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ObjectiveResultsDiscussion/ConclusionConcussions are a common condition in athletes leading to symptoms including headache, dizziness, and sometimes vestibular deficits. Concussion management typically involves rest and a gradual return to activity among other interventions. This case series includes three patients who were evaluated using Mechanical Diagnosis and Therapy (MDT) after sport-related injuries involving concussion-like symptoms. MDT is a system of evaluating patients using repeated movements and sustained positions to assess symptomatic and mechanical changes.Patients in this case series demonstrated rapid reduction of symptoms using variations of repeated cervical movements and sustained positions, which enabled them to return to play with a lasting resolution of symptoms.This highlights the importance of a classification system for the appropriate treatment of these cases who did not require management using concussion protocol, as they were classified as cervical derangement. [ABSTRACT FROM AUTHOR]

In statistics, probability theory, and computer science, a derangement, !n, is known to be a basic problem that computes total ways of rearranging n ∈ N items such that a result contains no item i that stands in the same position as it did in the input. Formally, the derangement problem has a problem instance of a finite collection C = {(x1,y1), .∙∙., (xn,yn)}, ∣C∣ = n. With this formulation, !n is a total number of qualified collections C' where C' contains n members of (xi,yj) where i ≠ j and every Xi and yj (1 ≤ i,j < n) must show up exactly once in C'. In this article, we present a dynamic programming algorithm that computes !n and its justification. We also provide a discussion about extending the limitation of the problem with an objective to cover a general case where we have a finite set of variables a1, a2∙∙∙∙ak rather than the traditional scenario that has only two variables: x and y. [ABSTRACT FROM AUTHOR]

Copyright of Naturaliste Canadien is the property of La Societe Provancher and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There is little consensus on the conservative management of lateral patellar dislocations (LPD). Mechanical diagnosis and therapy (MDT) is an established classification system in the spinal and extremity population. This case report describes the use of MDT in the management and classification of a patient with LPD. Case Description: The patient was a 20-year-old female with a 3-month history of left knee pain precipitated by a lateral patellar dislocation. The patient described pain and a feeling of instability with standing and walking and limitations in work and recreational activities which involve lifting, squatting, and running. Based on the patient’s response to repeated end range knee movements, the patient was found to have a directional preference (DP) for knee extension and instruction in performance of knee extension DP exercises was provided. Outcomes: The patient’s knee examination and subsequent intervention included her responses to repeated end range knee movements. Her knee pain was abolished, and strength, function, and motion were fully restored in five visits. A minimal clinically important difference (MCID) was achieved on the Lower Extremity Functional Scale (LEFS). At discharge, the patient was able to independently manage symptoms and perform all work and recreational activities at a pre-injury level and these improvements were maintained at a 9-month follow-up. Discussion: There are various management strategies for lateral patellar dislocation. This case demonstrated the use of classifying, subgrouping, and treating a patient with lateral patellar dislocation using the principle of DP. Conclusion: The patient’s outcomes suggest that MDT may be used in the nonoperative management of people with LPD who present with a DP. [ABSTRACT FROM AUTHOR]

A matching point in compositions and words is an extension to these objects of the well-studied concept of fixed points in permutations. The equivalent of the derangement problem is solved here by providing a formula for the number of compositions of n having no matching points, and showing that the number of words with no matching points tends to zero as (the length of the word) n tends to infinity. We also find formulae for the average number of matching points in both words and compositions. [ABSTRACT FROM AUTHOR]

The probability that a random permutation in $S_n$ is a derangement is well known to be $\displaystyle\sum\limits_{j=0}^n (-1)^j \frac{1}{j!}$. In this paper, we consider the conditional probability that the $(k+1)^{st}$ point is fixed, given there are no fixed points in the first $k$ points. We prove that when $n \neq 3$ and $k \neq 1$, this probability is a decreasing function of both $k$ and $n$. Furthermore, it is proved that this conditional probability is well approximated by $\frac{1}{n} - \frac{k}{n^2(n-1)}$. Similar results are also obtained about the more general conditional probability that the $(k+1)^{st}$ point is fixed, given that there are exactly $d$ fixed points in the first $k$ points.

