Description:
Background: Investigating population changes gives insight into effectiveness and need for prevention and rehabilitation services. Incidence rates of amputation are highly varied, making it difficult to meaningfully compare rates between studies and regions or to compare changes over time. Study Design: Historical cohort study of transtibial amputation, knee disarticulation, and transfemoral amputations resulting from vascular disease or infection, with/without diabetes, in 2003-2004, in the three Northern provinces of the Netherlands. Objectives: To report the incidence of first transtibial amputation, knee disarticulation, or transfemoral amputation in 2003-2004 and the characteristics of this population, and to compare these outcomes to an earlier reported cohort from 1991 to 1992. Methods: Population-based incidence rates were calculated per 100,000 person-years and compared across the two cohorts. Results: Incidence of amputation was 8.8 (all age groups) and 23.6 (≥45 years) per 100,000 person-years. This was unchanged from the earlier study of 1991-1992. The relative risk of amputation was 12 times greater for people with diabetes than for people without diabetes. Conclusions: Investigation is needed into reasons for the unchanged incidence with respect to the provision of services from a range of disciplines, including vascular surgery, diabetes care, and multidisciplinary foot clinics. Clinical relevance: This study shows an unchanged incidence of amputation over time and a high risk of amputation related to diabetes. Given the increased prevalence of diabetes and population aging, both of which present an increase in the population at risk of amputation, finding methods for reducing the rate of amputation is of importance.
Description:
Background and objectives: Recently, there have been calls for RFA to be implemented in the bipolar mode for cancer treatment due to the benefits it offers over the monopolar mode. These include the ability to prevent skin burns at the grounding pad and to avoid tumour track seeding. The usage of bipolar RFA in clinical practice remains uncommon however, as not many research studies have been carried out on bipolar RFA. As such, there is still uncertainty in understanding the effects of the different RF probe configurations on the treatment outcome of RFA. This paper demonstrates that the electrode lengths have a strong influence on the mechanics of bipolar RFA. The information obtained here may lead to further optimization of the system for subsequent uses in the hospitals. Methods: A 2D model in the axisymmetric coordinates was developed to simulate the electro-thermophysiological responses of the tissue during a single probe bipolar RFA. Two different probe configurations were considered, namely the configuration where the active electrode is longer than the ground and the configuration where the ground electrode is longer than the active. The mathematical model was first verified with an existing experimental study found in the literature. Results: Results from the simulations showed that heating is confined only to the region around the shorter electrode, regardless of whether the shorter electrode is the active or the ground. Consequently, thermal coagulation also occurs in the region surrounding the shorter electrode. This opened up the possibility for a better customized treatment through the development of RF probes with adjustable electrode lengths. Conclusions: The electrode length was found to play a significant role on the outcome of single probe bipolar RFA. In particular, the length of the shorter electrode becomes the limiting factor that influences the mechanics of single probe bipolar RFA. Results from this study can be used to further develop and optimize bipolar RFA as an effective and reliable cancer treatment technique. (C) 2019 Elsevier B.V. All rights reserved.
Description:
Lower back pain is commonly associated with golfers. The study aimed: to determine whether thoracic- and lumbar-erector-spinae muscle display signs of muscular fatigue after completing a golf practice session, and to examine the effect of the completed practice session on club head speed, ball speed and absolute carry distance performance variables. Fourteen right-handed male golfers participated in the laboratory-based-study. Surface electromyography (EMG) data was collected from the lead and trail sides of the thoracic- and lumbar-erector-spinae muscle. Normalized root mean squared (RMS) EMG activation levels and performance variables for the golf swings were compared before and after the session. Fatigue was assessed using median frequency (MDF) and RMS during the maximum voluntary contraction (MVC) performed before and after the session. No significant differences were observed in RMS thoracic- and lumbar-erector-spinae muscle activation levels during the five phases of the golf swing and performance variables before and after the session (p > .05). Significant changes were displayed in MDF and RMS in the lead lower lumbar and all trail regions of the erector-spinae muscle when comparing the MVC performed before and after the session (p < .05). Fatigue was evident in the trail side of the erector-spinae muscle after the session.
