The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol

Objective. The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. Design. The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26.13 years; SD = 4.48) performed a 10-week modified Hölmich therapeutic exercise protocol. Results. Outcome scores related to pain, hip adductor and abductor muscle strengths, and the ratio of maximum isometric and eccentric hip adduction to abduction strength increased significantly. Likewise, hip abduction and internal rotation ROM improved significantly compared to that at baseline. Furthermore, functional records (t-test, Edgren Side Step Test, and Triple Hop Test) showed significant improvement after treatment. Finally, 13 athletes (86.6% of the participants) successfully returned to sports activity in a mean time of 12.06 weeks (SD = 3.41). Conclusion. The findings of this study objectively show that the modified Hölmich protocol may be safer and more effective than the Hölmich protocol in athletes with LSAGP in promoting their return to sports activity. This trial is registered with  IRCT2016080829269N1

Evaluation of H.pylori infection and IL23R gene polymorphism in dyspeptic subjects

CagA strains of H.pylori (Hp) are known to be associated with gastroduodenal diseases. Polymorphisms in inflammation related genes, such as cytokines and their receptors, were thought to partly determine the outcome of Hp infection and the progression of gastritis. It is supposed that interleukin 23 receptor (IL23R), a basic cytokine receptor in the inflammatory IL-17/IL-23 axis, may be related to gastritis. In the present study, we evaluated the association of IL23R +2199 rs10889677 polymorphism and cagA positivity with chronic gastritis. In addition, we studied the infiltration of polymorphonuclear (PMN) and mononuclear (MN) Leukocytes into surrounding tissues of corpus. Biopsies taken from the corpus of the patients were classified as two groups: Hp-infected and Hpuninfected. The severity of gastritis was graded from normal to severe, chronic gastritis and chronic active gastritis. Virulence factor, cagA, was evaluated using PCR and the polymorphism in IL23R was investigated by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). AA and AC carriers of IL23R +2199 polymorphism, but not CC genotype in Hp-uninfected patients, were not associated with cellular infiltration and gastritis in both groups (p > 0.05). CagA positivity was significantly associated with increased risk of PMN (P= 0.013), but not with MN infiltration (P= 0.069). Also gastritis was found to be associated with cagA positivity (P= 0.044). Our results show decreased Hp infection probability in patients with CC genotype of 2199 +IL23R. According to the clinical and pathological features in Hp-infected group, IL23R polymorphism doesn't influence chronic gastritis and chronic active gastritis

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Studying the knee joint proprioception in generalized joint hypermobility as compared to healthy subjects

Introduction: The role of joint hypermobility in musculoskeletal injuries has been emphasized. In recent studies, proprioception defects have been reported in patients with hypermobility syndrome. In contrast to patients with general hypermobility, those with joint hypermobility syndrome have musculoskeletal disorders which may themselves cause proprioception disorders. So, these reports cannot purely confirm the effect of joint hypermobility on proprioception. The objective of this study was to assess the effect of generalized joint hypermobility on knee joint position sense in subjects with generalized joint hypermobility. Materials and Methods: In this case-control study, 20 subjects with generalized joint hypermobility who suffered from knee hypermobility in their dominant lower limb and 20 healthy subjects were recruited from available population of male and female college students through a simple convenient sampling. All subjects fell within the age range of 18 to 30 years. The position sense error was measured at three angles of knee extension -15°, -40° and -65° in sitting position via goniometry of digital pictures using Auto-CAD software. These errors were compared between two groups and also between different angles. Kolmogrov-Smirnov test confirmed the normal distribution of variables. Results: The results of this study showed that the position sense of knee joint in young subjects with generalized joint hypermobility was less accurate than in healthy subjects. Also the results indicated that the knee joint position sense in both groups was more accurate for angles at the end of range of knee extension that for those at inner range. Conclusion: The results of this study confirmed the existence of knee joint position sense defect in subjects with generalized joint hypermobility who have knee joint hypermobility. It is recommended to evaluate position sense of these joints in such subjects especially when they intend to enter sport activities in which the risk of joint injuries may elevate. Moreover, it is required to design training protocols for improving joint position sense in such cases. Keywords: Position sense, Proprioception, Generalized joint hypermobility, Knee join

