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Zielsetzung: Postoperative Schmerzen zu lindern und die Genesung zu fördern, ist das Ziel der osteopathischen Manipulationstherapie (OMT) bei chirurgischen Patient*innen. Die Auswirkungen der OMT wurden bei herzchirurgischen Patient*innen nicht umfassend untersucht, was vor allem darauf zurückzuführen ist, dass nur wenige osteopathisch tätige Ärztinnen und Ärzte eine thoraxchirurgische Ausbildung haben. Methoden: Systematische Literaturrecherche zur Ermittlung aller derzeit verfügbaren Daten zur postoperativen OMT bei herzchirurgischen Patient*innen; Ausschluss von Fallberichten und Fallserien. Das Risiko einer Verzerrung wurde anhand spezifischer Protokolle für jede Studie einzeln bewertet. Zu den interessierenden Ergebnissen gehörten postoperative Schmerzen, Dauer des Krankenhausaufenthalts, Veränderungen der Atmungskapazität sowie Veränderungen von Herzindex und gemischtvenösen Sauerstoffsättigung (SvO2). Ergebnisse: In die quantitative Analyse dieser Übersichtsarbeit wurden 4 in Frage kommende Studien einbezogen: 3 randomisierte kontrollierte Studien (RCTs) und 1 nicht-randomisierte kontrollierte Kohortenstudie. Die am häufigsten durchgeführten herzchirurgischen Eingriffe waren koronare Bypass-OPs, Klappen- und kombinierte Eingriffe und Aortenoperationen. Postoperativ wurden die Patient*innen mittels zahlreicher OMT-Modalitäten behandelt. In der OMT-Gruppe zeigten sich Verbesserungen hinsichtlich Schmerzen und Atmungskapazität sowie eine kürzere Krankenhausverweildauer. Schlussfolgerungen: Die osteopathische Behandlung könnte als Ergänzung zu den derzeitigen medizinischen Therapien hilfreich sein, um postoperative Schmerzen zu lindern und den Funktionsstatus von Patient*innen insgesamt zu verbessern. Objective: Osteopathic manipulative treatment (OMT) in surgical patients aims at reducing postoperative pain and enhancing recovery. The effects of OMT have not been extensively studied in cardiac surgery patients, mostly owing to the fact that a limited number of osteopathic physicians are trained in thoracic surgery. Methods: A systematic review of the literature was performed to identify all currently available data on post- operative OMT in cardiac surgery patients. Case reports and case series were excluded. Risk of bias of the eligible studies was assessed individually using specific protocols. Among the outcomes of interest were postoperative pain, hospital length of stay, changes in respiratory capacity, and changes in cardiac index and mixed oxygen venous saturation (SvO2) measurements. Results: We identified four eligible studies which were included in the quantitative analysis of the present review. There were three randomized controlled trials (RCTs) and one non-randomized controlled cohort study which investigated on outcomes of OMT in cardiac surgery patients. The most common cardiac operations performed were coronary artery bypass grafting, valve procedures, combined procedures, and aortic operations. Numerous OMT modalities were used on postoperative patients. The OMT group of patients showed improvement in pain management and respiratory capacity, and shorter hospital length of stay. Conclusions: Osteopathic treatment might be helpful as an adjunct to current medical therapies in mitigating postoperative pain and improving the overall patient's functional status. [ABSTRACT FROM AUTHOR]

Despite numerous advances in all areas of cardiovascular care, cardiovascular disease (CVD) is the leading cause of death in the United States (US). There is compelling evidence that interventions to improve diet are effective in cardiovascular disease prevention. This clinical practice statement emphasizes the importance of evidence-based dietary patterns in the prevention of atherosclerotic cardiovascular disease (ASCVD), and ASCVD risk factors, including hyperlipidemia, hypertension, diabetes, and obesity. A diet consisting predominantly of fruits, vegetables, legumes, nuts, seeds, plant protein and fatty fish is optimal for the prevention of ASCVD. Consuming more of these foods, while reducing consumption of foods with saturated fat, dietary cholesterol, salt, refined grain, and ultra-processed food intake are the common components of a healthful dietary pattern. Dietary recommendations for special populations including pediatrics, older persons, and nutrition and social determinants of health for ASCVD prevention are discussed.

A dual-polarized dielectric waveguide transmission system is proposed using low-loss material cyclic olefin copolymer (COC), with some other key components such as substrate integrated waveguide (SIW)-based orthomode transducers (OMT), the transitions between the OMT and dielectric waveguide, and the adaptors between the OMT and the standard rectangular waveguide. In the frequency range from 90 to 100 GHz, the proposed whole transmission system with a 40-cm-length COC-based dielectric waveguide has the lowest insertion loss of 5.31 dB caused by the coupling structure loss of 3.17 dB, the straight/bending COC-based dielectric waveguide losses of 2.33/2.47 dB/m, and the unavoidable radiation loss from the transition. The proposed system using COC-based dielectric waveguides could be a promising choice in low-loss and high-capacity off-chip short-to-medium wired transmission. [ABSTRACT FROM AUTHOR]

Background: Adhesive Capsulitis in the shoulder characterized as a self-limiting situation that lasts only while it has also been described as a 24 week long-term impairment caused by a chronic condition. SMET is a widely used method to restore normal ROM and reduce pain. PNF aims to improve joint synchronization, movement control, and mobility. Purpose: This study focuses on the effect of Spencer Muscle Energy Technique and Proprioceptive Neuromuscular Facilitation for reducing pain and disability in Adhesive Capsulitis. Materials and Methods: A total of 40 participants were selected based on inclusion and exclusion criteria from Eyan Healthcare Foundation during the period of November 2022 to July 2023. They were split into two groups, with 20 Participants receiving Spencer Muscle Energy Technique and 20 Participants receiving Proprioceptive Neuromuscular Facilitation. Subjects with age of 40-70 years, with or without diabetes and pain or stiffness on shoulder were included and Subjects with recent trauma, injury around the shoulder were excluded in the study. All the subjects underwent pre-test measurement with Shoulder Pain and Disability Index (SPADI) and the same repeated for post-test measurement at the end of 4 weeks. Results: By statistical analysis there is a significant difference between the two groups. The Spencer group displays a greater difference than the PNF group when comparing mean differences of the two groups using SPADI. Conclusion: The study concluded that subjects who underwent Spencer Muscle Energy Technique are found to be more effective in reducing pain and disability than Proprioceptive Neuromuscular Facilitation in Adhesive Capsulitis. [ABSTRACT FROM AUTHOR]

Low back pain is a real public health problem. Today's pain management programs use drug treatments in addition to non-drug therapies. Osteopathic manipulative treatment (OMT) is presented here: a study of 48 patients suffering from type L5 low back pain and treated osteopathically. The treatment consisted of a Osteo-pathic protocol in 2 sessions (OP2S), developed at the Nouméa pain center (New Caledonia), in which L5 manipulation is performed only in the second session. Of the 48 patients included, 46 were treated, 41 were cured or improved at one year after treatment with two sessions (89%), and 28 were cured or improved from the first session (61%). In cases of type L5 low back pain, local osteopathic treatments were sometimes aimed at osteopathic manipulation of the L5 vertebra. We believe that this local manipulative treatment is delicate in the first line, as L5 inflammation is often secondary to nearby or distant osteopathic dysfunctions. Conclusion This first study from the PO2S research project suggests that osteopathic proto-colization is possible, osteopathy has a place in the type L5 low back pain treatment, and L5 manipulation is unnecessary in 61% of cases. Randomized studies will have to confirm these hypotheses. [ABSTRACT FROM AUTHOR]

