Biomechanical parameters of the golf swing associated with lower back pain: A systematic review.

Low back pain (LBP) is the most common injury in golfers of all abilities. The primary aim of this review was to improve understanding of human golf swing biomechanics associated with LBP. A systematic review using the PRISMA guidelines was performed. Nine studies satisfying inclusion criteria and dually reporting golf swing biomechanics and LBP were identified. Human golf swing biomechanics potentially associated with LBP include: reduced lumbar flexion velocity; reduced transition phase length; reduced lumbar torsional load; earlier onset of erector spinae contraction; increased lumbar lateral flexion velocity; reduced or greater erector spinae activity; and earlier onset of external oblique contraction. These potential associations were undermined by a very limited and conflicting quality of evidence, study designs which introduced a severe potential for bias and a lack of prospective study design. There is no conclusive evidence to support the commonly held belief that LBP is associated with "poor" golf swing technique. The potential associations identified should be further investigated by prospective studies of robust design, recruiting participants of both sexes and dexterities. Once firm associations have been identified, further research is required to establish how this knowledge can be best integrated into injury prevention and rehabilitation

Electron probe microanalysis of ion exchange of selected elements between dentine and adhesive restorative materials

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Background: There have been numerous attempts to demonstrate the phenomenon of ion exchange between auto cure glass ionomer cements (GICs) and dentine. The purpose of this study was to employ an electron probe microanalysis (EPMA) technique to examine the interchange of elements between non-demineralized dentine and two types of restorative material, auto cure GICs and a resin composite. Methods: Restorations of auto cure GICs (Riva Fast, Fuji IX Fast, Ketac Molar Quick and Fuji VII) and a bonded composite resin were placed in each of 10 recently extracted human third molar teeth. After two weeks the restorations were sectioned and prepared for EPMA. Percentage weights of calcium, phosphorus aluminum, strontium and fluoride were calculated in the restorations 200μm from the restorative interface and 200μm into the dentine at 5μm intervals. Results: There was evidence of calcium and phosphorus in all five auto cure GICs to a depth of 50μm. Aluminum and strontium ions were also present in dentine except subjacent to Ketac Molar restorations. There was evidence of element transfer into composite resin and resin-bonded dentine. Conclusions: The findings of this paper support the concept of ion exchange as a bonding mechanism between auto cure GIC and dentine. Element penetration into tooth structure and GIC exceeded beyond the “ion exchange layer” observed in scanning electron microscopy studies. Penetration of calcium and phosphorus into composite resin from dentine likely occurred as a result of the self-etching process dissolving calcium and phosphorus and incorporating these elements into the hybrid layer. The presence of Al and Sr ions in dentine were likely to be associated with resin tags extending into the dentine.GM Knight, JM McIntyre, GG Craig and Mulyan

The effect of ongoing feedback on physical activity levels following an exercise intervention in older adults: a randomised controlled trial protocol

Background: Physical inactivity ranks as a major contributing factor in the development and progression of chronicdisease. Lifestyle interventions reduce the progression of chronic disease, however, compliance decreases over timeand health effects only persist as long as the new lifestyle is maintained. Telephone counselling (TC) is an effectiveway to provide individuals with ongoing support to maintain lifestyle changes. Remote physical activity monitoringand feedback (RAMF) via interactive technologies such as activity trackers and smartphones may be a cost-effectivealternative to TC, however, this comparison has not been made. This study, therefore, aims to determine the effectof ongoing feedback (TC vs. RAMF) on the maintenance of physical activity following a 12-week individualisedlifestyle program, and the effect of this on health risk factors and health services usage.Methods and design: A randomised controlled trial with a parallel groups design. A total of 150 adults (≥60 years)who participate in a 12-week face-to-face individualised lifestyle program will be randomised to twelve months ofRAMF (n = 50), TC (n = 50), or usual care (n = 50). Participants randomised to RAMF will use a smartphone activitytracker app, synced to a wrist worn activity tracker, to provide them with automated feedback regarding compliance toprescribed activity targets. Telephone counselling involves a follow-up phone call every fortnight for the first threemonths and a monthly call for the remaining nine months of the follow-up period.The primary outcome measures are physical activity compliance (accelerometry and Active Australia survey). Secondaryoutcome measures include cardiorespiratory fitness, muscle strength, dynamic balance, quality of life, blood pressure,body composition, and health services usage. Measures will be made before and after the individualised lifestyleprogram, and at three, six and twelve months during the intervention.Discussion: The results of this study will help to determine the efficacy of RAMF devices on compliance to prescribedphysical activity compared to the current gold standard of TC. If the remote monitoring proves effective, it mayprovide a cost efficient alternative method of assisting maintenance of behaviour change from lifestyle interventions

Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis

Background: The range of benefits associated with regular physical activity participation is irrefutable. Despite the well-knownbenefits, physical inactivity remains one of the major contributing factors to ill-health throughout industrialized countries.Traditional lifestyle interventions such as group education or telephone counseling are effective at increasing physical activityparticipation; however, physical activity levels tend to decline over time. Consumer-based wearable activity trackers that allowusers to objectively monitor activity levels are now widely available and may offer an alternative method for assisting individualsto remain physically active.Objective: This review aimed to determine the effects of interventions utilizing consumer-based wearable activity trackers onphysical activity participation and sedentary behavior when compared with interventions that do not utilize activity trackerfeedback.Methods: A systematic review was performed searching the following databases for studies that included the use of aconsumer-based wearable activity tracker to improve physical activity participation: Cochrane Controlled Register of Trials,MEDLINE, PubMed, Scopus, Web of Science, Cumulative Index of Nursing and Allied Health Literature, SPORTDiscus, andHealth Technology Assessments. Controlled trials of adults comparing the use of a consumer-based wearable activity trackerwith other nonactivity tracker–based interventions were included. The main outcome measures were physical activity participationand sedentary behavior. All studies were assessed for risk of bias, and the Grades of Recommendation, Assessment, Development,and Evaluation system was used to rank the quality of evidence. The guidelines of the Preferred Reporting Items for SystematicReviews and Meta-Analyses statement were followed. A random-effects meta-analysis was completed on the included outcomemeasures to estimate the treatment effect of interventions that included an activity tracker compared with a control group.Results: There was a significant increase in daily step count (standardized mean difference [SMD] 0.24; 95% CI 0.16 to 0.33;PConclusions: Utilizing a consumer-based wearable activity tracker as either the primary component of an intervention or aspart of a broader physical activity intervention has the potential to increase physical activity participation. As the effects of physicalactivity interventions are often short term, the inclusion of a consumer-based wearable activity tracker may provide an effectivetool to assist health professionals to provide ongoing monitoring and support

Older adults’ experiences of using a wearable activity tracker with health professional feedback over a 12-month randomised controlled trial

Objective:Wearable activity trackers can help older adults remain physically active. However, knowledge of the userexperience during long-term use is scarce. Therefore, this study examined older adults’ experiences with, and perceptionsof, wearable activity trackers combined with health professional feedback after a year’s use as part of a randomisedcontrolled trial.Methods: Twenty older adults (73.6 5.5 years) who had used a Jawbone UP24 activity tracker for 12 months during arandomised controlled trial were recruited for this study. All participants had at least one chronic condition. Acceptabilitydata relating to activity tracker wear time was combined with focus group data to explore participants experiences of longterm activity tracker use. Data was analysed using thematic analysis.Results: The activity tracker was well-accepted with the device worn on an average of 86% of possible days and participantsreported an overall positive experience. Four themes were identified: (a) increased sense of awareness of activity levels isrelated to motivation; (b) the level of engagement with the activity tracker influences the user experience; (c) the role offeedback from a health professional in providing ongoing support; d) the role of habits in supporting long-term behaviourchange.Conclusions: The use of an activity tracker combined with health professional support can assist older adults to maintaintheir activity levels over 12 months. Consideration should be given to the previous technology experience of users and thedesign and accuracy of an activity tracker when recommending their use in a research or clinical setting

