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We consider the market design problem of matching students to schools in the presence of crowding effects. These effects are salient in parents' decision-making and the empirical literature; however, they cause difficulties in the design of satisfactory mechanisms and, as such, are not currently considered. We propose a new framework and an equilibrium notion that accommodates crowding, no-envy, and respect for priorities. The equilibrium has a student-optimal element that induces an incentive-compatible mechanism and is implementable via a novel algorithm. Moreover, analogs of fundamental structural results of the matching literature (the rural hospitals theorem, welfare lattice, etc.) survive. (JEL D47, H75, I21, I28) [ABSTRACT FROM AUTHOR]

Postural instability is a common symptom of vestibular dysfunction that impacts a person's day-to-day activities. Vestibular rehabilitation is effective in decreasing dizziness, visual symptoms and improving postural control through several mechanisms including sensory reweighting of the vestibular, visual and somatosensory systems. As part of the sensory reweighting mechanisms, vestibular activation exercises with headshaking influence vestibular-ocular reflex (VOR). However, combining challenging vestibular and postural tasks to facilitate more effective rehabilitation outcomes is under-utilized. Understanding how and why this may work is unknown. The aim of the study was to assess sensory reweighting of postural control processing and VOR after concurrent vestibular activation and weight shift training (WST) in healthy young adults. Forty-two participants (18–35years) were randomly assigned into four groups: No training/control (CTL), a novel visual feedback WST coupled with a concurrent, rhythmic active horizontal or vertical headshake activity (HHS and VHS), or the same WST with no headshake (NHS). Training was performed for five days. All groups performed baseline- and post-assessments using the video head impulse test, sensory organization test, force platform rotations and electro-oculography. Significantly decreased horizontal eye movement variability in the HHS group compared to the other groups suggests improved gaze stabilization (p =.024). Significantly decreased horizontal VOR gain (p =.040) and somatosensory downweighting (p =.050) were found in the combined headshake groups (HHS and VHS) compared to the other two groups (NHS and CTL). The training also showed a significantly faster automatic postural response (p =.003) with improved flexibility (p =.010) in the headshake groups. The concurrent training influences oculomotor function and suggests improved gaze stabilization through vestibular recalibration due to adaptation and possibly habituation. The novel protocol could be modified into progressive functional activities that would incorporate gaze stabilization exercises. The findings may have implications for future development of vestibular rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Clinical Question: In physicians and athletic trainers, is burnout associated with self-reported medical errors (MEs)? Clinical Bottom Line: Burnout directly increased the odds of self-reported ME. Physicians and surgeons with burnout had a higher risk of an self-reported ME than athletic trainers with burnout. This disparity may reflect the different definitions, oversight, and opportunities to commit MEs in the respective fields. Emotional exhaustion and personnel accomplishment appear to drive MEs within clinically practicing athletic trainers, whereas emotional exhaustion and depersonalization are indicative of MEs within practicing physicians. Understanding the mechanism behind burnout within practice settings may provide insights into mitigation strategies to reduce MEs and improve patient outcomes. Strength of Recommendation Taxonomy B. [ABSTRACT FROM AUTHOR]

Dry needlings primary goal is to alleviate pain by inserting solid filament needles into muscles, tendons, and ligaments to provide a stimulus that inhibits nerve endings to decrease pain. This critically appraised topic investigates the effects dry needling has on patients with various chronic pain conditions and its ability to relieve pain. Articles were selected if patients had a chronic pain condition lasting at least 3 months, pain was reported using the Visual Analog Scale, and were randomized control trials or prospective studies. All selected studies for this critically appraised topic showed significant improvement in chronic pain. With these improvements, dry needling has been shown to be an effective treatment in chronic pain conditions. [ABSTRACT FROM AUTHOR]

Context: Swelling is a major consequence of musculoskeletal conditions and can be a barrier to healing. Cryotherapy has been reported to decrease swelling. How effective is cryotherapy in reducing swelling during rehabilitation? Methods: PubMed was searched in June 2022 using the Boolean phrases: Swelling OR edema AND cryotherapy OR ice, Swelling AND injury AND cryotherapy. Included articles were published during or after 2017, consisted of one or more cryotherapy interventions, and listed swelling as an outcome measure. The PEDro scale was used to assess study validity. Swelling was measured by the figure-of-eight method (in centimeters). Means, SDs, and 95% confidence interval (CI) were calculated. Results: Three articles were screened. Stasinopoulos et al. received a score of 9/10; Sari et al. and Tittley et al. received a score of 10/10. Tittley et al. reported a decrease in swelling from 52.7 (SD = 0.8; 95% CI [52.35, 53.05]) to 52.0 (SD = 0.8; 95% CI [51.65, 52.35]). Stasinopoulos et al. reported decreases from 62.62 (SD = 0.34; 95% CI [62.51, 62.80]) to 61.10 (SD = 0.30; 95% CI [60.98, 61.24]). Sari et al. also found minimal change in swelling from pre- to posttreatment, 38.7 (SD = 2.6; 95% CI [37.83, 39.57]) to 38.2 (SD = 2.4; 95% CI [37.40, 39.00]). Conclusion: There is consistent evidence indicating that cryotherapy applied during rehabilitation does not decrease swelling in a patient with a musculoskeletal condition. [ABSTRACT FROM AUTHOR]