In this study, we studied historical case notes to examine nomenclature of congenital upper limb anomalies and explore the changes in terminologies over time. Original diagnoses were reclassified according to previously published classifications and the most recent Oberg, Manske and Tonkin system. Two hundred and thirty-eight case notes were obtained from the period 1961–1991. Hand plate malformations where the diagnosis was obvious or traumatic defects, were excluded. Eighty-six cases (106 extremities) were finally included where an ambiguous diagnosis, such as 'congenital absence' was initially given. None of the re-classifications matched the original diagnoses except for cleft hand and radial dysplasia (n = 31). Eighteen phocomelia-type limbs were re-classifiable when seen as a continuum of longitudinal deficiency, but not as an intercalary deficit. This study provided further insights into the evolving nature of nomenclature in congenital upper limb anomalies, especially for the condition of phocomelia. Level of evidence: IV [ABSTRACT FROM AUTHOR]

BackgroundOsteopathic manual techniques are now widely used in medicine worldwide. At present, there are no clear conclusions regarding the possibility of affecting the function of the autonomic nervous system (ANS), respiratory system and head-cervical-shoulder complex by manual osteopathic techniques.ObjectivesThe aim of the study was to review the current literature regarding the possible impact of osteopathic manual techniques on the state of the autonomic nervous system, spirometric parameters of the respiratory system and the state of the head-collar-shoulder complex.MethodsPublications have been searched in the following databases: PubMed, Virtual Health Library and Cochrane Central Register of Controlled Trials. The search strategy included keywords related to manual osteopathic treatment, autonomic nervous system, spirometry, respiratory function and head, neck and shoulder pain. The methodological quality of the included studies was assessed. The PRISMA guidelines were used for the systematic review. Studies from 2010 to 2023 were selected.ResultsUsing the proposed descriptions and manual searches from the literature of other works, 40 studies were found, out of which 22 were rejected because they did not meet the inclusion criteria. The analysis included: 15 randomized controlled trials, 3 pilot studies.ConclusionStudies clearly show the effect of OMT on both spirometric parameters and the condition of the head-collar-shoulder complex. Most often this translates into improved ANS performance, but there are exceptions.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, CRD42023476963.

Background: Oxymatrine (OMT) is one of the authentic Chinese herbal medicines which has rich and complex active ingredients. however,the relevant potential targets of oxymatrine on rheumatoid arthritis and the mechanism remains unreported. The aim of this study was to determine the regulation of oxymatrine on rheumatoid arthritis using a collagen‐induced arthritis (CIA) mice models and blood samples from RA patients. Results: Our results indicated that Tfr cells in RA patients express low levels of Blimp‐1 and CTLA‐4. Oxymatrine treatment of CIA mice alleviated joint swelling, reduced the arthritis score, and improved joint damage. While flow cytometry results showed that oxymatrine treatment reduced Tfh cells and B cells, and increased Tfr cells in the spleen of CIA mice. In addition, oxymatrine treatment significantly down‐regulated the expression of TLR9（Toll‐like Receptors 9), IL‐21, MyD88, STAT3, p‐STAT3, and CXCR5 in the synovial tissues of CIA mice, and up‐regulated the expression of Foxp3, Blimp‐1, and CTLA‐4. Conclusion: Oxymatrine can alleviate rheumatoid arthritis by regulating the TLR9‐MyD88‐STAT3 signaling pathway to maintain immune balance between Tfr‐Tfh cells. © 2023 Society of Chemical Industry. [ABSTRACT FROM AUTHOR]

Although the evolutionary significance of the early-diverging flowering plant Amborella (Amborella trichopoda Baill.) is widely recognized, its metabolic landscape, particularly specialized metabolites, is currently underexplored. In this work, we analyzed the metabolomes of Amborella tissues using liquid chromatography high-resolution electrospray ionization mass spectrometry (LC-HR-ESI-MS). By matching the mass spectra of Amborella metabolites with those of authentic phytochemical standards in the publicly accessible libraries, 63, 39, and 21 compounds were tentatively identified in leaves, stems, and roots, respectively. Free amino acids, organic acids, simple sugars, cofactors, as well as abundant glycosylated and/or methylated phenolic specialized metabolites were observed in Amborella leaves. Diverse metabolites were also detected in stems and roots, including those that were not identified in leaves. To understand the biosynthesis of specialized metabolites with glycosyl and methyl modifications, families of small molecule UDP-dependent glycosyltransferases (UGTs) and O-methyltransferases (OMTs) were identified in the Amborella genome and the InterPro database based on conserved functional domains. Of the 17 phylogenetic groups of plant UGTs (A-Q) defined to date, Amborella UGTs are absent from groups B, N, and P, but they are highly abundant in group L. Among the 25 Amborella OMTs, 7 cluster with caffeoyl-coenzyme A (CCoA) OMTs involved in lignin and phenolic metabolism, whereas 18 form a clade with plant OMTs that methylate hydroxycinnamic acids, flavonoids, or alkaloids. Overall, this first report of metabolomes and candidate metabolic genes in Amborella provides a starting point to a better understanding of specialized metabolites and biosynthetic enzymes in this basal lineage of flowering plants.

O -Methyltransferases (OMTs) play important roles in antitumor lignan biosynthesis. To date, six OMTs catalyzing the methylation of dibenzylbutyrolactone lignans as biosynthetic precursors of antitumor lignans have been identified. However, there is still no systematic understanding of the diversity and regularity of the biosynthetic mechanisms among various plant lineages. Herein, we report the characterization of two OMTs from Anthriscus sylvestris and Thujopsis dolabrata var. hondae [designated as AsSecoNorYatein (SNY) OMT and TdSNYOMT] together with the six known OMTs to evaluate their diversity and regularity. Although A. sylvestris 5- O -methylthujaplicatin (SecoNorYatein) and 4- O -demethylyatein (NorYatein) OMT (AsSNYOMT) and TdSNYOMT accept 5- O -methylthujaplicatin and 4- O -demethylyatein as substrates, phylogenetic analysis indicated that these two OMTs shared low amino acid sequence identity, 33.8%, indicating a signature of parallel evolution. The OMTs and the six previously identified OMTs were found to be diverse in terms of their substrate specificity, regioselectivity and amino acid sequence identity, indicating independent evolution in each plant species. Meanwhile, two-entropy analysis detected four amino acid residues as being specifically acquired by dibenzylbutyrolactone lignan OMTs. Site-directed mutation of AsSNYOMT indicated that two of them contributed specifically to 5- O -methylthujaplicatin methylation. The results provide a new example of parallel evolution and the diversity and regularity of OMTs in plant secondary (specialized) metabolism. [ABSTRACT FROM AUTHOR]

