Assessing Knee Stability in Adolescent Athletes with Osgood-Schlatter Disease Using the Y-Balance Test.

PURPOSE OF THE STUDY Osgood-Schlatter disease develops secondary to chronic patellar tendon overloading. The present study was designed to determine whether athletes with Osgood-Schlatter disease perform significantly worse in the Y-Balance Test compared to healthy subjects in a control group. MATERIAL AND METHODS The study involved ten boys (average age 13.7 years). Seven participants had bilateral knee pain, swelling and tenderness whereas three had unilateral knee pain, swelling and tenderness (left knee in two cases, and right knee in one). Overall, 17 knees were assessed (left knee in nine cases and right knee in eight).Ten healthy adolescent professional football players (mean age 14.6 years) were selected as a control group. In both groups, complex knee stability was assessed using the Y-Balance Test and their data were analyzed using the methodology developed by Plisky et al. The test outcome was expressed in indexed (normalized) values for the right and left lower extremities, and averaged values for the individual directions were compared. RESULTS Significant differences between both groups were shown in the posteromedial and posterolateral directions. CONCLUSIONS Using the Y-Balance Test, our study documented reduced performance in the above directions in patients with OsgoodSchlatter disease. Key words: Osgood-Schlatter disease, knee, balance test, movement patterns patellar tendon overload.

Recommendations from a Canadian Delphi consensus study on best practice for optimal referral and appropriate management of severe asthma.

BACKGROUND: In Canada, severe asthma affects an estimated 5-10% of people with asthma and is associated with frequent exacerbations, poor symptom control and significant morbidity from the disease itself, as well as the high dose inhaled, and systemic steroids used to treat it. Significant heterogeneity exists in service structure and patient access to severe asthma care, including access to biologic treatments. There appears to be over-reliance on short-acting beta agonists and frequent oral corticosteroid use, two indicators of uncontrolled asthma which can indicate undiagnosed or suboptimally treated severe asthma. The objective of this modified Delphi consensus project was to define standards of care for severe asthma in Canada, in areas where the evidence is lacking through patient and healthcare professional consensus, to complement forthcoming guidelines. METHODS: The steering group of asthma experts identified 43 statements formed from eight key themes. An online 4-point Likert scale questionnaire was sent to healthcare professionals working in asthma across Canada to assess agreement (consensus) with these statements. Consensus was defined as high if ≥ 75% and very high if ≥ 90% of respondents agreed with a statement. RESULTS: A total of 150 responses were received from HCPs including certified respiratory educators, respirologists, allergists, general practitioners/family physicians, nurses, pharmacists, and respiratory therapists. Consensus amongst respondents was very high in 37 (86%) statements, high in 4 (9%) statements and was not achieved in 2 (5%) statements. Based on the consensus scores, ten key recommendations were proposed. These focus on referrals from primary and secondary care, accessing specialist asthma services, homecare provision for severe asthma patients and outcome measures. CONCLUSIONS: Implementation of these recommendations across the severe asthma care pathway in Canada has the potential to improve outcomes for patients through earlier detection of undiagnosed severe asthma, reduction in time to severe asthma diagnosis, and initiation of advanced phenotype specific therapies.

A study on the cross-section data of 43,44m,46,47Sc isotopes via (d,x) reactions on natural abundance targets under the effects of deuteron optical models.

Many studies have investigated the influence of theoretical models and factors involved in the acquisition of cross-section data of a nuclear reaction. The implications of different models of various variables such as level density, gamma strength function, and optical potentials on cross-section calculations whether used solo or jointly are investigated in a significant portion of the works conducted in this perspective. The aim of this particular study is to investigate the influence of different optical models on the cross-section calculations in production of several scandium isotopes, known for various medical uses, from several targets with natural abundances by (d,x) reactions. For this purpose, the cross-section calculations using five available deuteron optical models of TALYS code in natTi(d,x)43Sc, natTi(d,x)44mSc, natTi(d,x)46Sc, natTi(d,x)47Sc, natV(d,x)47Sc and natCr(d,x)47Sc reactions were performed and the obtained calculation results were compared with the experimental cross-section data gathered from the literature. To understand whether there is a significant and consistent relationship between the experimental data and the calculation results, both have been plotted together and analyzed with the naked-eye. In addition, the calculations of the mean standardized deviation, the mean relative deviation, the mean ratio and the mean square logarithmic deviation were performed in order to evaluate the results numerically.