Voids in the Large-Scale Structure

Voids are the most prominent feature of the LSS of the universe. Still, they have been generally ignored in quantitative analysis of it, essentially due to the lack of an objective tool to identify and quantify the voids. To overcome this, we present the Void-Finder algorithm, a novel tool for objectively quantifying galaxy voids. The algorithm classifies galaxies as either wall- or field-galaxies. Then it identifies voids in the wall-galaxy distribution. Voids are defined as continuous volumes that do not contain any wall-galaxies. The voids must be thicker than an adjustable limit, which is refined in successive iterations. We test the algorithm using Voronoi tessellations. By appropriate scaling of the parameters we apply it to the SSRS2 survey and to the IRAS 1.2 Jy. Both surveys show similar properties: ~50% of the volume is filled by the voids, which have a scale of at least 40 Mpc, and a -0.9 under-density. Faint galaxies populate the voids more than bright ones. These results suggest that both optically and IRAS selected galaxies delineate the same LSS. Comparison with the recovered mass distribution further suggests that the observed voids in the galaxy distribution correspond well to under-dense regions in the mass distribution. This confirms the gravitational origin of the voids.Comment: Submitted to ApJ; 33 pages, aaspp4 LaTeX file, using epsfig and natbib, 1 table, 12 PS figures. Complete gzipped version is available at http://shemesh.fiz.huji.ac.il/hagai/; uuencoded file is available at http://shemesh.fiz.huji.ac.il/papers/ep3.uu or ftp://shemesh.fiz.huji.ac.i

Structural identification of oxidized acyl-phosphatidylcholines that induce platelet activation

Oxidation of low-density lipoprotein (LDL) generates proinflammatory and prothrombotic mediators that may play a crucial role in cardiovascular and inflammatory diseases. In order to study platelet-activating components of oxidized LDL 1-stearoyl-2-arachidonoyl-sn-glycero-3- phosphocholine, a representative of the major phospholipid species in LDL, the 1-acyl-phosphatidylcholines (PC), was oxidized by CuCl2 and H2O2. After separation by high-performance liquid chromatography, three compounds were detected which induced platelet shape change at low micromolar concentrations. Platelet activation by these compounds was distinct from the pathways stimulated by platelet-activating factor, lysophosphatidic acid, lyso-PC and thromboxane A(2), as evidenced by the use of specific receptor antagonists. Further analyses of the oxidized phospholipids by electrospray ionization mass spectrometry structurally identified them as 1-stearoyl-2-azelaoyl-sn-glycero-3-phosphocholine (m/z 694; SAzPC), 1-stearoyl-2-glutaroyl-snglycero-3- phosphocholine (m/z 638; SGPC), and 1-stearoyl-2-( 5-oxovaleroyl)-sn-glycero-3-phosphocholine (m/z 622; SOVPC). These observations demonstrate that novel 1-acyl-PC which had previously been found to stimulate interaction of monocytes with endothelial cells also induce platelet activation, a central step in acute thrombogenic and atherogenic processes. Copyright (C) 2005 S. Karger AG, Basel

Systematic review with meta-analysis: the accuracy of serological tests to support the diagnosis of coeliac disease