Objective: This review aimed to systematically analyse the influence of clinical variables, diagnostic parameters and the overall image acquisition process on automation and deep learning in TMJ disorders. Methods: Articles were screened in late 2022 according to a predefined eligibility criteria adhering to the PRISMA protocol. Eligible studies were extracted from databases hosted by MEDLINE, EBSCOHost, Scopus, PubMed and Web of Science. Critical appraisals were performed on individual studies following Nature Medicine's MI‐CLAIM checklist while a combined appraisal of the image acquisition procedures was conducted using Cochrane's GRADE approach. Results: Twenty articles were included for full review following eligibility screening. The average experience possessed by the clinical operators within the eligible studies was 13.7 years. Bone volume, trabecular number and separation, and bone surface‐to‐volume ratio were clinical radiographic parameters while disc shape, signal intensity, fluid collection, joint space narrowing and arthritic changes were successful parameters used in MRI‐based deep machine learning. Entropy was correlated to sclerosis in CBCT and was the most stable radiomic parameter in MRI while contrast was the least stable across thermography and MRI. Adjunct serum and salivary biomarkers, or clinical questionnaires only marginally improved diagnostic outcomes through deep learning. Substantial data was classified as unusable and subsequently discarded owing to a combination of suboptimal image acquisition and data augmentation procedures. Inadequate identification of the participant characteristics and multiple studies utilising the same dataset and data acquisition procedures accounted for serious risks of bias. Conclusion: Deep‐learned models diagnosed osteoarthritis as accurately as clinicians from 2D and 3D radiographs but, in comparison, performed poorly when detecting disc disorders from MRI datasets. Complexities in clinical classification criteria; non‐standardised diagnostic parameters; errors in image acquisition; cognitive, contextual or implicit biases were influential variables that generally affected analyses of inflammatory joint changes and disc disorders. [ABSTRACT FROM AUTHOR]

The probability that a random permutation in Sn is a derangement is well known to be Xn j=0 (-1)j 1/j! . In this paper, we consider the conditional probability that the (k+1)st point is fixed, given there are no fixed points in the first k points. We prove that when n 6= 3 and k 6= 1, this probability is a decreasing function of both k and n. Furthermore, it is proved that this conditional probability is well approximated by 1 n-k/n²(n-1) . Similar results are also obtained about the more general conditional probability that the (k + 1)st point is fixed, given that there are exactly d fixed points in the first k points. [ABSTRACT FROM AUTHOR]

In [2] the third author studied arithmetic properties of a class of sequences that generalize the sequence of derangements. The aim of the following paper is to disprove two conjectures stated in [2]. The first conjecture regards the set of prime divisors of their terms. The latter one is devoted to the order of magnitude of considered sequences. [ABSTRACT FROM AUTHOR]

We find a lower bound on the proportion of derangements in a finite transitive group that depends on the minimal nontrivial subdegree. As a consequence, we prove that, if Γ is a G -vertex-transitive digraph of valency d ≥ 1 , then the proportion of derangements in G is greater than 1 / 2 d. [ABSTRACT FROM AUTHOR]

We study fixed points in integer partitions viewed, respectively, as weakly increasing or weakly decreasing structures. A fixed point is a point with value i in position i. We also study matching points in weakly decreasing partitions. These are defined as positions where the partition and its reverse have the same size parts. From the generating functions, we also obtain asymptotic estimates as n → ∞ of some of the above statistics. [ABSTRACT FROM AUTHOR]

We give two simple combinatorial proofs directly on derangements to the well-known identity d n = n d n - 1 + (- 1) n of derangement numbers. Inversion properties on derangements are given. Partial i n v q -analogues are established. [ABSTRACT FROM AUTHOR]

We investigate properties of random mappings whose core is composed of derangements as opposed to permutations. Such mappings arise as the natural framework for studying the Screaming Toes game described, for example, by Peter Cameron. This mapping differs from the classical case primarily in the behaviour of the small components, and a number of explicit results are provided to illustrate these differences. [ABSTRACT FROM AUTHOR]

