Histological Structure of the Medial and Lateral Patellofemoral Ligaments and Implications for Reconstructive Surgery and Anterior Knee Pain.

Biomechanically, the patellofemoral joint is one of the most complex human articulations and a common source of pain for active adults and adolescents, particularly females.1-4 Patellofemoral disorders account for 20%-40% of all knee problems seen in family practice, sports medicine, and orthopedic clinics.1, 3-5.

Change in somatosensory evoked potentials detect an acute arterial stent occlusion in lower extremity during spinal surgery: Case report.

The authors report a case in which an acute thrombosis of a pre-existing arterial stent occurs in a patient's lower extremity during a lumbar spinal fusion surgery. The event was detected by acute changes in somatosensory evoked potentials (SSEPs) which were being monitored during the procedure. The neurophysiology technologist reported a 10 % increased latency and 50 % loss of amplitude in the left posterior tibial nerve recordings. While still in the operating room, further investigation, including doppler and arteriogram, demonstrated a complete occlusion of one of the two contiguous stents within the superficial femoral artery (SFA). A vascular surgeon was then able to emergently perform trans-arterial thrombectomy and restore flow through the extremity while still in the operating room. The observed events demonstrate the ability of SSEP monitoring to potentially detect arterial occlusion early, allowing for a rapid diagnosis and expedient treatment, in this case immediate, thus avoiding significant limb threatening morbidity.

Corrigendum to "The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies".

[This corrects the article DOI: 10.1155/2019/5365608.].

The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies.

AIM: The aim of this narrative review was to explore the potential contributions of CAM to reduce antibiotic use. METHODS: We searched PubMed, Embase, and Cochrane Database of Systematic Reviews with a specific, limited set of search terms and collected input from a group of expert CAM researchers to answer the question: What is known about the contribution of CAM health and health promotion concepts, infection prevention, and infection treatment strategies to reduce antibiotic use? Results. The worldview-related CAM health concepts enable health promotion oriented infection prevention and treatment aimed at strengthening or supporting the self-regulating ability of the human organism to cope with diseases. There is some evidence that the CAM concepts of health (promotion) are in agreement with current conceptualization of health and that doctors who practice both CAM and conventional medicine prescribe less antibiotics, although selection bias of the presented studies cannot be ruled out. There is some evidence that prevention and some treatment strategies are effective and safe. Many CAM treatment strategies are promising but overall lack high quality evidence. CONCLUSIONS: CAM prevention and treatment strategies may contribute to reducing antibiotic use, but more rigorous research is necessary to provide high quality evidence of (cost-)effectiveness.

Field trials of blood culture identification FilmArray in regional Australian hospitals.

Purpose. In this field trial of rapid blood culture identification (BCID), we aimed to determine whether the improved speed and accuracy of specific BCID predicted in our earlier pilot study could be obtained in regional hospitals by deploying a multiplex PCR FilmArray (Biomerieux, France) capability in their laboratories.Methods. We trained local hospital laboratory staff to operate the FilmArray equipment and act on the results. To do this, we integrated the multiplex PCR into the standard laboratory blood culture workflow and reporting procedure.Results. Of 100 positive blood culture episodes, BCID FilmArray results were correct in all 42 significant monobacterial cultures, with a fully predictive identity in 38 (90.5 %) and a partial identity in another four (9.5 %). There was one major error; a false positive Pseudomonas aeruginosa. The minor errors were the detection of one methicillin-resistant Staphylococcus aureus, which proved to be a methicillin-sensitive S. aureus mixed with a methicillin-resistant coagulase-negative staphylococcus, five false negative coagulase-negative staphylococci and one false negative streptococcus species. We found that 41/49 (84 %) clinically significant mono- and polymicrobial culture results were fully predictive of culture-based identification to bacterial species level at a mean of 1.15 days after specimen collection.Conclusions. There was a reduction of 1.21 days in the time taken to produce a definitive BCID compared to the previous year, translating into earlier communication of more specific blood culture results to the treating physician. Reduced time to definitive blood culture results has a direct benefit for isolated Australian communities at great distances from specialist hospital services.

Listening to parents: the challenges of parenting kindergarten-aged children who are anxious.

