Context Matters: Revisiting the First Step of the ‘Sequence of Prevention’ of Sports Injuries

Abstract

It is possible to prevent sports injuries. Unfortunately, the demonstrated efficacy and effectiveness of injury prevention approaches are not translated into lasting real-world effects. Contemporary views in sports medicine and injury prevention suggest that sports injuries are 'complex' phenomena. If the problem we aim to prevent is complex, then the first step in the 'sequence of prevention' that defines the 'injury problem' already needs to have considered this. The purpose of this paper is to revisit the first step of the 'sequence of prevention', and to explore new perspectives that acknowledge the complexity of the sports injury problem. First, this paper provides a retrospective of the 'sequence of prevention', acknowledging contemporary views on sports injuries and their prevention. Thereafter, from the perspective of the socioecological model, we demonstrate the need for taking into account the complex nature of sports injuries in the first step. Finally, we propose an alternative approach to explore and understand injury context through qualitative research methods. A better understanding of the injury problem in context will guide more context-sensitive studies, thus providing a new perspective for sports injury prevention research.

from Sports Medicine via xlomafota13 on Inoreader https://ift.tt/2yP21tB
via IFTTT

Molecular characterization of microtubule-associated protein 1-light chain 3B in Megalobrama amblycephala fed with high fat/berberine diets

Abstract

This study tested the effect of berberine on autophagy-related protein of Megalobrama amblycephala fed with high fat diet under different feeding modes. The full-length complementary DNA (cDNA) of microtubule-associated protein 1-light chain 3B (LC3B) was 1871 bp with an open reading frame of 378 bp encoding 125 amino acids. High homology at nucleotide and amino acid sequences to carp LC3B was revealed though sequence analysis. LC3B was mainly (P < 0.05) expressed in hepatopancreas but lower in several peripheral tissues, including gill, intestine, kidney, and spleen. The fish (average initial weight 4.70 ± 0.02 g) were fed with eight experiment diets containing two lipid levels (5 and 10%) or four berberine-feeding modes (without berberine, supplementing 50 mg/kg berberine at 2-week intervals, 4-week intervals, or continuous) for 8 weeks. The results showed that the numbers of autophagosomes and hepatopancreas LC3B messenger RNA (mRNA) expression levels were significantly (P < 0.05) affected both by dietary lipid level and beberine feeding mode, and the highest (P < 0.05) numbers of autophagosomes and LC3B expression levels were observed in fish at berberine continuous feeding mode groups. The findings may provide the molecular mechanisms underlying lipid metabolism and immune effect of berberine, which was associated with enhanced autophagy in fish.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2MvVzK5
via IFTTT

Editorial Board

from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KqxTGc
via IFTTT

Improvement During Inpatient Rehabilitation Among Older Adults with Guillain-Barré Syndrome, Multiple Sclerosis, Parkinson Disease, and Stroke

Objective To quantify the improvement in independence experienced by patients with the following diagnoses: Guillain-Barré Syndrome (GBS), Multiple Sclerosis (MS), Parkinson Disease (PD), and stroke following inpatient rehabilitation. Design Subjects who were admitted to inpatient rehabilitation hospitals in 2012-2013 with an incident diagnosis of: GBS (n = 1079), MS (n = 1438), PD (n = 11,834), or stroke (n = 131,313) were included. The main outcome measure was improvement in Functional Independence Measure® (FIM) scores on self-care, mobility, and cognition during inpatient rehabilitation. We estimated percent improvement from a linear mixed-effects model adjusted for patients' age, sex, race/ethnicity, comorbidity count, diagnostic group (GBS, MS, PD, and stroke), and admission score. Results All patient diagnostic groups receiving inpatient rehabilitation improved across all three domains. The largest adjusted percent improvements were observed in the mobility domain and the smallest in the cognition domain for all groups. Percent improvement in mobility ranged from 84.9% (MS) to 144.0% (GBS), self-care from 49.5% (MS) to 84.1% (GBS), and cognition from 34.0% (PD) to 51.7% (GBS). Patients with GBS demonstrated the greatest percent improvement across all three domains. Conclusions Patients with GBS, MS, PD, and stroke should improve during inpatient rehabilitation but anticipated outcomes for patients with GBS should be even higher. Author Disclosures: The study was supported by funding secured by Kenneth J. Ottenbacher, PhD, OTR through the National Institutes of Health (grant numbers R01 HD069443, P2C HD065702, and K12 HD055929) and the National Institute on Disability, Independent Living, and Rehabilitation Research (grant number 90AR5009). This work was also supported by the National Institute on Aging (grant number P30 AG024832) and the Foundation for Physical Therapy's Center of Excellence in Physical Therapy Health Services and Health Policy Research and Training Grant. We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated and we certify that all financial and material support for this research (eg, NIH or NIA grants) and work are clearly identified here in the title page of the manuscript. Neither author has financially benefitted from this research project or its dissemination. The results of this study are accepted as an abstract for the 2018 Combined Sections Meeting of the American Physical Therapy Association. To date, the results of this study have not been presented or published elsewhere. Corresponding author: A. Williams Andrews, Campus Box 2085, Elon, NC 27244. 336-278-6351. andrewsb@elon.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