Preeclampsia, a complex and perplexing disorder unique to pregnancy, is widely recognized as primarily originating from placental dysfunction and can only be resolved by the delivery of the fetus in severe cases. Preeclampsia is a prevalent medical issue during pregnancy and is associated with elevated rates of maternal and infant mortality and morbidity. The exact cause of preeclampsia remains uncertain, although multiple factors have been implicated in its development based on current knowledge. Preeclampsia is characterized by maternal endothelial dysfunction due to the presence of fetal-derived circulatory substances from the placenta. The condition is associated with various risk factors, including maternal comorbidities such as chronic renal disease, hypertension (HTN), and obesity. Additionally, a family history of preeclampsia, nulliparity, multiple gestations, previous instances of preeclampsia, or intrauterine fetal growth restriction (IUGR) are considered risk factors. Electrolytes, including sodium, potassium, and chloride, play a critical role in the function of vascular smooth muscles and may potentially contribute to the pathophysiology of hypertension. In this review, we have summarized the literature on electrolytes in preeclampsia by conducting an extensive systematic search of databases such as PubMed, Excerpta Medica database (EMBASE), and Medical Literature Analysis and Retrieval System Online (MEDLINE)., 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, Gupta et al.)

We consider a sequence of four variable polynomials by refining Stieltjes's continued fraction for Eulerian polynomials. Using combinatorial theory of Jacobi-type continued fractions and bijections, we derive various combinatorial interpretations in terms of permutation statistics for these polynomials, which include special kinds of descents and excedances in a recent paper of Baril and Kirgizov. As a byproduct, we derive several equidistribution results for permutation statistics, which enables us to confirm and strengthen a recent conjecture of Vajnovszki and also to obtain several companion permutation statistics for two bistatistics in a conjecture of Baril and Kirgizov. [ABSTRACT FROM AUTHOR]

We use generating functions to account for alphabetic points (or the lack thereof) in compositions and words. An alphabetic point is a value j such that all the values to its left are not larger than j and all the values to its right are not smaller than j. We also provide the asymptotics for compositions and words which have no alphabetic points, as the size tends to infinity. This is achieved by the construction of upper and lower bounds which converge to each other, and in the latter case by probabilistic arguments. [ABSTRACT FROM AUTHOR]

Neck of femur fracture is a common consequence of falls in the elderly with a large burden of morbidity and mortality. Derangement in liver function tests (LFTs) is frequently seen in elderly people with neck of femur (NOF) fracture in the peri-operative period and can indicate serious and treatable underlying pathology as well as prognosis. On admission, raised alkaline phosphatase (ALP) levels with normal gamma-glutamyl transferase (GGT) suggest underlying bone pathology such as osteomalacia or Paget's disease but do not confirm or exclude osteoporosis. ALP can also be raised by non-bone pathology such as congestive cardiac failure and chronic kidney disease. LFT derangement in cardiac failure is associated with poorer prognosis. Post-operatively, ALP levels rise after the first week with a peak at 3–4 weeks and then fall thereafter. The rate at which they fall may help indicate bone healing in trochanteric fractures. Derangement in other LFTs is commonly due to hepatic injury; causes include trauma, alcohol, and viral hepatitis. There are also iatrogenic causes including surgery and commonly prescribed medication such as beta-lactam antibiotics, non-steroidal anti-inflammatories, and paracetamol. The differential diagnosis for deranged LFTs in the elderly peri-operatively is wide; however, most causes can be elicited through careful history and examination with occasional need for further investigations. [ABSTRACT FROM AUTHOR]

We examine the subgroup D (G) of a transitive permutation group G which is generated by the derangements in G. Our main results bound the index of this subgroup: we conjecture that, if G has degree n and is not a Frobenius group, then | G : D (G) | ⩽ n − 1 ; we prove this except when G is a primitive affine group. For affine groups, we translate our conjecture into an equivalent form regarding | H : R (H) | , where H is a linear group on a finite vector space and R (H) is the subgroup of H generated by elements having eigenvalue 1. If G is a Frobenius group, then D (G) is the Frobenius kernel, and so G / D (G) is isomorphic to a Frobenius complement. We give some examples where D (G) ≠ G , and examine the group-theoretic structure of G / D (G) ; in particular, we construct groups G in which G / D (G) is not a Frobenius complement. [ABSTRACT FROM AUTHOR]