Comparing functional outcomes in minimally invasive versus open inguinal hernia repair using the army physical fitness test.

PURPOSE: The advantages of minimally invasive inguinal hernia repair (MIHR) over open hernia repair (OHR) continue to be debated. We compared MIHR to OHR by utilizing the Army Physical Fitness Test (APFT) as an outcome measure. METHODS: The APFT is a three-component test scored on a normalized 300 point scale taken semiannually by active-duty military. We identified 1119 patients who met inclusion criteria: 588 in the OHR group and 531 in the MIHR group. Changes in APFT scores, time on post-operative duty restrictions (military profile), and time interval to first post-operative APFT were compared using regression analysis. RESULTS: Postoperatively, no APFT score change difference was observed between the OHR or MIHR groups (- 7.3 ± 30 versus - 5.5 ± 27.7, p = 0.2989). Service members undergoing OHR and MIHR underwent their first post-operative APFT at equal mean timeframes (6.6 ± 5 months versus 6.7 ± 5.1, p = 0.74). No difference was observed for time in months spent on an official temporary duty restriction (military profile) for either OHR or MIHR (0.16 ± 0.16 versus 0.15 ± 0.17, p = 0.311). On adjusted regression analysis, higher pre-operative APFT scores and BMI ≥ 30 were independently associated with reduction in post-operative APFT scores. Higher-baseline APFT scores were independently associated with less time on a post-operative profile, whereas higher BMI (≥ 30) and lower rank were independently associated with longer post-operative profile duration. Higher-baseline APFT scores and lower rank were independently associated with shorter time intervals to the first post-operative APFT. CONCLUSION: Overall, no differences in post-operative APFT scores, military profile time, or time to first post-operative APFT were observed between minimally invasive or open hernioplasty in this military population.

Traditional Buddhist meditations reduce mismatch negativity in experienced monk- practitioners.

Thousand-year-old Buddhist traditions have developed a wide range of methods for the subjective exploration of consciousness through meditation. Combining their subjective research with the possibilities of modern neuroscience can help us better understand the physiological mechanisms of consciousness. Therefore, we have been guided by specifically Buddhist explanations when studying the physiological mechanisms of altered states of consciousness during Buddhist meditations. In Buddhism, meditations are generally divided into two large categories: (1) one-pointed concentration and (2) analytical meditation. Maintaining both one-pointed concentration and analytical meditation on 'bodhicitta' ("the thought of awakening") and 'emptiness' is a necessary condition for transitioning into tantric practices. Tantric practices involve sophisticated visualizations of Buddhist deities, the 'energy structure' of the human body, and the visualization of the stage-by-stage process of dying accompanied with the dissolution of body elements. According to Buddhism, these meditations are characterized by the gradual withdrawal from "gross levels" of consciousness associated with the five senses. From a psychophysiological perspective, this withdrawal of sensory consciousness can be considered as the decrease of sensory stimuli recognition and attentional disengagement from the external world. We concentrated on how considered meditations affect sensory and cognitive processing of external stimuli. Auditory event-related potentials (ERPs) in the passive oddball paradigm were studied both during meditations and in a controlled state of relaxed wakefulness. It was shown with a group of 115 Buddhist monks that during meditation, mismatch negativity amplitudes, amplitudes of N1 and P2 components of ERPs to deviant stimuli, and the amplitudes of the P3a component to novel stimuli all decrease. These outcomes suggest that the considered Buddhist meditations, compared to the control state of relaxed wakefulness, are accompanied by a decrease in physiological processes responsible for maintaining attention on the outside world and recognizing changes in the stream of sensory stimuli.