from Rehabilitation via xlomafota13 on Inoreader https://ift.tt/2MoNnek
via IFTTT

Mannitol in Critical Care and Surgery Over 50+ Years: A Systematic Review of Randomized Controlled Trials and Complications With Meta-Analysis

Objective: Despite clinical use spanning 50+ years, questions remain concerning the optimal use of mannitol. The published reviews with meta-analysis frequently focused on mannitol's effects on a specific physiological aspect such as intracranial pressure (ICP) in sometimes heterogeneous patient populations. A comprehensive review of mannitol's effects, as well as side effects, is needed. Methods: The databases Medline (OvidSP), Embase (OvidSP), and NLM PubMed were systematically searched for randomized controlled trials (RCTs) comparing mannitol to a control therapy in either the critical care or perioperative setting. Meta-analysis was performed when feasible to examine mannitol's effects on outcomes, including ICP, cerebral perfusion pressure, mean arterial pressure (MAP), brain relaxation, fluid intake, urine output, and serum sodium. Systematic literature search was also performed to understand mannitol-related complications. Results: In total 55 RCTs were identified and 7 meta-analyses were performed. In traumatic brain injury, mannitol did not lead to significantly different MAP (SMD [95% confidence interval], CI)=−3.3 [−7.9, 1.3] mm Hg; P=0.16) but caused significantly different serum sodium concentrations (SMD [95% CI]=−8.0 [−11.0, −4.9] mmol/L; P

from Anaesthesiology via xlomafota13 on Inoreader https://ift.tt/2yPZjUx
via IFTTT

The Effect of Balancing Selection on Population Differentiation: A Study with HLA Genes

Balancing selection is defined as a class of selective regimes that maintain polymorphism above what is expected under neutrality. Theory predicts that balancing selection reduces population differentiation, as measured by FST. However, balancing selection regimes in which different sets of alleles are maintained in different populations could increase population differentiation. To tackle the connection between balancing selection and population differentiation, we investigated population differentiation at the HLA genes, which constitute the most striking example of balancing selection in humans. We found that population differentiation of single nucleotide polymorphisms (SNPs) at the HLA genes is on average lower than that of SNPs in other genomic regions. We show that these results require using a computation that accounts for the dependence of FST on allele frequencies. However, in pairs of closely related populations, where genome-wide differentiation is low, differentiation at HLA is higher than in other genomic regions. Such increased population differentiation at HLA genes for recently diverged population pairs was reproduced in simulations of overdominant selection, as long as the fitness of the homozygotes differs between the diverging populations. The results give insight into a possible "divergent overdominance" mechanism for the nature of balancing selection on HLA genes across human populations.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2Ke61ZU
via IFTTT

Targeted Chromosomal Rearrangements via a Combinatorial Use of CRISPR/Cas9 and Cre/LoxP Technologies in Caenorhabditis elegans

Rearranged chromosomes have been applied to construct genetic balancers to manipulate essential genes in C. elegans. Although much effort has been put into constructing balancer chromosomes, approximately 6% (map units) of the C. elegans genome has not been covered, and this area lies mostly in pairing centers (PCs). Here, we developed a method for conditional chromosomal engineering through combinatorial use of the CRISPR/Cas9 and Cre/LoxP technologies. Functional DNA fragments containing LoxP sequences were inserted into designated genomic loci using a modified counterselection (cs)-CRISPR method. Then, heat-shock-induced Cre recombinase induced an inversion of the chromosomal region between the two LoxP sites. The chromosomal inversions were subsequently detected by the appearance of pharyngeal GFP. Through this method, we have successfully generated several chromosomal inversion lines, providing valuable resources for studying essential genes in pairing centers.

from Genetics via xlomafota13 on Inoreader https://ift.tt/2KtReX9
via IFTTT