jak i rozkład przestrzenny opadów i obiegu wody. Trzy podstawowe typy opadów ekstremalnych: krótkotrwałe ulewy, opady rozlewne i pory opadowe różnią się nie tylko czasem trwania i wysokością, ale szczególnie natężeniem. Poznanie tych parametrów i ich związku z cechami podłoża (przepuszczalność, tempo infiltracji i retencji gruntowej) pozwala na wyznaczenie wartości progowych procesów erozyjnych i grawitacyjnych. Znajomość wysokości opadów dobowych i litologii głębszego podłoża jest niewystarczająca. Równie istotne jest określenie zasięgu przestrzennego ekstremalnego opadu, co przy braku gęstej sieci stacji możliwe jest poprzez rejestrację naziemną skutków ulewy. Autor ilustruje powyższe zagadnienia przykładami z ostatnich kilkunastu lat. Przeciwdziałanie skutkom ulew i powodzi zależy od wielu zmiennych i wymaga stosowania różnych środków. Na zakończenie autor proponuje wydzielenie kilku typów wezbrań, które może być użyteczne przy wyznaczaniu kierunków przeciwdziałania i przy prognozowaniu.In the evaluation of geomorphic effects of extreme rainfalls equally important are their temporal diversity and spatial distribution of rainfall and water circulation. Three main types of extreme rainfalls (heavy downpours, continuous rains and rainy seasons differ not only in the duration and totals but especially in their intensity. The recognition of these parameters and their relation to features of substratum (permeability, infiltration rate, groundwater storage) help to calculate the thresholds for erosional and gravitational processes. The recognition of only daily rainfall and lithology of deeper substratum is not enough. The equally important is the delimitation of spatial extend of extreme rainfall, what in case of very sparsly distributed raingauge network is possible to reconstruct by a ground survey of geomorphic effects. These questions are examplied by events from last decades. The counteraction to the effects of heavy rains and floods depend on various parameters and different measures may be undertaken. In closing chapter the author propose typology of floods which may have practical value in counteractions and forecasting