The relationship between air traffic noise and its induced annoyance in the southwest area in Tehran - Iran

Introduction: Noise pollution in urban areas has been recognized as a major problem. Since hearing damages are the main concern of noise exposure, other physical and psychological effects should not be ignored. Noise-induced annoyance and consequently its side-effects, such as fatigue and loss of concentration, would increase the probability of human errors occurrence and occasionally irreversible occupational accidents. This matter show the importance of noise exposure level from the standpoint of both community health and workplace safety. Material and Method: This cross-sectional study was conducted to investigate the annoyance caused by air transportation noise in tehran, 2014. In this sense, a sample of 200 individuals were selected from residential and nonindustrial noise-exposed population in four southwest regions in Tehran. Following, the study questionnaires including annoyance (Recommended based on ISO 15666-2003), visibility of airplane, noise perception, and demographic variables were distributed and completed by the participants. Data obtained from Integrated Noise Model (INM) and geographic coordinates of measurement stations, recorded by Glopal Positioning System (GPS), were entered into the GIS software in order to estimate air traffic noise. Result: The present study showed that the equivalent sound level of all regions during night, the day average sound level only in the Simetry Jey area, and the average night noise level in all regions except Dorahi Ghopan were more than the acceptable level; and the most precentage of people with high annoyance was belonged to night annoyance rate. On the other hand, the correlation between day level (DL) and day annoyance rate (P=0.01, R=0.142), night level and night annoyance rate (P=0.004, R=0.334), and Day-Night Average Sound Level (DNL) and the day-night annoyance rate (P<0.0001, R=0.235) were obtained statistically significant. Conclusion: Adopting management srategies for reduction of number of night flights or engineering measures such as improving construction to decrease the rate of receiving noise by exposed people can have a positive considerable effect on declining noise pollution and individuals&rsquo; annoyance rate

The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol

Objective. The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. Design. The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26.13 years; SD = 4.48) performed a 10-week modified Hölmich therapeutic exercise protocol. Results. Outcome scores related to pain, hip adductor and abductor muscle strengths, and the ratio of maximum isometric and eccentric hip adduction to abduction strength increased significantly. Likewise, hip abduction and internal rotation ROM improved significantly compared to that at baseline. Furthermore, functional records (t-test, Edgren Side Step Test, and Triple Hop Test) showed significant improvement after treatment. Finally, 13 athletes (86.6% of the participants) successfully returned to sports activity in a mean time of 12.06 weeks (SD = 3.41). Conclusion. The findings of this study objectively show that the modified Hölmich protocol may be safer and more effective than the Hölmich protocol in athletes with LSAGP in promoting their return to sports activity. This trial is registered with  IRCT2016080829269N1

SpykeTorch: Efficient Simulation of Convolutional Spiking Neural Networks With at Most One Spike per Neuron

International audienceApplication of deep convolutional spiking neural networks (SNNs) to artificial intelligence (AI) tasks has recently gained a lot of interest since SNNs are hardware-friendly and energy-efficient. Unlike the non-spiking counterparts, most of the existing SNN simulation frameworks are not practically efficient enough for large-scale AI tasks. In this paper, we introduce SpykeTorch, an open-source high-speed simulation framework based on PyTorch. This framework simulates convolutional SNNs with at most one spike per neuron and the rank-order encoding scheme. In terms of learning rules, both spike-timing-dependent plasticity (STDP) and reward-modulated STDP (R-STDP) are implemented, but other rules could be implemented easily. Apart from the aforementioned properties, SpykeTorch is highly generic and capable of reproducing the results of various studies. Computations in the proposed framework are tensor-based and totally done by PyTorch functions, which in turn brings the ability of just-in-time optimization for running on CPUs, GPUs, or Multi-GPU platforms