The Use of MotusBASEBALL For Pitch Monitoring and Injury Prevention

Introduction: MotusBASEBALL (MOTUS) has proven to be a reliable and accurate method for evaluating the multifactorial kinesiology involved with pitching. We sought to review the use of MOTUS in assessment of pitching parameters and identify its practicality as an injury prevention tool across the literature. Methods: A systemic review of the literature was preformed, using key words such as MOTUS, baseball, pitcher, sensor and arm sleeve, identifying 77 total articles. Inclusion criteria entailed original articles that used MOTUS and studied baseball pitchers across any level of sport. Results: A total of 13 articles met the inclusion criteria, producing a sample of 493 male athletes with a mean age of 18.7. Uniformly across studies, elbow torque was a primary metric and was observed in relation to a wide range of variables, such as pitch type, height, weight and arm length. Additionally, MOTUS was able to detect several other pitching metrics, such as arm speed, shoulder rotation and arm slot, displaying a wide range of capabilities. Conclusion: We suspect MOTUS technology could become a significant tool for observing pitching mechanics in real time, as well as an injury prevention tool to be used by players, coaches and trainers across all levels of baseball

Can Opioids be Eliminated After Arthroscopic Meniscus Surgery? A Prospective Randomized Controlled Trial

Purpose: To compare a multimodal nonopioid pain protocol to traditional opioid medication in controlling postoperative pain following arthroscopic meniscal surgery. Methods: Ninety-nine patients undergoing primary meniscectomy or meniscal repair were assessed for participation. A prospective randomized control trial was performed in accordance with the Consolidated Standards of Reporting Trials 2010 (CONSORT) statement. The two arms of the study included a multimodal non-opioid analgesic protocol and a standard opioid regimen with a primary outcome of postoperative pain level (visual analog scale) for 10 days. Secondary outcomes included patient reported outcomes, complications and patient satisfaction. Randomization was achieved using a random number generator. Patients were not blinded. Data collection was done by a blinded observer. Results: A total of 61 patients were analyzed with 30 randomized to the opioid regimen, and 31 randomized to the non-opioid regimen. Patients receiving the nonopioid regimen demonstrated non-inferior VAS scores compared to patients who received opioid pain medication (p\u3e0.05) No significant differences were found in preoperative (opioid: 58.9 ± 7.0; nonopioid: 58.2 ± 5.5, p = 0.724) nor postoperative (opioid: 59.8 ± 6.5; nonopioid: 54.9 ± 7.1, p = 0.064) PROMIS-Pain Interference Short Form scores. No difference was found in recorded side effects between both groups: constipation, nausea, diarrhea, upset stomach, and drowsiness (p \u3c 0.05). Conclusion: This study found that multimodal nonopioid pain protocol provided equivalent pain control and patient outcomes following primary meniscus surgery while having an equivalent side effect profile. All patients reported satisfaction with their pain management without requiring emergency opioid analgesia

Career Longevity and Performance Following Shoulder Instability in National Football League Athletes

Purpose: To investigate the career longevity, game utilization and performance of National Football League (NFL) athletes following glenohumeral instability events treated operatively versus nonoperatively. Methods: Public resources identified NFL players who sustained a shoulder instability event from 2000-2019. Players with prior shoulder instability, without NFL experience before injury, or who did not return to play (RTP) after injury were excluded. Demographic information, utilization (games and seasons), and season approximate value (SAV) statistics were recorded one year prior to injury and three years following return to play (RTP). Statistical analysis compared utilization and SAV following RTP for athletes managed operatively versus nonoperatively. Results: Ninety-seven NFL players who sustained their first instability event while playing in the NFL were identified, 91 of whom RTP (93.8%). Quarterbacks were significantly more likely to undergo immediate surgical management compared to other positions (P=.023). Final analysis included 58 players managed operatively and 33 players managed nonoperatively by the end of the index season. Players treated operatively played in significantly more seasons following RTP during their remaining career (4.1±2.7 vs. 2.8±2.5 seasons; P=.015). There were no differences in games played or started, offensive or defensive snap count percentage, or performance (SAV) before and after injury when compared between cohorts (P\u3e.05). Following surgical stabilization, time to RTP (36.62±10.32 vs. 5.43±12.33 weeks, P Conclusions: Athletes who RTP in the NFL following a shoulder instability injury do so with similar workload and performance irrespective of surgical or non-surgical management. While nonoperative treatment is associated with faster return to play, operative management is associated with fewer recurrent instability events, greater time between recurrent instability events, and greater career longevit

Nrf2-dependent persistent oxidative stress results in stress-induced vulnerability to depression.

