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Archives of Orthopaedic and Trauma... Aug 2013Lateral ankle sprains are common musculoskeletal injuries. (Review)
Review
BACKGROUND
Lateral ankle sprains are common musculoskeletal injuries.
OBJECTIVES
The objective of this study was to perform a systematic literature review of the last 10 years regarding evidence for the treatment and prevention of lateral ankle sprains.
DATA SOURCE
Pubmed central, Google scholar.
STUDY ELIGIBILITY CRITERIA
Meta-analysis, prospective randomized trials, English language articles.
INTERVENTIONS
Surgical and non-surgical treatment, immobilization versus functional treatment, different external supports, balance training for rehabilitation, balance training for prevention, braces for prevention.
METHODS
A systematic search for articles about the treatment of lateral ankle sprains that were published between January 2002 and December 2012.
RESULTS
Three meta-analysis and 19 articles reporting 16 prospective randomized trials could be identified. The main advantage of surgical ankle ligament repair is that objective instability and recurrence rate is less common when compared with non-operative treatment. Balancing the advantages and disadvantages of surgical and non-surgical treatment, we conclude that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery. For non-surgical treatment, long-term immobilization should be avoided. For grade III injuries, however, a short period of immobilization (max. 10 days) in a below knee cast was shown to be advantageous. After this phase, the ankle is most effectively protected against inversion by a semi-rigid ankle brace. Even grades I and II injuries are most effectively treated with a semi-rigid ankle brace. There is evidence that treatment of acute ankle sprains should be supported by a neuromuscular training. Balance training is also effective for the prevention of ankle sprains in athletes with the previous sprains. There is good evidence from high level randomized trials in the literature that the use of a brace is effective for the prevention of ankle sprains.
CONCLUSION
Balancing the advantages and disadvantages of surgical and non-surgical treatment, we conclude that the majority of grades I, II and III lateral ankle ligament ruptures can be managed without surgery. The indication for surgical repair should be always made on an individual basis. This systematic review supports a phase adapted non-surgical treatment of acute ankle sprains with a short-term immobilization for grade III injuries followed by a semi-rigid brace. More prospective randomized studies with a longer follow-up are needed to find out what type of non-surgical treatment has the lowest re-sprain rate.
Topics: Acute Disease; Ankle Injuries; Humans; Lateral Ligament, Ankle; Prospective Studies; Randomized Controlled Trials as Topic; Sprains and Strains
PubMed: 23712708
DOI: 10.1007/s00402-013-1742-5 -
Science China. Mathematics 2023Simultaneously investigating multiple treatments in a single study achieves considerable efficiency in contrast to the traditional two-arm trials. Balancing treatment...
Simultaneously investigating multiple treatments in a single study achieves considerable efficiency in contrast to the traditional two-arm trials. Balancing treatment allocation for influential covariates has become increasingly important in today's clinical trials. The multi-arm covariate-adaptive randomized clinical trial is one of the most powerful tools to incorporate covariate information and multiple treatments in a single study. Pocock and Simon's procedure has been extended to the multi-arm case. However, the theoretical properties of multi-arm covariate-adaptive randomization have remained largely elusive for decades. In this paper, we propose a general framework for multi-arm covariate-adaptive designs which also includes the two-arm case, and establish the corresponding theory under widely satisfied conditions. The theoretical results provide new insights into the balance properties of covariate-adaptive randomization procedures and make foundations for most existing statistical inferences under two-arm covariate-adaptive randomization. Furthermore, these open a door to study the theoretical properties of statistical inferences for clinical trials based on multi-arm covariate-adaptive randomization procedures.
PubMed: 35912316
DOI: 10.1007/s11425-020-1954-y -
Qualitative Health Research May 2011In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of... (Review)
Review
In this article we explore the concept of balance in the context of health. We became interested in balance during a grounded theory study of lay conceptualizations of cancer risk in which participants were concerned with having a good life, which relied heavily on balancing processes. This led us to the qualitative literature about balance in the context of health, which was large and in need of synthesis. We identified 170 relevant studies and used Thomas and Harden's technique of thematic synthesis to identify key balance-related themes and develop these into more abstract analytic categories. We found that balance and balancing were salient to people in three health-related contexts: health maintenance, disease or disability management, and lay or professional caregiving. In each of these contexts, balance or imbalance could be a state or a process. In addition, those using the word balance had either an internally or externally focused orientation to the world around them. Clinicians and public health practitioners might benefit from using these insights in their research and communication.
Topics: Adaptation, Psychological; Communication; Disease Management; Health Behavior; Health Status; Humans; Interpersonal Relations; Postural Balance; Psychological Theory; Qualitative Research; Risk; Sensation Disorders; Social Support; Stress, Psychological
PubMed: 21343435
DOI: 10.1177/1049732311399781 -
Cellular and Molecular Bioengineering Aug 2022First-generation college students face unique challenges compared to non-first-generation college students, especially in STEM fields. First-generation STEM students...