In this article we obtain the generating function of the sequence P(n; j), the number of j-permutations of n objects. We consider two applications. Our method, which employs integration by parts, gives an integral representation for the difference (e -- en) n!, where en = Σnj=0 1/j! denote the truncated expansion of the number e. By using this integral representation weobtain a sharp double sided inequality concerning the difference (e -- en) n!, and also we compute some moments of it. As the second application, we provide a recurrence method to compute power weighted sums concerning P(n, j), and also alternating power weighted sums of P(n; j) in terms of the number of derangements. [ABSTRACT FROM AUTHOR]

Objectives: Tinnitus is the perception of sound without any external auditory stimulus. Cervicogenic somatic tinnitus (CST) is a subset in which symptoms are modulated by maneuvers of the neck. The evidence for effective diagnosis and treatment of CST is limited. Mechanical Diagnosis and Therapy (MDT) is a biopsychosocial assessment and management system that uses the response to mechanical forces to classify clinical presentations accurately. The purpose of this case report is to describe the MDT assessment and management of a patient with chronic subjective tinnitus. Methods: A 67-year-old female with a 5-year history of left-sided subjective tinnitus, neck pain, and headache was referred for physiotherapy. Outcome measures included the Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and Neck Disability Index (NDI). She was evaluated and treated according to MDT principles with management consisting of individualized directional preference exercises and postural correction. Results: Significant improvements in symptoms, cervical range of motion, function, and psychosocial status were observed over the long-term. At 6 months, THI scores dropped from 62/100 to 18/100 and NDI scores dropped from 18/50 to 3/50. Discussion: A comprehensive MDT assessment led to a classification of Derangement, with treatment focusing on tailored self-management. Contrary to other interventions described for CST, the patient was able to make significant and lasting changes to her symptoms without the need for any externally applied interventions. The emphasis on self-management dovetails well with the biopsychosocial model of care. This case provides preliminary evidence for the utility of screening for Derangement in conservative tinnitus assessments. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

OBJECTIVES To evaluate the relationship between diuretic use, serum electrolyte concentrations, and supplementation requirements in infants admitted to the neonatal intensive care unit. METHODS This was a single-center retrospective cohort study conducted in a freestanding children's hospital Level IV NICU. Data were collected for all infants younger than 6 months, admitted to the NICU between January 2015 and May 2017, who received 2 or more consecutive doses of furosemide, chlorothiazide, hydrochlorothiazide, and/or hydrochlorothiazide/spironolactone. The primary outcome was the composite of the incidence of electrolyte abnormalities and/or electrolyte supplementation requirement within 30 days of diuretic exposure. RESULTS A total of 72 patients met inclusion criteria, with a median gestational age of 30 weeks. Overall, 92% of patients exposed to diuretics experienced derangement in at least 1 serum electrolyte and/or required electrolyte supplementation during diuretic therapy. Patients born at 36 to 41 weeks' gestational age, receiving thiazide diuretics, experienced a significantly lower rate of the primary outcome (37%, p ≤ 0.001). The most common electrolytes affected by diuretic use were potassium and bicarbonate, with the highest incidence of the primary outcome for potassium occurring in patients receiving furosemide (p = 0.0196). Last, the median total daily dose of chlorothiazide in patients with an adverse event was 15 mg/kg/day, compared with 10 mg/kg/day in patients without an adverse event (p = 0.0041). CONCLUSIONS Use of diuretics in young infants is likely to cause electrolyte derangements and/or require electrolyte supplementation. Patients born at earlier gestational ages may be at higher risk for developing such adverse effects. ABBREVIATIONS GA, gestational age; GFR, glomerular filtration rate; IV, intravenous; NICU, neonatal intensive care unit; PN, parenteral nutrition [ABSTRACT FROM AUTHOR]

Background: The prevalence and cost of hip osteoarthritis (OA) is rising. Mechanical diagnosis and therapy (MDT) is an orthopedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained end-range movements. There has been no investigation of the association between MDT and patients diagnosed with hip OA. Case Description: This case report presents a 71-year-old female diagnosed with hip OA and matching the currently accepted clinical prediction rule (CPR) for symptomatic hip OA. The patient was classified and treated by a Diplomat of MDT and co-examiner using MDT. Outcomes: Short- and long-term (13 months) outcomes were excellent, demonstrating rapid abolishment of symptoms and improvement in function in 5 visits over 21 days. The patient demonstrated the ability to prevent and manage reoccurrence of symptoms independently; nevertheless, she received a total hip replacement which was not in accordance with current guidelines and recommendations. Conclusion: This case report raises questions about whether or not pathologies traditionally associated with the etiology of hip OA are actually at fault. Moreover, it raises questions about the utility of special tests and CPRs typically utilized to identify those structures. The case report provides preliminary evidence from one patient that MDT may be capable of providing effective short- and long-term outcomes in the management of hip OA. [ABSTRACT FROM AUTHOR]

