bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shoulder Isokinetic Strength Balance Ratio in Overhead Athletes: A Cross-Sectional Study
Authors: Vargas Valentine Zimermann , Motta Caroline , Vancini Rodrigo Luiz , Barbosa de Lira Claudio Andre , Andrade Marilia Santos 
Published: June 2021

Background Studies have grouped different overhead sports and evaluated together the isokinetic strength of shoulder internal (IR) and external (ER) rotator muscles. However, muscular adaptations could be a consequence of the specific sport, and some strength imbalance between these muscles may exist as a consequence of the muscular demand unique to the sport. Therefore, grouping different overhead sports together may not be adequate. Purpose To compare strength balance ratios between different overhead sports (volleyball, handball, swimming, judo, baseball, softball, functional movements performed at high-intensity interval training, and tennis) with a control athletic group (no overhead group). Study design Cross-sectional study. Methods A total of 237 athletes were submitted to isokinetic shoulder strength tests. The isokinetic concentric and eccentric peak torque values of shoulder internal IR and external ER rotator muscles were measured. Conventional (CR) and functional strength ratios (FR) were calculated. Results There were no significant differences between the sports for the CR in the male group. Female softball athletes (90.4±13.6%) had a significantly higher CR than judo (67.3±6.9%), volleyball (74.9±15.9%), and swimming athletes (70.3±8.7%). In the female group, judo athletes had lower FR values (0.76±0.19) than soccer athletes (1.31±0.35), volleyball athletes (1.24±0.27), functional movements performed at high intensity (1.10±0.1), and softball athletes (1.40±0.39). Female handball athletes also had a lower FR (0.99±0.25) than soccer athletes (1.31±0.35) and softball athletes (1.40±0.39). Male handball (0.90±0.23), tennis (0.86±0.30), and judo (0.68±0.22) athletes had lower FR values than soccer athletes (1.20±0.21) and volleyball athletes (1.25±0.28). Conclusions CR for males may be analyzed together, as there were no significant differences between them. However, for females, the CR for softball athletes should be analyzed individually. As there were several differences between the overhead sports according to the FRs, the authors suggest caution in grouping overhead athletes across multiple sports. These results could have important implications for the design of injury prevention and rehabilitation programs associated with the shoulder joint in overhead sports. Level of Evidence 3
Gluteal Muscle Activation During Common Yoga Poses
Authors: Lehecka B.J. , Stoffregen Sydney , May Adam , Thomas Jacob , Mettling Austin , Hoover Josh , Hafenstine Rex , Hakansson Nils A 
Published: June 2021

Background Approximately 24% of physical therapists report regularly using yoga to strengthen major muscle groups. Although clinicians and athletes often use yoga as a form of strength training, little is known about the activation of specific muscle groups during yoga poses, including the gluteus maximus and medius. Hypothesis/Purpose The purpose of this study was to measure gluteus maximimus and gluteus medius activation via electromyography (EMG) during five common yoga poses. A secondary purpose of the current study was to examine differences in muscle activation between sexes and experience levels. Study Design Cross-Sectional Methods Thirty-one healthy males and females aged 18-35 years were tested during five yoga poses performed in a randomized order. Surface EMG electrodes were placed on subjects’ right gluteus maximus and gluteus medius. Subjects performed the poses on both sides following a maximal voluntary isometric contraction (MVIC) test for each muscle. All yoga pose EMG data were normalized to the corresponding muscle MVIC data. Results Highest gluteus maximus activation occurred during Half Moon Pose on the lifted/back leg (63.3% MVIC), followed by the stance/front leg during Half Moon Pose (61.7%), then the lifted/back leg during Warrior Three Pose (46.1%). Highest gluteus medius activation occurred during Half Moon Pose on the lifted/back leg (41.9%), followed by the lifted/back leg during the Warrior Three Pose (41.6%). A significant difference was found in %MVIC of gluteus medius activity between male and female subjects (p = 0.026), and between experienced and inexperienced subjects (p = 0.050), indicating higher activation among males and inexperienced subjects, respectively. Conclusion Half Moon Pose and Warrior Three Pose elicited the highest activation for both the gluteus maximus and the gluteus medius. Higher gluteus medius activation was seen in males and inexperienced subjects compared to their female and experienced counterparts. Level of Evidence 3
Rehabilitation Following Posterior Shoulder Stabilization
Authors: Goldenberg Brandon T , Goldsten Pamela , Lacheta Lucca , Arner Justin W , Provencher Matthew T , Millett Peter J 
Published: June 2021

