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Female soccer players are particularly susceptible to anterior cruciate ligament (ACL) injuries, accounting for 16% to 43% of the injury burden during the season. Despite the advancements in injury prevention programs, the rate of ACL injuries continues to rise.
To provide a comprehensive description of the mechanisms, situational pattern, and biomechanics of ACL injuries in women's soccer.
Case series; Level of evidence, 4.
We identified 57 consecutive ACL injuries that occurred in matches of 6 top female leagues across 3 seasons (2017-2020). A total of 35 (61%) injury videos were analyzed for the mechanism and situational pattern, while biomechanical analysis was possible in 29 cases. Three independent reviewers evaluated each video. The distribution of ACL injuries according to month, timing within the match, and field location at the time of injury was also reported.
In the 35 injury videos, there were 19 (54%) noncontact injuries, 12 (34%) indirect contact injuries, and 4 (11%) direct contact itions.
Female athletes showed remarkable similarities with elite male players in terms of the ACL mechanism and situational pattern of injury, and 88% of injuries involved no direct contact to the knee, with noncontact injuries being highly prevalent. Injuries occurred during 3 main situations, with accompanying alterations in multiplanar biomechanics. Interventions aimed at reducing ACL injuries in women's soccer should consider high-intensity defensive play at the beginning of a match. Instruction in the 3 main situations should be applied alongside appropriate neuromuscular training interventions.High Velocity Compaction (HVC) is a key technology to realize the performance of powder metallurgy parts "three high and one low" (high density, high precision, high performance, and low cost). The main purpose of this paper is to summarize the research results at home and abroad on the forming mechanism, forming influencing factors and theoretical basis of high velocity compaction. This paper analyzes and summarizes the literature and monographs at home and abroad through literature research methods to obtain the research results of high velocity powder metallurgy compaction, so as to fully and correctly understand the research progress, development trends and application prospects of high velocity compaction. This paper expounds the technical characteristics, advantages and limitations of high velocity compaction, and analyzes and looks forward to its development trend, application prospect and expansion field, So as to provide reference and reference for the future research and application direction of high velocity compaction technology.
A very common side effect of non-vitamin K antagonist oral anticoagulant (NOAC) is (minor) bleeding. Data about impact and costs of minor bleeds in NOAC therapy is still limited or not present in current literature. In this patient orientated study, we aim to provide an estimate of the costs of minor bleeds in patients with atrial fibrillation (AF) treated with a NOAC.
A retrospective observational cohort study was conducted. Patients with AF and on NOAC therapy were included. Data was obtained by questionnaires and information from electronic patient records. Reference prices were used to calculate the costs per patient. Furthermore, cost of minor bleeds per patient is compared with literature-based costs of minor and major bleeding.
139 patients were included. A total of 94 minor bleed were reported by 71 patients. The sum of minor bleeding costs from societal perspective were €9,851.49, or on average €70,87 (95% CI €54,37- €85,68) per patient with AF. The biggest cost drivers were rectal and vaginal bleeds, epistaxis was most commonly reported.
Total costs of minor bleeds from a societal perspective, in AF patients using NOACs, are non-trivial and exceed the costs presented in existing literature.
Total costs of minor bleeds from a societal perspective, in AF patients using NOACs, are non-trivial and exceed the costs presented in existing literature.
Those invested in the outcome of specific decisions may seek to inform the decision-maker by generating relevant evidence. With multiple decision-makers, the evidence generator benefits from understanding whether their needs differ. This was explored using relevant stakeholders' preferences on quality indicators (QIs) of rare disease patient registries (RDRs), a common vehicle for generating evidence, to support the adoption of new medicines.
The Jandhyala method was used to compare the observed consensus on RDR quality indicators from each stakeholder group (SHG) and between the combined pharmaceutical (pharma) and non-pharmaceutical (non-pharma) SHG population.
All non-pharmaceutical stakeholder groups were equally unique - suggesting QIs peculiar to themselves - Patients (13/102; 12.75%); Payors (5/102; 4.90%); Prescribers (7/102; 6.86%) to the same degree. Non-pharmaceutical stakeholders generated 31/102 (30.39%) unique QIs. Pharma stakeholder generated 25/102 (24.51%). This totals 56/102 (54.90%) Qment between generator and consumer of its RWE. Pharmaceutical SHG's were highlighted for greater alignment with Patients and Payor (non-pharma) groups.
Home medication review (HMR) programs could minimise patients' health-related costs and burdens, thereby enhancing the quality of life and well-being. The aim of this economic evaluation is to determine if home medication review by community pharmacists (HMR-CP) for patients with type 2 diabetes mellitus (T2DM) is a cost-effective intervention from the Malaysian healthcare provider perspective.
The economic evaluation was conducted alongside the randomised controlled trial (RCT) to estimate the intermediate cost-effectiveness of HMR-CP for patients with T2DM. A Markov model was then constructed to project the lifetime cost-effectiveness data beyond the RCT. The primary outcomes for the economic evaluation were HbA
and quality-adjusted life-years (QALYs).
