Relying on Adam Smith's concept of the "invisible hand," every economist can explain how markets react to individual economic power. Markets shape and reshape themselves to neutralize self-interested economic power by coaxing it into channels that serve the public good. But economists have devoted less attention to analyzing how markets systematically counteract coalitions of individuals' political power. Regulatory restraints imposed by the "visible hand" of political power shape markets just as surely as economic power does, but in ways designed to create or perpetuate economic power [15]. This paper endeavors to show that introducing political power into economic affairs initiates a dialectical process of adjustments and counteradjustments. In what resembles reflex action, markets rechannel regulatory power, as regulatees short-circuit regulator intentions
Context: Researchers have established that superior migration of the humeral head increases after fatigue of the rotator cuff muscles. In these studies, the investigators used imaging techniques to assess migration of the humeral head during statically held shoulder positions. Their results may not represent the amount of superior humeral head migration that occurs during dynamic arm elevation.Objective: To investigate the effect of rotator cuff fatigue on humeral head migration during dynamic concentric arm elevation (arm at the side [approximately 06] to 1356) in healthy individuals and to determine the test-retest reliability of digital fluoroscopic video for assessing glenohumeral migration.Design: Test-retest cohort study. Setting: Research laboratory.Patients or Other Participants: Twenty men (age 5 27.7 6 3.6 years, mass 5 81.5 6 11.8 kg) without shoulder disorders participated in this study.Intervention(s): Three digital fluoroscopic videos (2 prefatigue and 1 postfatigue) of arm elevation were collected at 30 Hz. The 2 prefatigue arm elevation trials were used to assess test-retest reliability with the arm at the side and at 456, 906, and 1356 of elevation. The prefatigue and postfatigue digital fluoroscopic videos were used to assess the effects of rotator cuff fatigue on glenohumeral migration. All measurements were taken in the right shoulder.Main Outcome Measure(s): The dependent measure was glenohumeral migration (in millimeters). We calculated the intraclass correlation coefficient and standard error of the measurement to assess the test-retest reliability. A 2 3 4 repeated-measures analysis of variance was used to assess the effects of fatigue on arm elevation at the 4 shoulder positions.Results: The test-retest reliability ranged from good to excellent (.77 to .92). Superior migration of the humeral head increased postfatigue (P , .001), regardless of angle.Conclusions: Digital fluoroscopic video assessment of shoulder kinematics provides a reliable tool for studying kinematics during arm elevation. Furthermore, superior migration of the humeral head during arm elevation increases with rotator cuff fatigue in individuals without shoulder dysfunction.Key Words: biomechanics, humeral head migration, imaging Key PointsN Superior migration of the humeral head increased during dynamic arm elevation after the supraspinatus, infraspinatus, and teres minor muscles of the rotator cuff were fatigued.N When used to analyze humeral head migration relative to the glenoid fossa, digital fluoroscopic video had good to excellent intrarater reliability.N Research is required to determine the influence of rotator cuff fatigue on glenohumeral migration in individuals with underlying shoulder disorders.
Background Most ischaemic strokes are caused by a blood clot blocking an artery in the brain. Clot prevention with anticoagulants might improve outcomes if bleeding risks are low. This is an update of a Cochrane review first published in 1995, with recent updates in 2004 and 2008. Objectives To assess the effectiveness and safety of early anticoagulation (within the first 14 days of onset) in people with acute presumed or confirmed ischaemic stroke.
ObjectiveThe purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders.MethodsA scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities.ResultsOf 3,453 candidate papers, 145 met study criteria and were included in this review. Risk factors were reported for group 1: non-specific low back pain (smoking, overweight/obesity, negative recovery expectations), non-specific neck pain (high job demands, monotonous work); group 2: degenerative spinal disease (workers’ compensation claim, degenerative scoliosis), and group 3: spinal tuberculosis (age, imprisonment, previous history of tuberculosis), spinal cord injury (age, accidental injury), vertebral fracture from osteoporosis (type 1 diabetes, certain medications, smoking), and neural tube defects (folic acid deficit, anti-convulsant medications, chlorine, influenza, maternal obesity). A range of comorbidities was identified for spinal disorders.ConclusionMany associated factors for common spinal disorders identified in this study are modifiable. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely comorbid versus ones that are risk factors. Modifiable risk factors present opportunities for policy, research, and public health prevention efforts on both the individual patient and community levels. Further research into prevention interventions for spinal disorders is needed to address this gap in the literature.
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