The influence of limb role, direction of movement and limb dominance on movement strategies during block jump-landings in volleyball

The identification of movement strategies in situations that are as ecologically valid as possible is essential for the understanding of lower limb interactions. This study considered the kinetic and kinematic data for the hip, knee and ankle joints from 376 block jump-landings when moving in the dominant and non-dominant directions from fourteen senior national female volleyball players. Two Machine Learning methods were used to generate the models from the dataset, Random Forest and Artificial Neural Networks. In addition, decision trees were used to detect which variables were relevant to discern the limb movement strategies and to provide a meaningful prediction. The results showed statistically significant differences when comparing the movement strategies between limb role (accuracy > 88.0% and > 89.3%, respectively), and when moving in the different directions but performing the same role (accuracy > 92.3% and > 91.2%, respectively). This highlights the importance of considering limb dominance, limb role and direction of movement during block jump-landings in the identification of which biomechanical variables are the most influential in the movement strategies. Moreover, Machine Learning allows the exploration of how the joints of both limbs interact during sporting tasks, which could provide a greater understanding and identification of risky movements and preventative strategies. All these detailed and valuable descriptions could provide relevant information about how to improve the performance of the players and how to plan trainings in order to avoid an overload that could lead to risk of injury. This highlights that, there is a necessity to consider the learning models, in which the spike approach unilaterally is taught before the block approach (bilaterally). Therefore, we support the idea of teaching bilateral approach before learning the spike, in order to improve coordination and to avoid asymmetries between limbs.

Efficacy of percutaneous transforaminal endoscopic discectomy unilateral and bilateral approach for bilateral decompression in treatment of degenerative lumbar spinal stenosis and their effects on quality of life

This study aimed to explore the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) unilateral and bilateral approach for bilateral decompression in the treatment of degenerative lumbar spinal stenosis (DLSS) and their effects on quality of life. Altogether 119 patients with DLSS admitted to our hospital from May 2012 to February 2014 were enrolled in this study. Patients in Group A (62 cases) were treated with PTED bilateral approach for bilateral decompression, while those in Group B (57 cases) were treated with PTED unilateral approach for bilateral decompression. The therapeutic effect and incidence of complications in the two groups were observed. Visual Analogue Scale (VAS) was used to assess the pain degree of the lower limbs. Oswestry Disability Index (ODI) was used to assess the improvement of neurological function. 36-ltem Short Form Health Survey (SF-36) developed by the Institute of Medicine was used to assess the quality of life. There were no significant differences between Group A and Group B in operative time, intraoperative blood loss, hospitalization time, the effective rate of treatment, and the incidence of complications (P>0.05). The recovery time of lumbar function in Group A was significantly shorter than that in Group B (P<0.01). VAS and ODI scores at 1, 3, and 6 months after operation in Group A were significantly lower than those in Group B (P<0.05). The scores of general health (GH), bodily pain (BP), social function (SF), vitality (VT), and mental health (MH) at 6 months after operation in Group A were significantly higher than those in Group B (P<0.05). In conclusion, PTED bilateral approach for bilateral decompression was effective in the treatment of patients with DLSS. It can promote the recovery of their lumbar function and neurological function, and improve their quality of life.

Safety and Efficacy of the Draf IIb Procedure: A Systematic Review

Objectives To systematically review the literature to evaluate the indications, safety, and efficacy of the Draf IIb procedure and to evaluate the added advantages of technical factors such as stents and flaps. Data Sources Articles published until July 2019 on Medline and Cochrane databases. Review Methods After a systematic review based on the 2018 PRISMA guidelines was conducted, 26 of 1533 articles were included and reviewed for indications of Draf IIb; surgical technique; use of flaps, stents, grafts, or mitomycin; complications during and after surgery; and success or recurrence rate. Results The main indication for Draf IIb was chronic frontal rhinosinusitis (61.82%). The postoperative patency rate was 87.85%. When flaps/grafts were applied, the rate was 93.5%, but their added value was not statistically significant. Stents could be an alternative for revision surgery. Treating frontal pathologies other than chronic rhinosinusitis was also satisfying. Safety was comparable to Draf III: no perioperative complications were reported, only a few postoperative ones (eyelid ecchymosis and periorbital cellulitis in 0.2% of the cases, hyposmia in 1.55%). Conclusion When properly indicated, Draf IIb frontal drilling is a safe and highly effective surgical technique for frontal pathology treatment, with efficiency and safety comparable to the Draf III, making it a valid option when a bilateral approach is not needed. More studies are required to confirm the added values of flaps, grafts, and stents.