Die Osteopathie wird von Osteopath*innen und osteopathisch tätigen Ärzt*innen zur Behandlung einer Vielzahl pädiatrischer Beschwerden eingesetzt. In der aktuellen Studie wurden die vorhandenen Studien ausgewertet, um die Wirksamkeit der Osteopathie bei pädiatrischen Beschwerden zu bestimmen. Im Juli 2020 wurde eine systematische Literatursuche nach randomisierten kontrollierten Studien (RCTs) ohne Einschränkung in Sprache oder Publikationsstatus in elektronischen medizinischen Datenbanken durchgeführt. Eingeschlossene Studien wurden ausgewertet und nach dem Cochrane Risk of Bias-Schema (RoB) bewertet. Die Gesamteffektgröße wurde, wenn möglich, berechnet. Die Daten wurden anhand des GRADE-Ansatzes zusammengeführt. 47 RCTs, die 37 pädiatrische Erkrankungen untersuchten, wurden in das systematische Review eingeschlossen und ausgewertet. 23 Studien berichteten über signifikant günstige Ergebnisse für die Osteopathie im Vergleich zur Kontrollintervention. 14 weitere Studien berichteten über nicht signifikante Ergebnisse, die auf potenziell günstige Auswirkungen der Osteopathie hindeuten. 15 der Studien wurden mit einem niedrigen RoB bewertet, 12 hatten ein hohes Risiko zur Verzerrung, bei den restlichen war das Verzerrungsrisiko unklar. Bei der Qualitätsbewertung der Evidenz (GRADE) gab es eine moderate Evidenz für die Wirksamkeit der Osteopathie für 13 der 43 Vergleiche, insbesondere für die Dauer des Krankenhausaufenthalts bei Frühgeborenen, aber keine hochwertige Evidenz für die osteopathische Behandlung bei irgendeiner pädiatrischen Erkrankung. Obwohl eine Reihe von Studien auf positive Ergebnisse der osteopathischen Behandlung hinweisen, wurden nur wenige pädiatrische Erkrankungen von mehr als einer Studie untersucht, so dass die Osteopathie bei keiner Erkrankung eine hochwertige Evidenz erreichte. Es ist wahrscheinlich, dass weitere Forschungsergebnisse die Einschätzungen dieser Studie in die eine oder andere Richtung verändern werden. Zum Aufbau einer hochwertigen Evidenz werden größere, qualitativ hochwertige RCTs, die sich auf eine kleinere Anzahl von Erkrankungen konzentrieren, empfohlen. Registrierung des systematischen Reviews: PROSPERO ID : CRD42020162479. Osteopathic manipulative treatment (OMT) is commonly used by osteopaths and osteopathic physicians to manage a large variety of pediatric complaints. The current study reviewed the literature to determine the effectiveness of OMT for all pediatric complaints. A systematic literature search for randomized controlled trials (RCTs) unrestricted by language or publication status was performed in July 2020 in electronic and ongoing trials databases. Included studies were assessed using the Cochrane Risk of Bias (RoB) instrument. Mean difference or standard mean difference and overall effect size were calculated. Data were synthesized using the GRADE approach. 47 RCTs examining 37 pediatric conditions were reviewed. 23 studies reported significant favorable outcomes for OMT relative to the control intervention, and 14 additional studies reported non-significant outcomes, which suggested potential favorable effects of OMT. 15 of the studies were judged to have a low RoB, 12 had high risk, and the remainder had unclear RoB. Using GRADE, there was moderate evidence for the effectiveness of OMT for 13 of the 43 comparisons, particularly for length of hospital stay for preterm infants, but no high-quality evidence for any condition. Although a number of studies indicated positive results with use of OMT, few pediatric conditions have been investigated in more than one study, which results in no high-quality evidence for any condition. Additional research may change estimates of effect, and larger, high-quality RCTs focusing on a smaller range of conditions are recommended. Systematic review registration: PROSPERO ID: CRD42020162479. [ABSTRACT FROM AUTHOR]

• A total of 38 members identified for the OMT gene family in R. rugosa. • Two subfamilies differentiated in sequence analysis and function identification. • RrCCoAOMT1 has tissue- and germplasm-special expression specificity. • RrCCoAOMT1 was the key structural gene involved in red petal color formation. Rosa rugosa , a valuable ornamental plant species, has high aromatic, ornamental and medicinal values. Diversification of flower color is one of the main purposes for ornamental horticultural breeding, especially the red phenotype. Understanding the molecular mechanism of red color formation regulated by O -methyltransferase (OMT) during anthocyanin biosynthesis is necessary. In this study, 38 candidate members belonging to the CCoAOMT (11) and COMT (27) subfamilies were systematically identified with average lengths of 227 and 360 amino acids, respectively. Two subfamily members had different chromosome distribution characteristics, exon/intron structures, and conserved motifs, consistent with the phylogenetic analysis result of 257 OMT members from six species. Cis -elements in the promoter region of RrCCoAOMTs were mainly involved in hormone and stress response. RrCCoAOMT1 was mainly expressed in petals, and its expression level was significantly decreased in red flowers with high relative percentage of cyanidin. Moreover, RrCCoAOMT1 was separated from other RrCCoAOMTs based on the multiple sequence alignment analysis. Silent expression of RrCCoAOMT1 caused the formation of red/deep-pink phenotypes on purple- and pink-flowered germplasms with an increase in the ratio of Cy3G5G to Pn3G5G. Overall, RrCCoAOMT1 was involved in the modification of red petal color in R. rugosa via changing the ratio of Cy3G5G to Pn3G5G, and may be transcriptionally regulated by MYB transcription factors. These findings provided a theoretical foundation for further studies on the regulation mechanism of red phenotype formation in R. rugosa , and provided important gene resources for flower color improvement breeding. [ABSTRACT FROM AUTHOR]

Feedhorn- and orthomode transducer- (OMT) coupled transition edge sensor (TES) bolometers have been designed and micro-fabricated to meet the optical specifications of the LiteBIRD high frequency telescope (HFT) focal plane. We discuss the design and optical characterization of two LiteBIRD HFT detector types: dual-polarization, dual-frequency-band pixels with 195/280 GHz and 235/337 GHz band centers. Results show well-matched passbands between orthogonal polarization channels and frequency centers within 3% of the design values. The optical efficiency of each frequency channel is conservatively reported to be within the range 0.64 - 0.72, determined from the response to a cryogenic, temperature-controlled thermal source. These values are in good agreement with expectations and either exceed or are within 10% of the values used in the LiteBIRD sensitivity forecast. Lastly, we report a measurement of loss in Nb/SiN x /Nb microstrip at 100 mK and over the frequency range 200–350 GHz, which is comparable to values previously reported in the literature. [ABSTRACT FROM AUTHOR]

On two occasions, five surgeons classified a cohort of 150 consecutive patients with congenital upper limb anomalies according to the Oberg–Manske–Tonkin classification (2020 update). We estimated reliability for the main anomaly code by means of Cohen's kappa (Κ) for ten rater pairs for five common and easily distinguishable anomalies (Group 1), and for all the other anomalies (Group 2). Inter-rater reliability for all patients (n = 150) was substantial, almost perfect for Group 1 (n = 64), but only moderate for Group 2 (n = 86). Intra-rater reliability was higher for all groups. We suggest simplifications to the Oberg–Manske–Tonkin classification and highlight specific requirements for instructions to increase its reliability. Level of evidence: I [ABSTRACT FROM AUTHOR]

The most frequent injuries in professional soccer players are those pertinent to the lower limbs. In particular, strains of the hamstrings and ligamentous injuries of the knee. Therefore, preventive measures are aimed to reduce such events. We aimed to investigate if an osteopathic manipulative treatment (OMT) of the pivots could improve lower limb function in young professional football players. Thirty-eight young male professional football players were recruited (mean age 17.8 ± 0.44 years). These were randomly assigned to an OMT or control group (n = 20 and 18, respectively). Both groups underwent osteopathic evaluation. A sit-and-reach test, a vertical jump test, a hand-grip strength test, a cervical ROM test and a balance evaluation were also performed. A significant improvement (p < 0.01) was observed between pre and post measures in the OMT for dysfunctional assessment of the pivots. However, only L3 and C2 also differed from the control group post evaluation (p < 0.0001). No differences were present for any functional measure in the control group. Only the sit-&-reach of the OMT increased significantly (p < 0.001). Static balance with open eyes in the OMT, but not in the control group, improved during post evaluation (p < 0.01). The OMT of the pivots was able to increase the sit-and-reach measure, improve postural control with open eyes and improve dysfunctional patterns of the lumbosacral and upper cervical spine in young professional football players. [ABSTRACT FROM AUTHOR]

Migraines make up a significant number of office visits every year, yet their pathophysiology and etiology remain largely elusive. This case report presents a 33-year-old patient who originally presented to the emergency department (ED) as a stroke alert and was later determined to have migraine with aura. The patient experienced an acute onset of headache, dizziness, and new-onset expressive aphasia. Before administration of a migraine cocktail, osteopathic manipulative treatment (OMT) was performed and was able to fully resolve all of her symptoms. In an effort to explain the outcomes in this case, a review of the current literature was performed, which provides an interesting perspective on the interplay of the musculoskeletal system and neuroanatomy. The literature establishes that somatic dysfunctions in the cervical vertebrae and trapezius may play a role in migraines and provide rationale for the use of OMT., (© 2024 the author(s), published by De Gruyter, Berlin/Boston.)