To assess the frequency of TMJ Arthrocentesis among patients of different age groups and genders by an institution based retrospective study. A retrospective cross-sectional cohort study was conducted using the patient records from the Department of Oral and Maxillofacial Surgery from June 2019-March 2020, and details of the patients were collected by Non-probability sampling. Among a sample size of 87 patients who had reported for TMJ pain and disorders, 20 patients had undergone TMJ Arthrocentesis as treatment and were included in the study. The data collected was analysed for gender, age, difference in mouth opening. Statistical analysis was done using SPSS Version 20. Chi square statistical test for significance was used. 60% patients subjected to TMJ Arthrocentesis were females (12 patients) and they were predominantly of the age group below 35 years of age (50% - 10 patients). It was also noticed that patients less than 35 years of age had an immediate improvement in mouth opening less than 5mm, and only 26.67% of the female patients had a mouth opening greater than 5mm. The prevalence of TMJ Arthrocentesis was predominant among female patients under the age of 35 years. [ABSTRACT FROM AUTHOR]

Copyright of Social Anthropology / Anthropologie Sociale is the property of Berghahn Books and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To explore possible changes in the community attributes of haematophagous insects as a function of forest disturbance. We compare the patterns of diversity and abundance, plus the behavioural responses of three epidemiologically distinct vector assemblages across sites depicting various levels of forest cover.Methods: Over a 3-year period, we sampled mosquitoes, sandflies and biting-midges in forested habitats of central Panama. We placed CDC light traps in the forest canopy and in the understorey to gather blood-seeking females.Results: We collected 168 405 adult haematophagous dipterans in total, including 26 genera and 86 species. Pristine forest settings were always more taxonomically diverse than the disturbed forest sites, confirming that disturbance has a negative impact on species richness. Species of Phlebotominae and Culicoides were mainly classified as climax (i.e. forest specialist) or disturbance-generalist, which tend to decrease in abundance along with rising levels of disturbance. In contrast, a significant portion of mosquito species, including primary and secondary disease vectors, was classified as colonists (i.e. disturbed-areas specialists), which tend to increase in numbers towards more disturbed forest habitats. At pristine forest, the most prevalent species of Phlebotominae and Culicoides partitioned the vertical niche by being active at the forest canopy or in the understorey; yet this pattern was less clear in disturbed habitats. Most mosquito species were not vertically stratified in their habitat preference.Conclusion: We posit that entomological risk and related pathogen exposure to humans is higher in pristine forest scenarios for Culicoides and Phlebotominae transmitted diseases, whereas forest disturbance poses a higher entomological risk for mosquito-borne infections. This suggests that the Dilution Effect Hypothesis (DEH) does not apply in tropical rainforests where highly abundant, yet unrecognised insect vectors and neglected zoonotic diseases occur. Comprehensive, community level entomological surveillance is, therefore, the key for predicting potential disease spill over in scenarios of pristine forest intermixed with anthropogenic habitats. We suggest that changes in forest quality should also be considered when assessing arthropod-borne disease transmission risk. [ABSTRACT FROM AUTHOR]

Let D h , E k and F α be sets of size h , k , α respectively, with k ≤ h . We define a strongly widened derangement to be a permutation of D h ∪ E k ∪ F α such that the elements of D h are not fixed and the elements of E k cannot occupy a site originally occupied by an object of the same type or by an object of F α . We show a connection between strongly widened derangements and generalized Laguerre polynomials that provides a generalization, for integer values of α , of Even and Gillis (Math Proc Camb Philos Soc, 79:135–143, 1976) different from the one presented in Foata and Zeilberger (SIAM J Discrete Math, 1:425–433, 1988). [ABSTRACT FROM AUTHOR]