Risk factors for need of reoperation in bilateral chronic subdural haematomas

Background Chronic subdural haematoma (CSDH) is one of the most common neurosurgical diseases. A subtype of CSDH is bilateral chronic subdural haematoma (bCSDH) which represents 20–25% of patients with CSDH and has a higher recurrence rate. There is no clear consensus on how bCSDH should be treated regarding upfront unilateral- or bilateral evacuation of both haematomas. The purpose of this study was to identify risk factors associated with reoperation of bCSDH. Methods A total of 326 patients with radiological evidence of bCSDH were included in this retrospective cohort study where 133 (40.8%) patients underwent primary bilateral evacuation and 193 (59.2%) primary unilateral evacuation. The two centres operated using different surgical approaches. Analyses were performed to identify risk factors associated with reoperation of bCSDH. Reoperation rate was defined as reoperation of CSDH on either side of the hemisphere within 3 months after primary evacuation. Results The cohort had a total reoperation rate of 26.4%. Patients which underwent unilateral evacuation had a reoperation rate of 32.1%, and the bilateral group had a reoperation rate of 18.0% (p=0.005). Multivariable logistic regression identified unilateral evacuation (OR 1.91, p=0.022) and complications according to Ibanez (OR 2.20, p=0.032) to be associated with the need of reoperation of bCSDH. One-burr hole craniostomy with active subgaleal drain was primarily performed in bilateral approach (69.4%) whereas patients operated with minicraniotomy with passive subdural drain were primarily operated by unilateral evacuation of the larger symptomatic side (92.8%). Conclusions Unilateral evacuation of bCSDH was associated with a higher risk for reoperation than upfront bilateral evacuations in this study. There is a need to further discuss the criteria for uni- or bilateral evacuation since patients are treated differently at different centres.

What Biden may bring to the Eastern Mediterranean Region

This paper aims to forecast the route that Joe Biden, will take in his foreign policy toward the Eastern Mediterranean, by trying to analyze the content of his speeches and rhetoric before and shortly after taking office. In this context, America’s relation to Turkey will be pivotal in order to gauge the impact of any change in U.S. course. After four years of Trump’s doctrine of ‘America First’ and his bilateral approach, there are many expectations that the newly elected president will follow a more multilateral approach and will put more importance on international organizations and alliances across the Atlantic. Those expectations are more like wishes, however, when it comes to the Eastern Mediterranean, which is on the verge of a critical standoff between Turkey and its neighbors. There are some speculations that Biden will take a more affirmative stance against Turkey. Indeed, Biden has stressed the value of cooperating with allies to achieve foreign policy objectives. But despite the harsh language, Biden used during his election campaign to describe Turkey’s leadership, it is still unclear whether Biden will place the U.S. on a collision course with Turkey.

Efficacy of Percutaneous Transforaminal Endoscopic Discectomy Unilateral and Bilateral Approach for Bilateral Decompression in Treatment of Degenerative Lumbar Spinal Stenosis and Their Effects on Quality of Life

This study aimed to explore the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) unilateral and bilateral approach for bilateral decompression in the treatment of degenerative lumbar spinal stenosis (DLSS) and their effects on quality of life. Altogether 119 patients with DLSS admitted to our hospital from May 2012 to February 2014 were enrolled in this study. Patients in Group A (62 cases) were treated with PTED bilateral approach for bilateral decompression, while those in Group B (57 cases) were treated with PTED unilateral approach for bilateral decompression. The therapeutic effect and incidence of complications in the two groups were observed. Visual Analogue Scale (VAS) was used to assess the pain degree of the lower limbs. Oswestry Disability Index (ODI) was used to assess the improvement of neurological function. 36-Item Short Form Health Survey (SF-36) developed by the Institute of Medicine was used to assess the quality of life. There were no significant differences between Group A and Group B in operative time, intraoperative blood loss, hospitalization time, the effective rate of treatment, and the incidence of complications (P>0.05). The recovery time of lumbar function in Group A was significantly shorter than that in Group B (P<0.01). VAS and ODI scores at 1, 3, and 6 months after operation in Group A were significantly lower than those in Group B (P<0.05). The scores of general health (GH), bodily pain (BP), social function (SF), vitality (VT), and mental health (MH) at 6 months after operation in Group A were significantly higher than those in Group B (P<0.05). In conclusion, PTED bilateral approach for bilateral decompression was effective in the treatment of patients with DLSS. It can promote the recovery of their lumbar function and neurological function, and improve their quality of life.