Direct observation of vortices in an electron fluid.

Vortices are the hallmarks of hydrodynamic flow. Strongly interacting electrons in ultrapure conductors can display signatures of hydrodynamic behaviour, including negative non-local resistance1-4, higher-than-ballistic conduction5-7, Poiseuille flow in narrow channels8-10 and violation of the Wiedemann-Franz law11. Here we provide a visualization of whirlpools in an electron fluid. By using a nanoscale scanning superconducting quantum interference device on a tip12, we image the current distribution in a circular chamber connected through a small aperture to a current-carrying strip in the high-purity type II Weyl semimetal WTe2. In this geometry, the Gurzhi momentum diffusion length and the size of the aperture determine the vortex stability phase diagram. We find that vortices are present for only small apertures, whereas the flow is laminar (non-vortical) for larger apertures. Near the vortical-to-laminar transition, we observe the single vortex in the chamber splitting into two vortices; this behaviour is expected only in the hydrodynamic regime and is not anticipated for ballistic transport. These findings suggest a new mechanism of hydrodynamic flow in thin pure crystals such that the spatial diffusion of electron momenta is enabled by small-angle scattering at the surfaces instead of the routinely invoked electron-electron scattering, which becomes extremely weak at low temperatures. This surface-induced para-hydrodynamics, which mimics many aspects of conventional hydrodynamics including vortices, opens new possibilities for exploring and using electron fluidics in high-mobility electron systems.

Effects of combining some theoretical models in the cross-section calculations of some alpha-induced reactions for natSb.

In cases where it is not possible to obtain the cross-section values experimentally due to various factors, the importance of obtaining them with theoretical models has been explained in many studies available in the literature. In this context, the comparison of the cross-section values obtained by using the theoretical models with the experimental data will also be very beneficial for updating and developing these models. Existing studies, which also serve this purpose, have given inspiration to this study and it is aimed to examine the effects of the simultaneous use of the alpha optical model potentials and the level density models on the cross-section calculations for some alpha-particle-induced reactions on natural antimony. The effects of theoretical models on the cross-section calculations were investigated by comparing the obtained calculation results with the experimental data taken from the literature. The TALYS code, which is frequently preferred in the literature, was used in all calculations within the scope of this study. For the comparison of the calculated results with the experimental data, not only a visual analysis by graphing the outcomes, but also a mean-weighted-deviation calculation was used, and the findings were interpreted by accounting for both of them.

Mass excess estimations using artificial neural networks.

Mass excess knowledge is important to investigate the fundamental properties of atomic nuclei. It is a meaningful and important parameter for the determinations of nucleon binding energy, nuclear reaction Q value, energy threshold and plays an undeniable role in the theoretical calculations of a reaction cross-section value in terms of the quantities it affects. In this research, a new artificial neural network (ANN) based algorithm is proposed to determine the mass excess of nuclei. The experimental data, which were taken from the RIPL3 database have been used for training the ANN. Proton, neutron, and mass numbers have been chosen as the input parameters. The Levenberg-Marquardt (LM) algorithm has been employed for the training section. The correlation coefficients have been found as 0.99984, 0.99977, 0.99984, and 0.99983 for training, validation, and testing, respectively. To validate our ANN results, ANN findings have been given as input parameters on TALYS 1.95 code and 56Fe(p,x) nuclear reactions have been simulated. The obtained results were compared with the literature. In conclusion, the findings of this study point to the ANN as a recommended tool that can be used to calculate estimates of mass information.

Racial and ethnic differences in perceptions of campus climate related to sexual violence.

Objective: To assess perceptions of university institutional climate related to sexual violence and whether these differed by race/ethnicity. Participants: Matriculated undergraduates > age 18 (n = 1028). Methods: Students were invited via campus email to participate in an online survey. Results: Overall, only 20% agreed that the university is creating an environment in which unwanted sexual experiences seemed common or normal, but these findings differed by race. Black students were more likely than their white peers to feel the university is creating an environment in which unwanted sexual experiences seem common or normal (37.3% vs. 19.7%, p < .001) and creating an environment in which such instances were more likely to occur (33.3% vs. 13.4%, p < .001). Conclusions: Data suggest that while students generally perceive that the university is working to create a positive and safe climate, these perceptions vary by race. Further investigation is necessary to better understand the concerns of students of color.