Stressful life events produce a state of vulnerability to depression in some individuals. The mechanisms that contribute to vulnerability to depression remain poorly understood. A rat model of intense stress (social defeat (SD), first hit) produced vulnerability to depression in 40% of animals. Only vulnerable animals developed a depression-like phenotype after a second stressful hit (chronic mild stress). We found that this vulnerability to depression resulted from a persistent state of oxidative stress, which was reversed by treatment with antioxidants. This persistent state of oxidative stress was due to low brain-derived neurotrophic factor (BDNF) levels, which characterized the vulnerable animals. We found that BDNF constitutively controlled the nuclear translocation of the master redox-sensitive transcription factor Nrf2, which activates antioxidant defenses. Low BDNF levels in vulnerable animals prevented Nrf2 translocation and consequently prevented the activation of detoxifying/antioxidant enzymes, ultimately resulting in the generation of sustained oxidative stress. Activating Nrf2 translocation restored redox homeostasis and reversed vulnerability to depression. This mechanism was confirmed in Nrf2-null mice. The mice displayed high levels of oxidative stress and were inherently vulnerable to depression, but this phenotype was reversed by treatment with antioxidants. Our data reveal a novel role for BDNF in controlling redox homeostasis and provide a mechanistic explanation for post-stress vulnerability to depression while suggesting ways to reverse it. Because numerous enzymatic reactions produce reactive oxygen species that must then be cleared, the finding that BDNF controls endogenous redox homeostasis opens new avenues for investigation

A microRNA profile of human CD8(+) regulatory T cells and characterization of the effects of microRNAs on Treg cell-associated genes.

Recently, regulatory T (Treg) cells have gained interest in the fields of immunopathology, transplantation and oncoimmunology. Here, we investigated the microRNA expression profile of human natural CD8(+)CD25(+) Treg cells and the impact of microRNAs on molecules associated with immune regulation. We purified human natural CD8(+) Treg cells and assessed the expression of FOXP3 and CTLA-4 by flow cytometry. We have also tested the ex vivo suppressive capacity of these cells in mixed leukocyte reactions. Using TaqMan low-density arrays and microRNA qPCR for validation, we could identify a microRNA 'signature' for CD8(+)CD25(+)FOXP3(+)CTLA-4(+) natural Treg cells. We used the 'TargetScan' and 'miRBase' bioinformatics programs to identify potential target sites for these microRNAs in the 3'-UTR of important Treg cell-associated genes. The human CD8(+)CD25(+) natural Treg cell microRNA signature includes 10 differentially expressed microRNAs. We demonstrated an impact of this signature on Treg cell biology by showing specific regulation of FOXP3, CTLA-4 and GARP gene expression by microRNA using site-directed mutagenesis and a dual-luciferase reporter assay. Furthermore, we used microRNA transduction experiments to demonstrate that these microRNAs impacted their target genes in human primary Treg cells ex vivo. We are examining the biological relevance of this 'signature' by studying its impact on other important Treg cell-associated genes. These efforts could result in a better understanding of the regulation of Treg cell function and might reveal new targets for immunotherapy in immune disorders and cancer

Evaluating the influence of microstructural attributes: Fraction, composition, size and spatial distribution of phases on the oxidation behaviour of high-entropy alloys

Oxidation behaviour of five high entropy alloys (HEAs): AlCoCrFeNi, Al2CoCrFeNi, Al2CoCr1.5FeNi, AlCoCrNi and AlCoCr0.5Ni, has been studied at 1100 °C in the cast-annealed condition. Al2CoCrFeNi and AlCoCr0.5Ni HEAs exhibit the lowest oxidation rates of the order of 10−12 g2 cm−4-s−1. Al-rich nanoscale precipitates are observed to aid protective oxide growth. The Al-lean phase fraction and its Al content also have a major effect on the alloy's oxidation behaviour. A parameter ‘X’ taking the ratio of these two has been introduced, which coupled with CALPHAD predictions can be a potential tool to shortlist HEAs for oxidation resistance applications