Los Sistemas de Información Turística han sido priorizados en el Plan de Desarrollo Nacional 2017 -2019 y en el Plan Sectorial de Turismo en Colombia como herramientas válidas para la planificación y la gestión del sector turístico. La información que arrojan dichos sistemas es empleada por los territorios en la búsqueda de mecanismos para el diseño de estrategias que atraigan un mayor gasto turístico e inversiones para fortalecer los procesos de desarrollo socioeconómico. El departamento del Magdalena es un territorio potencial para el desenvolvimiento de actividades turísticas enmarcadas en su riqueza natural, cultural e histórica; el Ministerio de Comercio, Industria y Turismo firmó un convenio con la Asociación Hotelera y Turística de Colombia Magdalena para la implementación de un sistema de información en el ya mencionado departamento, el cual se encarga de caracterizar el turismo receptor, interno y emisor; así como el impacto laboral y la industria turística. El presente artículo ilustra la metodología y principales resultados obtenidos en la medición del turismo interno y emisor, como un componente que ilustra las tendencias y características de viajes de los magdalenenses, a fin de fomentar el conocimiento interno del potencial turístico para proyectar su promoción hacia el mundo.

Bruxismus kann sowohl als Wach- (WB) wie als Schlafbruxismus (SB) auftreten. Die Prävalenz differiert je nach Untersuchungsmethode und wird bei WB mit 22,1–31% und bei SB mit 12,8±3,1% angegeben. Die Ätiologie des Bruxismus ist nur unvollständig bekannt, jedoch ist von einem multifaktoriellen Geschehen auszugehen. In diesem Artikel werden die Risikofaktoren vorgestellt. Des Weiteren werden neuroevolutionäre und paläoanthropologische Perspektiven erläutert und Einblicke in die Diagnostik gegeben. Zuletzt werden Behandlungsansätze beschrieben und das LEIT-Reset (Liem extrinsic and intrinsic TMJ-Reset) vorgestellt, bei dem extrinsische (osteopathisch manuelle Techniken – OMT) und intrinsische Kiefertechniken (Selbsthilfetechniken) aufeinander abgestimmt angewendet werden. Bruxism can occur both as waking bruxism (WB) and as sleep bruxism (SB). The prevalence differs according to the method of investigation and is reported to be 22.1–31% in WB and 12.8±3.1% in SB. The etiology of bruxism is not completely known, but a multifactorial cause can be assumed. In this article, the risk factors are presented. Furthermore, neuroevolutionary and paleoanthropological perspectives are outlined and insights into diagnostics are given. (Manual therapy) treatment approaches and self-help techniques for patients are described. Finally, treatment approaches are described and the LEIT-Reset (Liem extrinsic and intrinsic TMJ reset) is presented – in which extrinsic (osteopathic manual techniques, OMT) and intrinsic jaw techniques (self-help techniques) are applied in a coordinated way. [ABSTRACT FROM AUTHOR]

In this work, we report on the structural and morphological modifications, and their subsequent influence on the optoelectronic properties of platinum modified ordered mesoporous platinum-doped Titania (Pt-OMT). We found that higher Pt contents (>1 %Pt) lead to the destruction of the ordered structure and thus exhibit complex electrical conductivity behavior, which is intrigued by the grain boundary approximation model. The comprehensive investigation of temperature dependent resistance measurements (R-T curves) indicates a robust response to various gas environments and strong relationship between resistance, temperature and intergranular potential barrier eVs . The samples showed low eVs values in without gas ( eVs ∼0.26–0.45 eV) and nitrogen environment ( eVs ∼0.30–0.45 eV), while higher ( eVs ∼0.33–0.57 eV) values in the oxygen environment. Interpreting the adsorption mechanism relies on the eVs values in the oxygen environment, as well as the optical band gap, resistance values, and structural changes. This exploration provides a basis that researchers can extend to other ordered mesoporous metal oxides, paving the way for enhanced gas sensors and beyond. [Display omitted] [ABSTRACT FROM AUTHOR]

Flavonoids are ubiquitous polyphenolic compounds in plants, long recognised for their health-promoting properties in humans. Methylated flavonoids have received increasing attention due to the potential of methylation to enhance medicinal efficacy. Recently, Eucalyptus species with high levels of the O-methylated flavanone pinostrobin have been identified. Pinostrobin has potential commercial value due to its numerous pharmacological and functional food benefits. Little is known about the identity or mode of action of the enzymes involved in methylating flavanones. This study aimed to identify and characterise the methyltransferase(s) involved in the regiospecific methylation of pinostrobin in Eucalyptus and thereby add to our limited understanding of flavanone biosynthesis in plants. RNA-seq analysis of leaf tips enabled the isolation of a gene encoding a flavanone 7-O-methyltransferase (EnOMT1) in Eucalyptus. Biochemical characterisation of its in vitro activity revealed a range of substrates upon which EnOMT1 acts in a regiospecific manner. Comparison to a homologous sequence from a Eucalyptus species lacking O-methylated flavonoids identified critical catalytic amino acid residues within EnOMT1 responsible for its activity. This detailed molecular characterisation identified a methyltransferase responsible for chemical ornamentation of the core flavanone structure of pinocembrin and helps shed light on the mechanism of flavanone biosynthesis in Eucalyptus. [ABSTRACT FROM AUTHOR]