The purpose of this study was to increase understanding of the experience of parenting kindergarten-aged children who are anxious. Twenty-three in-depth interviews were conducted with parents of kindergarten-aged children who expressed interest in a parent-focused early intervention program for child anxiety offered in a local elementary school. Key concerns of the parents included their children's separation anxiety, social anxiety, and oppositional behaviour. The child's anxiety was identified as a stressor on the child, the parent, and the family. Parents utilized a range of parenting responses although they tended to be reactive and did not have a consistent strategy for managing the anxiety. A salient parenting struggle was whether or not to push the child to face challenging situations although there were few descriptions of overprotection or overcontrol. The findings suggest greater attention be given to the strengths of parents of children who are anxious and the ways in which parents may be a positive factor in mitigating the effects of child anxiety. Implications for intervention are discussed.

The O/OREOS mission: first science data from the Space Environment Survivability of Living Organisms (SESLO) payload.

We report the first telemetered spaceflight science results from the orbiting Space Environment Survivability of Living Organisms (SESLO) experiment, executed by one of the two 10 cm cube-format payloads aboard the 5.5 kg Organism/Organic Exposure to Orbital Stresses (O/OREOS) free-flying nanosatellite. The O/OREOS spacecraft was launched successfully to a 72° inclination, 650 km Earth orbit on 19 November 2010. This satellite provides access to the radiation environment of space in relatively weak regions of Earth's protective magnetosphere as it passes close to the north and south magnetic poles; the total dose rate is about 15 times that in the orbit of the International Space Station. The SESLO experiment measures the long-term survival, germination, and growth responses, including metabolic activity, of Bacillus subtilis spores exposed to the microgravity, ionizing radiation, and heavy-ion bombardment of its high-inclination orbit. Six microwells containing wild-type (168) and six more containing radiation-sensitive mutant (WN1087) strains of dried B. subtilis spores were rehydrated with nutrient medium after 14 days in space to allow the spores to germinate and grow. Similarly, the same distribution of organisms in a different set of microwells was rehydrated with nutrient medium after 97 days in space. The nutrient medium included the redox dye Alamar blue, which changes color in response to cellular metabolic activity. Three-color transmitted intensity measurements of all microwells were telemetered to Earth within days of each of the 48 h growth experiments. We report here on the evaluation and interpretation of these spaceflight data in comparison to delayed-synchronous laboratory ground control experiments.

In the eyes of the beholder: A non-self-report measure of workplace deviance.

Because employees may be reluctant to admit to performing deviant acts, the authors of this study reexamined the commonly used self-report measure of workplace deviance developed by R. J. Bennett and S. L. Robinson (2000). Specifically, the self-report measure was modified into a non-self-report measure based on multiple other-reported assessments to address methodological concerns with self-reported information regarding deviant workplace behaviors. The authors assessed the psychometric properties of this new measure by first conducting an exploratory factor analysis, which indicated a 3-factor structure (production deviance, property deviance, and personal aggression). Subsequent confirmatory factor analysis on a different sample verified these findings. Taken together, the results suggest that the content and psychometric qualities of this non-self-report measure of workplace deviance closely represent S. L. Robinson and R. J. Bennett's (1995) original typology of workplace deviance. The potential usefulness of this measure in organizational studies is discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

An integrative typology of personality assessment for aggression: implications for predicting counterproductive workplace behavior.

This study presents an integrative typology of personality assessment for aggression. In this typology, self-report and conditional reasoning (L. R. James, 1998) methodologies are used to assess 2 separate, yet often congruent, components of aggressive personalities. Specifically, self-report is used to assess explicit components of aggressive tendencies, such as self-perceived aggression, whereas conditional reasoning is used to assess implicit components, in particular, the unconscious biases in reasoning that are used to justify aggressive acts. These 2 separate components are then integrated to form a new theoretical typology of personality assessment for aggression. Empirical tests of the typology were subsequently conducted using data gathered across 3 samples in laboratory and field settings and reveal that explicit and implicit components of aggression can interact in the prediction of counterproductive, deviant, and prosocial behaviors. These empirical tests also reveal that when either the self-report or conditional reasoning methodology is used in isolation, the resulting assessment of aggression may be incomplete. Implications for personnel selection, team composition, and executive coaching are discussed.