PurposeAs a foundation for a dose escalation trial, we sought to characterize duodenal and non-duodenal small bowel organ motion between fractions of pancreatic radiation therapy.Patients and methodsNine patients (4 women, 5 men) undergoing radiation therapy were enrolled in this prospective study. The patients had up to four weekly CT scans performed during their course of radiation therapy. Pancreas, duodenum and non-duodenal small bowel were then contoured for each CT scan. On the initial scan, a four-field plan was generated to fully cover the pancreas. This plan was registered to each subsequent CT scan. Dose-volume histogram (DVH) analyses were performed for the duodenum, non-duodenal small bowel, large bowel, and pancreas.ResultsWith significant individual variation, the volume of duodenum receiving at least 80% of the prescribed dose was consistently greater than the remaining small bowel. In the patient with the largest inter-fraction variation, the fractional volume of non-duodenal small bowel irradiated to at least the 80% isodose line ranged from 1% to 20%. In the patient with the largest inter-fraction variation, the fractional volume of duodenum irradiated to at least the 80% isodose line ranged from 30% to 100%.ConclusionThe volume of small bowel irradiated during four-field pancreatic radiation therapy changes substantially between fractions. This suggests dose escalation may be possible. However, dose limits to the duodenum should be stricter than for other segments of small bowel.

Over 9,000 concussions occur annually in intercollegiate soccer in the United States with little known about the incidence of mechanisms (e.g., collisions) and possible factors (e.g., sex) associated with each mechanism. The purpose of this study was to describe the mechanism of injury (MOI) and examine factors associated with greater risk for specific MOIs involving concussions in collegiate soccer players. Participants included 3,288 collegiate soccer players from 28 institutions across four competitive seasons, 2014–17. MOIs were documented for 262 soccer-related concussions during the study and placed into one of four categories: collisions, unintentional contact, aerial challenges, and others. 70% of the concussions occurred in DI soccer players. Collisions and unintentional contact were the MOIs that resulted in 66.5% of all concussions. DI and DIII soccer players sustained more concussions by unintentional contact versus collisions and aerial challenges when compared to their DII counterparts. Defenders were more likely than midfielders to sustain concussions by aerial challenges than collisions. As expected, the field players experienced more concussions as a result of collisions, unintentional contact, and aerial challenges when compared to goalkeepers. Future research should explore preventive strategies for decreasing collisions, especially during aerial challenges while heading the soccer ball, and unintentional contacts from errant balls in soccer in order to decrease concussion risk. [ABSTRACT FROM AUTHOR]

Depression rates in collegiate student-athletes in the literature are varied and inconclusive, and data have only explored depression symptoms utilizing a crosssectional design. The purpose of the current study was to evaluate the temporal course of depression symptoms in student-athletes. Student-athletes (N = 93) from a Division II institution completed six administrations of a brief depression symptom screen once every 2 weeks throughout the fall athletic season. Ten (10.8%) student-athletes' PHQ-9 surveys were red-flagged for moderate to severe depression symptoms at least once throughout the season. A mixed between-within subjects analysis of variance (ANOVA) revealed a significant interaction effect for time and sex in depression symptom scores, F(3.69, 335.70) = 10.36, p ≤ .001. The repeated-measures design of this study suggests that there are clinical benefits for screening for depression symptoms in student-athletes at multiple intervals throughout an athletic season. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Sport-related concussions are common injuries during sport-related activities. Evaluations of these injuries involve symptom reporting. Unfortunately, concussion symptoms are widely underreported by athletes, and can lead to longer recovery times. Concussion education programs were created to encourage reporting of symptoms by athletes. Clinical Question: Does concussion education impact injury disclosure in high school athletes? Summary of Key Findings: Three studies were included in this appraisal. Two studies utilized an educational lecture, and one study utilized an informational video providing the concussion education. All three studies found significant increases in injury history disclosure from pre-education to immediate post-education. Clinical Bottom Line: There is moderate evidence to support the idea that education has a positive impact on concussion reporting behaviors. These studies found positive results immediately following concussion education therefore it may be beneficial to provide concussion education several times a year. Strength of Recommendation: There is Level B evidence to support the idea that implementing concussion education will impact concussion reporting behaviors as it pertains to injury history disclosure. [ABSTRACT FROM AUTHOR]