Erkrankungen des biliären Systems belasten zunehmend das Gesundheitssystem. Besonders für funktionelle Erkrankungen wie die Gallenblasendyskinesie existieren bisher keine erfolgversprechenden Therapiemöglichkeiten. Diese Interviewstudie beschäftigt sich mit der Frage, inwieweit sich Osteopathie zur Behandlung funktioneller biliärer Störungen eignet. Der Fokus liegt dabei auf dem Vorgehen der Osteopath*innen in der Praxis. Es handelt sich um eine qualitative Interviewstudie, in welcher 15 Osteopath*innen mit langjähriger Praxiserfahrung befragt wurden. Die Untersuchung ergab, dass 17 % aller Patient*innen in der osteopathischen Praxis biliäre Dysfunktionen aufweisen. Diese sind mit dem weiblichen Geschlecht, einem Alter zwischen 40 und 60 Jahren, einem erhöhten Body-Mass-Index, ungesunder Ernährung sowie Stress assoziiert. Der Fokus der Behandlung liegt auf der Förderung der Drainage der Gallensekrete und Verbesserung der Kontraktionsfähigkeit der Tunica mucosa, Ausgleich des vegetativen Nervensystems, Optimierung der Beweglichkeit der Oberbauchorgane sowie Reduktion negativer Einflüsse im Alltag. Drei Behandlungen binnen eines Monats führen laut der Expert*innen bei funktionellen Erkrankungen zur Symptomreduktion mit langanhaltender Schmerzlinderung. Es ergeben sich zudem Hinweise, dass sich Osteopathie zur Prävention struktureller biliärer Erkrankungen eignen könnte. Die Ergebnisse dieser Forschungsarbeit können als Grundlage zur Erstellung von randomisierten kontrollierten Studien beitragen. Eine Überprüfung nach den Richtlinien der evidenzbasierten Medizin ist zwingend erforderlich, um die Osteopathie als alternative Therapiemöglichkeit bei biliären Symptomatiken in Betracht ziehen zu können. Diseases of the biliary system are increasingly burdening the healthcare system. Especially for functional disorders such as gallbladder dyskinesia, there are no promising therapeutic treatments. This scientific study deals with the question to what extent osteopathy is suitable for the treatment of biliary disorders. The focus lies on the approach of osteopaths in daily practice. A qualitative interview study was conducted. 15 osteopaths with many years of practice experience were interviewed. The interview revealed that 17 % of all patients in osteopathic practice have biliary dysfunctions. These are associated with female gender, age 40 to 60 years, increased body mass index, previous diseases of the upper abdominal organs and stress in everyday life. The osteopathic manipulative treatment focuses on enhancing the drainage of bile secretions and improving the contractility of the tunica mucosa, balancing the autonomic nervous system, optimizing the mobility of the upper abdominal organs, and reducing negative influences in everyday life. According to the experts, three treatments within one month lead to symptom reduction with long-lasting pain relief. Findings indicate that osteopathy may be suitable for the prevention of structural biliary disease. The results of this scientific study may contribute as a basis for the design of randomized controlled trials. A review according to the guidelines of evidence-based medicine is mandatory to consider osteopathy as an alternative therapy option for biliary symptoms. [ABSTRACT FROM AUTHOR]

Long-term Proton Pump Inhibitor use is associated with low response rates and the risk of adverse events. The objective of this study was to assess the effectiveness of Osteopathic Treatment in patients with Gastroesophageal Reflux Disease (GERD). This study was a randomized controlled trial with a series of osteopathic interventions and an untreated control group. Patients in the osteopathic group (OG) received 4 osteopathic treatments within a time of eight weeks. The control group (CG) did not receive any osteopathic treatment. Primary outcome parameters were gastrointestinal symptoms, assessed by means of the Reflux Disease Questionnaire (RDQ). Secondary outcome parameters were Quality of life with regards to GERD symptoms, assessed by means of the Quality of Life in Reflux and Dyspepsia (QUOLRAD) questionnaire, medication use and osteopathic dysfunctions. Seventy patients were randomized. RDQ mean scores decreased statistically significantly in the OG but did not change in the CG; however, these data cannot be interpreted due to a large number of incorrectly completed questionnaires. The between group difference of the changes for the QOLRAD score was statistically significant 0.69 [95%CI = 0.35 to 1.0]. At week 20, changes in the QOLRAD of the OG were sustainable. Medication use decreased substantially in the OG whilst it remained the same in the CG. A series of osteopathic treatments might potentially be beneficial for patients suffering from GERD. Future studies should include longer follow-up times and establish the clinical significance of results by introducing a global rating of change measurement. [ABSTRACT FROM AUTHOR]

Osteopathic manipulative treatment (OMT) has been increasingly adopted by osteopathic practitioners to treat dizziness from neuro-otologic disorders. However, no systematic review has investigated effectiveness of OMT on benefit outcomes and harm outcomes associated with OMT for these conditions. The current protocol will provide pooled effect estimates for effectiveness of OMT for neuro-otologic disorders. The following databases will be searched: CINAHL, Embase, Ovid MEDLINE, AMED, Ovid Emcare, PEDro, PubMed, PsycINFO, OSTMED.DR, and CENTRAL. Eligible randomized controlled trials and observational studies published in English will be reviewed. Target outcomes are change in dizziness, frequency of falls, quality of life (QOL), disability, and return to work; harm outcomes are dropouts due to ineffectiveness, adverse effects, and all-cause dropout rates. Studies investigating individual types of OMT techniques will be pooled. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment tool will be used for data synthesis and to assess evidence quality. We will report effect estimates with weighted mean differences or standardized mean difference (SMD) for continuous outcome and odds ratios with 95% confidence intervals for binary outcomes. Our findings will be of importance to patients and osteopathic practitioners and will identify key areas for future research. [ABSTRACT FROM AUTHOR]

Abstract Background Opioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD). Especially, under the condition of imprisonment, OMT is a preventive measure regarding infectious diseases such as hepatitis C. However, only a minority of prisoners with OUD are currently in OMT in numerous countries. In 2009, the Ministry of Justice of the federal state of North Rhine-Westphalia (NRW), Germany, launched the process of implementing OMT in prisons with various elements (e.g. development of recommendations regarding the treatment of prisoners with OUD, monitoring the number of prisoners in OMT, education of prison doctors). In the recommendations OMT was defined as the gold standard of treatment of OUD. Methods To assess the effectiveness of the implementation strategy a survey on the prevalence of OMT in prisons in NRW was carried out twice a year by the Ministry of Justice between 2008 and 2016. Participants were prisoners in NRW, Germany. The diagnosis of OUD at admission to prison and the treatment state on survey dates was measured. Results The number of prisoners in NRW dropped from 17,301 in 2008 to 16,432 in 2016. In the same period, the number of prisoners with OUD (mainly males) dropped from 4201 persons to 3650 persons and the number of prisoners in OMT increased from 139 persons (3.3%) to 1415 (38.7%) persons. Discussion Currently, the percentage of prisoners with OUD in OMT in NRW is almost reaching the treatment rate outside prisons in Germany (45–50%). However, after release from prison there is still a high risk for a discontinuation of OMT. Conclusions Overall, the top-down approach of implementing OMT in prisons in the federal state of NRW was effective.

In the realm of cardiovascular care, the quest for innovative and holistic approaches to enhance patient outcomes persists. This study analyzes osteopathic manipulative treatment (OMT) and its potential impact on pain intensity, length of hospitalization, respiratory function, and hemodynamic response in patients undergoing coronary artery bypass grafting (CABG). OMT, with its emphasis on physical manipulation of the body's muscles and tissues, presents a potential treatment beyond the realms of conventional post-operative care. Google Scholar was used to identify four relevant articles for further review. RevMan 5.4 was utilized for meta-analytic evaluation in order to produce forest plots with associated standardized mean difference (SMD), confidence interval (CI), and heterogeneity (I²). Output from collection and analysis revealed statistically significant decreases in negatively viewed outcomes, including length of stay (SMD 0.39; 95% CI -0.02,-0.76; I² ≤ 0%) and pain control (SMD 1.67; 95% CI -1.34,-0.67; I² ≤ 94%). Parameters for respiratory function and hemodynamic response, including vital capacity (SMD 0.91; 95% CI 0.57,1.24; I² ≤ 96%) and maximal aerobic capacity (SMD 0.50; 95% CI 0.19, 0.82; I² ≤ 0%), showed a statistically significant increase. These findings suggest the incorporation of OMT as a viable adjunct for postoperative management in CABG patients, yielding favorable reductions in adverse outcomes such as length of hospitalization and pain. Moreover, it has demonstrated enhancement in maximal aerobic and vital capacity. This study suggests that the addition of osteopathic management to post-bypass standards can ultimately prevent certain morbidities associated with this specific patient population., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, McGonegal et al.)