BACKGROUND: There is growing support for a biopsy avoidant approach to diagnose coeliac disease in both children and adults, using a serological diagnosis instead. AIMS: To assess the diagnostic accuracy of serological tests for coeliac disease in adults and children. METHODS: Seven electronic databases were searched between January 1990 and August 2020. Eligible diagnostic studies evaluated the accuracy of serological tests for coeliac disease against duodenal biopsy. Risk of bias assessment was performed using QUADAS-2. Bivariate random-effects meta-analyses were used to estimate serology sensitivity and specificity at the most commonly reported thresholds. RESULTS: 113 studies (n = 28,338) were included, all in secondary care populations. A subset of studies were included in meta-analyses due to variations in diagnostic thresholds. Summary sensitivity and specificity of immunoglobulin A (IgA) anti-tissue transglutaminase were 90.7% (95% confidence interval: 87.3%, 93.2%) and 87.4% (84.4%, 90.0%) in adults (5 studies) and 97.7% (91.0%, 99.4%) and 70.2% (39.3%, 89.6%) in children (6 studies); and of IgA endomysial antibodies were 88.0% (75.2%, 94.7%) and 99.6% (92.3%, 100%) in adults (5 studies) and 94.5% (88.9%, 97.3%) and 93.8% (85.2%, 97.5%) in children (5 studies). CONCLUSIONS: Anti-tissue transglutaminase sensitivity appears to be sufficient to rule out coeliac disease in children. The high specificity of endomysial antibody in adults supports its use to rule in coeliac disease. This evidence underpins the current development of clinical guidelines for a serological diagnosis of coeliac disease. Studies in primary care are needed to evaluate serological testing strategies in this setting

Prescribing practices of primary-care veterinary practitioners in dogs diagnosed with bacterial pyoderma

Concern has been raised regarding the potential contributions of veterinary antimicrobial use to increasing levels of resistance in bacteria critically important to human health. Canine pyoderma is a frequent, often recurrent diagnosis in pet dogs, usually attributable to secondary bacterial infection of the skin. Lesions can range in severity based on the location, total area and depth of tissue affected and antimicrobial therapy is recommended for resolution. This study aimed to describe patient signalment, disease characteristics and treatment prescribed in a large number of UK, primary-care canine pyoderma cases and to estimate pyoderma prevalence in the UK vet-visiting canine population

The accuracy of diagnostic indicators for coeliac disease: A systematic review and meta-analysis

Background: The prevalence of coeliac disease (CD) is around 1%, but diagnosis is challenged by varied presentation and non-specific symptoms and signs. This study aimed to identify diagnostic indicators that may help identify patients at a higher risk of CD in whom further testing is warranted. // Methods: International guidance for systematic review methods were followed and the review was registered at PROSPERO (CRD42020170766). Six databases were searched until April 2021. Studies investigating diagnostic indicators, such as symptoms or risk conditions, in people with and without CD were eligible for inclusion. Risk of bias was assessed using the QUADAS-2 tool. Summary sensitivity, specificity, and positive predictive values were estimated for each diagnostic indicator by fitting bivariate random effects meta-analyses. // Findings: 191 studies reporting on 26 diagnostic indicators were included in the meta-analyses. We found large variation in diagnostic accuracy estimates between studies and most studies were at high risk of bias. We found strong evidence that people with dermatitis herpetiformis, migraine, family history of CD, HLA DQ2/8 risk genotype, anaemia, type 1 diabetes, osteoporosis, or chronic liver disease are more likely than the general population to have CD. Symptoms, psoriasis, epilepsy, inflammatory bowel disease, systemic lupus erythematosus, fractures, type 2 diabetes, and multiple sclerosis showed poor diagnostic ability. A sensitivity analysis revealed a 3-fold higher risk of CD in first-degree relatives of CD patients. // Conclusions: Targeted testing of individuals with dermatitis herpetiformis, migraine, family history of CD, HLA DQ2/8 risk genotype, anaemia, type 1 diabetes, osteoporosis, or chronic liver disease could improve case-finding for CD, therefore expediting appropriate treatment and reducing adverse consequences. Migraine and chronic liver disease are not yet included as a risk factor in all CD guidelines, but it may be appropriate for these to be added. Future research should establish the diagnostic value of combining indicators