Posterior shoulder instability has been noted in recent reports to occur at a higher prevalence than originally believed, with many cases occurring in active populations. In most cases, primary surgical treatment for posterior shoulder instability—a posterior labral repair—is indicated for those patients who have failed conservative management and demonstrate persistent functional limitations. In order to optimize surgical success and return to a prior level of function, a comprehensive and focused rehabilitation program is crucial. Currently, there is a limited amount of literature focusing on rehabilitation after surgery for posterior instability. Therefore, the purpose of this clinical commentary is to present a post-surgical rehabilitation program for patients following posterior shoulder labral repair, with recommendations based upon best medical evidence. Level of Evidence 5
Reliability and Validity of the Y-balance Test in Young Adults with Chronic Low Back Pain
Authors: Alshehre Yousef , Alkhathami Khalid , Brizzolara Kelli , Weber Mark , Wang-Price Sharon 
Published: June 2021

Background Individuals with chronic low back pain (CLBP) may demonstrate reduced ability to perform dynamic tasks due to fear of additional pain and injury in response to the movement. The Y-balance test (YBT) is a functional and inexpensive test used with various populations. However, the reliability and validity of the YBT used for assessing dynamic balance in young adults with CLBP have not yet been examined. Purpose To determine the inter-rater reliability of the YBT and to compare dynamic balance between young adults with CLBP and an asymptomatic group. Study Design Reliability and validity study. Methods Fifteen individuals with CLBP (≥ 12 weeks) and 15 age- and gender-matched asymptomatic adults completed the study. Each group consisted of 6 males and 9 females who were 21-38 years of age (27.47 ± 5.0 years). The YBT was used to measure participant’s dynamic balance in the anterior (ANT), posteromedial (PM) and posterolateral (PL) reach directions. The scores for each participant were independently determined and recorded to the nearest centimeter by two raters. Both the YBT reach distances and composite scores were collected from the dominant leg of asymptomatic individuals and the involved side of participants with CLBP and were used for statistical analysis. Results The YBT demonstrated excellent inter-rater reliability, with intraclass correlation coefficients ranging from 0.99 to 1.0 for the YBT scores of both asymptomatic and CLBP groups. The CLBP group had lower scores than those of the asymptomatic group in the reach distances of the ANT (p = 0.023), PM (p < 0.001), and PL (p = 0.001) directions, and the composite scores (p < 0.001). Conclusions The results demonstrated excellent inter-rater reliability and validity of the YBT for assessing dynamic balance in the CLBP population. The YBT may be a useful tool for clinicians to assess dynamic balance deficits in patients with CLBP. Level of Evidence 2b.
Recommendations for Plyometric Training after ACL Reconstruction – A Clinical Commentary
Authors: Buckthorpe Matthew , Della Villa Francesco 
Published: June 2021

This paper presents a four-stage plyometric program to be undertaken as part of criterion-based rehabilitation for athletes with anterior cruciate ligament reconstruction (ACLR). After ACLR, the patient experiences alterations of joint mobility, gait and movement patterns, neuromuscular function and general physical fitness. Plyometric training is an important component for neuromuscular and movement re-conditioning after ACLR. Effective use of plyometrics can support enhancements in explosive sporting performance, movement quality and lower risk of injury. Plyometric training, as a component of the ACL functional recovery process, can aid in restoring function and supporting timely return to sport. However, few patients undertake or complete a plyometric program prior to return-to-sport. To truly impact individual patients, a stronger focus on research implementation is needed from researchers to translate efficacious interventions into practice. In designing a plyometric program, it is important to match the specific plyometric tasks to the functional recovery status of the ACLR patient. To do this, it is important to understand the relative intensity of plyometrics tasks, align these tasks to the ACL functional recovery process and monitor the athlete as part of criterion based rehabilitation. Plyometric intensity is based on the intensity of efforts, the vertical and/or horizontal momentum prior to ground contact, the ground contact time and the surface or environment on which they are performed on/in. Furthermore, how the person technically performs the task will influence joint loading. There should be a gradual increase in task intensity and specificity throughout the program, with all tasks used for both neuromuscular and motor control re-conditioning. The aim of this paper is to provide recommendations to clinicians on how to design and implement plyometric training programs for the ACLR patient, as part of the functional recovery process. Level of evidence 5
Shoulder Strength and Closed Kinetic Chain Upper Extremity Stability Test Performance in Division III Collegiate Baseball and Softball Players.
Authors: Schilling David T. , Elazzazi Ashraf M. 
Published: June 2021