First-generation college students face unique challenges compared to non-first-generation college students, especially in STEM fields. First-generation STEM students drop out of their major at higher rates than non-first-generation students. This may be due to a lack of role models or mentorship in the college environment or in the field, a challenging curriculum, and difficulty balancing personal and academic commitments. There has been a lack of significant attention given to studying first-generation college students in undergraduate engineering, and therefore, there is limited understanding of how to navigate post-secondary education as a first-generation college student to succeed in undergraduate engineering. Here, I lay out tips for success based on my own experience as a first-generation student in engineering. This includes how to find the right major for you, adjust to college, have a solid support system, seek out research opportunities, become involved in outreach, experience inclusivity, balance courses with other commitments, and apply for scholarships. This article also discusses considerations in pursuing graduate education. With more support, mentoring and guidance, a greater percentage of first-generation students will succeed in pursuing undergraduate engineering degrees.
PubMed: 36119133
DOI: 10.1007/s12195-022-00736-w -
Neuron Nov 2021Many studies have shown that the excitation and inhibition received by cortical neurons remain roughly balanced across many conditions. A key question for understanding... (Review)
Review
Many studies have shown that the excitation and inhibition received by cortical neurons remain roughly balanced across many conditions. A key question for understanding the dynamical regime of cortex is the nature of this balancing. Theorists have shown that network dynamics can yield systematic cancellation of most of a neuron's excitatory input by inhibition. We review a wide range of evidence pointing to this cancellation occurring in a regime in which the balance is loose, meaning that the net input remaining after cancellation of excitation and inhibition is comparable in size with the factors that cancel, rather than tight, meaning that the net input is very small relative to the canceling factors. This choice of regime has important implications for cortical functional responses, as we describe: loose balance, but not tight balance, can yield many nonlinear population behaviors seen in sensory cortical neurons, allow the presence of correlated variability, and yield decrease of that variability with increasing external stimulus drive as observed across multiple cortical areas.
Topics: Cerebral Cortex; Models, Neurological; Neurons
PubMed: 34464597
DOI: 10.1016/j.neuron.2021.07.031 -
Critical Care (London, England) 2010The present review of fluid therapy studies using balanced solutions versus isotonic saline fluids (both crystalloids and colloids) aims to address recent controversy in... (Comparative Study)
Comparative Study Review
The present review of fluid therapy studies using balanced solutions versus isotonic saline fluids (both crystalloids and colloids) aims to address recent controversy in this topic. The change to the acid-base equilibrium based on fluid selection is described. Key terms such as dilutional-hyperchloraemic acidosis (correctly used instead of dilutional acidosis or hyperchloraemic metabolic acidosis to account for both the Henderson-Hasselbalch and Stewart equations), isotonic saline and balanced solutions are defined. The review concludes that dilutional-hyperchloraemic acidosis is a side effect, mainly observed after the administration of large volumes of isotonic saline as a crystalloid. Its effect is moderate and relatively transient, and is minimised by limiting crystalloid administration through the use of colloids (in any carrier). Convincing evidence for clinically relevant adverse effects of dilutional-hyperchloraemic acidosis on renal function, coagulation, blood loss, the need for transfusion, gastrointestinal function or mortality cannot be found. In view of the long-term use of isotonic saline either as a crystalloid or as a colloid carrier, the paucity of data documenting detrimental effects of dilutional-hyperchloraemic acidosis and the limited published information on the effects of balanced solutions on outcome, we cannot currently recommend changing fluid therapy to the use of a balanced colloid preparation.
Topics: Acidosis; Animals; Body Fluids; Clinical Trials as Topic; Colloids; Crystalloid Solutions; Fluid Therapy; Humans; Isotonic Solutions; Rehydration Solutions; Sodium Chloride; Water-Electrolyte Balance
PubMed: 21067552
DOI: 10.1186/cc9230 -
BMC Medical Research Methodology Jun 2023In the causal analysis of observational studies, covariates should be carefully balanced to approximate a randomized experiment. Numerous covariate balancing methods...
BACKGROUND
In the causal analysis of observational studies, covariates should be carefully balanced to approximate a randomized experiment. Numerous covariate balancing methods have been proposed for this purpose. However, it is often unclear what type of randomized experiments the balancing approaches aim to approximate; and this may cause ambiguity and hamper the synthesis of balancing characteristics within randomized experiments.
METHODS
Randomized experiments based on rerandomization, known for significant improvement on covariate balance, have recently gained attention in the literature, but no attempt has been made to integrate this scheme into observational studies for improving covariate balance. Motivated by the above concerns, we propose quasi-rerandomization, a novel reweighting method, where observational covariates are rerandomized to be the anchor for reweighting such that the balanced covariates obtained from rerandomization can be reconstructed by the weighted data.
RESULTS
Through extensive numerical studies, not only does our approach demonstrate similar covariate balance and comparable estimation precision of treatment effect to rerandomization in many situations, but it also exhibits advantages over other balancing techniques in inferring the treatment effect.