Description:
The purpose of this paper is to present the design and implementation of a novel rule-based algorithm for the classification of sitting postures in the sagittal plane. The research focused on individuals with severe musculoskeletal problems and, thus, specific requirements for posture and pressure management. Clients' body shapes were captured using the Cardiff Body Match system developed by the Rehabilitation Engineering Unit, Cardiff and Vale University Health Board. The algorithm consists of four main steps: the first step is the symmetry line detection, the second step involves the mathematical analysis of the curvature of the backrest profile, the third step is the sitting posture classification and the fourth step is the extraction of the geometric parameters from the curve. The results show the classification system was successful in identifying four types of curves characterizing sitting postures using local derivatives as curve descriptors with an overall accuracy of 93.9%.;
Description:
Because of the high dimensionality of the microarray data sets, feature selection (FS) has become an important challenge in molecular classification. Using the degree of differential prioritization (DDP) between relevance and antiredundancy, our proposed DDP-based FS technique is capable of achieving better accuracies than those previously reported, using a smaller predictor set. However, previously, we have neither devised nor used any method for determining the value of the DDP to be used for the data set of interest before the FS process. In this article, we propose a system for predicting the optimal value of the DDP, which costs less computationally than conventional tuning while maintaining the independence of the FS technique from the type of underlying classifier used
Description:
Background: Injuries are common in rugby sevens, but studies to date have been limited to short, noncontinuous periods and reporting of match injuries only. Purpose: To report the injury incidence rate (IIR), severity, and burden of injuries sustained by men and women in the Australian rugby sevens program and to provide the first longitudinal investigation of subsequent injury occurrence in rugby sevens looking beyond tournament injuries only. Study Design: Descriptive epidemiology study. Methods: Ninety international rugby sevens players (55 men and 35 women) were prospectively followed over 2 consecutive seasons (2015-2016 and 2016-2017). All medical attention injuries were reported irrespective of time loss. Individual exposure in terms of minutes, distance, and high-speed distance was captured for each player for matches and on-field training, with the use of global positioning system devices. The IIR and injury burden (IIR × days lost to injury) were calculated per 1000 player-hours, and descriptive analyses were performed. Results: Seventy-three players (81.1%) sustained 365 injuries at an IIR of 43.2 per 1000 player-hours (95% CI, 43.0-43.3). As compared with male players, female players experienced a lower IIR (incidence rate ratio, 0.91; 95% CI, 0.90-0.91). Female players also sustained a higher proportion of injuries to the trunk region (relative risk, 1.75; 95% CI, 1.28-2.40) but a lower number to the head/neck region (relative risk, 0.58; 95% CI, 0.37-0.93; P =.011). The majority (80.7%) of subsequent injuries were of a different site and nature than previous injuries. A trend toward a reduced number of days, participation time, distance, and high-speed distance completed before the next injury was observed after successive injury occurrence. Conclusion: Female players have a lower IIR than male players, with variation of injury profiles observed between sexes. With a surveillance period of 2 years, subsequent injuries account for the majority of injuries sustained in rugby sevens, and they are typically different from previous types of sustained injuries. After each successive injury, the risk profile for future injury occurrence appears to be altered, which warrants further investigation to inform injury prevention strategies in rugby sevens.
Description:
BACKGROUND: It is known that some people can, and do, sustain >1 injury over a playing season. However, there is currently little high-quality epidemiological evidence about the risk of, and relationships between, multiple and subsequent injuries. PURPOSE: To describe the subsequent injuries sustained by Australian Football League (AFL) players over 1 season, including their most common injury diagnoses. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Within-player linked injury data on all date-ordered match-loss injuries sustained by AFL players during 1 full season were obtained. The total number of injuries per player was determined, and in those with >1 injury, the Subsequent Injury Classification (SIC) model was used to code all subsequent injuries based on their Orchard Sports Injury Classification System (OSICS) codes and the dates of injury. RESULTS: There were 860 newly recorded injuries in 543 players; 247 players (45.5%) sustained >/=1 subsequent injuries after an earlier injury, with 317 subsequent injuries (36.9% of all injuries) recorded overall. A subsequent injury generally occurred to a different body region and was therefore superficially unrelated to an index injury. However, 32.2% of all subsequent injuries were related to a previous injury in the same season. Hamstring injuries were the most common subsequent injury. The mean time between injuries decreased with an increasing number of subsequent injuries. CONCLUSION: When relationships between injuries are taken into account, there is a high level of subsequent (and multiple) injuries leading to missed games in an elite athlete group.
Description:
Does Sports Club Participation Contribute to Health-Related Quality of Life? Med. Sci. Sports Exerc., Vol. 42, No. 5, pp. 1022-1028, 2010. Given the social nature of participation in sport, we hypothesized that club sports participants would have greater well-being and quality of life than participants in other forms of physical activity (PA). Purpose: The purpose of this study was to examine health-related quality of life and life satisfaction in women who participate in three contrasting forms of PA: club sport, gym activities, and walking. Methods: This was a cross-sectional study of the relationship between type of PA setting and measures of health-related quality of life (Short-Form Health Survey [SF-36]) and life satisfaction in 818 women living in rural Victoria, Australia, in 2007. Data were also compared with those from a normative sample of 2345 women. Results: After adjustment for potential confounders (age,! education, marital status, children aged <16 yr, perceived financial stress, and level of recreational PA), four of the eight SF-36 subscales, the SF-36 mental health component summary score, and life satisfaction were significantly higher in the club sport group than that in the other groups. Conclusion: Although cross-sectional research cannot establish causal links, the results suggest that participation in club sport may enhance the health benefits of PA.
Description:
Does Sports Club Participation Contribute to Health-Related Quality of Life? Med. Sci. Sports Exerc., Vol. 42, No. 5, pp. 1022-1028, 2010. Given the social nature of participation in sport, we hypothesized that club sports participants would have greater well-being and quality of life than participants in other forms of physical activity (PA). Purpose: The purpose of this study was to examine health-related quality of life and life satisfaction in women who participate in three contrasting forms of PA: club sport, gym activities, and walking. Methods: This was a cross-sectional study of the relationship between type of PA setting and measures of health-related quality of life (Short-Form Health Survey [SF-36]) and life satisfaction in 818 women living in rural Victoria, Australia, in 2007. Data were also compared with those from a normative sample of 2345 women. Results: After adjustment for potential confounders (age,! education, marital status, children aged <16 yr, perceived financial stress, and level of recreational PA), four of the eight SF-36 subscales, the SF-36 mental health component summary score, and life satisfaction were significantly higher in the club sport group than that in the other groups. Conclusion: Although cross-sectional research cannot establish causal links, the results suggest that participation in club sport may enhance the health benefits of PA.