Aim: Radiographs (X-rays) are used for the preoperative assessment of hallux valgus (HV). Our purpose was to determine how well quantitative measurements of HV on radiographs and MRI correlate with the qualitative soft tissue and internal derangement findings on MRI.Materials and Methods: After IRB approval, 56 consecutive patients with MRI and radiographs of the foot were retrospectively reviewed. Two trained readers independently evaluated radiographs, measuring hallux valgus angle (HVA) and intermetatarsal angle (IMA). Two separate readers assessed qualitative MRI data by evaluating 21 different soft tissue and bony features. Statistical analysis included inter-reader reliability (IRR) and correlation of quantitative and qualitative findings.Results: Excellent IRR (ICC = 0.89-0.96) was observed for radiograph and MRI measurements of the hallux valgus severity. For qualitative assessments on MRI, IRR was good to excellent for all features (ICC = 0.63-0.9). No significant difference was found for HVA or IMA between normal and abnormal qualitative MRI features. No statistically significant correlation between the severity of hallux valgus and injury to hallux joints and supporting structures was found.Conclusion: Hallux valgus measurements are reliable on x-rays and MRI and qualitative findings of 1st MTP joint show good to excellent inter-reader agreement on MRI. No statistically significant correlations exist between the severity of hallux valgus and qualitative MRI findings. [ABSTRACT FROM AUTHOR]

Copyright of Ri-vista: Ricerche per la progettazione del paesaggio is the property of Firenze University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Mechanical diagnosis and therapy (MDT) is a specific classification-based musculoskeletal examination and intervention system that uses repeated end range and sustained movement to classify patients into mechanical syndromes. Research has recently demonstrated increased prevalence, reliability, and efficacy of MDT syndromes in varied peripheral musculoskeletal populations. There is currently no research analyzing if predictive variables exist for establishing directional preference in peripheral joints, other than the wrist. The aim of this study was to examine the clinical application of predictive variables for establishing directional preference and spinal referral in patients with isolated peripheral joint pain. Case Description: Thirty-seven consecutive patients with isolated peripheral pain were evaluated and classified using MDT assessment. Secondary analysis of predetermined variables was performed for association with directional preference and identification of spinal referral in Derangement syndrome. Results: All 37 patients were classified using MDT assessment. Thirty-three (89.2%) were classified as Derangement syndrome: 17 as spinal Derangement (45.9%) and 16 as peripheral Derangement (43.2%). One peripheral derangement also had an underlying Articular Dysfunction. Additionally, there were four patients classified as Other (10.8%). Discussion: Historical and physical examination findings were analyzed to determine if there were associated variables of directional preference or spinal referral. Mechanical stress was found to be the most associated factor in predicting directional preference. No peripheral movement loss, paresthesia, and constant pain were more associated with spinal referral. These findings may lead to a greater understanding of peripheral MDT assessment, which may lead to increased identification of directional preference and improved patient outcomes. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

Introduction: Sacroiliac Joint (SIJ) is a familiar nociceptive source of Low Back Pain (LBP). Patients with SIJ pain commonly present with tenderness around the Posterior Superior Iliac Spine (PSIS) which can be recorded by using pressure pain algometer. Mechanical Diagnosis and Therapy (MDT) is a manual therapy technique which uses repetitive movements to assess and treat the dysfunction. MDT is found to be effective in treating SIJ pain; however, its effect on Pain Pressure Threshold (PPT) is not yet determined. Aim: To determine the effect of Mechanical Diagnosis and Therapy on Pain Pressure Threshold in Sacroiliac Joint pain. Materials and Methods: A total of 25 subjects with unilateral LBP of age group 20-65 years participated in the study. Subjects with the direction of preference, pain around the PSIS, positive on two out of four pain provocation tests were included in the study. These patients were given 30 repetitions of either anterior or posterior rotation of the innominate, for four sessions. PPT and Visual Analogue Scale (VAS) were used to measure the effect of treatment. Data were analysed by using paired t-test. Results: There was a significant improvement seen (p

