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The present research revisits citizen competence in the changing political and information environment, considering citizens as pluralistic issue publics. Using 2000 and 2004 American National Election Study data, Study 1 explores the conceptual premises of issue publics and the impact of the Web on domain-specific knowledge and extremity. Study 2 uses a unique data set combining an innovative direct measure of users' Web behavior records with survey responses from those users in the context of the 2004 U.S. general election. The results shed light on issue publics' information acquisition on the Web. This complementary data set provides a more complete picture of how issue publics develop unique patterns of information acquisition and make voting decisions. The findings indicate that issue publics enhanced their domain-specific knowledge by using information highly selectively. In addition, their selective information use contributed to increases in extremity and issue voting patterns. Implications for the functioning of democracy are discussed.

A biomechanical model for predicting paths of motion and the associated motion characteristics for the arm articulation joints is presented. The underlying principle of the model is that the average individual follows an optimizing criterion in performing his tasks. A detailed description of the model assumptions, mechanics, and formulation is presented for three-dimensional motions. Three approaches are presented for solving the model: (1) suboptimization (linear and geometric programming); (2) dynamic programming; and (3) simulation. The accuracy and the adequacy of the model in predicting human motion under planar conditions were tested and evaluated. Future perspectives and limitations of modeling human motion are outlined and discussed.

ABSTRACT Introduction: extremity tourniquet (TQ) use has increased in the civilian setting; the beneficial results observed in the military has influenced acceptance by EMS and bystanders. This review aimed to analyze extremity TQ types used in the civilian setting, injury site, indications, and complications. Methods: a systematic review was conducted based on original articles published in PubMed, Embase, and Cochrane following PRISMA guidelines from 2010 to 2019. Data extraction focused on extremity TQ use for hemorrhage control in the civilian setting, demographic data, study type and duration, mechanism of injury, indications for use, injury site, TQ type, TQ time, and complications. Results: of the 1384 articles identified, 14 were selected for review with a total of 3912 civilian victims with extremity hemorrhage and 3522 extremity TQ placements analyzed. The majority of TQs were applied to male (79%) patients, with blunt or penetrating trauma. Among the indications for TQ use were hemorrhagic shock, suspicion of vascular injuries, continued bleeding, and partial or complete traumatic amputations. Upper extremity application was the most common TQ application site (56%), nearly all applied to a single extremity (99%), and only 0,6% required both upper and lower extremity applications. 80% of the applied TQs were commercial devices, and 20% improvised. Conclusions: TQ use in the civilian setting is associated with trauma-related injuries. Most are single-site TQs applied for the most part to male adults with upper extremity injury. Commercial TQs are more commonly employed, time in an urban setting is under 1 hour, with few complications described.

Stress fractures account for between 1% and 20% of athletic injuries, with 80% of stress fractures in the lower extremity. Stress fractures of the lower extremity are common injuries among individuals who participate in endurance, high load-bearing activities such as running, military and aerobic exercise and therefore require practitioner expertise in diagnosis and management. Accurate diagnosis for stress fractures is dependent on the anatomical area. Anatomical regions such as the pelvis, sacrum, and metatarsals offer challenges due to difficulty differentiating pathologies with common symptoms. Special tests and treatment regimes, however, are similar among most stress fractures with resolution between 4 weeks to a year. The most difficult aspect of stress fracture treatment entails mitigating internal and external risk factors. Practitioners should address ongoing risk factors to minimize recurrence.

Leamor Kahanov,1 Lindsey E Eberman,2 Kenneth E Games,2 Mitch Wasik2 1College of Health Science, Misericordia University, Dallas, PA, USA; 2Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, IN, USA Abstract: Stress fractures account for between 1% and 20% of athletic injuries, with 80% of stress fractures in the lower extremity. Stress fractures of the lower extremity are common injuries among individuals who participate in endurance, high load-bearing activities such as running, military and aerobic exercise and therefore require practitioner expertise in diagnosis and management. Accurate diagnosis for stress fractures is dependent on the anatomical area. Anatomical regions such as the pelvis, sacrum, and metatarsals offer challenges due to difficulty differentiating pathologies with common symptoms. Special tests and treatment regimes, however, are similar among most stress fractures with resolution between 4 weeks to a year. The most difficult aspect of stress fracture treatment entails mitigating internal and external risk factors. Practitioners should address ongoing risk factors to minimize recurrence. Keywords: medial tibial stress syndrome, stress injury, nonunion stress fracture