Candida pericarditis presenting with cardiac tamponade and multiple organ failure after combined damage control thoracotomy and laparotomy with splenectomy in a trauma patient: Case report and review of literature.

Candida pericarditis is a rare condition which has previously been described after cardiothoracic surgery and immunosuppressive states (Geisler et al., 1981; Eng et al., 1981; Kraus et al., 1988; Kaufman et al., 1988; Tang et al., 2009; Glower et al., 1990; Carrel et al., 1991; Rabinovici et al., 1997; Canver et al., 1998; Farjah et al., 2005; Gronemeyer et al., 1982 [1-11]). We describe the case of a 19-year-old male blunt trauma patient, who survived a damage control thoracotomy and laparotomy with splenectomy, who later developed a loculated Candida pericardial effusion, complicated with cardiac tamponade and multiple organ failure, and required antifungals and surgical reintervention with thoracotomy for drainage. A literature search of the reported cases demonstrates that Candida pericarditis is indeed a rare but fatal condition if not identified and treated appropriately. This article discusses the difficulties we encountered while recognizing the disorder in our patient and proposes a guideline to adequately treat the condition in an effective and timely manner. Candida pericarditis poses a special challenge for the physician since its correct diagnosis and management requires a multidisciplinary approach.

Evaluation of the signs and symptoms of pseudotumor cerebri syndrome in pediatric population.

PURPOSE: Pseudotumor cerebri syndrome (PTC) is characterized by increased intracranial pressure without a space-occupying lesion and a normal cerebrospinal fluid (CSF) composition without evidence of CSF infection. In this study, we aimed to compare the symptoms, signs, and clinical characteristics of patients presenting with a preliminary diagnosis of pseudotumor cerebri syndrome (PTC) who were diagnosed and not diagnosed with PTC. METHOD: We conducted a retrospective study of patients who were referred to our clinic with signs and symptoms of PTC. We compared the patients' symptoms, signs, and clinical characteristics who were diagnosed with PTC with those who were not diagnosed with PTC using modified Dandy criteria. RESULTS: Ninety-four patients with the pre-diagnosis of PTC were included in the study. LP procedure was done in all patients. After LP, 75.3% of the patients were diagnosed with PTC, but 24.7% did not meet the criteria for PTC. A statistically significant relationship was found between the increase in headache complaints when leaning forward, headache that keeps the child from playing, and the CSF pressure level (p = 0.014, p = 0.019; p < 0.05). There was no statistically significant correlation between papilledema and CSF pressure level (p > 0.05). A statistically significant relationship was found between papilledema grade and CSF pressure level (p = 0.038; p < 0.05), and the rate of high CSF pressure in the groups with Grades 2-3 and Grade 4 papilledema was higher than that in the group with Grade 1 papilledema. Cranial nerve 6 palsy (CN6) (p = 0.048) and flattening of the posterior aspect of the globe (FPS) are found independent risk factors (p = 0.004 p < 0.05). CONCLUSIONS: PTC signs and symptoms show variability among pediatric population.

Effects of deuteron optical models on the cross-section calculations of deuteron induced reactions on natural germanium.

A common feature of scientific studies is that when experimental observation data are not available, theoretical calculations are used to obtain information about the subject under investigation. In this context, many parameters and theoretical models have been developed that can be used in nuclear physics studies just as it is in other branches of sciences. It is intended that by doing so, theoretical models can be improved using recent experimental data while also learning about outcomes where experimental data is unavailable or difficult to access. Among the many theoretical models available, there are also deuteron optical models whose effects are examined in this study. The objective of this study is to examine the effects of different deuteron optical models on the cross-section calculations of deuteron induced reactions on natural germanium. The cross-section values of natGe(d,x)70As, natGe(d,x)71As, natGe(d,x)72As, natGe(d,x)73As, natGe(d,x)74As and natGe(d,x)76As reactions were calculated using five deuteron optical models in the TALYS code's v1.95 for this aim, and the results were compared to the experimental data available in the database known as Experimental Nuclear Reaction Data (EXFOR) library. Graphics and quantitative analyses were also used to present the findings and interpretations of the outcomes.