Background Shoulder strength measured with a handheld dynamometer (HHD) and the Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) are clinical tools that have been used to measure athlete’s performance and track their progress. Purpose The specific aims of this study were to describe baseball (BB) and softball (SB) players isometric strength measures and their performance on the CKCUEST; examine the relationships between strength and the CKCUEST; compare isometric strength measures of the throwing and non-throwing arms; and compare the strength and the CKCUEST measures between BB and SB players. Study Design Observational cohort study. Methods Participants included 50 DIII BB and 24 DIII SB players. Shoulder strength for the internal and external rotators were measured using a HHD and the CKCUEST was performed. The CKCUEST score and power were calculated. Descriptive statistics and paired t-tests were used to compare throwing and non-throwing shoulder strength. Independent t-test was used to compare BB and SB players shoulder strength and the CKCUEST measures. Results The BB players demonstrated significant strength differences between the throwing and non-throwing shoulders and the internal rotators were significantly stronger than the external rotators (p < 0.05), while the strength ratio of the internal and external rotators was not different between arms (p=0.87). The SB players demonstrated no significant strength differences between the throwing and non-throwing shoulders for the internal and external rotators or the strength ratio of the rotators (p > 0.05). There were no significant differences between the strength of the internal and external rotators of the non-throwing shoulder (p=0.075) or the throwing shoulder (p=0.096). The BB players throwing and non-throwing shoulders produced significantly more internal and external force than the SB players (p < 0.001), however, the internal/external rotators strength ratio were similar (p=0.32, p=0.30). The CKCUEST power had inverse and significant correlations (p=0.006, p=0.003) with SB players internal and external rotators, respectively. The CKCUEST power was significantly different between BB and SB players (p < 0.001). Conclusion This study presented shoulder rotator strength and CKCUEST reference values for DIII BB and SB players. BB players demonstrated more strength but overall, less symmetry compared to SB players. CKCUEST power may be considered for the evaluation of athletes. Level of Evidence Level III
Post-traumatic cerebrospinal fluid rhinorrhea and Transcranial approach surgical outcomes.
Authors: Kalhoro Aurangzeb , Samad Abdul , Javeed Farrukh , Hassan Sher , Rehman Lal 
Published: June 2021

Objective: To assess the outcomes of the transcranial approach in traumatic cerebrospinal fluid rhinorrhea. Study Design: Descriptive study. Setting: J.P.M.C, Karachi. Period: 15-1-2017 to 17-7- 2019. Material & Method: Total of 57 patient were included. Including criteria were patient with a history of trauma, fall, assault, and delayed onset, however, patients presenting with spontaneous cerebrospinal fluid (CSF) rhinorrhea, brain abscess, brain space-occupying lesion, skull base surgery operated elsewhere were excluded. fasia lata, Pericranial flaps were used for the surgical repair. Data were analyzed on SPSS version 22.0. Result: Patients gone through the surgical approach having intradural repair in all patients, 25 (43.85%) patients with fasia lata graft while pericranium in 32 (56.1%) and the defect was filled with small bone pieces. In 38(66.6%) unilateral sub frontal approach was done while in 19 patients (33.3 %%) bicoronal craniotomy was carried out. All patient had dura defected, 37 patients (64.9%) had a fractured cribriform plate, 9 (15%) patient had fovea ethmoidal fracture. 30(52.63%) had right side leak, 20 had left side leak (35%), 7(12.28%) had bilateral from both nasals leakage. No reoperation was done. 93% procedure showed successfully. Conclusions: This method is effective with the low rate of morbidity in patients, it can be preferred for traumatic cerebrospinal fluid (CSF) leaks with the injuries associated with the brain, recurrent leak cases with a success rate of > 93%
The Impact of Surfactant Administration Techniques (LISA vs INSURE) on the Outcomes of Respiratory Distress Syndrome in premature babies.
Authors: Rehman Abdur , Ahmad Munir , Quddusi Ahmad Iqbal , Nadeem Aashee , Iqbal Imran 
Published: June 2021