Introduction: Sacroiliac Joint (SIJ) is a familiar nociceptive source of Low Back Pain (LBP). Patients with SIJ pain commonly present with tenderness around the Posterior Superior Iliac Spine (PSIS) which can be recorded by using pressure pain algometer. Mechanical Diagnosis and Therapy (MDT) is a manual therapy technique which uses repetitive movements to assess and treat the dysfunction. MDT is found to be effective in treating SIJ pain; however, its effect on Pain Pressure Threshold (PPT) is not yet determined. Aim: To determine the effect of Mechanical Diagnosis and Therapy on Pain Pressure Threshold in Sacroiliac Joint pain. Materials and Methods: A total of 25 subjects with unilateral LBP of age group 20-65 years participated in the study. Subjects with the direction of preference, pain around the PSIS, positive on two out of four pain provocation tests were included in the study. These patients were given 30 repetitions of either anterior or posterior rotation of the innominate, for four sessions. PPT and Visual Analogue Scale (VAS) were used to measure the effect of treatment. Data were analysed by using paired t-test. Results: There was a significant improvement seen (p<0.01) in PPT and VAS after four consecutive sessions of treatment. Conclusion: A significant statistical difference was seen in PPT and VAS with p-value <0.01 at the end of four sessions of MDT treatment. The study suggests that MDT can be used effectively in managing SIJ tenderness around the PSIS and pain. However, future studies should focus on comparing MDT with a control group or with other manual therapy techniques. [ABSTRACT FROM AUTHOR]

Background: Pain at the ankle-foot complex is a common musculoskeletal condition that can lead to dysfunction. Mechanical Diagnosis and Therapy (MDT) is an orthopedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained movement. There has been no investigation of the association between MDT and patients diagnosed with ankle-foot complex pain. Case description: This report presents four patients with a primary complaint of pain in the ankle-foot complex. Three patients had a medical diagnosis while the other was self-referred through direct access. All received classification and treatment by clinicians trained in MDT solely utilizing MDT principles. Outcomes: Short- and long-term (4-12 months) outcomes were excellent, demonstrating rapid abolishment of symptoms and return to prior levels of function in an average of six visits over 21 days (4-8 visits over 14-33 days) without the use of modalities, strength, or proprioceptive training. The patients demonstrated the ability to prevent and manage re-occurrence of symptoms independently without seeking further health care at long-term follow-up. Discussion: The rapid speed of recovery and return to functional activities demonstrated in this case series, raises questions about whether or not the pathologies traditionally associated with the etiology of ankle-foot injuries are actually at fault or understood. Moreover, it demonstrates that specific movements can rapidly worsen or improve symptoms challenging the current generalized rehabilitation protocols. This report provides preliminary evidence that MDT may be capable of providing more effective short-term outcomes in the management of ankle-foot complex injuries. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

In this paper, we study the derangement of 2n persons sitting 2 rows and n columns. In how many ways can the 2n persons rearrange their seating in accordance with the following condition. Each seat is located by one person and reoccupied by another person and each person moves to a horizontal or a vertical or a diagonal neighboring seat. We establish the system of recurrence relations for the solution of this problem and provide the solution of the system of recurrence relations. [ABSTRACT FROM AUTHOR]

Background: Directional preference is a phenomenon that occurs in musculoskeletal disorders. It is associated with improved symptomatic and functional outcomes. Research has shown a 90% increase in the identification of directional preference in the peripheral joints between 2006 and 2012. There is currently no research analyzing if predictive variables exist for establishing directional preference. Case Description: This report presents 19 consecutive patients with wrist pain. These patients were evaluated using a mechanical diagnosis and therapy (MDT)-based assessment. Patients were classified into the mechanical syndromes Derangement, Dysfunction, Postural, and Other. Patients classified with wrist Derangement were assessed for the presence of directional preference. Secondary analysis of predetermined variables was performed for association with directional preference. One case description was included to demonstrate MDT assessment, treatment, and clinical reasoning. Results: Of the 19 patients evaluated, 15 (79%) were classified as having wrist Derangement. All patients with wrist Derangement demonstrated directional preference. Eight movements were found to establish directional preference. Each was unique with varying degrees of direction, load, and force. Discussion: This report found directional preference to be higher (79%) than previously reported values. Historical and physical examination findings were analyzed to determine if there were associated variables of directional preference. Excessive mechanical stress was found to be the most associated factor in predicting directional preference. These findings may lead to a greater understanding of peripheral MDT assessment, which may lead to increased identification of directional preference and improved patient outcomes. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]