Correlation of Cervical Spinal Degeneration with Rise in Smartphone Usage Time in Young Adults.

AIMS: The study aimed to define the association between spinal degeneration parameters and the rise in smartphone usage time. This was a cross-sectional study. SUBJECTS AND METHODS: Young adults aged 20-35 years, who presented to our outpatient clinic due to neck pain between 2016 and 2018, were examined. Cervical disc degeneration, disc placement, Modic changes, and sagittal balance were retrospectively measured using magnetic resonance imaging (MRI) in 107 relatively patients. Data about daily phone usage times of the participants were obtained by a questionnaire filled in at the time of admission. RESULTS: The total number of disc distances analyzed was 535 (Group 1; n = 200, Group 2; 335). In Group 1, the disc displacement was present in 30%, and in Group 2, the disc displacement was present in 35%. In terms of DD severity, the total DD score was >10 in 18 (18/40; 45%) patients in Group 1, and in 39 patients (39/67; 58%) in Group 2. The mean Cobb angle of Group 1 was 10.3° ± 6.57° (range, 2° to 34°), and that of Group 2 was 7.6° ± 5.14° (range, 1° to 26°) (Pcobb = 0.048). Modic changes were detected in 17 of the 107 patients (15.8%). Of the 17 patients, 3 (3/40, %7.5) were Group 1 and 14 (14/67, %20.9) were Group 2. MC was detected in 4 vertebrae in Group 1, and 24 vertebrae in Group 2 (P = 0.001). CONCLUSIONS: The analysis of cervical spine MRI data of young adult patients with neck pain shows that the smartphone usage time is effective in cervical sagittal balance disruption, disc degeneration, and development of Modic changes.

Deep learning analysis provides accurate COVID-19 diagnosis on chest computed tomography.

INTRODUCTION: Computed Tomography is an essential diagnostic tool in the management of COVID-19. Considering the large amount of examinations in high case-load scenarios, an automated tool could facilitate and save critical time in the diagnosis and risk stratification of the disease. METHODS: A novel deep learning derived machine learning (ML) classifier was developed using a simplified programming approach and an open source dataset consisting of 6868 chest CT images from 418 patients which was split into training and validation subsets. The diagnostic performance was then evaluated and compared to experienced radiologists on an independent testing dataset. Diagnostic performance metrics were calculated using Receiver Operating Characteristics (ROC) analysis. Operating points with high positive (>10) and low negative (<0.01) likelihood ratios to stratify the risk of COVID-19 being present were identified and validated. RESULTS: The model achieved an overall accuracy of 0.956 (AUC) on an independent testing dataset of 90 patients. Both rule-in and rule out thresholds were identified and tested. At the rule-in operating point, sensitivity and specificity were 84.4 % and 93.3 % and did not differ from both radiologists (p > 0.05). At the rule-out threshold, sensitivity (100 %) and specificity (60 %) differed significantly from the radiologists (p < 0.05). Likelihood ratios and a Fagan nomogram provide prevalence independent test performance estimates. CONCLUSION: Accurate diagnosis of COVID-19 using a basic deep learning approach is feasible using open-source CT image data. In addition, the machine learning classifier provided validated rule-in and rule-out criteria could be used to stratify the risk of COVID-19 being present.

Photo-neutron cross-section calculations of 54,56Fe, 90,91,92,94Zr, 93Nb and 107Ag Isotopes with newly obtained Giant Dipole Resonance parameters.