While some online reviews explicitly praise or criticize a product, others reveal a neutral evaluation. We predicted that extreme reviews would be considered more useful than moderate ones, and that negative reviews would be considered more useful than positive ones. To test these predictions,
this study collected a dataset comprising 951,178 reviews of New York restaurants made by 142,286 reviewers on Yelp. com. By combining these two datasets, we incorporated each reviewer's unique reference point into a model and showed that extremely positive or negative reviews were considered
more useful than moderate ones and that negative reviews were considered more useful than positive ones. This dominance of negative over positive reviews was also more pronounced in the conditions of larger variance and lower average ratings for restaurants. Overall, these results support
the presence and influence of extremity and negativity biases, particularly in the context of high preference heterogeneity.

Since the civil war, combat sustained peripheral nerve injuries (CSPNI) have been documented during wartime. Warfare has evolved and current combat involves a greater severity of blast injuries secondary to increased use of improvised explosive devices. The purpose of this study was to describe CSPNI and report outcomes after evaluation and treatment. We hypothesize that a shorter time to evaluation will improve outcomes. METHODS: A database including all active duty service members who sustained a CSPNI and were treated by the PNC between 2004 and 2009 was used. Service member demographic information, injury mechanism, CSPNI description, and Medical Research Council (MRC) final motor and sensory outcomes were queried from this database. RESULTS: One hundred and four military service members sustained 144 PNIs. The average age was 26.7 years, and nearly all were men (98.1%). There was no correlation between Sunderland classification and age, specific PNI, injury type, or time to evaluation. Higher Sunderland classifications were found to be correlated with worse final motor (r = 0.51, P < 0.001) and final sensory (r = 0.41, P < 0.001) scores. Final motor and sensory scores were not associated with specific nerve injury, mechanism of injury, initial EMG, or surgical procedure. Shorter time to initial assessment was associated with improved final motor and sensory scores, but was not found to be statistically significant. CONCLUSIONS: As the complexity of CSPNIs progress as combat weaponry evolves, a firm understanding of treatment factors is important. Our study demonstrates in recent conflict that military service members' initial injury severity is a key factor in expected outcome.

INTRODUCTION: We examined antibiotic management of combat-related extremity wound infections (CEWI) among wounded US military personnel (2009–2012). METHODS: Patients were included if they sustained blast injuries, resulting in ≥1 open extremity wound, were admitted to participating US hospitals, developed a CEWI (osteomyelitis or deep soft-tissue infections) within 30 days post-injury, and received ≥3 days of relevant antibiotic(s) for treatment. RESULTS: Among 267 patients, 133 (50%) had only a CEWI, while 134 (50%) had a CEWI plus concomitant non-extremity infection. In the pre-diagnosis period (4–10 days prior to CEWI diagnosis), 95 (36%) patients started a new antibiotic with 28% of patients receiving ≥2 antibiotics. During CEWI diagnosis week (±3 days of diagnosis), 209 (78%) patients started a new antibiotic (71% with ≥2 antibiotics). In the week following diagnosis (4–10 days after CEWI diagnosis), 121 (45%) patients started a new antibiotic with 39% receiving ≥2 antibiotics. Restricting to ±7 days of CEWI diagnosis, patients commonly received two (35%) or three (27%) antibiotics with frequent combinations involving carbapenem, vancomycin, and fluoroquinolones. CONCLUSIONS: Substantial variation in antibiotic prescribing patterns related to CEWIs warrants development of combat-related clinical practice guidelines beyond infection prevention, to include strategies to reduce use of unnecessary antibiotics and improve stewardship.

We extend the study of political extremity to an evolving media landscape. We differentiate between political and non-political uses of both "traditional" and "new" media, and situate political extremity within a new conceptualization of public– egocentric publics –a meso-level phenomenon enabled by new communication technologies that overcomes the traditional dichotomy of small groups and mass publics. Testing the relationship between information, expression, and extremity in Colombia, a sociopolitical context with high levels of polarization and distrust, we find that traditional media use is mostly unrelated to the tested forms of extremity: party-, ideology-, or issue-based. In turn, expressive Internet use is related to extremity and—contrary to what some commentators have feared—this relationship is negative. Lower extremity associated with online expression is consistent with the notion of egocentric publics advanced in this article. The results underscore the importance of differentiating between various media formats in political communication research, reveal the media correlates of various forms of extremity can take, and provide evidence that the emerging publics made possible by new media are not necessarily polarizing.