Identification of ankle sprain motion from common sporting activities by dorsal foot kinematics data

This study presented a method to identify ankle sprain motion from common sporting activities by dorsal foot kinematics data. Six male subjects performed 300 simulated supination sprain trials and 300 non-sprain trials in a laboratory. Eight motion sensors were attached to the right dorsal foot to collect three-dimensional linear acceleration and angular velocity kinematics data, which were used to train up a support vector machine (SVM) model for the identification purpose. Results suggested that the best identification method required only one motion sensor located at the medial calcaneus, and the method was verified on another group of six subjects performing 300 simulated supination sprain trials and 300 non-sprain trials. The accuracy of this method was 91.3%, and the method could help developing a mobile motion sensor system for ankle sprain detection

Comparison of two surgical techniques for reconstructing posterolateral corner of the knee: a cadaveric study evaluated by navigation system

Purpose: This study aimed to evaluate the immediate effect on knee kinematics by 2 different techniques of posterolateral corner (PLC) reconstruction. Methods: Five intact formalin-preserved cadaveric knees were used in this study. A navigation system was used to measure knee kinematics (posterior translation, varus angulation, and external rotation) after application of a constant force and torque to the tibia. Four different conditions of the knee were evaluated during the biomechanical test: intact knee and PLC-sectioned knee and PLC-reconstructed knee by the doublefemoral tunnel technique and singlefemoral tunnel technique. Results: Sectioning of the PLC structures resulted in significant increases in external rotation at 30° of flexion from 11.2° (SD, 2.6) to 24.6° (SD, 6.2), posterior translation at 30° of flexion from 3.4 mm (SD, 1.5) to 7.4 mm (SD, 3.8), and varus angulation at 0° of flexion from 2.3° (SD, 2.1) to 7.9° (SD, 5.1). Both reconstruction techniques significantly restored the varus stability. The external rotation and posterior translation at 30° of flexion after reconstruction with the doublefemoral tunnel technique were 10.2° (SD, 1.3) and 3.4° (SD, 2.7), respectively, which were significantly better than those of the singlefemoral tunnel technique. Conclusions: Both techniques of reconstruction showed improved stability compared with PLC-sectioned knees. The doublefemoral tunnel technique in PLC reconstruction showed better rotational stability and resistance to posterior translation than the singlefemoral tunnel technique without compromising varus stability. Clinical Relevance: PLC reconstruction by a doublefemoral tunnel technique achieves better rotational control and resistance to posterior translation

Frequency and Correlates of Mycoplasma genitalium Antimicrobial Resistance Mutations and Their Association With Treatment Outcomes: Findings From a National Sentinel Surveillance Pilot in England

BACKGROUND: Mycoplasma genitalium infection is a public health concern due to extensive antimicrobial resistance. Using data from a pilot of M. genitalium antimicrobial resistance surveillance, we determined the prevalence and risk factors for resistance among specimens from sexual health clinic attendees and assessed treatment outcomes. METHODS: Seventeen sexual health clinics in England sent consecutive M. genitalium-positive specimens to the national reference laboratory from January to March 2019. Regions of the 23S rRNA, parC, and gyrA genes associated with macrolide and fluoroquinolone resistance, respectively, were amplified and sequenced where appropriate. Fisher exact tests, and univariate and multivariable logistic regression models were used to determine associations between demographic, clinical, and behavioral factors and resistance-associated mutations. RESULTS: More than two-thirds (173 of 249 [69%]) of M. genitalium specimens had mutations associated with macrolide resistance, whereas predicted fluoroquinolone (21 of 251 [8%]) and dual-drug (12 of 237 [5%]) resistance were less prevalent. No specimens had both gyrA and parC resistance-associated mutations. Macrolide resistance was more common in specimens from men who have sex with men compared with heterosexual men (adjusted odds ratio, 2.64; 95% confidence interval, 1.09-6.38; P = 0.03). There was an association between both macrolide and fluoroquinolone resistance and having a previous sexually transmitted infection (P = 0.06).Only 19% of individuals returned for a test of cure. Of those infected with a macrolide-resistant genotype who were given azithromycin, 57 of 78 (73%) were known or assumed to be clinically cured; however, 43 of these 57 (75%) also received doxycycline. Of the 21 with a macrolide-resistant genotype who failed treatment, 18 of 21 (86%) also received doxycycline. CONCLUSIONS: Although macrolide resistance was widespread, particularly among specimens from men who have sex with men and those with a previous sexually transmitted infection diagnosis in the past year, resistance-associated mutations in M. genitalium did not seem to be unequivocally predictive of treatment failure

Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)?

Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014-September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable

An individually moulded insole with 5-mm medial arch support reduces peak impact and loading at the heel after a one-hour treadmill run

Background: Foot pain experienced by long-distance runners could be relieved by functional insoles which aim at evenly distributing the plantar pressure. Research question: We hypothesised that an individually moulded insole with medial arch support would reduce the impact and loading under the heel and metatarsal regions. Methods: Twelve male recreational runners ran on a treadmill at 10 km/h for 1 hour with flat insoles and medial arch supported insoles. A pressure insole system (Novel Pedar, Germany) was used to obtain the peak pressure, peak force, time normalised pressure-time integrals, and the percentage of the total force-time integrals under 10 regions. Results: Medial arch supported insoles reduced the peak force under the heel (medial: -15.3%, p = 0.001; lateral: -19.2%, p = 0.037) during the initial run, and reduced peak pressure under the heel (medial: -13.3%, p = 0.005; lateral: -9.9%, p = 0.006), and peak force under the medial heel (-17.8%, p = 0.006) after the run. The percentage of the total force-time integrals under the heel was reduced (medial: -23.8%, p = 0.004; lateral: -13.6%, p = 0.022) after the run. No significant difference was found under the metatarsal regions. There is shift of load from the metatarsal regions to the medial mid-foot as indicated by the change of the percentage of total force-time integrals. Significance: Medial arch supported insoles were effective in reducing the impact and loading under the heel region in prolonged running on a treadmill. Level of evidence: Controlled laboratory study, Level

Maternal influences on fruit and vegetable consumption of schoolchildren: Case study in Hong Kong

This study investigated whether the consumption of fruit and vegetable by Chinese primary students in Hong Kong is associated with their mother's (1) nutrition knowledge on fruit and vegetables; (2) attitude towards healthy eating; and (3) fruit and vegetable consumption. Fourth- and fifth-grade students from 10 primary schools located in different districts, along with their mothers, were invited to each fill-in a questionnaire related to their diet intake. Accomplished questionnaires were matched and analysed. There were 1779 mother-child pairs who were successfully matched. Chi-square analysis revealed that students' fruit consumption is associated with their mother's (1) knowledge on fruit and vegetables (P = 0.006); (2) attitude towards healthy eating (P = 0.010); and (3) fruit consumption (P < 0.001). Students' vegetable consumption exhibited the same association with their mother's (1) knowledge (P < 0.001), (2) attitude towards healthy eating (P = 0.005), and (3) vegetable consumption (P < 0.001). Logistic regression showed that knowledge, attitude and dietary practice of mothers were independent factors associated with the consumption of fruit and vegetables by students and are not influenced by the level of education and household income. The results highlight the important role of parents in promoting fruit and vegetable consumption to primary students. It reaffirmed the importance of parent nutrition education in the formulation of a comprehensive health promotion strategy to school-aged children. © 2009 Blackwell Publishing Ltd.Link_to_subscribed_fulltex

Estimation of the Rate of Pelvic Inflammatory Disease Diagnoses: Trends in England, 2000–2008

BACKGROUND: Pelvic inflammatory disease (PID) is difficult to define and diagnose; therefore, a standardized methodology for identifying and monitoring PID diagnoses is required. We estimated the rate of PID in general practice in England, and investigated variations by definition of PID, time, age, and geographical area.METHODS: We analyzed the United Kingdom General Practice Research Database between 2000 and 2008. Definitions of "definite," "probable," and "possible" PID among female patients (aged 16 to 44 years) were determined according to medical codes that denoted diagnoses or symptoms indicative of PID. Diagnoses rates were calculated per 100,000 person-years (py). Trends were assessed using Poisson regression.RESULTS: The rate of clinical PID diagnoses was 281/100,000 py (95% confidence interval [95% CI]: 277-286) for definite cases; 326/100,000 py (95% CI: 321-331) for definite and probable cases; and 1117/100,000 py (95% CI: 1107-1126) for definite, probable, and possible cases. During 2000 to 2008, the rate of definite/probable PID decreased by 10.4% per year (95% CI: 9.7-11.1; P&lt;0.001). Rates declined in all areas and among all age groups with greatest decline in women aged 16 to 19 years. Meanwhile, the rate of possible PID increased.CONCLUSIONS: The definition of PID used has a major effect on the rate and trends over time. There was heterogeneity in rates of definite/probable PID by age and region, but homogeneity with regard to a trend of declining rates. Ongoing monitoring of PID diagnoses, with standard case definitions, will contribute to the evaluation of chlamydia screening in England.</p