Complementary medicine: evidence base, competence to practice and regulation.

This paper describes the current status and evidence base for acupuncture, homeopathy, herbal and manipulative medicine, as well as the regulatory framework within which these therapies are provided. It also explores the present role of the Royal College of Physicians' Subcommittee on Complementary and Alternative Medicine (CAM) in relation to these developments. A number of CAM professions have encouraged the Royal College of Physicians Subcommittee to act as a reference point for their discussions with the conventional medical profession and the subcomittee believes that they are able to fulfil this function.

Kava--the unfolding story: report on a work-in-progress.

This paper, originated as a submission (now updated) to the U.K. Medicines Control Agency and Committee of Safety of Medicines (CSM) on January 11, 2002, in response to a report circulated by the German Federal Institute for Drugs and Medical Products (German initials are BfArM), a compilation of which is summarized in Appendix 2. This agency issued notification in late November 2001 of some thirty adverse events associated with the use of concentrated standardized preparations of kava (Piper methysticum, Forst. f.) reported from Germany and Switzerland. An analysis of the summary of the BfArM case reports (see Appendix 2) shows that these contain duplications among the cases cited. The original submission that was sent to the CSM January 2002 has been updated to the version published here. This new version was completed in April 2002. As a result of the alert from BfArM, the evaluation of kava's safety is now occurring on a worldwide basis and, being that this a matter of considerable importance to the public, the health care community, and regulatory authorities as well as to kava farmers throughout Polynesia, it is it important to depict this progress report. As such, this updated report does not provide final answers. The material released by the BfArM is lacking in detail; however, it is hoped that this report will shed light on the kava controversy. It is anticipated that there will be further updates shortly. This report, prepared on behalf of the Traditional Medicines Evaluation Committee, a subcommittee of the European Herbal Practitioners Association, argues that many of the adverse events cited by the BfArM should not be attributed to kava. In addition, the report states that the properties of concentrated standardized kava extracts - as opposed to preparations that closely approximate those created for traditional use - contribute to causing adverse events. This report proposes a number of simple measures that will ensure that safe kava preparations may continue to be available in the United Kingdom.

Cortical mapping of visceral pain in patients with GI disorders using functional magnetic resonance imaging.

OBJECTIVE: We sought to identify central loci that activate in response to visceral stimuli (stool and pain). We had a particular interest in observing the anterior cingulate gyrus and frontal cortex in normals and in patients with intestinal disease, including inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). METHODS: Subjects underwent rectal balloon distention to a sensation of stool and to a sensation of pain while undergoing blood oxygenation level-dependent functional magnetic resonance imaging. Experiments were conducted in a Magnex 3.0-T whole body magnet with a Bruker Biospec console and a quadrature head coil. Four contiguous 5.0-mm oblique axial slices designed to optimize coverage of areas believed to be responsive to noxious stimulation were acquired. Activations were detected by using cross-correlation maps (p < 0.001) for individual subjects. The experimental groups were compared using both an analysis of variance and profile analysis. RESULTS: A significantly higher percentage of pixels activated in the anterior cingulate gyrus over both pain and stool conditions for the control group than for the IBS group and for the IBS group than for the IBD group (p < 0.035). Deactivation of left somatosensory cortex was greater for the IBS group than for the IBD group and greater for the IBD group than for the controls (p < 0.0065) in the boxcar condition. Frontal deactivation in controls compared with disease groups bordered on statistical significance. Profile analysis of the three groups across six regions of interest revealed that the control and IBD groups were distinguished by different profiles of response (p < 0.005). Nonparametric evaluation of the data suggests that, among the pixels in the anterior cingulate activating to pain, there are two patterns of response to pain-on/off and graded. This was true for both controls and disease groups. CONCLUSIONS: Normal controls and subjects with IBD and IBS share similar loci of activations to visceral sensations of stool and pain. Both activation and deactivation of particular regions of interest differentiate the three groups, as do profiles of patterned response across six of the regions of interest for the control and IBD groups.