CONCLUSION
Our quasi-rerandomization method can approximate the rerandomized experiments well in terms of improving the covariate balance and the precision of treatment effect estimation. Furthermore, our approach shows competitive performance compared with other weighting and matching methods. The codes for the numerical studies are available at https://github.com/BobZhangHT/QReR .
PubMed: 37391690
DOI: 10.1186/s12874-023-01977-7 -
Clinics in Orthopedic Surgery Mar 2014A goal of total knee arthroplasty is to obtain symmetric and balanced flexion and extension gaps. Controversy exists regarding the best surgical technique to utilize to... (Review)
Review
A goal of total knee arthroplasty is to obtain symmetric and balanced flexion and extension gaps. Controversy exists regarding the best surgical technique to utilize to obtain gap balance. Some favor the use of a measured resection technique in which bone landmarks, such as the transepicondylar, the anterior-posterior, or the posterior condylar axes are used to determine proper femoral component rotation and subsequent gap balance. Others favor a gap balancing technique in which the femoral component is positioned parallel to the resected proximal tibia with each collateral ligament equally tensioned to obtain a rectangular flexion gap. Two scientific studies have been performed comparing the two surgical techniques. The first utilized computer navigation and demonstrated a balanced and rectangular flexion gap was obtained much more frequently with use of a gap balanced technique. The second utilized in vivo video fluoroscopy and demonstrated a much high incidence of femoral condylar lift-off (instability) when a measured resection technique was used. In summary, the authors believe gap balancing techniques provide superior gap balance and function following total knee arthroplasty.
Topics: Arthroplasty, Replacement, Knee; Fluoroscopy; Humans; Knee Joint; Surgery, Computer-Assisted; Treatment Outcome
PubMed: 24605183
DOI: 10.4055/cios.2014.6.1.1 -
Frontiers in Psychology 2023We aimed to identify different, both balanced and imbalanced, effort-reward profiles and their relations to several indicators of employee well-being (work engagement,...
Overbenefitting, underbenefitting, and balanced: Different effort-reward profiles and their relationship with employee well-being, mental health, and job attitudes among young employees.
We aimed to identify different, both balanced and imbalanced, effort-reward profiles and their relations to several indicators of employee well-being (work engagement, job satisfaction, job boredom, and burnout), mental health (positive functioning, life satisfaction, anxiety, and depression symptoms), and job attitudes (organizational identification and turnover intention). We examined data drawn randomly from Finnish population ( = 1,357) of young adults (23-34 years of age) collected in the summer of 2021 with quantitative methods. Latent profile analysis revealed three emerging groups in the data characterized by different combinations of efforts and rewards: underbenefitting (16%, high effort/low reward), overbenefitting (34%, low effort/high reward), and balanced employees (50%, same levels of efforts and rewards). Underbenefitting employees reported poorest employee well-being and mental health, and more negative job attitudes. In general, balanced employees fared slightly better than overbenefitting employees. Balanced employees experienced higher work engagement, life satisfaction, and less depression symptoms. The findings highlight the importance of balancing work efforts with sufficient rewards so that neither outweighs the other. This study suggests that the current effort-reward model would benefit from conceptualizing the previously ignored perspective of overbenefitting state and from considering professional development as one of the essential rewards at work.
PubMed: 37051602
DOI: 10.3389/fpsyg.2023.1020494 -
Genes & Nutrition 2018Humans are not autonomous entities. We are all living in a complex environment, interacting not only with our peers, but as true holobionts; we are also very much in... (Review)
Review
Humans are not autonomous entities. We are all living in a complex environment, interacting not only with our peers, but as true holobionts; we are also very much in interaction with our coexisting microbial ecosystems living on and especially within us, in the intestine. Intestinal microorganisms, often collectively referred to as intestinal microbiota, contribute significantly to our daily energy uptake by breaking down complex carbohydrates into simple sugars, which are fermented to short-chain fatty acids and subsequently absorbed by human cells. They also have an impact on our immune system, by suppressing or enhancing the growth of malevolent and beneficial microbes. Our lifestyle can have a large influence on this ecosystem. What and how much we consume can tip the ecological balance in the intestine. A "western diet" containing mainly processed food will have a different effect on our health than a balanced diet fortified with pre- and probiotics. In recent years, new technologies have emerged, which made a more detailed understanding of microbial communities and ecosystems feasible. This includes progress in the sequencing of PCR-amplified phylogenetic marker genes as well as the collective microbial metagenome and metatranscriptome, allowing us to determine with an increasing level of detail, which microbial species are in the microbiota, understand what these microorganisms do and how they respond to changes in lifestyle and diet. These new technologies also include the use of synthetic and in vitro systems, which allow us to study the impact of substrates and addition of specific microbes to microbial communities at a high level of detail, and enable us to gather quantitative data for modelling purposes. Here, we will review the current state of microbiome research, summarizing the computational methodologies in this area and highlighting possible outcomes for personalized nutrition and medicine.
PubMed: 29556373
DOI: 10.1186/s12263-018-0594-6