The global burden of tuberculosis: results from the Global Burden of Disease Study 2015

Background: An understanding of the trends in tuberculosis incidence, prevalence, and mortality is crucial to tracking of the success of tuberculosis control programmes and identification of remaining challenges. We assessed trends in the fatal and non-fatal burden of tuberculosis over the past 25 years for 195 countries and territories. Methods: We analysed 10 691 site-years of vital registration data, 768 site-years of verbal autopsy data, and 361 site-years of mortality surveillance data using the Cause of Death Ensemble model to estimate tuberculosis mortality rates. We analysed all available age-specific and sex-specific data sources, including annual case notifications, prevalence surveys, and estimated cause-specific mortality, to generate internally consistent estimates of incidence, prevalence, and mortality using DisMod-MR 2.1, a Bayesian meta-regression tool. We assessed how observed tuberculosis incidence, prevalence, and mortality differed from expected trends as predicted by the Socio-demographic Index (SDI), a composite indicator based on income per capita, average years of schooling, and total fertility rate. We also estimated tuberculosis mortality and disability-adjusted life-years attributable to the independent effects of risk factors including smoking, alcohol use, and diabetes. Findings: Globally, in 2015, the number of tuberculosis incident cases (including new and relapse cases) was 10·2 million (95% uncertainty interval 9·2 million to 11·5 million), the number of prevalent cases was 10·1 million (9·2 million to 11·1 million), and the number of deaths was 1·3 million (1·1 million to 1·6 million). Among individuals who were HIV negative, the number of incident cases was 8·8 million (8·0 million to 9·9 million), the number of prevalent cases was 8·9 million (8·1 million to 9·7 million), and the number of deaths was 1·1 million (0·9 million to 1·4 million). Annualised rates of change from 2005 to 2015 showed a faster decline in mortality (–4·1% [–5·0 to –3·4]) than in incidence (–1·6% [–1·9 to –1·2]) and prevalence (–0·7% [–1·0 to –0·5]) among HIV-negative individuals. The SDI was inversely associated with HIV-negative mortality rates but did not show a clear gradient for incidence and prevalence. Most of Asia, eastern Europe, and sub-Saharan Africa had higher rates of HIV-negative tuberculosis burden than expected given their SDI. Alcohol use accounted for 11·4% (9·3–13·0) of global tuberculosis deaths among HIV-negative individuals in 2015, diabetes accounted for 10·6% (6·8–14·8), and smoking accounted for 7·8% (3·8–12·0). Interpretation: Despite a concerted global effort to reduce the burden of tuberculosis, it still causes a large disease burden globally. Strengthening of health systems for early detection of tuberculosis and improvement of the quality of tuberculosis care, including prompt and accurate diagnosis, early initiation of treatment, and regular follow-up, are priorities. Countries with higher than expected tuberculosis rates for their level of sociodemographic development should investigate the reasons for lagging behind and take remedial action. Efforts to prevent smoking, alcohol use, and diabetes could also substantially reduce the burden of tuberculosis

Stream-Based Authentication Strategy Using IoT Sensor Data in Multi-homing Sub-aqueous Big Data Network

Big data analytics has addressed many in-place and remote network issues in a sub-aqueous distributed computing environment. Recently, a new phenomenon is introduced in the data analytics clusters that focus on multi-homing network connectivity procedures among off-ground multiple nodes of the large-scale on-running wireless industrial applications. In this way, the clusters perform multi-layer cross-connected task processing among various networks simultaneously and perform stream based data block placement over multiple nodes in a sequential order. This satisfies the procedural performance of the cluster; however, security remains an open issue in it because of unavailability of inter-network data block processing authorization. In this paper, we propose a stream based authentication mechanism, that specifically addresses security concerns of multi-homing sub-aqueous big data networks and presents a key authorization infrastructure that performs a proper handing taking among multiple off-ground Datanodes before an inter-network data block exchange. The simulation results depict that our approach increases multi-homing network compatibility and reliability while processing a data block in the sub-aqueous distributed computing environment

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112