Objective: We aimed this study to find out the Impact of Surfactant Administration Techniques (LISA vs INSURE) on the Outcomes of RDS in premature newborns. Study Design: Retrospective study. Setting: Children’s Hospital and The institute of Child Health Multan. Period: October 2018 to March 2020. Material & Methods: 159 premature babies reported with RDS at Institute of child health, Multan were evaluated. Out of these 87 infants were given surfactant through LISA technique and 72 were given through INSURE. The surfactant used for all these babies was proractant alpha. Results: The duration of oxygen (O2) therapy was significantly less in LISA group (14.87 ± 11.21 days) as compare to INSURE (19.67 ± 9.79 days), p <0.001. Number of patients who require mechanical ventilation was (23% vs 44%, p< 0.05) and median days of nCPAP was (10.74 ± 3.07 vs 15.12 ± 8.79, p<0.05). Our analysis shows that no significant difference in mortality, incidence of air leak and bronchopulmonary dysplasia (BPD) between the two groups. Conclusion: Patients administered surfactant through LISA technique requires significantly less duration of oxygen therapy and need of mechanical ventilation as well as duration of nCPAP. We conclude that LISA technique is preferable method for surfactant administration in premature infants.
Immobilization of Nuclear Waste Using Carbon Nanotubes Prepared by Laser Ablation in Liquid Method
Authors: Abed al-hussein Thuraya amer , Jaber Ghufran S. 
Published: June 2021

In an attempt to disposal from nuclear waste which threats our health and environments. Therefore we have to find appropriate method to immobilize nuclear waste. So, in this research the nuclear waste (Strontium hydroxide) was immobilized by Carbon nanotubes (CNTs). The Nd-YAG laser with wave length 1064 nm, energy 750 mJ and 100 pulses used to prepare CNTs. After that adding Sr(HO)2 powder to the CNTs colloidal in calculated rate to get homogenous mixing of CNTs-Sr(OH)2. The Sr(HO)2 absorbs carbon dioxide from the air to form strontium carbonate so, the new solution is CNTs-SrCO3. To dry solution putting three drops from the new solution on the glass slides. To investigate the radiation damage on CNTs structure, the sample was irradiation by Beta source (90Sr/90Y) for different period of time. The structure properties were measured using X-ray diffraction XRD while the shape and size property was measured by scanning electron microscope SEM.
The result shows homogenous distribution of nanoparticles with average particle size about 20nm. The XRD spectra for all sample before and after irradiation shows the higher peaks that it’s almost appearance at 2 = 25 degree and when compared the XRD phase with Standard card the resultant nanomaterial is Strontium carbonite (SrCo3). From SEM micrograph, CNTs-SrCO3 were well decorated on the surface of CNTs and there was not any remarkable difference in the corresponding due to Beta radiation exposure.
A Study of Crystallographic and DC Electrical Characteristics of PPy/Ag Nanocomposites
Authors: Salman Mohammed abdilridha , Hassan Salma M. 
Published: June 2021

ABSTRACT: Polypyrrole and polypyrrole / silver nanocomposites were fabricated by in-situ polymerization employing Ammonium Persulphate as an oxidizing agent. Nanocomposites were synthesized by combining polypyrrole and silver nanoparticles in various weight percentages (0.1%, 0.5%, 3%, 5% and 7% wt.). Crystallographic data were collected using X-ray diffraction. PPy particles were found to have an orthorhombic symmetry. In contrast, PPy/Ag nanocomposites were reported to have monoclinic structure. The crystallite size was determined by XRD using Scherrer equation and considered to be within 49 nm range. DC conductivity of pelletized samples was evaluated in the temperature range of 323.15k to 453.15k. The conductivity displayed an increase when the temperature is increased from 323.15k to 453.15k. Activation energies were determined from plots of Arrhenius for all nanocomposites. The findings indicated that the activation energy decrease with increasing the weight percentage of Ag nanoparticles in the nanocomposites.
Restarting endoscopy services in Pakistan, in the covid era: The way forward
Authors: Samejo Shoukat Ali , Kadir Shanil , Niaz Saad Khalid 
Published: June 2021