Introduction: The introduction of Cardiac Computed Tomography (CCT) has changed the paradigm in the field of diagnostic cardiovascular medicine. CCT is the primary tool in the assessment of suspected Coronary Artery Disease (CAD) and should be followed by functional assessment when needed to stratify disease and to plan potential interventional or surgical therapy.Areas Covered: We provided the current state of the knowledge on the main aspects of technique of examination, image interpretation and clinical indications. We have focused our attention on the basic routine applications and activities.Expert Opinion: The primary role of CCT in suspected CAD will progressively become the standard approach. In general, any situation in which anatomy of the heart and thoracic vessels/structures is mandatory must be approached using CT first, whenever possible. The quantity and quality of information that can be provided by CCT is big and the operators should learn how to deal with this information. On the other hand, CCT is only apparently a straightforward and simple examination. It is actually the most complex diagnostic procedure that can be performed on CT and requires highly skilled operators and state-of-art-technology. [ABSTRACT FROM AUTHOR]

This work presents an original proposal for the reform of the Eurozone architecture according to an approach based on risk sharing (aiming to reach in the long-term the mutualization of public debt). The proposal envisages a new role for the European Stability Mechanism (ESM) which should gradually become the guarantor of the public debts of the European Economic and Monetary Union (EMU). In this way, the new ESM would support the full transition from national debts to a single Eurozone public debt (e.g. Eurobonds) with a single yield curve for all countries. Our proposal would benefit both core and peripheral EMU countries. Indeed, the riskiest countries, which would gain from the ESM conditional debt guarantee, should give up the possibility of redenominating their national debt and would pay to the ESM the corresponding market price of the guarantee. This would strengthen the capital endowment of the ESM and also allow it to use its leverage capability to support the realignment of the economic cycles of the different countries through profitable public investment plans concentrated in the weakest regions of the EMU. Such plans would be coordinated and implemented by the European Union. After a transition period, our Insurance Fund proposal would contribute to a much more resilient monetary union, with a European fiscal policy and mutualized debt. Admittedly this proposal presupposes a political consensus at the EU level to reinterpret the no bailout rule enshrined in the treaties so that risk sharing institutions implemented with fairly priced insurance scheme can be allowed. New risk sharing institutions will foster a common vision of belonging to the same federal, political union in the making, the only one compatible with the abdication of fiscal sovereignty by national governments. [ABSTRACT FROM AUTHOR]

Flavonoids are ubiquitous polyphenolic compounds in plants, long recognised for their health-promoting properties in humans. Methylated flavonoids have received increasing attention due to the potential of methylation to enhance medicinal efficacy. Recently, Eucalyptus species with high levels of the O-methylated flavanone pinostrobin have been identified. Pinostrobin has potential commercial value due to its numerous pharmacological and functional food benefits. Little is known about the identity or mode of action of the enzymes involved in methylating flavanones. This study aimed to identify and characterise the methyltransferase(s) involved in the regiospecific methylation of pinostrobin in Eucalyptus and thereby add to our limited understanding of flavanone biosynthesis in plants. RNA-seq analysis of leaf tips enabled the isolation of a gene encoding a flavanone 7-O-methyltransferase (EnOMT1) in Eucalyptus. Biochemical characterisation of its in vitro activity revealed a range of substrates upon which EnOMT1 acts in a regiospecific manner. Comparison to a homologous sequence from a Eucalyptus species lacking O-methylated flavonoids identified critical catalytic amino acid residues within EnOMT1 responsible for its activity. This detailed molecular characterisation identified a methyltransferase responsible for chemical ornamentation of the core flavanone structure of pinocembrin and helps shed light on the mechanism of flavanone biosynthesis in Eucalyptus.

Osteopathische Artikel zur „Spanischen Grippe" oder zur Behandlung von Infektionskrankheiten im Allgemeinen [ 1 ]–[ 7 ] verweisen gerne auf die großen Behandlungserfolge der Osteopathie in den USA im Vergleich zur medikamentösen Therapie während der großen Influenzapandemie 1918/19. Da die meisten Erkrankten nicht an der Grippe selbst, sondern an einer Pneumonie verstarben, werden dazu ergänzend oft zwei neuere osteopathische Studien zitiert [ 8 ], [ 9 ]. Doch wie zuverlässig sind die angeführten Zahlen, die die Erfolge der Osteopathie untermauern sollen, und welche Ergebnisse liefern die Studien zur Pneumonie? Dieser Beitrag stellt viele Fragen und versucht, einige Antworten zu geben. Osteopathic articles on the "Spanish flu" or the treatment of infectious diseases in general [ 1 ]–[ 7 ] like to refer to the great successes of osteopathy in the USA compared to drug therapy during the great pandemic influenza of 1918/19. Since most of the sick died from pneumonia rather than the flu itself, two more recent osteopathic studies on this topic are cited frequently [ 8 ], [ 9 ]. Actually, how reliable are the figures given, which are intended to back up the success of osteopathic treatment, and which results do the studies on pneumonia deliver? This article is asking a lot of questions and trying to give some answers. [ABSTRACT FROM AUTHOR]

This work addresses a critical analysis of the nature of cosmopolitan order encouraged by the World Tourism Organization. Given the growth of tourism activity and the challenges that it poses, this specialized agency of the United Nations has formally promoted equitable, responsible and sustainable development of tourism. However, the criticism of the principles from which the organization shapes tourism has put the focus on the objectives pursued. The conversion of these principles, included in the Global Code of Ethics for Tourism, adopted in 1999, into an international convention, approved in September 2017, presents a new scene that this work outlines from the cosmopolitanism perspective.

In den letzten Monaten und Jahren steigt die Nachfrage von Eltern nach osteopathischen Behandlungen für Neugeborene und Kinder deutlich an (Maier, 2016). Diese Entwicklung führt dazu, dass Kliniken Kooperationen mit Osteopathen eingehen, um die pädiatrische Osteopathie am Krankenhaus zu etablieren. Ziel dieser Arbeit ist es, den Ist-Zustand zu analysieren, um die Rolle der pädiatrischen Osteopathie am Krankenhaus zu definieren. Des Weiteren soll diese Arbeit einen Ausblick zeigen, wie die Kooperationen verbessert werden könnte. Bei der vorliegenden Arbeit handelt es sich um eine qualitative Interviewstudie. Es wurden leitfadengestützte Interviews durchgeführt und analysiert. Dem methodischen Vorgehen der Analyse liegt die Grounded Theory mit theoretischem Sampling und einer maximalen Triangulation zugrunde. Die anschließende Analyse ist nach den einzelnen Berufsgruppen und Krankenhäusern gegliedert. Aus den Ergebnissen der Analyse wird die Definition der Rolle der pädiatrischen Osteopathie am Krankenhaus abgeleitet und ein Ausblick für die Zukunft gegeben. Die Analyse ergibt, dass die Rolle der pädiatrischen Osteopathie am Krankenhaus darin besteht, die Multidisziplinarität am Krankenhaus zu ergänzen. Von der Osteopathie wird hierbei erwartet, dass sie ein komplementäres Verfahren zur Prävention und Intervention bei Kindern darstellt. Der Osteopath nimmt in diesem Konstrukt die Rolle der Vertrauensperson für die Eltern ein. Der Mehrwert durch die Eingliederung der Osteopathie am Krankenhaus mithilfe von Pilotprojekten ist dabei, eine osteopathische Grundversorgung aller Kinder in diesen Krankenhäusern zu gewährleisten. Das erstrebenswerte Ziel wäre, Osteopathie nicht nur multidisziplinär, sondern auch interdisziplinär ins Krankenhaus einzubinden und flächendeckend in allen deutschen Krankenhäusern zu integrieren, um eine osteopathische Grundversorgung für alle Kinder, die in Deutschland geboren werden, anzubieten. Dieses Optimum wird aufgrund von rechtlichen und wirtschaftlichen Gründen vorerst nicht umzusetzen sein. Parent requests for osteopathic treatment of children and newborns have been increasing for years. This development resulted in cooperation between clinics and osteopaths to implement paediatric osteopathy in hospitals. This paper intends to analyse the status quo, define the role of paediatric osteopathy in hospitals, and give suggestions as to how to improve cooperation. This paper is a qualitative interview study. The authors conducted and analysed guided interviews using Grounded Theory methodology including theoretical sampling and maximal triangulation. The analysis is structured in professional groups and hospitals. The results will help define the role of paediatric osteopathy in hospitals, and give a prospect for the future. The results show that paediatric osteopathy can add to the multidisciplinarity in hospitals. Paediatric osteopathy is expected to provide a complimentary approach in children care, and introduce the osteopath as a confidant. The implementation of osteopathic care in hospitals can be facilitated by means of pilot experiments, and might help ensuring an osteopathic primary care in hospitals. It is recommended to incorporate osteopathy not only as a multidisciplinary but also a interdisciplinary element in German hospitals to provide an osteopathic primary care for children born in Germany. However, for the time being it will not be possible to realise this step due to legal and economic reasons. [ABSTRACT FROM AUTHOR]