The intervention and health services costs throughout the 6-month HMR-CP trial were RM121.45 (USD28.64) [95%CI RM115.89 to 127.08 (USD27.33-29.97)] per participant. At a 6-month follow-up, a significant reduction in HbA
of 0.902% (95% CI 0.388% to 1.412%) was noted in the HMR-CP group compared to the control group. The ICER of HMR-CP intervention versus standard care was RM178.82 (USD 42.17) [95%CI RM86.77-364.03 (USD20.46-85.86)] per reduction of HbA
. HMR-CP intervention [RM12,764.82 (USD3010.57)] was associated with an incremental cost of RM83.34 (USD19.66) over control group [RM12,682.95 (USD2,991.26)] with an additional of 0.07 QALY gained. The ICER associated with HMR-CP intervention was RM1,190.57 (USD280.79) per QALY gained, which was below the ICER threshold in Malaysia, indicating that HMR-CP was a cost-effective option.
HMR-CP was a cost-effective intervention that had significantly reduced the HbA
among the T2DM patients, although associated with higher mean total costs per participant.
HMR-CP was a cost-effective intervention that had significantly reduced the HbA1c among the T2DM patients, although associated with higher mean total costs per participant.Health information technology (HIT) can enhance optimal health care access and utilization among individuals living with chronic diseases. This study aimed to provide population-level information on racial/ethnic disparities in HIT use and associated trends among those living with chronic diseases. The study sample consisted of adult respondents (≥18 years) of the 2011-2018 National Health Interview Survey living with at least 1 chronic condition. Binomial regression was used to analyze the association between race/ethnicity, year, and 4 measures of HIT use for patient-provider interaction. Regression parameter estimates were used to predict the trends in probability of the outcome variables across race/ethnicity. About 73% of the study sample were non-Hispanic Whites, 15% were non-Hispanic Blacks, and 13% were Hispanics. Compared to non-Hispanic Whites, there were decreased adjusted odds of any HIT use among non-Hispanic Blacks (OR = 0.72; 95% CI = 0.67, 0.76) and Hispanics (OR = 0.78; 95% CI = 0.72, 0.84). The likelihood of any HIT use increased with increasing year (OR 1.16; 95% CI = 1.15, 1.18). Trends in racial/ethnic disparities were wider for email communication with provider and online prescription refill compared to online scheduling of appointment. The COVID-19 pandemic has led to accelerated adoption or expansion of HIT for patient care. Limited HIT use among non-Hispanic Blacks and Hispanics could worsen the disproportionate chronic disease burden, suboptimal clinical outcomes, and preventable health care costs experienced by this subpopulation. In conclusion, there is a need for intentional and strategic population-level interventions to increase HIT adoption and use among non-Hispanic Blacks and Hispanics living with chronic diseases.We tested the hypothesis that adiponectin deficiency attenuates cardiac and coronary microvascular function and prevents exercise training-induced adaptations of the myocardium and the coronary microvasculature in adult mice. Adult wild-type (WT) or adiponectin knockout (adiponectin KO) mice underwent treadmill exercise training or remained sedentary for 8-10 wk. Systolic and diastolic functions were assessed before and after exercise training or cage confinement. Vasoreactivity of coronary resistance arteries was assessed at the end of exercise training or cage confinement. Before exercise training, ejection fraction and fractional shortening were similar in adiponectin KO and WT mice, but isovolumic contraction time was significantly lengthened in adiponectin KO mice. Exercise training increased ejection fraction (12%) and fractional shortening (20%) with no change in isovolumic contraction time in WT mice. In adiponectin KO mice, both ejection fraction (-9%) and fractional shortening (-12%) were reduced afsent.Endothelial cells (ECs) secrete different paracrine signals that modulate the function of adjacent cells; two examples of these paracrine signals are nitric oxide (NO) and neuregulin-1 (NRG1), a cardioprotective growth factor. Currently, it is undetermined whether one paracrine factor can compensate for the loss of another. Herein, we hypothesized that NRG1 can compensate for endothelial NO synthase (eNOS) deficiency. We characterized eNOS null and wild-type (WT) mice by cardiac ultrasound and histology and we determined circulating NRG1 levels. In a separate experiment, eight groups of mice were divided into four groups of eNOS null mice and WT mice; half of the mice received angiotensin II (ANG II) to induce a more severe phenotype. Mice were randomized to daily injections with NRG1 or vehicle for 28 days. eNOS deficiency increased NRG1 plasma levels, indicating that ECs increase their NRG1 expression when NO production is deleted. eNOS deficiency also increased blood pressure, lowered heart rate, induced cardiac fibrosis, and affected diastolic function. In eNOS null mice, ANG II administration not only increased cardiac fibrosis but also induced cardiac hypertrophy and renal fibrosis. NRG1 administration prevented cardiac and renal hypertrophy and fibrosis caused by ANG II infusion and eNOS deficiency. selleck compound Moreover, Nrg1 expression in the myocardium is shown to be regulated by miR-134. This study indicates that administration of endothelium-derived NRG1 can compensate for eNOS deficiency in the heart and kidneys.NEW & NOTEWORTHY ECs compensate for eNOS deficiency by increasing the secretion of NRG1. NRG1 administration prevents cardiac and renal hypertrophy and fibrosis caused by ANG II infusion and eNOS deficiency. NRG1 expression is regulated by miR-134.
My Website: https://www.selleckchem.com/products/rhapontigenin.html
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