The knowledge of the interaction of photons with matter is of vital importance to investigate fundamental nuclear physics problems. Giant dipole resonance (GDR) mechanism is dominant up to 30 MeV at photo-absorption cross-section. The photo-absorption cross-section curve against the photon energy displays one or multi-peak Lorentzian functions according to the deformation of the nucleus. Theoretical photo-absorption cross-section calculations generally focus on the estimation of GDR parameters. Theoretical reaction codes use GDR parameters to reproduce photon-induced nuclear reactions. In this study, photo-neutron cross-section calculations of 54,56Fe, 90,91,92,94Zr, 93Nb, and 107Ag isotopes have been done with the TALYS 1.8 and EMPIRE 3.2.2 nuclear reaction codes in the GDR region. During these calculations, both codes were firstly operated by using the predefined and existing GDR parameters within the codes. Later on, a new set of GDR parameters have been obtained by running a Lorentzian model based code in where the available experimental data are also considered. Levenberg-Marquardt algorithm has been used with 10-6 function tolerances and 400 iterations for optimization. These new obtained GDR parameters then replaced with the existing GDR parameters within the TALYS code and the photo-neutron cross-section calculations for the investigated isotopes have been repeated. Ultimately, in order to discuss the outcomes and the effects of using new GDR parameters, obtained results were analyzed by comparing them with the experimental data from the Experimental Nuclear Reaction Data (EXFOR) library.

A meta-analysis of flow effects and the perception of time.

An altered sense of the experience of time represents one of the nine dimensions that is conceived as characterizing a state of flow. While a number of other factors necessarily contribute to this overall experience of flow, subjective time perception is of particular quantitative interest and thus serves as the focus of the present meta-analysis. The extant body of relevant quantitative research was evaluated to identify data relating to both flow and change in the sense of time. Sixty-three (n = 63) articles were determined to qualify under the current specified inclusion criteria. These sixty-three studies yielded one thousand and ninety-four (n = 1094) effect sizes. All studies included in the meta-analysis were also coded for relevant moderator variables. Results indicated moderately positive correlations between affective, consciousness, and performance based aspects of flow (r = 0.4, 0.21, 0.17 respectively), thus reinforcing the original conceptualization of their relationship for the generation and maintenance of the flow state. Additionally, variations in environmental conditions (both physical and social) were found to have differential effects on the overall level of experienced flow. The results of this meta-analysis also serve to inform the process of further model development that can more accurately quantify and predict temporal perception as one metric of flow.

Investigation of gamma strength functions and level density models effects on photon induced reaction cross-section calculations for the fusion structural materials 46,50Ti, 51V, 58Ni and 63Cu.

Scientists have been focused on fusion reactor studies to overcome the increasing energy demand. The materials, which have the potential to be used in fusion reactors must be resistant to the harmful effects of radiation in the manner of material itself. Selection of the appropriate materials to be used in nuclear reactors has a crucial importance to achieve the maximum efficiency and security. Ti, V, Ni and Cu are known as some of the constructional fusion materials. Existence of many knowledge about those materials provides countless advantages to the researchers and one of them is the cross-section, which basically means the probability of a nuclear reaction's occurrence. In addition to the cross-section, there exist some other parameters, which could be pointed as gamma strength function and level density models that affect the theoretical calculations. In this study, photon induced reaction cross-sections of 46,50Ti, 51V, 58Ni and 63Cu target isotopes have been calculated by using TALYS 1.8 code with different gamma strength functions in the giant dipole resonance region. For gamma strength functions Kopecky-Uhl generalised Lorentzian Model, Brink-Axel Lorentzian Model, Hartree-Fock BCS tables, Hartree-Fock-Bogolyubov tables and Goriely's Hybrid Model have been employed. To appoint the best gamma strength function model, the relative variance calculations have been performed. Also, reaction cross-sections have been recalculated by using the best gamma strength function models through the different level density options. Constant Temperature Fermi Gas Model, Back Shifted Fermi Gas Model and Generalised Super Fluid Model have been employed for level density calculations. Experimental data for the investigated reactions have been taken from EXFOR library and used for comparisons of the obtained calculation results.