Der Larynx stellt eine bedeutsame Region für den Schluckvorgang und die Lautbildung dar. Mögliche Indikationen für eine osteopathische Behandlung sind Heiserkeit, Stimmstörungen, ventrale Halsschmerzen, im Weiteren auch laryngeale Krepitationen, Husten, Atemstörungen, Dysphagie, etc. In der Behandlung ist eine enge interdisziplinäre Zusammenarbeit, z. B. mit Logopäden und anderen medizinischen Berufsgruppen wesentlich. In diesem Beitrag werden mögliche Dysfunktionsmuster, Diagnostik, Inspektion, lokale bzw. regionale Tests und Behandlungsansätze dargestellt und diskutiert. Wesentlich ist hier neben medizinischer Differenzialdiagnostik ebenso ein osteopathisch spezifisches, systemisches Vorgehen (s. a. Liem 2020). Darüber hinausgehende globale Untersuchungs- und Behandlungsansätze würden hingegen den Rahmen sprengen und werden im vorliegenden Beitrag nicht diskutiert. The larynx is an important region for swallowing and sound formation. Possible indications for osteopathic treatment are hoarseness, voice disorders, ventral sore throat, and also laryngeal crepitations, coughing, breathing disorders, dysphagia, etc. In the treatment, a close interdisciplinary cooperation is necessary, e.g. with speech therapists and other medical professions. In this article, possible dysfunction patterns, diagnostics, inspection, local or regional tests and treatment approaches are presented and discussed. In addition to medical differential diagnosis, an osteopathically specific, systemic procedure is also essential here. [ABSTRACT FROM AUTHOR]

Shoulder complaints are common in the general population. Typically, the diagnosis of a specific pathology is lacking. The objective of this trial was to evaluate the effectiveness of an osteopathic treatment in patients suffering from shoulder pain. A pragmatic randomized controlled trial was conducted in patients with a history of shoulder pain of 6 weeks to 12 months, and a pain intensity level of at least 40% on the visual analogue scale (VAS). Participants were identified from the general population in Germany and allocated by means of external randomization to an intervention group or a control group. Patients in the intervention group received five osteopathic treatments at intervals of two weeks. Treatment was custom tailored and based on osteopathic principles. Controls received their osteopathic treatment after an 8-week untreated waiting period. Primary outcome parameters were pain intensity and frequency, measured by VAS and Likert Scales. Secondary outcome parameters were shoulder specific pain and disability (Shoulder Pain and Disability Index, SPADI), and quality of life (SF-36). A total of 70 patients aged 25–70 years (average age 45.6 ± 13.4 years) were included, 36 in the intervention group and 34 in the control group. The inter-group comparison of changes revealed clinically relevant improvements in favor of the intervention group for the main outcome parameters maximal pain intensity (VAS: between group difference of means 41.5; 95% CI: 34.6 to 48.3; p < 0.005) and average pain intensity (VAS: between group difference of means 40.4; 95% CI: 33.2 to 47.5; p < 0.005). The proportion of participants with a low frequency of pain increased in the osteopathic group only (from 7 to 34 vs. 9 to 6 in the control group, p = 0.006), and the number of patients with a high frequency decreased in the osteopathic group only (from 29 to 2 vs. 25 to 28, p < 0.0005). Shoulder specific pain and disability also improved. The follow-up assessment in the intervention group showed further improvements. Five osteopathic treatments over a period of eight weeks led to statistically significant and clinically relevant positive changes of pain and disability in patients suffering from shoulder pain. [ABSTRACT FROM AUTHOR]

In the wake of the Euro crisis, the mission statement on the European Central Bank's (ECB) website was changed from 'Our mission is to serve Europe's citizens' to 'Our mission is to serve the people of Europe'. This article situates this discursive shift within a broader change of the ECB's self‐presentation in public discourses and explores its meaning in terms of political theory and public law. The article argues that the shift represents a response to the perceived necessity of reimagining the ECB's foundation of legitimate governmental authority following its exercise of emergency powers during the Euro crisis. The discourse emphasizes an organic link between the ECB and 'the people of Europe' as a political subject able to authorize previously unauthorized governmental practices such as the outright monetary transactions programme. It reflects, furthermore, a new governing philosophy that stresses flexibility and discretion rather than strict adherence to rules in the ECB's exercise of power. [ABSTRACT FROM AUTHOR]

Im beginnenden 20. Jahrhundert wurden Patienten während Grippepandemien nicht nur erfolgreich osteopathisch behandelt, vielmehr zeigten sie auch deutlich geringere Sterblichkeitsraten im Vergleich zu Patienten, die medizinisch therapiert wurden. Mögliche Dysfunktionsmuster und die Behandlungsansätze der frühen Osteopathen werden im Beitrag dargestellt und diskutiert. In the early 20th century, pandemic influenca patients were not only successfully treated with osteopathy, they also showed significantly lower mortality rates compared to those undergoing medical interventions. Possible dysfunction patterns and treatment approaches of early osteopaths are presented and discussed in the article. [ABSTRACT FROM AUTHOR]

A new classification for congenital upper-extremity anomalies was first published in 2010. It has come to be known as the OMT classification highlighting the thought leaders behind it: Kerby Oberg, Paul Manske, and Michael Tonkin. Based on a dysmorphology framework, the OMT has been adopted by the International Federation of Society for Surgery of the Hand and surgeons who treat congenital upper-extremity anomalies. As predicted in the first publication, updates will be necessary based on an improved understanding of morphogenesis; the first update was in 2014 and this represents the second update to the original OMT classification. We carefully reviewed all aspects of the OMT classification, its current stratification, and updated literature on the developmental basis of limb anomalies. We also considered the clinical usefulness and challenges of the classification through discussions with stakeholders and those who care for patients with congenital upper-limb anomalies. These factors guided the current modifications of the OMT classification. In providing the updated classification, we provide the rationale for these changes. The updated OMT classification is by no means final. As our understanding of congenital anomalies progresses, we anticipate subsequent updates in the years to come. [ABSTRACT FROM AUTHOR]