Background: The emergence of SARS-COVID2 has completely reshaped the way we go about our daily business. Apart from other services, this has also impacted healthcare services and the way they are delivered. As endoscopy is an Aerosol generating procedure(AGP) with high risk of transmission, multiple endoscopy societies at the peak of the pandemic published guidelines on prioritizing of endoscopy services according to the urgency, highlighting the clinical indications which could be deferred until a more comprehensive plan is put out to safely perform endoscopy procedures or the infection rates drop down.
Aims and Objectives: We give an example of how our unit in a low Human development Index country, worked through the peak of pandemic providing service to patients in a safe manner which can be continued forward until the pandemic runs its course.
Materials and Methods: This prospective study was performed at Dr. Ziauddin University Hospital, Karachi. The ethical endorsement was taken from the Ethical Review Committee. Informed consent was secured in writing from each participant.Patients were assessed by a given screening questionnaire and COVID RT PCR of every patient was checked before endoscopy procedures, only those who tested negative were included in the study. Theendoscopy consultant, endoscopy trainee, anesthetist and the endoscopy staff along with the patients were reassessed for signs & symptoms of COVID-19 via a telephonic questionnaire, 2 weeks after the procedure.
Results : Total 80 patients were assessed, out of which 60 were males. All the patients had negative COVID-19 PCR at the time of endoscopy. The procedures were performed under propofol sedation with full Personal protective equipment (PPE) both for the endoscopist and the staff in the room. The PPE included N95 masks, hairnet, Face visor, surgical gloves and disposable gowns. 2 weeks post procedure both the patients and the endoscopy staff were assessed via telephonic questionnaire for any signs & symptoms of COVID-19 or any positive COVID PCR since the time of endoscopy.
Conclusion: SARS-COVID 19 pandemic is far from over. There is a dire need to restart endoscopy services in a safe and effective way. Ideally full PPE and negative pressure rooms for AGP is the way forward considering that quite a few patients are asymptomatic carriers and the dismissal rate of COVID PCR pick up rate .In low socioeconomic countries these facilities are not readily available. Hence doing a COVID PCR prior to the procedure with adequate PPE can be used as a way forward in COVID era until the pandemic is over.
A Clinical Study of Obstetrical and Perinatal Outcome In Teenage Pregnancies In Central Referral Hospital (CRH), Gangtok
Authors: Aggarwal Ashita , Pradhan Anup 
Published: June 2021

Background: Teenage pregnancy can be defined as pregnancy that occurs after menarche up to the age of 19 years. It is one of the important causes of maternal as well as neonatal morbidity and mortality. There is an increased incidence of preterm deliveries in teenage girls with its associated complications in newborn such as increased incidence of hyaline membrane disease in newborn baby, anaemia of prematurity, neonatal hypoglycaemia, hyperbilirubinemia and need for neonatal intensive care unit admissions.
Aims and Objectives: 1.To assess the quantum of problem of teenage pregnancy. 2. To ascertain the different risk factors associated with teenage pregnancy. 3. To evaluate outcome of pregnancy in teenage mothers. 4. Todetermine the extent and association of teenage pregnancy with poor obstetric outcome.
Materials and Methods: It was a hospital based prospective case control study. All teenage pregnant patients who were admitted during the study period were included in the study and a representative group of equal number of non-teenage pregnant women who were admitted during the study period were included in the study. For statistical purposes p value less than 0.05 was taken as statistically significant.
Results: The most common single complication in teenage pregnancies was found to be preterm deliveries which was seen in 15 (12%) patients followed by fetal distress (10.40%) Pre-Eclampsia (6.40%) and PROM (4.80%). Amongst non-teenage pregnancies the common complications seen were fetal distress (17.60%), PROM (8.80%). The incidence of PPH was found to be high in teenage pregnancies as compared to non-teenage pregnancies. The comparison of the neonates on the basis of incidence of low birth weight (LBW) showed that more LBW babies were born to teenage mother as compared to non-teenage pregnancies and the difference was found to be statistically significant (P<0.05).
Conclusion: Teenage pregnancy is associated with increased incidence of maternal as well as neonatal complications. In additions to maternal and neonatal complications it also has an immense impact on psychosocial consequences on teenage mothers.