Atherosclerosis is the primary cause of renal artery stenosis. Atherosclerotic renal artery stenosis (ARAS) is associated with three clinical problems: renovascular hypertension, ischemic nephropathy and cardiac destabilization syndrome which pose huge healthcare implications. There is a significant rate of natural disease progression with worsening severity of renal artery stenosis when renal revascularization is not pursued in a timely manner. Selective sub-groups of individuals with ARAS have had good outcomes after percutaneous renal artery stenting (PTRAS). For example, individuals that underwent PTRAS and had improved renal function were reported to have a 45% survival advantage compared to those without improvement in their renal function. Advances in the imaging tools have allowed for better anatomic and physiologic measurements of ARAS. Measuring translesional hemodynamic gradients has allowed for accurate assessment of ARAS severity. Renal revascularization with PTRAS provides a survival advantage in individuals with significant hemodynamic renal artery stenosis lesions. It is important that we screen, diagnosis, intervene with invasive and medical treatments appropriately in these high-risk patients. [ABSTRACT FROM AUTHOR]

Background: Opioid Maintenance Treatment (OMT) is a well-evaluated treatment of opioid use disorder (OUD). Especially, under the condition of imprisonment, OMT is a preventive measure regarding infectious diseases such as hepatitis C. However, only a minority of prisoners with OUD are currently in OMT in numerous countries. In 2009, the Ministry of Justice of the federal state of North Rhine-Westphalia (NRW), Germany, launched the process of implementing OMT in prisons with various elements (e.g. development of recommendations regarding the treatment of prisoners with OUD, monitoring the number of prisoners in OMT, education of prison doctors). In the recommendations OMT was defined as the gold standard of treatment of OUD.Methods: To assess the effectiveness of the implementation strategy a survey on the prevalence of OMT in prisons in NRW was carried out twice a year by the Ministry of Justice between 2008 and 2016. Participants were prisoners in NRW, Germany. The diagnosis of OUD at admission to prison and the treatment state on survey dates was measured.Results: The number of prisoners in NRW dropped from 17,301 in 2008 to 16,432 in 2016. In the same period, the number of prisoners with OUD (mainly males) dropped from 4201 persons to 3650 persons and the number of prisoners in OMT increased from 139 persons (3.3%) to 1415 (38.7%) persons.Discussion: Currently, the percentage of prisoners with OUD in OMT in NRW is almost reaching the treatment rate outside prisons in Germany (45-50%). However, after release from prison there is still a high risk for a discontinuation of OMT.Conclusions: Overall, the top-down approach of implementing OMT in prisons in the federal state of NRW was effective. [ABSTRACT FROM AUTHOR]

Optimization Modulo Theories (OMT ) is an extension of SMT which allows for finding models that optimize given objectives. OptiMathSAT is an OMT solver which allows for solving a list of optimization problems on SMT formulas with linear objective functions—on the Boolean, the rational and the integer domains, and on their combination thereof—including (partial weighted) MaxSMT. Multiple and heterogeneous objective functions can be combined together and handled either independently, or lexicographically, or in linear or min–max /max–min combinations. OptiMathSAT provides an incremental interface, it supports both an extended version of the SMT-LIBv2 language and a subset of the FlatZinc language, and can be interfaced via an API. In this paper we describe OptiMathSAT and its usage in full detail. [ABSTRACT FROM AUTHOR]

Andrew Taylor Still, der Gründer der Osteopathie, wurde in die Familie eines wandernden methodistischen Predigers hineingeboren. Während dieses methodistische Erbe in einigen seiner späteren Schriften für bestimmte Ausdrücke und metaphorische Bedeutungen anerkannt wurde, ist der Einfluss dieses Erbes auf Stills Weg zur Entdeckung der Osteopathie und ihrer späteren Praxis wenig untersucht worden. Der Autor dieses Artikels geht davon aus, dass es positive Einflüsse aus dem methodistischen Erbe von Still gegeben haben könnte, die das osteopathische Konzept, wie es in seinen Anfängen praktiziert wurde, geprägt haben. Andrew Taylor Still, the founder of osteopathy, was born into the family of a wandering Methodist preacher. While this Methodist legacy was recognized in some of his later writings for certain expressions and metaphorical meanings, little was known about the influence of this legacy on Still's path to the discovery of osteopathy and its later practice. The author of this article suggests that there may have been positive influences from the Methodist heritage of Still that could have shaped the osteopathic concept and how it was practiced in its beginnings. [ABSTRACT FROM AUTHOR]

Since 2010, heroin-assisted treatment (HAT) has been one of the treatment options available to people with opioid use disorder (OUD) in Denmark. This study aimed to characterize HAT patients at treatment start and compare their individual characteristics to those of patients entering traditional opioid maintenance treatment (OMT) with methadone or buprenorphine during the same period. Patients who initiated HAT or OMT with methadone or buprenorphine in Denmark from 2010 to 2018 were included (n=6798). Multiple national registers were linked to compare treatment groups in terms of socio-demographic variables, previous OUD treatment episodes, hospital-based care, and criminal conviction history. Nearly all HAT patients had a history of methadone treatment (91%) and half had residential treatment experience (48%). In the year previous to admission, HAT patients recorded the highest percentages of non-fatal overdoses (12%) and chronic hepatitis C diagnoses (16%), and the lowest percentages of psychiatric disorders (11%) compared to traditional OMT patients. Criminal convictions were also common: 39% of the HAT group had committed a property crime and 18% a drug-related crime the year before HAT entry. During the study period, an overall reduction in OMT enrollments for each year was recorded. The HAT proportion to the total remained fairly stable (4%−10%), while the buprenorphine proportion increased. In Denmark, OMT patients exhibited numerous vulnerabilities at treatment start, and among the patient groups, HAT patients were the most burdened. HAT seems to reach the target group and adhere to formulated eligibility criteria. • At treatment start, nearly all HAT patients had prior methadone treatment recorded. • Prior to treatment start, HAT patients had more overdoses than other OMT groups. • Before entry, HAT patients had more hospital-based care and criminal convictions. • The number of OMT enrollments per year in Denmark is decreasing over time. • The proportion of HAT enrollments per year is stable (4%−10%). [ABSTRACT FROM AUTHOR]

Research is a fundamental component of evidence-based practice. This scoping review will explore what peer reviewed empirical studies have been published between January 2010–March 2021 where osteopathic manual therapy (OMT) is used as an intervention. A deeper understanding of what research comprises the osteopathic body of literature may support osteopaths in their clinical decision making process. A 5-stage scoping review framework was followed. Finalised search terms were applied to four databases: PubMed, ScienceDirect, EBSCO and BASE. Reference lists of yielded articles were checked until evidence saturation occurred. Extraction fields included author, year of publication, study population and sample size, methodology, intervention, and comparator. Articles were also grouped into 10 broad categories based on the overarching topic of exploration. A total of 292 studies were included for review, 189 studies were determined as quantitative research with three qualitative and one mixed methods study. The remaining studies comprised 78 case report/case series and 24 systematic reviews. Musculoskeletal, neurological and paediatric categories made up 64% of the total literature. The osteopathic literature is largely dominated by quantitative research. Yielded studies covered a range of topics. However, the number of isolated research publications gives a fragmented impression of the literature and research gaps suggest inconsistent coverage in some areas. Osteopathic research may benefit from a more considered research agenda where research is methodically generated to fill contextual gaps in the literature. 1) This review gives an indication of where osteopathic manual therapy has been researched, leading to a better understanding of where there is evidence scarcity or saturation. 2) This review categorises the osteopathic research into 10 broad categories: musculoskeletal, neurological, paediatric, gastrointestinal & renal, cardiovascular & pulmonary, obstetrics and gynaecology, psychosocial, sensory, autoimmune & endocrine and other. By presenting the research in clinically relevant topics osteopathic practitioners may find it easier to seek out and thus apply research in practice. 3) It has been noted that the osteopathic research may have inconsistent coverage on some topics and methodologies, suggesting topics for further research. [ABSTRACT FROM AUTHOR]